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Published on: January 16, 2019
Narrative Review of Clinical Practice Guidelines for Rehabilitation of People With Spinal Cord Injury: 2010-2020
Lynn H Gerber1, Rati Deshpande, Shruthi Prabhakar
1From the Center for the Study of Chronic Illness and Disability, George Mason University, Fairfax, Virginia (LHG, SP); Beatty Center for Study of Liver Disease, Department of Medicine, Inova Health System, Falls Church, Virginia (LHG, RD); American Institutes for Research, Arlington, Virginia (CC); American Institutes for Research, Chapel Hill, North Carolina (SG); Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, Minnesota (LM); Department of Physical Medicine and Rehabilitation, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (ALH); and UPMC Rehabilitation Institute, Pittsburgh, Pennsylvania (ALH).
Abstract:
Clinical practice guidelines provide reliable, vetted, and critical information to bring research to practice. Some medical specialties (e.g., physical medicine and rehabilitation) provide multidomain treatment for various conditions. This presents challenges because physical medicine and rehabilitation is a small specialty, a diverse patient base in terms sociodemographics and diagnosis, treatments are difficult to standardize, and rehabilitation research is underfunded. We wished to identify quality and applicability of clinical practice guidelines and searched "Spinal Cord Injury AND Clinical Practice Guidelines AND Rehabilitation" and vetting process.Three hundred fifty-nine articles were identified of which 58 met all criteria for full-text review of which 13 were included in the final selection. Additional publications were accessed from a nondatabase search. Five articles addressed postacute care, community treatment. Nine articles had no recorded vetting process but addressed rehabilitation as an outcome and were included separately. Many of the clinical practice guidelines were developed without evidence from randomized controlled trials, one had input from stakeholders, and some are out of date and do not address important aspects of changes in demographics of the affected population and the use of newer technologies such as sensors and robotics and devices. Identification of these gaps may help stimulate treatment that is clinically relevant, accessible, and current.
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