Developing clinical practice guidelines for physiotherapists working with people with inherited bleeding disorders

Area of Science:

• Physiotherapy
• Clinical Practice Guidelines
• Bleeding Disorders Management

Background:

• Bleeding disorders often cause joint and muscle hemorrhages, requiring interdisciplinary team management.
• Physiotherapists play a crucial role in managing these conditions.
• The Canadian Physiotherapists in Hemophilia Care (CPHC) was established in 1997 to advance evidence-based practice, education, and collaboration.

Purpose of the Study:

• To outline the CPHC's systematic process for creating evidence-based clinical practice guidelines.
• To guide best practices and decision-making in physiotherapy for individuals with bleeding disorders.
• To serve as an educational resource for physiotherapists, students, and healthcare teams.

Main Methods:

• Adherence to the American Physical Therapy Association's Clinical Practice Guideline Process Manual (2018).
• Formation of a working group, defining guideline scope, and conducting a comprehensive literature search.
• Evidence selection, appraisal, drafting of practice statements, assigning recommendation strengths, and guideline dissemination.

Main Results:

• Development of 39 practice statements across nine key physiotherapy areas.
• Strength of evidence varied: strong for two, moderate for one, and weak for three statements.
• The majority of statements were classified as theoretical or best practice, indicating areas for future research.

Conclusions:

• These represent the first comprehensive evidence-based clinical practice guidelines for physiotherapy in bleeding disorders.
• Areas like exercise and manual therapy have received attention, but require further investigation.
• Low overall evidence levels and recommendation strengths underscore the need for more robust research in this field.