Rehabilitation in Neuromuscular Diseases: Best Turkish Practice Recommendations by Multidisciplinary Experts

Area of Science:

• Neurology
• Rehabilitation Medicine
• Clinical Practice Guidelines

Background:

• Neuromuscular diseases (NMDs) encompass a broad spectrum of conditions, including motor neurone diseases (MND), muscle diseases (MD), neuropathies, and neuromuscular junction diseases (NMJD).
• Existing literature offers fragmented management and rehabilitation recommendations specific to NMD subgroups.
• A comprehensive, expert-driven guideline addressing all facets of NMD rehabilitation is currently lacking globally.

Purpose of the Study:

• To establish a detailed set of rehabilitation recommendations for all NMDs, applicable to patients of all ages.
• To consolidate expert consensus on the management and rehabilitation of diverse neuromuscular conditions.
• To provide a practical resource for clinicians managing patients with NMDs.

Main Methods:

• A modified Delphi method involving three rounds and seven steps was employed via email.
• A multidisciplinary team of experts contributed to the development of recommendations.
• Strength of Agreement (SOA) was quantified using percentages, median values, interquartile range, and Kappa statistics.

Main Results:

• A comprehensive list of 110 recommendations for NMD patients was generated.
• Recommendations are categorized into general management (5), rehabilitation indications (20), rehabilitation contraindications (8), and rehabilitation specifics (77).
• The rehabilitation section includes general principles (7), modalities (13), and detailed exercise characteristics (57).

Conclusions:

• The developed recommendations offer detailed guidance, including exercise prescriptions, for clinical practice.
• This study provides a valuable resource for physicians managing patients with various neuromuscular diseases.
• The comprehensive nature of the guidelines aims to address a wide range of clinical questions and challenges in NMD rehabilitation.