A Clinical Practice Guideline for the Management of Patients With Acute Spinal Cord Injury: Recommendations on the Type and Timing of Rehabilitation.
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Authors
Fehlings, Michael G
Tetreault, Lindsay A
Aarabi, Bizhan
Anderson, Paul
Arnold, Paul M
Brodke, Darrel S
Chiba, Kazuhiro
Dettori, Joseph R
Furlan, Julio C
Harrop, James S
Hawryluk, Gregory
Holly, Langston T
Howley, Susan
Jeji, Tara
Kalsi-Ryan, Sukhvinder
Kurpad, Shekar
Kwon, Brian K
Marino, Ralph J
Martin, Allan R
Massicotte, Eric
Merli, Geno
Middleton, James W
Nakashima, Hiroaki
Nagoshi, Narihito
Palmieri, Katherine
Singh, Anoushka
Skelly, Andrea C
Tsai, Eve C
Vaccaro, Alexander
Wilson, Jefferson R
Yee, Albert
Burns, Anthony S
Publication Date
2017-09-01Journal Title
Global Spine Journal
ISSN
2192-5682
Publisher
SAGE
Volume
7
Issue
3 Suppl
Pages
231S-238S
Language
eng
Type
Article
Metadata
Show full item recordCitation
Fehlings, M. G., Tetreault, L. A., Aarabi, B., Anderson, P., Arnold, P. M., Brodke, D. S., Chiba, K., et al. (2017). A Clinical Practice Guideline for the Management of Patients With Acute Spinal Cord Injury: Recommendations on the Type and Timing of Rehabilitation.. Global Spine Journal, 7 (3 Suppl), 231S-238S. https://doi.org/10.1177/2192568217701910
Abstract
Introduction: The objective of this study is to develop guidelines that outline the appropriate type and timing of rehabilitation in patients with acute spinal cord injury (SCI). Methods: A systematic review of the literature was conducted to address key questions related to rehabilitation in patients with acute SCI. A multidisciplinary guideline development group used this information, and their clinical expertise, to develop recommendations for the type and timing of rehabilitation. Based on GRADE (Grading of Recommendation, Assessment, Development and Evaluation), a strong recommendation is worded as "we recommend," whereas a weaker recommendation is indicated by "we suggest. Results: Based on the findings from the systematic review, our recommendations were: (1) We suggest rehabilitation be offered to patients with acute spinal cord injury when they are medically stable and can tolerate required rehabilitation intensity (no included studies; expert opinion); (2) We suggest body weight-supported treadmill training as an option for ambulation training in addition to conventional overground walking, dependent on resource availability, context, and local expertise (low evidence); (3) We suggest that individuals with acute and subacute cervical SCI be offered functional electrical stimulation as an option to improve hand and upper extremity function (low evidence); and (4) Based on the absence of any clear benefit, we suggest not offering additional training in unsupported sitting beyond what is currently incorporated in standard rehabilitation (low evidence). Conclusions: These guidelines should be implemented into clinical practice to improve outcomes and reduce morbidity in patients with SCI by promoting standardization of care, decreasing the heterogeneity of management strategies and encouraging clinicians to make evidence-informed decisions.
Identifiers
External DOI: https://doi.org/10.1177/2192568217701910
This record's URL: https://www.repository.cam.ac.uk/handle/1810/283579
Rights
Attribution-NonCommercial-NoDerivatives 4.0 International
Licence URL: https://creativecommons.org/licenses/by-nc-nd/4.0/
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