Evidence based clinical practice guideline for follow-up care in persons with spinal cord injury

Front. Rehabil. Sci., 2024 · DOI: 10.3389/fresc.2024.1371556 · Published: September 9, 2024

Spinal Cord Injury Rehabilitation Research Methodology & Design

Simple Explanation

This guideline focuses on follow-up care for individuals with spinal cord injuries (SCI), including spina bifida (SB), to prevent or detect secondary health conditions (SHCs) early. The guideline development involved a systematic literature review, expert consensus, and adherence to German guideline development standards (DELBI). Recommendations cover nervous system issues, pain, cardiovascular health, respiratory function, immunological considerations, gastrointestinal function, endocrinological and nutritional aspects, urogenital health, reproductive health, musculoskeletal issues, pressure injuries, psychological health, and medication management.

Study Duration

Not specified

Participants

Persons with spinal cord injury [SCI, including spina biﬁda (SB)]

Evidence Level

Evidence-based clinical practice guideline

Key Findings

1
The guideline defines recommendations for follow-up care, addressing nervous system issues, pain management, cardiovascular health, and various other health aspects relevant to individuals with SCI.
2
The guideline emphasizes regular monitoring for all individuals with SCI, recommending follow-up appointments at specific intervals, ideally at specialized SCI clinics.
3
Follow-up care should encompass a broad range of health aspects, including SCI-specific issues and typical aging-related concerns, evaluated through an interdisciplinary approach.

Research Summary

This clinical practice guideline provides a comprehensive, evidence-based framework for follow-up care for individuals with SCI and SB, developed through a collaborative effort and adherence to established standards. The guideline addresses a wide range of health aspects, recommending specific assessments and evaluations to prevent SHCs and optimize rehabilitation status. The guideline acknowledges the need for individualized care, continuous updates, and further research to enhance the evidence base and improve the quality of care for individuals with SCI.

Practical Implications

Improved Follow-Up Care

Provides evidence-based recommendations for comprehensive follow-up care, leading to better management of secondary health conditions and improved quality of life for individuals with SCI.

Standardized Assessments

Establishes a framework for assessment of SHCs in persons with SCI, making outcomes of follow-up care appointments measurable and comparable.

Learning Health System

Facilitates a learning health system approach, where clinical data informs ongoing improvements in care delivery and allows for continuous adaptation of the guideline.

Study Limitations

1
Scarcity of high-quality evidence and randomized controlled trials.
2
Limited evidence concerning the frequency of follow-up care.
3
Research gaps exist for prevalence of certain conditions like breast and cervical cancer in women with SCI.

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