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  4. Evidence-based recommendations for the rehabilitation and management of the ageing population with spinal cord injury: a systematic review of clinical practice guidelines

Evidence-based recommendations for the rehabilitation and management of the ageing population with spinal cord injury: a systematic review of clinical practice guidelines

European Journal of Physical and Rehabilitation Medicine, 2024 · DOI: 10.23736/S1973-9087.24.08244-3 · Published: June 1, 2024

Spinal Cord InjuryAgingRehabilitation

Simple Explanation

This study looks at existing guidelines for treating and managing spinal cord injury (SCI) to see if they include recommendations specifically for older adults with SCI. This is important because as people with SCI live longer, or sustain SCI later in life, they have unique health needs. The researchers reviewed a number of clinical practice guidelines (CPGs) to identify those that include recommendations for people "ageing with SCI" or who have acquired an "SCI with ageing." The review aims to identify how well current guidelines cover the health and functioning needs of older adults with SCI and where the gaps are in these recommendations.

Study Duration
Not specified
Participants
52 Clinical Practice Guidelines
Evidence Level
Systematic Review

Key Findings

  • 1
    Only 30% of the reviewed clinical practice guidelines (CPGs) included recommendations related to aging with spinal cord injury.
  • 2
    Most of the guidelines with aging-related recommendations were from the USA or Europe and lacked specific sections on aging.
  • 3
    The recommendations were often based on low or very low-quality evidence and did not adequately consider the preferences of patients and stakeholders.

Research Summary

This systematic review assessed clinical practice guidelines (CPGs) for spinal cord injury (SCI) to determine the extent to which they address the needs of the aging population with SCI. The review found that only a minority of CPGs include specific recommendations for older adults with SCI, and these recommendations are often based on low-quality evidence. The study highlights the need for future research to generate high-quality evidence and develop age-sensitive CPGs that address the unique challenges faced by individuals aging with SCI.

Practical Implications

Improve Guideline Development

Future clinical practice guidelines for SCI should specifically address the needs of older adults, considering their unique health challenges and preferences.

Prioritize Research

More high-quality research is needed to generate evidence-based recommendations for managing and rehabilitating older adults with SCI.

Enhance Stakeholder Involvement

Involve patients, caregivers, and other stakeholders in the development of guidelines to ensure they are relevant and meet the needs of the target population.

Study Limitations

  • 1
    The criteria for categorizing a recommendation as ‘ageing-related’ were somewhat arbitrary.
  • 2
    There is disagreement in the literature about the definition of CPGs and different approaches to their development.
  • 3
    The study focused only on assessing the quality of individual recommendations within CPGs, rather than the overall quality of the CPGs themselves.

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