Home > Riviste > European Journal of Physical and Rehabilitation Medicine > Fascicoli precedenti > Articles online first > European Journal of Physical and Rehabilitation Medicine 2021 Mar 02

ULTIMO FASCICOLO
 

JOURNAL TOOLS

eTOC
Per abbonarsi
Sottometti un articolo
Segnala alla tua biblioteca
 

ARTICLE TOOLS

Publication history
Estratti
Permessi
Per citare questo articolo
Share

 

 

European Journal of Physical and Rehabilitation Medicine 2021 Mar 02

DOI: 10.23736/S1973-9087.21.06581-3

Copyright © 2021 EDIZIONI MINERVA MEDICA

lingua: Inglese

Osteoporosis guidelines from a rehabilitation perspective: systematic analysis and quality appraisal using AGREE II

Giovanni IOLASCON 1, Alessandro de SIRE 2, 3 , Claudio CURCI 4, Marco PAOLETTA 1, Sara LIGUORI 1, Dario CALAFIORE 4, Francesca GIMIGLIANO 5, Antimo MORETTI 1

1 Department of Medical and Surgical Specialties and Dentistry, University of Campania Luigi Vanvitelli, Naples, Italy; 2 Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont, Novara, Italy; 3 Rehabilitation Unit, Mons. L. Novarese Hospital, Moncrivello, Vercelli, Italy; 4 Section of Neuromotor Rehabilitation, Department of Neuroscience, ASST Carlo Poma, Mantua, Italy; 5 Department of Mental and Physical Health and Preventive Medicine, University of Campania Luigi Vanvitelli, Naples, Italy


PDF


BACKGROUND: People affected by osteoporosis and fragility fractures often report disability and poor health-related quality of life. Albeit rehabilitation has a crucial role in older people, post-menopausal women and other subjects with high risk of fragility fractures, the rehabilitation perspective has been poorly investigated in the available guidelines for osteoporosis.
AIM: To systematically evaluate the quality of guidelines for osteoporosis from a rehabilitation perspective.
DESIGN: Systematic analysis of guidelines.
SETTING: Not applicable.
POPULATION: Osteoporotic patients.
METHODS: On May 2020, we performed a systematic search on medical literature of all guidelines published in the last 10 years on PubMed, PEDro, and international guideline databases. The study selection was based on key terms "exercise", "physical activity" or "rehabilitation". All authors independently assessed the methodological quality through the Appraisal of Guidelines for Research & Evaluation (AGREE) II instrument, consisting of six domains (scope, stakeholder involvement, rigor and development, clarity of presentation, applicability, editorial independence).
RESULTS: Out of 331 documents retrieved, a total of 34 guidelines were selected after the screening phases. Twenty (58.8%) high quality guidelines were reported. According to AGREE II instrument, a mean score of 78.1±21.8% was reported for “scope and purpose” domain; for stakeholder involvement, the mean score was 58.1±22.1%; the rigor of development was good (mean score of 61.3±27.3%); for clarity of presentation the mean score was 79.4±20.3%; the applicability was poor (mean score of 30.9±25.2%); for editorial independence the mean score was 75.1±24.6%. Rehabilitation recommendations for osteoporotic patients were reported in 21 (61.8%) of the selected guidelines.
CONCLUSIONS: This is the first systematic analysis evaluating quality of the guidelines for osteoporosis using AGREE II instrument. Starting from a state of the art of the currently available evidence, we could conclude that therapeutic exercise at moderate to high intensity is encouraged by several guidelines for the management of people with osteoporosis and fragility fractures. More than half of guidelines were of high-quality. However, most guidelines are lacking specific indications about exercise features.
CLINICAL REHABILITATION IMPACT: This study might support the implementation of a rehabilitation perspective in the guidelines for osteoporotic patients.


KEY WORDS: Guideline; Osteoporosis; Rehabilitation; Osteoporotic Fractures; Exercise Therapy

inizio pagina