Department of Rheumatology (C1-R), Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, The Netherlands.
Rheumatology (Oxford). 2011 Oct;50(10):1879-88. doi: 10.1093/rheumatology/ker195. Epub 2011 Jul 9.
To assess the quality of guidelines published in peer-reviewed literature concerning the role of physiotherapy in the management of patients with RA.
A systematic literature search for clinical practice guidelines that included physiotherapy interventions was performed in four electronic databases. We assessed the quality of the selected guidelines using the appraisal of guidelines for research and evaluation (AGREE) instrument. In addition, the recommendations of guidelines with the highest quality scores were summarized.
Eight clinical practice guidelines fulfilled the inclusion criteria. Scope/purpose was the most often adequately addressed AGREE domain (in seven of the eight guidelines) and applicability the least (in two of the eight guidelines). Based on the AGREE domain scores, six guidelines could be recommended or strongly recommended for clinical use. Five out of these six (strongly) recommended guidelines included a recommendation on exercise therapy and/or patient education, with these interventions being recommended in every case. Transcutaneous electrical nerve stimulation and thermotherapy were recommended in four of these six guidelines. US, thermotherapy, low-level laser therapy, massage, passive mobilization and balneotherapy were addressed in one or two of these six guidelines.
Six of eight clinical practice guidelines addressing physiotherapy interventions were recommended or strongly recommended according to the AGREE instrument. In general, guideline recommendations on physiotherapy intervention, from both the recommended guidelines as well as from the not recommended guidelines, lacked detail concerning mode of delivery, intensity, frequency and duration.
评估同行评议文献中发表的关于物理治疗在类风湿关节炎患者管理中作用的指南的质量。
在四个电子数据库中进行了一项关于包含物理治疗干预的临床实践指南的系统文献搜索。我们使用评估研究和评估指南（AGREE）工具评估了选定指南的质量。此外，还总结了质量得分最高的指南的建议。
八项临床实践指南符合纳入标准。范围/目的是最常被充分解决的 AGREE 领域（在八项指南中的七项中），而适用性是最不被解决的领域（在八项指南中的两项中）。根据 AGREE 域得分，有六项指南可推荐或强烈推荐用于临床使用。在这六项中，有五项（强烈）推荐的指南包括对运动疗法和/或患者教育的建议，这些干预措施在每种情况下都被推荐。四项强烈推荐的指南包括经皮神经电刺激和热疗。六项中有一项或两项指南涉及超声、热疗、低水平激光疗法、按摩、被动运动和浴疗。
根据 AGREE 工具，八项针对物理治疗干预的临床实践指南中有六项被推荐或强烈推荐。一般来说，推荐指南以及未推荐指南中关于物理治疗干预的建议，在传递方式、强度、频率和持续时间方面都缺乏细节。
