Health Sciences North, Sudbury, Ontario, Canada.
Northern Ontario School of Medicine, School of Human Kinetics, Laurentian University, Sudbury, Ontario, Canada.
Phys Ther. 2021 Jan 4;101(1). doi: 10.1093/ptj/pzaa180.
Individuals with multiple myeloma (MM) often have reduced functional performance due to the cancer itself or as a direct side effect of cancer treatments. Physical therapy is a part of cancer rehabilitation; however, no guidelines are available to provide information and direction for physical therapists managing patients with MM. The goal of this guideline is to provide recommendations based on a systematic review and consensus process that physical therapists can use to manage patients with MM.
A systematic review of the literature published until August 2018 was performed in 8 databases with 2 independent reviewers assessing quality. Seventeen articles were identified as relevant, and a draft guideline was developed in the form of action statements. A total of 10 physical therapists with hematology experience and 10 patients with MM were recruited for consensus process. A priori threshold of 80% agreement was used to establish a consensus for each statement. The draft guidelines were reviewed externally by 4 methodologists using the AGREE II tool and a stakeholder representing OH (Cancer Care Ontario) Program in Evidence Based Care, McMaster University. The final guideline was reviewed and officially endorsed by the Canadian Physiotherapy Association.
A total of 30 action statements were developed that achieved consensus, indicating physical therapy recommendations based on physiological markers (ie, hemoglobin, platelet count), complete patient presentation, and the stage of medical treatment.
These clinical practice guidelines were developed to aid physical therapists in implementing evidence-based and best-practice care for patients with MM to optimize rehabilitation outcomes.
These guidelines fill an important knowledge gap and are the first to provide information specifically for physical therapist management of patients with MM.
多发性骨髓瘤（MM）患者常因癌症本身或癌症治疗的直接副作用而导致功能表现下降。物理疗法是癌症康复的一部分；然而，目前尚无指南为管理 MM 患者的物理治疗师提供信息和指导。本指南的目标是根据系统评价和共识过程提供建议，物理治疗师可以使用这些建议来管理 MM 患者。
在 8 个数据库中进行了截至 2018 年 8 月发表的文献的系统评价，由 2 名独立评审员评估质量。确定了 17 篇相关文章，并以行动声明的形式制定了指南草案。共招募了 10 名具有血液学经验的物理治疗师和 10 名 MM 患者参与共识过程。使用 80%的一致性先验阈值来为每个声明建立共识。该草案指南由 4 名方法学家使用 AGREE II 工具以及代表安大略省癌症护理计划（证据为基础的护理）的利益相关者（麦克马斯特大学）进行了外部审查。最终指南由加拿大物理治疗协会审查和正式认可。
共制定了 30 项达成共识的行动声明，表明了基于生理标志物（即血红蛋白、血小板计数）、完整的患者表现和治疗阶段的物理治疗建议。
这些临床实践指南的制定旨在帮助物理治疗师为 MM 患者实施基于证据和最佳实践的护理，以优化康复结果。
这些指南填补了一个重要的知识空白，是第一个为管理 MM 患者的物理治疗师提供信息的指南。
