Department of Mental and Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Largo Madonna delle Grazie n. 1, 80138, Naples, Italy.
Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli", Via De Crecchio n.4, 80138, Naples, Italy.
J Orthop Traumatol. 2020 Nov 14;21(1):20. doi: 10.1186/s10195-020-00560-w.
The identification of existing rehabilitation interventions and related evidence represents a crucial step along the development of the World Health Organization's (WHO) Package of Interventions for Rehabilitation (PIR). The methods for such identification have been developed by the WHO Rehabilitation Programme and Cochrane Rehabilitation under the guidance of the WHO's Guideline Review Committee secretariat. The aim of this paper is to report on the results of the systematic search for clinical practice guidelines (CPGs) relevant to the rehabilitation of adults with fractures and to present the current state of evidence available from the identified CPGs.
This paper is part of the Best Evidence for Rehabilitation (be4rehab) series, developed according to the methodology presented in the World Health Organization's (WHO) Package of Interventions for Rehabilitation (PIR) introductory paper. It is a systematic review of existing CPGs on fractures in adult population published from 2009 to 2019.
We identified 23 relevant CPGs after title and abstract screening. According to inclusion/exclusion criteria, we selected 13 CPGs. After checking for quality, publication time, multiprofessionality, and comprehensiveness, we finally included five CPGs dealing with rehabilitative management of fractures in adult population, two CPGs addressing treatment of distal radius fracture and three the treatment of femoral/hip fracture.
The selected CPGs on management of distal radius and femoral/hip fracture include few recommendations regarding rehabilitation, with overall low to very low quality of evidence and weak/conditional strength of recommendation. Moreover, several gaps in specific rehabilitative topics occur. Further high-quality trials are required to upgrade the quality of the available evidence.
Level 1.
识别现有的康复干预措施及相关证据是世界卫生组织（WHO）康复干预措施包（PIR）发展过程中的关键步骤。这些识别方法是由WHO 康复计划和 Cochrane 康复在 WHO 指南审查委员会秘书处的指导下制定的。本文旨在报告与成人骨折康复相关的临床实践指南（CPG）的系统搜索结果，并介绍从已确定的 CPG 中获得的现有证据状况。
本文是根据 WHO 康复干预措施包（PIR）入门文件中提出的方法开发的 Best Evidence for Rehabilitation (be4rehab) 系列的一部分。这是对 2009 年至 2019 年期间发表的关于成人骨折的现有 CPG 的系统评价。
经过标题和摘要筛选，我们确定了 23 项相关 CPG。根据纳入/排除标准，我们选择了 13 项 CPG。在检查质量、出版时间、多专业和全面性后，我们最终纳入了 5 项涉及成人骨折康复管理的 CPG，2 项涉及桡骨远端骨折治疗的 CPG，3 项涉及股骨/髋部骨折治疗的 CPG。
所选的桡骨远端和股骨/髋部骨折管理 CPG 中包含的康复建议很少，整体证据质量为低到极低，推荐强度为弱/有条件。此外，在特定康复主题方面存在几个空白。需要进一步进行高质量的试验以提高现有证据的质量。
1 级。
