Avin Keith G, Nithman Robert W, Osborne Raine, Betz Sherri R, Lindsey Carleen, Hartley Gregory W
Department of Physical Therapy, School of Health & Human Sciences, Indiana University, Indianapolis.
Physical Therapy Program, Center for Graduate Studies, West Coast University, Los Angeles, California.
J Geriatr Phys Ther. 2022;45(2):E120-E126. doi: 10.1519/JPT.0000000000000347.
Osteoporosis is a systemic, metabolic bone disease that affects bone quality, increases susceptibility to low-trauma bone fracture, and has downstream effects on falls and fragility fractures. Osteoporosis is a multifactorial disease process that requires management from multiple health care providers including physicians, nurses, and physical therapists. However, the paucity of information regarding comprehensive physical therapist management for patients with osteoporosis indicated the need for an evidence-based document. The purpose of this document was to provide the best available expert guidance for clinicians in the selection of screening tools, essential tests and measures, treatment goals, and interventions for patients with osteoporosis.
A Delphi process was used. Thirty-one physical therapists with expertise in the care of patients with osteoporosis participated in a series of 3 sequential surveys designed to build and reach agreement on the management of patients with osteoporosis. The desired survey outcomes were to: (1) identify the range of examination and plan of care components considered important to physical therapists' care for patients with osteoporosis, (2) determine which components should be considered essential, and (3) achieve consensus on the final list of essential components and related operational definitions.
A clear consensus on the essential components of examination and interventions was achieved. In general, there were 4 to 6 items across each category of history, tests and measures, education/goals, and treatment.
The prioritization of these management items will better support clinicians working with adults who have osteoporosis.
骨质疏松症是一种全身性代谢性骨病，会影响骨质量，增加低创伤性骨折的易感性，并对跌倒和脆性骨折产生下游影响。骨质疏松症是一个多因素疾病过程，需要包括医生、护士和物理治疗师在内的多个医疗保健提供者进行管理。然而，关于物理治疗师对骨质疏松症患者进行全面管理的信息匮乏，这表明需要一份基于证据的文件。本文档的目的是为临床医生在选择骨质疏松症患者的筛查工具、基本检查和测量方法、治疗目标及干预措施方面提供最佳的专家指导。
采用德尔菲法。31名在骨质疏松症患者护理方面具有专业知识的物理治疗师参与了一系列3次连续调查，旨在就骨质疏松症患者的管理达成共识。期望的调查结果是：（1）确定物理治疗师对骨质疏松症患者护理中认为重要的检查范围和护理计划组成部分，（2）确定哪些组成部分应被视为必不可少的，（3）就基本组成部分的最终清单及相关操作定义达成共识。
在检查和干预的基本组成部分上达成了明确的共识。一般来说，病史、检查和测量、教育/目标以及治疗的每个类别中都有4至6项内容。
这些管理项目的优先排序将更好地支持为患有骨质疏松症的成年人提供服务的临床医生。
