Department of Physical Therapy, Mercer University, Atlanta, Georgia, USA.
Department of Physical Therapy, Marquette University, Milwaukee, Wisconsin, USA.
Phys Ther. 2022 Aug 4;102(8). doi: 10.1093/ptj/pzac057.
No matter the practice setting, physical therapists work with patients who are at risk for or who have a history of venous thromboembolism (VTE). In 2016, the first clinical practice guideline (CPG) addressing the physical therapist management of VTE was published with support by the American Physical Therapy Association's Academy of Cardiovascular and Pulmonary Physical Therapy and Academy of Acute Care, with a primary focus on lower extremity deep vein thrombosis (DVT). This CPG is an update of the 2016 CPG and contains the most current evidence available for the management of patients with lower extremity DVT and new key action statements (KAS), including guidance on upper extremity DVT, pulmonary embolism, and special populations. This document will guide physical therapist practice in the prevention of and screening for VTE and in the management of patients who are at risk for or who have been diagnosed with VTE. Through a systematic review of published studies and a structured appraisal process, KAS were written to guide the physical therapist. The evidence supporting each action was rated, and the strength of statement was determined. Clinical practice algorithms based on the KAS were developed that can assist with clinical decision-making. Physical therapists, along with other members of the health care team, should implement these KAS to decrease the incidence of VTE, improve the diagnosis and acute management of VTE, and reduce the long-term complications of VTE.
无论在何种实践环境下，物理治疗师都需要与存在静脉血栓栓塞症（VTE）风险或有 VTE 病史的患者合作。2016 年，在美国物理治疗协会心血管和肺物理治疗学院以及急性护理学院的支持下，首次发布了针对 VTE 管理的临床实践指南（CPG），该指南主要侧重于下肢深静脉血栓形成（DVT）。本 CPG 是对 2016 年 CPG 的更新，包含了针对下肢 DVT 患者管理的最新可用证据，并提出了新的关键行动声明（KAS），包括上肢 DVT、肺栓塞和特殊人群的管理指南。本文件将指导物理治疗师在 VTE 的预防、筛查以及下肢 DVT 风险患者或确诊 VTE 患者的管理方面的实践。通过对已发表研究的系统审查和结构化评估过程，制定了 KAS 以指导物理治疗师。对每项行动的证据进行了评估，并确定了声明的强度。基于 KAS 开发了临床实践算法，可协助临床决策。物理治疗师与医疗保健团队的其他成员应实施这些 KAS，以降低 VTE 的发生率，改善 VTE 的诊断和急性管理，并减少 VTE 的长期并发症。
