15 June 2023

A team of senior physiotherapists from Austin Health have undertaken an ambitious project over the past two years: the creation of a new Spinal Cord Injury (SCI) Physiotherapy Clinical Guideline.

“This guideline is the first of its kind, and while it was created in collaboration with physiotherapists across Australia and New Zealand, it has capacity to translate to international spinal cord injury rehabilitation settings,” says Victorian Spinal Cord Service, and Austin Health Senior Physiotherapist, Leanne Rees.

The guidelines are now accessible through their dedicated website, which has been officially launched and available at SCI Physiotherapy Guidelines.

In collaboration with various SCI services across Australia, including the University of Sydney, the National Injury Insurance Scheme Queensland, the Transport Accident Commission Victoria, and the Lifetime Support Authority South Australia, this initiative aims to provide clear guidance on the physiotherapy management of adults with SCI.

“Five physiotherapists from Austin Health were involved in the development of this guideline, with nearly 100 years of clinical spinal cord injury experience between us.”

“It's the first time there has been such a big collaboration and it’s a privilege to be part of it.”

The SCI Physiotherapy Clinical Guideline seeks to address the entire range of care for individuals with SCI. It comprises evidence-based recommendations and consensus-based opinion statements relating to over 100 key questions pertaining to physiotherapy management. These questions are presented in the PICO format: Participant, Intervention, Comparison, and Outcome.

By structuring the guideline in this manner, the authors have ensured a systematic and comprehensive approach to addressing the various aspects of SCI physiotherapy.

The new guideline includes both Evidence Recommendations and Consensus-Based Opinion Statements. The recommendations utilize the language established by GRADE (Grading of Recommendations Assessment, Development, and Evaluation) to express the direction and strength of each recommendation.

A ‘Strong’ recommendation indicates that the desirable effects of an intervention outweigh the undesirable effects, while a ‘Weak’ recommendation suggests that there is appreciable uncertainty regarding the balance between desirable and undesirable effects. Additionally, a ’No Recommendation’ occurs when the panel deems the evidence too speculative or experiences difficulty in determining the direction of the recommendation.

“We hope these guidelines will help people with spinal cord injury receive consistent evidence-informed physiotherapy management and care now, and into the distant future.”