Essential Components of Physical Therapist Management of Patients With Osteoporosis: A Delphi Study.
Keith G Avin, Robert W Nithman, Raine Osborne and 3 others
PMID 35384944WHAT IT FOUND
Expert physical therapists agreed on 17 essential components for osteoporosis care, focusing on exercise history, fall risk, and education.
They did not reach consensus on screening tools or specific manual therapies, prioritizing fracture prevention and safe movement instead.
Key findings
01A panel of 31 experts reached consensus on 17 essential items for examination and plan of care.
02Items like rib-to-pelvis distance and FRAX were not retained, likely because the panel assumed patients already had a confirmed diagnosis.
03Manual therapy, self-mobilization, and dynamic bracing were not included in the essential list, possibly reflecting a focus on slowing bone loss and safety.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Delphi studies rely on expert opinion, which is a lower level of evidence than randomized controlled trials. The panel was limited to United States-trained physical therapists, which may not reflect global practice standards. The study assumed patients already had a diagnosis of osteoporosis or osteopenia, which explains why screening tools were not prioritized. Some items that were not retained might be generalizable to all patients rather than specific to osteoporosis, so their absence does not mean they are unimportant. The panel did not include other professions like occupational therapists or speech-language pathologists, limiting the scope to PT-specific management.
Declared interests
The text states the study was reviewed and determined exempt from IRB oversight. It does not report specific financial conflicts of interest or funding sources for the authors or the panelists.
The easy way to misread this
Do not interpret the absence of screening tools like FRAX or rib-to-pelvis distance from the essential list as a recommendation against using them. The panel excluded these because they assumed the patients in the study already had a confirmed diagnosis of osteoporosis.