PTOTOtherFrontiers in rehabilitation sciences2024

Evidence based clinical practice guideline for follow-up care in persons with spinal cord injury.

Inge Eriks-Hoogland, Lorena Müller, Michael Baumberger and 9 others

PMID 39314837

WHAT IT FOUND

A new guideline recommends spinal cord injury follow-up care at 3, 6, and 12 months post-rehab, then annually.

It urges checking for secondary conditions like pain, bladder issues, and mobility changes, though the evidence behind these schedules is currently low.

Key findings

01Follow-up appointments are recommended at 3, 6, and 12 months after primary rehabilitation, then annually at specialized clinics.

02Assessments should cover neurological status, internal medicine, musculoskeletal health, urogenital function, and rehabilitation progress.

03The guideline relies heavily on expert opinion and low-to-moderate quality evidence because no randomized controlled trials exist for follow-up frequency.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTs

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What it does not show

The evidence base is very thin: only 19 studies for SCI and 6 for spina bifida met inclusion criteria, and none were randomized controlled trials. Recommendations for the frequency of follow-up (3, 6, 12 months, then annual) are based largely on expert consensus and indirect evidence, not on proven outcomes. The guideline acknowledges significant gaps in evidence for specific populations, such as women with SCI regarding cancer screening, and the aging SCI population. The detailed recommendations and assessment tools are contained in supplementary tables not fully reproduced in the main text, requiring clinicians to access external documents for specific protocols. The guideline is developed by a German medical society, so its applicability to other healthcare systems and insurance models may be limited.

Declared interests

The authors declare that no financial support was received for the research, authorship, or publication of this article.

The easy way to misread this

Do not treat the recommended follow-up schedule (3, 6, 12 months, then annual) as evidence-based proof of efficacy. The guideline explicitly states that no randomized controlled trials exist to support this frequency, and the recommendation relies on expert consensus and low-quality evidence.

Read it on PubMed →