Evidence-based position paper of the UEMS PRM on the role of Physical and Rehabilitation Medicine (PRM) physician in the management of children and adults with spinal dysraphism.
Ivana Petronic Markovic, Dejan Nikolic, Minna Stahl and 5 others
PMID 35575455WHAT IT FOUND
This consensus statement defines the role of the rehabilitation physician in managing spinal dysraphism across the lifespan.
It recommends interdisciplinary team care, ICF-based assessment, and lifelong follow-up, but provides no evidence on whether these interventions improve patient outcomes.
Key findings
01The paper establishes 32 recommendations for rehabilitation physicians, graded mostly as expert opinion (Strength of Evidence IV) rather than high-quality trial data.
02Management requires a multidisciplinary team including physical therapists, occupational therapists, and speech-language therapists, coordinated by a rehabilitation physician.
03Rehabilitation interventions must be provided at all stages of life, including the transition from childhood to adulthood, to prevent patients being lost to care.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The recommendations are based on a Delphi consensus and expert opinion (Strength of Evidence IV for most items), not on new clinical trials or meta-analyses of specific interventions. The paper does not report outcome data, so it cannot tell therapists which specific exercises or techniques work best. The search was limited to literature from 2015-2020, potentially missing more recent evidence. It focuses on the role of the physician, so the specific scope and autonomy of PT, OT, and SLP roles are defined by physician prescription rather than independent professional practice.
Declared interests
The paper was produced by the Union of European Medical Specialists (UEMS) PRM Section. No specific funding sources or commercial conflicts of interest for the individual authors are detailed in the provided text, but it is a professional society position paper.
The easy way to misread this
Do not read these recommendations as evidence that specific rehabilitation techniques improve outcomes. The paper reports expert consensus on what physicians should order, not data on whether those orders actually help patients.