Inclusion of rehabilitation approach in Japanese clinical practice guidelines: a descriptive analysis.
Shuhei Fujimoto, Motohide Kobayashi, Shizuka Fujimoto and 2 others
PMID 31164780WHAT IT FOUND
Only 26 of 44 Japanese disease guidelines for conditions judged to need rehabilitation mentioned rehabilitation; none cited physical therapy guidelines.
Check rehabilitation-specific guidance rather than assuming disease guidelines cover it.
Key findings
01Of the 44 enrolled guidelines, 26 (59.1%) had at least one description of rehabilitation in a clinical question, chapter, section or recommendation.
02No extracted guideline referenced or cited a Japanese physical therapy guideline, and none provided information on rehabilitation-specific guidelines.
03Among 443 systematic reviews related to rehabilitation within the relevant periods, 67 (15.1%) were quoted in the guidelines.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The diseases selected for review were chosen by eight professionals recruited by convenience sampling, so they may not represent all Japanese rehabilitation clinicians. The analysis covered only Japanese disease-specific guidelines, so the results may not apply to other countries. This was a descriptive count of guideline text, not a test of whether rehabilitation helps patients. The reported counts are inconsistent: 44 guidelines were enrolled, 26 had at least one rehabilitation description, and the paper also states 15 had no description. The authors counted systematic reviews only, not interventional or observational studies, so the evidence base may be understated. Only guidelines available on the Minds webpage and meeting inclusion criteria were included.
Declared interests
The authors declared no funding and no conflicts of interest.
The easy way to misread this
Do not read this as evidence that rehabilitation is ineffective or unnecessary. The paper only counted how often Japanese disease guidelines mentioned rehabilitation and did not measure patient outcomes.