Rehabilitation of the lower extremities, standing and walking function in people with spinal cord injury or disease: Guideline of the German-Speaking Medical Society for Spinal Cord Injury

Introduction: According of the level and severity of the spinal cord injury or disease (SCI/D), and the impairment of motor, sensory, and autonomic functions, individuals with SCI/D recover some standing and walking capabilities. To increase quality of rehabilitation and use newest evidence, the cli...

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Main Authors: Irrgang, Sophie, Himmelhaus, Sandra, Allek, Kirstin, Bartholet, Claudio, Bersch-Porada, Ines, Curt, Armin, Huber, Burkhart, Kuhn, Daniel, Kynast, Karen, Weidner, Norbert, Scheel-Sailer, Anke
Format: Article
Language:deu
Published: German Medical Science GMS Publishing House 2025-06-01
Series:GMS German Medical Science
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Online Access:https://journals.publisso.de/en/journals/gms/volume23/000338
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author Irrgang, Sophie
Himmelhaus, Sandra
Allek, Kirstin
Bartholet, Claudio
Bersch-Porada, Ines
Curt, Armin
Huber, Burkhart
Kuhn, Daniel
Kynast, Karen
Weidner, Norbert
Scheel-Sailer, Anke
author_facet Irrgang, Sophie
Himmelhaus, Sandra
Allek, Kirstin
Bartholet, Claudio
Bersch-Porada, Ines
Curt, Armin
Huber, Burkhart
Kuhn, Daniel
Kynast, Karen
Weidner, Norbert
Scheel-Sailer, Anke
author_sort Irrgang, Sophie
collection DOAJ
description Introduction: According of the level and severity of the spinal cord injury or disease (SCI/D), and the impairment of motor, sensory, and autonomic functions, individuals with SCI/D recover some standing and walking capabilities. To increase quality of rehabilitation and use newest evidence, the clinical practice guideline (CPG) “S2e-Guideline Rehabilitation of lower extremities, standing and walking function in people with SCI/D” of the German speaking Medical Association for Paraplegiology (DMGP) was updated. Methods: Following a multi-tiered approach systematic searches were conducted to identify appropriate literature. For this purpose, the Databases PubMed, EMBASE, Cochrane Library and PEDro were searched. Recommendations on assessments were grouped to the categories “activity and participation” or “body functions/body structures”. Recommendations on interventions were labeled with outcomes standing, walking, strength, range of motion, pain and muscle tonus. Results: In total, 9,871 studies were identified during the search. Of these, four systematic reviews and eleven primary studies were utilized in composing the recommendations. A total of 25 recommendations were made, with 20 derived from the literature and 5 based on expert consensus. In total 14 functional assessments and 11 rehabilitation interventions became compiled. The assembled recommendations regarding assessments could be well built on published literature, while overall there is a paucity of literature proofing the evidence of specific interventions used in clinical practice. Therefore, the expertise of the international expert group and input from patient representatives were pivotal. Conclusion: The method of an evidence-based guideline was sufficient for the recommendation of functional assessments but showed the need scientific clarification in the field of clinically established interventions.
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spelling doaj-art-7ce8062b02e3474692dff4a4cf79dd882025-08-20T02:40:29ZdeuGerman Medical Science GMS Publishing HouseGMS German Medical Science1612-31742025-06-0123Doc0210.3205/000338Rehabilitation of the lower extremities, standing and walking function in people with spinal cord injury or disease: Guideline of the German-Speaking Medical Society for Spinal Cord InjuryIrrgang, Sophie0Himmelhaus, Sandra1Allek, Kirstin2Bartholet, Claudio3Bersch-Porada, Ines4Curt, Armin5Huber, Burkhart6Kuhn, Daniel7Kynast, Karen8Weidner, Norbert9Scheel-Sailer, Anke10Swiss Paraplegic Research, Nottwil, SwitzerlandSwiss Paraplegic Research, Nottwil, SwitzerlandSpinal Cord Injury Center, Zentralklinik Bad Berka, GermanySpinal Cord Injury Center, University Hospital Balgrist, Zurich, SwitzerlandSwiss Paraplegic Center, Nottwil, SwitzerlandSpinal Cord Injury Center, University Hospital Balgrist, Zurich, SwitzerlandSpinal Cord Injury Rehabilitation Center, Bad Häring, AustriaClinic for Physical and Rehabilitative Medicine, Berufsgenossenschaftliche Kliniken Bergmannstrost, Halle, GermanySpinal Cord Injury Center, Heidelberg University Hospital, Heidelberg, GermanySpinal Cord Injury Center, Heidelberg University Hospital, Heidelberg, GermanySwiss Paraplegic Research, Nottwil, SwitzerlandIntroduction: According of the level and severity of the spinal cord injury or disease (SCI/D), and the impairment of motor, sensory, and autonomic functions, individuals with SCI/D recover some standing and walking capabilities. To increase quality of rehabilitation and use newest evidence, the clinical practice guideline (CPG) “S2e-Guideline Rehabilitation of lower extremities, standing and walking function in people with SCI/D” of the German speaking Medical Association for Paraplegiology (DMGP) was updated. Methods: Following a multi-tiered approach systematic searches were conducted to identify appropriate literature. For this purpose, the Databases PubMed, EMBASE, Cochrane Library and PEDro were searched. Recommendations on assessments were grouped to the categories “activity and participation” or “body functions/body structures”. Recommendations on interventions were labeled with outcomes standing, walking, strength, range of motion, pain and muscle tonus. Results: In total, 9,871 studies were identified during the search. Of these, four systematic reviews and eleven primary studies were utilized in composing the recommendations. A total of 25 recommendations were made, with 20 derived from the literature and 5 based on expert consensus. In total 14 functional assessments and 11 rehabilitation interventions became compiled. The assembled recommendations regarding assessments could be well built on published literature, while overall there is a paucity of literature proofing the evidence of specific interventions used in clinical practice. Therefore, the expertise of the international expert group and input from patient representatives were pivotal. Conclusion: The method of an evidence-based guideline was sufficient for the recommendation of functional assessments but showed the need scientific clarification in the field of clinically established interventions.https://journals.publisso.de/en/journals/gms/volume23/000338spinal cord injuryrehabilitationlower extremitiesstandingwalking
spellingShingle Irrgang, Sophie
Himmelhaus, Sandra
Allek, Kirstin
Bartholet, Claudio
Bersch-Porada, Ines
Curt, Armin
Huber, Burkhart
Kuhn, Daniel
Kynast, Karen
Weidner, Norbert
Scheel-Sailer, Anke
Rehabilitation of the lower extremities, standing and walking function in people with spinal cord injury or disease: Guideline of the German-Speaking Medical Society for Spinal Cord Injury
GMS German Medical Science
spinal cord injury
rehabilitation
lower extremities
standing
walking
title Rehabilitation of the lower extremities, standing and walking function in people with spinal cord injury or disease: Guideline of the German-Speaking Medical Society for Spinal Cord Injury
title_full Rehabilitation of the lower extremities, standing and walking function in people with spinal cord injury or disease: Guideline of the German-Speaking Medical Society for Spinal Cord Injury
title_fullStr Rehabilitation of the lower extremities, standing and walking function in people with spinal cord injury or disease: Guideline of the German-Speaking Medical Society for Spinal Cord Injury
title_full_unstemmed Rehabilitation of the lower extremities, standing and walking function in people with spinal cord injury or disease: Guideline of the German-Speaking Medical Society for Spinal Cord Injury
title_short Rehabilitation of the lower extremities, standing and walking function in people with spinal cord injury or disease: Guideline of the German-Speaking Medical Society for Spinal Cord Injury
title_sort rehabilitation of the lower extremities standing and walking function in people with spinal cord injury or disease guideline of the german speaking medical society for spinal cord injury
topic spinal cord injury
rehabilitation
lower extremities
standing
walking
url https://journals.publisso.de/en/journals/gms/volume23/000338
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