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首页> 外文期刊>Journal of physiotherapy >Appraisal of Clinical Practice Guideline: CRISM National Guideline for the Clinical Management of Opioid Use Disorder
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Appraisal of Clinical Practice Guideline: CRISM National Guideline for the Clinical Management of Opioid Use Disorder

机译：评估临床实践指南：CRISM国家临床管理指南的阿片类药物使用障碍

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Dateoflatestupdate:2017.Dateofnextupdate:Notspecified.Patientgroup:Patientswith shoulder pain and mobility deficits (adhesive capsulitis). Intended audience: Patients with adhesive capsulitis, orthopaedic physiotherapy clinicians, academic instructors, clinical in- structors,students,internsandfellows.Originalversion:Adetailedversionwaspublishedin the Journal of Orthopaedic & Sports Physical Therapy in 2013. 1 Additional version: These guidelines were reviewed by the Orthopaedic Section, American Physical Therapy Association (APTA) in 2017. Both versions are available from the Academy of Orthopaedic Physical Therapy (www.orthopt.org). Expert working group: The panel included experts on developing clinical practice guidelines for musculoskeletal conditions of the shoulder that are commonly treated by physiotherapists. Those experts were appointed by the Orthopaedic section, APTA. Consultation with: Additional experts were invited to provide consultation to the work group from other areas, including: orthopaedic physiotherapy clinical practice and education; sports physiotherapy clinical practice and education; orthopaedic surgeons; epidemiologists; claims review; coding and rheumatology. Funded by: Not mentioned. Approved by: The Orthopaedic Section of APTA reviewed and approved these guidelines for publication. Location: The guidelines and additional documents are available at: https://www.orthopt.org/content/practice/clinical-practice- guidelines. Description and key recommendations: This clinical practice guideline was presented as a Journal of Orthopaedic & Sports Physical Therapy special communication. The recommendations are based on a systematic search of MEDLINE, CINAHL and the Cochrane Database of Systematic Reviews. The main aim of the review was to create evidence-based practice guidelines for orthopaedic physiotherapy management of pa- tientswithadhesivecapsulitis,asdescribedbytheInternationalClassificationofFunctioning, DisabilityandHealth.Findingsfromthereviewweresynthesisedinto14recommendations: five pertained to impairment/function-based diagnosis, three to examination and six to interventions. Each clinical research article was graded according to criteria described by the Centre for Evidence-Based Medicine, Oxford, UK for diagnostic, prospective and therapeutic studies (I. high-quality to V. expert opinion), and each recommendation was assigned a level of confidence (A. strong evidence to F. expert opinion). Of interest to physiotherapists, the strongest recommendations (A) were for the use of validated patient-reported functional outcome measures for examination, and for the use of intra-articular corticosteroid injections combined with shoulder mobility and stretching exercises to provide short-term (4 to 6 weeks) pain relief and improved function. Moderate evidence (B) was available for the clinical course (staged progres- sion of pain and mobility deficits), patient education and stretching exercises. Female patients aged 40 to 65 years and patients with diabetes and thyroid disease are at risk for developing adhesive capsulitis (C-weak evidence). Weak evidence was also avail- able fortheuse of modalities(shortwave diathermy,ultrasound,electrical stimulation) combinedwith mobilityand stretchingexercises, andjoint mobilisationto reduce pain and increase motion. Transitional manipulation can be used if conservative in- terventions fail. The loss of passive motion in multiple planes, especially external rotation, measuring pain, and active and passive range of motion can be used to guide treatment planning. However, these measures were based on theoretical/foundational (E)evidence.Lastly,expertopinionwasavailabletoconfirmdiagnosisandfortheuseof activity limitation and participation measures to assess shoulder improvement over the episode of care.
机译：dateoflatestupdate：2017.dateofnextupdate：notspecified.patientgroup：患者肩部疼痛和移动性缺陷（胶囊毛茸茸）。预定的受众：粘性胶囊炎患者，骨科物理治疗临床医生，学术指导者，临床构造师，学生，学生，internsandfellows.originalversion：2013年骨科和体育物理治疗杂志。附加版本：骨科部分审查了这些指南，2017年美国物理治疗协会（APTA）。两种版本都可以从骨科物理治疗学院（www.orthopt.org）获得。专家组：小组包括开发患有物理治疗师通常治疗的肩膀骨骼条件的临床实践指南的专家。这些专家由骨科部分委任，APTA任命。邀请咨询：邀请额外专家向其他地区的工作组提供磋商，包括：矫形物理治疗临床实践和教育;体育物理治疗临床实践与教育;矫形外科医生;流行病学家;索赔审查;编码和风湿病学。由以下内容提供资金：未提及。批准：APTA的骨科部分审查并批准了这些出版指南。位置：指南和其他文件可用于：https://www.orthopt.org/content/practice/clinical -practice-指南。描述和关键建议：此临床实践指南被呈现为骨科和体育物理治疗特别沟通的杂志。这些建议基于系统搜索Medline，Cinahl和Cochrane数据库的系统评价。审查的主要目的是创建基于透析的矫形物理疗法治疗的透析性症状治疗症，asdescribedbythechationalclisification办公室，残疾人植物治疗症状，残疾人植物休眠.Fthereviewweresynthesisedinto14：五个与损伤/职能的诊断有关，三个考试和六个干预。每个临床研究文章根据循证医学中心描述的标准进行分级，英国牛津，用于诊断，前瞻性和治疗研究（I.高质量到V.专家意见），每个建议都被分配了一级信心（A.专家意见的强有力证据）。物理治疗师的兴趣，最强烈的建议（a）用于使用经过验证的患者报告的功能结果结果措施进行检查，并用于使用关节内皮质类固醇注射，与肩部移动性和伸展练习相结合，以提供短期（4到6周）疼痛缓解和改进功能。适度的证据（b）可用于临床课程（痛苦和移动性缺陷的分阶段），患者教育和伸展运动。女性患者40至65岁及糖尿病患者和甲状腺疾病的患者面临粘合剂胶囊炎（C弱证据）。弱的证据也可利用了偶然的方式（短波透视，超声，电刺激）组合的MobilityAnd Stratingexercises，Andjoint Mobilisation减少疼痛并增加运动。如果保守局势失败，可以使用过渡操作。在多个平面中失去被动运动，尤其是外部旋转，测量疼痛和主动和被动的运动范围可用于引导治疗计划。然而，这些措施基于理论/基本（e）证据.Lastly，ExpertopinionwasavailableToconfirmDiagnosisandandfortheuseof活动限制和参与措施，以评估肩部改进的护理发作。

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