ABSTRACT

Objective: This study aimed to develop guidelines for occupational therapists treating patients with spinal cord injury based on a systematic literature review of evaluation and intervention guidelines. Methods: Using the adoption and direct development approach, the guideline development process involved 7 stages: determining the scope of key questions and guideline development, guideline search, selection, evaluation, and recommendation of identified guidelines, development of additional recommendations for unresolved clinical questions, completion of the guideline draft, expert group evaluation, and completion of the final guidelines. Results: The developed guidelines consisted of a total of 75 items, including 17 items in the evaluation domain and 58 items in the intervention domain. In the evaluation domain, 5 items for functional assessment, 3 for pressure ulcer management, 3 for social participation, 2 for quality of life, 2 for pain management, 1 for discharge evaluation, and 1 for occupational balance were identified. In the intervention domain, 24 items for upper limb protection strategies, 8 for physical function improvement, 8 for activities of daily living, 7 for pressure ulcer management, 4 for respiratory management, 2 for rehabilitation timing, and 1 each for lifestyle, driving rehabilitation, vocational rehabilitation, leisure activities, and others were identified. Each item was assigned a recommendation level (A~D), and 35 items were rated as either A or B. Recommendations with high levels were found in the areas of physical function improvement intervention, pressure ulcer management intervention, upper limb protection strategies, and activities of daily living. Conclusion: It is expected that the developed guidelines have helped occupational therapists treating patients with spinal cord injury establish evidence-based treatment approaches and clarify their professional roles.