Clinical practice guidelines for rehabilitation management of people with osteoporosis

This short chapter addresses the rationale, organization structure, writing and finally implementation of the National Osteoporosis Foundation (NOF) Clinical Parameters on Rehabilitation of patients with Osteoporosis. These practice parameters were an outgrowth of the rehabilitation area being inadequately addressed in the medical practice parameters previously developed. The NOF is the national organization representing consumers concerned about and interested in osteoporosis. While consumer based, it has a medical advisory committee and an interspecialty medical council with representatives of many osteoporosis related professional organizations. A special panel was empowered to write the clinical practice parameters with input from the interspecialty medical council, input from the medical advisory board, approved by the Board of Directors and endorsed by the interspecialty medical council individual representative organizations. Constituent organizations of the NOF Scientific Advisory Board were asked to endorse the parameter, which was accomplished by the International Society of Physical and Rehabilitation Medicine (ISPRM). Following a critical review of the literature on the following areas: exercise, pain, modalities and assistive devices, articles were ranked in an evidence-based manner. The Practice Parameter Task Force, meeting in. person and by c-mail wrote and reviewed each section based on evidence-based and/or consensus-based information. The review of the literature found limited evidence-based information in the area of pain treatment secondary to osteoporosis in the literature in pharmaceutical and/or modality area but some evidence in the area of exercise. It is expected these guidelines, to be published in 2003, will provide healthcare practitioners a road map to better manage patients with osteoporosis both in the areas of prevention and treatment. Appropriate use of pain medication combined with appropriate physical modalities and exercises as well as assistive devices should decrease pain, increase function and improve quality, of life in patients with osteoporosis.