Physical therapist management of patients with suspected or confirmed osteoporosis – German translation and contextual adaptation of a clinical practice guideline from the Academy of Geriatric Physical Therapy (USA)

IntroductionOsteoporosis is one of the major causes of fractures in individuals over the age of 50 years worldwide and an increasing public health problem. Trustworthy evidence indicates that physical exercise can reduce the risk of fall-related fractures in people with osteoporosis. Patients with suspected or confirmed osteoporosis are frequently referred to physiotherapy to address fall risk, bone health, pain, range of motion, and physical functioning. In Germany, there was no specific guidance on physiotherapeutic management for patients with osteoporosis. Thus, we aimed to identify, translate and adapt the most appropriate international physiotherapy guideline for the management of patients with osteoporosis.MethodsThe guideline adaptation process was informed by internationally accepted methodological frameworks and included six modules. We conducted a systematic review of the literature to identify relevant guideline(s) for adaptation (module 1), assessed guideline quality with AGREE-II (module 2), decided on one source guideline according to prespecified criteria (module 3), translated this guideline into German (module 4), reviewed and revised several guideline drafts by means of an expert committee, 3 physiotherapists and 2 older individuals with osteoporosis and adapted the guideline to the German healthcare context (module 5), and initiated implementation and dissemination of the final German guideline version (module 6).ResultsIn total, we screened 873 records from databases and via other methods, and finally selected the “APTA Geriatrics’ (Academy of Geriatric Physical Therapy, American Physical Therapy Association, USA) guideline published in 2022. Expert, end-user, and patient feedback (module 5) was used to make minor adaptations to the guideline (e.g., adding a glossary). We did not change any recommendation concerning physiotherapy management. A final German version of the guideline was approved by the whole research team and the developers of the source guideline and is now available open access (https://osf.io/yav94/files/s357b).ConclusionThe APTA Geriatrics osteoporosis guideline was translated and adapted for German-speaking countries through a structured, participatory process. The guideline can serve as the basis for evidence-based physiotherapy in German-speaking countries.Trial registrationThe study protocol was published prospectively (https://doi.org/10.17605/OSF.IO/TYXGF).