AAPM&R Endorsed or Affirmed Guidelines

The Clinical Practice Guidelines (CPG) Committee is charged with reviewing, endorsing and advocating for key guidelines critical to the field of PM&R. The CPG Committee also assists in identifying members to serve on national panels to develop guidelines relevant to PM&R. The CPG Committee provides members with a repository of practice guidelines that may be meaningful to their practice, and helps identify gaps for future guideline development.

Practice Guidelines endorsed or affirmed by the Academy are intended to provide guidance for particular patterns of practice and not to dictate the care of a particular patient. Physicians are advised to make individual treatment decisions according to their own medical judgment in light of each patient’s individual circumstances. Guidelines are intended to promote beneficial or desirable outcomes but cannot guarantee any specific outcome. Guidelines developed or endorsed by the Academy are subject to periodic revision as warranted by the evolution of medical knowledge, technology and practice. 

• Official AAPM&R endorsement: Fully meets AAPM&R standards defining clinical practice guidelines; AAPM&R endorses all the recommendations.
• Affirmation of Value to Physiatrists: Does not fully meet AAPM&R standards defining clinical practice guidelines; AAPM&R cannot endorse all the recommendations; however, AAPM&R leadership feels it is of benefit to the membership.
• No endorsement: Does not meet AAPM&R standards defining clinical practice guidelines; AAPM&R cannot endorse all the recommendations; It is not of benefit to the membership.
  

The CPG Committee reviews guidelines for structural integrity, not for content. Using a tool called the AGREE II, the committee evaluates the guideline being reviewed to ensure that cited evidence was researched appropriately and supports the guideline, that the group which developed the guideline was represented by all applicable professional specialties, recommendations are specific and non-ambiguous, provision is made for timely updates, among other aspects of construction.

Clinical Practice Guidelines that have been reviewed in the last five years are included in the current endorsement cycle. Clinical Practice Guidelines that were reviewed beyond the last five years are archived until the CPG Committee reviews an updated version of the Guideline.

Clinical Practice Guidelines within the current Academy endorsement cycle:

• Clinical Practice Guideline (CPG) for the Management of Anterior Cruciate Ligament (ACL) Injuries (2022) - This guideline was endorsed by the AAPM&R CPG Committee. View the letter to the American Academy of Orthopaedic Surgeons (AAOS).

• Expert Consensus Statement on Evaluation and Management of Arrhythmic Risk in Neuromuscular Disorders (2022) - This consensus statement was affirmed by the AAPM&R CPG Committee. View the letter to the Heart Rhythm Society (HRS).

• Clinical Practice Guideline (CPG) for the Management of Hip Fractures in Older Adults (2021) - This guideline was endorsed by the AAPM&R CPG Committee. View the letter to the American Academy of Orthopaedic Surgeons (AAOS).

• Consensus practice guidelines on interventions for cervical spine joint pain from a multispecialty, international working group (2021) - This guideline was affirmed by the AAPM&R Clinical Practice Guidelines (CPG) Committee. View the letter to the American Society of Regional Anesthesia and Pain Medicine (ASRA-PM).

• Youth running consensus statement: minimising risk of injury and illness in youth runners (2020) - This consensus statement was affirmed by the AAPM&R CPG Committee. View the letter to the Organising committee (BJK, WOR and AST).

• Management of Glenohumeral Joint Osteoarthritis Evidence-Based Clinical Practice Guideline (2020) - This guideline was endorsed by the AAPM&R Clinical Practice Guidelines (CPG) Committee. View the endorsement letter to the American Academy of Orthopaedic Surgeons (AAOS).

• Evidence-Based Clinical Guideline for Multidisciplinary Spine Care: Diagnosis & Treatment of Low Back Pain (2020) - This guideline was endorsed by the AAPM&R Clinical Practice Guidelines (CPG) Committee. View the endorsement letter to the North American Spine Society (NASS). View AAPM&R CPG Commentary Review for the NASS Low Back Pain Guideline.

• Clinical Practice Guideline and Appropriate Use Criteria for Psychosocial Factors Influencing Trauma Recovery from Adult Orthopaedic Trauma (2020) - This guideline and AUC was endorsed by the AAPM&R Clinical Practice Guidelines (CPG) Committee. View the endorsement letter to the American Academy of Orthopaedic Surgeons (AAOS) in collaboration with the Major Extremity Trauma and Rehabilitation Consortium (METRC).

• Canadian Best Practice Recommendations for Stroke Care (2019) - This guideline was endorsed by the AAPM&R Clinical Practice Guidelines (CPG) Committee. This guideline was developed by the Canadian Stroke Strategy (Joint initiative of the Canadian Stroke Network and the Heart and Stroke Foundation of Canada).

• Exercise Guidelines for Cancer Survivors: Consensus Statement from International Multidisciplinary Roundtable (2019) - This paper was endorsed by the AAPM&R Clinical Practice Guidelines (CPG) Committee. View the endorsement letter to  the American College of Sports Medicine (ACSM).

• Exercise Is Medicine in Oncology: Engaging Clinicians to Help Patients Move through Cancer (2019) - This paper was endorsed by the AAPM&R Clinical Practice Guidelines (CPG) Committee. View the endorsement letter to the American College of Sports Medicine (ACSM).

• American College of Sports Medicine Roundtable Report on Physical Activity, Sedentary Behavior, and Cancer Prevention and Control (2019) - This paper was endorsed by the AAPM&R Clinical Practice Guidelines (CPG) Committee. View the endorsement letter to the American College of Sports Medicine (ACSM).

• Physical Activity Guidelines for Americans, 2nd Edition (2018) - This guideline was endorsed by the AAPM&R Clinical Practice Guidelines (CPG) Committee. This guideline was developed by the U.S. Department of Health and Human Services.

• Evidence-Based Guideline: Neuromuscular Ultrasound for the Diagnosis of Carpal Tunnel Syndrome (Re-affirmed in 2017) - This practice statement was developed by the American Academy of Neuromuscular and Electrodiagnostic Medicine (AANEM) and was affirmed by the AAPM&R Clinical Practice Guidelines (CPG) Committee. As there is no evidence available that warrants an update to the guideline, the statement is essentially up to date, despite initially being published in 2012. 

Archived Clinical Practice Guidelines:

• Guidelines for Adult Stroke Rehabilitation and Recovery (2016) - This guideline was endorsed by the AAPM&R Clinical Practice Guidelines (CPG) Committee, a determination with which the AAPM&R Board of Governors agreed. This guideline was developed by the American Heart Association/American Stroke Association.

• Appropriateness Criteria for Low Back Pain (2016) - This Appropriate Use Criteria was affirmed by the AAPM&R Clinical Practice Guidelines (CPG) Committee, a determination with which the AAPM&R Board of Governors agreed. This Appropriate Use Criteria was developed by the American College of Radiology.

• Practice Guideline Update Summary: Botulinum Neurotoxin for the Treatment of Blepharospasm, Cervical Dystonia, Adult Spasticity, and Headache (2016) - This guideline was affirmed by AAPM&R. This guideline was developed by the American Academy of Neurology. 

• Appropriate Prehospital Care of the Spine-Injured Athlete (2015)- This guideline was affirmed by the Clinical Practice Guidelines (CPG) Committee, a determination with which the Quality Practice Policy and Research (QPPR) Committee agreed. This guideline was developed by the National Athletic Trainers’ Association (NATA).

• Management of Hip Fractures in the Elderly (2015) - This guideline was endorsed by the AAPM&R Clinical Practice Guidelines (CPG) Committee, a determination with which the AAPM&R Board of Governors agreed. This guideline was developed by the American Academy of Orthopaedic Surgeons (AAOS).

• Management of Anterior Cruciate Ligament Injuries (2015) - This guideline was endorsed by the AAPM&R Clinical Practice Guidelines (CPG) Committee, a determination with which the AAPM&R Board of Governors agreed. This guideline was developed by the American Academy of Orthopaedic Surgeons.

• AHA/ASA Scientific Statement Palliative and End-of-Life Care in Stroke (2014) - This guideline was endorsed by the AAPM&R Clinical Practice Guidelines (CPG) Committee, a determination with which the AAPM&R Board of Governors agreed. This guideline was developed by the American Heart Association/American Stroke Association. 

• Complementary and Alternative Medicine in Multiple Sclerosis (2014) - This guideline was affirmed by the AAPM&R Clinical Practice Guidelines (CPG) Committee, a determination with which the AAPM&R Board of Governors agreed. This guideline was developed by the American Academy of Neurology.

• Diagnosis and Treatment of Degenerative Spondylolisthesis (2014) - This guideline was endorsed by the AAPM&R Clinical Practice Guidelines (CPG) Committee, a determination with which the AAPM&R Board of Governors agreed. This guideline was developed by the North American Spine Society (NASS). 

• Evidence-based guideline summary: Diagnosis and treatment of limb-girdle and distal dystrophies (2014) - This guideline was endorsed by the AAPM&R Clinical Practice Guidelines (CPG) Committee, a determination with which the AAPM&R Board of Governors agreed. This guideline was developed by the American Academy of Neurology.

• ACOEM Practice Guidelines: Opioids for Treatment of Acute, Subacute, Chronic, and Postoperative Pain (2014) - This guideline was affirmed by AAPM&R. This guideline was developed by the American College of Occupational and Environmental Medicine. 

• Summary of evidence-based guideline update: Evaluation and management of concussion in sports (2013) - This guideline was endorsed by the AAPM&R Clinical Practice Guidelines (CPG) Committee, a determination with which the AAPM&R Board of Governors agreed. This guideline was developed by the American Academy of Neurology (AAN). 

• Treatment of Osteoarthritis of the Knee (2013) - This guideline was affirmed by the AAPM&R Clinical Practice Guidelines (CPG) Committee, a determination with which the AAPM&R Board of Governors agreed. This guideline was developed by the American Academy of Orthopaedic Surgeons.

• Diagnosis and Management of Childhood Obstructive Sleep Apnea Syndrome (2012) - This guideline was affirmed by the Clinical Practice Guidelines (CPG) Committee, a determination with which the Quality Practice Policy and Research (QPPR) Committee agreed. This guideline was developed by the American Academy of Pediatrics (AAP).

• Urinary incontinence in neurological disease: assessment and management (2012) - This guideline was endorsed by the AAPM&R Clinical Practice Guidelines (CPG) Committee, a determination with which the Quality Practice Policy and Research (QPPR) Committee agreed. This guideline was developed by the National Institute for Health and Clinical Excellence (NICE).

• Recommendations for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip, and knee (2012) - This guideline was affirmed by the AAPM&R Clinical Practice Guidelines (CPG) Committee, a determination with which the AAPM&R Board of Governors agreed. This guideline was developed by the American College of Rheumatology (ACR).

• Guidelines for the Management of Pediatric Severe Traumatic Brain Injury, Third Edition: Update of the Brain Trauma Foundation Guidelines (2019) – This third edition update was endorsed by the AAPM&R Clinical Practice Guidelines (CPG) Committee. 

• Low back pain: clinical practice guidelines linked to the International Classification of Functioning, Disability, and Health (2012) - This guideline was affirmed by the AAPM&R Clinical Practice Guidelines (CPG) Committee, a determination with which the AAPM&R Board of Governors agreed. This guideline was developed by the Orthopaedic Section of the American Physical Therapy Association.

• Diagnosis and Treatment of Degenerative Lumbar Spinal Stenosis (2011) - This guideline was endorsed by the AAPM&R Clinical Practice Guidelines (CPG) Committee, a determination with which the AAPM&R Board of Governors agreed. This guideline was developed by the North American Spine Society (NASS).

• Management of Stroke Rehabilitation (2010) - This guideline was affirmed by the AAPM&R Clinical Practice Guidelines (CPG) Committee, a determination with which the AAPM&R Board of Governors agreed. This guideline was developed by the Department of Veterans Affairs; Department of Defense; The American Heart Association/ American Stroke Association.

• Comprehensive Overview of Nursing and Interdisciplinary Rehabilitation Care of the Stroke Patient: A Scientific Statement (2010) - This guideline was endorsed by the AAPM&R Clinical Practice Guidelines (CPG) Committee, a determination with which the AAPM&R Board of Governors agreed. This guideline was developed by the American Heart Association. 

• Assessment Scales for Disorders of Consciousness: Evidence-Based Recommendations for Clinical Practice and Research (2010) - This guideline was endorsed by the AAPM&R Clinical Practice Guidelines (CPG) Committee, a determination with which the AAPM&R Board of Governors agreed. This guideline was developed by the American Congress of Rehabilitation Medicine.  

• Treatment of Symptomatic Osteoporotic Spinal Compression Fractures (2010) - This guideline was endorsed by the AAPM&R Clinical Practice Guidelines (CPG) Committee, a determination with which the AAPM&R Board of Governors agreed. This guideline was developed by the American Academy of Orthopaedic Surgeons.  

• Guidelines for Mild Traumatic Brain Injury and Persistent Symptoms - This guideline was endorsed by the AAPM&R Clinical Practice Guidelines (CPG) Committee, a determination with which the AAPM&R Board of Governors agreed. This guideline was developed by the Ontario Neurotrauma Foundation.

• Optimizing the Management of Rotator Cuff Injuries - This guideline was affirmed by the AAPM&R Clinical Practice Guidelines (CPG) Committee, a determination with which the AAPM&R Board of Governors agreed. This guideline was developed by the American Academy of Orthopaedic Surgeons AAOS).