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)
8 affiliations
- 1Department of Health, HSD Hochschule Döpfer, Cologne, Germany
- 2Praxis für Physiotherapie, Isla Vitalis, Sankt Augustin, Germany
- 3Institute for Geriatric Research, University Hospital Ulm, AGAPLESION Bethesda Clinic Ulm, Ulm, Germany
- 4Department of Physiotherapy, Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg, Germany
- 5School of Health, Education and Social Sciences, SRH University, Heidelberg, Germany
- 6Department of Physical Therapy, University of Miami, Miller School of Medicine, Coral Gables, FL, United States
- 7Department of Physical Therapy, School of Health & Human Sciences, Indiana University, Indianapolis, IN, United States
- 8Department of Health and Nursing, Ernst Abbe University of Applied Sciences Jena (EAH), Jena, Germany
Abstract
Introduction: Osteoporosis 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.
Methods: The 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).
Results: In 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).
Conclusion: The 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 registration: The study protocol was published prospectively (https://doi.org/10.17605/OSF.IO/TYXGF).
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BibTeX
@article{braun2026physical,
title = {{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)}},
author = {Tobias Braun and Maxime Hermanns and Vanessa Haug and Jessica Nau and Bettina Scheffler and Gudrun Diermayr and Gregory W. Hartley and Keith G. Avin and Susanne Saal},
journal = {Frontiers in Rehabilitation Sciences},
year = {2026},
month = oct,
doi = {10.3389/fresc.2026.1933821},
url = {https://doi.org/10.3389/fresc.2026.1933821},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - 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)
AU - Tobias Braun
AU - Maxime Hermanns
AU - Vanessa Haug
AU - Jessica Nau
AU - Bettina Scheffler
AU - Gudrun Diermayr
AU - Gregory W. Hartley
AU - Keith G. Avin
AU - Susanne Saal
PY - 2026
DA - 2026/10/12
JO - Frontiers in Rehabilitation Sciences
DO - 10.3389/fresc.2026.1933821
UR - https://doi.org/10.3389/fresc.2026.1933821
AB - Introduction: Osteoporosis 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. Methods: The 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). Results: In 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). Conclusion: The 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 registration: The study protocol was published prospectively (https://doi.org/10.17605/OSF.IO/TYXGF).
SN - 2673-6861
ER -