Bone Mineral Density Summary

Passive standing (v no intervention) on bone mineral density

consensus: No Recommendation

No evidence recommendation or consensus-based opinion statement

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	Passive standing (v no intervention) on bone mineral density
P	People with SCI	Evidence recommendation No evidence recommendation Reason: No recommendation due to insufficient or inconclusive evidence.	No evidence recommendation or consensus-based opinion statement No recommendation can be made on passive standing to improve bone mineral density in people with SCI.
I	Passive standing
C	No intervention	Consensus-based opinion statement No consensus statements Reason: No consensus could be reached
O	Bone mineral density
	SUMMARY	1 RCT56	Mean difference (95% CI): Bone mineral density g/cm2 0.01 (-0.02 to 0.03) Favours passive standing
	GRADE Very low certainty ⨁◯◯◯	Risk of bias Serious	Inconsistency Serious	Imprecision No serious	Indirectness Serious	Publication bias Serious

PASSIVE STANDING ON BONE MINERAL DENSITY: GRADE Evidence to Decision
PROBLEM	No	Probably no	Probably yes	Yes		Don't know
DESIRABLE EFFECTS	Trivial	Small	Moderate	Large		Don't know
UNDESIRABLE EFFECTS	Large	Moderate	Small	Trivial		Don't know
CERTAINTY OF EVIDENCE	Very low	Low	Moderate	High		No included studies
HOW MUCH PEOPLE VALUE THE MAIN OUTCOME	Important uncertainty or variability	Possibly important uncertainty or variability	Probably no important uncertainty or variability	No important uncertainty or variability
BALANCE OF EFFECTS	Favours the Control	Probably favours the Control	Does not favour either the intervention (I) or the comparison (C)	Probably favours the I	Favours the I	Don't know
RESOURCES REQUIRED	Large costs	Moderate costs	Negligible costs and savings	Moderate savings	Large savings	Don't know
CERTAINTY OF EVIDENCE OF REQUIRED RESOURCES	Very low	Low	Moderate	High		No included studies
COST EFFECTIVENESS	Favours the comparison	Probably favours the comparison	Does not favour either the intervention or the comparison	Probably favours the intervention	Favours the intervention	No included studies
EQUITY	Reduced	Probably reduced	Probably no impact	Probably increased	Increased	Don't know
ACCEPTABILITY	No	Probably no	Probably yes	Yes		Don't know
FEASIBILITY	No	Probably no	Probably yes	Yes		Don't know

PASSIVE STANDING ON BONE MINERAL DENSITY: Randomised Controlled Trial Details
STUDY	COMPARISON	DOSAGE/DETAILS	PARTICIPANTS	N (Rx/C)	OUTCOME	ROB 2 PEDRo
BEN 2005	Long duration stretch V No intervention	30 minutes, 3 x per week for 12 weeks of standing on TT	People with SCI and LL paralysis	20/20	Bone mineral density g/cm2	Some Concerns of Risk of Bias PEDro = 8/10

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The Australian and New Zealand Physiotherapy Guidelines for people with SCI was funded by icare NSW, National Injury Insurance Scheme Queensland, Transport Accident Commission Victoria, and Lifetime Support Authority South Australia.

Acknowledgement of Country – The Australian and New Zealand Clinical Practice Guidelines team acknowledges the Traditional Custodians of country throughout Australia and their connections to land, sea and community. We pay our respect to their Elders past and present and extend that respect to all Aboriginal and Torres Strait Islander peoples today.

Honouring Te Tiriti – Ethical approval, including Māori consultation through University of Otago, Christchurch, Te Komiti Whakarite (Canterbury District Health Board), and through Māori consultation (Counties Manukau District Health Board) was obtained for Phase 1 of the study. In developing these guidelines, we were committed to meeting our obligations under Te Tiriti and reflect the principles of tino rangatiratanga, equity, active protection, options, and partnership.