1. 1

    Do not discharge patients with osteoporotic fractures without an assessment and/or treatment for osteoporosis

  2. 2

    Discourage the use of lumbar supports or prolonged periods of bed rest in patients with non-specific low back pain

  3. 3

    Do not use Mini Mental State Examination as the only tool to assess cognitive deficit in acquired brain injury

  4. 4

    Do not routinely use splinting for prevention and/or management of contractures after stroke   

  5. 5

    Do not use imaging for diagnosing non-specific acute low back pain in the absence of red flags   

How this list was developed

A working group within AFRM initially identified 10 recommendations on low value practices in the field of rehabilitation medicine that may be widespread in Australia and New Zealand. Following a review of the evidence these were reduced to seven. An online survey based on these seven recommendations was distributed to all AFRM members asking them to rate these recommendations based on whether they thought they were evidence based, whether the low-value practices targeted were still being undertaken in significant numbers, and whether the recommendation was important in terms of reducing harm and unnecessary costs to patients. The working group reviewed the feedback and finalised the ‘top 5’ recommendations which were approved by AFRM Executive in mid-2017.

In December 2018, RMSANZ was asked by AFRM to cobrand the original list developed by AFRM and following extensive discussion and consultation RMSANZ agreed to do so subject to some minor amendments in recommendation 2.

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