Evidence based practice considers patient preferences, resources, and practitioner 's expertise, in addition to the best research evidences. The formulation of clinical practice guidelines involves systematic collection of the research evidence and selection of the best-recommended evidence, considering patient preference, benefit balance, risks, and several more aspects. Therefore, clinical practice guidelines can be considered as a relevant body of evidence. Recently "shared decision-making"has attracted a lot of attention worldwide. It involves sharing information regarding evidence (and clinical expertise), patient 's comprehension, expectation, and preference. “Informed consent" is comparable to “shared decision-making". Informed consent is a process that obtains patient’s permission through one-way explanation of a practitioner. However, because a physical therapist has not learned knowledge of the clinical practice guidelines and shared decision-making process, then "shared decision-making" is not reflected in clinical practice. There are fewer opportunities for physical therapists to know more regarding clinical practice guidelines and shared decision-making. Considering the potential of these techniques, understanding the relevance of clinical practice guidelines and shared decision-making could become essential for physical therapists in the near future. Here, we have explained the importance of clinical practice guidelines and shared decision-making and considered their possible application in clinical practice.

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Introduction: Although the pervasive comorbidity documented in elderly people with visual impairments may be linked to physical inactivity, little is known regarding the extent to which mobility and health status can be improved among this population. Purpose: The aim of this preliminary research study is to evaluate the feasibility using autonomic function analysis to assess the impact of clinical fear on the reproducibility of aerobic exercise movement in elderly people with visual impairment. Subjects and Method: Methods: During a 24-week period, the autonomic nervous function (LF/HF) during the performance of an aerobic exercise movement and the reproducibility of aerobic exercise movements were measured in 15 elderly people (age = 65 + 15 years) with visual impairments. Following the reproducibility of aerobic exercise movements, participants’ clinical fear as assessed by autonomic function analysis was calculated as the ratio of the integration area between the low-frequency and high-frequency components of sympathetic nervous system activity from the inter-beat (RR) interval in heart rate before the movement. Results: The autonomic nervous function (LF/HF) during the movement can be estimated by a polynomial approximation curve. The LF/HF values can be divided into a medium-frequency range (0.6 ± 0.2). A 95% confidence interval of the estimated values by the exponential model showed significance. Conclusion: Presence of fear has been suggested to affect the learning of aerobics exercise movements in visually impaired elderly people.

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