Systematic reviews (SRs) are considered the type of study with the highest level of scientific evidence to support decision-making in clinical practice, including in the physical therapy field. In this type of study, in order to establish to what extent the evidence found is reliable, it is highly recommended to use the Grading of Recommendations Assessment, Development and Evaluation (GRADE) tool, as it allows the classification of the quality (certainty) of the evidence of selected studies, through the use of transparent and systematic criteria. When this analysis is neglected, judgment and interpretation of the results presented are impaired, which may reflect on the development and implementation of ineffective intervention and rehabilitation strategies.

To evaluate the frequency with which the SRs of interventions in physical therapy, published in high impact journals, use the GRADE tool to analyze the quality of evidence of the included studies.

Using the Rayyan software, two reviewers independently selected all SRs of physical therapy interventions published in any language, from March 2020 to August 2022, in the 10 journals with the highest impact factor in the field of rehabilitation, evaluated by the Journal Citation Reports (JCR). Divergences were resolved by a third reviewer. The use of the GRADE approach to assess the quality of evidence in the SRs was analyzed using descriptive statistics, with frequencies and percentages.

In the selection, 3,032 records were identified, published in English, of which 2,927 were excluded for not meeting the eligibility criteria. In total, 105 SRs were included, published in journals with an impact factor ranging from 4.762 to 10.714 (JCR, 2021). Among the 105 included SRs, 50.48% (53) used the GRADE tool and 49.52% (52) did not. Of the latter, 25% (13) did not have any type of assessment of the methodological quality or the risk of bias of the included studies, which makes it even more difficult to interpret the reliability of the results.

It was found that a significant part of the SRs on physical therapy interventions, currently published in high impact journals in the rehabilitation field, neglect the systematic and transparent assessment of the quality of the evidence of the included studies. Future systematic reviews should consider evaluating the certainty of the evidence, to increase the clarity and reliability in the interpretation of their results, to better support clinical decision-making.

This study presents important considerations regarding the lack of transparency on the reliability of the results presented in systematic reviews, even when published in journals with a high impact factor in the area of physical therapy. Failure to carry out a systematic analysis of the certainty of evidence is particularly problematic, as it compromises the safety of published results and does not provide an adequate basis for clinical decision-making by physical therapists.