Abstract
Background: Clinical practice guidelines (CPGs) contain recommendation statements which aim to optimise patient care. In stroke rehabilitation there are a number of CPGs internationally, however less is known about how similar they are nor about which guidelines to implement into practice.
Aims: This study aimed to determine the quality, scope and consistency of clinical practice guideline recommendations for stroke rehabilitation.
Method: Systematic review of CPGs for inpatient rehabilitation and/or community rehabilitation for adults with stroke or any other acquired brain injury diagnosis. Electronic databases (n = 2), guideline organisations (n = 4), and websites of professional societies (n = 17) were searched up to March 2016. The Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument and textual synthesis were used to appraise and compare recommendations.
Results: From 411 papers, 20 papers comprising of 19 guidelines met the inclusion criteria. Only three guidelines rated high (>75%) across all domains of AGREE-II. ‘Scope and purpose’ and ‘clarity’ domains rate highest (87%, SD 12.4 and 72.2%, SD 18.9 respectively) with ‘applicability’ domain rating the lowest (37%, SD 34.6). Recommendations on assessment and motor therapies were consistent, guidelines varied in the level of detail and breadth of rehabilitation.
Conclusion: Stroke guidelines are consistent in scope, but variable with respect to recommendations, methodological quality and applicability. Clinicians should be mindful that their local guideline might not contain all available evidence.
Aims: This study aimed to determine the quality, scope and consistency of clinical practice guideline recommendations for stroke rehabilitation.
Method: Systematic review of CPGs for inpatient rehabilitation and/or community rehabilitation for adults with stroke or any other acquired brain injury diagnosis. Electronic databases (n = 2), guideline organisations (n = 4), and websites of professional societies (n = 17) were searched up to March 2016. The Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument and textual synthesis were used to appraise and compare recommendations.
Results: From 411 papers, 20 papers comprising of 19 guidelines met the inclusion criteria. Only three guidelines rated high (>75%) across all domains of AGREE-II. ‘Scope and purpose’ and ‘clarity’ domains rate highest (87%, SD 12.4 and 72.2%, SD 18.9 respectively) with ‘applicability’ domain rating the lowest (37%, SD 34.6). Recommendations on assessment and motor therapies were consistent, guidelines varied in the level of detail and breadth of rehabilitation.
Conclusion: Stroke guidelines are consistent in scope, but variable with respect to recommendations, methodological quality and applicability. Clinicians should be mindful that their local guideline might not contain all available evidence.
| Original language | English |
|---|---|
| Pages (from-to) | 25 |
| Number of pages | 1 |
| Journal | International Journal of Stroke |
| Volume | 12 |
| Issue number | 2_suppl |
| DOIs | |
| Publication status | Published - Aug 2017 |