Kingau N1,2, Rhoda A3, Elbadawi M4, Mlenzana N3
1Moi University, Orthopaedics & Rehabilitation, Eldoret, Kenya, 2Linköping University, Linkoping, Sweden, 3University of the Western Cape, Cape Town, South Africa, 4Moi University, Eldoret, Kenya
Background: Management of impairment secondary to stroke is imperative for functional recovery. Given the resource-intense nature of stroke rehabilitation, it is imperative that services be provided in an evidence-based and cost-efficient manner.
Purpose: The purpose of this review was to systematically identify and appraise the available evidence-based Clinical Practice Guideline (CPGs) for stroke rehabilitation.
Methods: A systematic review was conducted. Thirteen guideline clearinghouses and 14 electronic databases were searched for eligible Clinical Practice Guideline (CPGs) published between the years 1995 and May 2016. Clinical Practice Guideline (CPGs) meeting the inclusion criteria were appraised using the Appraisal of Guidelines Research and Evaluation tool (AGREE) II.
Results: Of the 160 guideline identified, 8 were eligible, and 3 were included. The methodological rigor of CPG development was highly variable, and the mean domain score was 67%. The highest mean score was obtained from stakeholder involvement (Domain 2) (94%), while the lowest mean score was obtained for the applicability (Domain 5) (14%). There was varying use of frameworks to combine the level of evidence and the strength of the recommendations in the included CPGs. The scope and content of the included CPGs focussed on physiotherapy management.
Conclusion(s): Several CPGs for stroke rehabilitation exists, varying in their scope and methodological quality. This study focuses on specific elements to enhance the development and reporting of CPGs, which may play a role in the uptake of guidelines into clinical practice. These elements include improved reporting of methodological aspects, the use of frameworks to augment decision making processes, and the consideration of factors influencing applicability of recommendations
Implications: Availabile contextual relevant evidence based recommendation for stroke rehabilitation for resource scarce setting.
Keywords: Clinical practice guidelines, Stroke rehabilitation, Systematic review
Funding acknowledgements: Moi-Linköping Universities Collaboration
Purpose: The purpose of this review was to systematically identify and appraise the available evidence-based Clinical Practice Guideline (CPGs) for stroke rehabilitation.
Methods: A systematic review was conducted. Thirteen guideline clearinghouses and 14 electronic databases were searched for eligible Clinical Practice Guideline (CPGs) published between the years 1995 and May 2016. Clinical Practice Guideline (CPGs) meeting the inclusion criteria were appraised using the Appraisal of Guidelines Research and Evaluation tool (AGREE) II.
Results: Of the 160 guideline identified, 8 were eligible, and 3 were included. The methodological rigor of CPG development was highly variable, and the mean domain score was 67%. The highest mean score was obtained from stakeholder involvement (Domain 2) (94%), while the lowest mean score was obtained for the applicability (Domain 5) (14%). There was varying use of frameworks to combine the level of evidence and the strength of the recommendations in the included CPGs. The scope and content of the included CPGs focussed on physiotherapy management.
Conclusion(s): Several CPGs for stroke rehabilitation exists, varying in their scope and methodological quality. This study focuses on specific elements to enhance the development and reporting of CPGs, which may play a role in the uptake of guidelines into clinical practice. These elements include improved reporting of methodological aspects, the use of frameworks to augment decision making processes, and the consideration of factors influencing applicability of recommendations
Implications: Availabile contextual relevant evidence based recommendation for stroke rehabilitation for resource scarce setting.
Keywords: Clinical practice guidelines, Stroke rehabilitation, Systematic review
Funding acknowledgements: Moi-Linköping Universities Collaboration
Topic: Neurology: stroke; Neurology
Ethics approval required: Yes
Institution: University of the Western Cape
Ethics committee: Senate Research Committee of the University of the Western Cape
Ethics number: (14/7/7
All authors, affiliations and abstracts have been published as submitted.
