Systematic review of clinical practice guidelines to identify recommendations for rehabilitation after stroke and other acquired brain injuries

What a fucking waste. GUIDELINES not RESULTS! Does no one understand that survivors want results NOT lazy guidelines? This should already be out there in that publicly available database of stroke protocols.
http://bmjopen.bmj.com/content/8/2/e018791 

1. Laura Jolliffe

1,

Natasha A Lannin

1,2,3,

Dominique A Cadilhac

,5,

Tammy Hoffmann

6

Author affiliations

Discipline of Occupational Therapy, School of Allied Health, College of Science, Health and Engineering, La Trobe University, Bundoora, Australia

Occupational Therapy Department, Alfred Health, Prahran, Australia

John Walsh Centre for Rehabilitation Research, Sydney Medical School (Northern), The University of Sydney, Sydney, Australia

Stroke and Ageing Research, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia

The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Australia

Centre for Research in Evidence-Based Practice, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia

1. Correspondence to

Dr Natasha A Lannin; n.lannin@latrobe.edu.au

Abstract

Objectives Rehabilitation clinical practice guidelines (CPGs) contain recommendation statements aimed at optimising care for adults with stroke and other brain injury. The aim of this study was to determine the quality, scope and consistency of CPG recommendations for rehabilitation covering the acquired brain injury populations.

Design Systematic review.

Interventions Included CPGs contained recommendations for inpatient rehabilitation or community rehabilitation for adults with an acquired brain injury diagnosis (stroke, traumatic or other non-progressive acquired brain impairments). Electronic databases (n=2), guideline organisations (n=4) and websites of professional societies (n=17) were searched up to November 2017. Two independent reviewers used the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument, and textual syntheses were used to appraise and compare recommendations.

Results From 427 papers screened, 20 guidelines met the inclusion criteria. Only three guidelines were rated high (>75%) across all domains of AGREE-II; highest rated domains were ‘scope and purpose’ (85.1, SD 18.3) and ‘clarity’ (76.2%, SD 20.5). Recommendations for assessment and for motor therapies were most commonly reported, however, varied in the level of detail across guidelines.

Conclusion Rehabilitation CPGs were consistent in scope, suggesting little difference in rehabilitation approaches between vascular and traumatic brain injury. There was, however, variability in included studies and methodological quality.

PROSPERO registration number CRD42016026936.

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

http://dx.doi.org/10.1136/bmjopen-2017-018791