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. 2018 Feb 28;8(2):e018791.
doi: 10.1136/bmjopen-2017-018791.

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

Laura Jolliffe  1 , Natasha A Lannin  1   2   3 , Dominique A Cadilhac  4   5 , Tammy Hoffmann  6
Affiliations

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

Laura Jolliffe et al. BMJ Open. .

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.

Keywords: brain injury; evaluation; practice guideline; rehabilitation; stroke.

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Conflict of interest statement

Competing interests: NAL, TH and DAC have been involved in the development of clinical practice guidelines referenced in this paper. They have also authored papers (randomised controlled trials) cited within the body of the guidelines that this systematic review appraised.

Figures

Figure 1
Figure 1
Flow chart of papers through the review.
See this image and copyright information in PMC

References

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    1. Scottish Intercollegiate Guidelines Network (SIGN). Brain Injury Rehabilitation in Adults: a national clinical guideline. Edinburgh: SIGN, 2013. Publication 130.
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