Systematic review of clinical practice guidelines to identify recommendations for rehabilitation after stroke and other acquired brain injuries.
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.
['Jolliffe|Laura|L|0000-0002-1369-9442', 'Lannin|Natasha A|NA|', 'Cadilhac|Dominique A|DA|0000-0001-8162-682X', 'Hoffmann|Tammy|T|']
D000328:Adult D000070642:Brain Injuries, Traumatic D006801:Humans D017410:Practice Guidelines as Topic D016032:Randomized Controlled Trials as Topic D020521:Stroke D000071939:Stroke Rehabilitation
practice guideline rehabilitation stroke brain injury evaluation