Background and Aims

Clinical practice guidelines (CPGs) provide an evidence-based foundation to build optimal services for people with stroke. In comparison to High Income Countries where many comprehensive stroke rehabilitation guidelines exist, identifying evidence-based guidelines specific to Low-and-Middle-Income Countries (LMICs) is challenging. This project aims to:

1. Evaluate the quality and content of existing CPGs for Stroke rehabilitation from LMICs

2. Develop LMIC-specific CPGs based on findings identified

Methods

This project will be executed by a multi-disciplinary core team of stroke rehabilitation professionals, through a multi-phased process. An advisory board of global stroke-rehabilitation experts will provide periodic inputs wherever essential.

Phase I: A systematic review on the existing CPGs for stroke rehabilitation from LMICs will be conducted. Quality and methodological rigour of the CPGs will be assessed based on an identified cut-off on AGREE-II and AGREE-REX tools.

Phase II: CPGs which meet the essential criteria in Phase I will be compared for content with the standardized WSO Global services guidelines and action plan, to identify the existing gaps.

Phase III: LMIC-specific stroke rehabilitation CPGs will be developed informed by the merits and demerits identified in previous phases.

Results

Through this project we intend to study the quality and content of CPGs for stroke rehabilitation, identify the existing gaps and develop new evidence-based CPGs specific to LMICs.

Conclusions

There exist wide gaps in the availability as well as implementation of CPGs for stroke rehabilitation in LMICs. This study is designed with the larger objective of identifying those gaps, and developing CPGs specifically tailored to LMICs.