Evidence map›Paper›PMID 39097962›Full record

SynthesisCerebrovascular diseases (Basel, Switzerland)2025

Stroke Rehabilitation Clinical Practice Guidelines in Low- and Middle-Income Countries: A Systematic Review of Quality and Unique Features.

Dorcas B C Gandhi, Sureshkumar Kamalakannan, Gerard Urimubenshi, Ivy A Sebastian, Vinicius V A Montanaro, Nistara S Chawla, Jennifer V D'souza, Etienne Ngeh, Amreen Mahmood, Marika Demers and 3 more

Erratum issuedAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Cerebrovascular diseases (Basel, Switzerland), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

13 authors.

Dorcas B C GandhiPhysiotherapy, Manipal Academy of Higher Education, Christian Medical College and Hospital Ludhiana, Ludhiana, India.
Sureshkumar KamalakannanDepartment of Social Work, Education, and Community Wellbeing, Northumbria University, Newcastle upon Tyne, UK.
Gerard UrimubenshiDepartment of Physiotherapy, University of Rwanda, Kigali, Rwanda.
Ivy A SebastianDepartment of Neuroclinical Sciences, University of Calgary, Calgary, Alberta, Canada.
Vinicius V A MontanaroNeurology, Sarah Network of Rehabilitation Hospitals, Macapá, Brazil.
Nistara S ChawlaDepartment of Physiotherapy, Manipal Academy of Higher Education, Manipal, India.
Jennifer V D'souzaDepartment of Physiotherapy, St. John's Medical College Hospital, Bangalore, India.
Etienne NgehDepartment of Physiotherapy, Research Organization for Health Education and Rehabilitation-Cameroon, Buea, Cameroon.
Amreen MahmoodDepartment of Health Professions, Manchester Metropolitan University, Manchester, UK.
Marika DemersSchool of Rehabilitation, Université de Montréal, Montreal, Québec, Canada.
Aditi HombaliVxisible Analytics and Nuffield, Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
John M SolomonDepartment of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India.
GCSR Collaborators

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionEfforts toward reducing stroke burden have been an immense challenge. One important reasons could be the scope and quality of clinical practice guidelines (CPGs) developed for stroke rehabilitation in low- and middle-income countries (LMICs), restricting its translation to clinical practice. This systematic review aimed to assess the availability, scope and quality of CPGs for stroke rehabilitation in LMICs.

methodsFollowing PRISMA guidelines, CPGs for stroke rehabilitation in LMICs were searched across four major electronic databases (Medline, Embase, CINAHL, and PEDro). Additional studies were identified from grey literature and a hand search of key bibliographies and search engines. The availability and content of the CPGs were narratively summarized and quality of de novo CPGs was analyzed using "Appraisal of Guidelines REsearch and Evaluation" (AGREE) tools: version II & Recommendations Excellence (REX) version. Features of contextualizations/adaptations of non-de novo CPGs were narratively summarized.

resultsTwelve CPGs from 10 countries were included. CPGs from Pakistan, Sri Lanka, India, and China were developed de novo. CPGs from Kenya, Philippines, South Africa, Cameroon, Mongolia, and Ukraine were contextualized/adapted based on existing guidelines from high-income countries. Most contextualized CPGs had limited stakeholder involvement, local health systems/patient pathway analyses. All ten countries included recommendations for physiotherapy, seven for communication, swallowing, and five for occupational therapy services poststroke. Quality assessment using AGREE-REX and AGREE-II for de novo guidelines was poor, especially scoring low in development and applicability.

conclusionContextualized CPGs for stroke rehabilitation in LMICs were scarcely available and not meeting required quality. There is a need for development of context-specific, culturally relevant CPGs for stroke rehabilitation in LMICs to improve implementation/translation into clinical practice.

Indexed as

Developing CountriesEvidence-Based MedicinePractice Guidelines as TopicQuality Indicators, Health CareStrokeStroke RehabilitationHumansRecovery of FunctionTreatment OutcomeContextualizationEvidence-based practiceQuality assessmentStroke rehabilitation

Identifiers

PMID39097962
PMCPMC12324695

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.