Systematic Review of Existing Stroke Guidelines: Case for a Change
BioMed Research International
Wijeratne, T., Sales, C., et al. (2022).
BioMed Research International, 2022, 5514793.
This umbrella systematic review of clinical practice guidelines investigates the similarities and differences in these guidelines regarding acute ischemic stroke globally. Conclusions relevant to the scope of practice of SLPs are included in this article summary.
Not stated
<p>This umbrella systematic review contains a number of guidelines, only some of which are relevant to speech-language pathologists. Of particular relevance to the article’s conclusions are the following:</p>
<ul>
<li>Boulanger, J. M., Lindsay, M. P., et al. (2018). Canadian Stroke Best Practice Recommendations for Acute Stroke Management: Prehospital, Emergency Department, and Acute Inpatient Stroke Care, 6th Edition, Update 2018. <em>International Journal of Stroke, 13</em>(9), 949-984. doi:10.1177/1747493018786616</li>
<li>Inzitari, D. (2000). The Italian Guidelines for Stroke Prevention. The Stroke Prevention and Educational Awareness Diffusion (SPREAD) Collaboration. <em>Neurological Sciences, 21</em>(1), 5-12. doi:10.1007/s100720070112</li>
<li>Ministry of Public Health of Qatar. (2018). Clinical Guidelines for the State of Qatar: The Diagnosis and Management of Stroke and Transient Ischaemic Attack. Available from: <a title="http://www.researchgate.net/publication/319376697_ Clinical_Guidelines_for_the_State_of_Qatar_The_ diagnosis_and_management_of_stroke_and_transient_ ischemic_attack" href="http://www.researchgate.net/publication/319376697_%20Clinical_Guidelines_for_the_State_of_Qatar_The_%20diagnosis_and_management_of_stroke_and_transient_%20ischemic_attack" target="_blank" rel="noopener">http://www.researchgate.net/publication/319376697_ Clinical_Guidelines_for_the_State_of_Qatar_The_ diagnosis_and_management_of_stroke_and_transient_ ischemic_attack</a></li>
<li>Rudd, A. G., Bowen, A., Young, G. R., & James, M. A. (2017). The Latest National Clinical Guideline for Stroke. <em>Clinical Medicine, 17</em>(2), 154-155. doi:10.7861/clinmedicine.17-2-154</li>
<li>Sri Lanka. Management of Stroke and Transient Ischaemic Attack in Adults. (n. d.). Available from: <a title="https://global-uploads.webflow.com/5e19f85d3feecdf9ff105b40/5e5f486f7b704fbc25d66298_CCP-stroke-guidelines-1798.pdf" href="https://global-uploads.webflow.com/5e19f85d3feecdf9ff105b40/5e5f486f7b704fbc25d66298_CCP-stroke-guidelines-1798.pdf" target="_blank" rel="noopener">https://global-uploads.webflow.com/5e19f85d3feecdf9ff105b40/5e5f486f7b704fbc25d66298_CCP-stroke-guidelines-1798.pdf</a> </li>
<li>Venketasubramanian, N., Pwee, K. H., et al. (2011). Singapore Ministry of Health Clinical Practice Guidelines on Stroke and Transient Ischemic Attacks. <em>International Journal of Stroke, 6</em>(3), 251-258. doi:10.1111/j.1747-4949.2011.00602.x</li>
</ul>
<p>The guidelines that are found elsewhere in the Evidence Maps are linked below in the Associated Article(s) section.</p>
2000 to October 2020
Clinical practice guidelines with graded recommendations
15
The majority of guidelines emphasized the importance of early rehabilitation. The authors note that rehabilitation initiated within seven days of stroke is associated with "complex neurobiological processes which [are] instrumental in early neurologic recovery" (p. 6). Adherence to guideline recommendations regarding post-acute rehabilitation was associated with good clinical outcomes. There was significant heterogeneity regarding recommendations on how to implement rehabilitation within comprehensive stroke care centers.
Weak to moderate strength of recommendations were noted for professional dysphagia assessment. American, Australian, and United Kingdom guidelines emphasized the importance of functional assessment for post-stroke rehabilitation.
