Perceived determinants of clinical practice guideline implementation for stroke rehabilitation in LMICs a multinational REFORM survey

Implementation of clinical practice guidelines (CPGs) is integral to improving the quality of stroke rehabilitation in low- and middle-income countries (LMICs). However, various barriers hinder their effective utilization. This survey aimed to identify the barriers faced by rehabilitation professionals in utilizing CPGs for post-stroke motor rehabilitation. A cross-sectional survey based on the Australian Living Guidelines for Stroke Rehabilitation was developed to identify factors that influence healthcare professionals' adherence to clinical practice guidelines. The survey comprised 50 questions spanning five domains: demographics, work practices, rehabilitation techniques, clinical practice awareness, and CPG feasibility and implementation. A panel of 10 experts validated the questionnaire. The survey was disseminated via emails, through professional associations, and platforms such as WhatsApp, LinkedIn, and X (formerly Twitter). Quantitative analysis data were analysed using Jamovi 2.3.21. The results indicated that less experienced professionals were more likely to implement CPGs, utilize telerehabilitation, and follow transition care protocols, while experienced practitioners adhered to both CPGs and hospital guidelines and employed motor outcome measures. Identified barriers included limited awareness, insufficient training, resource constraints, and challenges related to language and cultural relevance. To enhance CPG implementation, it is necessary to develop context-specific CPGs, establish stepwise clinical protocols, integrate evidence-based practice and CPG training into university curricula, and increase awareness among policymakers and stroke survivors. Engaging diverse stakeholders-patients, caregivers, multidisciplinary teams, and policymakers-is essential to foster an enabling environment for CPG adoption and advancing stroke rehabilitation practices in LMICs.

Authors

Institutions

Publication Details

Journal
Scientific Reports
Published
2025-12-04
DOI
https://doi.org/10.1038/s41598-025-16738-3
Primary Topic
Clinical practice guidelines implementation
Type
article
Field-Weighted Citation Impact
0.00
Controls
|||
ALL TIME
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
article

Perceived determinants of clinical practice guideline implementation for stroke rehabilitation in LMICs a multinational REFORM survey

Gerard Urimubenshi, Dimple Dawar, R. C. Mascarenhas, Guilherme Hoff Affeldt et al.
Scientific Reports
Clinical practice guidelines implementation
article

Perceived determinants of clinical practice guideline implementation for stroke rehabilitation in LMICs a multinational REFORM survey

Gerard Urimubenshi, Dimple Dawar, R. C. Mascarenhas, Guilherme Hoff Affeldt, Abhilash Patra, Coralie English, Vinícius Viana Abreu Montanaro, Dorcas B.C. Gandhi, Pranay J. Vijayanand, Jennifer D’souza, Isha Akulwar Tajane, Ivy Sebastian, Jeyaraj Durai Pandian, Etienne Ngeh Ngeh, Amreen Mahmood, Ranjit J. Injety, K. Saravanan, John M. Solomon, P.N. Shetty, Carla Bastida Fernández, Nistara Chawla, Sania Zarren, Aditi hombail, Sureshkumar Kamlakannan
article en

Abstract

Implementation of clinical practice guidelines (CPGs) is integral to improving the quality of stroke rehabilitation in low- and middle-income countries (LMICs). However, various barriers hinder their effective utilization. This survey aimed to identify the barriers faced by rehabilitation professionals in utilizing CPGs for post-stroke motor rehabilitation. A cross-sectional survey based on the Australian Living Guidelines for Stroke Rehabilitation was developed to identify factors that influence healthcare professionals' adherence to clinical practice guidelines. The survey comprised 50 questions spanning five domains: demographics, work practices, rehabilitation techniques, clinical practice awareness, and CPG feasibility and implementation. A panel of 10 experts validated the questionnaire. The survey was disseminated via emails, through professional associations, and platforms such as WhatsApp, LinkedIn, and X (formerly Twitter). Quantitative analysis data were analysed using Jamovi 2.3.21. The results indicated that less experienced professionals were more likely to implement CPGs, utilize telerehabilitation, and follow transition care protocols, while experienced practitioners adhered to both CPGs and hospital guidelines and employed motor outcome measures. Identified barriers included limited awareness, insufficient training, resource constraints, and challenges related to language and cultural relevance. To enhance CPG implementation, it is necessary to develop context-specific CPGs, establish stepwise clinical protocols, integrate evidence-based practice and CPG training into university curricula, and increase awareness among policymakers and stroke survivors. Engaging diverse stakeholders-patients, caregivers, multidisciplinary teams, and policymakers-is essential to foster an enabling environment for CPG adoption and advancing stroke rehabilitation practices in LMICs.

Scientific ReportsVol. 15(1)
Manchester Metropolitan University (GB), Universidade Federal do Rio Grande do Sul (BR), University of Leicester (GB), Manipal Academy of Higher Education (IN), University of Calgary (CA), Christian Medical College, Vellore (IN), University of Bamenda (CM), Northumbria University (GB), University of Oxford (GB), Bamenda University of Science and Technology (CM), University of Rwanda (RW), Christian Medical College (IN), Cameroon Baptist Convention Health Services (CM), Swami Vivekanand College of Pharmacy (IN), Sarah Network of Rehabilitation Hospitals (BR), St.John's Medical College Hospital (IN), Indian Institute of Public Health Gandhinagar (IN), Kasturba Medical College, Mangalore (IN), K J Somaiya Medical College (IN), Kasturba Medical College, Manipal (IN), University of Newcastle Australia (AU), University of Rio Grande and Rio Grande Community College (US), McMaster University (CA)
Openalex Percentile: Top 51%
Clinical practice guidelines implementation
DOIOpen Access PDFOpenAlex
AI Navigator

Ask Laika to Summarize, Analyze, and Connect papers live on the map.

Summarize Papers & Methodologies

Extract key findings, datasets, and comparative methods across publications.

Benchmark Rankings & Visual Analytics

Rank top research institutions, authors, funders, topics, and journals by Field-Weighted Citation Impact (FWCI) and paper volume with instant charts.

Connect Distant Disciplines

Bridge topological clusters on the map to find hidden collaborative intersections.