Contextualised evidence-based rehabilitation recommendations to optimise function in African people with stroke

Quinette Louw, Janine Dizon, Sjan-Marie van Niekerk, Dawn Ernstzen, Karen Grimmer

Research output: Chapter in Book/Report/Conference proceedingChapterpeer-review

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Background: The identification, contextualisation and uptake of evidence-based stroke rehabilitation strategies are important to optimise the patient and healthcare system outcomes.

Aim: This chapter aims to report on the innovative methods used to produce the SA-cSRG 2017–2018 (2019) and summarises the evidence-based recommendations for implementation in the African context.

Methods: The methodology consisted of eight steps: ask clinically relevant questions; acquire evidence; appraise the evidence; extract the evidence; extracting data; grade the evidence level; endorsement and stakeholder feedback. The quality of the included component guidelines, which answered these questions, was scored using the Appraisal of Guidelines Research and Evaluation, Version II (AGREE II). The extracted
recommendations were graded according to a standardised strength of the body of evidence (SoBE) method. The recommendations were then contextualised to the local context based on stakeholder input.

Findings: Seventy-eight composite recommendations were developed. Twenty-three (29%) recommendations were supported by strong evidence. Thirty-six recommendations were supported by moderate evidence (46%) and 19 recommendations were supported by low levels of evidence, no evidence or contradictory evidence.

Conclusion: This chapter outlines steps undertaken to contextualise recommendations to the African setting. These steps provide a blueprint for future guideline writers in LMIC settings to efficiently produce evidence-based guidance for other conditions that can be implemented despite local barriers to evidence uptake.
Original languageEnglish
Title of host publicationCollaborative capacity development to complement stroke rehabilitation in Africa
EditorsQuinette Louw
PublisherAOSIS Publishing
Number of pages32
ISBN (Electronic)978-1-928523-87-1, 978-1-928523-86-4
ISBN (Print)978-1-928523-85-7
Publication statusPublished - 2020
Externally publishedYes

Publication series

NameHuman Functioning, Technology and Health


  • Evidence-based
  • Rehabilitation
  • Africa
  • Contextual barriers
  • Service performance
  • Evidence levels
  • Recommendations


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