{
  "abstract": "BackgroundClinical practice guidelines provide evidence-based recommendations for stroke rehabilitation, but the extent to which guideline-concordant care is delivered in routine practice remains uncertain. The goal of this study was to estimate the pooled rate of patient- or chart-level delivery of selected guideline-based care processes in adult stroke rehabilitation.MethodsA systematic review and meta-analysis was conducted to identify studies reporting patient-, chart-, or care-episode-level adherence to guideline-recommended stroke rehabilitation care. Eligible studies included adults with stroke and reported extractable numerator/denominator data for at least one rehabilitation-relevant guideline-concordant care process.ResultsSix studies were included in the quantitative synthesis, contributing a combined denominator of 547 patients or patient charts. The included studies assessed overall physical therapy adherence, cognitive screening, depression screening, sexuality-related rehabilitation, community rehabilitation contact, and aerobic-intensity therapy. The six studies evaluated distinct care processes in different rehabilitation settings. Individual adherence estimates ranged from 0.0% to 82.9%. The pooled adherence rate was 35.6% (95% CI: 11.0%-71.3%). Heterogeneity was substantial (τ2 = 3.21; I2 = 97.6%; Q(5) = 136.46, p < 0.001), showing marked variation in rehabilitation domains, settings, and adherence definitions.ConclusionPatient-level adherence to guideline-concordant stroke rehabilitation care appears suboptimal and highly heterogeneous. Given the substantial clinical and construct heterogeneity, the pooled estimate has limited clinical interpretability and primarily provides a descriptive summary of the included care-process measures. These findings highlight persistent evidence-practice gaps in stroke rehabilitation and support the need for targeted implementation strategies, routine audit, and domain-specific quality improvement.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420261405899, PROSPERO CRD420261405899.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Physical Therapy, College of Medical Rehabilitation Sciences, Taibah University, Madinah, Saudi Arabia",
    "King Salman Center for Disability Research, Riyadh, Saudi Arabia",
    "Department of Health Rehabilitation, College of Applied Medical Sciences at Shaqra, Shaqra University, Shaqra, Saudi Arabia"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 3,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Marwan M. A. Aljohani"
    },
    {
      "affs": [
        1
      ],
      "name": "Marwan M. A. Aljohani"
    },
    {
      "affs": [
        2
      ],
      "name": "Abdullah Ibrahim Alhusayni"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/5914wpsdt9bm9.bib",
  "cited_by": 0,
  "doi": "10.3389/fmed.2026.1963143",
  "fulltext_url": "https://www.frontiersin.org/articles/10.3389/fmed.2026.1963143/full",
  "id": "5914wpsdt9bm9",
  "issns": [
    "2296-858X"
  ],
  "landing_url": "https://doi.org/10.3389/fmed.2026.1963143",
  "language": "en",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "R5-920"
    ],
    [
      "openalex",
      "2739|Clinical practice guidelines implementation"
    ]
  ],
  "openalex": "W7223917149",
  "pdf_url": "https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2026.1963143/pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-27",
  "publisher": "Frontiers Media S.A.",
  "ris": "https://research.draconitic.com/paper/5914wpsdt9bm9.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T14:21:51Z",
      "native_id": "0ba90a13d5d747369ceb2629b28ec55a",
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      "url": "https://doi.org/10.3389/fmed.2026.1963143"
    }
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2739|Clinical practice guidelines implementation",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Delivery of selected guideline-based care processes in adult stroke rehabilitation: a systematic review and meta-analysis",
  "title_text": "Delivery of selected guideline-based care processes in adult stroke rehabilitation: a systematic review and meta-analysis",
  "type": "peer-reviewed",
  "updated_at": "2026-10-31T14:21:51Z",
  "url": "https://research.draconitic.com/paper/5914wpsdt9bm9",
  "venue": "Frontiers in Medicine",
  "versions": []
}