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Standardized tools for assessing balance and mobility in stroke clinical practice guidelines worldwide: a scoping review

Background: Use of standardized tools to assess balance and mobility limitations is a recommended practice in stroke rehabilitation. The extent to which clinical practice guidelines (CPGs) for stroke rehabilitation recommend specific tools and provide resources to support their implementation is unk...

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Published: 2023
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LEADER 00000njm a2000000a 4500
001 oai:repository.ui.edu.ng:123456789/13172
042 |a dc 
720 |a Barbosa dos Santos, R.  |e author 
720 |a Fiedler A.  |e author 
720 |a Badwal A.  |e author 
720 |a Legasto-Mulvale J. M.  |e author 
720 |a Sibley, K. M.  |e author 
720 |a Olaleye, O. A.  |e author 
720 |a Diermayr, D.  |e author 
720 |a Salbach, N. M.  |e author 
260 |c 2023 
520 |a Background: Use of standardized tools to assess balance and mobility limitations is a recommended practice in stroke rehabilitation. The extent to which clinical practice guidelines (CPGs) for stroke rehabilitation recommend specific tools and provide resources to support their implementation is unknown. Purpose: To identify and describe standardized, performance-based tools for assessing balance and/or mobility and describe postural control components challenged, the approach used to select tools, and resources provided for clinical implementation, in CPGs for stroke. Methods: A scoping review was conducted. We included CPGs with recommendations on the delivery of stroke rehabilitation to address balance and mobility limitations. We searched seven electronic databases and grey literature. Pairs of reviewers reviewed abstracts and full texts in duplicate. We abstracted data about CPGs, standardized assessment tools, the approach for tool selection, and resources. Experts identified postural control components challenged by each tool. Results: Of the 19 CPGs included in the review, 7 (37%) and 12 (63%) were from middle and high-income countries, respectively. Ten CPGs (53%) recommended or suggested 27 unique tools. Across 10 CPGs, the most commonly cited tools were the Berg Balance Scale (BBS) (90%), 6-Minute Walk Test (6MWT) (80%), Timed Up and Go Test (80%) and 10-Meter Walk Test (70%). The tool most frequently cited in middle- and high-income countries was the BBS (3/3 CPGs), and 6MWT (7/7 CPGs), respectively. Across 27 tools, the three components of postural control most frequently challenged were underlying motor systems (100%), anticipatory postural control (96%), and dynamic stability (85%). Five CPGs provided information in varying detail on how tools were selected; only 1 CPG provided a level of recommendation. Seven CPGs provided resources to support clinical implementation; one CPG from a middle-income country included a resource available in a CPG from a high-income country. Conclusion: CPGs for stroke rehabilitation do not consistently provide recommendations for standardized tools to assess balance and mobility or resources to facilitate clinical application. Reporting of processes for tool selection and recommendation is inadequate. Review findings can be used to inform global efforts to develop and translate recommendations and resources for using standardized tools to assess balance and mobility post-stroke. 
024 8 |a 2673-6861 
024 8 |a ui_art_barbosa-dos-santos_standardized_2023 
024 8 |a Frontiers in Rehabilitation Sciences 4, pp. 1-19 
024 8 |a https://repository.ui.edu.ng/handle/123456789/13172 
653 |a Stroke rehabilitation 
653 |a Balance 
653 |a mobility 
653 |a Clinical practice guideline 
653 |a Standardized assessment tools 
653 |a Implementation resources 
653 |a Country income 
245 0 0 |a Standardized tools for assessing balance and mobility in stroke clinical practice guidelines worldwide: a scoping review