Neurorehabilitation Clinical Pathways in Stroke: The Padova Model

Area of Science:

• Neuroscience and Rehabilitation Medicine
• Clinical Practice Guidelines
• Evidence-Based Medicine Implementation

Background:

• Rising prevalence of neurological disabilities necessitates evidence-based neurorehabilitation.
• A gap exists between current evidence and clinical practice in neurorehabilitation.
• This study addresses the need for standardized stroke neurorehabilitation care.

Purpose of the Study:

• To propose a structured, evidence-based framework for stroke neurorehabilitation.
• To standardize care and improve functional outcomes in neurorehabilitation units.
• To bridge the gap between evidence and clinical implementation in stroke recovery.

Main Methods:

• Utilized a modified Delphi Panel methodology with a multidisciplinary expert panel.
• Systematically searched and appraised evidence-based guidelines for stroke rehabilitation domains.
• Achieved consensus through iterative feedback rounds and in-person meetings (Nov 2023 - Mar 2024).

Main Results:

• Identified and appraised 52 guidelines, excluding 8 due to low quality.
• Reached consensus on assessment tools and interventions across upper limb, gait, balance, cognitive, speech, and dysphagia rehabilitation.
• Developed a framework stratifying interventions by behavioral deficits and impairment severity, aligned with the ICF.

Conclusions:

• A structured, multidisciplinary consensus approach yielded evidence-based neurorehabilitation pathways.
• The framework offers a reproducible model for translating guideline evidence into standardized inpatient practice.
• This approach has the potential to optimize functional outcomes and quality of life for individuals with neurological disabilities.