Availability and content analysis of post-stroke rehabilitation guidelines in Latin America: A systematic review

Post-stroke rehabilitation is vital for functional recovery and social reintegration. However, access to evidence-based rehabilitation services across Latin America remains inconsistent. Clinical practice guidelines support standardised care and equity, yet the extent and quality of such guidelines in the Latin American regoin are uncertain. This study aims to identify national post-stroke rehabilitation guidelines in Latin American countries and assess their scope and methodological quality, benchmarking them against the 2023 World Stroke Organization recommendations.

We conducted a systematic review of international and regional databases and governmental websites from Latin American countries to identify national post-stroke rehabilitation guidelines. Content was benchmarked against World Stroke Organization 2023 recommendations, and methodological quality was assessed using the AGREE II instrument.

Of the 888 identified records, 9 guidelines were included from Argentina, Bolivia, Brazil, Chile, Colombia, Guatemala, Mexico, Peru, and Uruguay. Core rehabilitation recommendations were generally included; however, domains such as palliative care, management of mood and cognitive disorders, and community-based rehabilitation were insufficiently covered. The median overall AGREE II score was 58% (IQR 50-71%). The lowest scores were observed in "rigour of development" (36%) and "applicability" (10%). Colombia, Mexico, and Uruguay demonstrated comparatively higher methodological robustness.

Few Latin American countries have national stroke rehabilitation guidelines, and available documents vary in completeness and methodological quality. Key content areas-including palliative care, psychosocial management, and data-collection systems-remain underdeveloped. Strengthening and expanding context-appropriate, evidence-based rehabilitation guidelines is essential to enhance equity and improve post-stroke outcomes across Latin American countries.