Using knowledge translation interventions to move stroke rehabilitation research into clinical practice: A systematic review and meta-analysis

Background: Implementation of interventions designed to bridge the evidence-to-practice gap in stroke rehabilitation are inconsistent across clinical contexts. Diverse interventions have produced limited actionable recommendations.
Objective: To evaluate the effectiveness of recently published interventions that implement evidence into stroke rehabilitation practice, focusing on clinician practice changes and patient outcomes.
Methods: In this updated review, we comprehensively searched EMBASE, CINAHL, Cochrane and MEDLINE databases from April 2019 to December 2025. We included randomized controlled trials involving clinicians working in stroke rehabilitation and reporting changes in clinician practice behaviour, patient outcomes, or both. Data describing intervention strategies, and patient outcomes were extracted and tabulated. Domain-specific subgroup analyses were also conducted to generate pooled effect estimates.
Results: Of the 1225 unique studies screened, 39 were reviewed in full text, with 25 included in the quantitative synthesis. Certainty of evidence ranged from very low to high and downgraded due to inconsistency or indirectness. Certainty was hi􀀲h for short-term mortality, moderate-to-severe disability, and stroke recurrence, moderate for quality of life and systolic blood pressure; and very low to low for functional outcomes and length of stay. Risk of bias showed that while randomization was consistently low risk, deviations from the intended intervention represented the primary source of high risk. Meta­analyses showed significant improvements in systolic blood pressure (MD=-2.28 mmHg, 95%CI: -2.87 to -1.68) and quality of life (SMD=0.058, 95%CI: 0.022 to 0.093). However, no statistically significant benefits were found for short or long-term mortality, disability, length of stay, or stroke recurrence.
Conclusion: Multifaceted and digital knowledge translation strategies can successfully improve guideline adherence and specific clinical markers during stroke rehabilitation. While these findings support their utility, benefits across all functional and survival outcomes were inconsistent. Further research is needed to determine how to best leverage these platforms to benefit people with stroke.