Neurorehabilitation Clinical Pathways in Stroke: The Padova Model

BACKGROUND: The rising prevalence of neurological disabilities underscores the need for neurorehabilitation units grounded in evidence-based medicine. However, a gap persists between available evidence and its consistent implementation in clinical practice. In this study, we present the experience of a single tertiary medical center and propose a structured, evidence-based framework for stroke neurorehabilitation aimed at standardizing care and improving functional outcomes. METHODS: An iterative consensus process adapted from the modified Delphi Panel methodology was conducted. A multidisciplinary panel of clinicians and experts in stroke and neurorehabilitation reviewed evidence-based guidelines addressing upper limb rehabilitation, gait and balance, cognitive rehabilitation, speech and language therapy, and dysphagia. Guidelines were identified through systematic searches of databases, professional society websites, and reference lists, and appraised using the AGREE II instrument by three independent evaluators. Consensus was achieved through remote feedback rounds and structured in-person meetings between November 2023 and March 2024. Agreement was defined as ≥75% panel consensus. RESULTS: Fifty-two guidelines were identified; eight were excluded due to low methodological quality (AGREE II score