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Systematic Review and Meta-Analysis of Home-Based Rehabilitation on Improving Physical Function Among Home-Dwelling Patients With a Stroke

Published:November 02, 2019DOI:https://doi.org/10.1016/j.apmr.2019.10.181

      Abstract

      Objective

      To evaluate the effects of home-based rehabilitation on improving physical function in home-dwelling patients after a stroke.

      Data Sources

      Various electronic databases, including PubMed, Cumulative Index to Nursing and Allied Health, Embase, the Cochrane Central Register of Controlled Trials, and 2 Chinese data sets (ie, Chinese Electronic Periodical Services and China Knowledge Resource Integrated) were searched for studies published before March 20, 2019.

      Study Selection

      Randomized controlled trials conducted to examine the effect of home-based rehabilitation on improving physical function in home-dwelling patients with a stroke and published in English or Chinese were included. In total, 49 articles in English (n=23) and Chinese (n=26) met the inclusion criteria.

      Data Extraction

      Data related to patient characteristics, study characteristics, intervention details, and outcomes were extracted by 2 independent reviewers.

      Data Synthesis

      A random-effects model with a sensitivity analysis showed that home-based rehabilitation exerted moderate improvements on physical function in home-dwelling patients with a stroke (g=0.58; 95% CI, 0.45∼0.70). Moderator analyses revealed that those patients with stroke of a younger age, of male sex, with a first-ever stroke episode, in the acute stage, and receiving rehabilitation training from their caregiver showed greater improvements in physical function.

      Conclusions

      Home rehabilitation can improve functional outcome in survivors of stroke and should be considered appropriate during discharge planning if continuation care is required.

      Keywords

      List of abbreviations:

      ADL (activities of daily living), BI (Barthel Index), ES (effect size), FIM (functional independence measure), MBI (Modified Barthel Index), OT (occupational therapy), PT (physiotherapy), RCT (randomized controlled trial)
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