Self-rehabilitation for post-stroke motor recovery and activity

Background: Due to rises in stroke incidence, a lack of resources to implement effective rehabilitation and a significant proportion of patients with remaining impairments after treatment, there is an increased demand for effective and prolonged rehabilitation. Development of self-rehabilitation programs provides an opportunity to meet these increasing demands. Objective: The primary aim of this meta-analysis was to determine the motor outcome effectiveness of self-rehabilitation in comparison to conventional rehabilitation among patients with stroke. The secondary aim was to assess the influence of trial location (continent), technology, time since stroke (acute/subacute vs chronic), dose (total training duration > vs ≤ 15 hours) and intervention design (self-rehabilitation in addition/substitution to conventional therapy) on effectiveness. Methods: Studies were selected if participants were adults with stroke; the intervention consisted of a self-rehabilitation program defined as a tailored program where for most of the time, the patient performed rehabilitation exercises independently; the control group received conventional therapy; outcomes included motor function and activity; and the study was a randomized controlled trial with a PEDro score ≥ 5. Results: Thirty-five trials were selected (2225 participants) and accumulated motor outcome data analysed. Trials had a median PEDro Score of 7 [6-8]. Self-rehabilitation programs were shown to be as effective as conventional therapy. Trial location, use of technology, stroke stage and intervention design did not appear to have a significant influence on outcomes. Conclusion: This meta-analysis showed low to moderate certainty of evidence that self-rehabilitation and conventional therapy efficacy was equally valuable for post-stroke motor function and activity.

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Everard, G., Luc, A., Doumas, I., Ajana, K., Stoquart, G., Edwards, M., & Lejeune, T. (2021). Self-rehabilitation for post-stroke motor recovery and activity. Virtual International Society of Physical and Rehabilitation Medicine (ISPRM) 2021 Congress, Virtual. https://hdl.handle.net/2078.5/215672