Systematic review of hospital-based interventions to improve post-stroke independence in activities of daily living

IF 2.1 4区医学 Q2 REHABILITATION

Australian Occupational Therapy Journal Pub Date : 2026-08-20 DOI:10.1111/1440-1630.70119

Tayla Grant, Kylie Wales, Laura Jolliffe, Emma J. Schneider, Jade Glascott, Danielle Sansonetti, Avril E. Drummond, Natasha A. Lannin

{"title":"Systematic review of hospital-based interventions to improve post-stroke independence in activities of daily living","authors":"Tayla Grant, Kylie Wales, Laura Jolliffe, Emma J. Schneider, Jade Glascott, Danielle Sansonetti, Avril E. Drummond, Natasha A. Lannin","doi":"10.1111/1440-1630.70119","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Introduction</h3>\n \n <p>Early after stroke, inpatients commonly experience difficulty performing activities of daily living (ADL). Occupational therapists are key to providing early rehabilitation to optimise recovery. However, the effectiveness of early, activity-based retraining of ADLs is not clear. The aim of this systematic scoping review is to determine whether activity-based retraining targeting basic activities of daily living (b-ADL) and/or simple cognitive instrumental activities of daily living (C-IADL) delivered early after stroke improves functional independence.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>MEDLINE, CINAHL, and Embase were searched. Eligible studies included randomised controlled trials or quasi-randomised trials, with at least 75% of participants over the age of 18, with a stroke diagnosis, and who received activity-based interventions within the hospital setting. Articles were screened by two authors using Covidence. Risk of bias was assessed using Cochrane's Risk of Bias tool (RoB2). All results were meta-analysed using Comprehensive Meta Analysis software (V4.0).</p>\n </section>\n \n <section>\n \n <h3> Consumer and community involvement</h3>\n \n <p>No consumer or community involvement was included in this study.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>A total of 7546 articles were screened, and six studies including n = 254 participants met the inclusion criteria. Performance outcome measure results were meta-analysed; there was no statistically significant impact of activity-based interventions on functional performance (standardised mean difference [SMD] = 0.41; 95% confidence interval [CI] −0.06, 0.87; P = 0.09). Two studies reviewed quality of life and satisfaction outcomes; data were not synthesised.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Whereas individual trials suggested improvements early after activity-based training, our meta-analysis showed variability in effects in trials to date. Further research is required to determine the clinical and cost-effectiveness of activity-based interventions within the hospital setting to guide occupational therapy practice.</p>\n </section>\n </div>","PeriodicalId":55418,"journal":{"name":"Australian Occupational Therapy Journal","volume":"73 4","pages":""},"PeriodicalIF":2.1000,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1440-1630.70119","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Australian Occupational Therapy Journal","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/1440-1630.70119","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"REHABILITATION","Score":null,"Total":0}

引用次数: 0

Abstract

Introduction

Early after stroke, inpatients commonly experience difficulty performing activities of daily living (ADL). Occupational therapists are key to providing early rehabilitation to optimise recovery. However, the effectiveness of early, activity-based retraining of ADLs is not clear. The aim of this systematic scoping review is to determine whether activity-based retraining targeting basic activities of daily living (b-ADL) and/or simple cognitive instrumental activities of daily living (C-IADL) delivered early after stroke improves functional independence.

Methods

MEDLINE, CINAHL, and Embase were searched. Eligible studies included randomised controlled trials or quasi-randomised trials, with at least 75% of participants over the age of 18, with a stroke diagnosis, and who received activity-based interventions within the hospital setting. Articles were screened by two authors using Covidence. Risk of bias was assessed using Cochrane's Risk of Bias tool (RoB2). All results were meta-analysed using Comprehensive Meta Analysis software (V4.0).

Consumer and community involvement

No consumer or community involvement was included in this study.

Results

A total of 7546 articles were screened, and six studies including n = 254 participants met the inclusion criteria. Performance outcome measure results were meta-analysed; there was no statistically significant impact of activity-based interventions on functional performance (standardised mean difference [SMD] = 0.41; 95% confidence interval [CI] −0.06, 0.87; P = 0.09). Two studies reviewed quality of life and satisfaction outcomes; data were not synthesised.

Conclusion

Whereas individual trials suggested improvements early after activity-based training, our meta-analysis showed variability in effects in trials to date. Further research is required to determine the clinical and cost-effectiveness of activity-based interventions within the hospital setting to guide occupational therapy practice.

查看原文本刊更多论文

以医院为基础的干预措施改善中风后日常生活活动的独立性的系统评价

卒中后早期，住院患者通常难以进行日常生活活动（ADL）。职业治疗师是提供早期康复以优化恢复的关键。然而，早期基于活动的adl再训练的有效性尚不清楚。本系统综述的目的是确定卒中后早期进行以基本日常生活活动（b-ADL）和/或简单认知工具日常生活活动（C-IADL）为目标的基于活动的再训练是否能改善功能独立性。方法检索MEDLINE、CINAHL和Embase。符合条件的研究包括随机对照试验或准随机试验，至少75%的参与者年龄在18岁以上，有中风诊断，并在医院内接受了基于活动的干预。文章由两位作者使用covid - ence进行筛选。使用Cochrane风险偏倚工具（RoB2）评估偏倚风险。使用综合Meta分析软件（V4.0）对所有结果进行Meta分析。消费者和社区参与本研究不包括消费者或社区参与。结果共筛选到7546篇文献，6项研究（n = 254名受试者）符合纳入标准。对绩效结果测量结果进行meta分析；以活动为基础的干预对功能表现没有统计学上的显著影响（标准化平均差[SMD] = 0.41； 95%可信区间[CI] - 0.06, 0.87; P = 0.09）。两项研究回顾了生活质量和满意度结果；数据没有合成。结论：尽管个别试验表明基于活动的训练后早期有所改善，但我们的荟萃分析显示迄今为止试验的效果存在差异。需要进一步的研究来确定医院环境中以活动为基础的干预措施的临床和成本效益，以指导职业治疗实践。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Australian Occupational Therapy Journal 医学-康复医学

CiteScore

2.80

自引率

16.70%

发文量

审稿时长

6-12 weeks

期刊介绍： The Australian Occupational Therapy Journal is a leading international peer reviewed publication presenting influential, high quality innovative scholarship and research relevant to occupational therapy. The aim of the journal is to be a leader in the dissemination of scholarship and evidence to substantiate, influence and shape policy and occupational therapy practice locally and globally. The journal publishes empirical studies, theoretical papers, and reviews. Preference will be given to manuscripts that have a sound theoretical basis, methodological rigour with sufficient scope and scale to make important new contributions to the occupational therapy body of knowledge. AOTJ does not publish protocols for any study design The journal will consider multidisciplinary or interprofessional studies that include occupational therapy, occupational therapists or occupational therapy students, so long as ‘key points’ highlight the specific implications for occupational therapy, occupational therapists and/or occupational therapy students and/or consumers.