Content and Effectiveness of Community-Based Rehabilitation on Quality of Life in People Post Stroke: a Systematic Review with Meta-Analysis
Purpose: The study aimed to review the content and evaluate the effects of CBR on quality of life (QoL), balance, and walking capacity for people post stroke, compared to other rehabilitation protocols or no care.
Methods: A systematic search and meta-analysis of clinical trials of CBR interventions for stroke survivors was conducted. Five online electronic databases (MEDLINE/PubMed, Web of sciences, Scopus, Hinari, and Pedro) were searched for articles published in English and French languages, from inception up to December 2021. Sixteen studies were included that reported on QoL outcomes from CBR interventions involving 1755 adults post stroke.
Results: The different CBR interventions that were selected were grouped into three clusters: a) exercise programmes, b) task-oriented training, and c) educational and taking-charge programmes. CBR interventions were more effective than other rehabilitation protocols (SMD=0.16[0.02, 0.30], P=0.03, I2 =40%) on QoL for people with chronic stroke. The effects of interventions on walking capacity and balance demonstrated non-significant difference (SMD=0.31[-0.02, 0.64], P=0.06, I2 =88%, and SMD= 0.20[-0.12, 0.53], P=0.22, I2 =68%, respectively).
Conclusion: Current data indicates that CBR can be used in many forms or in combinations to benefit people with chronic stroke. Also, CBR is as effective as other rehabilitative protocols on walking capacity and balance, while being more effective than institution-based rehabilitation or no care, in improving quality of life which is a well-recognised goal in the rehabilitation of people with chronic stroke.
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