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Meta-Analysis
. 2008 Apr 16;2008(2):CD005952.
doi: 10.1002/14651858.CD005952.pub2.

Therapy-based rehabilitation services for patients living at home more than one year after stroke

N A Aziz  1 , J Leonardi-Bee, M Phillips, J R F Gladman, L Legg, M F Walker
Affiliations
Meta-Analysis

Therapy-based rehabilitation services for patients living at home more than one year after stroke

N A Aziz et al. Cochrane Database Syst Rev. .

Abstract

Background: Current practice of rehabilitation intervention mainly concentrates on the first six months of stroke. At present, there is no agreed consensus about the benefits of such a service more than one year after stroke.

Objectives: To ascertain whether therapy-based rehabilitation services can influence outcome one year or more after stroke.

Search strategy: We searched the trials registers of the following Cochrane Review Groups: Stroke Group (last searched September 2007), Effective Practice and Organisation of Care Group (last searched October 2006) and Dementia and Cognitive Improvement Group (last searched October 2006). We also searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 4, 2006), MEDLINE (1966 to October 2006), EMBASE (1980 to October 2006), CINAHL (1982 to October 2006), AMED (1985 to October 2006), PEDro (1952 to October 2006), British Nursing Index (1993 to October 2006), DARE (1994 to October 2006), HMIC (1979 to October 2006) and NHS EED (1991 to October 2006). We also searched dissertation databases and ongoing trials and research registers, scanned reference lists and contacted researchers and experts in the field.

Selection criteria: All randomised controlled trials of community-based stroke patients, in which at least 75% were recruited one year after stroke and received a therapy-based rehabilitation intervention that was compared with conventional care.

Data collection and analysis: Two review authors independently selected trials and extracted data on a number of pre-specified outcomes. The primary outcomes were the proportion of participants who had deteriorated or were dependent in personal activities of daily living at the end of scheduled follow up.

Main results: We identified five trials of 487 participants that were eligible for the review. Overall, there was inconclusive evidence as to whether therapy-based rehabilitation intervention one year after stroke was able to influence any relevant patient or carer outcome. Trials varied in design, type of interventions provided, quality, and outcomes assessed.

Authors' conclusions: This review highlights the dearth of evidence investigating long-term therapy-based rehabilitation interventions for patients with stroke.

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Conflict of interest statement

None known

Figures

1.1
1.1. Analysis
Comparison 1 Performance in personal activities of daily living, Outcome 1 Barthel Index.
2.1
2.1. Analysis
Comparison 2 Case fatality at the end of follow up, Outcome 1 Case fatality at the end of follow up.
3.1
3.1. Analysis
Comparison 3 Patient's performance in extended activities of daily living by the end of scheduled follow up, Outcome 1 Patient's performance in activities of daily living (Frenchay Activities Index).
3.2
3.2. Analysis
Comparison 3 Patient's performance in extended activities of daily living by the end of scheduled follow up, Outcome 2 Patient's performance in activities of daily living (Nottingham EADL).
4.1
4.1. Analysis
Comparison 4 Patient's subjective health status at the end of scheduled follow up, Outcome 1 Sickness Index Profile.
5.1
5.1. Analysis
Comparison 5 Patient's mood at the end of scheduled follow up, Outcome 1 Patient's mood at the end of scheduled follow up.
6.1
6.1. Analysis
Comparison 6 Carer's mood at the end of scheduled follow up, Outcome 1 Carer's mood at the end of scheduled follow up.
See this image and copyright information in PMC

Update of

References

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