Activities of daily living interventions on activity performance of inpatients post-stroke: A systematic review and meta-analysis

Abstract

Introduction: Inpatient rehabilitation is the best time window to improve patient performance post-stroke. Little is known about the type and effectiveness of activity interventions. This study aims to review activities of daily living interventions and evaluate their effectiveness on activity performance for stroke inpatients.

Method: MEDLINE, Embase, CINAHL and Web of Science were searched. Randomised controlled trials investigating the effects of activities of daily living interventions for stroke inpatients were included. Two reviewers independently selected the studies and extracted data. Meta-analysis was conducted on relevant data with a random effect model with 95% CI.

Results: Fourteen randomised controlled trials involving 602 stroke inpatients, were included. Both experimental and control groups offered activities of daily living interventions. Thirteen experimental groups offered added components, such as imagery and repetitive practice. Five studies reported significant improvement in activity performance within experimental and control groups. A meta-analysis of 12 randomised controlled trials with 512 participants revealed non-significant results for activity performance between the two groups.

Conclusion: Both experimental and control groups in the included studies provided activities of daily living interventions. Added components were included in 13 out of 14 experimental groups. Meta-analysis revealed no significant difference between the two groups as they both offered activities of daily living interventions.

Keywords: Activities of daily living; activity performance; inpatient rehabilitation; stroke.

Figure 1.

PRISMA flow diagram (Moher et al., 2009).

Figure 2.

(a) Forest plots for experimental interventions measuring BADL. (b) Forest plots for experimental interventions measuring IADL. (c) Forest plots for experimental interventions measuring quality of life. (d) Forest plots for experimental interventions measuring Motor Function. BADL: basic activities of daily living; IADL: instrumental activities of daily living; RE, random effects.