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Meta-Analysis
. 2025 Oct;39(10):1277-1295.
doi: 10.1177/02692155251362735. Epub 2025 Aug 12.

Effectiveness of interventions in increasing physical activity of inpatients after stroke: A systematic review and meta-analysis

Peter Hartley  1   2 , Katie Bond  1 , Rachel Dance  3 , Isla Kuhn  4 , Joanne McPeake  2 , Faye Forsyth  5   6   7
Affiliations
Meta-Analysis

Effectiveness of interventions in increasing physical activity of inpatients after stroke: A systematic review and meta-analysis

Peter Hartley et al. Clin Rehabil. 2025 Oct.

Abstract

ObjectiveTo synthesise the evidence of the effectiveness of interventions to increase levels of physical activity or reduce levels of sedentary activity of inpatients after a new stroke.Data sourcesMedline, PsychINFO, AMED and CINAHL were search between inception and June 2025 for randomised controlled studies of in-hospital interventions for adults after stroke which measured physical activity.Review methodsInterventions were grouped by common components. For each intervention group, the outcomes of physical activity (primary outcome), physical functional ability, and quality of life were analysed with meta-analysis. Adverse events were synthesised narratively.ResultsTen studies (696 participants) were included in the review. General activity feedback (SMD = 0.52, 95% CI: -0.07 to 1.10; I2 = 76.7%, 4 trials, n = 272) and additional physiotherapy (SMD = 0.89, 95% CI: -0.02 to 0.99; I2 = 94.2%, 4 trials, n = 246) may result in moderate to large increases of in-hospital physical activity (very low certainty). Patient-directed activity programmes (one study) may have no effect on physical activity (low certainty). Upper-limb activity feedback (one study) may increase upper-limb activity (very low certainty).The evidence regarding the secondary outcomes demonstrated no effect (very low to moderate certainty), with the exception that additional physiotherapy may increase the risk of falls (low certainty).ConclusionsInterventions incorporating activity feedback or additional physiotherapy are promising, but further evidence is required for all interventions to increase the certainty in their estimates of effect.PROSPERO ID: CRD42024611456.

Keywords: Stroke; hospital; meta-analysis; physical activity; systematic review.

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Conflict of interest statement

Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Study flow diagram.
Figure 2.
Figure 2.
Meta-analysis of the effect of activity feedback on physical activity (walking and sitting to standing transitions).
Figure 3.
Figure 3.
Meta-analysis of the effect of general activity feedback on physical functional ability (walking speed m/s).
Figure 4.
Figure 4.
Meta-analysis of the effect additional physiotherapy on physical activity (step count, standing activity and sitting to standing transitions).
Figure 5.
Figure 5.
Meta-analysis of the effect additional physiotherapy on physical functional ability.
See this image and copyright information in PMC

References

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