Effect of community-based rehabilitation on activities of daily living in stroke survivors: A systematic review and meta-analysis

Abstract

Many studies have introduced various types of community-based rehabilitation (CBR) for stroke rehabilitation, but the effects and evidence on activities of daily living are still unclear. The purpose of this study was to conduct a systematic review and meta-analysis to investigate the effect of CBR on activities of daily living (ADL) in stroke survivors. The methodological quality of the included randomized controlled trials was assessed using the Physiotherapy Evidence Database (PEDro) scale. A total of ten studies were included. Qualitative data related to participants, community-based rehabilitation program, measured outcomes ADL, and follow-up were extracted. PEDro scale showed one fair-quality and nine high-quality studies. The overall effect size of CBR on ADL in stroke survivors is a large effect size (ES = 0.999; CI = 0.346∼1.651), moderating variable was the frequency of intervention (more than 20, Qb = 6.363, p<.05), and moderating variable was the age of participants (60's or younger, Qb = 5.844, p<.05). CBR demonstrated a large effect size when the intervention spanned 20 or more sessions and participants were under the age of 60. While these findings can assist clinicians and rehabilitation specialists in designing evidence-based CBR programs to optimize activities of daily living for stroke survivors, they should be regarded as exploratory factors based on visualized graphs and weighted data analysis rather than definitive conclusions.