Interventions used by allied health professionals in sexual rehabilitation after stroke: A systematic review

Abstract

Word count: 249 Background: Although sexuality can be affected post-stroke, few individuals receive sexual rehabilitation because of clinicians' lack of knowledge regarding evidence-based interventions. Objective: To document and describe the best available evidence supporting interventions that target post-stroke rehabilitation of sexuality. Methods: This systematic review searched the databases Medline, Embase, Psycinfo, CINAHL, Web of science, PEDRO and OTSeeker up to May 29, 2020. Inclusion criteria were: published studies with a sample composed of ≥ 50% stroke clients and describing an intervention that could be applied by an allied health professional. Data was extracted according to the PRISMA guidelines by two independent reviewers. Interventions were described according to the Template for intervention description and replication checklist. Results: Among the 2446 articles reviewed, 8 met the inclusion criteria. Two randomized controlled trials (RCT) and one non-RCT showed improvement in sexual functioning and satisfaction following a 30-45-minute structured rehabilitation program. Two other RCT showed significant improvement in sexual functioning with physical therapy oriented towards 1) structured physical and verbal sexual counselling and 2) pelvic floor muscle training. Three studies showed that interdisciplinary sexual rehabilitation improved satisfaction and sexual functioning; implementation of an interview script for clinicians improved the proportion of clients who addressed sexuality from 0 to 80% in 10 months; and two-day couple retreats improved perceived intimacy between couples. Conclusions: This review highlights promising interventions that could orient future research and improve the access to sexual rehabilitation services for post-stroke, with structured sexual rehabilitation and pelvic floor muscle training being the most strongly supported.

Talking about Sexuality in Stroke Individuals: The New Era of Sexual Rehabilitation

“…These categories would aid implementation teams in comprehending what elements, or determinants, are most or least likely to influence practices or behaviors. Indeed, their systematic review showed that only multidisciplinary and structured interventions, including sexual counselling and pelvic-floor-muscle training, may be supported to improve sexual function in the rehabilitation setting [ 56 ]. Moreover, in a recent extensive review, the same authors aimed at identifying the assessment methods used by rehabilitation professionals to investigate sexuality in post-stroke patients [ 57 ], before any rehabilitative approach is applied.…”

Relationship between Female Sexual Dysfunction and Trunk Stability Post-Stroke: A Cross-Sectional Study

“…In addition, the influence of psycho-emotional and social aspects-depression, anxiety, fear, changes in self-perception, and changes in the couple's role-has a direct impact on sexual quality in women post-stroke. Post-stroke rehabilitation focused on SD traditionally targets psychological characteristics, disregarding anatomical and physical aspects that can interfere with sexual function [12][13][14][15].…”

Sexual Rehabilitation After a Stroke: A Multi-site Qualitative Study About Influencing Factors and Strategies to Improve Services

“…It is thus imperative that patients are provided evidence-based sexuality rehabilitation. A recent systematic review [ 21 ] found benefits of carrying out sexual rehabilitation using an interdisciplinary approach for people who sustained a stroke, which included specific skills development [ 22 ], pelvic floor muscle training [ 23 ] and education [ 24 , 25 ]. Moreover, this review suggested a need for more robust studies in the field of sexual rehabilitation, considering that only four randomized controlled trials were found in the literature [ 21 ].…”