Self-Rehabilitation for Post-Stroke Motor Function and Activity–A Systematic Review and Meta-Analysis

Abstract

Background. Due to an increasing stroke incidence, a lack of resources to implement effective rehabilitation and a significant proportion of patients with remaining impairments after treatment, there is a rise in demand for effective and prolonged rehabilitation. Development of self-rehabilitation programs provides an opportunity to meet these increasing demands. Objective. The primary aim of this meta-analysis was to determine the effect of self-rehabilitation on motor outcomes, in comparison to conventional rehabilitation, among patients with stroke. The secondary aim was to assess the influence of trial location (continent), technology, time since stroke (acute/subacute vs chronic), dose (total training duration > vs ≤ 15 hours), and intervention design (self-rehabilitation in addition/substitution to conventional therapy) on effect of self-rehabilitation. Methods. Studies were selected if participants were adults with stroke; the intervention consisted of a self-rehabilitation program defined as a tailored program where for most of the time, the patient performed rehabilitation exercises independently; the control group received conventional therapy; outcomes included motor function and activity; and the study was a randomized controlled trial with a PEDro score ≥5. Results. Thirty-five trials were selected (2225 participants) and included in quantitative synthesis regarding motor outcomes. Trials had a median PEDro Score of 7 [6–8]. Self-rehabilitation programs were shown to be as effective as conventional therapy. Trial location, use of technology, stroke stage, and intervention design did not appear to have a significant influence on outcomes. Conclusion. This meta-analysis showed low to moderate evidence that self-rehabilitation and conventional therapy efficacy was equally valuable for post-stroke motor function and activity.

Effect of early integrated robot-assisted gait training on motor and balance in patients with acute ischemic stroke: a single-blinded randomized controlled trial

“…(1) RAGT does not need to follow the principles that gradually increase the density of training during the assisted standing process to improve trunk stability, followed by active standing training under safe conditions to enhance standing ability. 32 Unarmed functional walking training has, however, inadequate intensity, low efficiency, and difficulty in controlling the gait of patients, thus assisting patients in developing a correct pattern for repeated training. Comparably, RAGT employs electromechanical devices that assist stepping cycles by supporting body weight while automatizing the gait process through the support and facilitation of movement in one or several lower limb joints.…”

The analysis of nursing diagnoses determined by students for patients in rehabilitation units

“…It can also be seen that nursing students reflected not only the physical problems of rehabilitation patients, but also psy- chosocial problems in the nursing process. According to the preceding literature, the occurrence of self-care deficit after stroke is usually aftereffects of cerebral hypoperfusion (Everard et al, 2021;Oliveira-Kumakura et al, 2020;Oliveira-Kumakura et al, 2021), and nursing diagnosis associated with self-care deficits also show an association with motor and sensorial aftereffects. Third, it is necessary to examine the diagnostic indicators that includes defining characteristics, related/risk factors of each nursing diagnosis that nursing students select for rehabilitation patients.…”

Reversing the Ruin: Rehabilitation, Recovery, and Restoration After Stroke

“…However, even in the absence of demonstrable improvement over conventional therapy, broadening the diversity of available therapies that are similarly effective provides patients and clinicians with better tools to respond to individual patient needs and preferences, potentially improving overall outcomes. For example, self-rehabilitation of post-stroke motor function is similarly valuable to conventional therapy [ 33 ].…”