Disability and rehabilitation · 2026
Effects of recreational therapy on psychological and social outcomes among stroke survivors: a systematic review and meta-analysis.
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Sun Liping, Liao Yuexia, Gu Zhi'e, Wan Xiaojuan, Liu Ningning
Аннотация
PURPOSE: To investigate the effects of recreational therapy on psychological and social outcomes in stroke survivors and identify key intervention features.
METHODS: Eleven databases were systematically searched up to 15 April 2026. Two reviewers independently performed study selection, risk of bias assessment using Cochrane RoB 2.0, and evidence grading via GRADE. Meta-analyses were conducted with RevMan 5.4.
RESULTS: Nineteen studies were included. Recreational therapy significantly improved depressive symptoms (SMD = -0.46, 95% CI: -0.65 to -0.28; p < 0.01, I2 = 44%, low certainty), social participation (SMD = 0.53, 95% CI: 0.07-0.99; p = 0.02, I2 = 87%, moderate certainty), but had no significant effect on anxiety (SMD = -0.32, 95% CI: -0.92 to 0.29; p = 0.31, I2 = 79%, moderate certainty) or quality of life (SMD = 0.77, 95% CI: -0.05 to 1.59, p = 0.07, I2 = 94%, very low certainty). Art-based recreational therapy may alleviate depressive symptoms. Available studies failed to show a meaningful sustained effect beyond 3 months.
CONCLUSIONS: Recreational therapy may improve depressive symptoms and social participation in stroke survivors, particularly with interventions ≤3 months. Given the very low to moderate evidence quality, well-designed studies are needed to confirm long-term effectiveness.
METHODS: Eleven databases were systematically searched up to 15 April 2026. Two reviewers independently performed study selection, risk of bias assessment using Cochrane RoB 2.0, and evidence grading via GRADE. Meta-analyses were conducted with RevMan 5.4.
RESULTS: Nineteen studies were included. Recreational therapy significantly improved depressive symptoms (SMD = -0.46, 95% CI: -0.65 to -0.28; p < 0.01, I2 = 44%, low certainty), social participation (SMD = 0.53, 95% CI: 0.07-0.99; p = 0.02, I2 = 87%, moderate certainty), but had no significant effect on anxiety (SMD = -0.32, 95% CI: -0.92 to 0.29; p = 0.31, I2 = 79%, moderate certainty) or quality of life (SMD = 0.77, 95% CI: -0.05 to 1.59, p = 0.07, I2 = 94%, very low certainty). Art-based recreational therapy may alleviate depressive symptoms. Available studies failed to show a meaningful sustained effect beyond 3 months.
CONCLUSIONS: Recreational therapy may improve depressive symptoms and social participation in stroke survivors, particularly with interventions ≤3 months. Given the very low to moderate evidence quality, well-designed studies are needed to confirm long-term effectiveness.