Australian occupational therapy journal · 2026
Systematic review of hospital-based interventions to improve post-stroke independence in activities of daily living.
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Grant Tayla, Wales Kylie, Jolliffe Laura, Schneider Emma J, Glascott Jade, Sansonetti Danielle, Drummond Avril E, Lannin Natasha A
Аннотация
INTRODUCTION: Early after stroke, inpatients commonly experience difficulty performing activities of daily living (ADL). Occupational therapists are key to providing early rehabilitation to optimise recovery. However, the effectiveness of early, activity-based retraining of ADLs is not clear. The aim of this systematic scoping review is to determine whether activity-based retraining targeting basic activities of daily living (b-ADL) and/or simple cognitive instrumental activities of daily living (C-IADL) delivered early after stroke improves functional independence.
METHODS: MEDLINE, CINAHL, and Embase were searched. Eligible studies included randomised controlled trials or quasi-randomised trials, with at least 75% of participants over the age of 18, with a stroke diagnosis, and who received activity-based interventions within the hospital setting. Articles were screened by two authors using Covidence. Risk of bias was assessed using Cochrane's Risk of Bias tool (RoB2). All results were meta-analysed using Comprehensive Meta Analysis software (V4.0).
CONSUMER AND COMMUNITY INVOLVEMENT: No consumer or community involvement was included in this study.
RESULTS: A total of 7546 articles were screened, and six studies including n = 254 participants met the inclusion criteria. Performance outcome measure results were meta-analysed; there was no statistically significant impact of activity-based interventions on functional performance (standardised mean difference [SMD] = 0.41; 95% confidence interval [CI] -0.06, 0.87; P = 0.09). Two studies reviewed quality of life and satisfaction outcomes; data were not synthesised.
CONCLUSION: Whereas individual trials suggested improvements early after activity-based training, our meta-analysis showed variability in effects in trials to date. Further research is required to determine the clinical and cost-effectiveness of activity-based interventions within the hospital setting to guide occupational therapy practice.
METHODS: MEDLINE, CINAHL, and Embase were searched. Eligible studies included randomised controlled trials or quasi-randomised trials, with at least 75% of participants over the age of 18, with a stroke diagnosis, and who received activity-based interventions within the hospital setting. Articles were screened by two authors using Covidence. Risk of bias was assessed using Cochrane's Risk of Bias tool (RoB2). All results were meta-analysed using Comprehensive Meta Analysis software (V4.0).
CONSUMER AND COMMUNITY INVOLVEMENT: No consumer or community involvement was included in this study.
RESULTS: A total of 7546 articles were screened, and six studies including n = 254 participants met the inclusion criteria. Performance outcome measure results were meta-analysed; there was no statistically significant impact of activity-based interventions on functional performance (standardised mean difference [SMD] = 0.41; 95% confidence interval [CI] -0.06, 0.87; P = 0.09). Two studies reviewed quality of life and satisfaction outcomes; data were not synthesised.
CONCLUSION: Whereas individual trials suggested improvements early after activity-based training, our meta-analysis showed variability in effects in trials to date. Further research is required to determine the clinical and cost-effectiveness of activity-based interventions within the hospital setting to guide occupational therapy practice.