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Systematic Review and Meta-Analysis of Home-Based Rehabilitation on Improving Physical Function Among Home-Dwelling
Nai-Fang Chi1, Yi-Chieh Huang2, Hsiao-Yean Chiu2
1Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei; Department of Neurology, Shuang Ho Hospital, Taipei Medical University, Taipei; Cerebrovascular Research Center, Taipei Medical University, Taipei; Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
Objective:
To evaluate the effects of home-based rehabilitation on improving physical function in home-dwelling patients after a stroke.
Data Sources:
Various electronic databases, including PubMed, Cumulative Index to Nursing and Allied Health, Embase, the Cochrane Central Register of Controlled Trials, and 2 Chinese data sets (ie, Chinese Electronic Periodical Services and China Knowledge Resource Integrated) were searched for studies published before March 20, 2019.
Study Selection:
Randomized controlled trials conducted to examine the effect of home-based rehabilitation on improving physical function in home-dwelling patients with a stroke and published in English or Chinese were included. In total, 49 articles in English (n=23) and Chinese (n=26) met the inclusion criteria.
Data Extraction:
Data related to patient characteristics, study characteristics, intervention details, and outcomes were extracted by 2 independent reviewers.
Data Synthesis:
A random-effects model with a sensitivity analysis showed that home-based rehabilitation exerted moderate improvements on physical function in home-dwelling patients with a stroke (g=0.58; 95% CI, 0.45∼0.70). Moderator analyses revealed that those patients with stroke of a younger age, of male sex, with a first-ever stroke episode, in the acute stage, and receiving rehabilitation training from their caregiver showed greater improvements in physical function.
Conclusions:
Home rehabilitation can improve functional outcome in survivors of stroke and should be considered appropriate during discharge planning if continuation care is required.
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