Exercise-based interventions for post-stroke social participation: A systematic review and network meta-analysis

Area of Science:

• Neurorehabilitation
• Evidence-based practice
• Social determinants of health

Background:

• Social participation is a key goal in post-stroke rehabilitation.
• Exercise interventions are effective non-pharmacological methods for enhancing social participation.
• The comparative effectiveness of different exercise interventions remains unclear.

Purpose of the Study:

• To conduct a network meta-analysis comparing exercise interventions for stroke survivors.
• To rank the efficacy of various exercise-based interventions in improving social participation.

Main Methods:

• A random-effects network meta-analysis of randomized control trials.
• Searched multiple databases (MEDLINE, Cochrane Library, etc.) up to January 2020.
• Included trials focused on exercise interventions for stroke patients with social participation as the primary outcome.

Main Results:

• 16 trials with 1704 patients and 12 intervention arms were analyzed.
• Motor relearning programs showed the highest effectiveness for overall and short-term social participation.
• Home-based combined exercise ranked highest for long-term efficacy, and cognitive-based exercise for high adherence (>90%).

Conclusions:

• Motor relearning programs and home-based combined exercise show promise for improving social participation post-stroke.
• Cognitive-based exercise is highly effective when adherence is high.
• Further large, multicenter trials are recommended to validate these findings.