Experience and needs of stroke patients in physical rehabilitation: a systematic review and meta-synthesis

As stroke is a disease with a high disability rate, stroke patients generally have an urgent need for physical rehabilitation to maximize functional independence. However, owing to the complexity of the stroke rehabilitation process and the limited knowledge of patients, patients are often confused and uncertain in the rehabilitation process, which in turn affects their compliance and hinders their rehabilitation process. Exploring the real experiences and unsatisfied needs of stroke patients in the process of physical rehabilitation is highly important for the optimization of future intervention strategies.

Nine databases were searched from inception to September 2024, with an update in January 2025. Studies were critically appraised using the Critical Appraisal Skills Programme tool, and the data were thematically synthesized following the steps of the thematic synthesis method according to Thomas and Harden.

A total of 28 papers (n = 468) were included, and 117 findings were distilled into 24 new categories, which were synthesized into 4 integrated findings: (1) Body perceptionan and dynamic adaptation (Limb loading, Poorly designed rehabilitation equipment, Dynamic changes, Improvement in physical function); (2) Psychological course and emotional experience (Negative emotions and social avoidance, Desire for restoration of limb function, Confusion, Fear and self-doubt, Lack of therapeutic care, Loss of patience, Psychological adaptation and emotional transformation); (3) Multi-dimensional motivations and facilitators (Positive feedback, Diverse external support, Challenging design, Goal setting and sense of achievement, Positive emotional attitudes and personality traits, Avoiding disability labeling and functional degradation, Self-responsibility); (4) Unmet needs and directions for optimizing intervention strategies (Convenient and continuous demand for rehabilitation services, Access to rehabilitation information and resources, Individualized rehabilitation guidance, Socialization and group interaction between patients with similar experiences, Economic support and policy guarantees, Real-time feedback and intelligent adjustments).

Healthcare professionals should pay attention to stroke patients' real feelings and inner needs during exercise rehabilitation and their real dilemmas about participating in exercise rehabilitation. They should formulate personalized exercise rehabilitation boosting strategies for stroke patients to realize scientific and precise exercise rehabilitation and improve patients' long-term rehabilitation outcomes.

PROSPERO [CRD42024594929].