Exploring Unsupervised Home-Based Exercise Therapy in Chronic Post-Stroke Individuals: A Scoping Review

BackgroundPhysical exercise is crucial for reducing disability and enhancing function after stroke. However, therapists regret lacking time within therapy sessions to perform exercises. Implementing unsupervised interventions could be a valuable strategy to support daily exercise in chronic stroke patients.ObjectivesThis scoping review maps the modalities of unsupervised home-based rehabilitation interventions for chronic post-stroke patients.MethodsA scoping review of randomized controlled trials (RCTs) published in English or French since 2020 was conducted. The review examined exercise modalities-frequency, intensity, time, and type-along with materials and devices used, outcomes assessed, participant interactions, and strategies for adherence monitoring. Databases searched included Medline, Google Scholar, the Cochrane Library, and Pedro. Studies were included if they involved unsupervised home-based exercise therapy for patients at least 6 months post-stroke. Study quality was evaluated using the PEDro scale.ResultsSix RCTs with a total of 135 participants were included. Exercise sessions varied from 3 days per week to daily, with low- to moderate-intensity and durations of 20 to 75 min. Interventions targeted balance, mobility, and core stability, and were delivered via mHealth apps (n = 2), video-guided programs (n = 1), or boxing-based exercise (n = 1). Two studies incorporated physiological monitoring, and balance and walking capacity were the most common outcomes. To support adherence, most programs provided regular therapist support, except in mHealth app interventions. Caregivers were involved in three studies.DiscussionThe review reveals diverse approaches in exercise modalities, technological integration, and adherence strategies, indicating that further research is needed to determine the overall effectiveness of these unsupervised home-based interventions.