The Effectiveness of Rehabilitation Interventions on Improving Leisure Participation Following Stroke: A Systematic...

ObjectiveTo investigate the effectiveness of rehabilitation interventions on increasing leisure participation in adult survivors of stroke.Data SourcesDatabases (Medline, EMBASE, CINAHL, and Cochrane Central Register of Controlled Trials) were searched from inception to September 2025.Study Selection and Data CollectionIncluded studies were randomized and nonrandomized controlled trials investigating leisure rehabilitation for community-living adults with stroke, which include a measure of leisure participation. Data extraction was performed using a predetermined data extraction form. The PEDro Scale was used to assess the risk of bias.FindingsA total of 6,813 records were retrieved, 46 were assessed at full-text review, and 8 studies were included. The meta-analysis included four studies, and another four studies were synthesized narratively. Leisure participation was higher in the intervention groups at the end of the intervention compared with the control (standardized mean difference = 0.80, 95% confidence interval 0.03 to 1.56). There was low certainty for this evidence due to the small number of studies and high heterogeneity. Subgroup analysis indicated possible benefits when intervention is provided earlier poststroke, and that leisure rehabilitation increases the number of leisure activities, but not the regularity of participation. It remains unclear whether any one intervention approach is more effective.Conclusions and RelevanceLeisure rehabilitation may improve leisure participation; however, the quality of evidence is low. Further well-designed trials are needed to address leisure participation following stroke, investigating the optimal timing of leisure rehabilitation and identifying the effective elements of the intervention.