Article

PURPOSE: To conduct a systematic review to explore the effectiveness of
community-based rehabilitation interventions delivered by allied health
professionals and/or nursing staff in reducing depression, facilitating
participation and improving health-related quality of life (HRQoL) post-inpatient
stroke rehabilitation. METHOD: A search was conducted in the databases of
MEDLINE, PEDro, CINAHL and the Cochrane Library. Publications were classified
into categories based on the type of the interventions. Best evidence synthesis
and meta-analysis were utilised to determine the level of evidence. RESULTS:
Fifty-four studies were included in the review, and divided into nine broad
intervention categories. Meta-analysis demonstrated significant reduction in
depression with exercise interventions (n = 137; effect estimate SMD: -2.03,
95%CI: -3.22, -0.85). Community-based interventions targeting participation and
leisure domains showed moderate evidence for improvement in global participation
measures and HRQoL. Comprehensive rehabilitation demonstrated limited evidence
for depression and participation, and strong evidence for HRQoL CONCLUSIONS:
There is limited to moderate evidence supporting some rehabilitation
interventions in affecting the outcomes of depression, participation and HRQoL
post-stroke. Heterogeneity of the studies made evidence synthesis difficult.
Further consideration needs to be given to the type and timing of outcome
measures selected to represent the domains of participation and HRQoL.

Langue : ANGLAIS