This thesis should have never been necessary. That database of all stroke research and stroke protocols run by that great stroke association would obviate the need to ever do systematic reviews. The database would be continually updated as all new research comes in. Doctors would not need to be reading thousands of research articles every year and trying to place them into their practices.
Effectiveness of caregiver-mediated exercise interventions on activities of daily living (ADLs), anxiety and depression of post-stroke rehabilitation individuals: A systematic review and meta-analysis
| Authors: | CHOO WEN TING |
| Keywords: | Stroke rehabilitation exercise caregivers ADLs anxiety depression meta-analysis |
| Issue Date: | 31-May-2021 |
| Citation: | CHOO WEN TING (2021-05-31). Effectiveness of caregiver-mediated exercise interventions on activities of daily living (ADLs), anxiety and depression of post-stroke rehabilitation individuals: A systematic review and meta-analysis. ScholarBank@NUS Repository. |
| Abstract: | Background: Decreased mobility is one of the major concerns for stroke survivors, with demand for post stroke rehabilitation to restore optimal functional levels. Engaging caregivers in rehabilitation exercises show promise to support higher intensity training to improve functional and possibly psychological outcomes post-stroke. However, the effectiveness of caregiver mediated exercise (CME) interventions to improve such outcomes remains inconclusive. Objectives: To examine updated evidence to evaluate the effectiveness of CME interventions on basic Activities of Daily Living (ADLs), extended ADLs, anxiety and depression of post-stroke rehabilitation individuals. Methods: Six databases were systematically searched: CINAHL, CENTRAL, Embase, PubMed, PsycINFO and Scopus. Grey literature and trial registry were also searched. Only randomised controlled trials (RCTs) written in English including participants clinically diagnosed with stroke and CME interventions were included. Data extraction and risk of bias assessment were performed by two reviewers independently. Meta-analyses were conducted for basic ADLs, extended ADLs, anxiety and depression outcomes using the RevMan software. Overall quality of evidence was assessed using GRADE. Results: A total of 11 RCTs comprising 2120 participants were identified for inclusion, with ten trials meta-analysed. Meta-analyses indicated statistically significant effects favouring CME interventions for basic ADLs (d=0.18). Subgroup analyses revealed significant effects for exercise-only interventions mediated by caregivers for basic ADLs (d=0.63). No significant effects were found for extended ADLs, anxiety and depression for stroke survivors. However, possible publication bias was detected. Overall quality of evidence appraised was low. Conclusions and Implications: CME interventions appear to have beneficial impacts on basic ADLs for stroke survivors, suggesting CME interventions as a potentially feasible way to improve functional independence. Caregivers can be engaged in rehabilitation exercises in hospitals or home setting. Future research may include high-quality studies with focus on specific intervention components or to explore caregiver outcomes. |
| URI: | https://scholarbank.nus.edu.sg/handle/10635/193949 |
| Appears in Collections: | Bachelor's Theses |
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