Deans' stroke musings: Activity-Based Interventions to Increase Independence After Stroke In the Hospital Setting: Protocol for a Systematic Review

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Thursday, July 10, 2025

Activity-Based Interventions to Increase Independence After Stroke In the Hospital Setting: Protocol for a Systematic Review

Having to do this is directly the result of MASSIVE INCOMPETENCE OF OUR FUCKING FAILURES OF STROKE ASSOCIATIONS IN NOT CREATING A DATABASE OF ALL RESEARCH AND THE CREATED PROTOCOLS!

Activity-Based Interventions to Increase Independence After Stroke In the Hospital Setting: Protocol for a Systematic Review

Tayla Grant 1 2, Laura Jolliffe 1 3 4, Kylie Wales 1 5, Emma Schneider 2 6, Avril E Drummond 7, Natasha A Lannin 1 2

Affiliations

PMID: 40627860
DOI: 10.2196/73133

Free article

Abstract

Background: Stroke is a leading cause of disability, commonly resulting in difficulty completing basic and instrumental activities of daily living. Rehabilitation is recommended to improve functional performance; however, it remains unknown whether early (hospital-based) intervention is effective; nor is it known what intervention components should be delivered.

Objective: We propose a systematic review to summarize the evidence for the effectiveness of activity-based interventions, led by occupational therapists, for improving performance of basic activities of daily living (b-ADL) or simple cognitive instrumental activities of daily living (C-IADL) among adults with stroke. Reviewing simple C-IADLs as opposed to instrumental activities of daily living will allow us to review interventions for activities with similar executive functioning demands. By identifying effective interventions, we aim to improve outcomes for stroke survivors by maximizing independence during hospitalization.

Methods: Searches will be conducted in MEDLINE, CINAHL, EMBASE, and Cochrane Central Register of Controlled Trials. We will include randomized controlled trials and quasi-randomized controlled trials that include adult stroke survivors and tested interventions (delivered in the hospital setting) aiming to improve or promote independence in b-ADLs or C-IADLs. Two reviewers will independently screen full-text articles, and one reviewer will extract data, with a second reviewer providing confirmation. The Physiotherapy Evidence Database (PEDro) scale will be used to assess the methodological quality of studies. The Cochrane Q test will assess heterogeneity among studies, and where appropriate, meta-analysis will then be performed. Measures of outcomes may include global ratings of function (such as the Functional Independence Measure) or specific task performance assessments (such as the Nottingham Dressing Assessment).

Results: Results will be presented based on subgroup analyses where possible, including activity type (activity or occupation level), time after stroke (within or after 1 week), and delivery of intervention (group or individualized).

Conclusions: This systematic review will address the current gap in the literature regarding activity-based interventions for stroke survivors in the inpatient setting and provide clinical guidance on the most effective methods, if any, for improving independence early after stroke.

Trial registration: PROSPERO CRD42024562195; https://www.crd.york.ac.uk/PROSPERO/view/CRD42024562195.

International registered report identifier (irrid): DERR1-10.2196/73133.

Keywords: activities of daily living; hemiplegia; occupational therapy; rehabilitation; stroke; stroke rehabilitation.

©Tayla Grant, Laura Jolliffe, Kylie Wales, Emma Schneider, Avril E Drummond, Natasha A Lannin. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 08.07.2025.