Deans' stroke musings: The Effectiveness of Rehabilitation Interventions for Improving Leisure Participation Following Stroke: 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.

Tuesday, March 3, 2026

The Effectiveness of Rehabilitation Interventions for Improving Leisure Participation Following Stroke: Protocol for a Systematic Review

WHY? You provide 100% recovery protocols and this research isn't needed! Can't you blithering idiots think at all?

The Effectiveness of Rehabilitation Interventions for Improving Leisure Participation Following Stroke: Protocol for a Systematic Review

Serena Alves-Stein^{1, 2}

; Natasha A Lannin^{1, 2}

; Kylie Wales^{1, 3}

; Sharon Kramer^{1, 2, 4}

; Laura Jolliffe^{5, 6, 7}

Background:Leisure participation is an important rehabilitation goal for survivors of stroke. Following stroke, there is a reduction in leisure participation; however, the focus of rehabilitation is typically on remediation of personal care activities and mobility. Furthermore, previous systematic reviews and current clinical practice guidelines provide inconsistent recommendations for rehabilitation interventions to improve leisure participation. This highlights the need for a comprehensive and targeted review of the literature to help inform clinical practice.

Objective:We propose a systematic review to synthesize data on the effectiveness of rehabilitation interventions to increase leisure participation in adult survivors of stroke, taking into account time since stroke and intervention context.

Methods:Searches will be conducted in MEDLINE, CINAHL, Embase, and CENTRAL. We will include randomized controlled trials and nonrandomized controlled trials that include adult survivors of stroke and test the effectiveness of rehabilitation interventions for leisure participation. Eligible interventions will be those that aim to improve leisure participation or where leisure participation is an outcome of interest. Two reviewers will independently screen full-text articles, and one reviewer will extract data, with a second reviewer providing confirmation. The Physiotherapy Evidence Database Scale will be used to assess the methodological quality of the studies. A random-effects meta-analysis will be performed, and a Cochran Q test will assess heterogeneity among studies. Outcome measures of leisure participation may include measures of amount, satisfaction and confidence, and performance. Secondary outcomes will include quality of life measures, adverse events, and resource use.

Results:Results will be discussed based on subgroup analyses where possible, including (1) time since stroke (early subacute, late subacute, and chronic), (2) delivery of the intervention (group or individualized), and (3) type of intervention (functional impairment, leisure education, and recreation participation). At the time of this protocol publication, the systematic review has progressed to data analysis, with publication of results expected in early 2026.

Conclusions:The findings of this review will increase understanding of effective rehabilitation practices to increase leisure participation after stroke and may contribute to updates of existing clinical practice guidelines for stroke rehabilitation.

Trial Registration:PROSPERO CRD42024547133; https://www.crd.york.ac.uk/PROSPERO/view/CRD42024547133

International Registered Report Identifier (IRRID):DERR1-10.2196/71353

JMIR Res Protoc 2026;15:e71353

doi:10.2196/71353