Systematic Review and Meta-analysis of Home-Based Rehabilitation on Improving Physical Function Among Home-dwelling Patients with a Stroke

Abstract Objective To evaluate the effects of home-based rehabilitation on improving physical function in home-dwelling patients after a stroke. Data sources Various electronic databases, including PubMed, CINAL, Embase, the Cochrane Central Register of Controlled Trials, and two Chinese datasets (i.e., Chinese Electronic Periodical Services and China Knowledge Resource Integrated) were searched for studies published before March 20, 2019. Study selection Randomized controlled trials conducted to examine the effect of home-based rehabilitation on improving physical function in home-dwelling patients with a stroke and published in English or Chinese were included. In total, 49 articles in English (n=23) and Chinese (n=26) met the inclusion criteria. Data extraction Data related to patient characteristics, study characteristics, intervention details, and outcomes were extracted by two independent reviewers. Data synthesis A random-effects model with a sensitivity analysis showed that home-based rehabilitation exerted moderate improvements on physical function in home-dwelling patients with a stroke (g = 0.58, 95% confidence interval [CI] 0.45∼0.70). Moderator analyses revealed that those stroke patients of a younger age, of a male gender, with a first-ever stroke episode, in the acute stage, and receiving rehabilitation training from their caregiver showed greater improvements in physical function. Conclusions Home rehabilitation can improve functional outcome in stroke survivors and should be considered appropriate during discharge planning if continuation care is required.