Meta-Analysis: Association between Empowerment of Home-Based Rehabilitation Intervention on the Escalation of Functional Ability in Post Stroke Patients

Authors

  • Muhammad Husein Syawaludin Masters Program in Public Health, Universitas Sebelas Maret
  • Sumardiyono Sumardiyono Department of Public Health, Faculty of Medicine, Universitas Sebelas Maret
  • Bhisma Murti Department of Public Health, Faculty of Medicine, Universitas Sebelas Maret

Abstract

Background: Stroke is a disease that is the third leading cause of death in the world after heart and cancer. Stroke is also a disease that causes serious and permanent disability in the first order in the world. The rehabilitation program or recovery of stroke patients will greatly affect the improvement of functional abilities and independence of post-stroke patients, one of the keys to functional improvement is the intensity of therapy and family involvement in supporting the rehabilitation process. This study aims to analyze the relationship between empowering home-based recovery interventions to improve the functional ability of post-stroke patients, with a meta-analysis of primary studies conducted by previous authors.

Subjects and Method: This study is a systematic review and meta-analysis with the following PICO, Population: stroke patients. Intervention: home-based recovery. Comparison: not home based recovery. Outcomes: functional ability. The articles used in this study were obtained from several databases, namely PubMed, Springer Link, Cochrane Database, Hindawi, Elsevier, JBBA, LWW, Google Scholar. Search keywords “home-based” AND “intervention” OR “rehabilitation” OR “exer­cise” OR “therapy” OR “care” AND “stroke” AND “functional ability” OR “functional capacity” AND “Randomized Controlled Trial “ OR “ RCT". The articles included are full-text English and Indo­nesian languages with a study design of a Randomized Controlled Trial from 2000 to 2021 and reporting on the Mean and SD in multivariate analysis. The selection of articles is done by using PRISMA flow diagram. Articles were analyzed using the Review Manager 5.3 application.

Results: A total of 9 randomized controlled trials from Iran, Turkey, Australia, Taiwan, China, Thailand and the Netherlands were selected for a systematic review and meta-analysis. The data collected showed that the home-based recovery intervention improved functional ability in post-stroke patients compared to usual care (SMD = 2.70; 95% CI = 1.53 to 3.87; p<0.001). There is a publication bias that indicates an overestimation). 

Conclusion: Home-based recovery interventions improve functional ability in post-stroke patients.

Keywords: Home-based recovery, functional ability, stroke patients, meta-analysis

Correspondence: Muhammad Husein Syawaludin. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: fahusein26@gmail.com. Mobile: +6285­728989309.

Journal of Health Policy and Management (2022), 07(01): 46-57
https://doi.org/10.26911/thejhpm.2022.07.01.05

References

Andeson C, Rubenach S, Mhurchu CN, Clark M, Spencer C, Winsor A (2000). Home or Hospital for Stroke Rehabilitation? Results of a Randomized Controlled Trial: I Health Outcomes at 6 Months. Am. Heart J. 31(5):102431. https://doi.org/10.1161/01.str.31.5.1024.

American Heart Association (AHA). (2018). Guideline for the early management of patients with acute ischemic stroke: A guideline for healthcare profesionals. J Am Heart Assoc. 50(12): e344e418. https://doi.org/10.1161/STR.0000000000000211. Biering

Sørensen T, Hansen RB, Biering Sørensen F (2009). Home aids and personal assistance 10-45 years after spinal cord injury. Spinal Cord. 47: 405 12. Doi: 10.1038/sc.2008.132.

CEBM (2021). Critical appraisal tools Center for Evidence-Based-Medicine. Retrieved from https://www.cebm.ox.ac.uk/resources/ebmtools/criticalappraisaltools.

Chaiyawat P, Kulkantrakorn K, Sritisukho P (2009). Effectiveness of home rehabilitation for ischemic stroke. Neurol. Int. 1(1):e10. https://doi.org/10.4081/ni.2009.e10.

Chaiyawat P, Kulkantrakorn K (2012). Effectiveness of home rehabilitation program for ischemic stroke upon disability and quality of life: a randomized controlled trial. Clin Neurol Neurosurg. 114(7): 866-70. https://doi.org/10.1016/j.clineuro.2012.01.018.

Chen J, Jin W, Dong WS, Jin Y, Qiao FL, Zhou YF, Ren CC (2017). Effects of home-based telesupervising rehabilitation on physical function for stroke survivors with hemiplegia randomized controlled trial. Am J Phys Med Rehabil. 96(3):152-160. https://doi.org/10.1097/phm.0000000000000559.

Cochrane. (2014). RevMan 5.3 User Guide.The Cochrane Collaboration

Dodakian L, McKenzie AL, Le V, See J, PearsonFuhrhop K, Quinlan EB, Zhou RJ, et al. (2007). A homebased telerehabilitation program for patients with stroke. Neurorehabil Neural Repair. 31(10-11): 923-933. https://doi.org/10.1177/1545968317733818.

Gelaw AY, Janakiraman B, Gembremeskel BF, Ravicandran H (2020). Effectiveness of Homebased rehabilitation in improving physical function of person with stroke and other physical disability: A Systematic review of randomized controlled trials. J Stroke Cerebrovasc Dis. 29(6): 104800. https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.104800.

Han DS, Chuang PW, Chiu EC (2020). Effect of home based reablement program on improving activities of daily living for patients with stroke A pilot study. J Med. 99(49):e23512. https://doi.org/10.1097/md.0000000000023512.

Hekmatpou D, Baghban EM, Dehkodi LM (2019). The effect of patient care education on burden of care and the quality of life of caregivers of stroke patients. J Multidiscrip Healthc. 12: 211-217. https://doi.org/10.2147/jmdh.s196903.

Karunia E (2016). Hubungan antara dukungan keluarga dengan kemandirian activity of daily living pasca stroke (The relationship between family support and independence activity of daily living post stroke). JBE Unair. 4(2): 213-224. http://ejournal.unair.ac.id/JBE/article/view/2147/2462.

Koc A (2015). Exercise in patients with subacute stroke: A randomized, controlled pilot study or homebased exercise in subacute stroke. Work. 52(3): 5417. https://doi.org/10.3233/wor-152156. Lingga L (2013). All about stroke: Hidup sebelum dan paska stroke (All about stroke: Life before and after stroke). Jakarta: PT Elex Media Komputind.

Pallesen H, Bjerk M, Pedersen AR, Nielsen JF, Evald L (2019). The effects of highintensity aerobic exercise on cognitive performance after stroke: a pilot randomised controlled trial. J Cent Nerv Syst Dis. 11: 1179573519843493. https://doi.org/10.1177/1179573519843493.

Rahayu UB. (2019). Fisioterapi Neurologi Pada Sistem Saraf Pusat (Neurological Physiotherapy in the Central Nervous System). Surakarta: Muhammadiyah University Press.

Raine S, Ellerington ML, Meadows L (2019). Bobath Concept, Teori & Praktik Klinis dalam Rehabilitasi Neurologis. Jakarta.

EGC Rezaei M, Sharifi A, Vaccaro AR, Movaghar VR (2019). Home-based rehabilitation programs: promising field to maximize function of patient with traumatic spinal cord injury. Asian J Neurosurg. 14(3): 634-640. https://doi.org/10.4103/ajns.ajns_86_17.

Rinajumita (2011). Faktor-faktor yang Mempengaruhi Kemandirian Lansia di Wilayah Kerja Puskesmas Lampas Kecamatan Payakumbuh Utara Tahun 2011 (Factors Affecting Elderly Independence in the Working Area of the Lampas Health Center, North Payakumbuh District in 2011). Padang: Universitas Andalas.

Saadatnia M, Khorvash F, Shahnazi H, Ghashghagi FE. The impact of homebased exercise rehabilitation on functional capacity patien with acute ischemic stroke: A randomized controlled trial. Home Health Care Manag Pract. 32(3). https://doi.org/10.1177%2F1084822319895982.

Silva DAD, Narayanaswamy V, Artemio AR, Loh PK, Yair L (2014). Understanding Stroke A Guide for Survivors and Their Families. http://www.neuroaid.com/

Vluggen TPMM, Haastregt JCM, Tan FE, Verbunt JA, Heugten CMV, Schols JMGA (2021). Effectiveness of an integrated multidisciplinary geriatric rehabilitation programme for older persons with stroke: a multicentre randomised controlled trial. BMC Geriatrics. 21(1):134. https://doi.org/10.1186/s12877021020824.

World Health Organization (2014). Stroke, Cerebrovascular Accident. Retrieved October 1, 2021, from http://www.who.int/topics/cerebrovascular_accident/en/.

Downloads

Published

16-01-2022

How to Cite

Syawaludin, M. H., Sumardiyono, S., & Murti, B. (2022). Meta-Analysis: Association between Empowerment of Home-Based Rehabilitation Intervention on the Escalation of Functional Ability in Post Stroke Patients. Journal of Health Policy and Management, 7(1), 46–57. Retrieved from https://thejhpm.com/index.php/thejhpm/article/view/260

Issue

Section

Articles