THE EFFECTIVENESS OF COMMUNITY-BASED REHABILITATION IN IMPROVING ACTIVITIES OF DAILY LIVING AND QUALITY OF LIFE OUTCOMES IN PERSONS WITH STROKE

R. Tosoc1, R. Lazaro2,1
1University of the Philippines Manila, Physical Therapy, Manila, Philippines, 2California State University Sacramento, Physical Therapy, Sacramento, United States

Background: Despite the growth of community-based rehabilitation (CBR) literature in the past 40 years, its effectiveness especially in improving outcomes related to activities of daily living (ADL) and quality of life (QOL) in people with stroke is unknown.  

Purpose: This systematic review compared the effectiveness of community-based rehabilitation and usual or hospital-based treatments in improving ADL and QOL in patients with stroke.

Methods: Four databases were systematically searched from their inception until April 30, 2019 for relevant experimental studies that compared CBR and usual/hospital rehabilitation on outcomes related to ADLs and QOL in patients with stroke. All intervention studies about community-based rehabilitation interventions coming from both developed and developing countries were included.

Results: Ten experimental studies were included in this review, involving 1575 participants (806 male, 656 female, 113 not classified) with estimated age range from 22-103 years. Assessment shows that risk of bias among the studies is primarily due to issues with randomization, blinding and follow-up. The description of baseline characteristics specific to stroke such as length of time since diagnosis and laterality were not consistent across the selected studies. Seven studies measured ADL performance, while ten measure QOL. Although CBR generally demonstrated better ADL and QOL values than usual care, the results were inconclusive due to heterogeneity of the intervention described and the outcome measure used for both groups.

Conclusion(s): Standardizing outcome measures and interventions is needed in future CBR research. CBR interventions hold promise in terms of improving ADL and QOL outcomes for people with stroke.

Implications: A change in paradigm concerning education and research in CBR is warranted as cost-effective care is a mutual concern globally to achieve rehabilitation outcomes by 2030.

Funding, acknowledgements: None

Keywords: community-based rehabilitation, stroke, activities of daily living

Topic: Community based rehabilitation

Did this work require ethics approval? No
Institution: University of the Philippines
Committee: Institutional Review Board
Reason: This was a systematic review of the available literature


All authors, affiliations and abstracts have been published as submitted.

Back to the listing