This systematic review aimed to verify the effectiveness of home-based rehabilitation and compare it with that of hospital-based rehabilitation and usual care, focusing on improving ADL after stroke.
The databases Ovid Medline, Ovid Embase, and the Cochrane Library were searched for studies published from January 2000 to January 2024. This review was registered with the International Prospective Register of Systematic Reviews. We included randomized controlled trials focused on home-based rehabilitation for stroke patients. The studies evaluated outcomes such as ADL, upper limb function, mobility, balance, aerobic endurance, and quality of life. Data extraction was performed by two independent researchers using a standardized form, who also assessed the risk of bias and the quality of the evidence.
A total of 46 studies were included in the qualitative synthesis, and 34 studies were included in the quantitative analysis using Review Manager software 5.4. There was no significant difference in ADL between patients receiving home-based rehabilitation and those receiving hospital-based rehabilitation (standardized mean difference = 0.14, 95% confidence interval [−0.04, 0.32], I² = 34%). However, a significant difference was found between home-based rehabilitation and usual care (standardized mean difference = 1.16, 95% confidence interval [0.65, 1.67], I² = 90%).
Home-based rehabilitation is comparable to hospital-based rehabilitation and more effective than usual care for stroke patients. Thus, it should be considered a viable option to support effective recovery after discharge. However, the overall high risk of bias in the studies necessitates careful interpretation of these findings.
Home-based rehabilitation is an effective alternative method for improving ADL in patients with stroke by providing a familiar and convenient environment.
Home-based rehabilitation
Activities of daily living
