Therapy-based rehabilitation services for patients living at home more than one year after stroke

Aziz, Noor Azah Abd; Leonardi‐Bee, Jo; Phillips, Margaret; Gladman, John; Legg, Lynn; Walker, Marion F

doi:10.1002/14651858.cd005952.pub2

Cited by 67 publications

(55 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[70][71][72][73][74][75][76][77][78][79][80][81][82] ( Figure 7). These reviews collectively represented 101 individual RCTs, 29 of which were included in more than one review ( Table 16).…”

Section: Systematic Reviews Identifiedmentioning

confidence: 99%

“…Full-text articles excluded (n = 79) Seven reviews explored interventions based on therapy rehabilitation, [71][72][73][74][75][76][77] though the focus of the interventions varied. Two reviews looked at interventions designed specifically for people with cognitive impairment.…”

Section: Priority Meta-review: Self-management Support For Stroke Surmentioning

confidence: 99%

“…Two reviews looked at interventions designed specifically for people with cognitive impairment. 72,75 The remaining reviews explored therapy rehabilitation generally, 71,74 or occupational therapy (OT) specifically. 73,76,77 Components relevant to our definition of self-management support in the therapy-based reviews included problem-solving; remediation training; goal-setting; information provision; support with adaptive equipment; liaison with other services; and training in activities of daily living (ADL).…”

Section: Priority Meta-review: Self-management Support For Stroke Surmentioning

confidence: 99%

“…Delivery of the therapy rehabilitation was initiated soon after the acute stroke event in five reviews, [72][73][74]76,77 and later in stroke recovery (6 months to more than 1 year) in two reviews. 71,75 Outcomes were measured between 1 week and 12 months after the end of the intervention period.…”

Section: Priority Meta-review: Self-management Support For Stroke Surmentioning

confidence: 99%

See 3 more Smart Citations

A rapid synthesis of the evidence on interventions supporting self-management for people with long-term conditions: PRISMS – Practical systematic RevIew of Self-Management Support for long-term conditions

Taylor

Pinnock

Epiphaniou

et al. 2014

Health Services and Delivery Research

345

451

View full text Add to dashboard Cite

BackgroundDespite robust evidence concerning self-management for some long-term conditions (LTCs), others lack research explicitly on self-management and, consequently, some patient groups may be overlooked.AimTo undertake a rapid, systematic overview of the evidence on self-management support for LTCs to inform health-care commissioners and providers about what works, for whom, and in what contexts.MethodsSelf-management is ‘the tasks . . . individuals must undertake to live with one or more chronic conditions . . . [including] . . . having the confidence to deal with medical management, role management and emotional management of their conditions’. We convened an expert workshop and identified characteristics of LTCs potentially of relevance to self-management and 14 diverse exemplar LTCs (stroke, asthma, type 2 diabetes mellitus, depression, chronic obstructive pulmonary disease, chronic kidney disease, dementia, epilepsy, hypertension, inflammatory arthropathies, irritable bowel syndrome, low back pain, progressive neurological disorders and type 1 diabetes mellitus). For each LTC we conducted systematic overviews of systematic reviews of randomised controlled trials (RCTs) of self-management support interventions (‘quantitative meta-reviews’); and systematic overviews of systematic reviews of qualitative studies of patients’ experiences relating to self-management (‘qualitative meta-reviews’). We also conducted an original systematic review of implementation studies of self-management support in the LTCs. We synthesised all our data considering the different characteristics of LTCs. In parallel, we developed a taxonomy of the potential components of self-management support.ResultsWe included 30 qualitative systematic reviews (including 515 unique studies), 102 quantitative systematic reviews (including 969 RCTs), and 61 studies in the implementation systematic review. Effective self-management support interventions are multifaceted, should be tailored to the individual, their culture and beliefs, a specific LTC and position on the disease trajectory, and underpinned by a collaborative/communicative relationship between the patient and health-care professional (HCP) within the context of a health-care organisation that actively promotes self-management. Self-management support is a complex intervention and although many components were described and trialled in the studies no single component stood out as more important than any other. Core components include (1) provision of education about the LTC, recognising the importance of understanding patients’ pre-existing knowledge and beliefs about their LTC; (2) psychological strategies to support adjustment to life with a LTC; (3) strategies specifically to support adherence to treatments; (4) practical support tailored to the specific LTC, including support around activities of daily living for disabling conditions, action plans in conditions subject to marked exacerbations, intensive disease-specific training to enable self-management of specific clinical tasks; and (5) social support as appropriate. Implementation requires a whole-systems approach which intervenes at the level of the patient, the HCP and the organisation. The health-care organisation is responsible for providing the means (both training and time/material resources) to enable HCPs to implement, and patients to benefit from, self-management support, regularly evaluating self-management processes and clinical outcomes. More widely there is a societal need to address public understanding of LTCs. The lack of public story for many conditions impacted on patient help-seeking behaviour and public perceptions of need.ConclusionsSupporting self-management is inseparable from the high-quality care for LTCs. Commissioners and health-care providers should promote a culture of actively supporting self-management as a normal, expected, monitored and rewarded aspect of care. Further research is needed to understand how health service managers and staff can achieve this culture change in their health-care organisations.Study registrationThis study is registered as PROSPERO CRD42012002898.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

show abstract

Section: Systematic Reviews Identifiedmentioning

confidence: 99%

Section: Priority Meta-review: Self-management Support For Stroke Surmentioning

confidence: 99%

Section: Priority Meta-review: Self-management Support For Stroke Surmentioning

confidence: 99%

Section: Priority Meta-review: Self-management Support For Stroke Surmentioning

confidence: 99%

See 2 more Smart Citations

A rapid synthesis of the evidence on interventions supporting self-management for people with long-term conditions: PRISMS – Practical systematic RevIew of Self-Management Support for long-term conditions

Taylor

Pinnock

Epiphaniou

et al. 2014

Health Services and Delivery Research

345

451

View full text Add to dashboard Cite

show abstract

“…1 İnme sonrası 1 yılı aşkın dönemde rehabilitasyona dair az sayıda çalışma olup, veriler bu dönemdeki rehabilitasyona dair öneri getirmek için yetersizdir. 8 …”

Section: Rehabilitasyonun Miktar Yoğunluk Ve Zamanlamasıunclassified

After Stroke: Guidelines Of Turkish Society Of Cerebrovascular Diseases – 2015

Bakar¹,

Ozdag²,

Melek³

et al. 2015

Türk Beyin Damar Hast Derg

View full text Add to dashboard Cite

ÖZETBu bölümde, sensorimotor işlev bozulması, düşmeler, epilepsi, depresyon ve demans gibi inme sonrası komplikasyonlar ve bunlara yönelik güncel tedavi yaklaşım önerilerinden bahsedilecektir. Anahtar Sözcükler: İnme, sensorimotor işlev bozulması, düşme, epilepsi, depresyon, demans. AFTER STROKE: GUIDELINES OF TURKISH SOCIETY OF CEREBROVASCULAR DISEASES -2015 ABSTRACTIn this section, recommendation of recent management approaches about post-stroke complications such as sensorymotor function impairment, drops, epilepsy, depression and dementia will be offered.

show abstract

Interventions for improving upper limb function after stroke

Pollock

Farmer

Brady

et al. 2014

Cochrane Database of Systematic Reviews

628

529

View full text Add to dashboard Cite

Large numbers of overlapping reviews related to interventions to improve upper limb function following stroke have been identified, and this overview serves to signpost clinicians and policy makers toward relevant systematic reviews to support clinical decisions, providing one accessible, comprehensive document, which should support clinicians and policy makers in clinical decision making for stroke rehabilitation.Currently, no high-quality evidence can be found for any interventions that are currently used as part of routine practice, and evidence is insufficient to enable comparison of the relative effectiveness of interventions. Effective collaboration is urgently needed to support large, robust RCTs of interventions currently used routinely within clinical practice. Evidence related to dose of interventions is particularly needed, as this information has widespread clinical and research implications.

show abstract

Therapy-based rehabilitation services for patients living at home more than one year after stroke

Abstract: Therapy-based rehabilitation services for patients living at home more than one year a er stroke.

Cited by 67 publications

References 36 publications

A rapid synthesis of the evidence on interventions supporting self-management for people with long-term conditions: PRISMS – Practical systematic RevIew of Self-Management Support for long-term conditions

A rapid synthesis of the evidence on interventions supporting self-management for people with long-term conditions: PRISMS – Practical systematic RevIew of Self-Management Support for long-term conditions

After Stroke: Guidelines Of Turkish Society Of Cerebrovascular Diseases – 2015

Interventions for improving upper limb function after stroke

Contact Info

Product

Resources

About