Wray, F orcid.org/0000-0001-9351-5019, Clarke, D orcid.org/0000-0001-6279-1192 and Forster, A orcid.org/0000-0001-7466-4414 (2018) Post-stroke self-management interventions: a systematic review of effectiveness and investigation of the inclusion of stroke survivors with aphasia. Disability and Rehabilitation, 40 (11). pp. 1237-1251. ISSN 0963-8288
Abstract
Purpose: To systematically review self-management interventions to determine their efficacy for people with stroke in relation to any health outcome and to establish whether stroke survivors with aphasia were included. Method: We searched MEDLINE, EMBASE, PsycINFO, CINAHL, The Cochrane Library, and IBSS and undertook gray literature searches. Randomized controlled trials were eligible if they included stroke survivors aged 18 + in a “self-management” intervention. Data were extracted by two independent researchers and included an assessment of methodological quality. Results: 24 studies were identified. 11 out of 24 reported statistically significant benefits in favor of self-management. However, there were significant limitations in terms of methodological quality, and meta-analyses (n= 8 studies) showed no statistically significant benefit of self-management upon global disability and stroke-specific quality of life at 3 months or ADL at 3 or 6 months follow-up. A review of inclusion and exclusion criteria showed 11 out of 24 (46%) studies reported total or partial exclusion of stroke survivors with aphasia. Four out of 24 (17%) reported the number of stroke survivors with aphasia included. In nine studies (38%) it was unclear whether stroke survivors with aphasia were included or excluded. Conclusions: Robust conclusions regarding the effectiveness of poststroke self-management approaches could not be drawn. Further trials are needed, these should clearly report the population included. •Implications for rehabilitation •There is a lack of evidence to demonstrate the effectiveness of self-management approaches for stroke survivors. •It is unclear whether self-management approaches are suitable for stroke survivors with aphasia, particularly those with moderate or severe aphasia. •Further research is needed to understand the optimal timing for self-management in the stroke pathway and the format in which self-management support should be offered.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | (c) 2017 Taylor & Francis. This is an Accepted Manuscript of an article published by Taylor & Francis in Disability and Rehabilitation on 8 Mar 2017, available online: https://doi.org/10.1080/09638288.2017.1294206. Uploaded in accordance with the publisher's self-archiving policy. |
Keywords: | Stroke, self-management, aphasia, systematic review |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Health Sciences (Leeds) > Academic Unit of Elderly Care and Rehabilitation (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 09 Mar 2017 15:30 |
Last Modified: | 28 Mar 2018 08:34 |
Status: | Published |
Publisher: | Taylor & Francis |
Identification Number: | 10.1080/09638288.2017.1294206 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:113410 |