Accepted for/Published in: JMIR Research Protocols
Date Submitted: Jan 16, 2025
Date Accepted: Dec 31, 2025
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The effectiveness of rehabilitation interventions on improving leisure participation following stroke: Protocol for a systematic review
ABSTRACT
Background:
Leisure participation is an important rehabilitation goal for survivors of stroke. Several factors are likely to influence return to leisure participation, including stroke-related impairments as well as rehabilitation interventions provided and time since stroke. Previous systematic reviews and current clinical practice guidelines provide inconsistent recommendations regarding rehabilitation interventions to achieve increased participation in leisure.
Objective:
We propose a systematic review protocol to synthesize data on the effectiveness of rehabilitation interventions to increase leisure participation in adult stroke survivors, taking into account time post-stroke and intervention context.
Methods:
Searches will be conducted in MEDLINE, CINAHL, EMBASE, and Cochrane Controlled Register of Trials. We will include randomized controlled trials and non-randomized controlled trials which include adult stroke survivors and are testing the effectiveness of rehabilitation interventions for leisure. Eligible interventions will be those which aim to improve leisure participation, or where leisure participation is an outcome of interest. Two reviewers will independently screen full-text articles, and one reviewer will extract data, with a second reviewer providing confirmation. The PEDro Scale will be used to assess methodological quality of studies. A random effects meta-analysis will be performed, and a Cochran Q test will assess heterogeneity among studies. Outcome measures of leisure participation may include measures of leisure participation amount, satisfaction/confidence, and performance. Secondary outcomes will include quality of life measures, adverse events, and resource use.
Results:
Results will be discussed based on subgroup analyses where able, including (1) time post-stroke (acute-subacute or chronic), (2) delivery of intervention (group or individualized), (3) type of intervention (education, impairment-based, activity participation, or mixed).
Conclusions:
Findings of this review will increase understanding of effective rehabilitation practices to increase leisure participation after stroke and may contribute to updates of existing clinical practice guidelines for stroke rehabilitation. Clinical Trial: PROSPERO, https://www.crd.york.ac.uk/prospero/ (Registration ID: CRD42024547133)
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