한국전문물리치료학회지 (Physical Therapy Korea)

  • 제31권2호
  • /
  • Pages.91-103
  • /
  • 2024
  • /
  • 1225-8962(pISSN)
  • /
  • 2287-982X(eISSN)
한국전문물리치료학회 (Korean Research Society of Physical Therapy)
권호 표지
DOI QR코드

DOI QR Code

Effect of Home-based Rehabilitation on Balance and Gait Function in Patient With Stroke: A Systematic Review and Meta-analysis

  • Yong-gu Han (Department of Physical Therapy, the Graduate School, Yonsei University) ;
  • Chung-hwi Yi (Department of Physical Therapy, College of Software and Digital Healthcare Convergence, Yonsei University)
  • 투고 : 2024.04.19
  • 심사 : 2024.07.02
  • 발행 : 2024.08.20
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Stroke is one of the most common disabilities experienced by the elderly in the community. However, stroke progresses to a chronic level, patients are discharged from medical institutions and eventually no longer receive therapeutic interventions at home. In this systematic review, we compared home-based rehabilitation (HBR) with comparison for patients with stroke. Literature published in Cumulative Index for Nursing and Allied Health Literature (CINAHL), Embase, Physiotherapy Evidence Database (PEDro), PubMed, and Google Scholar were reviewed. A total of 1,158 studies were initially retrieved. After reading the full texts, 11 articles were included in the systematic review. Quality assessment of the included studies was conducted using Risk of Bias (RoB) 2.0, and Egger's regression test was used to evaluate publication bias. Data analysis was performed using the R studio software (R Studio). According to the quality assessment using RoB 2.0, three studies were evaluated as low risk, two as of some concern, and three as high risk. The overall effect size was moderate (0.309). The value of the balance function was a small effect size (0.201), while the value of the gait function was a moderate effect size (0.353). The values were small and moderate effect (0.154, 0.411) for the chronic and subacute conditions, respectively. According to the Egger's regression test, no publication bias was observed. The findings of this study indicate that HBR resulted in the greatest improvement in gait function in patients with subacute stroke compared to those with chronic stroke. Therefore, the application of this intervention to patients with stroke in the community is recommended.

키워드

참고문헌

  1. Sharififar S, Shuster JJ, Bishop MD. Adding electrical stimulation during standard rehabilitation after stroke to improve motor function. A systematic review and meta-analysis. Ann Phys Rehabil Med 2018;61(5):339-44.  https://doi.org/10.1016/j.rehab.2018.06.005
  2. Chien WT, Chong YY, Tse MK, Chien CW, Cheng HY. Robot-assisted therapy for upper-limb rehabilitation in subacute stroke patients: a systematic review and meta-analysis. Brain Behav 2020;10(8):e01742. 
  3. Veldema J, Jansen P. Resistance training in stroke rehabilitation: systematic review and meta-analysis. Clin Rehabil 2020;34(9):1173-97.  https://doi.org/10.1177/0269215520932964
  4. Chen J, Or CK, Chen T. Effectiveness of using virtual reality-supported exercise therapy for upper extremity motor rehabilitation in patients with stroke: systematic review and meta-analysis of randomized controlled trials. J Med Internet Res 2022;24(6):e24111. 
  5. Huang J, Ji JR, Liang C, Zhang YZ, Sun HC, Yan YH, et al. Effects of physical therapy-based rehabilitation on recovery of upper limb motor function after stroke in adults: a systematic review and meta-analysis of randomized controlled trials. Ann Palliat Med 2022;11(2):521-31.  https://doi.org/10.21037/apm-21-3710
  6. Baek CY, Yoon HS, Kim HD, Kang KY. The effect of the degree of dual-task interference on gait, dual-task cost, cognitive ability, balance, and fall efficacy in people with stroke: a cross-sectional study. Medicine (Baltimore) 2021;100(24):e26275. 
  7. Wolfe CD, Tilling K, Rudd AG. The effectiveness of community-based rehabilitation for stroke patients who remain at home: a pilot randomized trial. Clin Rehabil 2000;14(6):563-9.  https://doi.org/10.1191/0269215500cr362oa
  8. Nadeau SE, Wu SS, Dobkin BH, Azen SP, Rose DK, Tilson JK, et al. Effects of task-specific and impairment-based training compared with usual care on functional walking ability after inpatient stroke rehabilitation: LEAPS Trial. Neurorehabil Neural Repair 2013;27(4):370-80.  https://doi.org/10.1177/1545968313481284
  9. Malagoni AM, Cavazza S, Ferraresi G, Grassi G, Felisatti M, Lamberti N, et al. Effects of a "test in-train out" walking program versus supervised standard rehabilitation in chronic stroke patients: a feasibility and pilot randomized study. Eur J Phys Rehabil Med 2016;52(3):279-87. 
  10. Chen J, Jin W, Dong WS, Jin Y, Qiao FL, Zhou YF, et al. Effects of home-based telesupervising rehabilitation on physical function for stroke survivors with hemiplegia: a randomized controlled trial. Am J Phys Med Rehabil 2017;96(3):152-60.  https://doi.org/10.1097/PHM.0000000000000559
  11. Vahlberg B, Cederholm T, Lindmark B, Zetterberg L, Hellstrom K. Short-term and long-term effects of a progressive resistance and balance exercise program in individuals with chronic stroke: a randomized controlled trial. Disabil Rehabil 2017;39(16):1615-22.  https://doi.org/10.1080/09638288.2016.1206631
  12. Nordin NAM, Aziz NA, Sulong S, Aljunid SM. Effectiveness of home-based carer-assisted in comparison to hospital-based therapist-delivered therapy for people with stroke: a randomised controlled trial. NeuroRehabilitation 2019;45(1):87-97.  https://doi.org/10.3233/NRE-192758
  13. Chen S, Lv C, Wu J, Zhou C, Shui X, Wang Y. Effectiveness of a home-based exercise program among patients with lower limb spasticity post-stroke: a randomized controlled trial. Asian Nurs Res (Korean Soc Nurs Sci) 2021;15(1):1-7.  https://doi.org/10.1016/j.anr.2020.08.007
  14. Lim JH, Lee HS, Song CS. Home-based rehabilitation programs on postural balance, walking, and quality of life in patients with stroke: a single-blind, randomized controlled trial. Medicine (Baltimore) 2021;100(35):e27154. 
  15. Aphiphaksakul P, Siriphorn A. Home-based exercise using balance disc and smartphone inclinometer application improves balance and activity of daily living in individuals with stroke: a randomized controlled trial. PLoS One 2022;17(11):e0277870. 
  16. Jarbandhan A, Toelsie J, Veeger D, Bipat R, Vanhees L, Buys R. Feasibility of a home-based physiotherapy intervention to promote post-stroke mobility: a randomized controlled pilot study. PLoS One 2022;17(3):e0256455. 
  17. Mao YR, Zhao JL, Bian MJ, Lo WLA, Leng Y, Bian RH, et al. Spatiotemporal, kinematic and kinetic assessment of the effects of a foot drop stimulator for home-based rehabilitation of patients with chronic stroke: a randomized clinical trial. J Neuroeng Rehabil 2022;19(1):56. 
  18. Jang HY, Kim YL, Lee SM. Perception and use of balance measures for stroke patients among physical therapists in South Korea. J Phys Ther Sci 2017;29(2):255-60.  https://doi.org/10.1589/jpts.29.255
  19. Cho KH, Lee JY, Lee KJ, Kang EK. Factors related to gait function in post-stroke patients. J Phys Ther Sci 2014;26(12):1941-4.  https://doi.org/10.1589/jpts.26.1941
  20. Lewek MD, Bradley CE, Wutzke CJ, Zinder SM. The relationship between spatiotemporal gait asymmetry and balance in individuals with chronic stroke. J Appl Biomech 2014;30(1):31-6.  https://doi.org/10.1123/jab.2012-0208
  21. Lopes PG, Lopes JA, Brito CM, Alfieri FM, Rizzo Battistella L. Relationships of balance, gait performance, and functional outcome in chronic stroke patients: a comparison of left and right lesions. Biomed Res Int 2015;2015:716042. 
  22. Hornby TG, Reisman DS, Ward IG, Scheets PL, Miller A, Haddad D, et al. Clinical practice guideline to improve locomotor function following chronic stroke, incomplete spinal cord injury, and brain injury. J Neurol Phys Ther 2020;44(1):49-100.  https://doi.org/10.1097/NPT.0000000000000303
  23. Johnston TE, Keller S, Denzer-Weiler C, Brown L. A clinical practice guideline for the use of ankle-foot orthoses and functional electrical stimulation post-stroke. J Neurol Phys Ther 2021;45(2):112-96.  https://doi.org/10.1097/NPT.0000000000000347
  24. Winstein CJ, Stein J, Arena R, Bates B, Cherney LR, Cramer SC, et al. Guidelines for adult stroke rehabilitation and recovery: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2016;47(6):e98-169.  https://doi.org/10.1161/STR.0000000000000098
  25. Deutschbein J, Grittner U, Schneider A, Schenk L. Community care coordination for stroke survivors: results of a complex intervention study. BMC Health Serv Res 2020;20(1):1143. 
  26. Wang F, Zhang S, Zhou F, Zhao M, Zhao H. Early physical rehabilitation therapy between 24 and 48h following acute ischemic stroke onset: a randomized controlled trial. Disabil Rehabil 2022;44(15):3967-72.  https://doi.org/10.1080/09638288.2021.1897168
  27. Lee M, Jeon B. A literature review of issues and tasks by period of revision of regulations related to convalescent rehabilitation wards in Japan: focusing on quality evaluation. J Korean Phys Ther 2022;34(1):26-37.  https://doi.org/10.18857/jkpt.2022.34.1.26
  28. Moshabela M, Sips I, Barten F. Needs assessment for home-based care and the strengthening of social support networks: the role of community care workers in rural South Africa. Glob Health Action 2015;8:29265. 
  29. Yamada T, Chen CC, Yamada T, Fahs M, Fukawa T. Behavioral analysis of the choice of community-based formal home care, informal home care and nursing home care in Japan. Geneva Pap Risk Insur Issues Pract 2006;31(4):600-32.  https://doi.org/10.1057/palgrave.gpp.2510101
  30. Chan A. An overview of Singapore's long-term care system: towards a community model care. In: Komazawa O, Saito Y editors. Coping with rapid population ageing in Asia. ERIA; 2021; 28-35. 
  31. Lee H, Lee SH. Effectiveness of multicomponent home-based rehabilitation in older patients after hip fracture surgery: a systematic review and meta-analysis. J Clin Nurs 2023;32(1-2):31-48.  https://doi.org/10.1111/jocn.16256
  32. Costa SN, Ferreira LHB, Bento PCB. Effects of home-based exercise programs on mobility, muscle strength, balance, and gait in community-dwelling older adults: a systematic review and meta-analysis. J Aging Phys Act 2023;31(4):693-704.  https://doi.org/10.1123/japa.2022-0221
  33. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021;372:n71. 
  34. Farrah K, Young K, Tunis MC, Zhao L. Risk of bias tools in systematic reviews of health interventions: an analysis of PROSPERO-registered protocols. Syst Rev 2019;8(1):280. 
  35. Linares-Espinos E, Hernandez V, Dominguez-Escrig JL, Fernandez-Pello S, Hevia V, Mayor J, et al. Methodology of a systematic review. Actas Urol Esp (Engl Ed) 2018;42(8):499-506.  https://doi.org/10.1016/j.acuro.2018.01.010
  36. Martimbianco ALC, Sa KMM, Santos GM, Santos EM, Pacheco RL, Riera R. Most Cochrane systematic reviews and protocols did not adhere to the Cochrane's risk of bias 2.0 tool. Rev Assoc Med Bras (1992) 2023;69(3):469-72.  https://doi.org/10.1590/1806-9282.20221593
  37. Bowden J, Davey Smith G, Burgess S. Mendelian randomization with invalid instruments: effect estimation and bias detection through Egger regression. Int J Epidemiol 2015;44(2):512-25.  https://doi.org/10.1093/ije/dyv080
  38. Han YG, Kim MK. Effectiveness of whole-body vibration in patients with cerebral palsy: a systematic review and meta-analysis. Medicine (Baltimore) 2023;102(48):e36441.  https://doi.org/10.1097/MD.0000000000036441
  39. Zainal NZ, Booth S, Huppert FA. The efficacy of mindfulness-based stress reduction on mental health of breast cancer patients: a meta-analysis. Psychooncology 2013;22(7):1457-65.  https://doi.org/10.1002/pon.3171
  40. Borenstein M, Hedges LV, Higgins JPT, Rothstein HR. Introduction to meta-analysis. 2nd ed. Wiley; 2021. 
  41. Han YG, Yun CK. Effectiveness of treadmill training on gait function in children with cerebral palsy: meta-analysis. J Exerc Rehabil 2020;16(1):10-9.  https://doi.org/10.12965/jer.1938748.374
  42. Grigoras IF, Stagg CJ. Recent advances in the role of excitation-inhibition balance in motor recovery post-stroke. Fac Rev 2021;10:58. 
  43. Meltzer EO, Wallace D, Dykewicz M, Shneyer L. Minimal clinically important difference (MCID) in allergic rhinitis: agency for healthcare research and quality or anchor-based thresholds? J Allergy Clin Immunol Pract 2016;4(4):682-8.e6.  https://doi.org/10.1016/j.jaip.2016.02.006
  44. Han YG, Yi CH. Effects of home-visit rehabilitation services provided via community-integrated care on the quality of life, balance control, cognitive function, activities of daily living and occupational performance among home-based people with disabilities. Korean J Phys Mult Health Disabil 2023;66(3):95-108. 
  45. Rauch A, Cieza A, Stucki G. How to apply the International Classification of Functioning, Disability and Health (ICF) for rehabilitation management in clinical practice. Eur J Phys Rehabil Med 2008;44(3):329-42. 
  46. Grzelczyk D, Szymanowska O, Awrejcewicz J. Gait pattern generator for control of a lower limb exoskeleton. Vib Phys Syst 2018;29:2018007. 
  47. Lee KB, Lim SH, Kim KH, Kim KJ, Kim YR, Chang WN, et al. Six-month functional recovery of stroke patients: a multi-time-point study. Int J Rehabil Res 2015;38(2):173-80.  https://doi.org/10.1097/MRR.0000000000000108
  48. Andrews AW, Bohannon RW. Short-term recovery of limb muscle strength after acute stroke. Arch Phys Med Rehabil 2003;84(1):125-30.  https://doi.org/10.1053/apmr.2003.50003
  49. Hunt S. Effective medication management in older people. In: Dunning T editor. Nursing care of older people with diabetes. Blackwell Publishing; 2005; 230-49.