Non-pharmacological interventions for the improvement of post-stroke activities of daily living and disability amongst older stroke survivors: A systematic review

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dc.contributor.author Stewart, Carrie
dc.contributor.author Subbarayan, Selvarani
dc.contributor.author Paton, Pamela
dc.contributor.author Gemmell, Elliot
dc.contributor.author Abraha, Iosief
dc.contributor.author Myint, Phyo Kyaw
dc.contributor.author O'Mahony, Denis
dc.contributor.author Cruz-Jentoft, Alfonso J.
dc.contributor.author Cherubini, Antonio
dc.contributor.author Soiza, Roy L.
dc.date.accessioned 2019-09-02T14:35:26Z
dc.date.available 2019-09-02T14:35:26Z
dc.date.issued 2018-10-04
dc.identifier.citation Stewart, C., Subbarayan, S., Paton, P., Gemmell, E., Abraha, I., Myint, P.K., O’Mahony, D., Cruz-Jentoft, A.J., Cherubini, A. and Soiza, R.L., 2018. Non-pharmacological interventions for the improvement of post-stroke activities of daily living and disability amongst older stroke survivors: A systematic review. PloS one, 13(10), (e0204774).DOI: 10.1371/journal.pone.0204774 en
dc.identifier.volume 13 en
dc.identifier.issued 10 en
dc.identifier.startpage 1 en
dc.identifier.endpage 52 en
dc.identifier.uri http://hdl.handle.net/10468/8430
dc.identifier.doi 10.1371/journal.pone.0204774 en
dc.description.abstract Globally, stroke remains a leading cause of death and disability, with older adults disproportionately affected. Numerous non-pharmacological stroke rehabilitation approaches are in use to address impairments, but their efficacy in older persons is largely unknown. This systematic review examined the evidence for such interventions as part of the Optimal Evidence-Based Non-Drug Therapies in Older Persons (ONTOP) project conducted under an European Union funded project called the Software Engine for the Assessment and Optimisation of Drug and Non-Drug Therapies in Older Persons (SENATOR) [http://www.senator-project.eu]. A Delphi panel of European geriatric experts agreed activities of daily living and disability to be of critical importance as stroke rehabilitation outcomes. A comprehensive search strategy was developed and five databases (Pubmed, CINAHL, Embase, PsycInfo and Cochrane Database of Systematic Reviews) searched for eligible systematic reviews. Primary studies meeting our criteria (non-pharmacologic interventions, involving stroke survivors aged ≥65 years, assessing activities of daily living and/or disability as outcome) were then identified from these reviews. Eligible papers were double reviewed, and due to heterogeneity, narrative analysis performed. Cochrane risk of bias and GRADE assessment tools were used to assess bias and quality of evidence, allowing us to make recommendations regarding specific non-pharmacologic rehabilitation in older stroke survivors. In total, 72 primary articles were reviewed spanning 14 types of non-pharmacological intervention. Non-pharmacological interventions based on physiotherapy and occupational therapy techniques improved activities of daily living amongst older stroke survivors. However, no evidence was found to support use of any non-pharmacological approach to benefit older stroke survivors’ disability. Evidence was limited by poor study quality and the small number of studies targeting older stroke survivors. We recommend future studies explore such interventions exclusively in older adult populations and improve methodological and outcome reporting. en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher NLM (Medline) en
dc.relation.uri https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0204774
dc.rights © 2018 Stewart et al en
dc.rights.uri https://creativecommons.org/licenses/by/4.0/ en
dc.subject Stroke en
dc.subject Rehabilitation en
dc.subject Geriatric en
dc.subject Optimal evidence-based non-drug therapies in older persons (ONTOP) en
dc.title Non-pharmacological interventions for the improvement of post-stroke activities of daily living and disability amongst older stroke survivors: A systematic review en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother Denis O'Mahony, Department of Geriatric Medicine, University College Cork, Cork, Ireland. +353-21-490-3000 Email: denis.omahony@ucc.ie en
dc.internal.availability Full text available en
dc.description.version Published Version en
dc.contributor.funder Seventh Framework Programme en
dc.description.status Peer reviewed en
dc.identifier.journaltitle PloS one en
dc.internal.IRISemailaddress denis.omahony@ucc.ie en
dc.identifier.articleid e0204774 en
dc.relation.project info:eu-repo/grantAgreement/EC/FP7::SP1::HEALTH/305930/EU/Development and clinical trials of a new Software ENgine for the Assessment & Optimization of drug and non-drug Therapy in Older peRsons/SENATOR en
dc.identifier.eissn 1932-6203


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