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

dc.contributor.authorStewart, Carrie
dc.contributor.authorSubbarayan, Selvarani
dc.contributor.authorPaton, Pamela
dc.contributor.authorGemmell, Elliot
dc.contributor.authorAbraha, Iosief
dc.contributor.authorMyint, Phyo Kyaw
dc.contributor.authorO'Mahony, Denis
dc.contributor.authorCruz-Jentoft, Alfonso J.
dc.contributor.authorCherubini, Antonio
dc.contributor.authorSoiza, Roy L.
dc.contributor.funderSeventh Framework Programmeen
dc.date.accessioned2019-09-02T14:35:26Z
dc.date.available2019-09-02T14:35:26Z
dc.date.issued2018-10-04
dc.description.abstractGlobally, 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.description.statusPeer revieweden
dc.description.versionPublished Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.articleide0204774en
dc.identifier.citationStewart, 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.0204774en
dc.identifier.doi10.1371/journal.pone.0204774en
dc.identifier.eissn1932-6203
dc.identifier.endpage52en
dc.identifier.issued10en
dc.identifier.journaltitlePloS oneen
dc.identifier.startpage1en
dc.identifier.urihttps://hdl.handle.net/10468/8430
dc.identifier.volume13en
dc.language.isoenen
dc.publisherPublic Library of Science (PLoS)en
dc.relation.projectinfo: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/SENATORen
dc.relation.urihttps://journals.plos.org/plosone/article?id=10.1371/journal.pone.0204774
dc.rights© 2018 Stewart et alen
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/en
dc.subjectStrokeen
dc.subjectRehabilitationen
dc.subjectGeriatricen
dc.subjectOptimal evidence-based non-drug therapies in older persons (ONTOP)en
dc.titleNon-pharmacological interventions for the improvement of post-stroke activities of daily living and disability amongst older stroke survivors: A systematic reviewen
dc.typeArticle (peer-reviewed)en
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