Telerehabilitation for Lower Extremity Recovery Poststroke: a Systematic Review and Meta-analysis Protocol

Overview

Journal BMJ Open

Specialty General Medicine

Date 2022 Mar 10

PMID 35264359

Authors

Sarah Park

Ada Tang

Courtney Pollock

Brodie M Sakakibara

Affiliations

Soon will be listed here.

Abstract

Introduction: Approximately 30% of individuals with stroke report unmet lower extremity recovery needs after formal hospital-based rehabilitation programmes have ended. Telerehabilitation can mitigate issues surrounding accessibility of rehabilitation services by providing ongoing support to promote recovery, however, no review exists that is specific to telerehabilitation for lower extremity recovery. This paper describes the protocol of a systematic review and meta-analysis that aims to describe and evaluate the effectiveness of lower extremity-focused telerehabilitation interventions on clinical outcomes poststroke.

Methods And Analysis: A systematic review of relevant electronic databases (MEDLINE, Embase, CINAHL, PsycINFO, Web of Science, Google Scholar, PEDro, PubMed and Cochrane Library) between inception and February 2022 will be undertaken to identify eligible interventional studies published in English that compared telerehabilitation focusing on lower extremity recovery to another intervention or usual care for individuals living in the community with stroke. Clinical outcomes examined will include those related to physical function and impairment, activities and participation that are typically assessed in clinical practice and research. Two reviewers will independently screen results, identify studies to be included for review, extract data and assess risk of bias. Meta-analyses will be performed if sufficient data exist. Sensitivity analyses will be performed by removing studies with low methodological quality, and subgroup analyses will be performed if data allow by stratifying papers based on salient demographic or stroke factors and comparing results. The reporting of the review will follow the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. The quality of evidence regarding various outcomes for telerehabilitation for lower extremity recovery poststroke will be assessed according to the Grading of Recommendation, Assessment, Development and Evaluation approach.

Ethics And Dissemination: No ethical approval or informed consent is needed for this systematic review. The findings of this review will be disseminated via peer-reviewed publications and conference presentations.

Prospero Registration Number: CRD42021246886.

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References

Faria-Fortini I, Basilio M, Polese J, Menezes K, Faria C, Scianni A . Strength deficits of the paretic lower extremity muscles were the impairment variables that best explained restrictions in participation after stroke. Disabil Rehabil. 2016; 39(21):2158-2163. DOI: 10.1080/09638288.2016.1219397. View

Guyatt G, Oxman A, Vist G, Kunz R, Falck-Ytter Y, Alonso-Coello P . GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ. 2008; 336(7650):924-6. PMC: 2335261. DOI: 10.1136/bmj.39489.470347.AD. View

Bushnell C, Lee J, Duncan P, Newby L, Goldstein L . Impact of comorbidities on ischemic stroke outcomes in women. Stroke. 2008; 39(7):2138-40. PMC: 2633088. DOI: 10.1161/STROKEAHA.107.509281. View

. United Kingdom transient ischaemic attack (UK-TIA) aspirin trial: interim results. UK-TIA Study Group. Br Med J (Clin Res Ed). 1988; 296(6618):316-20. PMC: 2544832. View

Umeano O, Phillips-Bute B, Hailey C, Sun W, Gray M, Roulhac-Wilson B . Gender and age interact to affect early outcome after intracerebral hemorrhage. PLoS One. 2013; 8(11):e81664. PMC: 3842307. DOI: 10.1371/journal.pone.0081664. View

Nakayama H, Jorgensen H, Raaschou H, Olsen T . The influence of age on stroke outcome. The Copenhagen Stroke Study. Stroke. 1994; 25(4):808-13. DOI: 10.1161/01.str.25.4.808. View

Savitz S, Lew R, Bluhmki E, Hacke W, Fisher M . Shift analysis versus dichotomization of the modified Rankin scale outcome scores in the NINDS and ECASS-II trials. Stroke. 2007; 38(12):3205-12. DOI: 10.1161/STROKEAHA.107.489351. View

Luk J, Cheung R, Ho S, Li L . Does age predict outcome in stroke rehabilitation? A study of 878 Chinese subjects. Cerebrovasc Dis. 2006; 21(4):229-34. DOI: 10.1159/000091219. View

Desilles J, Meseguer E, Labreuche J, Lapergue B, Sirimarco G, Gonzalez-Valcarcel J . Diabetes mellitus, admission glucose, and outcomes after stroke thrombolysis: a registry and systematic review. Stroke. 2013; 44(7):1915-23. DOI: 10.1161/STROKEAHA.111.000813. View

10.

Sarfo F, Ulasavets U, Opare-Sem O, Ovbiagele B . Tele-Rehabilitation after Stroke: An Updated Systematic Review of the Literature. J Stroke Cerebrovasc Dis. 2018; 27(9):2306-2318. PMC: 6087671. DOI: 10.1016/j.jstrokecerebrovasdis.2018.05.013. View

11.

Bohannon R, Horton M, Wikholm J . Importance of four variables of walking to patients with stroke. Int J Rehabil Res. 1991; 14(3):246-50. DOI: 10.1097/00004356-199109000-00010. View

12.

Chen J, Jin W, Dong W, Jin Y, Qiao F, Zhou Y . Effects of Home-based Telesupervising Rehabilitation on Physical Function for Stroke Survivors with Hemiplegia: A Randomized Controlled Trial. Am J Phys Med Rehabil. 2016; 96(3):152-160. DOI: 10.1097/PHM.0000000000000559. View

13.

Bagg S, Pombo A, Hopman W . Effect of age on functional outcomes after stroke rehabilitation. Stroke. 2002; 33(1):179-85. DOI: 10.1161/hs0102.101224. View

14.

Patel A, Duncan P, Lai S, Studenski S . The relation between impairments and functional outcomes poststroke. Arch Phys Med Rehabil. 2000; 81(10):1357-63. DOI: 10.1053/apmr.2000.9397. View

15.

Forster A, Young J . Incidence and consequences of falls due to stroke: a systematic inquiry. BMJ. 1995; 311(6997):83-6. PMC: 2550147. DOI: 10.1136/bmj.311.6997.83. View

16.

Ovbiagele B, Goldstein L, Higashida R, Howard V, Johnston S, Khavjou O . Forecasting the future of stroke in the United States: a policy statement from the American Heart Association and American Stroke Association. Stroke. 2013; 44(8):2361-75. DOI: 10.1161/STR.0b013e31829734f2. View

17.

Deng H, Durfee W, Nuckley D, Rheude B, Severson A, Skluzacek K . Complex versus simple ankle movement training in stroke using telerehabilitation: a randomized controlled trial. Phys Ther. 2011; 92(2):197-209. PMC: 3269771. DOI: 10.2522/ptj.20110018. View

18.

Simic-Panic D, Boskovic K, Milicevic M, Zikic T, Bosnjak M, Tomasevic-Todorovic S . The Impact of Comorbidity on Rehabilitation Outcome after Ischemic Stroke. Acta Clin Croat. 2018; 57(1):5-15. PMC: 6400340. DOI: 10.20471/acc.2018.57.01.01. View

19.

Moseley A, Elkins M, van der Wees P, Pinheiro M . Using research to guide practice: The Physiotherapy Evidence Database (PEDro). Braz J Phys Ther. 2019; 24(5):384-391. PMC: 7563998. DOI: 10.1016/j.bjpt.2019.11.002. View

20.

Chess L, Gagnier J . Applicable or non-applicable: investigations of clinical heterogeneity in systematic reviews. BMC Med Res Methodol. 2016; 16:19. PMC: 4756511. DOI: 10.1186/s12874-016-0121-7. View