Self-management programmes for people post stroke: a systematic review

Lennon, Sheila
McKenna, Suzanne
Jones, Fiona

¹Physiotherapy, School of Medicine, Flinders University, Adelaide, Australia
²School of Health Sciences, Institute of Nursing and Health Research, University of Ulster, Antrim, UK
³Faculty of Health and Social Care, St George's University of London and Kingston University, UK

Received: 27 October 2011; accepted: 9 February 2013

Corresponding author:

Sheila Lennon, Physiotherapy (Flinders University), Health Sciences Building, Repatriation General Hospital, Daws Road, Daw Park, Adelaide, SA 5041, Australia.

Email: [email protected]

Clinical Rehabilitation 27(10):p 867-878, October 2013. | DOI: 10.1177/0269215513481045

Abstract

Objective:

To examine the evidence base underlying self-management programmes specific to stroke survivors.

Data sources:

Eleven electronic databases were searched using combinations of keywords related to stroke and self-management.

Review methods:

Studies involving adults with a clinical diagnosis of stroke, which explored self-management interventions, were included. Study selection was verified by two reviewers who independently conducted methodological quality appraisal and data extraction using a tool developed by The American Academy for Cerebral Palsy and Developmental Medicine.

Results:

Fifteen studies were included in this review. Significant treatment effects in favour of the self-management intervention were found in six out of nine randomized controlled trials, and three out of six non-randomized trials in our review. Four randomized controlled trials involving more than 100 participants per trial reported statistically significant results in favour of the self-management group in relation to measures of disability, confidence in recovery, the stroke specific quality of life (sub-scales of family roles and fine motor tasks), and the physical component scale of the short form SF-36 Score. The wide range of outcome measures used prevented comparison across studies.

Conclusions:

This review provides some preliminary support for the potential importance of self-management interventions after stroke. The most appropriate content and best approach for delivery of these interventions remains to be determined. Further high-quality randomized controlled trials are needed to test the feasibility, acceptability, and efficacy of stroke self-management programmes.