School of Psychology, University of Adelaide, Adelaide, South Australia, Australia.
School of Social Sciences and Psychology, University of Western Sydney, Penrith, New South Wales, Australia.
Top Stroke Rehabil. 2014 Jan-Feb;21(1):40-51. doi: 10.1310/tsr2101-40.
Evidence suggests that the incorporation of leisure activities in adult stroke rehabilitation can contribute to improved physical, cognitive, and psychological outcomes. However, differences in study design and treatment delivery may affect these findings. Furthermore, the magnitude of therapeutic change associated with leisure therapy is unclear, with few quantitative reviews available.
To synthesize and evaluate the empirical evidence examining leisure therapy in stroke rehabilitation.
Eight independent studies (N = 615 participants) were identified from a comprehensive database search. Study quality was evaluated using the Oxford Levels of Evidence. Pre- and posttreatment data for participants who received leisure therapy, in comparison with peers who received standard care or no treatment, were evaluated by calculating Cohen's d effect sizes and 95% confidence intervals.
No studies met the criteria for the highest level of methodological rigor, although all used randomization procedures. Leisure therapy contributed to significant short-term improvements in psychological outcomes, namely quality of life and mood (d range, 2.10 to 0.54), in addition to leisure-specific outcomes, including increased participation in and satisfaction with leisure activities (d range, 0.81 to 1.23). Longer term effects of treatment could not be determined, with one study providing data and reporting nonsignificant effects (d range, -0.07 to 0.17).
There is some evidence that leisure therapy offers an opportunity to enhance short-term treatment gains in community-based stroke rehabilitation. Further controlled research is needed to establish its longer term effects and assist the development of evidence-based guidelines for this treatment.
有证据表明，将休闲活动融入成人中风康复中可以促进身体、认知和心理方面的改善。然而，研究设计和治疗方法的差异可能会影响这些发现。此外，休闲疗法带来的治疗效果变化幅度尚不清楚，目前定量综述较少。
综合评估休闲疗法在中风康复中的实证证据。
通过全面的数据库搜索，确定了 8 项独立研究（共 615 名参与者）。使用牛津证据等级评价研究质量。与接受标准护理或未治疗的同龄人相比，接受休闲疗法的参与者的治疗前和治疗后数据，通过计算 Cohen's d 效应大小和 95%置信区间进行评估。
没有研究达到最高方法严谨性标准，尽管所有研究都使用了随机分组程序。休闲疗法在短期心理结果（生活质量和情绪，d 值范围为 2.10 至 0.54）方面有显著改善，同时在休闲特定结果（包括增加休闲活动的参与度和满意度，d 值范围为 0.81 至 1.23）方面也有显著改善。治疗的长期效果无法确定，一项研究提供的数据显示治疗效果无显著差异（d 值范围为-0.07 至 0.17）。
有一些证据表明，休闲疗法为改善社区中风康复的短期治疗效果提供了机会。需要进一步的对照研究来确定其长期效果，并为这种治疗方法制定循证指南提供帮助。
