Rehabilitation Department, West China Medical School, Sichuan University, Chengdu, PR China.
Institute for Disaster Management and Reconstruction, Sichuan University and Hong-Kong Polytechnic University, Chengdu, PR China.
Disabil Rehabil. 2023 Feb;45(3):403-414. doi: 10.1080/09638288.2022.2037755. Epub 2022 Feb 24.
This study aimed at establishing the impact of community-based rehabilitation (CBR) on the physical functioning and activity of daily living (ADL) of patients with stroke (PWS).
Based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, an electronic search was conducted in five databases, including PubMed, OVID Embase, OVID Medline, Cochrane Library, and Web of Science between May 2010 and 2020. Meta-analysis was performed using the Comprehensive Meta-Analysis Version 2 software to establish whether the studies were sufficiently homogenous.
Twenty studies out of 828 publications were included in the present systematic review. A significant difference between CBR intervention and control groups was identified about the physical functional capacity in mobility, 6-metre walk test (6MWT) ( = 0.351, 95% CI (0.110, 0.592)), community walking test (g= -0.473, 95% CI (-0.926, -0.020)) and on the other hand a significant improvement in ADL was found ( = 0.138, 95% CI(0.051, 0.224)).
CBR is revealed to be effective in improving the physical functioning and ADL for PWS and is drawn based on eligible studies which were conducted in high-income countries (HICs). This highlights a gap between developed and less-resourced countries as far as CBR for PWS is concerned and calls for a further study. CRD42020159683Implication for rehabilitationCommunity-based rehabilitation (CBR) is recommended as one of the best programme for treating stroke patients with stroke (PWS) after they are discharged from hospitals.CBR is effective in improving the physical functioning and activity of daily living of PWS.Further research should be carried out to compare between CBR and institution-based rehabilitation for PWS, especially the less-resourced settings which are grappling with a challenge of limited skilled rehabilitation professionals.
本研究旨在探讨社区康复（CBR）对脑卒中患者（PWS）身体功能和日常生活活动（ADL）的影响。
根据系统评价和荟萃分析的首选报告项目（PRISMA）指南，我们在 2010 年 5 月至 2020 年期间在五个数据库（PubMed、OVID Embase、OVID Medline、Cochrane Library 和 Web of Science）中进行了电子检索。使用 Comprehensive Meta-Analysis Version 2 软件进行荟萃分析，以确定研究是否具有足够的同质性。
在 828 篇文献中，有 20 篇研究被纳入本系统综述。CBR 干预组与对照组在移动能力、6 米步行测试（6MWT）（ = 0.351，95%置信区间（0.110，0.592））、社区行走测试（g= -0.473，95%置信区间（-0.926，-0.020））和 ADL 方面有显著差异。
CBR 被证明在提高 PWS 的身体功能和 ADL 方面是有效的，这是基于在高收入国家（HICs）进行的合格研究得出的。这突出了在 CBR 用于 PWS 方面，发达国家和资源较少国家之间存在差距，需要进一步研究。
社区康复（CBR）被推荐为治疗脑卒中后出院患者（PWS）的最佳方案之一。CBR 可有效改善 PWS 的身体功能和日常生活活动能力。应开展进一步的研究，比较 CBR 与机构为基础的康复对 PWS 的作用，特别是在资源有限、面临有限熟练康复专业人员挑战的情况下。
