Background/Aims: After stroke there is a known reduction in leisure participation, which correlates with lower quality of life. Given the potential for rehabilitation interventions to improve leisure outcomes, in this systematic review we aimed to determine the effectiveness of interventions to increase leisure participation.
Method: Systematic review with meta-analysis. Electronic databases (n=4) were searched for pre-test/post-test randomised and non-randomised controlled trials. Inclusion criteria: population = adult survivors of stroke; intervention = outpatient or community-based rehabilitation interventions to address leisure participation (group or individual); leisure participation outcomes = amount, satisfaction/confidence, and performance. Methodological quality was assessed using the PEDro Scale. A random effects meta-analysis was performed and heterogeneity among studies was assessed using a Cochran Q test.
Results: n=4551 papers were located; after screening n=8 met inclusion criteria and were included in the systematic review. Interventions included occupational therapy tailored to a leisure goal and protocolised education programs. Meta-analysis of n=4 trials showed leisure interventions increase leisure participation (standardised mean difference = 0.80, 95% confidence interval 0.03 to 1.56), and increase the number of leisure activities a person participates in (standardised mean difference = 1.34, 95% confidence interval 0.35 to 2.33). Subgroup analysis indicated possible benefits when intervention is provided within the first three months following stroke.
Conclusion: Rehabilitation interventions which aim to improve leisure participation may be effective, particularly if provided in the first three months. Further, well-designed randomised controlled trials are needed.