Effectiveness Of Multidisciplinary Rehabilitation In Stroke Recovery: Integrating Physiotherapy, Occupational Therapy, And Cognitive Therapy- Systematic Review
DOI:
https://doi.org/10.48047/43d4ew52Keywords:
: Stroke Rehabilitation, Multidisciplinary Therapy, Physiotherapy, Occupational Therapy, Cognitive Therapy, Systematic ReviewAbstract
Background
Stroke is a leading global cause of long-term disability, often resulting in impairments that affect motor function, cognition, and communication. Traditional rehabilitation approaches frequently focus on isolated therapies, yet growing evidence supports the integration of multidisciplinary care. Despite this, the effectiveness of combined physiotherapy, occupational therapy, and cognitive or speech therapy remains inconsistently evaluated across literature, warranting a systematic review to clarify its clinical utility.
Objective: This systematic review aims to evaluate the effectiveness of multidisciplinary rehabilitation—specifically integrating physiotherapy, occupational therapy, and cognitive or speech therapy—in improving functional, cognitive, and communicative outcomes in adult stroke survivors.
Methods: A systematic review was conducted following PRISMA guidelines. Databases searched included PubMed, Scopus, Web of Science, Cochrane Library, and Google Scholar for studies published between 2012 and 2024. Inclusion criteria covered randomized controlled trials, observational studies, and qualitative research involving post-stroke adults undergoing multidisciplinary rehabilitation. Studies not in English, those focusing on single-modality therapy, or involving animal subjects were excluded. Risk of bias was assessed using the Cochrane Risk of Bias Tool and Newcastle-Ottawa Scale. Data were extracted using a standardized form, and results were synthesized narratively due to heterogeneity in outcome measures.
Results: Nine studies met inclusion criteria. Most reported significant improvements in balance, fine motor skills, activities of daily living, and communication when multidisciplinary rehabilitation was implemented. One trial showed a 91% improvement across multiple functional domains, while others highlighted enhanced independence and quality of life. Risk of bias was generally low to moderate, and findings were consistent across diverse healthcare settings.
Conclusion: Multidisciplinary rehabilitation appears to be more effective than isolated therapy approaches in supporting stroke recovery across physical, cognitive, and communicative domains. While the evidence is promising, variability in study designs and sample sizes suggests a need for further standardized, large-scale trials to validate these findings and guide clinical implementation.
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References
Fakhretdinov VV, Brynza NS, Al’bert AK. Effectiveness of a multidisciplinary approach in the rehabilitation treatment of post-stroke patients at the outpatient stage of medical rehabilitation. Russian Medicine. 2020;26(1):4-9.
de Oliveira Cacho R, Moro CHC, Bazan R, da Guarda SNF, Pinto EB, dos Santos Andrade SMM, et al. Access to rehabilitation after stroke in Brazil (AReA study): multicenter study protocol. Arquivos de neuro-psiquiatria. 2022;80(10):1067-74.
Ilsa Waqi Khunsha FA, Haris Hassan, Affaf Ameen, Sundus Fatima, Faiza Badar, Ayesha Farrukh. Examining the Benefits of Multidisciplinary Rehabilitation Intervention for Stroke Patients. Allied Medical Research Journal. 2024;2(1).
Onose G, Martinková P, Philipp T, Rasová K, Rasová K, Martinková P, et al. COMIRESTROKE—A clinical study protocol for monitoring clinical effect and molecular biological readouts of COMprehensive Intensive. 2022.
Niyonkuru F, Nshimiyimana J, Girizina D, Niyitegeka JP, Urimubenshi G. Perceptions of stroke patients attending King Faisal Hospital-Rwanda regarding the effectiveness of the rehabilitation services. Rwanda Public Health Bulletin. 2024;5(4):36-42.
V. V. Polyanskaya MSV, A. E. Kardasheva, L. M. Sharifyanova, E. Z. Khaidarov. Efficacy of modern rehabilitation methods after stroke. Clinical Medicine (Russian Journal). 2024 102(7).
Montanaro VVA. Letter to “Access to rehabilitation after stroke in Brazil (AReA study): multicenter study protocol”. Arquivos de Neuro-Psiquiatria. 2023;81(7):701-2.
Bettger JAP, Stineman MG. Effectiveness of multidisciplinary rehabilitation services in postacute care: state-of-the-science. A review. Archives of physical medicine and rehabilitation. 2007;88(11):1526-34.
Turner-Stokes L. Evidence for the effectiveness of multi-disciplinary rehabilitation following acquired brain injury: a synthesis of two systematic approaches. Journal of rehabilitation Medicine. 2008;40(9):691-701.
Walker MF, Sunnerhagen KS, Fisher RJ. Evidence-based community stroke rehabilitation. Stroke. 2013;44(1):293-7.
Fens M, Vluggen TP, van Haastregt JC, Verbunt JA, Beusmans G, van Heugten CM. Multidisciplinary care for stroke patients living in the community: a systematic review. Journal of rehabilitation medicine. 2013;45(4):321-30.
Steultjens EM, Dekker J, Bouter LM, Van de Nes JC, Cup EH, Van den Ende CH. Occupational therapy for stroke patients: a systematic review. Stroke. 2003;34(3):676-87.
Sulch D, Perez I, Melbourn A, Kalra L. Randomized controlled trial of integrated (managed) care pathway for stroke rehabilitation. Stroke. 2000;31(8):1929-34.
Hatem SM, Saussez G, Della Faille M, Prist V, Zhang X, Dispa D, et al. Rehabilitation of motor function after stroke: a multiple systematic review focused on techniques to stimulate upper extremity recovery. Frontiers in human neuroscience. 2016;10:442.
Řasová K, Martinková P, Vařejková M, Miznerová B, Pavlíková M, Hlinovská J, et al. COMIRESTROKE—A clinical study protocol for monitoring clinical effect and molecular biological readouts of COM prehensive I ntensive RE habilitation program after STROKE: A four-arm parallel-group randomized double blinded controlled trial with a longitudinal design. Frontiers in Neurology. 2022;13:954712.
Malik AN, Tariq H, Afridi A, Azam Rathore F. Technological advancements in stroke rehabilitation. Journal of Pakistan Medical Association. 2022;72(8):1672-4.
Hall P, Williams D, Hickey A, Brewer L, Mellon L, Dolan E, et al. Access to rehabilitation at six months post stroke: a profile from the Action on Secondary Prevention Interventions and Rehabilitation in Stroke (ASPIRE-S) Study. Cerebrovascular Diseases. 2016;42(3-4):247-54.
Pinter MM, Brainin M. Rehabilitation after stroke in older people. Maturitas. 2012;71(2):104-8.
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