Telehealth Interventions to Support Self-Management in Stroke Survivors: A Systematic Review
Abstract
:1. Introduction
2. Materials and Methods
2.1. Search Strategy and Selection Criteria
2.2. Quality Appraisal
2.3. Outcomes and Relevance
3. Results
3.1. Participants’ Characteristics
3.2. Types of TH delivery
3.3. Frequency, Duration, and Length of Intervention
3.4. Intervention
3.4.1. Education: Stroke Related Issues and Self-Management
3.4.2. Information: Sources of Social or Peer Support or Adaptive Equipment
3.4.3. Remote Monitoring with Feedback and Action Plans
3.4.4. Training/Rehearsal for Everyday Activities
3.4.5. Clinical Review: Regular Follow-Up Reviews
3.4.6. Adherence Support
3.4.7. Psychological Support: Goal Setting, Action Planning, and Problem Solving Strategies
3.4.8. Social Support: Peer Support, Peer Mentoring, and Group Socialization
3.4.9. Lifestyle Advice and Support: Practical Advice in Relation to Handling Life Stressors
3.5. Outcome Measures
3.5.1. SM Behaviors
3.5.2. Clinical Outcomes
3.5.3. Self-Efficacy
3.5.4. QOL
3.5.5. TH Acceptance
4. Discussion
4.1. Interventions
4.2. Types of TH Delivery
4.3. Outcomes and Effects of TH-SM Support Intervention
4.4. Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Conflicts of Interest
References
- O’Neill, D.; Horgan, F.; Hickey, A.; McGee, H. Stroke is a chronic disease with acute events. BMJ 2008, 336, 461. [Google Scholar] [CrossRef] [Green Version]
- Kendall, E.; Rogers, A. Extinguishing the social?: State sponsored self-care policy and the Chronic Disease Self-Management Programme. Disabil. Soc. 2007, 22, 129–143. [Google Scholar]
- World Health Organization. Innovative Care for Chronic Conditions: Building Blocks for Action. Available online: https://www.who.int/chp/knowledge/publications/icccglobalreport.pdf?ua=1 (accessed on 3 January 2021).
- Adams, K.; Greiner, A.C.; Corrigan, J.M. Institute of Medicine Committee on the Crossing the Quality Chasm: Next Steps Toward a New Health Care, S. In The 1st Annual Crossing the Quality Chasm Summit: A Focus on Communities; National Academies Press: Washington, DC, USA, 2004. [Google Scholar]
- Corbin, J.; Strauss, A. Unending Work and Care: Managing Chronic Illness at Home; Jossey-Bass: San Francisco, CA, USA, 1988. [Google Scholar]
- Pearce, G.; Parke, H.L.; Pinnock, H.; Epiphaniou, E.; Bourne, C.L.; Sheikh, A.; Taylor, S.J. The PRISMS taxonomy of self-management support: Derivation of a novel taxonomy and initial testing of its utility. J. Health Serv. Res. Policy 2016, 21, 73–82. [Google Scholar] [CrossRef] [PubMed]
- Hoffmann, T.C.; Erueti, C.; Glasziou, P.P. Poor description of non-pharmacological interventions: Analysis of consecutive sample of randomised trials. BMJ 2013, 347, f3755. [Google Scholar] [PubMed] [Green Version]
- Hanlon, P.; Daines, L.; Campbell, C.; McKinstry, B.; Weller, D.; Pinnock, H. Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer. J. Med. Internet Res. 2017, 19, e172. [Google Scholar] [PubMed]
- Kvedar, J.; Coye, M.J.; Everett, W. Connected health: A review of technologies and strategies to improve patient care with telemedicine and telehealth. Health Aff. 2014, 33, 194–199. [Google Scholar] [CrossRef] [Green Version]
- Brennan, D.; Mawson, S.; Brownsell, S. Telerehabilitation: Enabling the remote delivery of healthcare, rehabilitation, and self management. Stud. Health Technol. Inform. 2009, 145, 231–248. [Google Scholar] [PubMed]
- Schwamm, L.H.; Holloway, R.G.; Amarenco, P.; Audebert, H.J.; Bakas, T.; Chumbler, N.R.; Handschu, R.; Jauch, E.C.; Knight, W.A.t.; Levine, S.R.; et al. A review of the evidence for the use of telemedicine within stroke systems of care: A scientific statement from the American Heart Association/American Stroke Association. Stroke 2009, 40, 2616–2634. [Google Scholar] [CrossRef]
- Johansson, T.; Wild, C. Telerehabilitation in stroke care-a systematic review. J. Telemed. Telecare 2011, 17, 1–6. [Google Scholar]
- Feigin, V.L.; Roth, G.A.; Naghavi, M.; Parmar, P.; Krishnamurthi, R.; Chugh, S.; Mensah, G.A.; Norrving, B.; Shiue, I.; Ng, M.; et al. Global burden of stroke and risk factors in 188 countries, during 1990-2013: A systematic analysis for the Global Burden of Disease Study 2013. Lancet Neurol. 2016, 15, 913–924. [Google Scholar] [CrossRef] [Green Version]
- Sarfo, F.S.; Akassi, J.; Awuah, D.; Adamu, S.; Nkyi, C.; Owolabi, M.; Ovbiagele, B. Trends in stroke admission and mortality rates from 1983 to 2013 in central Ghana. J. Neurol. Sci. 2015, 357, 240–245. [Google Scholar] [CrossRef]
- Chow, C.K.; Redfern, J.; Hillis, G.S.; Thakkar, J.; Santo, K.; Hackett, M.L.; Jan, S.; Graves, N.; de Keizer, L.; Barry, T.; et al. Effect of Lifestyle-Focused Text Messaging on Risk Factor Modification in Patients with Coronary Heart Disease: A Randomized Clinical Trial. JAMA 2015, 314, 1255–1263. [Google Scholar] [CrossRef]
- Wan, L.H.; Zhang, X.P.; You, L.M.; Ruan, H.F.; Chen, S.X. The Efficacy of a Comprehensive Reminder System to Improve Health Behaviors and Blood Pressure Control in Hypertensive Ischemic Stroke Patients: A Randomized Controlled Trial. J. Cardiovasc. Nurs. 2018, 33, 509–517. [Google Scholar] [CrossRef]
- Moher, D.; Liberati, A.; Tetzlaff, J.; Altman, D.G.; The, P.G. Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med. 2009, 6, e1000097. [Google Scholar] [CrossRef] [Green Version]
- Physiotherapy Evidence Database. PEDro Scale. Available online: https://www.pedro.org.au/english/downloads/pedro-scale/ (accessed on 27 January 2020).
- Kim, S.Y.; Park, J.E.; Lee, Y.J.; Seo, H.J.; Sheen, S.S.; Hahn, S.; Jang, B.H.; Son, H.J. Testing a tool for assessing the risk of bias for nonrandomized studies showed moderate reliability and promising validity. J. Clin. Epidemiol. 2013, 66, 408–414. [Google Scholar] [CrossRef]
- Cadilhac, D.A.; Andrew, N.E.; Busingye, D.; Cameron, J.; Thrift, A.G.; Purvis, T.; Li, J.C.; Kneebone, I.; Thijs, V.; Hackett, M.L.; et al. Pilot randomised clinical trial of an eHealth, self-management support intervention (iVERVE) for stroke: Feasibility assessment in survivors 12–24 months post-event. Pilot Feasibility Stud. 2020, 6, 172. [Google Scholar] [CrossRef]
- Chumbler, N.R.; Quigley, P.; Li, X.; Morey, M.; Rose, D.; Sanford, J.; Griffiths, P.; Hoenig, H. Effects of telerehabilitation on physical function and disability for stroke patients: A randomized, controlled trial. Stroke 2012, 43, 2168–2174. [Google Scholar] [CrossRef] [Green Version]
- Chumbler, N.R.; Li, X.; Quigley, P.; Morey, M.C.; Rose, D.; Griffiths, P.; Sanford, J.; Hoenig, H. A randomized controlled trial on Stroke telerehabilitation: The effects on falls self-efficacy and satisfaction with care. J. Telemed. Telecare 2015, 21, 139–143. [Google Scholar] [CrossRef] [Green Version]
- Ifejika, N.L.; Bhadane, M.; Cai, C.C.; Noser, E.A.; Grotta, J.C.; Savitz, S.I. Use of a Smartphone-Based Mobile App for Weight Management in Obese Minority Stroke Survivors: Pilot Randomized Controlled Trial with Open Blinded End Point. JMIR mHealth uHealth 2020, 8, e17816. [Google Scholar] [CrossRef]
- Kamoen, O.; Maqueda, V.; Yperzeele, L.; Pottel, H.; Cras, P.; Vanhooren, G.; Vanacker, P. Stroke coach: A pilot study of a personal digital coaching program for patients after ischemic stroke. Acta Neurol. Belg. 2020, 120, 91–97. [Google Scholar] [CrossRef] [PubMed]
- Huijbregts, M.P.; McEwen, S.; Taylor, D. Exploring the feasibility and efficacy of a telehealth stroke self-management programme: A pilot study. Physiother Can. 2009, 61, 210–220. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Taylor, D.M.; Cameron, J.I.; Walsh, L.; McEwen, S.; Kagan, A.; Streiner, D.L.; Huijbregts, M.P. Exploring the feasibility of videoconference delivery of a self-management program to rural participants with stroke. Telemed. J. E Health 2009, 15, 646–654. [Google Scholar] [CrossRef] [PubMed]
- Skolarus, L.E.; Piette, J.D.; Pfeiffer, P.N.; Williams, L.S.; Mackey, J.; Hughes, R.; Morgenstern, L.B. Interactive Voice Response-An Innovative Approach to Post-Stroke Depression Self-Management Support. Transl. Stroke Res. 2017, 8, 77–82. [Google Scholar] [CrossRef] [Green Version]
- Kamwesiga, J.T.; Eriksson, G.M.; Tham, K.; Fors, U.; Ndiwalana, A.; von Koch, L.; Guidetti, S. A feasibility study of a mobile phone supported family-centred ADL intervention, F@ceTM, after stroke in Uganda. Glob. Health 2018, 14, 82. [Google Scholar] [CrossRef]
- Guidetti, S.; Gustavsson, M.; Tham, K.; Andersson, M.; Fors, U.; Ytterberg, C. F@ce: A team-based, person-centred intervention for rehabilitation after stroke supported by information and communication technology-a feasibility study. BMC Neurol. 2020, 20, 387. [Google Scholar] [CrossRef]
- Hasin, D.S.; Goodwin, R.D.; Stinson, F.S.; Grant, B.F. Epidemiology of major depressive disorder: Results from the National Epidemiologic Survey on Alcoholism and Related Conditions. Arch. Gen. Psychiatry 2005, 62, 1097–1106. [Google Scholar] [CrossRef]
- Parikh, R.M.; Robinson, R.G.; Lipsey, J.R.; Starkstein, S.E.; Fedoroff, J.P.; Price, T.R. The impact of poststroke depression on recovery in activities of daily living over a 2-year follow-up. Arch. Neurol. 1990, 47, 785–789. [Google Scholar] [CrossRef]
- Miranda, J.J.; Moscoso, M.G.; Toyama, M.; Cavero, V.; Diez-Canseco, F.; Ovbiagele, B. Role of mHealth in overcoming the occurrence of post-stroke depression. Acta Neurol. Scand. 2018, 137, 12–19. [Google Scholar] [CrossRef] [Green Version]
- Baseman, S.; Fisher, K.; Ward, L.; Bhattacharya, A. The relationship of physical function to social integration after stroke. J. Neurosci. Nurs. 2010, 42, 237–244. [Google Scholar] [CrossRef]
- Ru, X.; Dai, H.; Jiang, B.; Li, N.; Zhao, X.; Hong, Z.; He, L.; Wang, W. Community-Based Rehabilitation to Improve Stroke Survivors’ Rehabilitation Participation and Functional Recovery. Am. J. Phys. Med. Rehabil. 2017, 96, e123–e129. [Google Scholar] [CrossRef]
- Warner, G.; Packer, T.; Villeneuve, M.; Audulv, A.; Versnel, J. A systematic review of the effectiveness of stroke self-management programs for improving function and participation outcomes: Self-management programs for stroke survivors. Disabil. Rehabil. 2015, 37, 2141–2163. [Google Scholar] [CrossRef] [PubMed]
- Rimmer, J.H.; Braunschweig, C.; Silverman, K.; Riley, B.; Creviston, T.; Nicola, T. Effects of a short-term health promotion intervention for a predominantly African-American group of stroke survivors. Am. J. Prev. Med. 2000, 18, 332–338. [Google Scholar] [CrossRef]
- Ovbiagele, B.; Saver, J.L.; Fredieu, A.; Suzuki, S.; McNair, N.; Dandekar, A.; Razinia, T.; Kidwell, C.S. PROTECT: A coordinated stroke treatment program to prevent recurrent thromboembolic events. Neurology 2004, 63, 1217–1222. [Google Scholar] [CrossRef] [PubMed]
- Wang, J.; Cai, C.; Padhye, N.; Orlander, P.; Zare, M. A Behavioral Lifestyle Intervention Enhanced with Multiple-Behavior Self-Monitoring Using Mobile and Connected Tools for Underserved Individuals with Type 2 Diabetes and Comorbid Overweight or Obesity: Pilot Comparative Effectiveness Trial. JMIR mHealth uHealth 2018, 6, e92. [Google Scholar] [CrossRef]
- Champion, V.; Skinner, C. The health belief model. In Health Behavior and Health Education: Theory, Research, Practice, 4th ed.; Glanz, K., Rimer, B.K., Viswanath, K., Eds.; San Josseybass: Francisco, CA, USA, 2008; pp. 45–65. [Google Scholar]
- Kassavou, A.; Sutton, S. Automated telecommunication interventions to promote adherence to cardio-metabolic medications: Meta-analysis of effectiveness and meta-regression of behaviour change techniques. Health Psychol. Rev. 2018, 12, 25–42. [Google Scholar] [CrossRef] [PubMed]
- Posadzki, P.; Mastellos, N.; Ryan, R.; Gunn, L.H.; Felix, L.M.; Pappas, Y.; Gagnon, M.P.; Julious, S.A.; Xiang, L.; Oldenburg, B.; et al. Automated telephone communication systems for preventive healthcare and management of long-term conditions. Cochrane Database Syst. Rev. 2016, 12, Cd009921. [Google Scholar] [CrossRef] [Green Version]
- Son, Y.J.; Lee, Y.; Lee, H.J. Effectiveness of Mobile Phone-Based Interventions for Improving Health Outcomes in Patients with Chronic Heart Failure: A Systematic Review and Meta-Analysis. Int. J. Environ. Res. Public Health 2020, 17, 1749. [Google Scholar] [CrossRef] [Green Version]
- Tighe, S.A.; Ball, K.; Kensing, F.; Kayser, L.; Rawstorn, J.C.; Maddison, R. Toward a Digital Platform for the Self-Management of Noncommunicable Disease: Systematic Review of Platform-Like Interventions. J. Med. Internet Res. 2020, 22, e16774. [Google Scholar] [CrossRef]
- Parke, H.L.; Epiphaniou, E.; Pearce, G.; Taylor, S.J.; Sheikh, A.; Griffiths, C.J.; Greenhalgh, T.; Pinnock, H. Self-Management Support Interventions for Stroke Survivors: A Systematic Meta-Review. PLoS ONE 2015, 10, e0131448. [Google Scholar] [CrossRef]
- Kim, J.S.; Choi-Kwon, S. Poststroke depression and emotional incontinence: Correlation with lesion location. Neurology 2000, 54, 1805–1810. [Google Scholar] [CrossRef]
- Buckley, K.M.; Tran, B.Q.; Prandoni, C.M. Receptiveness, use and acceptance of telehealth by caregivers of stroke patients in the home. Online J. Issues Nurs. 2004, 9, 9. [Google Scholar] [PubMed]
- Mahmood, A.; Blaizy, V.; Verma, A.; Stephen Sequeira, J.; Saha, D.; Ramachandran, S.; Manikandan, N.; Unnikrishnan, B.; Solomon, J.M. Acceptability and Attitude towards a Mobile-Based Home Exercise Program among Stroke Survivors and Caregivers: A Cross-Sectional Study. Int. J. Telemed. Appl. 2019, 2019, 5903106. [Google Scholar] [CrossRef] [PubMed] [Green Version]
Autor, Year | Cadilhac et al., 2020 [20] | Chumbler et al., 2012 [21] | Chumbler et al., 2015 [22] | Ifejika et al., 2020 [23] |
---|---|---|---|---|
Eligibility | yes | yes | yes | yes |
Random allocation | yes | yes | yes | yes |
Concealed allocation | no | yes | yes | no |
Baseline comparability | yes | yes | yes | yes |
Blind subjects | no | no | no | no |
Blind therapists | no | no | no | no |
Blind assessors | yes | yes | yes | no |
Adequate follow-up | yes | yes | yes | yes |
Intention-to-treat analysis | yes | yes | yes | no |
Between-group comparisons | yes | yes | yes | yes |
Point estimated variability | yes | yes | yes | yes |
Score; Quality | 7/10; high | 8/10; high | 8/10; high | 5/10; Fair |
Autor, Year | Kamoen et al., 2019 [24] | Huijbregts et al., 2009 [25] | Taylor et al., 2009 [26] | Skolarus et al., 2019 [27] | Kamwesiga et al., 2018 [28] | Guidetti et al., 2020 [29] |
---|---|---|---|---|---|---|
Comparability of participants | low | low | low | low | high | low |
Selection of participants | low | low | low | low | low | low |
Confounding variables | low | low | high | high | high | high |
Exposure measurement | low | low | low | low | low | low |
Blinding of outcome assessment | high | high | high | high | high | high |
Outcome assessment | low | low | low | low | low | low |
Incomplete outcome data | low | low | low | low | low | low |
Selective outcome reporting | low | low | low | low | low | low |
Author (Year) | Design; Participants | Time Post-Stroke | Telehealth Technology/ TH Type | Contents | Regime | |
---|---|---|---|---|---|---|
IG | CG | |||||
Cadilhac et al., 2020 [20] | RCT IG = 29 CG = 25 | Chronic stroke | Messaging Sync + Async |
| Usual care
|
|
Chumbler et al., 2012 [21] | RCT IG = 27 CG = 25 | Acute- Chronic stroke survivors | Telephone & Messaging Sync + Async |
| Usual care
|
|
Chumbler et al., 2015 [22] | RCT IG = 27 CG = 25 | Acute- Chronic stroke survivors | Telephone & Messaging Sync + Async |
| Usual care
|
|
Ifejika et al., 2020 [23] | RCT IG = 17 CG = 19 | Acute stroke | App-based & Messaging Async |
| Food journal self-monitoring
|
|
Kamoen et al., 2019 [24] | Nonequivalent Control Group IG = 94 CG = 53 uncontrolled | Acute stroke survivors | Web-based Sync + Async |
| - |
|
Huijbregts et al., 2009 [25] | Nonequivalent Control Group IG = 10 CG = 8 | Not stated | Web-based Sync |
| Waiting list |
|
Taylor et al., 2009 [26] | One group pre-post IG = 12 | Acute- Chronic stroke survivors | Web-based Sync |
|
| |
Skolarus et al., 2019 [27] | One group pre-post Total = 13 | Acute stroke survivors with at least moderate depressive symptoms | Telephone Async |
| - |
|
Kamwesiga et al., 2018 [28] | Nonequivalent Control Group IG = 15 CG = 15 | Acute- Chronic stroke survivors | Telephone & Messaging Sync + Async |
| Usual care |
|
Guidetti et al., 2020 [29] | One group pre-post IG = 13 | Acute- Chronic stroke survivors | Web-based & Messaging Sync + Async |
| - |
|
Strategy | Cadilhac et al., 2020 [20] | Chumbler et al., 2012 [21] | Chumbler et al., 2015 [22] | Ifejika et al., 2020 [23] | Kamoen et al., 2019 [24] | Huijbregts et al., 2009 [25] | Taylor et al., 2009 [26] | Skolarus et al., 2019 [27] | Kamwesiga et al., 2018 [28] | Guidetti et al., 2020 [29] |
---|---|---|---|---|---|---|---|---|---|---|
Education: stroke related issues and SM | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ |
Information: sources of social or peer support or adaptive equipment | ✕ | ✓ | ✓ | ✕ | ✓ | ✓ | ✓ | ✕ | ✕ | ✕ |
Remote monitoring with feedback and action plans | ✕ | ✓ | ✓ | ✓ | ✓ | ✕ | ✕ | ✓ | ✓ | ✓ |
Training/rehearsal for everyday activities | ✕ | ✕ | ✕ | ✓ | ✕ | ✓ | ✓ | ✕ | ✓ | ✓ |
Clinical review: regular follow-up reviews | ✕ | ✓ | ✓ | ✓ | ✓ | ✕ | ✕ | ✓ | ✓ | ✓ |
Adherence support | ✓ | ✓ | ✓ | ✓ | ✕ | ✕ | ✕ | ✓ | ✓ | ✓ |
Psychological support: goal setting, action planning, and problem solving strategies | ✓ | ✓ | ✓ | ✓ | ✕ | ✓ | ✓ | ✓ | ✓ | ✓ |
Social support: peer support, peer mentoring, and group socialization | ✕ | ✕ | ✕ | ✕ | ✕ | ✓ | ✓ | ✕ | ✕ | ✕ |
Lifestyle advice and support: practical advice in relation to handling life stressors | ✓ | ✓ | ✓ | ✕ | ✓ | ✓ | ✓ | ✕ | ✓ | ✓ |
Number of components used | 4/9 | 7/9 | 7/9 | 6/9 | 5/9 | 6/9 | 6/9 | 5/9 | 7/9 | 7/9 |
Author (Year) | Outcome Measures | Aim; Results | |||
---|---|---|---|---|---|
Pre | Post | Assessment | |||
T1 | T2 | ||||
Cadilhac et al., 2020 [20] | BL | 4 weeks |
| To assess the feasibility, acceptability and potential effectiveness of eHealth support messaging system;
| |
Chumbler et al., 2012 [21] | BL | 3 months | 6 months |
| To determine the effect of stroke telerehabilitation on physical function and disability;
|
Chumbler et al., 2015 [22] | BL | 3 months | 6 months |
| To determine the effect of stroke telerehabilitation in-home intervention on falls-related self-efficacy and patient satisfaction;
|
Ifejika et al., 2020 [23] | BL | 1 months | 3 months/6 months (T3) |
| To determine the feasibility and preliminary treatment effects of a smartphone-based weight loss intervention to monitor dietary patterns;
|
Kamoen et al., 2019 [24] | BL | 6 months |
| To test personal digital coaching program to improve cardiovascular risk factor control;
| |
Huijbregts et al., 2009 [25] | BL | 9 weeks | 18 weeks |
| To investigate the efficacy of telehealth delivery of SM program in improving aspects of community reintegration and well-being in community-dwelling persons with stroke;
|
Taylor et al., 2009 [26] | BL | 9 weeks | 21 weeks |
| To explore the feasibility of videoconference delivery of SM program to rural communities;
|
Skolarus et al., 2016 [27] | BL | 3 months |
| To assess the feasibility and acceptability of IVR as an adjunct to post-stroke depression follow-up care;
| |
Kamwesiga et al., 2018 [28] | BL | 9 weeks |
| To evaluate the feasibility of the mobile phone supported family-centered intervention, and the effects of the intervention;
| |
Guidetti et al., 2020 [29] | BL | 4 weeks | 8 weeks |
| To evaluate the feasibility of (i) web-based family-centered intervention within in-patient and primary care rehabilitation after stroke, (ii) the study design and outcome measures used, and (iii) the fidelity, adherence, and acceptability of the intervention;
|
Outcome | Number of Studies | RCT | NRCT | |||||
---|---|---|---|---|---|---|---|---|
Nonequivalent Control Group | One-Group Pretest-Posttest | |||||||
Study | Effect | Study | Effect | Study | Effect | |||
SM behaviors | Goal attainment | 5 | Cadilhac et al., 2020 [20] | – | Huijbregts et al., 2009 [25] Kamwesiga et al., 2018 [28] | - +++(COPM; performance) | Taylor et al., 2009 [26] Guidetti et al., 2020 [29] | ^ ^ |
SM skill | 1 | Cadilhac et al., 2020 [20] | – | |||||
ADL | 1 | Kamwesiga et al., 2018 [28] | + | |||||
Participation | 5 | Cadilhac et al., 2020 [20] | - | Huijbregts et al., 2009 [25] Kamwesiga et al., 2018 [28] | - + | Taylor et al., 2009 [26] Guidetti et al., 2020 [29] | ^ x | |
Medication adherence | 1 | Kamoen et al., 2019 [24] | # | |||||
Clinical outcome | Levels of disability | 4 | Chumbler et al., 2012 [21] | ++ | Kamoen et al., 2019 [24] Kamwesiga et al., 2018 [28] | - - | Guidetti et al., 2020 [29] | ^(some sub-items) |
Emotional status | 5 | Cadilhac et al., 2020 [20] Ifejika et al., 2020 [23] | - +++ | Skolarus et al., 2019 [27] Taylor et al., 2009 [26] Guidetti et al., 2020 [29] | ^ +++ - | |||
Physical function | 1 | Chumbler et al., 2012 [21] | ++ | |||||
Mobility | 2 | Huijbregtset al., 2009 [25] | +++(BBS) -(CMSA-AI) | Taylor et al., 2009 [26] | +++(6MVT) ^(BBS) | |||
Fatigue | 1 | Guidetti et al., 2020 [29] | - | |||||
Cardiovascular risk | 1 | Kamoen et al., 2019 [24] | + | |||||
Body weight | 1 | Ifejika et al., 2020 [23] | - | |||||
Self-efficacy | Balancing ability | 1 | Taylor et al., 2009 [26] | +++ | ||||
Fall-related | 1 | Chumbler et al., 2015 [22] | ++ | |||||
Performance | 2 | Kamwesiga et al., 2018 [28] | +++ | Guidetti et al., 2020 [29] | ^ | |||
QOL | 3 | Cadilhac et al., 2020 [20] | - | Kamoen et al., 2019 [24] Huijbregts et al., 2009 [25] | +++ - | |||
TH acceptance | Adherence | 4 | Ifejika et al., 2020 [23] | + | Huijbregts et al., 2009 [25] Kamoen et al., 2019 [24] | # # | Guidetti et al., 2020 [29] | # |
Acceptability | 1 | Guidetti et al., 2020 [29] | # | |||||
Satisfaction | 1 | Chumbler et al., 2015 [22] | +++(some sub-items) | |||||
Feedback from participant | 6 | Cadilhac et al., 2020 [20] Chumbler et al., 2015 [22] | # # | Kamoen et al., 2019 [24] Huijbregts et al., 2009 [25] | # # | Skolarus et al., 2019 [27] Taylor et al., 2009 [26] | # # |
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. |
© 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Hwang, N.-K.; Park, J.-S.; Chang, M.-Y. Telehealth Interventions to Support Self-Management in Stroke Survivors: A Systematic Review. Healthcare 2021, 9, 472. https://doi.org/10.3390/healthcare9040472
Hwang N-K, Park J-S, Chang M-Y. Telehealth Interventions to Support Self-Management in Stroke Survivors: A Systematic Review. Healthcare. 2021; 9(4):472. https://doi.org/10.3390/healthcare9040472
Chicago/Turabian StyleHwang, Na-Kyoung, Ji-Su Park, and Moon-Young Chang. 2021. "Telehealth Interventions to Support Self-Management in Stroke Survivors: A Systematic Review" Healthcare 9, no. 4: 472. https://doi.org/10.3390/healthcare9040472