Self-management programmes for people post stroke: a systematic review

Objective: To examine the evidence base underlying self-management programmes specific to stroke survivors. Data sources: Eleven electronic databases were searched using combinations of keywords related to stroke and self-management. Review methods: Studies involving adults with a clinical diagnosis of stroke, which explored selfmanagement interventions, were included. Study selection was verified by two reviewers who independently conducted methodological quality appraisal and data extraction using a tool developed by The American Academy for Cerebral Palsy and Developmental Medicine. Results: Fifteen studies were included in this review. Significant treatment effects in favour of the selfmanagement intervention were found in six out of nine randomized controlled trials, and three out of six non-randomized trials in our review. Four randomized controlled trials involving more than 100 participants per trial reported statistically significant results in favour of the self-management group in relation to measures of disability, confidence in recovery, the stroke specific quality of life (sub-scales of family roles and fine motor tasks), and the physical component scale of the short form SF-36 Score. The wide range of outcome measures used prevented comparison across studies. Conclusions: This review provides some preliminary support for the potential importance of selfmanagement interventions after stroke. The most appropriate content and best approach for delivery of these interventions remains to be determined. Further high-quality randomized controlled trials are needed to test the feasibility, acceptability, and efficacy of stroke self-management programmes.