Effectiveness of interventions in increasing physical activity of inpatients after stroke: A systematic review and meta-analysis.

Abstract

ObjectiveTo synthesise the evidence of the effectiveness of interventions to increase levels of physical activity or reduce levels of sedentary activity of inpatients after a new stroke.Data sourcesMedline, PsychINFO, AMED and CINAHL were search between inception and June 2025 for randomised controlled studies of in-hospital interventions for adults after stroke which measured physical activity.Review methodsInterventions were grouped by common components. For each intervention group, the outcomes of physical activity (primary outcome), physical functional ability, and quality of life were analysed with meta-analysis. Adverse events were synthesised narratively.ResultsTen studies (696 participants) were included in the review. General activity feedback (SMD = 0.52, 95% CI: -0.07 to 1.10; I2 = 76.7%, 4 trials, n = 272) and additional physiotherapy (SMD = 0.89, 95% CI: -0.02 to 0.99; I2 = 94.2%, 4 trials, n = 246) may result in moderate to large increases of in-hospital physical activity (very low certainty). Patient-directed activity programmes (one study) may have no effect on physical activity (low certainty). Upper-limb activity feedback (one study) may increase upper-limb activity (very low certainty).The evidence regarding the secondary outcomes demonstrated no effect (very low to moderate certainty), with the exception that additional physiotherapy may increase the risk of falls (low certainty).ConclusionsInterventions incorporating activity feedback or additional physiotherapy are promising, but further evidence is required for all interventions to increase the certainty in their estimates of effect.PROSPERO ID: CRD42024611456.