Linking Medical Treatment and Physiotherapy in Stroke Recovery: A Meta-Analytical Statistical Synthesis

Autores

  • Abeer Mohammed
  • Mohamed Elfar
  • Amira Afify
  • Heba Gaber
  • Mohamed Raafat Department of Physical Therapy, Faculty of Allied Medical Sciences, Al-Ahliyya Amman University, Amman, Jordan https://orcid.org/0000-0002-3400-2034
  • Kholoud Soliman
  • Amash Alajmi Department of Medicine and Surgery, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan. https://orcid.org/0009-0007-0172-4827
  • Ahmad Quneis
  • Forat Alomoush
  • Kalmah AL-Olimat Department of maternal and child health, School of nursing, Zarqa University, Zarqa, Jordan https://orcid.org/0009-0007-9635-846X
  • Shorooq Almaaitah Department of Medicine, School of Medicine, Mu'tah University,Alkarak, Jordan
  • Yazeed Hijazi
  • Asma Atwa
  • Ahmed Alja'fari Department of Medicine, School of Medicine, Mu'tah University,Alkarak, Jordan https://orcid.org/0009-0000-6216-6581
  • Wessam Mohamed Department of physical therapy, Faculty of Allied Medical Sciences, Al-Ahliyya university,Amman, Jordan.

DOI:

https://doi.org/10.47197/retos.v67.115269

Palavras-chave:

Stroke Recovery, Physiotherapy, Medical Treatment, Meta-Analysis, Rehabilitation Outcomes.

Resumo

Stroke remains a leading cause of long-term disability worldwide, necessitating integrated approaches to rehabilitation. This meta-analytical study synthesized data from previously published peer-reviewed articles to assess the combined impact of physiotherapy and medical treatment on stroke recovery. To investigate motor and cognitive outcomes, independence in recovery time to (ADLs) and quality of life, data from studies that contained information from over 10,000 patients were analyzed. The meta-analysis covered 18 studies (2010–2023) from PubMed, Scopus, Web of Science, Cochrane, and Google Scholar. Studies were selected based on predefined inclusion and exclusion criteria focusing on adult stroke patients and quantitative outcome reporting. Statistical analysis utilized independent t-tests, ANOVA, and multiple linear regression. Key findings revealed a significant improvement in motor function in the combined treatment group (M = 71, SD = 9.4) compared to the medical-only group (M = 58, SD = 10.1), t (9988) = 35.2, p < 0.001, Cohen’s d = 1.32. Cognitive scores were also significantly higher in the combined group (M = 83.4, SD = 8.2) versus medical-only (M = 70.3, SD = 9.1), t (9988) = 30.1, p < 0.001, Cohen’s d = 1.25. Regression analysis indicated that treatment type and age were significant predictors of recovery outcomes (R² = 0.67, F (4, 9945) = 506.3, p < 0.001). Demographic subgroup analysis highlighted better outcomes in younger female patients and those with hemorrhagic stroke. The study underscores the importance of early, structured physiotherapy within multidisciplinary care models and provides statistically grounded insights to inform stroke rehabilitation protocols.

Referências

Ali, A. M. M., Bahrain, A. K., Billah, M. M., Kadir, K. A., & Faez A, Z. M. (2019, July). Analysis of 4 degree of freedom robotic arms with spasticity patient. In AIP Conference Proceedings (Vol. 2129, No. 1). AIP Publishing. https://doi.org/10.1063/1.5118132

Allsassmah, E. A. (2020). Measuring knowledge of Jordanian nurses working in critical care units toward stroke patients. World Science, 8(60), 19–29. https://doi.org/10.31435/rsglobal_ws/31102020/7214

American Heart Association. (2017). Heart disease and stroke statistics—2017 update: A report from the American Heart Association. 10.1161/CIR.0000000000000485

Boehringer Ingelheim. (2020). Pathophysiology of stroke.

Bushnell, C. D., Chaturvedi, S., Gage, K. R., Herson, P. S., Hurn, P. D., Jiménez, M. C., & Rundek, T. (2018). Sex differences in stroke: Challenges and opportunities. Stroke, 38(12), 2179–2191. https://doi.org/10.1177/0271678X18793324

Cramer, S. C., Wolf, S. L., Jr, H. P., Chen, D., Dromerick, A. W., Dunning, K., & Roth, E. (2017). Stroke recovery & rehabilitation research: Issues, opportunities, and the NIH StrokeNet. Stroke, 48(3), 813–819. https://doi.org/10.1161/STROKEAHA.116.015501

Flemban, A., & Elsayed, W. (2018). Effect of combined rehabilitation program with botulinum toxin type A injections on gross motor function scores in children with spastic cerebral palsy. Journal of Physical Therapy Science, 30(7), 902–905. https://doi.org/10.1589/jpts.30.902

Giuliano, C., Parmenter, B. J., Baker, M. K., Mitchell, B. L., Williams, A. D., Lyndon, K., & Levinger, I. (2017). Cardiac rehabilitation for patients with coronary artery disease: A practical guide to enhance patient outcomes through continuity of care. Clinical Medicine Insights: Cardiology, 11, 1–7. https://doi.org/10.1177/1179546817710028

Langhorne, P., Bernhardt, J., & Kwakkel, G. (2011). Stroke rehabilitation. The Lancet, 377(9778), 1693–1702. 10.1016/S0140-6736(11)60325-5

Li, X., He, Y., Wang, D., & Rezaei, M. J. (2024). Stroke rehabilitation: From diagnosis to therapy. Frontiers in Neurology, 15, 1402729. https://doi.org/10.3389/fneur.2024.1402729

Mulhern, M. (2023). Cognitive rehabilitation interventions for post-stroke populations. Delaware Journal of Public Health, 9(3), 70–74. 10.32481/djph.2023.08.012

Nelson, M. L., Singh, H., Nie, J., MacDonald, S., Bayley, M., Fortin, C., & Upshur, R. (2023). Comparing stroke rehabilitation inpatients and clinical trials eligibility criteria: A secondary chart review analysis revealing that most patients could have been excluded from rehabilitation trials based on comorbidity status. Journal of Multimorbidity and Comorbidity, 13(1), 1-7. https://doi.org/10.1177/26335565231211668

Neves, L. T., Paz, L. V., Wieck, A., Mestriner, R. G., de Miranda Monteiro, V. A., & Xavier, L. L. (2024). Environmental enrichment in stroke research: An update. Translational Stroke Research, 15, 339–351. https://doi.org/10.1007/s12975-023-01132-w

Page, P. L., Furtado, R., Hayward, M., Law, S., Tan, A., Vivian, S., & Falk, G. (2015). Durability of giant hiatus hernia repair in 455 patients over 20 years. Annals, 97(3), 188–193. https://doi.org/10.1308/003588414X14055925060839

Pathak, A., Gyanpuri, V., Dev, P., & Dhiman, N. R. (2021). The Bobath concept (NDT) as rehabilitation in stroke patients: A systematic review. Journal of Family Medicine and Primary Care, 10(11), 3983–3990. DOI: 10.4103/jfmpc.jfmpc_528_21

Pollock, A., Farmer, S. E., Brady, M. C., Langhorne, P., Mead, G. E., Mehrholz, J., & van Wijck, F. (2014). Interventions for improving upper limb function after stroke. Cochrane Database of Systematic Reviews, 2014(11), CD010820. https://doi.org/10.1002/14651858.CD010820.pub2

Ramanathan, R. P., & Chandrasekaran, B. (2014). Reference equations for 6-min walk test in healthy Indian subjects (25–80 years). Lung India, 31(1), 35–38. DOI: 10.4103/0970-2113.125892

Shahid, J., Kashif, A., & Shahid, M. K. (2023). A comprehensive review of physical therapy interventions for stroke rehabilitation: Impairment-based approaches and functional goals. Brain Sciences, 13(5), 717. https://doi.org/10.3390/brainsci13050717

Downloads

Publicado

28-04-2025

Edição

Vol. 67 (2025)

Secção

Revisões teóricas sistemáticas e/ou metanálises

Licença

Direitos de Autor (c) 2025 Abeer Mohammed, Mohamed Elfar, Amira Afify, Heba Gaber, Mohamed Raafat, Kholoud Soliman, Mohamed Ghareeb, Ahmad Quneis, Forat Alomoush, amash alajmi, Kalmah AL-Olimat, Yazeed Hijazi, Mohamed Zidan, Kerolous Kelini, Asma Atwa, Ahmed Alja'fari , Wessam Mohamed, ma'in Abu-shaikha

Creative Commons License

Este trabalho encontra-se publicado com a Licença Internacional Creative Commons Atribuição-NãoComercial-SemDerivações 4.0.

Autores que publicam nesta revista concordam com os seguintes termos:

  1. Autores mantém os direitos autorais e assegurar a revista o direito de ser a primeira publicação da obra como licenciado sob a Licença Creative Commons Attribution que permite que outros para compartilhar o trabalho com o crédito de autoria do trabalho e publicação inicial nesta revista.
  2. Os autores podem estabelecer acordos adicionais separados para a distribuição não-exclusiva da versão do trabalho publicado na revista (por exemplo, a um repositório institucional, ou publicá-lo em um livro), com reconhecimento de autoria e publicação inicial nesta revista.
  3. É permitido e os autores são incentivados a divulgar o seu trabalho por via electrónica (por exemplo, em repositórios institucionais ou no seu próprio site), antes e durante o processo de envio, pois pode gerar alterações produtivas, bem como a uma intimação mais Cedo e mais do trabalho publicado (Veja O Efeito do Acesso Livre) (em Inglês).

Esta revista é a "política de acesso aberto" de Boai (1), apoiando os direitos dos usuários de "ler, baixar, copiar, distribuir, imprimir, pesquisar, ou link para os textos completos dos artigos". (1) http://legacy.earlham.edu/~peters/fos/boaifaq.htm#openaccess

Como Citar

Mohammed, A. ., Elfar, M. ., Afify, A., Gaber, H., Raafat, M., Soliman, K. ., Alajmi, A., Quneis, A., Alomoush, F., AL-Olimat, K., Almaaitah, S., Hijazi, Y., Atwa, A., Alja'fari , A., & Mohamed, W. (2025). Linking Medical Treatment and Physiotherapy in Stroke Recovery: A Meta-Analytical Statistical Synthesis. Retos, 67, 1177-1189. https://doi.org/10.47197/retos.v67.115269