Caregiver-mediated exercises for improving outcomes after stroke

Judith D. M. Vloothuis, Marijn Mulder, Janne M. Veerbeek, Manin Konijnenbelt, Johanna M. A. Visser-Meily, Johannes C. F. Ket, Gert Kwakkel, Erwin E. H. van Wegen

Research output: Contribution to journalArticleAcademicpeer-review



Stroke is a major cause of long‐term disability in adults. Several systematic reviews have shown that a higher intensity of training can lead to better functional outcomes after stroke. Currently, the resources in inpatient settings are not always sufficient and innovative methods are necessary to meet these recommendations without increasing healthcare costs. A resource efficient method to augment intensity of training could be to involve caregivers in exercise training. A caregiver‐mediated exercise programme has the potential to improve outcomes in terms of body function, activities, and participation in people with stroke. In addition, caregivers are more actively involved in the rehabilitation process, which may increase feelings of empowerment with reduced levels of caregiver burden and could facilitate the transition from rehabilitation facility (in hospital, rehabilitation centre, or nursing home) to home setting. As a consequence, length of stay might be reduced and early supported discharge could be enhanced.


To determine if caregiver‐mediated exercises (CME) improve functional ability and health‐related quality of life in people with stroke, and to determine the effect on caregiver burden.

Search methods

We searched the Cochrane Stroke Group Trials Register (October 2015), CENTRAL (the Cochrane Library, 2015, Issue 10), MEDLINE (1946 to October 2015), Embase (1980 to December 2015), CINAHL (1982 to December 2015), SPORTDiscus (1985 to December 2015), three additional databases (two in October 2015, one in December 2015), and six additional trial registers (October 2015). We also screened reference lists of relevant publications and contacted authors in the field.

Selection criteria

Randomised controlled trials comparing CME to usual care, no intervention, or another intervention as long as it was not caregiver‐mediated, aimed at improving motor function in people who have had a stroke.

Data collection and analysis

Two review authors independently selected trials. One review author extracted data, and assessed quality and risk of bias, and a second review author cross‐checked these data and assessed quality. We determined the quality of the evidence using GRADE. The small number of included studies limited the pre‐planned analyses.
Original languageEnglish
Article numberCD011058
JournalCochrane Database of Systematic Reviews
Issue number12
Publication statusPublished - 2016

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