The Journal of Korean Society of Community-Based Occupational Therapy Vol.13 No.1 pp.49-60
Meta-Analysis for the Effects of Home-based Occupational Therapy on the Improvement of Quality of Life in Stroke Survivors
Key Words : Home-based Occupational Therapy,Stroke,Quality of Life
Objective : This study aimed to investigate the effect of home-based occupational therapy on improving the quality of life of stroke survivors. Methods : Among foreign papers verifying the effectiveness of a home-based occupational therapy program conducted for the purpose of improving the quality of life of stroke survivors, a systematic review and meta-analysis, focusing on randomized controlled trial studies published after 2000, were conducted. The Data Base selected for retrieval used PubMed, CINAHL, and Cochrane libraries, and quality was analyzed using Cochrane's risk of bias. Overall effect size analysis through meta-analysis, moderating effect analysis through Meta-ANOVA, and publication bias analysis through Egger's regression test were conducted. Results : A total of 7 literatures was selected, and 6 literatures were classified as ‘high-level bias' in the area of ‘ group participant dropout bias' in the quality verification of literature. The overall effect size of the home-based occupational therapy program was large (ES=1,069, 95%CI=0.221∼1.917, p=0.013), and ‘intervention period' appeared as a significant moderating variable (Q=7.530, p=0.023), and the intervention period of 3 months or longer showed a significantly higher effect size than other periods (ES=2.065, 95% CI=1.145-2.984, p=0.00). In the moderating variable of ‘intervention type', ‘visit type' showed a higher effect size than ‘telerehabilitation type' (ES=1.184, 95%CI=-0.266∼2.633, p=0.110), but there was no significant difference between groups. (Q=0.034, p=0.855). It was confirmed that there was no publication bias (p>.05). Conclusion : The home-based occupational therapy program showed a large-sized effect in improving the quality of life of stroke survivors, and there was no significant difference in the type of intervention. In addition, the intervention period of 3 months or longer showed a larger effect size on the improvement of quality of life than other periods, and the intervention period was identified as a significant moderating variable affecting the effect size. If a home-based occupational therapy program is implemented for the purpose of improving the quality of life on stroke survivors in the future, it is proposed to apply an intervention period of more than 3 months and less than 6 months (90 minutes once, 5 times a week).