Introduction / Rationale
Self-directed training is a valuable approach that remains to be fully explored in inpatient stroke rehabilitation. While existing literature have illustrated its effectiveness in improving outcomes, majority of the studies focused on upper extremity (UE) recovery in home-based settings for chronic stroke survivors. This underlines the need to better understand the benefits of self-directed training in inpatient settings in order to optimize neuroplasticity and spontaneous recovery for individuals in the acute and subacute phases of recovery.
Objectives
To investigate the effectiveness of self-directed training interventions in improving upper extremity, lower extremity, motor, and functional outcomes in inpatient stroke survivors.
Methods / Approach
Following the guidelines established by the American Occupational Therapy Association (AOTA), a systematic review was conducted. A database search using CINAHL, PubMed, SPORTDISCUS, EMBASE and OT seeker was implemented from March 2024 to April 2024. Quantitative studies with level three and above evidence that contained self-directed approaches in the inpatient setting and outcomes related to motor, function and activity participation were included.
Results / Practice Implications
Eight studies were found with four types of self-directed interventions utilized in inpatient stroke rehabilitation: robotics, functional practice, general mobility and mirror therapy. There was a range of strong to low strength of evidence identified for self-directed training interventions in persons with stroke in the inpatient setting.
Conclusion / Contribution to the occupational therapy profession
Self-directed training demonstrates promise in improving UE and functional outcomes for inpatient stroke survivors. Identified outcomes can inform clinical practice and future research as they illuminate the potential benefits of utilizing this approach in maximizing recovery prior to discharge from hospital settings.