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Purpose <p>Stroke remains a leading cause of long-term disability, with survivors experiencing a substantial decline in their health-related quality of life (HRQoL). Although nonpharmacological interventions (NPIs) are known to improve HRQoL, which modalities are most effective and which design characteristics maximize HRQoL outcomes remains unclear. This compared the effects of different NPI types and identified key design determinants, particularly intervention duration, using meta-regression.</p> Methods <p>PubMed, Embase, the Cochrane Library, and CINAHL were searched for relevant randomized controlled trials (RCTs) published in English between January 2000 and July 2025. We conducted a systematic review and meta-analysis of RCTs involving adult stroke survivors testing education/self-management, exercise/physical training, or psychological/emotional interventions, with HRQoL measured using validated instruments. Meta-regression analyses examined the influence of intervention type and duration on HRQoL improvement. Study selection, data extraction, and quality assessment (risk of bias 2.0) were performed independently by two reviewers.</p> Results <p>Thirty-two RCTs were analyzed. NPIs significantly improved HRQoL compared to that in controls. Psychological/emotional interventions showed the greatest effect compared to education/self-management and exercise. Meta-regression identified intervention duration as a critical determinant of effectiveness, with programs lasting ≥ 12 weeks yielding significantly greater HRQoL improvements than shorter interventions.</p> Conclusions <p>Beyond confirming the overall benefits of NPIs, this study demonstrates that both intervention modality and duration are key design determinants of HRQoL improvement after stroke. These findings provide evidence-based guidance on how nonpharmacological rehabilitation programs should be structured—highlighting the importance of psychosocial components and sustained intervention duration—to maximize quality-of-life outcomes in stroke survivors.</p> Registration <p>The protocol for this review was prospectively registered with the Open Science Framework on October 3, 2025 (<a href="https://doi.org/10.17605/OSF.IO/Q8VUD">https://doi.org/10.17605/OSF.IO/Q8VUD</a>).</p>

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Effects of nonpharmacological interventions on post-stroke quality of life: a systematic review, meta-analysis, and meta-regression

  • 期刊论文

  • 发表日期：

    2026年3月4日

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  • Ha-Young Park,
  • Insun Yeom

摘要

Purpose

Stroke remains a leading cause of long-term disability, with survivors experiencing a substantial decline in their health-related quality of life (HRQoL). Although nonpharmacological interventions (NPIs) are known to improve HRQoL, which modalities are most effective and which design characteristics maximize HRQoL outcomes remains unclear. This compared the effects of different NPI types and identified key design determinants, particularly intervention duration, using meta-regression.

Methods

PubMed, Embase, the Cochrane Library, and CINAHL were searched for relevant randomized controlled trials (RCTs) published in English between January 2000 and July 2025. We conducted a systematic review and meta-analysis of RCTs involving adult stroke survivors testing education/self-management, exercise/physical training, or psychological/emotional interventions, with HRQoL measured using validated instruments. Meta-regression analyses examined the influence of intervention type and duration on HRQoL improvement. Study selection, data extraction, and quality assessment (risk of bias 2.0) were performed independently by two reviewers.

Results

Thirty-two RCTs were analyzed. NPIs significantly improved HRQoL compared to that in controls. Psychological/emotional interventions showed the greatest effect compared to education/self-management and exercise. Meta-regression identified intervention duration as a critical determinant of effectiveness, with programs lasting ≥ 12 weeks yielding significantly greater HRQoL improvements than shorter interventions.

Conclusions

Beyond confirming the overall benefits of NPIs, this study demonstrates that both intervention modality and duration are key design determinants of HRQoL improvement after stroke. These findings provide evidence-based guidance on how nonpharmacological rehabilitation programs should be structured—highlighting the importance of psychosocial components and sustained intervention duration—to maximize quality-of-life outcomes in stroke survivors.

Registration

The protocol for this review was prospectively registered with the Open Science Framework on October 3, 2025 (https://doi.org/10.17605/OSF.IO/Q8VUD).