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Determinants influencing the implementation of home-based stroke rehabilitation: a systematic review

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Author: Siemonsma, P. · Dopp, C. · Alpay, L. · Tak, E. · Meeteren, N, van · Chorus, A.
Source:Disability and rehabilitation, 24, 36, 2019-2030
Identifier: 492682
doi: doi:/10.3109/09638288.2014.885091
Keywords: Health · Barriers · Determinants · Home-based · Implementation · Stroke · Healthy for Life · Healthy Living · Behavioural Changes Healthy Living · LS - Life Style HL - Healthy for Life · ELSS - Earth, Life and Social Sciences


Purpose: Home-based rehabilitation is a promising alternative to regular center-based stroke rehabilitation. The objective of this study was to identify what is currently known about determinants that influence the implementation of home-based stroke rehabilitation (HBSR) in clinical practice. Methods: A systematic review of determinants of HBSR was conducted, using a framework for innovation (including determinants related to the innovation, the user, the organization, and the socio-political context). Reviews, meta-analyses, and qualitative studies were included. Studies were selected if they concerned: home-based rehabilitation of stroke patient’s (motor) function, changes in in-person service delivery (424 h to 12 months poststroke) and determinants of implementation. Results: A total of 88 studies were identified, of which 7 studies met the inclusion criteria. Identified determinants of implementation of HBSR were: intervention effectiveness, the exact nature of the medical condition, satisfaction with services, coordination of services, inter-professional collaborations, availability of appropriate training equipment, and costs. However, none of the studies had the primary aim to identify determinants of implementation. Conclusion: A more complete and detailed overview of existing determinants of HBSR is needed to assist professionals and organizations in decisionmaking on HBSR implementation and development of suitable strategies for implementation.