• Nur Chayati Faculty of Medicine, Gadjah Mada University, Sleman 55281, Yogyakarta, Indonesia; School of Nursing, Faculty of Medicine and Health Sciences, Muhammadiyah University of Yogyakarta, Bantul 55183, Yogyakarta, Indonesia.
  • Ismail Setyopranoto Department of Neurology, Faculty of Medicine, Gadjah Mada University, Sleman 55281, Yogyakarta, Indonesia.
  • Christantie Effendy Medical-Surgical Nursing Departement, Faculty of Medicine, Gadjah Mada University, Sleman 55281, Yogyakarta, Indonesia.
Keywords: home-based care, outcomes, physical, psychological, stroke


Many people with neurological impairment following stroke prefer home-based care instead of long-term hospitalization. This study aims to identify the physical and psychological outcomes of home-based care after a stroke. The studies were identified by searching the following electronic databases, PubMed, ProQuest, Web of Science, PsyARTICLES, MedLINE, CINAHL, and EBSCO. Twenty-seven articles analyzed and reviewed using the content analysis method. Most physical interventions resulted in increased upper body motor function. The most common equipment were treadmill and computer games. The studies we reviewed highlighted the muscle limb pain and falling as the adverse events that occur during home-based care, but most studies did not systematically document those adverse events. Home-based interventions are particularly effective to improve motor function and reduce anxiety and depression.


Takahashi K, Islam MM. A qualitative study on the home-based exercise of stroke patients. Physiotherapy 2015; 101:e1472–e1473

Feigin VL, Forouzanfar MH, Krishnamurthi R et al. Global and regional burden of stroke during 1990-2010: findings from the Global Burden of Disease Study 2010. Lancet 2014; 383(9913):245–254.

Narain JP, Garg R, Fric A. Non-communicable diseases in the South-East Asia region: burden, strategies and opportunities. National Medical Journal of India 2011; 24(5):280-287.

Ezeugwu VE, Manns PJ. Reducing prolonged sedentary behaviour after a stroke: STand Up Frequently From Stroke (STUFFS). WellSpring 1–5. 2018.

American Heart Association. (2015). Complications After Stroke [AmericanStrokeAssociation]. [Accessed January 6, 2015].

Norris M, Allotey P, Barrett G. “It burdens me”: the impact of stroke in central Aceh, Indonesia. Sociol Health and Illn 2012; 34:826–840.

Daniel K, Wolfe CD, Busch MA et al. What are the social consequences of stroke for working-aged adults? a systematic review. Stroke 2009; 40(6):e431–e441.

Teasell R, Foley N, Richardson M et al. Outpatient stroke rehabilitation. Canada: Evidence-based review of stroke rehabilitation. 2013.

Tarricone R, Tsouros AD. Home care in Europe. The solid facts. New York: World Health Organization. 2008.

Direktorat Pelayanan Sosial Lanjut Usia. Pedoman pendampingan dan perawatan sosial lanjut usia di rumah (home care). Jakarta: Indonesia Ministry of Social. 2014.

Brown DS, Thompson WW, Zack MM et al. Associations between health-related quality of life and mortality in older adults. Prevention Science 2015; 16(1):21–30.

Barbosa SF, Tronchin DMR. Manual for monitoring the quality of nursing home care records. Revista Brasileira de Enfermagem 2015; 68(2):227–234, 253-260

Van der Veen DJ, Dopp CME, Siemonsma PC et al. Factors influencing the implementation of Home-Based Stroke Rehabilitation: Professionals’ perspective. PLOS One 2019; 14:1–16.

Tsuchihashi-Makaya M, Matsuo H, Kakinoki S et al. Home-based disease management program to improve psychological status in patients with heart failure in Japan. Circulation 2013; 77(4):926–933.

Sorocco KH, Bratkovich KL, Wingo R et al. Integrating care coordination home telehealth and home based primary care in rural Oklahoma : A pilot study. Psychology Service 2013; 10(3):350–352.

Liberati A, Altman DG, Tetzlaff J et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. PlOS Medicine 2009; 6:1-27.

Chaiyawat P, Kulkantrakorn K. Effectiveness of home rehabilitation program for ischemic stroke upon disability and quality of life : A randomized controlled trial. Clinical Neurology and Neurosurgery 2011; 114(7):866–870.

Linder SM, Rosenfeldt AB, Bay CR et al. Improving quality of life and depression after stroke through telerehabilitation. American Journal of Occupational Therapy 2015; 69(2):1–10.

Linder SM, Rosenfeldt AB, Reiss A et al. The home stroke rehabilitation and monitoring system trial: a randomized controlled trial. International Journal of Stroke 2013; 8(1):46–53.

Mayo NE, Mackay-lyons MJ, Scott SC et al. A randomized trial of two home-based exercise programmes to improve functional walking post-stroke. Clinical Rehabilitation 2013; 27:65-71.

Maier M, Ballester BR, Duarte E et al. Social integration of stroke patients through the multiplayer rehabilitation gaming system. In: Göbel S., Wiemeyer J. (eds) Games for Training, Education, Health and Sports. GameDays 2014. Lecture Notes in Computer Science 2014; 8395:100–114.

Page SJ, Levine P, Hill V. Mental practice – triggered electrical stimulation in chronic, moderate, upper-extremity hemiparesis after stroke. American Journal of Occupational Therapy 2013; 69(1):1–8.

Dean CM, Ada L, Lindley RI. Treadmill training provides greater benefit to the subgroup of community Dwelling people after stroke who walk faster than 0.4 m/s: a randomized trial. Journal of Physiotherapy 2014; 60(2):97-101

Dobkin BHK, Nadeau SE, Behrman AL et al. Prediction of responders for outcome measures of locomotor experience applied post stroke trial. Journal of Rehabilitation Research and Development 2014; 51(1):39–50.

Duncan PW, Sullivan KJ, Behrman AL et al. Body-weight–supported treadmill rehabilitation after stroke. New England Journal of Medicine 2011; 364(21):2026–2036.

Chaiyawat P, Kulkantrakorn K. Randomized controlled trial of home rehabilitation for patients with ischemic stroke : impact upon disability and elderly depression. Psychogeriatrics 2012; 12(3):193–199.

King M, Hijmans J, Sampson M et al. Home-based stroke rehabilitation using computer gaming. New Zealand Journal of Physiotherapy 2012; 40:128–134.

Levy CE, Silverman E, Jia H et al. Effects of physical therapy delivery via home video telerehabilitation on functional and health-related quality of life outcomes. Journal of Rehabilitation Research and Development 2015; 52(3):361–370.

Slijper A, Svensson KE, Backlund P et al. Computer game-based upper extremity training in the home environment in stroke persons : a single subject design. Journal of NeuroEngineering and Rehabilitation 2014; 11:1–8.

Suat E, Fatma U, Nilgu B. The effects of dynamic ankle-foot orthoses on functional ambulation activities, weight bearing and spatiotemporal characteristics of hemiparetic gait. Disability and Rehabilitation 2011; 33(25-26):2605-2611.

Sivan M, Gallagher J, Makower S et al. Home-based computer-assisted arm rehabilitation (hCAAR) robotic device for upper limb exercises after stroke: Results of a feasibility study in home setting. Journal of NeuroEngineering and Rehabilitation 2014; 11(1):163–163.

Sullivan JE, Hurley D, Hedman LD. The afferent stimulation provided by glove electrode during task-specific arm exercise following a stroke. Clinical Rehabilitation 2012; 26(11):1010–1020.

Brunner IC, Skouen JS, Strand LI. Is modified constraint-induced movement therapy more effective than bimanual training in improving arm motor function in the subacute phase post stroke ? A randomized controlled trial. Clinical Rehabilitation 2012; 26(12):1078–1086.

Buss A, Wolf-Ostermann K, Dassen T et al. Effectiveness of educational nursing home visits on quality of life, functional status and care dependency in older adults with mobility impairments: a randomized controlled trial. Journal of Evaluation in Clinical Practice 2016; 22(2):213–221.

Allen L, Richardson M, McIntyre A et al. Community stroke rehabilitation teams : providing home-based stroke rehabilitation in Ontario, Canada. Canadian Journal of Neurological Sciences 2014; 41(6):697–703.

Dragert K, Zehr EP. High-intensity unilateral dorsiflexor resistance training results in bilateral neuromuscular plasticity after stroke. Experimental Brain Research 2013; 225(1):93–104.

Gordon CD, Wilks R, McCaw-Binns A. Effect of aerobic exercise (walking) training on functional status and health-related quality of life in chronic stroke survivors. Stroke 2013; 44(4):1179–1181.

Langstaff C, Martin C, Brown G. Enhancing community-based rehabilitation for stroke survivors: creating a discharge link. Topics in Stroke Rehabilitation 2014; 21(6):510–519.

Low LL, Vasanwala FF, Ng LB et al. Effectiveness of a transitional home care program in reducing acute hospital utilization : a quasi-experimental study. BMC Health Services Research 2015; 15:100.

Mackenzie C, Muir M, Allen C et al. Non-speech oro-motor exercises in post-stroke dysarthria intervention : a randomized feasibility trial. International Journal of Language & Communication Disorders 2014; 49(5):602–617.

Mares K, Cross J, Clark A et al. Feasibility of a randomized controlled trial of functional strength training for people between six months and five years after stroke : FeSTivaLS trial. BMC Trials 2014; 15:322.

Suh JH, Han SJ, Jeon SY et al. Effect of rhythmic auditory stimulation on gait and balance in hemiplegic stroke patients. NeuroRehabilitation 2014; 34(1):193–199.

Cornally N, McGlade C, Weathers E et al. Evaluating the systematic implementation of the ’Let Me Decide’ advance care planning programme in long-term care through focus groups : staff perspectives. BMC Palliative Care 2015; 14:55.

Langhorne P, Coupar F, Pollock A. Motor recovery after stroke : a systematic review. Lancet Neurology 2009; 8(8):741–754.

de Vries S, Mulder T. Motor imagery and stroke rehabilitation: A critical discussion. Journal of Rehabilitation Medicine 2007; 39(1):5-13.

Ada L, Dean CM, Lindley RI. Randomized trial of treadmill training to improve walking in community-dwelling people after stroke : the AMBULATE trial. International Journal of Stroke 2013; 8(6):436–444.

Jeon YH, Simpson JM, Low LF et al. A pragmatic randomised controlled trial (RCT) and realist evaluation of the Interdisciplinary Home-bAsed Reablement Program (I-HARP) for improving functional independence of community dwelling older people with dementia: An effectiveness-implementation hyb. BMC Geriatrics 2019; 19(1):199.

Park J, Park SY, Kim YW et al. Comparison between treadmill training with rhythmic auditory stimulation and ground walking with rhythmic auditory stimulation on gait ability in chronic stroke patients: A pilot study. NeuroRehabilitation 2015; 37(2):193–202.

Macko RF, Ivey FM, Forrester LW et al. Treadmill exercise rehabilitation improves ambulatory function and cardiovascular fitness in patients with chronic stroke: a randomized, controlled trial. Stroke 2005; 36(10):2206–2211.

Kim KH, Lee KB, Bae YH et al. Effects of progressive backward body weight suppoted treadmill training on gait ability in chronic stroke patients: a randomized controlled trial. Technol Health Care 2017; 25(5):867–876.

Saunders DH, Sanderson M, Brazzelli M et al. Physical fitness training for stroke patients (Review). Cochrane Database of Systematic Reviews 2013; 10:1–334.

How to Cite
Nur Chayati, Ismail Setyopranoto, & Christantie Effendy. (2020). THE EFFECTIVENESS OF HOME-BASED CARE INTERVENTIONS FOR STROKE SURVIVORS: A SYSTEMATIC REVIEW OF PHYSICAL AND PSYCHOLOGICAL OUTCOMES. Malaysian Journal of Public Health Medicine, 20(1), 199-219.