The Effectiveness of Rehabilitation Interventions for Improving Leisure Participation Following Stroke: Protocol for a Systematic Review
Bibliographic record
Abstract
Background: Leisure participation is an important rehabilitation goal for survivors of stroke. Following stroke, there is a reduction in leisure participation; however, the focus of rehabilitation is typically on remediation of personal care activities and mobility. Furthermore, previous systematic reviews and current clinical practice guidelines provide inconsistent recommendations for rehabilitation interventions to improve leisure participation. This highlights the need for a comprehensive and targeted review of the literature to help inform clinical practice. Objective: We propose a systematic review to synthesize data on the effectiveness of rehabilitation interventions to increase leisure participation in adult survivors of stroke, taking into account time since stroke and intervention context. Methods: Searches will be conducted in MEDLINE, CINAHL, Embase, and CENTRAL. We will include randomized controlled trials and nonrandomized controlled trials that include adult survivors of stroke and test the effectiveness of rehabilitation interventions for leisure participation. Eligible interventions will be those that aim to improve leisure participation or where leisure participation is an outcome of interest. Two reviewers will independently screen full-text articles, and one reviewer will extract data, with a second reviewer providing confirmation. The Physiotherapy Evidence Database Scale will be used to assess the methodological quality of the studies. A random-effects meta-analysis will be performed, and a Cochran Q test will assess heterogeneity among studies. Outcome measures of leisure participation may include measures of amount, satisfaction and confidence, and performance. Secondary outcomes will include quality of life measures, adverse events, and resource use. Results: Results will be discussed based on subgroup analyses where possible, including (1) time since stroke (early subacute, late subacute, and chronic), (2) delivery of the intervention (group or individualized), and (3) type of intervention (functional impairment, leisure education, and recreation participation). At the time of this protocol publication, the systematic review has progressed to data analysis, with publication of results expected in early 2026. Conclusions: The findings of this review will increase understanding of effective rehabilitation practices to increase leisure participation after stroke and may contribute to updates of existing clinical practice guidelines for stroke rehabilitation.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.070 | 0.083 |
| Meta-epidemiology (narrow) | 0.007 | 0.006 |
| Meta-epidemiology (broad) | 0.023 | 0.024 |
| Bibliometrics | 0.012 | 0.012 |
| Science and technology studies | 0.005 | 0.005 |
| Scholarly communication | 0.008 | 0.009 |
| Open science | 0.006 | 0.006 |
| Research integrity | 0.007 | 0.009 |
| Insufficient payload (model declined to judge) | 0.077 | 0.009 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".