Examining the feasibility and effectiveness of a culturally adapted participation-focused stroke self-management program in a day-rehabilitation setting: A randomized pilot study

Measuring Exercise Self-Efficacy After Stroke: Validity and Reliability of Current Measures

BACKGROUND AND PURPOSE

Many physically capable stroke survivors are insufficiently active, with low self-efficacy considered an important contributor. However, validity and reliability of self-efficacy measures in stroke survivors have not been established. This research aims to evaluate the test-retest reliability and construct validity of 3 self-efficacy measures: Self-Efficacy for Exercise Scale (SEE), Spinal Cord Injury Exercise Self-Efficacy Scale (SCI-ESES), and Participation Strategies Self-Efficacy Scale (PS-SES).

METHODS

A repeated measures study with community-dwelling, independently mobile adult stroke survivors (n = 51, mean age 74 years, 45% female, median 22 months poststroke) was completed. Test-retest reliability was assessed using intraclass correlation coefficients and Bland-Altman analyses. Construct validity was assessed using 8 pre-determined hypotheses concerning physical activity level (subjective and objective), comorbidities, work and volunteering, and measures of function.

RESULTS

Retest reliability was established for the SEE (intraclass correlation coefficient, ICC = 0.77) and PS-SES (ICC = 0.78) but not for the SCI-ESES (ICC = 0.68). Bland-Altman analysis showed participants consistently scored higher on the second test for all measures. The SEE achieved construct validity by meeting 75% of hypotheses, whereas the PS-SES and SCI-ESES did not. Self-efficacy was positively related to steps/day, functional capacity, self-reported activity levels, and work or volunteering participation.

DISCUSSION AND CONCLUSIONS

The SEE was found to be the most appropriate tool to measure exercise self-efficacy in independently mobile chronic stroke survivors in terms of retest reliability and validity.

TRIAL REGISTRATION

N/A.

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for more insights from the authors (see the Video, Supplemental Digital Content 1 "Espernberger-JNPT-Video-Abstract," available at: http://links.lww.com/JNPT/A489 ).

Effects of a nurse-led peer support intervention on psychosocial outcomes of stroke survivors: A randomised controlled trial

BACKGROUND

Living with stroke poses many psychosocial challenges. Interventions for improving stroke survivors' psychosocial outcomes are lacking. Peer support interventions may contribute to recovery after stroke. However, current evidence is insufficient to suggest their application in enhancing stroke survivors' psychosocial well-being.

OBJECTIVE

This study aimed to evaluate the effectiveness of a nurse-led peer support intervention for improving the psychosocial outcomes of stroke survivors.

DESIGN

An assessor-blinded two-arm randomised controlled trial with an attention control group.

SETTINGS

A community health centre and a rehabilitation unit in Yangzhou, China.

PARTICIPANTS

First-ever or recurrent ischaemic or haemorrhagic stroke survivors.

METHODS

A convenience sample of 120 stroke survivors was recruited with 60 participants randomly assigned to each of the intervention and control groups. Intervention group participants received the nurse-led peer support intervention. Control group participants received attention care. The primary outcomes were social participation and participation self-efficacy. The secondary outcomes were psychological distress, perceived social support, stigma towards diseases, and quality of life. Data were collected at baseline (T0), immediately post-intervention (T1) and three months post-intervention (T2). Generalised estimating equations models were used to determine the effects of the intervention on the outcomes.

RESULTS

The intervention significantly improved social participation (T1: adjusted mean difference = -18.45, 95 % CI: -22.89 to -14.01, p < 0.001; T2: adjusted mean difference = -14.71, 95 % CI: -22.36 to -7.05, p < 0.001), participation self-efficacy (T1: adjusted mean difference = 47.92, 95 % CI: 37.56 to 58.27, p < 0.001; T2: adjusted mean difference = 39.58, 95 % CI: 17.88 to 61.28, p < 0.001) and perceived social support (T1: adjusted mean difference = 7.56, 95 % CI: 4.93 to 10.19, p < 0.001; T2: adjusted mean difference = 7.41, 95 % CI: 4.01 to 10.80, p < 0.001), and reduced psychological distress (T1: adjusted mean difference = -4.97, 95 % CI: -6.25 to -3.69, p < 0.001; T2: adjusted mean difference = -4.67, 95 % CI: -6.24 to -3.11, p < 0.001) and stigma towards diseases (T1: adjusted mean difference = -3.83, 95 % CI: -5.14 to -2.51, p < 0.001; T2: adjusted mean difference = -3.19, 95 % CI: -5.20 to -1.19, p < 0.001) at both T1 and T2. The intervention significantly improved quality of life at T1 only (adjusted mean difference = 0.12, 95 % CI: 0.06 to 0.19, p = 0.02).

CONCLUSIONS

The results provide empirical support for the effectiveness of the nurse-led peer support intervention in improving the psychosocial outcomes of stroke survivors and provide additional evidence to support their inclusion in stroke rehabilitation.

REGISTRATION

ChiCTR.org.cn (ChiCTR2100050853), Start of recruitment: October 2021.

Therapeutic groups run for community-dwelling people with acquired brain injury: a scoping review

PURPOSE

Therapeutic group interventions are commonly provided in acquired brain injury (ABI) inpatient rehabilitation settings, but little is known about the extent of therapeutic groups run for community-dwellers with ABI. This paper seeks to review current literature concerning the nature of therapeutic groups run for community-dwellers with ABI and the involvement of occupational therapists.

MATERIALS & METHODS

A scoping review was conducted with systematic searching of relevant databases guided by Arksey and O'Malley's framework. Studies were included if they reported on therapeutic groups for community-dwellers with ABI. Articles were collated and summarised with key findings presented in narrative form with accompanying tables.

RESULTS

Seventy articles met inclusion. Groups are used as therapeutic change agents for community-dwellers with ABI and target a diverse range of participation barriers. Participants valued group programs that established safe environments, a sense of belonging, growth opportunities and social connections. Group accessibility needs to be improved, with better funding avenues available for service providers, as well as greater consumer involvement in group design and facilitation.

CONCLUSIONS

Groups are a valuable therapeutic modality supporting community-dwellers with ABI. Further research is warranted into the use of groups by occupational therapists working with community-dwellers with ABI.

Application of the Person-Environment-Occupation-Performance Model: A Scoping Review

The Person-Environment-Occupation-Performance (PEOP) Model is one of several occupation-based models in occupational therapy. The model describes the transactional nature of person, environment, and occupation factors that support performance (doing), participation (engagement), and well-being (health and quality of life). The purpose of this study was to explore the extent and nature of evidence on the PEOP Model. We used a scoping review to identify and analyze journal articles that used the PEOP Model as a framework for study. The PRISMA extension for scoping reviews (PRISMA-ScR) criteria were used to develop the research methods. We found 109 articles that adopted the PEOP Model as an organizing framework. The studies reviewed represent the breadth of occupational therapy practice and the transactional nature of person, environment, occupation, and performance in the PEOP Model. The PEOP Model is a useful international framework for research and practice across populations, conditions, life circumstances, settings, and areas of practice.

Motivational strategies used by health care professionals in stroke survivors in rehabilitation: a scoping review of experimental studies

Introduction

Cognitive and motor impairments are common among stroke survivors. Physical therapy is often used to improve the functional capacity of stroke survivors. However, limited adherence to rehabilitation programs is a challenge. Motivation plays a crucial role in the success of rehabilitation programs as it influences individual adherence to treatment and overall health outcomes. This review aims to identify current trends in motivational strategies used by healthcare professionals for stroke survivor rehabilitation.

Methods

Following the framework developed by Arksey and O'Malley, a scoping review was conducted. We performed a literature search using MEDLINE, CINAHL, the Cochrane Central Register of Controlled Trials, Nursing & Allied Health, and MedicLatina databases.

Results

A total of 906 papers were identified. After selecting and analyzing the articles, 17 papers were included in this review. Health professionals use various strategies to motivate stroke survivors. These approaches include establishing a therapeutic alliance, improving patients' health literacy, defining realistic goals, fostering problem-solving skills, personalizing the rehabilitation program, showcasing success stories, utilizing persuasive techniques, offering encouragement and compliments, providing emotional support, and effectively managing symptoms.

Conclusion

The knowledge gathered in this review can guide healthcare professionals in helping patients overcome barriers to rehabilitation, improve their motivation, and ultimately enhance their recovery outcomes.

Effectiveness of Community-Based Rehabilitation (CBR) Centers for Improving Physical Fitness for Community-Dwelling Older Adults: A Systematic Review and Meta-Analysis

To synthesise the best available evidence for the effectiveness of interventions delivered in community-based rehabilitation (CBR) centers on physical fitness, for community-dwelling older adults living in Asian countries. This study is a systematic review and meta-analysis. Seven English and two Chinese electronic databases were searched for randomised controlled trials (RCTs) and quasi-experimental studies that were conducted by centers providing CBR. Independent reviewers screened, quality-appraised and extracted data. The primary outcome was physical fitness measured by validated assessment tools, including the Timed Up and Go Test (TUG), gait speed, hand grip strength, Functional Reach Test (FRT), and one-leg standing test. Assessments of activity of daily living and quality of life using tools including the Barthel Index, Short Form (SF)-12, and SF-36 were secondary outcomes. After screening 5,272 studies, 29 studies were included (16 RCTs, 13 quasi-experimental studies) from four countries. Meta-analyses found that CBR programs significantly decreased TUG time (mean difference [MD], -1.89 seconds; 95% confidence interval [95% CI], -2.84 to -0.94; I2=0%; Z=3.90, p<0.0001), improved gait speed (MD, 0.10 m/s; 95% CI, 0.01-0.18; I2=0%; Z=2.26, p=0.02), and increased one-leg standing time (MD, 2.81 seconds; 95% CI, 0.41-5.22; I2=0%; Z=2.29, p=0.02). Handgrip strength and FRT showed no statistically significant improvement in the meta-analyses. CBR may improve aspects of physical fitness for older adults in Asian countries. However, variability in intervention components and measurement tools reduced the ability to pool individual studies. Further trials are required with robust designs including standardised measures of physical fitness.

Efficacy of rehabilitation interventions evaluated in common neurological conditions in improving participation outcomes: A systematic review

OBJECTIVE

Modern clinical rehabilitation practice aligned to the International Classification of Functioning, Disability and Health and the Convention on the Rights of Persons with Disabilities highlights the importance of attention to participation in the rehabilitation formulation. This systematic review investigates the efficacy of rehabilitation interventions evaluated in common neurological disorders reported to influence participation outcomes.

DATA SOURCES

PubMed, Web of Science and PsycINFO databases were searched from inception to 25 April 2023. Only randomised controlled trials were considered for inclusion.

REVIEW METHODS

The data were extracted by two independent reviewers in the following categories: characteristics of the included study publications, description of intervention and outcome measures.

RESULTS

A total of 1248 unique article records were identified through the databases. Twenty-eight randomized controlled trials were included with 15 publications having participation as a primary outcome measure. Articles were related to multiple sclerosis (N = 4), spinal cord injury (N = 2), stroke (N = 16) and traumatic brain injury (N = 6). Four publications showed significant differences in pre- and post-intervention within experimental groups. All four articles described participation as primary outcome measure.

CONCLUSION

There is a limited evidence of the identified rehabilitation interventions to improve participation in common neurological conditions. However, there was a paucity of articles involving individual with Parkinson's disease that met the inclusion criteria.

Intervention patterns and preliminary effectiveness on Social Participation following stroke: a scoping review

BACKGROUND

Stroke survivors suffer an overall loss of social participation. However, the interventions aiming at improving social participation have not yet been well-established. There is a need to synthesize existing knowledge on clinical interventions aiming at improving social participation among people with stroke.

OBJECTIVE

To describe the patterns of intervention that have been applied to stroke survivors to improve social participation and to determine the preliminary effects of these patterns.

METHODS

Eight online databases, including Cochrane Library, PubMed, Web of Science, Embase, Medline, CINAHL plus, PsycINFO, and Scoups were searched with predefined search terms from inception to September 22, 2022. References of included articles and previous reviews were also checked to identify additional studies. Two reviewers independently selected eligible studies and extracted data from the included articles.

RESULTS

A total of 98 studies were included, of which only 25 studies considered social participation as primary outcome of clinical interventions. The patterns of intervention were various, consisting of exercise-based intervention, occupational therapy, self-management program, and complex intervention. Of the 25 studies, eight studies found a positive effect of relative clinical intervention on social participation for stroke survivors. Of note, the same modality of intervention such as exercise-based intervention and self-management program produced paradoxical conclusion on social participation.

CONCLUSION

Exercised-based intervention, occupational therapy, self-management program, and complex intervention were important intervention modalities for the improvement of social participation among stroke survivors. Even though the preliminary effectiveness on social participation seems to be potentially positive, further high-quality researches are still required to reach a consensus to achieve optimal social participation among stroke survivors.

The effect of self-management programs on post-stroke social participation: A systematic review and meta-analysis

OBJECTIVE

The aim of this study was to identify the effectiveness of self-management programs on the improvement of social participation among stroke survivors. Data Sources: Cochrane Library, PubMed, Web of Science database, EMBASE, Medline, CINAHL plus, and APA PsycArticles were searched from their inception to December 20, 2021.

METHODS

We considered randomized controlled trials and non-randomized controlled trials without language limits. Two reviewers independently screened the literature, evaluated risk of bias using the Cochrane's risk of bias tool, scored the methodological quality using criteria of the Australian Evidence-based Health Care Center, and extracted the data. The outcome was social participation. RevMan 5.3 was used, and intergroup differences were determined by calculating standardized mean difference (SMD) and 95% confidence intervals (CIs).

RESULTS

Of 1894 initial studies, totally 15 studies met the eligible criteria, consisting of six randomized controlled trials and nine non-randomized controlled trials. Four randomized controlled trials showed high methodological quality and two demonstrated medium quality. The randomized controlled trials involved a total of 430 stroke survivors and were published between 2007 and 2020. The meta-analysis from five randomized controlled trials demonstrates that the overall effect of self-management programs on social participation was not statistically significant (95% CI, -0.23 to 0.40; p = 0.61). Most of the non-randomized controlled trials were pre-/post-test design with an average sample size of 15.4. The effect of self-management program on social participation in most non-randomized controlled trials was insignificant as well.

CONCLUSION

The self-management programs seem not to be superior to usual care for the improvement on social participation in stroke survivors based on current evidence. Further well-designed investigation considering social participation as the primary outcome is still warranted.

Occupational therapy for cognitive impairment in stroke patients

BACKGROUND

Cognitive impairment is a frequent consequence of stroke and can impact on a person's ability to perform everyday activities. Occupational therapists use a range of interventions when working with people who have cognitive impairment poststroke. This is an update of a Cochrane Review published in 2010.

OBJECTIVES

To assess the impact of occupational therapy on activities of daily living (ADL), both basic and instrumental, global cognitive function, and specific cognitive abilities in people who have cognitive impairment following a stroke.

SEARCH METHODS

We searched the Cochrane Stroke Group Trials Register, CENTRAL, MEDLINE, Embase, four other databases (all last searched September 2020), trial registries, and reference lists.

SELECTION CRITERIA

We included randomised and quasi-randomised controlled trials that evaluated an intervention for adults with clinically defined stroke and confirmed cognitive impairment. The intervention needed either to be provided by an occupational therapist or considered within the scope of occupational therapy practice as defined in the review. We excluded studies focusing on apraxia or perceptual impairments or virtual reality interventions as these are covered by other Cochrane Reviews. The primary outcome was basic activities of daily living (BADL) such as dressing, feeding, and bathing. Secondary outcomes were instrumental ADL (IADL) (e.g. shopping and meal preparation), community integration and participation, global cognitive function and specific cognitive abilities (including attention, memory, executive function, or a combination of these), and subdomains of these abilities. We included both observed and self-reported outcome measures.

DATA COLLECTION AND ANALYSIS

Two review authors independently selected studies that met the inclusion criteria, extracted data, and assessed the certainty of the evidence. A third review author moderated disagreements if consensus was not reached. We contacted trial authors for additional information and data, where available. We assessed the certainty of key outcomes using GRADE.  MAIN RESULTS: We included 24 trials from 11 countries involving 1142 (analysed) participants (two weeks to eight years since stroke onset). This update includes 23 new trials in addition to the one study included in the previous version. Most were parallel randomised controlled trials except for one cross-over trial and one with a two-by-two factorial design. Most studies had sample sizes under 50 participants. Twenty studies involved a remediation approach to cognitive rehabilitation, particularly using computer-based interventions. The other four involved a compensatory and adaptive approach. The length of interventions ranged from 10 days to 18 weeks, with a mean total length of 19 hours. Control groups mostly received usual rehabilitation or occupational therapy care, with a few receiving an attention control that was comparable to usual care; two had no intervention (i.e. a waiting list). Apart from high risk of performance bias for all but one of the studies, the risk of bias for other aspects was mostly low or unclear.  For the primary outcome of BADL, meta-analysis found a small effect on completion of the intervention with a mean difference (MD) of 2.26 on the Functional Independence Measure (FIM) (95% confidence interval (CI) 0.17 to 4.22; P = 0.03, I2 = 0%; 6 studies, 336 participants; low-certainty evidence). Therefore, on average, BADL improved by 2.26 points on the FIM that ranges from 18 (total assist) to 126 (complete independence). On follow-up, there was insufficient evidence of an effect at three months (MD 10.00, 95% CI -0.54 to 20.55; P = 0.06, I2 = 53%; 2 studies, 73 participants; low-certainty evidence), but evidence of an effect at six months (MD 11.38, 95% CI 1.62 to 21.14, I2 = 12%; 2 studies, 73 participants; low-certainty evidence). These differences are below 22 points which is the established minimal clinically important difference (MCID) for the FIM for people with stroke. For IADL, the evidence is very uncertain about an effect (standardised mean difference (SMD) 0.94, 95% CI 0.41 to 1.47; P = 0.0005, I2 = 98%; 2 studies, 88 participants). For community integration, we found insufficient evidence of an effect (SMD 0.09, 95% CI -0.35 to 0.54; P = 0.68, I2 = 0%; 2 studies, 78 participants). There was an improvement of clinical importance in global cognitive functional performance after the intervention (SMD 0.35, 95% CI 0.16 to 0.54; P = 0.0004, I2 = 0%; 9 studies, 432 participants; low-certainty evidence), equating to 1.63 points on the Montreal Cognitive Assessment (MoCA) (95% CI 0.75 to 2.52), which exceeds the anchor-based MCID of the MoCA for stroke rehabilitation patients of 1.22. We found some effect for attention overall (SMD -0.31, 95% CI -0.47 to -0.15; P = 0.0002, I2 = 20%; 13 studies, 620 participants; low-certainty evidence), equating to a difference of 17.31 seconds (95% CI 8.38 to 26.24), and for executive functional performance overall (SMD 0.49, 95% CI 0.31 to 0.66; P < 0.00001, I2 = 74%; 11 studies, 550 participants; very low-certainty evidence), equating to 1.41 points on the Frontal Assessment Battery (range: 0-18). Of the cognitive subdomains, we found evidence of effect of possible clinical importance, immediately after intervention, for sustained visual attention (moderate certainty) equating to 15.63 seconds, for working memory (low certainty) equating to 59.9 seconds, and thinking flexibly (low certainty), compared to control.

AUTHORS' CONCLUSIONS

The effectiveness of occupational therapy for cognitive impairment poststroke remains unclear. Occupational therapy may result in little to no clinical difference in BADL immediately after intervention and at three and six months' follow-up. Occupational therapy may slightly improve global cognitive performance of a clinically important difference immediately after intervention, likely improves sustained visual attention slightly, and may slightly increase working memory and flexible thinking after intervention. There is evidence of low or very low certainty or insufficient evidence for effect on other cognitive domains, IADL, and community integration and participation.  Given the low certainty of much of the evidence in our review, more research is needed to support or refute the effectiveness of occupational therapy for cognitive impairment after stroke. Future trials need improved methodology to address issues including risk of bias and to better report the outcome measures and interventions used.

Effects of peer support interventions on physical and psychosocial outcomes among stroke survivors: A systematic review and meta-analysis

BACKGROUND

High level of unmet needs were reported by stroke survivors after hospital discharge. Peer support interventions may play a valuable role in the management of stroke, but the evidence is unclear.

OBJECTIVES

To determine the effects of peer support interventions on physical and psychosocial outcomes of stroke survivors; and to identify the key characteristics of peer support interventions for stroke survivors.cv DESIGN: A systematic review and meta-analysis.

REVIEW METHODS

Seven English databases and four Chinese databases were searched to identify eligible articles. Two reviewers screened the eligible studies, appraised the risk of bias, and extracted the data independently. Version 2 of the Cochrane risk-of-bias tool was used to evaluate the risk of bias for randomized controlled trials, while the Risk of Bias in Non-randomized Studies of Interventions tool was used for the quasi-experimental studies. The Grading of Recommendations Assessment, Development and Evaluation profiler Guideline Development Tool was used to assess the quality of evidence. Meta-analyses were conducted using Review Manager 5.3, and narrative analyses were performed when meta-analysis was inappropriate.

RESULTS

Eleven studies were included. Peer support interventions could improve the activities of daily living (MD = 15.53, 95% CI: 1.39 to 29.68; P = 0.03, I2 = 99%; very low quality of evidence), limb function, depression (SMD = -1.27, 95% CI: -2.18 to -0.36; P = 0.006, I2 = 91%; very low quality of evidence) and anxiety. Although pooled analysis showed that social participation (SMD= 0.74, 95% CI: 0.09 to 1.39; P = 0.03, I2 = 69%; low quality of evidence) and quality of life (SMD = 0.41, 95% CI: 0.09 to 0.73; P = 0.01, I2 = 0%; low quality of evidence) improved after peer support interventions, the studies which were not pooled due to insufficient data drew inconsistent results.

CONCLUSIONS

Stroke survivors may benefit from peer support interventions to improve their physical and psychological outcomes. The evidence about the impact of peer support interventions on social participation and quality of life is very uncertain. It should be noted that the quality of evidence ranged from very low to low, thus highlighting the need for more research of higher quality to substantiate these findings.

Validation of a translated Chinese version of the Participation Strategies Self-Efficacy Scale: a cross-sectional study

PURPOSE

To examine the psychometric properties of a Chinese version of the Participation Strategies Self-Efficacy Scale (PS-SES) among stroke survivors.

METHODS

The PS-SES was translated into Chinese. A cross-sectional descriptive study was conducted with 336 stroke survivors recruited from the neurology departments of five hospitals in China. Reliability, concurrent validity, and construct validity of the scale were determined.

RESULTS

The Chinese version of the PS-SES (PS-SES-C) showed good internal consistency and test-retest reliability, with a Cronbach's α of 0.98 and an intraclass correlation coefficient of 0.79. There was a moderate to strong positive correlation between the PS-SES-C and Chinese version of the General Self-Efficacy Scale (r = 0.59, p < .001), positive correlations between the PS-SES-C and Chinese versions of the Modified Barthel Index (r = 0.59, p < .001), Rivermead Mobility Index (r = 0.70, p < .001), and Reintegration to Normal Living Index (r = 0.70, p < .001), and a negative correlation between the PS-SES-C and National Institutes of Health Stroke Scale (r = -0.63, p < .001). Known-group validity and factorial validity were also supported.

CONCLUSIONS

The PS-SES-C is a reliable and valid instrument for assessing self-efficacy in managing the participation of Chinese stroke survivors.Implications for rehabilitationSelf-efficacy significantly predicts activity and participation in stroke survivors and is a major outcome measure in many stroke rehabilitation programmes.The translated Chinese version of the Participation Strategies Self-efficacy Scale is a valid and reliable tool to evaluate stroke survivors' self-efficacy in managing participation.The Chinese version of the Participation Strategies Self-efficacy Scale can be used to assess stroke recovery among the Chinese population in clinical and research settings.

Relationship between Occupational Identity Post-Stroke and Outcomes of a Self-Management Participation-Focused Intervention: A Preliminary Investigation

Self-management programs are used to assist stroke survivors to manage their condition and participation. This study was designed to examine correlations between occupational identity and outcomes of participation-focused self-management program using the Occupational Performance History Interview for the occupational identity and participation and self-efficacy as outcome measures. Spearman's rho correlations were calculated between occupational Identity and the program's outcomes. Results showed moderate significant positive correlations with self-efficacy for self-management and self-efficacy for participation scales at baseline; few were found at post-intervention and follow-up. Non-significant correlations were found between occupational identity and the change in outcome measures from baseline to post-intervention and to follow-up. Findings suggest occupational identity is strongly related to self-efficacy after stroke, and less related to intervention outcomes. However, other factors may possibly affect the effectiveness of self-management programs for a stroke population. Exploration of these factors might help develop programs better tailored to each stroke survivor.

Effect of Self-Management Support for Elderly People Post-Stroke: A Systematic Review

A systematic review was undertaken to determine the efficacy of self-management interventions for people with stroke over the age of 65 in relation to psychosocial outcomes. PubMed, Embase, and PsycInfo were searched for randomized controlled clinical trials. Studies were eligible if the included people with stroke had a mean age ≥65 years in both the intervention and control group. Data on psychosocial measurements were extracted and an assessment of methodological quality was undertaken. Due to heterogeneity across the studies, the results were synthesized narratively. Eleven studies were identified. They included different self-management interventions in terms of theoretical rationales, delivery, and content. Seven psychosocial outcomes were identified: i) self-management, ii) self-efficacy, iii) quality of life, iv) depression, v) activities of daily living, vi) active lifestyle, and vii) other measures. Self-management interventions for people with stroke over the age of 65 may be beneficial for self-management, self-efficacy, quality of life, activity of daily living, and other psychosocial outcomes. However, low study quality and heterogeneity of interventions, as well as variation in time of follow-up and outcome measures, limit the possibility of making robust conclusions.