Table 1.
Study characteristics.
| First author (year of publication) | Rehabilitation setting | Population (mean age; n randomized intervention/control) | Design | Intervention | Relevant outcome measures | Analysis | Findings | Considerations |
|---|---|---|---|---|---|---|---|---|
| Beckerman et al.19 (2004) | Rehabilitation centre (inpatient) | 651 rehabilitation patients admitted for the following diagnosis: amputation of a lower limb, spinal cord injury, Guillain–Barré syndrome, postpoliomyelitis syndrome (mean age 56.0; 214/437) | Non-randomized trial in three prospective cohorts: RAP (n = 214), partial RAP (=282) and care as usual group (=437) | Rehabilitation Activities Profile (RAP). An interdisciplinary goal-setting and evaluation tool, which offers the team a structured method to goal-setting | Barthel Index Duration of rehabilitation |
Descriptive statistics at discharge Multilevel logistic regression analysis for duration of rehabilitation, linear multilevel regression analysis for Barthel scores at discharge |
Intervention group (RAP) had lower Barthel scores compared
to control (−3.7%, 95% confidence interval (CI): −7.0 to
−0.3). No significant effect on duration of rehabilitation (odds ratio RAP versus control: 1.98, 95% CI 0.59 to 6.67) |
Not included in the meta-analysis because of the
design Data of partial RAP group not included in review |
| Colquhoun et al.20 (2010) | Rehabilitation unit (inpatient) | 103 geriatric rehabilitation patients admitted for longer than two weeks (mean age 81.6; 45/58) | Historical controlled study | Canadian Occupational Performance Measure (COPM) | Functional Independence Measure Duration of rehabilitation |
Descriptive statistics at discharge. Independent sample t-test and generalized linear modelling | No significant difference for any outcome | Not included in the meta-analysis because of the design |
| Duncan and Pozehl21 (2003) | Cardiac rehabilitation facility (outpatient) | 15 heart failure patients who had permission from their attending cardiologist and were able to attend week exercise programme three times a week (mean age 66.4; 8/7) | Randomized controlled trial | Goal-setting with visual feedback and problem-solving support | 6-minute Walk Test Minnesota Living With Heart Failure (quality of life) |
Descriptive statistics at 12 and 24 weeks after the start of the study. Two-tailed, independent t-tests. | No statistically significant differences | The meta-analysis included data from 12 weeks follow-up |
| Gagné and Hoppes22 (2003) | Rehabilitation hospital (inpatient) | 31 rehabilitation patients admitted longer than two weeks and a FIM score <26 (no mean age reported, range: 56–93; 15/16) | Randomized controlled trial | Structured goal-setting by daily discussion of goal notebook by means of a standard format in describing rehabilitation goals | Functional Independence Measure | Descriptive statistics two weeks after the start of the study. Mann–Whitney U test | The intervention group had a higher FIM sub score for upper-body dressing (P = 0.019). No other significant differences | Not included in meta-analysis because total FIM score lacking |
| Guidetti et al.23 (2010) | 3 Rehabilitation clinics (inpatient) | 40 stroke rehabilitation patients (mean age 67.6; 19/21) | Randomized controlled trial | Client-Centred Self Care Intervention (CCSCI); a nine-step programme | Barthel Index Functional Independence Measure Duration of rehabilitation |
Descriptive statistics at three months of follow-up. T-test for independent continuous samples data. Wilcoxon matched pairs test for within groups analysis | There were no significant differences for any outcome | Not included in the primary meta-analysis because functional outcomes were reported in medians instead of means |
| Guidetti et al.12 (2015) | 16 Rehabilitation units (inpatient) | 280 stroke rehabilitation patients (mean age 72.4; 129/151) | Cluster-randomized controlled trial | Client-centred activities of daily living intervention (CADL). A nine-step structured goal-setting method | Barthel Index | Descriptive statistics at 3, 6 and 12 months. Linear mixed-effects models were used for continuous outcomes | There were no significant differences between CADL and care as usual | The meta-analysis included data from three months
follow-up A design effect correction was calculated for inclusion in the meta-analyse |
| Harwood et al.24 (2011) | Community stroke rehabilitation (outpatient) | 172 stroke patients recruited 6 to 12 weeks after stroke and living in the community (mean age 61.4; 46/39) | Randomized controlled trial | Take Charge Session (TCS) a structured individual assessment to facilitate self-directed rehabilitation (n = 46), ‘Inspirational’ DVD (iDVD) (n = 48), combination of TCS and iDVD (n = 39) | Barthel Index Physical Component Summary Score |
Descriptive statistics at 12 months of
follow-up Analysis of variance (ANOVA) for continuous outcome and logistic regression with odds ratio for categorical outcome. Kruskal–Wallis test for Barthel Index |
TCS had higher PCS scores compared to control (6.0; 95% CI: 2.0–10.0, P = 0.004). No other significant differences | The meta-analysis only included the TCS (goal-setting intervention) compared to the control group |
| O’Brien et al.25 (2013) | Physiotherapy clinic (outpatient) | 27 patients with hip and/or knee osteoarthritis (mean age 63.4; 17/10) | Randomized controlled trial | Goal-setting by means of completing action and coping planning under guidance of a research assistant | 6-minute Walk Test | Descriptive statistics at discharge using ANOVA | There were no significant differences for any outcome | |
| Oestergaard et al.26 (2012) | Rehabilitation at the hospital (inpatient) | 87 patients with degenerative disc disease who had undergone lumbar fusion surgery (mean age 55; 40/47) | Randomized controlled trial | Canadian Occupational Performance measure (COPM) | Activities of daily living (ADL) performance
questionnaire Duration of rehabilitation |
Descriptive statistics at one week, 1 and three months and three years after the start of the study. The chi-square or Fisher’s exact test were used for comparison of proportions | No significant difference for any outcome | Not included in the meta-analysis because functional outcomes were reported in median instead of means |
| Ogawa et al.27 (2016) | Rehabilitation at the hospital (inpatient) | 44 patients with disabling diseases (mean age 78.6; 22/22) | Quasi-randomized controlled trial | Goal Attainment Scaling (GAS) | Functional Independence Measure | Descriptive statistics at four weeks. Analysis of variance was used for continuous data | No significant difference in change score of the Functional Independence Measure between the two groups | In the systematic review and meta-analysis we only included control group I (real control) and control group II (goal-setting). Intervention group was excluded |
| Taylor et al.28 (2011) | 4 inpatient rehabilitation services (inpatient) | 41 stroke patients (mean age 61.3; 18/23) | Cluster-randomized controlled trial | Canadian Occupational Performance (COPM) | Functional Independence Measure SF-36 (quality of life) Duration of rehabilitation |
Descriptive statistics at 12 weeks after start of the study
and at discharge No statistical test used for comparing outcome data |
A statistically significant longer duration of rehabilitation in the intervention group | |
| Tomori et al.29 (2015) | 10 sub-acute rehabilitation units (inpatient) | 54 patients with disabling diseases (mean age 66.2; 27/27) | Randomized controlled trial | Aid for Decision-making in Occupation Choice (ADOC) | Functional Independence Measure SF-36 (quality of life) Duration of rehabilitation |
Descriptive statistics at two months. Two-tailed independent t-test for between-group comparison | There were no significant differences in any post-intervention outcomes between the groups | |
| Verhoef et al.30 (2007) | Rheumatology rehabilitation clinic (inpatient and outpatient) | 165 rheumatology patients (median age 61a, 85/80) | Controlled before-and-after study in a prospective cohort study with a pre-post-test non-equivalent design | Rehabilitation Activities Profile (RAP). An interdisciplinary goal-setting tool, which offers the team a structured method to goal-setting | Health Assessment Questionnaire (functional
ability) Rheumatoid Arthritis Quality of Life questionnaire Duration of rehabilitation |
Descriptive statistics at discharge and six weeks after
discharge. Chi-square test, Fischer Exact Test, Mann–Whitney U test |
There were no significant differences for any outcome | Not included in the meta-analysis because of the design |
| Wressle et al.31 (2002) | 2 rehabilitation hospitals (inpatient and outpatient) | 206 rehabilitation patients (median age 79a, 151/55) | Non-randomized trial in a prospective cohort study | Canadian Occupational Performance (COPM) | Klein–Bell ADL Scale | Descriptive statistics at discharge Mann–Whitney U test, Wilcoxon signed-rank test |
Significant change in score on Klein–Bell scale in favour of control (P = 0.002) | Not included in the meta-analysis because functional outcomes were reported in median instead of means |
a
In case of absence of a total median age, the lowest age median was given of either the control or intervention group.