Dietary and lifestyle interventions for overweight and obesity in post-acute stroke rehabilitation: a scoping review.

OBJECTIVE

Overweight and obesity are prevalent among individuals in post-acute stroke rehabilitation and are associated with poorer functional outcomes and increased cardiovascular risk. Interventions targeting weight management in this population are complex and often involve multiple behavioural components; however, characteristics are not well defined. This scoping review aimed to identify and map the literature on professional dietary and lifestyle interventions targeting the management of overweight and obesity during post-acute stroke rehabilitation.

DESIGN

This scoping review followed the Joanna Briggs Institute methodology and a previously published protocol. A three-step, librarian-assisted search was conducted in MEDLINE, Embase, CINAHL and Web of Science, supplemented by grey literature searches. Eligible sources included primary studies and clinical guidelines reporting on dietary and lifestyle interventions among adults with stroke during post-acute rehabilitation. Reviews were identified but excluded from the main synthesis. Publications in English or Scandinavian languages from January 2010 onwards were included. Two reviewers independently screened, selected and extracted data in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) checklist.

SETTING

Studies were conducted across inpatient, community and home-based post-acute stroke rehabilitation settings.

RESULTS

Of 3254 records screened, 14 studies met the inclusion criteria. Interventions varied in duration (3 weeks to 2 years), frequency (6-22 sessions) and content. Most were multicomponent strategies including dietary counselling, app-based self-monitoring, group education and behaviour change techniques. Interventions were primarily delivered in community or home-based settings. Health professionals involved dietitians, nurses, psychologists, physiotherapists and interprofessional teams. Digital interventions featured prominently. Only three studies addressed caregiver involvement and environmental barriers.

CONCLUSION

This review maps characteristics of dietary and lifestyle interventions targeting the management of overweight and obesity in post-acute stroke rehabilitation. The evidence base is heterogeneous and largely comprises multicomponent interventions. Gaps were identified regarding cognitive impairment, caregiver involvement and environmental adaptations. Further research is needed to support development, implementation and evaluation in this population.

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