Purpose: To examine evidence about involving family and other primary caregivers (F-PCs) in the rehabilitation process of patients with stroke or traumatic brain injury (TBI) to enhance occupational engagement and occupational performance outcomes.

Methods: Five electronic databases were searched for the period 2008-2018 and a manual search of references was conducted.  Quality of the methodology and evidence of included studies was assessed using the Critical Appraisal Skill Programme and the Oxford Centre for Evidence Based Medicine.

Results: After removal of duplicates, 304 abstracts were screened of which 40 articles were screened for eligibility. Ten studies were included in the review. Findings revealed that additional exercise training provided by F-PCs showed weak to moderate evidence of improvement in physical functioning. Furthermore, there was weak to moderate evidence of significant associations between F-PCs’ and patients’ characteristics which impact on outcomes in occupational engagement and occupational performance.

Conclusions: There is evidence that F-PC-mediated interventions and caregiver characteristics are associated with improvements in occupational engagement and occupational performance. However, there is lack of high-quality evidence on this topic. It is suggested that there is a need for occupation-focussed approaches that educate and guide F-PCs to provide additional exercise training focussed on both individual goals and the needs and capacities of F-PCs and patients.