OBJECTIVE: To evaluate an occupational therapy intervention to improve outdoor mobilityafter stroke. DESIGN: Randomised controlled trial. SETTING: General practice registers, social services departments, a primary care rehabilitation service, and a geriatric day hospital. PARTICIPANTS: 168 community dwelling people with a clinical diagnosis of stroke in previous 36 months: 86 were allocated to the intervention group and 82 to the control group. INTERVENTIONS: Leaflets describing local transport services for disabled people (control group) and leaflets with assessment and up to seven intervention sessions by an occupational therapist (intervention group). MAIN OUTCOME MEASURES: Responses to postal questionnaires at four and 10 months: primary outcome measure was response to whether participant got out of the house as much as he or she would like, and secondary outcome measures were response to how many journeys outdoors had been made in the past month and scores on the Nottingham extended activities of daily living scale, Nottingham leisure questionnaire, and general health questionnaire. RESULTS: Participants in the treatment group were more likely to get out of the house as often as they wanted at both four months (relative risk 1.72, 95% confidence interval 1.25 to 2.37) and 10 months (1.74, 1.24 to 2.44). The treatment group reported more journeys outdoors in the month before assessment at both four months (median 37 in intervention group, 14 in control group: P < 0.01) and 10 months (median 42 in intervention group, 14 in control group: P < 0.01). At four months the mobility scores on the Nottingham extended activities of daily living scale were significantly higher in the intervention group, but there were no significant differences in the other secondary outcomes. No significant differences were observed in these measures at 10 months. CONCLUSION: A targeted occupational therapy intervention at home increases outdoor mobility in people after stroke.
RCT Entities:
OBJECTIVE: To evaluate an occupational therapy intervention to improve outdoor mobility after stroke. DESIGN: Randomised controlled trial. SETTING: General practice registers, social services departments, a primary care rehabilitation service, and a geriatric day hospital. PARTICIPANTS: 168 community dwelling people with a clinical diagnosis of stroke in previous 36 months: 86 were allocated to the intervention group and 82 to the control group. INTERVENTIONS: Leaflets describing local transport services for disabled people (control group) and leaflets with assessment and up to seven intervention sessions by an occupational therapist (intervention group). MAIN OUTCOME MEASURES: Responses to postal questionnaires at four and 10 months: primary outcome measure was response to whether participant got out of the house as much as he or she would like, and secondary outcome measures were response to how many journeys outdoors had been made in the past month and scores on the Nottingham extended activities of daily living scale, Nottingham leisure questionnaire, and general health questionnaire. RESULTS:Participants in the treatment group were more likely to get out of the house as often as they wanted at both four months (relative risk 1.72, 95% confidence interval 1.25 to 2.37) and 10 months (1.74, 1.24 to 2.44). The treatment group reported more journeys outdoors in the month before assessment at both four months (median 37 in intervention group, 14 in control group: P < 0.01) and 10 months (median 42 in intervention group, 14 in control group: P < 0.01). At four months the mobility scores on the Nottingham extended activities of daily living scale were significantly higher in the intervention group, but there were no significant differences in the other secondary outcomes. No significant differences were observed in these measures at 10 months. CONCLUSION: A targeted occupational therapy intervention at home increases outdoor mobility in people after stroke.
Authors: Esther M J Steultjens; Joost Dekker; Lex M Bouter; Jos C M van de Nes; Edith H C Cup; Cornelia H M van den Ende Journal: Stroke Date: 2003-02-27 Impact factor: 7.914
Authors: C J Parker; J R Gladman; A E Drummond; M E Dewey; N B Lincoln; D Barer; P A Logan; K A Radford Journal: Clin Rehabil Date: 2001-02 Impact factor: 3.477
Authors: H Dawes; N Korpershoek; J Freebody; C Elsworth; N van Tintelen; D T Wade; H Izadi; D H Jones Journal: J Neurol Neurosurg Psychiatry Date: 2006-04-13 Impact factor: 10.154
Authors: Pip A Logan; Mat P Leighton; Marion F Walker; Sarah Armstrong; John R F Gladman; Tracey H Sach; Shirley Smith; Ossie Newell; Tony Avery; Hywel Williams; James Scott; Kathleen O'Neil; Annie McCluskey; Simon Leach; David Barer; Claire Ritchie; Ailie Turton; Jane Bisiker; David Smithard; Tess Baird; Paul Guyler; Therese Jackson; Ingrid Watmough; Maggie Webster; Janet Ivey Journal: Trials Date: 2012-06-21 Impact factor: 2.279
Authors: Nicola Fairhall; Catherine Sherrington; Susan E Kurrle; Stephen R Lord; Keri Lockwood; Ian D Cameron Journal: BMC Med Date: 2012-10-15 Impact factor: 8.775