OBJECTIVE: To compare changes regarding perceived participation, independence in activities of daily living (ADL) and life satisfaction between 3, 6 and 12 months after inclusion in a study of a client-centred ADL intervention and usual ADL intervention after stroke. DESIGN: A multicentre randomized controlled trial. METHODS:Sixteen rehabilitation units were randomly assigned to provide client-centred ADL intervention or usual ADL intervention. Eligible participants were persons ≤ 3 months after stroke who had been treated in a stroke unit, were dependent in two ADL domains, had not been diagnosed with dementia, and were able to understand instructions. Data collection was performed by blinded assessors. The primary outcome, perceived participation, was assessed with the Stroke Impact Scale 3.0, domain 8. The secondary outcomes, participation, independence in ADL, and life satisfaction, were assessed with validated instruments. For statistical power, 280 participants were required. Statistical analyses were performed on an intention-to-treat basis. RESULTS: There were no differences between the groups regarding changes in perceived participation, independence in ADL, or life satisfaction during the first 12 months. There was a trend towards a clinically meaningful positive change in perceived participation that favoured client-centred ADL intervention. CONCLUSION: Further research is required to understand the benefits of client-centred interventions.
RCT Entities:
OBJECTIVE: To compare changes regarding perceived participation, independence in activities of daily living (ADL) and life satisfaction between 3, 6 and 12 months after inclusion in a study of a client-centred ADL intervention and usual ADL intervention after stroke. DESIGN: A multicentre randomized controlled trial. METHODS: Sixteen rehabilitation units were randomly assigned to provide client-centred ADL intervention or usual ADL intervention. Eligible participants were persons ≤ 3 months after stroke who had been treated in a stroke unit, were dependent in two ADL domains, had not been diagnosed with dementia, and were able to understand instructions. Data collection was performed by blinded assessors. The primary outcome, perceived participation, was assessed with the Stroke Impact Scale 3.0, domain 8. The secondary outcomes, participation, independence in ADL, and life satisfaction, were assessed with validated instruments. For statistical power, 280 participants were required. Statistical analyses were performed on an intention-to-treat basis. RESULTS: There were no differences between the groups regarding changes in perceived participation, independence in ADL, or life satisfaction during the first 12 months. There was a trend towards a clinically meaningful positive change in perceived participation that favoured client-centred ADL intervention. CONCLUSION: Further research is required to understand the benefits of client-centred interventions.
Authors: Lynn A Legg; Sharon R Lewis; Oliver J Schofield-Robinson; Avril Drummond; Peter Langhorne Journal: Cochrane Database Syst Rev Date: 2017-07-19
Authors: Julius T Kamwesiga; Gunilla M Eriksson; Kerstin Tham; Uno Fors; Ali Ndiwalana; Lena von Koch; Susanne Guidetti Journal: Global Health Date: 2018-08-15 Impact factor: 4.185
Authors: Malin Tistad; Maria Flink; Charlotte Ytterberg; Gunilla Eriksson; Susanne Guidetti; Kerstin Tham; Lena von Koch Journal: BMJ Open Date: 2018-08-05 Impact factor: 2.692