Tove Lise Nielsen1,2,3, Niels Trolle Andersen4, Kirsten Schultz Petersen5, Helene Polatajko6, Claus Vinther Nielsen1,3. 1. a Section for Clinical Social Medicine and Rehabilitation, Department of Public Health , Aarhus University , Aarhus , Denmark. 2. b Department of Occupational Therapy , VIA University College , Aarhus , Denmark. 3. c DEFACTUM Central Denmark Region , Aarhus , Denmark. 4. d Section for Biostatistics, Department of Public Health , Aarhus University , Aarhus , Denmark. 5. e Department of Health Science and Technology, The Faculty of Medicine, Public Health and Epidemiology Group , Aalborg University , Aalborg , Denmark. 6. f Department of Occupational Science and Occupational Therapy, and Rehabilitation Sciences Institute , University of Toronto , Toronto , ON , Canada.
Abstract
BACKGROUND: There is growing interest in enabling older adults' occupational performance. We tested whether 11 weeks of intensive client-centred occupational therapy (ICC-OT) was superior to usual practice in improving the occupational performance of home-dwelling older adults. METHODS: An assessor-masked randomized controlled trial among adults 60 + with chronic health issues, who received or applied for homecare services. Recruitment took place September 2012 to April 2014. All participants received practical and personal assistance and meal delivery as needed. In addition, they were randomized to receive either a maximum 22 sessions of occupation-based ICC-OT (N = 59) or to receive usual practice with a maximum three sessions of occupational therapy (N = 60). The primary outcome was self-rated occupational performance assessed with the Canadian Occupational Performance Measure (COPM). RESULTS: No important adverse events occurred. ICC-OT was accepted by 46 participants (88%), usual practice by 60 (100%). After 3 months, the ICC-OT-group had improved 1.86 points on COPM performance; the Usual-Practice group had improved 0.61 points. The between-group difference was statistically significant (95% confidence interval 0.50 to 2.02), t-test: p = 0.001. CONCLUSIONS:ICC-OT improved older adults' occupational performance more effectively than usual practice. This result may benefit older adults and support programmatic changes.
RCT Entities:
BACKGROUND: There is growing interest in enabling older adults' occupational performance. We tested whether 11 weeks of intensive client-centred occupational therapy (ICC-OT) was superior to usual practice in improving the occupational performance of home-dwelling older adults. METHODS: An assessor-masked randomized controlled trial among adults 60 + with chronic health issues, who received or applied for homecare services. Recruitment took place September 2012 to April 2014. All participants received practical and personal assistance and meal delivery as needed. In addition, they were randomized to receive either a maximum 22 sessions of occupation-based ICC-OT (N = 59) or to receive usual practice with a maximum three sessions of occupational therapy (N = 60). The primary outcome was self-rated occupational performance assessed with the Canadian Occupational Performance Measure (COPM). RESULTS: No important adverse events occurred. ICC-OT was accepted by 46 participants (88%), usual practice by 60 (100%). After 3 months, the ICC-OT-group had improved 1.86 points on COPM performance; the Usual-Practice group had improved 0.61 points. The between-group difference was statistically significant (95% confidence interval 0.50 to 2.02), t-test: p = 0.001. CONCLUSIONS: ICC-OT improved older adults' occupational performance more effectively than usual practice. This result may benefit older adults and support programmatic changes.
Authors: Mackenzi Pergolotti; Allison M Deal; Grant R Williams; Ashley L Bryant; Lauren McCarthy; Kirsten A Nyrop; Kelley R Covington; Bryce B Reeve; Ethan Basch; Hyman B Muss Journal: J Am Geriatr Soc Date: 2019-05 Impact factor: 5.562