This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Parker, C J Articles by Radford, K A Search for Related Content PubMed PubMed Citation Articles by Parker, C J Articles by Radford, K A Social Bookmarking                         What's this?

A multicentre randomized controlled trial of leisure therapy and conventional occupational therapy after stroke

J RF Gladman

A ER Drummond

Division of Rehabilitation and Ageing, University of Nottingham, Nottingham, UK

M E Dewey

Trent Institute for Health Services Research, University of Nottingham, Nottingham, UK

N B Lincoln

Department of Psychology, University of Nottingham, Nottingham, UK

D Barer

Department of Medicine, University of Newcastle, Newcastle Upon Tyne, UK

P A Logan

K A Radford

Division of Rehabilitation and Ageing, University of Nottingham, Nottingham, UK on behalf of the TOTAL Study Group

Objective: To evaluate the effects of leisure therapy and conventional occupational therapy (OT) on the mood, leisure participation and independence in activities of daily living (ADL) of stroke patients 6 and 12 months after hospital discharge.

Design: Multicentre randomized controlled trial.

Setting and participants: Four hundred and sixty-six stroke patients from five UK centres.

Main outcome measures: The General Health Questionnaire (12 item), the Nottingham Extended ADL Scale and the Nottingham Leisure Questionnaire, assessed by post, with telephone clarification.

Results: Four hundred and forty (94%) and 426 (91%) subjects were alive at 6 and 12 months, respectively. Three hundred and seventy-four (85% of survivors) and 311 (78% of survivors) responded at 6 and 12 month follow-up respectively. At six months and compared to the control group, those allocated to leisure therapy had nonsignificantly better GHQ scores (–1.2: 95% CI –2.9, +0.5), leisure scores (+0.7, 95% CI –1.1, +2.5) and Extended ADL scores (+0.4: 95% CI –3.8, +4.5): the ADL group had nonsignificantly better GHQ scores (–0.1: 95% CI –1.8, +1.7) and Extended ADL scores (+1.4: 95% CI –2.9, +5.6) and nonsignificantly worse leisure scores (–0.3: 95% CI –2.1, +1.6). The results at 12 months were similar.

Conclusion: In contrast to the findings of previous smaller trials, neither of the additional OT treatments showed a clear beneficial effect on mood, leisure activity or independence in ADL measured at 6 or 12 months.

Clinical Rehabilitation, Vol. 15, No. 1, 42-52 (2001)
DOI: 10.1191/026921501666968247


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				The Optimising Analysis of Stroke Trials (OAST) Co Can We Improve the Statistical Analysis of Stroke Trials?: Statistical Reanalysis of Functional Outcomes in Stroke Trials * OAST Supplemental Appendix I: Statistical Tests Compared (see Table I) * OAST Supplemental Appendix II: Supplementary Analyses * OAST Supplemental Appendix III: Trial Data (see Tables II and III) * OAST Supplemental Appendix IV: Results (see Table IV) Stroke, June 1, 2007; 38(6): 1911 - 1915. [Abstract] [Full Text] [PDF]

				P A Logan, J R F Gladman, A Avery, M F Walker, J Dyas, and L Groom Randomised controlled trial of an occupational therapy intervention to increase outdoor mobility after stroke BMJ, December 11, 2004; 329(7479): 1372 - 1375. [Abstract] [Full Text] [PDF]

				G. Kwakkel, R. van Peppen, R. C. Wagenaar, S. Wood Dauphinee, C. Richards, A. Ashburn, K. Miller, N. Lincoln, C. Partridge, I. Wellwood, et al. Effects of Augmented Exercise Therapy Time After Stroke: A Meta-Analysis Stroke, November 1, 2004; 35(11): 2529 - 2539. [Abstract] [Full Text] [PDF]

				M.F. Walker, J. Leonardi-Bee, P. Bath, P. Langhorne, M. Dewey, S. Corr, A. Drummond, L. Gilbertson, J.R.F. Gladman, L. Jongbloed, et al. Individual Patient Data Meta-Analysis of Randomized Controlled Trials of Community Occupational Therapy for Stroke Patients Stroke, September 1, 2004; 35(9): 2226 - 2232. [Abstract] [Full Text] [PDF]

				U. Sveen, B. Thommessen, E. Bautz-Holter, T. B. Wyller, and K. Laake Well-being and instrumental activities of daily living after stroke Clinical Rehabilitation, March 1, 2004; 18(3): 267 - 274. [Abstract] [PDF]

				P A Logan, J R. Gladman, A E. Drummond, and K A Radford A study of interventions and related outcomes in a randomized controlled trial of occupational therapy and leisure therapy for community stroke patients Clinical Rehabilitation, March 1, 2003; 17(3): 249 - 255. [Abstract] [PDF]

				E. M.J. Steultjens, J. Dekker, L. M. Bouter, J. C.M. van de Nes, E. H.C. Cup, C. H.M. van den Ende, F. Landi, and R. Bernabei Occupational Therapy for Stroke Patients: A Systematic Review * Occupational Therapy for Stroke Patients: When, Where, and How? Stroke, March 1, 2003; 34(3): 676 - 687. [Abstract] [Full Text] [PDF]

				A E. Drummond, C J Parker, J R. Gladman, and P A Logan Development and validation of the Nottingham Leisure Questionnaire (NLQ) Clinical Rehabilitation, June 1, 2001; 15(6): 647 - 656. [Abstract] [PDF]

				D. T Wade Research into the black box of rehabilitation: the risks of a Type III error Clinical Rehabilitation, January 1, 2001; 15(1): 1 - 4. [Abstract] [PDF]