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 Logan, P A Articles by Radford, K A Search for Related Content PubMed PubMed Citation Articles by Logan, P A Articles by Radford, K A Pubmed/NCBI databases Medline Plus Health Information Stroke Social Bookmarking                         What's this?

A study of interventions and related outcomes in a randomized controlled trial of occupational therapy and leisure therapy for community stroke patients

Division of General Practice, University of Nottingham, Nottingham on behalf of the TOTAL Study Group

J RF Gladman

A ER Drummond

K A Radford

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

Objective: To undertake a detailed analysis of therapy provided in a multicentred randomized controlled trial of activities of daily living (ADL) and leisure (TOTAL), testing the hypothesis that specific interventions given in the trial affected specific aspects of outcome.

Subjects: Three hundred and nine stroke patients who had been randomly allocated to receive either occupational therapy aimed at ADL activities (n = 156) or leisure (n = 153).

Measures: Number, duration and type of activity undertaken per patient. Barthel Index, Extended Activities of Daily Living Scale (EADL) and Nottingham Leisure Questionnaire (NLQ) six months after entry to the study.

Method: Activities that had been used in treatment were coded and categorized. Frequently used activities identified. These activities were matched to items from the six-month outcome measures. Patient independence in these outcome items was compared between the leisure and ADL groups.

Results: Three hundred and nine therapy record forms were returned. Patients received a median of ten sessions with a median duration of 55 minutes. The ADL group received significantly more, mobility training, transfer training, cleaning, dressing, cooking and bathing training (chi-squared, p < 0.05). Sport, creative activities, games, hobbies, gardening, entertainment and shopping were used significantly more in the leisure group (chi-squared, p < 0.05) than the ADL group. Fifteen items from the outcome measures were identified as specific to these interventions. There were no statistically significant differences in outcome on these 15 items between the ADL and leisure groups (chi-squared, p > 0.05).

Conclusions: We found no evidence that specific ADL or leisure interventions led to improvements in specific relevant outcomes. We believe that these findings should prompt a review of the relationship between process and outcome of occupational therapy.

Clinical Rehabilitation, Vol. 17, No. 3, 249-255 (2003)
DOI: 10.1191/0269215503cr593oa


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

This article has been cited by other articles:

				L. De Wit, H. Kamsteegt, B. Yadav, G. Verheyden, H. Feys, and W. De Weerdt Defining the content of individual physiotherapy and occupational therapy sessions for stroke patients in an inpatient rehabilitation setting. Development, validation and inter-rater reliability of a scoring list Clinical Rehabilitation, May 1, 2007; 21(5): 450 - 459. [Abstract] [PDF]

				L. De Wit, K. Putman, N. Lincoln, I. Baert, P. Berman, H. Beyens, K. Bogaerts, N. Brinkmann, L. Connell, E. Dejaeger, et al. Stroke Rehabilitation in Europe: What Do Physiotherapists and Occupational Therapists Actually Do? Stroke, June 1, 2006; 37(6): 1483 - 1489. [Abstract] [Full Text] [PDF]