Published Online
on August 3, 2006

A more recent version of this article appeared on September 1, 2006

This Article Full Text (PDF) All Versions of this Article: 37/9/2336    most recent 01.STR.0000237124.20596.92v1 Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Sackley, C. Articles by Reel, K. Search for Related Content PubMed PubMed Citation Articles by Sackley, C. Articles by Reel, K. Pubmed/NCBI databases Medline Plus Health Information Nursing Homes Stroke Related Collections Exercise/exercise testing/rehabilitation

Submitted on May 7, 2006
Revised on June 2, 2006
Accepted on June 12, 2006

Cluster Randomized Pilot Controlled Trial of an Occupational Therapy Intervention for Residents With Stroke in UK Care Homes

Catherine Sackley PhD^*; Derick T. Wade MD; David Mant FRCGP; Jo Copley Atkinson MRes; Patricia Yudkin DPhil; Karina Cardoso MSc; Sonya Levin MSc; Vanessa Blanchard Lee DipCOT; and Kevin Reel MSc

From the School of Health Sciences (C.S.), University of Birmingham, UK; the Oxford Centre for Enablement (D.T.W.), Nuffield Orthopaedic Centre, UK; the Department of Primary Health Care (D.M., J.C.A., P.Y., K.C., S.L.), University of Oxford, UK; and the Oxford Brookes University (V.B., K.R.), UK.

^* To whom correspondence should be addressed. E-mail: c.m.sackley{at}bham.ac.uk.

Background and Purpose--A pilot evaluation of an occupational therapy intervention to improve self-care independence for residents with stroke-related disability living in care homes was the basis of this study.

Methods--A cluster randomized controlled trial with care home as the unit of randomization was undertaken in Oxfordshire, UK. Twelve homes (118 residents) were randomly allocated to either intervention (6 homes, 63 residents) or control (6 homes, 55 residents). Occupational therapy was provided to individuals but included carer education. The control group received usual care. Assessments were made at baseline, postintervention (3 months) and at 6-months to estimate change using the Barthel Activity of Daily Living Index (BI) scores, "poor global outcome", (defined as deterioration in BI score, or death) and the Rivermead Mobility Index.

Results--At 3 months BI score in survivors had increased by 0.6 (SD 3.9) in the intervention group and decreased by 0.9 (2.2) in the control group; a difference of 1.5 (95% CI allowing for cluster design, -0.5 to 3.5). At 6 months the difference was 1.9 (-0.7 to 4.4). Global poor outcome was less common in the intervention group. At 3 months, 20/63 (32%) were worse/dead in the intervention group compared with 31/55 (56%) in the control group, difference -25% (-51% to 1%). At 6 months the difference was similar, -26% (-48% to -3%). Between-group changes in Rivermead Mobility Index scores were not significantly different.

Conclusion--Residents who received an occupational therapy intervention were less likely to deteriorate in their ability to perform activities of daily living.

Key words: nursing homes • occupational therapy • stroke

This article has been cited by other articles:

				C E Clarke, A Furmston, E Morgan, S Patel, C Sackley, M Walker, S Bryan, and K Wheatley Pilot randomised controlled trial of occupational therapy to optimise independence in Parkinson's disease: the PD OT trial J. Neurol. Neurosurg. Psychiatry, September 1, 2009; 80(9): 976 - 978. [Abstract] [Full Text] [PDF]

				C. M Sackley, M. E van den Berg, K. Lett, S. Patel, K. Hollands, C. C Wright, and T. J Hoppitt Effects of a physiotherapy and occupational therapy intervention on mobility and activity in care home residents: a cluster randomised controlled trial BMJ, September 1, 2009; 339(sep01_2): b3123 - b3123. [Abstract] [Full Text] [PDF]

				G Eva, J Paley, M Miller, and B Wee Patients' constructions of disability in metastatic spinal cord compression Palliative Medicine, March 1, 2009; 23(2): 132 - 140. [Abstract] [PDF]