Article

OBJECTIVE: To compare occupation-based and impairment-based approaches in
occupational therapy and determine the feasibility of patient recruitment and
retention. DESIGN: A multicenter, randomized, controlled pilot trial with a
single blind assessor. SETTING: Ten subacute rehabilitation units in Japan.
PARTICIPANTS: Fifty-four patients with subacute stroke. INTERVENTIONS: The
experimental group used the iPad application, Aid for Decision-making in
Occupation Choice, to establish occupation-based goals, and evaluation and
intervention were conducted mainly through real occupations. The control group
was evaluated according to patients' generic abilities and activities of daily
living (ADL), and the intervention mainly involved the impairment-based approach.
MAIN OUTCOME MEASURES: Short Form-36, Functional Independence Measure, Brunnstrom
recovery stages, The Client Satisfaction Questionnaire, and length of hospital
stay. RESULTS: Of the 1465 potential participants, 54 (3%) subacute stroke
patients were enrolled over 16 months and 68% (n = 36) were retained to the
2-month assessment: experimental group (n = 16); control group (n = 21). Although
there was no significant intergroup difference for any outcomes, the experimental
group had a small effect size advantage on the Short Form-36 "General health" (d
= 0.42) and "Role emotional" (d = 0.43) subscales relative to the control group.
A sample of 118 subacute stroke patients per group would be required for a lager
study. CONCLUSIONS: Results suggest that the occupation-based approach has more
potential to improve "General health" and "Role emotional" scores on the Short
Form-36 than the impairment-based approach. Further investigation of study
protocol with interventions and recruiting is needed prior to a larger trial.
CI - (c) The Author(s) 2014.

Langue : ANGLAIS