Occupational therapy for patients with problems in personal activities of daily living after stroke: Systematic review of randomised trials

Legg, Lynn, Drummond, Avril, Leonardi-Bee, Jo, Gladman, J. R. F., Corr, Susan, Donkervoort, Mireille, Edmans, Judi, Gilbertson, Louise, Jongbloed, Lyn, Logan, Pip, Sackley, Catherine, Walker, Marion and Langhorne, Peter (2007) Occupational therapy for patients with problems in personal activities of daily living after stroke: Systematic review of randomised trials. BMJ, 335 (7626). ISSN 0959-8138

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Abstract

Objective: To determine whether occupational therapy focused specifically on personal activities of daily living improves recovery for patients after stroke. Design: Systematic review and meta-analysis. Data sources: The Cochrane stroke group trials register, the Cochrane central register of controlled trials, Medline, Embase, CINAHL, PsycLIT, AMED, Wilson Social Sciences Abstracts, Science Citation Index, Social Science Citation, Arts and Humanities Citation Index, Dissertations Abstracts register, Occupational Therapy Research Index, scanning reference lists, personal communication with authors, and hand searching. Review methods: Trials were included if they evaluated the effect of occupational therapy focused on practice of personal activities of daily living or where performance in such activities was the target of the occupational therapy intervention in a stroke population. Original data were sought from trialists. Two reviewers independently reviewed each trial for methodological quality. Disagreements were resolved by consensus. Results: Nine randomised controlled trials including 1258 participants met the inclusion criteria. Occupational therapy delivered to patients after stroke and targeted towards personal activities of daily living increased performance scores (standardised mean difference 0.18, 95% confidence interval 0.04 to 0.32, P=0.01) and reduced the risk of poor outcome (death, deterioration or dependency in personal activities of daily living) (odds ratio 0.67, 95% confidence interval 0.51 to 0.87, P=0.003). For every 100 people who received occupational therapy focused on personal activities of daily living, 11 (95% confidence interval 7 to 30) would be spared a poor outcome. Conclusions: Occupational therapy focused on improving personal activities of daily living after stroke can improve performance and reduce the risk of deterioration in these abilities. Focused occupational therapy should be available to everyone who has had a stroke.

Item Type:	Article
Uncontrolled Keywords:	randomized controlled trials as topic,aged, 80 and over,occupational therapy,humans,stroke,prognosis,aged,activities of daily living,middle aged,cluster analysis
Faculty \ School:	Faculty of Medicine and Health Sciences > School of Rehabilitation Sciences (former - to 2014)
UEA Research Groups:	Faculty of Medicine and Health Sciences > Research Groups > Rehabilitation
Depositing User:	Pure Connector
Date Deposited:	16 Oct 2013 00:43
Last Modified:	09 Apr 2024 10:30
URI:	https://ueaeprints.uea.ac.uk/id/eprint/43705
DOI:	10.1136/bmj.39343.466863.55

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