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Randomized Controlled Trial
. 2019 Feb;33(2):262-276.
doi: 10.1177/0269215518809791. Epub 2018 Nov 9.

Five-year follow-up of a cluster-randomized controlled trial of a client-centred activities of daily living intervention for people with stroke

Annicka Hedman  1 , Gunilla Eriksson  1   2 , Lena von Koch  1   3 , Susanne Guidetti  1
Affiliations
Randomized Controlled Trial

Five-year follow-up of a cluster-randomized controlled trial of a client-centred activities of daily living intervention for people with stroke

Annicka Hedman et al. Clin Rehabil. 2019 Feb.

Abstract

Objective:: To compare five-year outcomes and changes over time of a client-centred activities of daily living (ADL) intervention versus usual ADL interventions for people with stroke and their significant others.

Design:: Five-year follow-up of a cluster-randomized controlled trial where a client-centred ADL intervention ( n = 129) or usual ADL interventions ( n = 151) were delivered to people with stroke.

Setting:: Multicentre study including 16 inpatient or home-based rehabilitation units.

Participants:: People with stroke and significant others.

Intervention:: The client-centred ADL intervention aimed at enabling agency in daily activities and participation in everyday life and at reducing caregiver burden.

Main measures:: For people with stroke, perceived participation (Stroke Impact Scale), independence in ADL, life satisfaction, and use of formal/informal care were measured. For significant others, caregiver burden, life satisfaction, and mood (Hospital Anxiety and Depression Scale) were assessed.

Results:: Five years post-intervention, data were collected from 145 people with stroke (intervention group: n = 71/control group: n = 74) and 75 significant others (intervention group: n = 36/control group: n = 39). For those with stroke, the Participation domain of the Stroke Impact Scale showed no group differences at year five (68.9 vs 75.4, P = 0.062) or in changes over time. At year five, the control group had better outcomes regarding Other help/supervision. Significant others in the control group were more likely to show signs of depression at year five (odds ratio = 22.3; P < 0.001).

Conclusion:: The client-centred ADL intervention appears to render similar long-term effects as usual ADL interventions for people with stroke, but for significant others signs of depression might be reduced.

Keywords: Stroke rehabilitation; caregivers; evaluation studies; follow-up studies; longitudinal studies; occupational therapy; rehabilitation.

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Conflict of interest statement

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Participant flow from baseline to follow-up at five years.
See this image and copyright information in PMC

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