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Domiciliary occupational therapy for patients with stroke discharged from hospital: randomised controlled trial

Gilbertson, L., Langhorne, P., Walker, A., Allen, A., and Murray, G.D. (2000) Domiciliary occupational therapy for patients with stroke discharged from hospital: randomised controlled trial. British Medical Journal, 320 . pp. 603-606. ISSN 0959-535X (doi:10.1136/bmj.320.7235.603)

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Publisher's URL: http://dx.doi.org/10.1136/bmj.320.7235.603

Abstract

OBJECTIVE: To establish if a brief programme of domiciliary occupational therapy could improve the recovery of patients with stroke discharged from hospital. DESIGN: Single blind randomised controlled trial. SETTING: Two hospital sites within a UK teaching hospital. SUBJECTS: 138 patients with stroke with a definite plan for discharge home from hospital. INTERVENTION: Six week domiciliary occupational therapy or routine follow up. MAIN OUTCOME MEASURES: Nottingham extended activities of daily living score and "global outcome" (deterioration according to the Barthel activities of daily living index, or death). RESULTS: By eight weeks the mean Nottingham extended activities of daily living score in the intervention group was 4.8 points (95% confidence interval -0.5 to 10.0, P=0.08) greater than that of the control group. Overall, 16 (24%) intervention patients had a poor global outcome compared with 30 (42%) control patients (odds ratio 0.43, 0.21 to 0.89, P=0.02). These patterns persisted at six months but were not statistically significant. Patients in the intervention group were more likely to report satisfaction with a range of aspects of services. CONCLUSION: The functional outcome and satisfaction of patients with stroke can be improved by a brief occupational therapy programme carried out in the patient's home immediately after discharge. Major benefits may not, however, be sustained.

Item Type:Article
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Langhorne, Prof Peter
Authors: Gilbertson, L., Langhorne, P., Walker, A., Allen, A., and Murray, G.D.
Subjects:R Medicine > RC Internal medicine
R Medicine > RM Therapeutics. Pharmacology
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
College of Medical Veterinary and Life Sciences
Journal Name:British Medical Journal
Journal Abbr.:BMJ
Publisher:BMJ Publishing Group
ISSN:0959-535X
ISSN (Online):1756-1833
Copyright Holders:© BMJ Publishing Group
First Published:First published in the BMJ 320:603-606.
Publisher Policy:Reproduced in accordance with the copyright policy of the publisher.

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