随机对照试验研究:卒中后专业治疗增加户外活动能力

来源 :世界核心医学期刊文摘(神经病学分册) | 被引量 : 0次 | 上传用户:csnd123
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Objective: To evaluate an occupational therapy intervention to improve outdoo r mobility after stroke. Design: Randomised controlled trial. Setting General pr actice registers, social services departments, a primary care rehabilitation service, and a ger iatric day hospital. Participants: 168 community dwelling people with a clinical diagnosis of stroke in previous 36 months: 86 were allocated to the interventio n group and 82 to the control group. Interventions: Leaflets describing local tr ansport services for disabled people (control group) and leaflets with assessmen t and up to seven intervention sessions by an occupational therapist (interventi on group). Main outcome measures: Responses to postal questionnaires at four and 10 months: primary outcome measure was response to whether participant got out of the house as much as he or she would like, and secondary outcome measures wer e response to how many journeys outdoors had been made in the past month and sco res on the Nottingham extended activities of daily living scale, Nottingham leis ure questionnaire, and general health questionnaire. Results: Participants in th e treatment group were more likely to get out of the house as often as they want ed at both four months (relative risk 1.72, 95% confidence interval 1.25 to 2. 37) and 10 months (1.74, 1.24 to 2.44). The treatment group reported more journe ys outdoors in the month before assessment at both four months (median 37 in int ervention group, 14 in control group: P < 0.01) and 10 months (median 42 in inte rvention group, 14 in control group: P < 0.01). At four months the mobility scor es on the Nottingham extended activities of daily living scale were significantl y higher in the intervention group, but there were no significant differences in the other secondary outcomes. No significant differences were observed in these measures at 10 months. Conclusion:A targeted occupational therapy intervention at home increases outdoor mobility in people after stroke. Objective: To evaluate an occupational therapy intervention to improve outdoo r mobility after stroke. Design: Randomized controlled trial. Setting General pr actice registers, social services departments, a primary care rehabilitation service, and a ger iatric day hospital. people with a clinical diagnosis of stroke in previous 36 months: 86 were allocated to the interventio n group and 82 to the control group. Interventions: Leaflets describing local tr ansport services for disabled people (control group) and leaflets with assessors t and up to seven intervention sessions by an occupational therapist (interventi on group). Main outcome measures: Responses to postal questionnaires at four and 10 months: primary outcome measure was response to whether participant got out of the house as much as he or she would like, and secondary outcome measures wer e response to how many journeys outdoors had been made in the past month and sco res on the Nottingh am extended activities of daily living scale, Nottingham leis ure questionnaire, and general health questionnaire. Results: Participants in th e treatment group were more likely to get out of the house as often as they want ed both at four months (relative risk 1.72, 95% confidence interval 1.25 to 2. 37) and 10 months (1.74, 1.24 to 2.44). The treatment group reported more journe ys outdoors in the month before assessment at both four months (median 37 in int ervention group, 14 in control group At four months the mobility scor es on the Nottingham extended activities of daily living scale were significantl y higher in the intervention group (median 42 in control group, 14 in control group: P <0.01) , but there were no significant differences in the other secondary outcomes. No significant differences were observed in these measures at 10 months. Conclusion: A targeted occupational therapy intervention at home has outdoor mobility in people after stroke.
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