A multicentre randomized controlled trial of leisure therapy and conventional occupational therapy after stroke. TOTAL Study Group. Trial of Occupational Therapy and Leisure.
OBJECTIVE
To evaluate the effects of leisure therapy and conventional occupational therapy (OT) on the mood, leisure participation and independence in activities of daily living (ADL) of stroke patients 6 and 12 months after hospital discharge.


METHODS
Multicentre randomized controlled trial.


METHODS
Four hundred and sixty-six stroke patients from five UK centres.


METHODS
The General Health Questionnaire (12 item), the Nottingham Extended ADL Scale and the Nottingham Leisure Questionnaire, assessed by post, with telephone clarification.


RESULTS
Four hundred and forty (94%) and 426 (91%) subjects were alive at 6 and 12 months, respectively. Three hundred and seventy-four (85% of survivors) and 311 (78% of survivors) responded at 6 and 12 month follow-up respectively. At six months and compared to the control group, those allocated to leisure therapy had nonsignificantly better GHQ scores (-1.2: 95% CI -2.9, +0.5), leisure scores (+0.7, 95% CI -1.1, +2.5) and Extended ADL scores (+0.4: 95% CI -3.8, +4.5): the ADL group had nonsignificantly better GHQ scores (-0.1: 95% CI -1.8, +1.7) and Extended ADL scores (+1.4: 95% CI -2.9, +5.6) and nonsignificantly worse leisure scores (-0.3: 95% CI -2.1, +1.6). The results at 12 months were similar.


CONCLUSIONS
In contrast to the findings of previous smaller trials, neither of the additional OT treatments showed a clear beneficial effect on mood, leisure activity or independence in ADL measured at 6 or 12 months.
Parker
C J
CJ
Division of Rehabilitation and Ageing, University of Nottingham, UK.
Gladman
J R
JR
Drummond
A E
AE
Dewey
M E
ME
Lincoln
N B
NB
Barer
D
D
Logan
P A
PA
Radford
K A
KA
D000203:Activities of Daily Living; D000339:Affect; D000368:Aged; D005260:Female; D006801:Humans; D007899:Leisure Activities; D008297:Male; D009788:Occupational Therapy; D011788:Quality of Life; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome