[Controlled trials on the efficacy of occupational therapy with elderly. Part I: Research question, search strategy and methodological quality of trials].
OBJECTIVE
To investigate how far controlled trials give evidence for the assumption that occupational therapy treatment improves or stabilises the competence, autonomy or satisfaction of elderly while performing every day activities.


METHODS
Clinical trials with randomised, quasi-experimental or crossover control group design and "occupational therapy" as the main subject were identified by an electronic search of the medline database. The criteria for the analysis were derived from the CONSORT-Statement and adapted for occupational therapy. They relate to the quality of sample, intervention, measurement and data analysis.


RESULTS
The 31 identified studies (RCT, n=23; quasi-experimental, n=2; crossover, n=6) were mainly conducted in Great Britain, USA and Canada, but not in Germany. They are heterogeneous regarding the characteristics and size of samples, the outcome variables and treatment approaches. They give evidence for a significant efficacy of occupational therapy with elderly, but also show some methodological shortcomings.


CONCLUSIONS
While on an international level the positive potential of occupational therapy for the elderly is evident, there is a strong need for further studies in Germany. Therefore a methodological harmonization and a co-operation with occupational therapy research and occupational science emerging currently in Europe are recommended.
Voigt-Radloff
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Zentrum für Geriatrie und Gerontologie, Universitätsklinikum Albert-Ludwigs-Universität, Lehener Str. 88, 79106 Freiburg, Germany. sebastian.voigt@uniklinik-freiburg.de
Schochat
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Heiss
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D000203:Activities of Daily Living / Q000145:classification / Q000523:psychology; D000368:Aged; D003431:Cross-Cultural Comparison; D018592:Cross-Over Studies; D019317:Evidence-Based Medicine / Q000592:standards*; D016330:Frail Elderly / Q000523:psychology*; D015577:Geriatric Assessment; D005858:Germany; D006801:Humans; D009788:Occupational Therapy / Q000592:standards*; D010043:Outcome and Process Assessment, Health Care; D011786:Quality Control; D011788:Quality of Life / Q000523:psychology; D016032:Randomized Controlled Trials as Topic / Q000592:standards*