title: Cluster randomized pilot controlled trial of an occupational therapy intervention for residents with stroke in UK care homes.
abstract: OBJECTIVE
  A pilot evaluation of an occupational therapy intervention to improve self-care independence for residents with stroke-related disability living in care homes was the basis of this study.
  
  
  METHODS
  A cluster randomized controlled trial with care home as the unit of randomization was undertaken in Oxfordshire, UK. Twelve homes (118 residents) were randomly allocated to either intervention (6 homes, 63 residents) or control (6 homes, 55 residents). Occupational therapy was provided to individuals but included carer education. The control group received usual care. Assessments were made at baseline, postintervention (3 months) and at 6-months to estimate change using the Barthel Activity of Daily Living Index (BI) scores, "poor global outcome", (defined as deterioration in BI score, or death) and the Rivermead Mobility Index.
  
  
  RESULTS
  At 3 months BI score in survivors had increased by 0.6 (SD 3.9) in the intervention group and decreased by 0.9 (2.2) in the control group; a difference of 1.5 (95% CI allowing for cluster design, -0.5 to 3.5). At 6 months the difference was 1.9 (-0.7 to 4.4). Global poor outcome was less common in the intervention group. At 3 months, 20/63 (32%) were worse/dead in the intervention group compared with 31/55 (56%) in the control group, difference -25% (-51% to 1%). At 6 months the difference was similar, -26% (-48% to -3%). Between-group changes in Rivermead Mobility Index scores were not significantly different.
  
  
  CONCLUSIONS
  Residents who received an occupational therapy intervention were less likely to deteriorate in their ability to perform activities of daily living.
authors.affiliation: School of Health Sciences, University of Birmingham, UK. c.m.sackley@bham.ac.uk
authors.forename: Catherine
authors.initials: C
authors.lastname: Sackley
authors.forename: Derick T
authors.initials: DT
authors.lastname: Wade
authors.forename: David
authors.initials: D
authors.lastname: Mant
authors.forename: Jo Copley
authors.initials: JC
authors.lastname: Atkinson
authors.forename: Patricia
authors.initials: P
authors.lastname: Yudkin
authors.forename: Karina
authors.initials: K
authors.lastname: Cardoso
authors.forename: Sonya
authors.initials: S
authors.lastname: Levin
authors.forename: Vanessa Blanchard
authors.initials: VB
authors.lastname: Lee
authors.forename: Kevin
authors.initials: K
authors.lastname: Reel
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes; D009788:Occupational Therapy; D010865:Pilot Projects; D020521:Stroke / Q000401:mortality / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D013997:Time Factors; D006113:United Kingdom