title: The DRESS trial: a feasibility randomized controlled trial of a neuropsychological approach to dressing therapy for stroke inpatients.
abstract: OBJECTIVE
  To investigate two approaches to treating patients with persistent dressing problems and cognitive difficulties following stroke.
  
  
  METHODS
  Pilot randomized controlled trial.
  
  
  METHODS
  Inpatient stroke rehabilitation service.
  
  
  METHODS
  Seventy consecutive stroke patients with persistent dressing problems and accompanying cognitive difficulties at two weeks after their stroke.
  
  
  METHODS
  Patients were randomly allocated to six weeks of either a systematic neuropsychological approach, based on analysis of dressing problems and further cognitive testing, or to the control group who received conventional (functional) dressing practice. Both groups received treatment three times a week in accordance with two separately prepared manuals.
  
  
  METHODS
  Nottingham Stroke Dressing Assessment (NSDA), Line Cancellation, 10-hole peg transfer test, Object Decision, Gesture Imitation. Patients were assessed at six weeks after randomization by an independent assessor masked to group allocation.
  
  
  RESULTS
  Both neuropsychological and functional groups improved performance on the NSDA over the treatment period (31% and 22%, respectively) but there was no significant difference between groups at six weeks. However, the neuropsychological group showed a significantly greater improvement on a line cancellation test of visual neglect (t(62) = 2.1, P < 0.05) and a planned subanalysis for those with right hemisphere damage showed a trend towards better dressing outcome (P = 0.07, one-tailed).
  
  
  CONCLUSIONS
  Results demonstrate the potential benefits of a systematic neuropsychological approach to dressing therapy, particularly for patients with right hemisphere damage. This study suggests the need for a phase III study evaluating the efficacy of a systematic neuropsychological approach in treating dressing difficulties, targeting patients with right hemisphere stroke and visuospatial impairments.
authors.affiliation: Division of Rehabilitation and Ageing, Community Health Sciences, University of Nottingham, UK. marion.walker@nottingham.ac.uk
authors.forename: Marion F
authors.initials: MF
authors.lastname: Walker
authors.forename: Alan
authors.initials: A
authors.lastname: Sunderland
authors.forename: Joanna
authors.initials: J
authors.lastname: Fletcher-Smith
authors.forename: Avril
authors.initials: A
authors.lastname: Drummond
authors.forename: Pip
authors.initials: P
authors.lastname: Logan
authors.forename: Judi A
authors.initials: JA
authors.lastname: Edmans
authors.forename: Katherine
authors.initials: K
authors.lastname: Garvey
authors.forename: Robert A
authors.initials: RA
authors.lastname: Dineen
authors.forename: Paul
authors.initials: P
authors.lastname: Ince
authors.forename: Jane
authors.initials: J
authors.lastname: Horne
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Fisher
authors.forename: Jenny L
authors.initials: JL
authors.lastname: Taylor
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003020:Clothing; D003072:Cognition Disorders / Q000209:etiology / Q000534:rehabilitation; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D009484:Neuropsychology; D010865:Pilot Projects; D012046:Rehabilitation / Q000379:methods; D020521:Stroke / Q000150:complications; D000071939:Stroke Rehabilitation