title: A client-centred ADL intervention: three-month follow-up of a randomized controlled trial.
abstract: OBJECTIVE
  The aim was to study a client-centred activities of daily living (ADL) intervention (CADL) compared with the usual ADL intervention (UADL) in people with stroke regarding: independence in ADL, perceived participation, life satisfaction, use of home-help service, and satisfaction with training and, in their significant others, regarding: caregiver burden, life satisfaction, and informal care.
  
  
  METHODS
  In this multicentre study, 16 rehabilitation units were randomly assigned to deliver CADL or UADL. The occupational therapists who provided the CADL were specifically trained. Eligible for inclusion were people with stroke treated in a stroke unit ≤3 months after stroke, dependent in ≥two ADL, not diagnosed with dementia, and able to understand instructions. Data were collected at inclusion and three months thereafter. To detect a significant difference between the groups in the Stroke Impact Scale (SIS) domain "participation", 280 participants were required. Intention-to-treat analysis was applied.
  
  
  RESULTS
  At three months, there was no difference in the outcomes between the CADL group (n = 129) and the UADL group (n = 151), or their significant others (n = 87/n = 93) except in the SIS domain "emotion" in favour of CADL (p = 0.04).
  
  
  CONCLUSIONS
  The CADL does not appear to bring about short-term differences in outcomes and longer follow-ups are required.
authors: Department of Neurobiology, Care Sciences and Society, Karolinska Institutet , Stockholm , Sweden .
authors: Ann-Sofie
authors: AS
authors: Bertilsson
authors: Maria
authors: M
authors: Ranner
authors: Lena
authors: L
authors: von Koch
authors: Gunilla
authors: G
authors: Eriksson
authors: Ulla
authors: U
authors: Johansson
authors: Charlotte
authors: C
authors: Ytterberg
authors: Susanne
authors: S
authors: Guidetti
authors: Kerstin
authors: K
authors: Tham
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006704:Homemaker Services / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009788:Occupational Therapy / Q000379:methods*; D018802:Patient-Centered Care; D010549:Personal Satisfaction; D011788:Quality of Life; D058992:Social Participation / Q000523:psychology; D020521:Stroke / Q000523:psychology*; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome
keywords: activity; caregiver; everyday occupation; goal setting; lived experience; multicentre study; occupational therapy; participation; rehabilitation; stroke