title: Reablement in community-dwelling adults: study protocol for a randomised controlled trial.
abstract: BACKGROUND
  As a result of the ageing population, there is an urgent need for innovation in community health-care in order to achieve sustainability. Reablement is implemented in primary care in some Western countries to help meet these challenges. However, evidence to support the use of such home-based rehabilitation is limited. Reablement focuses on early, time-intensive, multidisciplinary, multi-component and individualised home-based rehabilitation for older adults with functional decline. The aim of this study is to investigate the effectiveness of reablement in home-dwelling adults compared with standard treatment in relation to daily activities, physical functioning, health-related quality of life, use of health-care services, and costs.
  
  
  METHODS
  The study will be a 1:1 parallel-group randomised controlled superiority trial conducted in a rural municipality in Norway. The experimental group will be offered reablement and the control group offered standard treatment. A computer-generated permuted block randomisation sequence, with randomly selected block sizes, will be used for allocation. Neither participants nor health-care providers will be blinded, however all research assistants and researchers will be blinded. The sample size will consist of 60 participants. People will be eligible if they are home-dwelling, over 18 years of age, understand Norwegian and have functional decline. The exclusion criteria will be people in need of institution-based rehabilitation or nursing home placement, and people who are terminally ill or cognitively reduced. The primary outcome will be self-perceived performance, and satisfaction with performance of daily activities, assessed with the Canadian Occupational Performance Measure. In addition, physical capacity, health-related quality of life, use of health-care services, and cost data will be collected at baseline, and after 3 and 9 months in both groups, and again after 15 months in the intervention group. Data will be analysed on an intention-to-treat basis using a linear mixed model for repeated measures.
  
  
  CONCLUSIONS
  The findings will make an important contribution to evaluating cost-effective and evidence-based rehabilitation approaches for community-dwelling adults.
  
  
  BACKGROUND
  The trial was registered in ClinicalTrials.gov November 20, 2012, identifier: NCT02043262.
authors.affiliation: Centre for Care Research Western Norway, and Department of Occupational Therapy, Physiotherapy and Radiography, Bergen University College, P,O, Box 7030, 5020 Bergen, Norway. Hanne.Kristin.Tuntland@hib.no.
authors.forename: Hanne
authors.initials: H
authors.lastname: Tuntland
authors.forename: Birgitte
authors.initials: B
authors.lastname: Espehaug
authors.forename: Oddvar
authors.initials: O
authors.lastname: Forland
authors.forename: Astri Drange
authors.initials: AD
authors.lastname: Hole
authors.forename: Egil
authors.initials: E
authors.lastname: Kjerstad
authors.forename: Ingvild
authors.initials: I
authors.lastname: Kjeken
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology; D003153:Community Health Services / Q000191:economics* / Q000379:methods*; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D057187:Independent Living / Q000191:economics* / Q000523:psychology; D008297:Male; D009664:Norway / Q000453:epidemiology; D011320:Primary Health Care / Q000191:economics / Q000379:methods; D011788:Quality of Life / Q000523:psychology; D016037:Single-Blind Method