title: A "client-centred activities of daily living" intervention for persons with stroke: One-year follow-up of a randomized controlled trial.
abstract: OBJECTIVE
  To compare changes regarding perceived participation, independence in activities of daily living (ADL) and life satisfaction between 3, 6 and 12 months after inclusion in a study of a client-centred ADL intervention and usual ADL intervention after stroke.
  
  
  METHODS
  A multicentre randomized controlled trial.
  
  
  METHODS
  Sixteen rehabilitation units were randomly assigned to provide client-centred ADL intervention or usual ADL intervention. Eligible participants were persons ≤ 3 months after stroke who had been treated in a stroke unit, were dependent in two ADL domains, had not been diagnosed with dementia, and were able to understand instructions. Data collection was performed by blinded assessors. The primary outcome, perceived participation, was assessed with the Stroke Impact Scale 3.0, domain 8. The secondary outcomes, participation, independence in ADL, and life satisfaction, were assessed with validated instruments. For statistical power, 280 participants were required. Statistical analyses were performed on an intention-to-treat basis.
  
  
  RESULTS
  There were no differences between the groups regarding changes in perceived participation, independence in ADL, or life satisfaction during the first 12 months. There was a trend towards a clinically meaningful positive change in perceived participation that favoured client-centred ADL intervention.
  
  
  CONCLUSIONS
  Further research is required to understand the benefits of client-centred interventions.
authors.affiliation: Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Box 23 200, SE-141 83 Huddinge, Sweden. susanne.guidetti@ki.se.
authors.forename: Susanne
authors.initials: S
authors.lastname: Guidetti
authors.forename: Maria
authors.initials: M
authors.lastname: Ranner
authors.forename: Kerstin
authors.initials: K
authors.lastname: Tham
authors.forename: Magnus
authors.initials: M
authors.lastname: Andersson
authors.forename: Charlotte
authors.initials: C
authors.lastname: Ytterberg
authors.forename: Lena
authors.initials: L
authors.lastname: von Koch
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D000071939:Stroke Rehabilitation