title: Comparing Differences in ADL Outcomes for the STOMP Intervention for Dementia in the Natural Home Environment Versus a Clinic Environment.
abstract: BACKGROUND
  Few studies have examined structured rehabilitation techniques for improving activities of daily living in people with mild-moderate dementia. We sought to examine the advantages to delivering the Skill-building through Task-Oriented Motor Practice (STOMP) intervention in the home environment (versus the clinic), hypothesizing that ADL improvement would be significantly better, time to meeting goals would be faster and fewer displays of behavior would be noted.
  
  
  METHODS
  Compared results of two quasi-experimental studies of STOMP, one completed in the home, one completed previously in a clinic. Participants were English-speaking; community dwelling adults aged 50-90 diagnosed with mild-moderate dementia who could participate in an intensive rehabilitation program (5 days/week, 3 hours/day, for 2 weeks). Outcome measurements include examiner-observation of performance and proxy-report of performance and satisfaction with performance in patient-selected goals.
  
  
  RESULTS
  No differences existed in the sociodemographic characteristics between the home and clinic groups where the groups were primarily white, married, had > high school education and had mild-moderate dementia. Results from the home group indicate that participants made significant improvement in ADL which was generally retained at the 90 day follow-up. These results were not significantly different than the clinic group. No significant advantages were noted for the home group in terms of time to meeting goals or exhibition of fewer behaviors.
  
  
  CONCLUSIONS
  The STOMP intervention appeared to work equally as well in the home and in the clinic. Future studies should continue to examine the benefits of massed practice using high-dose regimens.
authors.affiliation: Department of Rehabilitation Sciences, University of Oklahoma Health Sciences Center, USA.
authors.forename: C A
authors.initials: CA
authors.lastname: Ciro
authors.affiliation: Department of Occupational Therapy, University of New Mexico, USA.
authors.forename: J L
authors.initials: JL
authors.lastname: Poole
authors.affiliation: Department of Family and Community Medicine, University of New Mexico, USA.
authors.forename: B
authors.initials: B
authors.lastname: Skipper
authors.affiliation: Department of Neurology, University of Oklahoma Health Sciences Center, USA.
authors.forename: L A
authors.initials: LA
authors.lastname: Hershey
keywords: Activities of daily living; Cognitive rehabilitation; Dementia; Goal attainment scale; Occupational therapy