Effects of the model of human occupation-based home modifications on the time use, occupational participation and activity limitation in people with disabilities: a pilot randomized controlled trial

Abstract

Purpose To compare the effect of intervention providing home modifications and assistive devices based on MOHO theory with home exercise on people with disability in time use, competence and values of occupational performance and activity limitations. Methods Participants were 20 people with disabilities due to deficits in central nervous system. Eleven people in the experimental group partook in environmental modifications and assistive device intervention and nine people in the control partook in home exercise programmes. A total of eight sessions were progressed, one pre-test, six sessions of interventions and one post-test. Occupational Questionnaire (OQ) was used to evaluate one’s time use. Occupational Self Assessment (OSA) was used to test the competence and values of one’s everyday occupational performance. Activity Limitations Measure (ACTIVLIM) was used to assess the activity limitation of one’s functional ability. Wilcoxon signed rank test was used to analyse the comparison of the pre-post of time use, competence and values of occupational performance, and activity limitations. Mann–Whitney U was used to compare between both groups. Results Among the four occupational areas of OQ, the participation time in ADL significantly increased and rest significantly decreased in the experimental group (p<.05). The competence of occupational performance also increased in the experimental group whereas the values of occupational performance increased in the control group (p<.05). The activity limitation significantly decreased in control group (p<.05) but not in the experimental group. Conclusions Using the interaction between human and environment for environmental modification increased the time use in occupational participation and competence to perform occupation in people with disability. By applying MOHO theory to evaluate and modify one’s home environment and activity performance, we could comprehend the life style of clients and suggest opportunities to actively participate in ADLs. Implications for rehabilitation Using the interaction between human and environment for environmental modification increased the time use in occupational participation and competence to perform occupation in people with disability. By applying MOHO theory to evaluate and modify one’s home environment, we could comprehend the life style of clients and suggest opportunities to actively participate in ADLs. Adapting MOHO theory to enhance activity participation will contribute to enhance the quality of occupational therapy services in community settings.