Evaluation of dressing practice for stroke patients after discharge from hospital: a crossover design study

Abstract

Objective: To determine whether giving dressing practice to patients at home with unresolved dressing problems following stroke reduces the problems. Design: A randomized crossover study design was used, randomly allocating patients to receive no intervention for three months followed by three months' treatment, or the reverse. Setting: All patients were at home, and treatment was given in the home. Subjects: Patients at home with problems in dressing six months after acute stroke, having been discharged from hospital. Intervention: A senior occupational therapist gave regular dressing practice to patients with their families. Specific techniques depended upon the problem. Outcome measures: An independent assessor used the Nottingham Stroke Dressing Assessment, the Rivermead ADL, self-care section, and the Notting ham Health Profile to measure outcome. Results: Fifteen patients were included in each group. Both groups showed statistically significant improvement during the treatment phase (Wilcoxon matched pairs test: z = 2.47, p = 0.01; z = 3.01, p = 0.002). Neither group showed any change during the non-treatment phase. Patients who received treatment in the first three months maintained their improvement (z= 0.90, p = 0.36). Conclusion: Dressing practice given at home to patients who have residual problems in dressing six months after acute stroke leads to a sustained reduction in their problems.