Abstract
Introduction To determine effect size and feasibility of experimental occupational therapy (OT) intervention in addition to standard care in a population of complex patients undergoing rehabilitation in a hospital-home-based setting. Method 40 complex patients admitted to the rehabilitation ward of the Local Health Authority-Research Institute of Reggio Emilia (Italy) were randomized in a parallel-group, open-label controlled trial. Experimental OT targeting occupational needs in the areas of self-care, productivity, and leisure was delivered by occupational therapists. Standard care consisted of task-oriented rehabilitation delivered by a multiprofessional team. Results The experimental OT intervention was completed by 75% of patients assigned to this group. The average changes in the Canadian Occupational Performance Measure (COPM) performance score significantly and clinically favored experimental OT [−3,06 (−4.50; −1.61); delta > 2 points, resp.]. Similar trends were detected for COPM satisfaction and independence in instrumental activities of daily living (ADL). At follow-up, level of social participation was higher for patients treated with experimental OT (p = 0.043) than for controls. Conclusions Experimental OT was feasible in complex patients in a hospital-home-based setting. It ameliorated both patients' performance and satisfaction in carrying out relevant activities and improved independence in instrumental ADL. The trial is registered with ClinicalTrials.gov NCT02677766.
Highlights
To determine effect size and feasibility of experimental occupational therapy (OT) intervention in addition to standard care in a population of complex patients undergoing rehabilitation in a hospital-home-based setting
Eight patients withdrew from the trial and were not reassessed at follow-up (T2), five in the intervention group (IG), and three in the control group (CG)
Consistent with previous evidence, this study showed an average higher reintegration to normal living of patients treated with experimental OT, compared to the control group, this advantage was barely significant, and this significance was not confirmed in the between-group differences of average changes for this measure
Summary
To determine effect size and feasibility of experimental occupational therapy (OT) intervention in addition to standard care in a population of complex patients undergoing rehabilitation in a hospital-home-based setting. Regardless of the underlying pathology, patients undergoing rehabilitation habitually manifest similar basic needs, while their level of functioning and advanced needs, namely, those related to leisure, productivity, and Occupational Therapy International social role, may be different [4]. This was brought to light by Phipps and Richardson’s work [5], which showed that when rehabilitation focuses on individual significant activities, gains in performance and satisfaction are noticeable both in patients with traumatic brain injury and in those with stroke. Occupational therapy (OT) has proven to be beneficial in patients with different types of cancer when based on patient requests [6]
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