Examining the Evidence Base for Occupational Therapy with Clients following Stroke

Abstract

In order to conduct occupational therapy services that are evidence based, studies are urgently required which demonstrate the effectiveness of interventions offered. This paper presents the findings of a study undertaken to determine occupational therapy outcomes for clients with stroke during inpatient rehabilitation.

The participants were 43 clients with stroke and four occupational therapists. Therapy outcomes for personal activities of daily living were measured using the Functional Independence Measure (Adult FIM^SM); instrumental activities of daily living were measured using the Assessment of Living Skills and Resources (ALSAR); and quality of life was measured using the Quality of Life Index (Q-L Index) and a semi-structured interview. The semi-structured interview was also used to understand clients' perceptions of the outcome of their participation in occupational therapy. The data were collected at client admission, discharge and 3 months' follow-up.

The results indicated that the clients believed that their ability to perform activities of daily living (Adult FIM^SM t (38) = −7.80, p = 0.000, and ALSAR t (35) = 4.82, p = 0.000) and their quality of life (Q-L Index t (39) = −7.23, p = 0.000) improved over the course of their inpatient rehabilitation. The therapists also rated the clients as improving during their rehabilitation in relation to activities of daily living (Adult FIM^SM t (42) = −9.71, p = 0.000, and ALSAR t (40) = 7.75, p = 0.000) and quality of life (Q-L Index t (39) = −11.20, p = 0.000). Many of the clients interviewed attributed these gains to participation in the occupational therapy programme.

In conclusion, this study demonstrated that a triangulated approach to data collection and analysis was useful in providing evidence that occupational therapy, as part of comprehensive rehabilitation, made a difference to the lives of many of the clients studied.