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A cluster randomized controlled trial of a client-centred, activities of daily living intervention for people with stroke: one year follow-up of caregivers [with consumer summary]
Bertilsson A-S, Eriksson G, Ekstam L, Tham K, Andersson M, von Koch L, Johansson U
Clinical Rehabilitation 2016 Aug;30(8):765-775
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: No; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: Compare caregiver burden, provision of informal care, participation in everyday occupations and life satisfaction of caregivers to people with stroke, who either had received a client-centred, activities of daily living intervention or usual activities of daily living interventions. DESIGN: A multicentre cluster randomized controlled trial in which 16 rehabilitation units were randomly assigned to deliver a client-centred, activities of daily living intervention or usual activities of daily living interventions. Caregiver outcomes were compared cross-sectionally at 12 months and changes in outcomes between three and 12 months after people with stroke were included in the study. SETTING: Inpatient and outpatient rehabilitation. PARTICIPANTS: Caregivers of people with stroke enrolled in the trial. INTERVENTION: A client-centred, activities of daily living intervention aiming to increase agency in daily activities and participation in everyday life for people after stroke. MAIN MEASURES: Caregiver Burden Scale, Occupational Gaps Questionnaire, LiSat-11. RESULTS: There were no differences in outcomes between caregivers in the client-centred, activities of daily living (n = 88) and the usual activities of daily living (n = 95) group at 12 months. The caregiver burden score was 42.7 versus 41.8, p = 0.75, mean occupational gaps were 3.5 versus 4.0, p = 0.52 and satisfaction with life was 53% versus 50%, p = 0.87. There were no differences in changes between three and 12 months. However, within groups there were significant differences in caregiver burden, factor general strain, for caregivers in the client-centred, activities of daily living group, and in provision of informal care for the usual activities of daily living group. CONCLUSION: The client-centred intervention did not bring about any difference between caregiver-groups, but within groups some difference was found for caregiver burden and informal care.

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