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Reablement of Instrumental Activities of Daily Living for Patients With Stroke: A Randomized Crossover Trial [with consumer summary]
Chen P-T, Chiu E-C
The American Journal of Occupational Therapy 2024 Mar;78(2):7802180160
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: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

IMPORTANCE: Reablement is a person-centered and goal-oriented rehabilitative intervention to optimize people's chances to live independently. OBJECTIVE: To investigate the effects of a reablement intervention on performance of instrumental activities of daily living (IADLs) in three aspects (ie, actual performance, ability, and self-perceived difficulty) for patients with stroke. DESIGN: A single-blinded, randomized crossover study. SETTING: Participants' home and community. PARTICIPANTS: Twenty-seven patients with stroke. INTERVENTIONS: Each participant received two interventions (IADL reablement and health education). Each intervention was administered for 6 wk. All participants were randomly assigned to one intervention and then received the other intervention after a 4-wk washout period. OUTCOMES AND MEASURES: Outcomes of actual performance and self-perceived difficulty were derived from the Frenchay Activities Index (FAI) and the difficulty dimension of the Participation Measure-3 Domains, 4 Dimensions (PM-3D4D), respectively. Outcomes of ability were measured with the Lawton Instrumental Activities of Daily Living Scale (LIADL) and the Canadian Occupational Performance Measure Performance score (COPM Performance). RESULTS: No statistically significant differences were found in the three aspects between the IADL reablement and health education (ps = 0.148 to 0.570). Compared with the health education, the IADL reablement showed better improvements on the FAI, LIADL, COPM Performance, and difficulty dimension of the PM-3D4D with trivial to small effect sizes (ds = 0.17 to 0.45). CONCLUSIONS AND RELEVANCE: Our results reveal that the IADL reablement has the potential to increase the frequency of IADL administration, enhancing the capability to perform IADLs and reducing the self-perceived difficulty of carrying out IADLs.
Copyright by the Amerrican Occupational Therapy Association Inc. Reprinted with permission.

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