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Evaluation of dressing practice for stroke patients after discharge from hospital: a crossover design study
Walker MF, Drummond AER, Lincoln NB
Clinical Rehabilitation 1996 Feb;10(1):23-31
clinical trial
5/10 [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: 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*

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 Nottingham 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.

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