The DRESS trial: a feasibility randomized controlled trial of a neuropsychological approach to dressing therapy for stroke inpatients
| Autor: | Jane Horne, Jenny L. Taylor, Joanne Fletcher-Smith, Marion F Walker, Pip Logan, Judi Edmans, Rebecca J Fisher, Paul Ince, Robert A. Dineen, Katherine Garvey, Alan Sunderland, Avril Drummond |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2012 |
| Předmět: |
Occupational therapy
Adult Male medicine.medical_specialty Randomization Activities of daily living medicine.medical_treatment Physical Therapy Sports Therapy and Rehabilitation Pilot Projects law.invention Clothing Physical medicine and rehabilitation Randomized controlled trial law Neuropsychology occupational therapy Activities of Daily Living Medicine Humans Stroke Aged cognitive impairment Aged 80 and over Inpatients Rehabilitation business.industry Stroke Rehabilitation Evaluative Studies Middle Aged medicine.disease Cognitive test Stroke Rehabilitation Activities of daily living Cognitive impairment Occupational therapy Physical therapy Feasibility Studies Female business Cognition Disorders |
| Zdroj: | Clinical Rehabilitation |
| ISSN: | 0269-2155 |
| Popis: | Objective: To investigate two approaches to treating patients with persistent dressing problems and cognitive difficulties following stroke. Design: Pilot randomized controlled trial. Setting: Inpatient stroke rehabilitation service. Subjects: Seventy consecutive stroke patients with persistent dressing problems and accompanying cognitive difficulties at two weeks after their stroke. Interventions: Patients were randomly allocated to six weeks of either a systematic neuropsychological approach, based on analysis of dressing problems and further cognitive testing, or to the control group who received conventional (functional) dressing practice. Both groups received treatment three times a week in accordance with two separately prepared manuals. Main measures: Nottingham Stroke Dressing Assessment (NSDA), Line Cancellation, 10-hole peg transfer test, Object Decision, Gesture Imitation. Patients were assessed at six weeks after randomization by an independent assessor masked to group allocation. Results: Both neuropsychological and functional groups improved performance on the NSDA over the treatment period (31% and 22%, respectively) but there was no significant difference between groups at six weeks. However, the neuropsychological group showed a significantly greater improvement on a line cancellation test of visual neglect ( t(62) = 2.1, P < 0.05) and a planned subanalysis for those with right hemisphere damage showed a trend towards better dressing outcome ( P = 0.07, one-tailed). Conclusions: Results demonstrate the potential benefits of a systematic neuropsychological approach to dressing therapy, particularly for patients with right hemisphere damage. This study suggests the need for a phase III study evaluating the efficacy of a systematic neuropsychological approach in treating dressing difficulties, targeting patients with right hemisphere stroke and visuospatial impairments. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|