Occupational therapy can improve the lives of patients who have suffered a stroke and lessen their chances of deteriorating, according to a study published on bmj.com today.

Stroke is the second leading cause of death in the world and the leading cause of serious, long-term disability in adults. Six months after a stroke approximately half of survivors are dependent on others to help them carry out everyday tasks such as eating, dressing and going to the toilet.

We already know that rehabilitation is important after a stroke, but don’t know enough about the effectiveness of the separate components of the rehabilitation package.

Occupational therapy is defined as the use of purposeful activity designed to achieve outcomes which promote health, prevent injury or disability and which develop, improve or restore the highest possible level of independence. But it has many different components. This study reviewed trials comparing an occupational therapy intervention which focussed on the activities of daily living with a control group where there was no routine intervention.

Researchers looked at nine randomised controlled trials with a total group size of 1258 people. The mean age ranged from 55 to 87.5 years. They found that patients who had undergone occupational therapy after a stroke were significantly more independent and able to carry out everyday tasks. This may not seem surprising, but the study also found that the odds of a poor outcome such as dependency on others and deterioration were also significantly lower.

Lynn Legg and colleagues conclude: “Occupational therapy after stroke “works” in that it improves outcome in terms of ability in personal activities of daily living.”

They say further work is needed to define which individuals are most likely to benefit from occupational therapy and which specific interventions are the most effective.

Contact: Emma Dickinson
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BMJ-British Medical Journal