Changes in Perceived Impact of Stroke on Everyday Life over Five Years in a Rehabilitation Sample that Received an Activity of Daily Living Intervention: A Follow-Up Study.
Mandana Fallahpour, Gunilla Eriksson, Susanne Guidetti
PMID 35582945WHAT IT FOUND
Five years after stroke, patients reported better participation in daily life than at three months, regardless of whether they received client-centred or usual ADL training.
However, perceived impact on communication, mobility, and hand function worsened over time in the client-centred group.
Key findings
01Changes in perceived stroke impact over five years were not related to whether participants received client-centred ADL (CADL) or usual ADL (UADL) interventions.
02In the CADL group, perceived impact on participation decreased (improved) between 3 and 12 months and was maintained at 5 years, while impact on communication, mobility, and hand function increased (worsened) over the same period.
03In the UADL group, perceived impact on participation also decreased between 3 and 12 months and was maintained at 5 years, while impact on mobility increased between 12 months and 5 years.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The sample was heavily skewed toward mild stroke (78% CADL, 95% UADL), with only one person with severe stroke in the CADL group and none in the UADL group, limiting generalizability to more disabled patients. Baseline differences existed between groups, with the UADL group having milder strokes and higher independence at admission, which may have influenced outcomes. The study had limited power due to dropouts, particularly of more vulnerable participants. The UADL intervention may have included client-centred components due to occupational therapists' usual practice, making it difficult to distinguish the specific effects of the CADL intervention. Normal ageing processes over five years likely contributed to declines in mobility and hand function, confounding the assessment of stroke impact.
Declared interests
The authors have no conflicts of interest to declare.
The easy way to misread this
Do not assume that client-centred ADL intervention leads to better long-term outcomes than usual care. The study found no significant difference between the groups in how perceived stroke impact changed over five years, and both groups showed similar patterns of participation improvement and functional decline.