Occupational Therapy in Complex Patients: A Pilot Randomized Controlled Trial.
Martina Pellegrini, Debora Formisano, Veronica Bucciarelli and 3 others
PMID 30250407WHAT IT FOUND
Client-centered OT added to standard care improved self-reported performance and satisfaction in complex rehabilitation patients.
The study was unblinded, so therapists knew who got the extra treatment. This pilot shows the approach is feasible but does not prove it works better than standard care alone.
Key findings
01Patients receiving the experimental OT had a significantly larger improvement in their self-reported performance of chosen activities compared to those receiving standard care alone.
02The intervention was considered feasible, with 75% of the treatment group completing the planned sessions.
03There were no significant differences between groups in mood, independence in basic daily living, or quality of life.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The study was open-label, meaning both patients and the occupational therapists administering the primary outcome measure knew which treatment group patients were assigned to, which may have influenced self-reported outcomes. The sample size was small (40 patients), and the study was designed as a pilot to estimate effect size rather than to definitively prove efficacy. Patients with severe cognitive impairment or communication disabilities were excluded, so results do not apply to those populations. The intervention group had worse baseline scores on the primary outcome, which may have influenced the magnitude of observed gains.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not assume this pilot proves client-centered OT is superior to standard care for all complex patients. The primary outcome was self-reported and unblinded, and the study found no significant benefits in objective measures like basic independence or mood.