Occupational Therapy in Complex Patients: A Pilot Randomized Controlled Trial

Abstract EN

Introduction.

To determine effect size and feasibility of experimental occupational therapy (OT) intervention in addition to standard care in a population of complex patients undergoing rehabilitation in a hospital-home-based setting.

Method.

40 complex patients admitted to the rehabilitation ward of the Local Health Authority-Research Institute of Reggio Emilia (Italy) were randomized in a parallel-group, open-label controlled trial.

Experimental OT targeting occupational needs in the areas of self-care, productivity, and leisure was delivered by occupational therapists.

Standard care consisted of task-oriented rehabilitation delivered by a multiprofessional team.

Results.

The experimental OT intervention was completed by 75% of patients assigned to this group.

The average changes in the Canadian Occupational Performance Measure (COPM) performance score significantly and clinically favored experimental OT [−3,06 (−4.50; −1.61); delta>2 points, resp.].

Similar trends were detected for COPM satisfaction and independence in instrumental activities of daily living (ADL).

At follow-up, level of social participation was higher for patients treated with experimental OT (p=0.043) than for controls.

Conclusions.

Experimental OT was feasible in complex patients in a hospital-home-based setting.

It ameliorated both patients’ performance and satisfaction in carrying out relevant activities and improved independence in instrumental ADL.

The trial is registered with ClinicalTrials.gov NCT02677766.