Early occupational therapy improves post-stroke outcomes

1. Early occupational therapy in stroke patients significantly improves recovery of functional independence, quality of life, cognition skills, and level of depression 3 months post-discharge

Evidence Rating Level: 1 (Excellent)

Strokes incur significant changes in patients’ lives causing health, social, and economic problems that can cause disability. Additionally, there is an increasing incidence of stroke in the younger population leading to long-term health problems including mental health, cognitive impairment, and difficulties in activities of daily living (ADLs). Post-stroke rehabilitation provides an opportunity for functional improvements in patients’ lives. This prospective, randomized, controlled trial aimed to look at the effect of an Early Occupational Therapy Intervention Post-Stroke (EOTIPS) on hospital discharge post-stroke and quality of life for patients seen in the Spanish healthcare system. The EOTIPS intervention involved a personalized approach where individualized objectives were established. Sessions were an initial evaluation at the hospital, a post-discharge home visit, a follow-up home visit one month later, and a final evaluation 3 months post-discharge. The most common individual goal was related to performing ADLs, social participations, and activities related to self- and occupational identity. The control group only received the typical care and rehabilitation within the healthcare system. The primary outcomes were quality of life (Stroke and Aphasia Quality of Life Scale). Other outcomes included functional independence (Barthel Index, Modified Rankin Scale, and Stroke Impact Scale-16), sensory-motor skills (Fugl Meyer Assessment, Berg Balance Scale, and Timed Up & Go), communication skills (Communicative Activity Log), and mood disorders (Beck Depression Inventory-II and Hamilton Anxiety Scale). The EOTIPS group showed significantly better recovery of functional independence, quality of life, cognition skills, and level of depression relative to the control group. However, it is important to note that regardless of the rehabilitation program, all patients significantly improved in all forms of evaluation.

Click to read the study in PLOSONE

Image: PD

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