Intensiv klientcentreret ergoterapi i hjemmet forbedre ældre borgeres aktivitetsudførelse og er stadig effektivt ved follow-up 6 måneder efter baseline: Resultater fra et dansk randomiseret studie

Abstract
Introduction /Rationale
In Denmark, older adults are offered home-rehabilitation, including occupational therapy, to improve and maintain their occupational performance. A small amount of evidence shows that client-centred in-home occupational therapy for older adults may effectively improve occupational performance, yet achieved effects may quickly be lost again.
Objectives
We tested whether intensive, client-centred occupational therapy (ICC-OT) could improve older adults’ occupational performance compared to the usual practice of a Danish municipality and whether achieved effects were still present at follow-up.
Method
A single-blind randomised controlled trial among 119 home-dwelling adults aged 60+. Occupational performance was measured on the Canadian Occupational Performance Measure (COPM) at baseline, post intervention and at follow-up 6 months after baseline. Change from baseline to post-test was the primary outcome; change from baseline to follow-up was a secondary outcome. All older adults were offered usual-practice: standard home-care services, physiotherapy, and assistive devices when meeting certain criteria. In addition, the intervention group received 11 weeks of ICC-OT addressing client-chosen occupational goals.
Results
Post-intervention, the older adults in the ICC-OT group had improved their occupational performance statistically significantly more than those who only received usual practice: The between-group difference in change concerning COPM-performance was 1.26 points (95%CI:0.50;2.02). At follow-up, not all improvement was maintained, yet a statistically significant between-group difference in change in favour of ICC-OT was still present: 0.98 points (95%CI:0.27;1.70).
Conclusion
In a Scandinavian home-care context, client-centred occupational therapy can be a powerful tool in meeting pressing societal challenges by improving and preserving older adults’ occupational performance.