This is a cluster randomized controlled trial in which client-centered rehabilitation of activities of daily living (CADL) will be compared to usual rehabilitation of activities of daily living (UADL) regarding participation in activities of daily living, independence in activities of daily living and life satisfaction during the first year after stroke. In addition use of health services, caregiver burden and significant others' life satisfaction will be studied. Study design, methods and power analysis are based on our previous pilot study. Participating rehabilitation centers in the counties of Stockholm, Uppsala and Gavleborg have been randomized to supply CADL or UADL. Patients are included who are: \< 3 months after stroke, dependent in at least two activities of daily living, understand instructions and referred to a participating rehabilitation unit. Data are collected at baseline, 3, 6 and 12 months. For sufficient power 280 participants will be included. In addition qualitative longitudinal studies will be performed in order to describe how CADL is integrated.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
SINGLE
Enrollment
280
Client-centered ADL refers to rehabilitation of activities of daily living specifically guided by the needs as expressed by the client/patient and her/his significant others, a process that specifically aims to support the client by taking the client's goals and views as the guide for the rehabilitation process.
The variation of strategies and ways to conduct usual ADL rehabilitation according to the routines and praxis of the participating rehabilitation units randomized to supply the control condition.
Karolinska Institutet
Stockholm, Sweden
Perceived participation
Time frame: 12 months
Life satisfaction
Time frame: 3 and 12 months
Utilization of health care and health related services
Time frame: During one year after inclusion
Fatigue
Time frame: baseline, 3, 6 and 12 months
Caregiver burden
Time frame: 3 and 12 months
Self rated impact of stroke
Stroke Impact Scale
Time frame: 3, 6 and 12 months
Activities of daily living
Time frame: baseline, 3, 6 and 12 months
Satisfaction with care
Time frame: 3, 6 and 12 months
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