Occupational therapy for patients with problems in activities of daily living after stroke

Lynn Legg; Avril Drummond; Peter Langhorne

doi:10.1002/14651858.CD003585.pub2

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Analysis 1.1

Comparison 1 Occupational therapy versus no routine input, Outcome 1 Activities of daily living.

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Analysis 1.2

Comparison 1 Occupational therapy versus no routine input, Outcome 2 Death or 'poor outcome' (deterioration or dependency).

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Analysis 1.3

Comparison 1 Occupational therapy versus no routine input, Outcome 3 Death by the end of scheduled follow up.

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Analysis 1.4

Comparison 1 Occupational therapy versus no routine input, Outcome 4 Death or requiring institutional care by the end of scheduled follow up.

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Analysis 1.5

Comparison 1 Occupational therapy versus no routine input, Outcome 5 Death or dependency by the end of scheduled follow up.

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Analysis 1.6

Comparison 1 Occupational therapy versus no routine input, Outcome 6 Extended activities of daily living scores.

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Analysis 1.7

Comparison 1 Occupational therapy versus no routine input, Outcome 7 Subjective health status scores.

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Analysis 1.8

Comparison 1 Occupational therapy versus no routine input, Outcome 8 Mood/distress scores.

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Analysis 1.9

Comparison 1 Occupational therapy versus no routine input, Outcome 9 Carers: quality of life.

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Analysis 1.10

Comparison 1 Occupational therapy versus no routine input, Outcome 10 Carers: mood/distress.

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Analysis 1.11

Comparison 1 Occupational therapy versus no routine input, Outcome 11 Sensitivity to missing data (odds of poor outcome: better).

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Analysis 1.12

Comparison 1 Occupational therapy versus no routine input, Outcome 12 Sensitivity to missing data (odds of poor outcome: worse).

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Table 1. Completeness of data: activities of daily living (outcome 1)

Study	N(I)	n(I)	Dead(I)	Missing(I)	N(C)	n(C)	Dead(C)	Missing(C)
Cardiff 1995	55	46	9	0	55	39	11	5
Nottingham 1996	15	12	0	3	15	15	0	0
Nottingham 1997	53	45	5	3	58	38	7	13
Nottingham 1999	94	84	6	4	91	79	7	5
Glasgow 2000	67	60	6	1	71	62	5	4
Nottingham 2001	53	53	8	0	47	47	17	0
TOTAL 2001	309	218	29	62	157	110	11	36
Hong Kong 2004	30	30	0	0	23	23	0	0

Table 1. Completeness of data: activities of daily living (outcome 1)

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Table 2. Completeness of data: death or poor outcome (outcome 2)

Study	N(I)	n(I)	Dead(I) or deterior	Missing(I)	N(C)	n(C)	Dead(C) or deterior	Missing(C)	Measure
Cardiff 1995	55	55	9 + 24 = 33	0	55	54	11 + 21 = 32	1	Barthel deterioration
Nottingham 1995	42	42	0 + 2 = 2	0	23	23	1 + 2 = 3	0	Barthel deterioration
Nottingham 1997	53	53	5 + 1 = 6	0	58	58	7 + 7 = 14	0	Institutionalisation
Nottingham 1999	94	90	6 + 12 = 18	4	91	86	7 + 20 = 27	5	Barthel < 15 dependence
Glasgow 2000	67	66	6 + 27 = 33	1	71	67	5 + 36 = 41	4	Barthel deterioration
Nottingham 2001	53	53	27	0	47	47	36	0	Barthel deterioration
TOTAL 2001	309	248	29 + 77 = 106	61	157	123	11 + 45 = 56	34	Barthel < 15 dependence

Table 2. Completeness of data: death or poor outcome (outcome 2)

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Table 3. Completeness of data: death (outcome 3)

Study	N(I)	n(I)	Dead(I)	Missing(I)	N(C)	n(C)	Dead(C)	Missing(C)
Cardiff 1995	55	55	9	0	55	55	11	0
Nottingham 1995	42	42	1	0	23	23	0	0
Nottingham 1996	15	15	0	0	15	15	0	0
Nottingham 1997	53	53	5	0	58	58	7	0
Nottingham 1999	94	94	6	0	91	91	7	0
Glasgow 2000	67	67	6	0	71	71	5	0
Nottingham 2001	53	53	8	0	47	47	17	0
TOTAL 2001	309	248	29	61	157	123	11	34
Hong Kong 2004	30	30	0	0	23	23	0	0

Table 3. Completeness of data: death (outcome 3)

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Table 4. Completeness of data: death or requiring institutional care (outcome 4)

Study	N(I)	n(I)	Dead(I) or instit	Missing(I)	N(C)	n(C)	Dead(C) or instit	Missing(C)
Cardiff 1995	55	55	9 + 16 = 25	0	55	54	11 + 18 = 29	1
Nottingham 1997	53	53	5 + 1 = 6	0	58	58	7 + 7 = 14	0
Glasgow 2000	67	67	6 + 4 = 10	0	71	71	5 + 4 = 9	0

Table 4. Completeness of data: death or requiring institutional care (outcome 4)

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Table 5. Completeness of data: death or dependency (outcome 5)

Study	N(I)	n(I)	Dead(I) or dependent	Missing(I)	N(C)	n(C)	Dead(C) or dependent	Missing(C)	Measure
Cardiff 1995	55	55	9 + 32 = 41	0	55	54	11 + 30 = 41	1	Barthel < 15
Nottingham 1999	94	90	6 + 12 = 18	4	91	86	7 + 20 = 27	5	Barthel < 15
Glasgow 2000	67	66	6 + 21 = 27	1	71	66	6 + 14 = 20	5	Barthel < 15
TOTAL 2001	309	248	29 + 77 = 106	61	157	123	11 + 45 = 56	34	Barthel < 15

Table 5. Completeness of data: death or dependency (outcome 5)

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Table 6. Completeness of data: extended activities of daily living (outcome 6)

Study	N(I)	n(I)	Dead(I)	Missing(I)	N(C)	n(C)	Dead(C)	Missing(C)
Cardiff 1995	55	45	9	1	55	39	11	5
Nottingham 1995	42	41	0	1	23	23	1	0
Nottingham 1997	53	45	5	3	58	38	7	13
Nottingham 1999	94	84	6	4	91	79	7	5
Glasgow 2000	67	60	6	1	71	62	5	4
TOTAL 2001	309	219	29	61	157	112	11	34

Table 6. Completeness of data: extended activities of daily living (outcome 6)

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Table 7. Completeness of data: quality of life (outcome 7)

Study	N(I)	n(I)	Dead(I)	Missing(I)	N(C)	n(C)	Dead(C)	Missing(C)
Nottingham 1995	42	40	0	2	23	19	1	4
Glasgow 2000	67	54	6	7	71	54	5	12

Table 7. Completeness of data: quality of life (outcome 7)

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Table 8. Completeness of data: mood/distress (outcome 8)

Study	N(I)	n(I)	Dead(I)	Missing(I)	N(C)	n(C)	Dead(C)	Missing(C)
Cardiff 1995	55	41	9	5	55	31	11	13
Nottingham 1997	53	39	5	9	58	34	7	17
Nottingham 1999	94	83	6	5	91	77	7	7
TOTAL 2001	309	219	29	61	157	112	11	34

Table 8. Completeness of data: mood/distress (outcome 8)

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Table 9. Completeness of data: carers quality of life (outcome 9)

Study	N(I)	n(I)	Dead(I)	Missing(I)	N(C)	n(C)	Dead(C)	Missing(C)
Cardiff 1995	55	30	0	25	55	24	0	31

Table 9. Completeness of data: carers quality of life (outcome 9)

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Table 10. Completeness of data: carers mood (outcome 10)

Study	N(I)	n(I)	Missing(I)	N(C)	n(C)	Missing(C)	Measure
Nottingham 1997	53	29	24	58	26	32	General Health Questionnaire
Nottingham 1999	94	58	36	91	39	52	General Health Questionnaire
Glasgow 2000	67	49	18	71	58	13	General Health Questionnaire
TOTAL 2001	309	219	90	157	112	45	General Health Questionnaire

Table 10. Completeness of data: carers mood (outcome 10)

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Comparison 1. Occupational therapy versus no routine input

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Activities of daily living Show forest plot	8	961	Std. Mean Difference (IV, Random, 95% CI)	0.18 [0.04, 0.32]

2 Death or 'poor outcome' (deterioration or dependency) Show forest plot	7	1065	Peto Odds Ratio (Peto, Fixed, 95% CI)	0.67 [0.51, 0.87]

3 Death by the end of scheduled follow up Show forest plot	9	1163	Peto Odds Ratio (Peto, Fixed, 95% CI)	0.84 [0.57, 1.25]

4 Death or requiring institutional care by the end of scheduled follow up Show forest plot	3	358	Peto Odds Ratio (Peto, Fixed, 95% CI)	0.72 [0.43, 1.19]

5 Death or dependency by the end of scheduled follow up Show forest plot	4	788	Peto Odds Ratio (Peto, Fixed, 95% CI)	0.90 [0.67, 1.23]

6 Extended activities of daily living scores Show forest plot	6	847	Std. Mean Difference (IV, Random, 95% CI)	0.21 [0.03, 0.39]

7 Subjective health status scores Show forest plot	2	167	Std. Mean Difference (IV, Random, 95% CI)	0.17 [‐0.14, 0.48]

8 Mood/distress scores Show forest plot	4	636	Std. Mean Difference (IV, Random, 95% CI)	0.07 [‐0.09, 0.23]

9 Carers: quality of life Show forest plot	1	54	Std. Mean Difference (IV, Random, 95% CI)	0.12 [‐0.41, 0.66]

10 Carers: mood/distress Show forest plot	4	590	Std. Mean Difference (IV, Random, 95% CI)	0.23 [‐0.05, 0.51]

11 Sensitivity to missing data (odds of poor outcome: better) Show forest plot	7	1175	Peto Odds Ratio (Peto, Fixed, 95% CI)	0.71 [0.55, 0.92]

12 Sensitivity to missing data (odds of poor outcome: worse) Show forest plot	7	1175	Peto Odds Ratio (Peto, Fixed, 95% CI)	0.67 [0.52, 0.86]

Comparison 1. Occupational therapy versus no routine input

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