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Reablement in community-dwelling adults: study protocol for a randomised controlled trial.

https://arctichealth.org/en/permalink/ahliterature271035
Source
BMC Geriatr. 2014;14:139
Publication Type
Article
Date
2014
Author
Hanne Tuntland
Birgitte Espehaug
Oddvar Forland
Astri Drange Hole
Egil Kjerstad
Ingvild Kjeken
Source
BMC Geriatr. 2014;14:139
Date
2014
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Aging - psychology
Community Health Services - economics - methods
Cost-Benefit Analysis
Female
Humans
Independent Living - economics - psychology
Male
Norway - epidemiology
Primary Health Care - economics - methods
Quality of Life - psychology
Single-Blind Method
Abstract
As a result of the ageing population, there is an urgent need for innovation in community health-care in order to achieve sustainability. Reablement is implemented in primary care in some Western countries to help meet these challenges. However, evidence to support the use of such home-based rehabilitation is limited. Reablement focuses on early, time-intensive, multidisciplinary, multi-component and individualised home-based rehabilitation for older adults with functional decline. The aim of this study is to investigate the effectiveness of reablement in home-dwelling adults compared with standard treatment in relation to daily activities, physical functioning, health-related quality of life, use of health-care services, and costs.
The study will be a 1:1 parallel-group randomised controlled superiority trial conducted in a rural municipality in Norway. The experimental group will be offered reablement and the control group offered standard treatment. A computer-generated permuted block randomisation sequence, with randomly selected block sizes, will be used for allocation. Neither participants nor health-care providers will be blinded, however all research assistants and researchers will be blinded. The sample size will consist of 60 participants. People will be eligible if they are home-dwelling, over 18 years of age, understand Norwegian and have functional decline. The exclusion criteria will be people in need of institution-based rehabilitation or nursing home placement, and people who are terminally ill or cognitively reduced. The primary outcome will be self-perceived performance, and satisfaction with performance of daily activities, assessed with the Canadian Occupational Performance Measure. In addition, physical capacity, health-related quality of life, use of health-care services, and cost data will be collected at baseline, and after 3 and 9 months in both groups, and again after 15 months in the intervention group. Data will be analysed on an intention-to-treat basis using a linear mixed model for repeated measures.
The findings will make an important contribution to evaluating cost-effective and evidence-based rehabilitation approaches for community-dwelling adults.
The trial was registered in ClinicalTrials.gov November 20, 2012, identifier: NCT02043262.
Notes
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PubMed ID
25519828 View in PubMed
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Reablement in community-dwelling older adults: a randomised controlled trial.

https://arctichealth.org/en/permalink/ahliterature273144
Source
BMC Geriatr. 2015;15:145
Publication Type
Article
Date
2015
Author
Hanne Tuntland
Mona Kristin Aaslund
Birgitte Espehaug
Oddvar Førland
Ingvild Kjeken
Source
BMC Geriatr. 2015;15:145
Date
2015
Language
English
Publication Type
Article
Keywords
Activities of Daily Living - psychology
Aged
Aged, 80 and over
Female
Home Care Services - organization & administration
Humans
Independent Living - psychology
Male
Norway
Patient satisfaction
Program Evaluation
Quality of Life
Recovery of Function
Rural Population
Treatment Outcome
Abstract
There has been an increasing interest in reablement in Norway recently and many municipalities have implemented this form of rehabilitation despite a lack of robust evidence of its effectiveness. The aim of this study was to investigate the effectiveness of reablement in home-dwelling older adults compared with usual care in relation to daily activities, physical functioning, and health-related quality of life.
This is a parallel-group randomised controlled trial conducted in a rural municipality in Norway. Sixty-one home-dwelling older adults with functional decline were randomised to an intervention group (n = 31) or a control group (n = 30). The intervention group received ten weeks of multicomponent home-based rehabilitation. The Canadian Occupational Performance Measure (COPM) was used to measure self-perceived activity performance and satisfaction with performance. In addition, physical capacity and health-related quality of life were measured. The participants were assessed at baseline and at 3- and 9-month follow-ups.
There were significant improvements in mean scores favouring reablement in COPM performance at 3 months with a score of 1.5 points (p = 0.02), at 9 months 1.4 points (p = 0.03) and overall treatment 1.5 points (p = 0.01), and for COPM satisfaction at 9 months 1.4 points (p = 0.03) and overall treatment 1.2 points (p = 0.04). No significant group differences were found concerning COPM satisfaction at 3 months, physical capacity or health-related quality of life.
A 10-week reablement program resulted in better activity performance and satisfaction with performance on a long-term basis, but not the other outcomes measured.
The trial was registered in ClinicalTrials.gov November 20, 2012, identifier NCT02043262 .
Notes
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PubMed ID
26537789 View in PubMed
Less detail