Article

AIM: To evaluate the feasibility of a randomized controlled trial including
process and potential impact of occupational therapy in Parkinson's disease.
DESIGN: Process and outcome were quantitatively and qualitatively evaluated in an
exploratory multicentre, two-armed randomized controlled trial at three months.
PARTICIPANTS: Forty-three community-dwelling patients with Parkinson's disease
and difficulties in daily activities, their primary caregivers and seven
occupational therapists. INTERVENTION: Ten weeks of home-based occupational
therapy according to the Dutch guidelines of occupational therapy in Parkinson's
disease versus no occupational therapy in the control group. MAIN MEASURES:
Process evaluation measured accrual, drop-out, intervention delivery and protocol
adherence. Primary outcome measures of patients assessed daily functioning:
Canadian Occupational Performance Measure (COPM) and Assessment of Motor and
Process Skills. Primary outcome for caregivers was caregiver burden: Zarit Burden
Inventory. Participants' perspectives of the intervention were explored using
questionnaires and in-depth interviews. RESULTS: Inclusion was 23% (43/189),
drop-out 7% (3/43) and unblinding of assessors 33% (13/40). Full intervention
protocol adherence was 74% (20/27), but only 60% (71/119) of baseline Canadian
Occupational Performance Measure priorities were addressed in the intervention.
The outcome measures revealed negligible to small effects in favour of the
intervention group. Almost all patients and caregivers of the intervention group
were satisfied with the results. They perceived: 'more grip on the situation' and
used 'practical advices that make life easier'. Therapists were satisfied, but
wished for a longer intervention period. CONCLUSIONS: The positive perceived
impact of occupational therapy warrants a large-scale trial. Adaptations in
instructions and training are needed to use the Canadian Occupational Performance
Measure as primary outcome measure.

Langue : ANGLAIS