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Occupational therapy for elderly

Evidence mapping of randomised controlled trials from 2004–2012

Ergotherapie bei Älteren

Evidenzmapping der randomisiert kontrollierten Studien von 2004 bis 2012

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Abstract

Objective

Previous systematic reviews on occupational therapy for elderly included studies until 2003. The present evidence mapping summarizes recent evidence for the efficacy of occupational therapy with older persons based on randomised controlled trials from 2004–2012.

Method

An electronic search in Cochrane and Medline databases identified publications of randomised controlled trials on occupational therapy interventions for persons ≥ 65 years old. Two raters independently extracted data and analysed the quality of samples, interventions and outcome evalutations according to PRISMA criteria.

Results

In all, 136 abstracts were identified and 48 studies analysed, from these 12 on stroke, 15 on falls and mobility, 7 on dementia, 4 on prevention and 10 on other conditions. Reports of adverse events and evaluations of costs and long-term outcomes are frequently lacking.

Conclusion

The most promising fields for further research are primary and secondary prevention in persons with stroke, falls or mobility problems and tertiary prevention in persons with dementia. Future trials should be conducted and reported according to consented reporting guidelines of the equator network.

Zusammenfassung

Einleitung

Bisherige Übersichtsarbeiten zur Ergotherapie bei Älteren umfassen publizierte Studien bis Ende 2003. Die nun vorgelegte Arbeit untersucht, inwieweit randomisiert kontrollierte Studien von 2004 bis 2012 die Wirksamkeit von Ergotherapie im Alltagsleben älterer Menschen belegen.

Methoden

Eine elektronische Literaturrecherche in der Cochrane- und Medline-Datenbank identifizierte Publikationen von randomisiert kontrollierten Studien mit ergotherapeutischen Interventionen bei Menschen von 65 Jahren und älter. Zwei unabhängige Untersucher analysierten die Stichproben-, Interventions- sowie die Mess- und Auswertungsqualität nach PRISMA-Kriterien.

Ergebnisse

Insgesamt wurden 136 Abstracts identifiziert und 48 Studien analysiert, davon 12 zu Schlaganfall, 15 zu Stürzen und Mobilität, 7 zu Demenz, 4 zu Prävention und 10 zu anderen Erkrankungen. Berichte zu unerwünschten Ereignissen fehlten häufig, ebenso Untersuchungen zu Kosten und Langzeitwirkung.

Schlussfolgerung

Felder mit Potenzial für weitere Studien sind die sekundäre Prävention bei Menschen mit Schlaganfall, Stürzen und Mobilitätsproblemen sowie die tertiäre Prävention bei Personen mit Demenzerkrankung. Zukünftige Forschung sollte gemäß den konsentierten Leitlinien für Forschungsberichte des Equator-Netzwerkes durchgeführt und berichtet werden.

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Compliance with ethical guidelines

Conflict of interest. S. Voigt-Radloff, G. Ruf, A. Vogel, F. van Nes, and M. Hüll state that there are no conflicts of interest.

The accompanying manuscript does not include studies on humans or animals.

Author information

Authors and Affiliations

  1. Zentrum für Geriatrie und Gerontologie, Universitätsklinikum Freiburg, Lehener Str. 88, 79106, Freiburg, Germany

    S. Voigt-Radloff, G. Ruf & M. Hüll

  2. Abteilung für Psychiatrie und Psychotherapie, Universitätsklinikum Freiburg, Freiburg, Germany

    A. Vogel

  3. Hogeschool van Amsterdam, Amsterdam, Netherlands

    F. van Nes

Authors
  1. S. Voigt-Radloff
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  2. G. Ruf
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  3. A. Vogel
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  4. F. van Nes
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  5. M. Hüll
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Corresponding author

Correspondence to S. Voigt-Radloff.

Appendix 1: Studies excluded after analyzing full text on eligibility

Appendix 1: Studies excluded after analyzing full text on eligibility

Patients too young (n = 36)

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Maitra KK, Philips K, Rice MS (2010) Grasping naturally versus grasping with a reacher in people without disability: motor control and muscle activation differences. Am J Occup Ther 64(1):95–104. Erratum in: (2010) Am J Occup Ther 64(5):678.

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McPherson KM, Kayes N, Weatherall M; Members of the Goals-SR Research Group (2009) A pilot study of self-regulation informed goal setting in people with traumatic brain injury. Clin Rehabil 23(4):296–309

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Schweickert WD, Pohlman MC, Pohlman AS et al (2009) Early physical and occupational therapy in mechanically ventilated, critically ill patients: a randomised controlled trial. Lancet 373(9678):1874–1882

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Eklund M, Ornsberg L, Ekström C et al (2008) Outcomes of activity-based assessment (BIA) compared with standard assessment in occupational therapy. Scand J Occup Ther 15(4):196–203

Adams J, Burridge J, Mullee M et al (2008) The clinical effectiveness of static resting splints in early rheumatoid arthritis: a randomized controlled trial. Rheumatology (Oxford) 47(10):1548–1553

Heebner ML, Roddey TS (2008) The effects of neural mobilization in addition to standard care in persons with carpal tunnel syndrome from a community hospital. J Hand Ther 21(3):229–240; quiz 241

Lambert RA, Harvey I, Poland F (2007) A pragmatic, unblinded randomised controlled trial comparing an occupational therapy-led lifestyle approach and routine GP care for panic disorder treatment in primary care. J Affect Disord 99(1–3):63–71

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Chan SH, Lee SW, Chan IW (2007) TRIP: a psycho-educational programme in Hong Kong for people with schizophrenia. Occup Ther Int 14(2):86–98

Li LC, Davis AM, Lineker SC, Coyte PC, Bombardier C (2006) Effectiveness of the primary therapist model for rheumatoid arthritis rehabilitation: a randomized controlled trial. Arthritis Rheum 55(1):42–52

Popovic MR, Thrasher TA, Adams ME et al (2006) Functional electrical therapy: retraining grasping in spinal cord injury. Spinal Cord 44(3):143–151

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No RCT on occupational therapy (n = 6)

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Voigt-Radloff, S., Ruf, G., Vogel, A. et al. Occupational therapy for elderly. Z Gerontol Geriat 48, 52–72 (2015). https://doi.org/10.1007/s00391-013-0540-6

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