Effectiveness of an individualised occupational therapy intervention programme (ABLE) using adaptational strategies on activities of daily living among persons with chronic conditions: A randomised controlled trial (RCT)

OBJECTIVE: Compare the effectiveness of a problem-solving, individualised, home-based occupational therapy intervention (ABLE 2.0), to usual occupational therapy, on activities of daily living (ADL) ability in persons with chronic conditions.

DESIGN: A single-centre, double-blinded, randomised controlled trial with 10- and 26-week follow-up.

SETTING: A Danish municipality.

SUBJECTS: Persons with chronic conditions experiencing problems performing ADL tasks ( n  = 80).

INTERVENTIONS: ABLE 2.0 was compared with usual occupational therapy.

MAIN MEASURES: Coprimary outcomes were self-reported ADL ability (ADL-Interview Performance) and observed ADL motor ability (Assessment of Motor and Process Skills) at Week 10. Secondary outcomes were self-reported ADL ability (ADL-Interview Performance) and observed ADL motor ability (Assessment of Motor and Process Skills) at Week 26, and perceived satisfaction with ADL ability (ADL-Interview Satisfaction) and observed ADL process ability (Assessment of Motor and Process Skills) at Weeks 10 and 26.

RESULTS: In total, 78 persons were randomly assigned: 40 to usual occupational therapy and 38 to ABLE 2.0. No statistically significant nor clinically relevant difference between group mean changes in primary outcomes was identified from baseline to Week 10 (ADL-Interview Performance [-0.16; 95% CI: -0.38 to 0.06] and Assessment of Motor and Process Skills ADL motor ability [-0.1; 95% CI: -0.3 to 0.1]). At Week 26, a statistically significant and clinically relevant difference was found in Assessment of Motor and Process Skills ADL motor ability (LS mean change: -0.3; 95% CI: -0.5 to -0.1) between groups.

CONCLUSION: ABLE 2.0 was effective in improving observed ADL motor ability at 26 weeks.