Background: In spite of the importance of occupational therapy (OT) for rehabilitation of stroke patients, the efficacy of a variety of occupational therapy intervention has not been systematically addressed.
Objectives: To identify the effects of OT interventions on outcomes for stroke patients. Search strategy: A number of databases such as MEDLINE, CINAHL, EMBASE, SCISEARCH, AME were searched.
Selection criteria: Studies that met the following criteria were included: (a) involve a controlled design or pretest/posttest and time series, (b) evaluate OT interventions for adult stroke patients, (c) conduct primary outcome measures, and (d) is full-length.
Data collection and analysis: Six OT intervention categories were applied to classify the studies. Two reviewers independently assessed the methodological quality of the studies. The results of each intervention were analyzed by applying either a quantitative or qualitative approach.
Main results: Of the 32 studies included in the review, 18 were randomized controlled trials, 6 were case-control trials, and 8 were non-controlled designs. The findings were presented in six categories: (1) training of sensory-motor functions, (2) teaching of cognitive functions, (3) acquisition of skills, (4) advice and instruction regarding assistive devices, (5) provision of splints, and (6) education of family or primary caregiver. An additional category included studies that employed multiple interventions.
Conclusions: The findings identified comprehensive OT as having small but significant effect sizes on activities of daily living and social participation. There is a lack of evidence for training of cognitive functions, training of skills, advice and instruction regarding assistive devices, and provision of splints. For the evaluation of efficacy of OT interventions, more randomized controlled trials are needed.