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A "client-centred activities of daily living" intervention for persons with stroke: One-year follow-up of a randomized controlled trial

Contact Information


Susanne Guidetti,

stroke rehabilitation; participation; occupational therapy; multicentre study; lived experience; everyday occupa-tion; activity; longitudinal.


Objective: To compare changes regarding perceived participation, independence in activities of daily living (ADL) and life satisfaction between 3, 6 and 12 months after inclusion in a study of a client-centred ADL intervention and usual ADL intervention after stroke. Design: A multicentre randomized controlled trial. Methods: Sixteen rehabilitation units were randomly assigned to provide client-centred ADL intervention or usual ADL intervention. Eligible participants were persons ≤ 3 months after stroke who had been treated in a stroke unit, were dependent in two ADL domains, had not been diagnosed with dementia, and were able to understand instructions. Data collection was performed by blinded assessors. The primary outcome, perceived participation, was assessed with the Stroke Impact Scale 3.0, domain 8. The secondary outcomes, participation, independence in ADL, and life satisfaction, were assessed with validated instruments. For statistical power, 280 participants were required. Statistical analyses were performed on an intention-to-treat basis. Results: There were no differences between the groups regarding changes in perceived participation, independence in ADL, or life satisfaction during the first 12 months. There was a trend towards a clinically meaningful positive change in perceived participation that favoured client-centred ADL intervention. Conclusion: Further research is required to understand the benefits of client-centred interventions.


Guidetti, S., Ranner, M., Tham, K., Andersson, M., Ytterberg, C., & von Koch, L. (2015). A "client-centred activities of daily living" intervention for persons with stroke: One-year follow-up of a randomized controlled trial. Journal of rehabilitation medicine, 47(7), 605–611.





Conent Area

Susanne Guidetti

EWB-Related Construct

(1) goal pursuit; (2) life satisfaction; (3) positive affect; (4) quality of life; (5) sense of meaning

Study Design

Species or Study Population

(5) RCT

Sex (%Female)


Age (Mean, SD)

Intervention: 74, 10
Control: 71, 11

Younger Controls?


Longitudinal Data?


Sample Size



client-centred activities of daily living intervention

Ethnicity (%white)

not stated (Sweden)

Inclusion Criteria

Participants in the study were persons ≤ 3 months after stroke onset who: (i) had been treated for acute stroke in a stroke unit; (ii) were dependent in at least 2 activities of daily living domains, according to Katz Extended ADL Index (KE) (10); (iii) had not been diagnosed with dementia; (iv) were able to understand and follow instructions; and (v) had been referred for rehabilitation to 1 of the 16 participating units.

Exclusion Criteria

not stated

EWB Measures

(1) Life Satisfaction Scale (LiSat-11)

Non-EWB Behavioral

(1) Stroke Impact Scale
(2) Frenchay Activity Index
(3) Occupational Gaps
(4) Impact on Participation & Autonomy
(5) Personal & Instrumental-ADL
(6) Barthel Index

Physiological Measures


Brain IMaging Modality

Brain IMaging Paradigm


Brain Region/Circuit


Biological Measures


Other Neural Measures

Data Availability?


Data Avalability Details


Diagnostic Measures

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