Skip to main content

Research Repository

Advanced Search

The DRESS trial: a feasibility randomized controlled trial of a neuropsychological approach to dressing therapy for stroke inpatients

Walker, Marion F.; Sunderland, Alan; Fletcher-Smith, Joanne; Drummond, Avril E.R.; Logan, Pip; Edmans, Judi A.; Garvey, Katherine; Dineen, Robert A.; Ince, Paul; Horne, Jane; Fisher, Rebecca J.; Taylor, Jenny L.

Authors

Marion F. Walker

Alan Sunderland

Joanne Fletcher-Smith

AVRIL DRUMMOND avril.drummond@nottingham.ac.uk
Professor of Healthcare Research

PIP LOGAN pip.logan@nottingham.ac.uk
Professor of Rehabilitation Research

Judi A. Edmans

Katherine Garvey

Robert A. Dineen

Paul Ince

JANE HORNE jane.horne@nottingham.ac.uk
Senior Research Fellow

Rebecca J. Fisher

Jenny L. Taylor



Abstract

Objective: To investigate two approaches to treating patients with persistent dressing problems and cognitive difficulties following stroke.

Design: Pilot randomized controlled trial.

Setting: Inpatient stroke rehabilitation service.

Subjects: Seventy consecutive stroke patients with persistent dressing problems and accompanying cognitive difficulties at two weeks after their stroke.

Interventions: Patients were randomly allocated to six weeks of either a systematic neuropsychological approach, based on analysis of dressing problems and further cognitive testing, or to the control group who received conventional (functional) dressing practice. Both groups received treatment three times a week in accordance with two separately prepared manuals.

Main measures: Nottingham Stroke Dressing Assessment (NSDA), Line Cancellation, 10-hole peg transfer test, Object Decision, Gesture Imitation. Patients were assessed at six weeks after randomization by an independent assessor masked to group allocation.

Results: Both neuropsychological and functional groups improved performance on the NSDA over the treatment period (31% and 22%, respectively) but there was no significant difference between groups at six weeks. However, the neuropsychological group showed a significantly greater improvement on a line cancellation test of visual neglect (t(62) = 2.1, P < 0.05) and a planned subanalysis for those with right hemisphere damage showed a trend towards better dressing outcome (P = 0.07, one-tailed).

Conclusions: Results demonstrate the potential benefits of a systematic neuropsychological approach to dressing therapy, particularly for patients with right hemisphere damage. This study suggests the need for a phase III study evaluating the efficacy of a systematic neuropsychological approach in treating dressing difficulties, targeting patients with right hemisphere stroke and visuospatial impairments.

Citation

Walker, M. F., Sunderland, A., Fletcher-Smith, J., Drummond, A. E., Logan, P., Edmans, J. A., …Taylor, J. L. (2012). The DRESS trial: a feasibility randomized controlled trial of a neuropsychological approach to dressing therapy for stroke inpatients. Clinical Rehabilitation, 26(8), doi:10.1177/0269215511431089

Journal Article Type Article
Publication Date Aug 1, 2012
Deposit Date May 21, 2014
Publicly Available Date May 21, 2014
Journal Clinical Rehabilitation
Print ISSN 0269-2155
Electronic ISSN 0269-2155
Publisher SAGE Publications (UK and US)
Peer Reviewed Peer Reviewed
Volume 26
Issue 8
DOI https://doi.org/10.1177/0269215511431089
Keywords Stroke, Rehabilitation, Activities of daily living, Cognitive impairment, Occupational therapy
Public URL http://eprints.nottingham.ac.uk/id/eprint/3180
Publisher URL http://cre.sagepub.com/content/26/8/675
Copyright Statement Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by-nc/4.0

Files


Walker_The_DRESS_trial_-_a_feasibility_randomized_controlled_trial.pdf (627 Kb)
PDF

Copyright Statement
Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by-nc/4.0





You might also like



Downloadable Citations