Marion F. Walker
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.
AVRIL DRUMMOND email@example.com
Professor of Healthcare Research
PIP LOGAN firstname.lastname@example.org
Professor of Rehabilitation Research
Judi A. Edmans
Robert A. Dineen
JANE HORNE email@example.com
Senior Research Fellow
Rebecca J. Fisher
Jenny L. Taylor
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.
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|
|Publisher||SAGE Publications (UK and US)|
|Peer Reviewed||Peer Reviewed|
|Keywords||Stroke, Rehabilitation, Activities of daily living, Cognitive impairment, Occupational therapy|
|Copyright Statement||Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by-nc/4.0|
Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by-nc/4.0
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