The objective of this study was to compare the clinical effectiveness of a programme of physiotherapy and occupational therapy with standard care in care home residents who have mobility limitations and are dependent in performing activities of daily living. Care home residents with mobility limitations, limitations in activities of daily living (as screened by the Barthel index), and not receiving end of life care took part in a targeted three month occupational therapy and physiotherapy programme. 24 of 77 nursing and residential homes that catered for residents with mobility limitations and dependency for activities of daily living were selected for study: 12 were randomly allocated to the intervention arm (128 residents, mean age 86 years) and 12 to the control arm (121 residents, mean age 84 years). After adjusting for home effect and baseline characteristics, no significant differences were found in mean Barthel index scores at six months post-randomisation between treatment arms, across assessments, or in the interaction between assessment and intervention. Similarly, no significant differences were found in the mean Rivermead mobility index scores.
The three month occupational therapy and physiotherapy programme had no significant effect on mobility and independence. On the other hand, the variation in residents′ functional ability, the prevalence of cognitive impairment, and the prevalence of depression were considerably higher in this sample than expected on the basis of previous work.
Sackley CM, van den Berg ME, Lett K, Patel S, Hollands K, Wright CC, Hoppitt TJ. Effects of a physiotherapy and occupational therapy intervention on mobility and activity in care home residents: a cluster randomised controlled trial. BMJ. 2009;339:b3123