A comparison of the functional and remedial intervention evidence base for self care with stroke patients

Current healthcare demands the use of evidence-based practise (EBP) through national standards, such as National Service Frameworks (Department of Health, 2004) and as part of professional registration (Health Professions Council (HPC), 2004) when justifying treatment. This study, completed as undergraduate research, compared the evidence base for functional and remedial intervention in self-care rehabilitation for stroke patients in order to establish the most effective treatment. A literature review searched electronic databases and identified 11 articles, which covered ten different interventions within the functional and remedial approaches. Literature was critiqued using Taylor’s (2000) tool for EBP in occupational therapy. Themes were identified through critique, and evidence for both treatment approaches was compared and contrasted. The results were inconclusive, forming tentative suggestions rather than conclusive evidence on which to base interventions. Functional intervention was favoured, as this had the strongest evidence-base. Evidence supported and rejected interventions in both approaches, highlighting the need to research specific interventions as part of EBP, rather than treatment approaches. Results also highlighted lack of rigour in current research. There is a need to develop outcome measures that go beyond physical and cognitive improvement to establish occupational outcomes in addition to further research.