Reablement in community-dwelling adults: study protocol for a randomised controlled trial
Journal article, Peer reviewed
© 2014 tuntland et al.; licensee bio med central. this is an open access article distributed under the terms of the creative commons attribution license ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. the creative commons public domain dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
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Original versionTuntland, H., Espehaug, B., Forland, O., Hole, A. D., Kjerstad, E., & Kjeken, I. (2014). Reablement in community-dwelling adults: study protocol for a randomised controlled trial. BMC geriatrics, 14(1), 139. http://dx.doi.org/10.1186/1471-2318-14-139
Background As a result of the ageing population, there is an urgent need for innovation in community health-care in order to achieve sustainability. Reablement is implemented in primary care in some Western countries to help meet these challenges. However, evidence to support the use of such home-based rehabilitation is limited. Reablement focuses on early, time-intensive, multidisciplinary, multi-component and individualised home-based rehabilitation for older adults with functional decline. The aim of this study is to investigate the effectiveness of reablement in home-dwelling adults compared with standard treatment in relation to daily activities, physical functioning, health-related quality of life, use of health-care services, and costs. Methods/Design The study will be a 1:1 parallel-group randomised controlled superiority trial conducted in a rural municipality in Norway. The experimental group will be offered reablement and the control group offered standard treatment. A computer-generated permuted block randomisation sequence, with randomly selected block sizes, will be used for allocation. Neither participants nor health-care providers will be blinded, however all research assistants and researchers will be blinded. The sample size will consist of 60 participants. People will be eligible if they are home-dwelling, over 18 years of age, understand Norwegian and have functional decline. The exclusion criteria will be people in need of institution-based rehabilitation or nursing home placement, and people who are terminally ill or cognitively reduced. The primary outcome will be self-perceived performance, and satisfaction with performance of daily activities, assessed with the Canadian Occupational Performance Measure. In addition, physical capacity, health-related quality of life, use of health-care services, and cost data will be collected at baseline, and after 3 and 9 months in both groups, and again after 15 months in the intervention group. Data will be analysed on an intention-to-treat basis using a linear mixed model for repeated measures. Discussion The findings will make an important contribution to evaluating cost-effective and evidence-based rehabilitation approaches for community-dwelling adults. Trial registration The trial was registered in ClinicalTrials.gov November 20, 2012, identifier: NCT02043262.