Relative importance of rehabilitation therapy characteristics on functional outcomes for persons with stroke .
The long-term outcomes from a randomized controlled trial of an educational–behavioural joint protection programme for people with rheumatoid arthritis
Objective : To evaluate the long-term effects of joint protection on health status of people with early rheumatoid arthritis ( RA ) . Design : A four-year follow-up of a r and omized , controlled , assessor-blinded trial was conducted . Setting : Two rheumatology outpatient departments . Participants : People with rheumatoid arthritis less than five years since diagnosis . Interventions : Two 8-hour interventions were originally compared : a st and ard arthritis education programme , including 21/2 hours of joint protection based on typical UK occupational therapy practice ( plus 51/2 hours on RA , exercise , pain management , diet and foot care ) ; and a joint protection programme , using educational-behavioural training . Main measures : Adherence to joint protection , pain , h and pain on activity , Arthritis Impact Measurement Scales 2 and Arthritis Self-efficacy were recorded at 0 and 4 years . Results : Sixty-five people attended the joint protection and 62 the st and ard programmes . Groups at entry were similar in age ( 51 years ; 49 years ) , disease duration ( 21 months : 17.5 months ) and use of nonsteroidal anti-inflammatory and disease-modifying drugs . At four years , the joint protection group continued to have significantly better : joint protection adherence ( p=0.001 ) ; early morning stiffness ( p=0.01 ) ; AIMS 2 activities of daily living ( ADL ) scores ( p=0.04 ) compared with the st and ard group . The joint protection group also had significantly fewer h and deformities : metacarpophalangeal ( MCP ) ( p=0.02 ) and wrist joints ( p=0.04 ) . Conclusion : Attending an educational = behavioural joint protection programme significantly improves joint protection adherence and maintains functional ability long term . This approach is more effective than st and ard methods of training and should be more widely adopted
Relative importance of rehabilitation therapy characteristics on functional outcomes for persons with stroke .