Some thoughts related to some factors that affect ADL/IADL training

ADL/IADL training

Intervention approaches:
1. Restorative (remedial) approach: focus on restoration of impairments
2. Adaptive (compensatory/functional) approach: compensate for loss of function
3. Cognitive rehabilitation approach: develop awareness and self-monitoring skills

Based on the client centered practice, we need to think about some factors that may influence the efficacy of these intervention approaches:

1. Patient's/Family's knowledge of OT/Stroke
2. Patient-Clinician relationship
3. Patient’s motivation
4. Patient’s compliance
5. Patient’s satisfaction
6. Family support

* 2,3,4,5,6: affected by 1

How can we develop an evidence-based ADL training program?
If we use a valid, reliable, and responsive measure to monitor the patient’s progress in ADL/IADL, and the ADL/IADL training is not showed effective, is this training really ineffective?
Not really…
Because the factors aforementioned may also affect the efficacy of the ADL/IADL training…

After we make sure that these factors are being controlled (i.e., the patients have adequate OT/Stroke knowledge, the compliance and satisfaction are OK...), we can say that the evidence of the efficacy of ADL/IADL training is reliable.