Physical Disability Clinical Trial
Official title:
Evaluating Reablement for Home-dwelling Elderly in a Norwegian Municipality
The purpose of this study is to determine whether a special kind of rehabilitation offered to home-dwelling older adults is effective with regards to functional ability and municipal costs.
Early detection of functional decline among home dwelling older adults and immediate onset
of rehabilitation, can improve function, and reduce or delay need for home-based assistance
and nursing home placement. Towards year 2050 there will be a significant increase in number
of elderly persons in Norway, with an urgent need for new models for early intervention and
rehabilitation in order to give service to a larger amount of elderly persons. Reablement is
a new and promising rehabilitation model which many Norwegian municipalities are
implementing in order to meet current and future needs for municipal home-based services.
However, very little research has been conducted regarding the effectiveness of this
intervention. This study aims at assessing the effectiveness of reablement in terms of daily
functioning and economic costs compared to standard home-based treatment and care.
The study will be conducted in the municipality of Voss in Western Norway, a municipality
with only 14000 inhabitants. It is a double-blinded, block-randomized controlled
intervention trial, recruiting home-dwelling older adults with an initial functional decline
in daily activities. The intervention is intensive, multidisciplinary, home-based
rehabilitation given by home-trainers, under supervision from an occupational therapist or a
physiotherapist. The control intervention is standard home-based treatment and care.
Thirty participants will be recruited in each arm of the study. The participants will be
assessed at baseline, and at 3-, and 9 months follow-up. Primary outcomes will be
participation, activity, and municipal expenditures. Costs are generated by the working
hours of the different professions. Hence, there will be a daily registration of the working
hours different health care professions spend in the private homes of the participants.
Power calculations based on study with a similar target group using the instrument Canadian
Occupational Performance Measure, estimate a need for only 21 participants in each group due
to the longitudinal design. However, in order to account for possibilities of frailer target
group or a large drop out rate (40 %), a total number of 30 participants in each group will
be tried recruited. Data analyses will be performed according to intention to treat. The
working hour data is panel data and will be analyzed accordingly; a random or a mixed effect
regression model will be employed. Also, descriptive statistics and simpler tests will be
carried out.
;
Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Double Blind (Investigator, Outcomes Assessor), Primary Purpose: Treatment
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