Evaluation of evidence within occupational therapy in stroke rehabilitation

Evidence-based practice creates practice that integrates research-driven evidence with clinical expertise and patients' preferences in clinical decision-making. Aim: The aim of this study was to investigate and evaluate the quality and applicability of scientific research in occupational therapy intervention related to the use of everyday life occupations and client-centred practice within stroke rehabilitation. Design: Systematic searches of research studies published in English during 2000-2007 in peer-reviewed journals were undertaken. Thirty-nine articles and one Cochrane review were appraised and the quality evaluated using an evidence taxonomy and an evidence hierarchy. Results: Evidence arose providing support for a client-centred approach, entailing outcome related to better ability to recall goals, the patients feeling more involved and able to manage more everyday life occupations after rehabilitation. There is also considerable evidence for the use of everyday life occupations in occupational therapy. Occupational therapy was evaluated as an important aspect of stroke rehabilitation improving outcomes in everyday life occupations including activities of daily living (ADL) and participation. Discussion: As research of relevance for the profession to a large extent includes qualitative research it gives rise to reflection on including more tools than the evidence hierarchy while evaluating evidence within occupational therapy.