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The Effects of In‐Home Rehabilitation on Task Self‐Efficacy in Mobility‐Impaired Adults: A Randomized Clinical Trial
Author(s) -
Sanford Jon A.,
Griffiths Patricia C.,
Richardson Peg,
Hargraves Katina,
Butterfield Tina,
Hoenig Helen
Publication year - 2006
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.2006.00913.x
Subject(s) - medicine , randomized controlled trial , rehabilitation , physical therapy , confidence interval , veterans affairs , self efficacy , intervention (counseling) , statistical significance , likert scale , clinical trial , nursing , statistics , mathematics , psychology , psychotherapist
OBJECTIVES: To examine the effect on mobility self‐efficacy of a multifactorial, individualized, occupational/physical therapy (OT/PT) intervention delivered via teletechnology or in‐home visits. DESIGN: Randomized, clinical trial. SETTING: One Department of Veterans Affairs and one private rehabilitation hospital. PARTICIPANTS: Sixty‐five community‐dwelling adults with new mobility devices. Thirty‐three were randomized to the control or usual care group (UCG), 32 to the intervention group (IG). INTERVENTION: Four, once‐weekly, 1‐hour OT/PT sessions targeting three mobility and three transfer tasks. A therapist delivered the intervention in the traditional home setting (trad group n=16) or remotely via teletechnology (tele group n=16). MEASUREMENTS: Ten‐item Likert‐scale measure of mobility self‐efficacy. RESULTS: The IG had a statistically significantly greater increase in overall self‐efficacy over the study period than the UCG (mean change: IG 8.8, 95% confidence interval (CI)=3.8–13.7; UCG 1.2, 95% CI=−5.8–8.2). Descriptively, the IG exhibited positive changes in self‐efficacy for all tasks and greater positive change than the UCG on all items with the exception of getting in and out of a chair. Comparisons of the two treatment delivery methods showed a medium standardized effect size (SES) in both the tele and trad groups, although it did not reach statistical significance for the tele group (SES: tele=0.35, 95% CI=−2.5–0.95; trad=0.54, 95% CI=0.06–1.14). CONCLUSION: A multifactorial, individualized, home‐based OT/PT intervention can improve self‐efficacy in mobility‐impaired adults. The trend toward increased self‐efficacy irrespective of the mode of rehabilitation delivery suggests that telerehabilitation can be a viable alternative to or can augment traditional in‐home therapy.