Ability and Skill Retraining with Task-Oriented Intervention to Improve Functional Independence in Persons with Stroke

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Encompass Digital Archive: Online Theses and Dissertations

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Thacker, Trista
Encompass Digital Archive, Eastern Kentucky University
Ability and Skill Retraining; Functional Independence Measure (FIM); Stroke; Task-Oriented; Occupational Therapy
thesis / dissertation description
The purpose of the study was to examine the difference that ability and skill retraining used with task-oriented intervention can make on functional independence (as measured by FIM subscales) in persons with stroke. The findings of this study can contribute to the body of literature to support occupational therapy. Review of related literature includes background support for the use of FIM with the stroke population through analysis of the psychometric properties of the instrument. Also, the review of related literature provides support for the use of ability and skill retraining and task-oriented interventions with the stroke population. This supports the use of FIM admission and discharge scores to measure functional improvement and the division of ability and skill retraining and task-oriented interventions used in this study. Part of a large data set of a retrospective study of medical records for persons in long term care with the primary diagnosis of stroke was reviewed for the current study. Baseline and discharge FIM subscale scores were examined for 50 patients. The FIM subscales used were eating, grooming, bathing, upper body dressing, lower body dressing, toileting, bed, chair, and wheelchair transfers, and walk/wheelchair locomotion. Means, standard deviations, and t-tests with post hoc testing were used to analyze the data and determine if there were significant differences between baseline and discharge mean scores of the FIM subscales. IBM SPSS Statistics Version 21 was used for analysis. Billing information was also gathered on the 50 patients to determine which interventions were billed for the most often. The interventions were divided into ability and skill retraining or task-oriented/functional oriented interventions to allow for a comparison of which is used the most in a long term care setting. Major results of the study were improvement was seen on each of the eight FIM subscales used and statistically significant improvement was found in all of the measured FIM subscales, with the exception of eating. Other major findings of the study included that about two-thirds of the billed intervention was task-oriented/functional oriented interventions and the other one-third was ability and skill retraining interventions. Discussion and clinical implications of the results conclude the thesis.