Papers by Esther Steultjens
Wetenschappelijk Tijdschrift Voor Ergotherapie, 2009
Er is veel wetenschappelijk bewijs voor de effectiviteit van ergotherapie na een beroerte. Dit be... more Er is veel wetenschappelijk bewijs voor de effectiviteit van ergotherapie na een beroerte. Dit bewijs is gebundeld in de Ergotherapierichtlijn Beroerte. Deze richtlijn wil ergotherapeuten praktische handreikingen geven en wil voor andere discipline transparent maken wat ergotherapie te bieden heeft: de organisatie van ergotherapeutische zorg, de ergotherapeutische diagnostiek en evaluatie en het trainen / begeleiden en cliënt / systeemgericht adviseren. Uit de grote hoeveelheid bewijs is een selectie gemaakt van de vijf belangrijkste onderwerpen, namelijk multidisciplinaire samenwerking, transmurale (keten)zorg, cliëntgerichte benadering, betekenisvolle activiteiten en naastbetrokkenen / mantelzorger. Over deze onderwerpen wordt in de richtlijn in verschillende hoofdstukken het beschikbare bewijs gepresenteerd. Vooral voor betekenisvolle activiteiten is veel bewijs gevonden. Onder andere is aangetoond dat het specifiek trainen van betekenisvolle activiteiten effectief is. Het traine...
Australian occupational therapy journal, 2014
Journal of rehabilitation medicine, 2014
Despite beneficial effects on communication and process measures, client-centred practice has bee... more Despite beneficial effects on communication and process measures, client-centred practice has been shown to result in poor functional outcomes. To examine a potential explanation for poor functional outcomes, this paper aims to assess whether in client-centred therapy more time is spent on diagnostic consultation and less time on actual treatment compared to usual care. A multicentre cluster randomised controlled trial was performed. Thirteen hospitals and rehabilitation centres, 29 therapists and 269 outpatients with multiple sclerosis participated. Measurements included an inventory of diagnostic and treatment goals, the number of sessions, therapy duration and therapy intensity. In client-centred therapy, more sessions were used for diagnostic consultation (10.9% points difference, p = 0.030); the time needed to formulate the first treatment goal was longer (11.4 days difference, p = 0.041); there was a tendency towards more goals directed to diagnostic issues (0.69 goals differe...
Huisarts en Wetenschap, 2006
Reviews, 1996
Cognitive impairment is a frequent consequence of stroke and can impact on a person&a... more Cognitive impairment is a frequent consequence of stroke and can impact on a person's ability to perform everyday activities. There are a number of different intervention strategies that occupational therapists may use when working with people who have cognitive impairment post-stroke. To determine whether occupational therapy improves functional performance of basic activities of daily living (ADL) and specific cognitive abilities in people who have cognitive impairment following a stroke. We searched the Cochrane Stroke Group Trials Register (last searched May 2009), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 1, 2009), MEDLINE (1966 to April 2009), EMBASE (1980 to April 2009), CINAHL (1982 to April 2009), PsycINFO (1840 to April 2009), PsycBITE, OTseeker and Dissertation Abstracts (the latest three were searched up to April 2009). In an effort to identify further published, unpublished, and ongoing trials, we also tracked relevant references through the cited reference search in Science Citation Index (SCI) and Social Science Citation Index (SSCI), reviewed the reference lists of relevant studies and reviews, handsearched relevant occupational therapy journals, and contacted key researchers in the area. Randomised and quasi-randomised controlled trials that evaluated an intervention focused on providing cognitive retraining to adults with clinically defined stroke and confirmed cognitive impairment. The intervention needed either to be provided by an occupational therapist or given under the supervision of an occupational therapist. Two review authors independently examined the abstracts that might meet the inclusion criteria, assessed the quality and extracted data. We have presented results using mean differences. We included one trial with 33 participants in this review. We found no difference between groups for the two relevant outcomes that were measured: improvement in time judgement skills and improvement in basic ADLs on the Barthel Index. The effectiveness of occupational therapy for cognitive impairment post-stroke remains unclear. The potential benefits of cognitive retraining delivered as part of occupational therapy on improving basic daily activity function or specific cognitive abilities, or both, of people who have had a stroke cannot be supported or refuted by the evidence included in this review. More research is required.
This article is a reproduction of the original text of appendix 2 of the NIVEL survey about prior... more This article is a reproduction of the original text of appendix 2 of the NIVEL survey about priority of research into the effectivity and suitability of ergotherapy and speach and language therapy (2004). It describes a report on the state of affairs in the extamural speech and language therapy in 2002. The report examines among other things the quantity of speech and language therapists who work extramural and the results of reviews about the effect of speech and language therapy. (aut.ref.)
Stroke, 2003
Background and Purpose-Occupational therapy (OT) is an important aspect of stroke rehabilitation.... more Background and Purpose-Occupational therapy (OT) is an important aspect of stroke rehabilitation. The objective of this study was to determine from the available literature whether OT interventions improve outcome for stroke patients. Methods-An extensive search in MEDLINE, CINAHL, EMBASE, AMED, and SCISEARCH was performed. Studies with controlled and uncontrolled designs were included. Seven intervention categories were distinguished and separately analyzed. If a quantitative approach (meta-analysis) of data analysis was not appropriate, a qualitative approach (best-evidence synthesis), based on the type of design, methodological quality, and significant findings of outcome and/or process measures, was performed. Results-Thirty-two studies were included in this review, of which 18 were randomized controlled trials. Ten randomized controlled trials had a high methodological quality. For the comprehensive OT intervention, the pooled standardized mean difference for primary activities of daily living (ADL) (0.46; CI, 0.04 to 0.88), extended ADL (0.32; CI, 0.00 to 0.64), and social participation (0.33; CI, 0.03 to 0.62) favored treatment. For the training of skills intervention, some evidence for improvement in primary ADL was found. Insufficient evidence was found to indicate that the provision of splints is effective in decreasing muscle tone. Conclusions-This review identified small but significant effect sizes for the efficacy of comprehensive OT on primary ADL, extended ADL, and social participation. These results correspond to the outcome of a systematic review of intensified rehabilitation for stroke patients. The amount of evidence with respect to specific interventions, however, is limited. More research is needed to enable evidence-based OT for stroke patients. (Stroke. 2003;34:676-687.)
Occupational Therapy International, 2012
This study explored how the evidenced-based practise (EBP) is perceived by Dutch occupational the... more This study explored how the evidenced-based practise (EBP) is perceived by Dutch occupational therapists (OTs), what sources of research data are used to make clinical decisions, and what barriers are identified in implementing EBP. A self-administered, pre-tested, questionnaire was distributed through an email survey and postal mail among the 200 randomly stratified selected OTs out of a total population of 2,019 Dutch OTs. Analyses of data comprised descriptive statistics of all variables and test statistics to evaluate the differences between demographical groups. Dutch OTs have a very positive attitude toward the EBP. Barriers experienced are mostly related to a lack of skills needed to implement the EBP and to the characteristics of the work environment. The attitude, experiences and barriers are mainly similar to research findings in other countries or professions. A unique barrier to the implementation of the EBP found in this study was that Dutch OTs perceived evidence written in a foreign (non-Dutch) language as a barrier to using evidence in non-Dutch languages. The results of the study, derived from a partly representative group of working OTs, implicate universal problems regarding the effective implementation of the EBP. Solutions to increase the implementation of the EBP from an international point of view are called for and need to be evaluated.
Journal of Clinical Epidemiology, 2006
Background and Objective: To identify the strategies used to deal with the clinical heterogeneity... more Background and Objective: To identify the strategies used to deal with the clinical heterogeneity of interventions and multiple outcome measures used in Cochrane reviews on physiotherapy and occupational therapy.
International Psychogeriatrics, 2012
The aim of this study is to evaluate aspects of inter-rater reliability of the Perceive, Recall, ... more The aim of this study is to evaluate aspects of inter-rater reliability of the Perceive, Recall, Plan, and Perform (PRPP) system of task analysis for assessing daily functioning of home-dwelling dementia patients. Videotaped recordings of 30 German patients with dementia performing a relevant daily task in their own homes were scored independently by ten Dutch PRPP trained occupational therapists, randomly selected from a pool of 25. Intra-class correlations (ICC) (one-way single measure) were calculated for PRPP Stage One independence score, and PRPP Stage Two information processing scale, quadrant scales, and subquadrant scales from a total of 300 PRPP scores. ICCs for Stage One PRPP independence score were good to excellent (0.63; 0.94) for both individual rater and test reliability. The Stage Two PRPP total score showed moderate correlations (0.46) for the single rater absolute agreement and excellent agreement (0.90) for test reliability. The four quadrant scale scores of the PRPP showed limited single rater absolute agreement (0.37-0.39) but excellent average test agreement (0.85-0.87). All subquadrants of information processing showed limited single rater absolute agreement (0.26-0.38) and good to excellent average test agreement (0.78-0.86). This suggests that the PRPP total is reliable in assessing information processing during activity performance in dementia patients. The PRPP is a reliable measure to evaluate individual performances of routines and tasks in community-living dementia patients by multiple raters. Future research should address reliability and validity features of the PRPP for dementia patients with incorporation of criterion-referenced test characteristics.
Disability and Rehabilitation, 2013
To assess the efficacy of client-centred occupational therapy (OT) according to a client-centred ... more To assess the efficacy of client-centred occupational therapy (OT) according to a client-centred process framework, as compared to usual care OT, in patients with multiple sclerosis (MS). A multicentre cluster randomised controlled trial with the institution (i.e. hospital or rehabilitation centre) as the unit of randomisation was performed. A total of 269 outpatients with MS, 13 hospitals and rehabilitation centres and 29 occupational therapists participated. Primary outcomes included measures of disability, participation and autonomy. Secondary outcomes included fatigue, generic health-related quality of life, quality and evaluation of therapy, therapy compliance and therapy frequency. Measurements were taken at baseline, four months and at eight months follow-up. Primary outcome measures did not show significant differences between the two interventions. Secondary outcomes revealed significant differences in favour of the usual care OT on fatigue (physical scale and total scale) and health-related quality of life (bodily pain and vitality) at four months. After eight months only significant differences on mental health were found. Process outcomes (i.e. the information scale of therapy quality and the client-centredness of the organisation) were in favour of the client-centred intervention. Because the client-centred intervention resulted in no effects on the primary outcomes and small but negative effects on the secondary functional outcomes, we should seriously reconsider the application of client-centred practice. An increasing number of interventions claim to incorporate client-centred practice. Client-centred practice is associated with improved satisfaction but the effects on functional health-related outcomes have not been fully evaluated. The findings of this study show that the process outcomes of therapy were in favour of the client-centred intervention, but no effects were found on the primary outcomes and negative effects on the secondary functional health outcomes. It is suggested that the implementation of client-centred practice should be adjusted in order to achieve optimal health outcomes.
Clinical Rehabilitation, 2004
Objective: Occupational therapy (OT) for cerebral palsy focuses on the development of skills nece... more Objective: Occupational therapy (OT) for cerebral palsy focuses on the development of skills necessary for the performance of activities of daily living. The aim of this systematic review was to determine whether OT interventions improve outcome for children with cerebral palsy (CP). Methods: An extensive search in MEDLINE, CINAHL, EMBASE, AMED and SCISEARCH was performed. Studies with controlled and uncontrolled designs were included. Six intervention categories were distinguished and individually analysed using a best-evidence synthesis. This synthesis is based on the type of design, the methodological quality, the type of outcome measures and the statistical signi cance of the ndings. Results: Seventeen studies were included in this review, seven of which were randomized controlled trials (RCTs). One RCT had a high methodological quality. The analyses resulted in insuf cient evidence of the ef cacy of occupational therapy in all intervention categories, due to the low methodological quality of studies presenting statistically nonsigni cant results. Conclusion: Despite the reasonable number of studies identi ed, the inconclusive ndings regarding the ef cacy of occupational therapy for children with cerebral palsy may be a re ection of the dif culties in ef cacy research in OT for children with CP. Future research should critically re ect on methodological issues.
Clinical Rehabilitation, 2005
Evidence of the efficacy for occupational therapy in different conditions: an overview of systema... more Evidence of the efficacy for occupational therapy in different conditions: an overview of systematic reviews.
Australian Occupational Therapy Journal, 2009
Lannin, N., Gustafsson, L., Cusick, A., Walker, M., Steultjens, E., Fricke, J., Turton, A., Wågø ... more Lannin, N., Gustafsson, L., Cusick, A., Walker, M., Steultjens, E., Fricke, J., Turton, A., Wågø Aas, R., Logan, P., Froude, E., McCluskey, A., Drummond, A., Corr, S., Fletcher-Smith, J., Radford, K., Pinnington, L., Novak, I. and Wallen, M.(2009), Scholarly communication and ...
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Papers by Esther Steultjens