Design and construction of goal-setting model in KAIFUKUKI rehabilitation ward

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Objective: To examine the efficacy of the top-down approach to occupational therapy for patients with subacute stroke, compare the top-down and bottom-up approaches. Design: A multicenter, randomized, controlled pilot trial with a single blind assessor. Interventions: The TOP group used the Aid for Decision-making in Occupation Choice (ADOC) to establish occupation-based goals. Evaluation and intervention were conducted mainly through real occupation. The BOT group was usual practice. Main outcome measures: Short Form 36 (SF-36), Functional Independence Measure, Brunnstrom recovery stages, The Client Satisfaction Questionnaire, and duration of hospital stay. Conclusions: Our results suggest that top-down and bottom-up approaches to occupational therapy have comparable efficacy for patients with subacute stroke; however, the top-down approach has more potential to improve general health and role emotional scores on the SF-36 than the bottom-up approach does.