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

目的：为检验自上而下作业疗法对亚急性脑卒中患者的疗效，比较自上而下和自下而上作业疗法。设计：一项多中心、随机、对照、单盲试验。干预措施：TOP组使用职业选择决策辅助工具（ADOC）来建立基于职业的目标。评价和干预主要通过真实的职业进行。BOT集团是惯例。主要结局指标：SF-36、功能独立性测量、Brunnstrom恢复阶段、客户满意度问卷和住院时间。结论：我们的研究结果表明，自上而下和自下而上的职业治疗方法对亚急性脑卒中患者具有可比的疗效;然而，自上而下的方法比自下而上的方法更有潜力改善SF-36的总体健康和角色情感评分。

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.