Stroke is the third leading cause of death in Austria after cardiovascular diseases and cancer, and often leads to functional and cognitive impairment and chronic disability in survivors. Approximately one-third of the patients surviving a stroke remain dependent on their caregivers. The central aim of occupational therapy is to achieve the maximum degree of autonomy of the patient, above all by improving activities of daily living (ADL) and participation in social life.

Part III of the project on occupational therapy analysed the efficacy of occupational therapy interventions with the focus on activities of daily living and on cognitive impairments for patients after stroke, compared to no intervention or routine care.

The systematic review is based on two Cochrane Reviews published in 2006 and 2010 respectively, and added results from recent RCTs. A total of 4 studies that fulfilled the inclusion criteria could be identified through a systematic literature search in 6 data bases and a hand search.

Occupational therapy with the focus on ADL training improves basic ADL (e.g. dressing, feeding, hygiene) and extended/ instrumental ADL (e.g. mobility, household, leisure activities) significantly. It reduces the risk of the combined outcome "death or a poor outcome" (deterioration on the ADL scale or dependency). No significant improvement was found regarding the mood of patients and care providers and their quality of life. The question of efficacy of occupational therapy focused on cognitive impairment could not be answered due to the lack of information from studies published so far.