Evidence for your Practice: Adjusting the challenge-skill balance in rehabilitation improves subjective quality of life

Article: Yoshida, I., Hirao, K., & Kobayashi, R. (2019). The effect on subjective quality of life of occupational therapy based on adjusting the challenge–skill balance: a randomized controlled trial. Clinical rehabilitation, 0269215519858713.

Study Aim: To verify the effect of adjusting the challenge–skill balance with respect to rehabilitation process.

Population: Patients in a recovery rehabilitation unit in Japan with cerebral or spinal disease and musculoskeletal diseases between the ages of 50 and 100.

Methods: Clients were randomly divided into two groups: the experimental group, who received occupational therapy with adjustment of the challenge-skill balance, and the control group who received conventional occupational therapy.

Adjustment of challenge-skill balance involved a collaborative (therapist and patient) evaluation of ADL performance based on challenge (the client’s perception of the activity’s difficulty on a scale of 1-7) and skill level (client’s perception of the required skill associated with the activity on a scale of 1-7). The activity was re-adjusted depending on the challenge-skill balance, and was re-evaluated until challenge and skills levels were balanced. 
  
Key Findings: Significant differences were observed between the experimental and control groups in measures of: 

• Subjective quality of life
• Health related quality of life

Bottom Line for OT: 
Adjusting the challenge–skill balance in the rehabilitation process may improve the client’s subjective quality of life

Read the article abstract

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