D1.5 Occupational therapist

Occupational therapists provide specific skills in task optimi­sation and prescription for those with severe disease of adaptive equipment and home modifications. Some therapists also teach energy conserva­tion for activities of daily living and can help in the set-up of home and portable oxygen.

The effect of individualised occupational therapy in patients with moderate to severe COPD was evaluated in an RCT (Martinsen 2017). 52 patients were randomly assigned to the intervention group (occupational therapy) or control group (treatment as usual). Participants were recruited from the outpatient and inpatient pulmonary department at a hospital in Norway and through advertisements in local newspapers and distribution of leaflets to GPs’ offices. The primary outcome was assessed using the Canadian Occupational Performance Measure (COPM), and participants were assessed at baseline and after four and 12 months. The results indicate that compared with the usual care, occupational therapy did not improve occupational performance or satisfaction with performance. Small but significant changes in activity performance in favour of the intervention group were found in some of the secondary outcomes.

In a randomised controlled trial, activity training by occupational therapists combined with exercise improved functional status more than exercise alone or together with education, especially in elderly people with moderate to severe COPD (Norweg 2005).