Background: Occupational Therapy aims to assist people achieve their maximum level of function and independence in all aspects of daily life.

Objectives: To determine whether Occupational Therapy focused specifically on activities of daily living improves the outcomes for patients following stroke.

Methods: We searched (until December 2003) for all randomised controlled trials (RCTs) of stroke patients receiving an occupational therapy intervention where practice of activities of daily living was the intervention and/ or the outcome was compared to no input or usual care. The primary outcome of interest was functional decline i.e. deterioration in ability to perform activities of daily living. We searched the Cochrane Controlled Trials Register, MEDLINE, EMBASE, CINAHL, PsycLIT Occupational Therapy Research Index, Dissertation Abstracts; Science Citation Index; Social Sciences Citation Index; Arts and Humanities Citation Index using a search strategy developed by the Cochrane Stroke Group. Reference lists of specialist journals were hand searched. Data were abstracted and methodological quality assessed by two independent reviewers.

Results: We included ten RCTs (1348 participants). The risk of deteriorating in ability to perform activities of daily was reduced in participants who received occupational therapy compared to no or usual care odds ratio 0.73 (95% confidence interval (CI), 0.55 to 0.96, p = 0.02) with no significant heterogeneity. There was a trend towards improved ability to perform activities of daily living in the participants receiving occupational therapy but this was not statistically significant standardised mean difference 0.10 (95% CI 0.04 to 0.23), p = 0.15).

Conclusions: Preliminary results suggest that patients who receive occupational therapy are less likely to decline in performance of activities of daily living.