Background/Aims Despite the emphasis on supporting meaningful occupations for community-dwelling stroke survivors in Japan, home-visit rehabilitation tends to focus on physical function training over occupation-based interventions. This preliminary exploratory study aimed to evaluate longitudinal changes in performance of and satisfaction with individually meaningful occupations (primary outcomes), alongside physical/cognitive functions, daily functioning, caregiver burden, and quality of life (secondary outcomes) among community-dwelling older adult stroke survivors. Methods In this single-group exploratory pre-post study, 12 participants (mean age: 78.5 ± 6.6 years) received a multicomponent home-visit rehabilitation programme incorporating the Aid for Decision-Making in Occupation Choice tool and the Management Tool for Daily Life Performance, with collaborative goal setting and tailored practice over 3–12 months. Longitudinal trajectories were evaluated using Bayesian generalised linear mixed models across follow-up time points. Results Primary outcomes demonstrated clear positive longitudinal trends over time for both occupational performance (monthly estimate=0.41, 95% credible interval: [0.30, 0.51]) and satisfaction (estimate=0.36, 95% credible interval: [0.26, 0.45]). Secondary outcomes, including physical performance, basic and instrumental activities of daily living and health-related quality of life, also showed gradual monthly improvements. Conversely, no clear evidence of change was observed in cognitive function, depressive symptoms or caregiver burden. Conclusions A multicomponent home-visit rehabilitation programme using the Management Tool for Daily Life Performance and Aid for Decision-Making in Occupation Choice is feasible and may support gains in primary occupational outcomes and functional status for older adult stroke survivors. However, given the uncontrolled single-group design, small sample size, and unblinded evaluations, these preliminary findings should be interpreted cautiously and warrant confirmation in future randomised controlled trials. Implications for practice Combining visual goal setting using the Aid for Decision-Making in Occupation Choice with structured planning through the Management Tool for Daily Life Performance offers practical insights into the feasibility of incorporating occupation-based practice into routine home-visit rehabilitation. This approach provides clinicians with a useful framework for observing potential changes in stroke survivors’ occupational performance and overall quality of life.
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Suzuki et al. (2026) studied this question.
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