The online version of this article (doi:10.1186/s13195-017-0247-9) contains supplementary material, which is available to authorized users.
Errorless learning (EL) is a method for optimizing learning, which uses feed-forward instructions in order to prevent people from making mistakes during the learning process. The majority of previous studies on EL taught patients with dementia artificial tasks of little or no relevance for their daily lives. Furthermore, only a few controlled studies on EL have so far been performed and just a handful of studies have examined the long-term effects of EL. Tasks were not always trained in the patients’ natural or home environment, limiting the external validity of these studies. This multicenter parallel randomized controlled trial examines the effects of EL compared with trial and error learning (TEL) on the performance of activities of daily living in persons with Alzheimer’s or mixed-type dementia living at home.
Patients received nine 1-hour task training sessions over eight weeks using EL or TEL. Task performance was measured using video observations at week 16. Secondary outcome measures were task performance measured at week 26, satisfaction with treatment, need for assistance, challenging behavior, adverse events, resource utilization and treatment costs.
A total of 161 participants were randomized, of whom 71 completed the EL and 74 the TEL arm at week 11. Sixty-nine EL patients and 71 TEL patients were assessed at the 16-week follow-up (the primary measurement endpoint). Intention-to-treat analysis showed a significantly improved task performance in both groups. No significant differences between the treatment groups were found for primary or secondary outcomes.
Structured relearning improved the performance of activities of daily living. Improvements were maintained for 6 months. EL had no additional effect over TEL.
German Register of Clinical Trials DRKS00003117. Registered 31 May 2011.
Additional file 1: Table S1. Presenting characteristics of the therapists participating in both learning conditions (years in the field, qualification, cases trained and sex). (DOCX 13 kb)
Additional file 2: Table S2. Presenting an overview of resource utilization (treatment hours and costs, intensity of professional and primary care and use of dementia related medicines) following structured relearning of individually selected daily living tasks for both learning conditions at baseline and weeks 11, 16 and 26. (DOCX 16 kb)
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- Structured relearning of activities of daily living in dementia: the randomized controlled REDALI-DEM trial on errorless learning
Maartje M. E. de Werd
Danielle H. E. Boelen
Marcel G. M. Olde Rikkert
Gerhard W. Eschweiler
Roy P. C. Kessels
- BioMed Central