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This article discusses service delivery for Spinal Cord Injured (SCI) in the Netherlands. In this wealthy country, almost everyone has access to domestic adaptations and other equipment, regardless of income and with low, or without user contributions. However, satisfaction with this system or its products is rarely examined. Subjects in this research are 318 SCI individuals between 18 and 65 years of age, living in the community at a mean time of 3.6 years after injury. Availability of accessible housing, domestic adaptations, wheelchairs and outdoor transportation is investigated. Satisfaction with available services and satisfaction with service delivery procedures is measured by self-developed questionnaires. Relationships between these satisfaction scores and measures for functional health status (SIP68) and life satisfaction (LSQ) are analyzed. The presence of domestic adaptations is high, and 78.3% said their houses were suciently adapted at the time of the interview. Wheelchairs were generally available and most respondents had more than one. However, many users had complaints about their wheelchairs: 35.9% about their manual wheelchairs and 47.5% about their electric wheelchairs. Public transport was rarely used, 51.1% of respondents had an adapted car. Having an adapted car was signi®cantly related to the ability to drive independently. Satisfaction with available services was acceptable, but satisfaction with service delivery procedures was very low. Satisfaction with available services did have a signi®cant relationship with functional health status when the in¯uence of the type of injury was taken into account. Satisfaction with available services also had a signi®cant relationship with life satisfaction, after the in¯uence of functional health status was taken into account. Further research on this topic is recommended.

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Objective: Evaluation of a therapy programme for stroke patients with apraxia. The programme is based on teaching patients strategies to compensate for the presence of apraxia. This programme was designed for assessment and treatment by occupational therapists. Design: The outcome was studied in a pre–post test design. Measurements were conducted at baseline and 12 weeks later. Subjects: Thirty-three stroke patients with apraxia were treated at occupational therapy departments in general hospitals, rehabilitation centres and nursing homes. Main outcome measures: The following measurements were conducted: an apraxia test, a motor functioning test, observation of activities of daily living (ADL), Barthel Index, and an ADL questionnaire for the therapist and the patient. Results: The patients showed large improvements in ADL functioning on all measures and small improvements on the apraxia test and the motor functioning test. The effect sizes for the disabilities, ranging from 0.92 to 1.06, were large compared to the effect sizes for apraxia (0.34) and motor functioning (0.19). The significant effect of treatment is also seen when individual improvement and subjective improvement are considered. Measured with the Barthel Index for instance, 71% of the patients improved. Conclusions: These results suggest that the programme seems to be successful in teaching patients compensatory strategies that enable them to function more independently, despite the lasting presence of apraxia.

These results suggest that the programme seems to be successful in teaching patients compensatory strategies that enable them to function more independently, despite the lasting presence of apraxia.