Occupational Therapy International最新文献

Background: Few studies have examined the activity of the accessory inspiratory muscles as well as respiratory function simultaneously in individuals with chronic obstructive pulmonary disease (COPD) while performing activities of daily living (ADLs). This cross-sectional study is aimed at understanding the differences in the demands for respiratory expenditure and activity of the upper limbs and accessory inspiratory muscles during functional performance in individuals with and without COPD. Methods: Thirteen patients with mild to moderate COPD and 10 healthy adults were enrolled. All participants were asked to complete the requested ADL tasks involving upper limb elevation while recording activities of muscles of the accessory inspiratory muscles, as well as respiratory expenditure via the Delsys Trigno electromyography and Ultima CardiO2 system, respectively. Results: Muscle activity of the pectoralis major (PM) in the COPD group was significantly higher than that in the non-COPD group during washing both sides of the head (p < 0.05) and storing 2- and 4-kg objects on a shoulder-height shelf (p < 0.05). Ventilatory inefficiency and metabolic expenditure were significantly higher during the storage of objects at head height in the COPD group. A positive correlation was observed between sternocleidomastoid muscle activity and metabolic/ventilatory expenditure in the non-COPD group. However, muscle activity of the upper trapezius was significantly correlated with metabolic/ventilatory expenditure in the COPD group. Higher PM muscle activity and ventilatory inefficiency in the COPD group were found during performing ADLs involving upper limb elevation. Conclusions: Individuals with COPD demonstrated increased accessory inspiratory muscle activity, reduced ventilatory efficiency, and higher metabolic expenditure during ADLs involving upper limb elevation compared to healthy controls. The PM in the COPD group was the major accessory inspiratory muscle for performing ADLs involving upper limb elevation. These findings could inform recommendations for individuals with COPD to adjust their strategies for upper limb elevation while performing ADLs. Training of the larger accessory inspiratory muscles in rehabilitation programs has also been considered to enhance ADL performance in individuals with COPD. Trial Registration: ClinicalTrials.gov identifier: NCT04146948.

Objective: This study is aimed at testing the immediate and retained treatment efficacies of digital mirror therapy (DMT) and digital action observation therapy (DAOT) on clinical outcomes in chronic stroke patients, in comparison with dose-matched, active control rehabilitation (CR). Methods: Nineteen patients were randomly assigned to the DMT, DAOT, or CR for 3 weeks. Outcome measures, including the Fugl-Meyer Assessment of the Upper Extremity (FMA-UE), Chedoke Arm and Hand Activity Inventory (CAHAI), Revised Nottingham Sensory Assessment, Motor Activity Log (MAL), and visual analogue scale of the EQ-5D-5L, were conducted at preintervention (T0), postintervention (T1), and 1-month follow-up (T2). Results: There were no significant differences among the three groups on the outcomes at different time points. However, in the DMT group, scores were significantly higher on the FMA-UE and the CAHAI at T2 than at T0; in the DAOT group, those on the FMA-UE and the quality of movement subscale of the MAL were significantly higher at T2 than at T0. In the CR group, scores on the FMA-UE and the CAHAI were significantly higher at T1 than at T0. Conclusions: Both DMT and DAOT had retained treatment effects on motor function. DMT and DAOT might be feasible as alternative intervention strategies for chronic stroke patients. Trial Registration: ClinicalTrials.gov identifier: NCT04441190.

Despite the critical role of occupational therapists in healthcare, there has been limited focus on understanding their job satisfaction compared to other health-related disciplines. This gap is significant as job satisfaction among occupational therapists profoundly influences employee morale, client care, and organizational dynamics. This study explored factors influencing occupational therapists' job satisfaction through an ecological lens to enhance their work environments, promoting both personal and professional growth. A scoping review of qualitative evidence was conducted from 1921 to 2024 via CINAHL, Medline, Scopus, and AMED, including 10 qualitative articles. Thematic analysis was used to identify key themes. Four key themes were identified impacting job satisfaction including humanistic values driving professional fulfillment, professional identity and recognition, workplace structural barriers, and advocacy and strengthening approaches. Although occupational therapists find their job rewarding and fulfilling because of its client-centered care, they confront challenges particularly with professional recognition, career identity, and limited support. To enhance their job satisfaction, a more system-level ecological approach is required to enhance the leadership approaches, mentorship, communication channels, and collaboration opportunities.

Occupational therapy (OT) is an emerging healthcare profession in Vietnam, with limited awareness and understanding among local healthcare professionals (HCPs). This study is aimed at assessing the impact of an educational intervention designed to improve HCPs' knowledge and attitudes toward OT in Vietnamese healthcare settings. Utilizing a mixed-methods approach, the study involved 13 participants from Da Nang Orthopedics and Rehabilitation Hospital and Da Nang Psychiatric Hospital, representing various healthcare disciplines. The intervention included a series of journal club sessions focused on the principles, scope, and culturally relevant applications of OT. Quantitative data from pre- and postintervention assessments revealed significant improvements in HCPs' general knowledge of OT, its practice areas, and goals, with statistical significance observed in multiple domains. Qualitative data collected through field notes and reflective journals provided additional insights into HCPs' evolving perceptions of OT's role in holistic and mental healthcare. Notably, the study highlighted cultural factors, such as family involvement in patient care, which align with OT's client-centered approach but may also pose challenges in the integration of OT services. Barriers to OT adoption, including resource limitations and institutional support, were identified, underscoring the need for ongoing advocacy and resource allocation to sustain the progress achieved through the intervention. The findings suggest that culturally tailored educational programs are essential for the effective integration of OT in Vietnam and similar contexts. This research contributes to the global understanding of OT's role in diverse healthcare environments, providing a framework for expanding OT services in emerging regions.

Introduction: Weighted blankets are an intervention used in healthcare settings for alleviating anxiety and sleep problems. Selection of appropriate outcome measures that capture relevant effects is important in clinical practice and research. However, outcomes used are diverse and not standardised. Therefore, this scoping review is aimed at identifying, synthesising, and describing available research and used outcome measures in research studies evaluating weighted blankets. Methods: A scoping review was conducted, with a search of four databases. The search included studies published until February 2024. Results were categorized according to target population (adult or child) and primary outcome (sleep or anxiety). A conceptual map was developed to describe outcome measures used in the field. Results: A total of 38 studies were identified, including 12 randomised controlled trials, 13 pre-post-studies, 6 case studies, 3 register studies, and 3 qualitative studies. The State-Trait Anxiety Inventory and the Anxiety Visual Analogue Scale were commonly used outcome measurements in evaluation of weighted blanket effects on anxiety and most commonly conducted in an adult population. There was considerable heterogeneity in the outcomes used, particularly within the domain of sleep. In studies evaluating weighted blankets as a sleep intervention for children, objective measurement methods such as actigraphy were common, as was the use of a sleep diary. Conclusion: Even though there is extensive research available evaluating weighted blanket use and effects, there is a lack of standardised outcome measures and instruments are not adapted to use within occupational therapy practice. More research is necessary, informing clinical practice about which measures to use and when. Furthermore, there is a need to develop an instrument specifically tailored for use within occupational therapy practice to evaluate sleep interventions.

Introduction: In this study, we aim to apply BIG to patients with schizophrenia to confirm changes in mental symptoms, task performance, and occupational balance through motor and cognitive enhancement. Method: This study used a single-subject A-B-A design. It consisted of a total of 22 sessions, with 4 sessions in the baseline period, 16 sessions in the intervention period (Lee Silverman Voice Treatment-BIG), and 2 sessions in the follow-up period. The subjects were three male patients diagnosed with chronic schizophrenia, all severe cases. During the 22 sessions, the timed up and go test (TUG) and functional reach test (FRT) and the Montreal Cognitive Assessment (MoCA) were used to determine changes in motor function and cognition, and the subjective cognitive and mental score (SS), Canadian Occupational Performance Measure (COPM), and Occupational Balance Questionnaire-Korean (OBQ-K) were used to determine changes in psychiatric symptoms, work performance, and work balance satisfaction before and after the intervention. Statistically significant changes were determined using the two standard deviation (2SD) band method. Results: The TUG, FRT, and MoCA showed significant results in the intervention period compared to the baseline period. The SS, COPM, and OBQ-K also showed positive changes in scores from pre- to postintervention. Conclusion: In this study, BIG was found to promote improvement in motor and cognitive function in chronic schizophrenia patients, with positive effects on psychiatric symptoms, task performance, and occupational balance satisfaction.

Objective: The purpose of this study was to determine the impact of client-centered occupational therapy intervention on the mental health, activities of daily living (ADL), and community participation of older adults with depression. Methods: This study was a single-blind, randomized controlled study conducted on older adults with depression, and those who met the selection and exclusion criteria were randomly divided into an experimental group of 15 people and a control group of 15 people. The experimental group performed client-centered occupational therapy intervention using the Canadian Occupational Performance Measure (COPM) and Barth Time Construction (BTC), and the control group performed case management and a strength-brain exercise program. Both groups underwent intervention twice a week for 60 min, for a total of 16 sessions. Before and after the intervention, depression, anxiety, stress, ADL, and community partitioning were measured using assessment tools with proven reliability and validity in both the experimental group and the control group. Results: The experimental group exhibited significant changes after the intervention in depression, anxiety, stress, social integration, and community integration scores (p < 0.05 and p < 0.01), while the control group showed significant changes only in depression scores (p < 0.05). As a result of comparing the amount of change between the experimental and control groups, significant differences were found in social integration among the areas of depression, stress, and community integration (p < 0.05 and p < 0.01). Conclusion: These results suggest that client-centered occupational therapy intervention could serve as an effective intervention for improving mental health, ADL, and community participation in older adults with depression. Trial Registration: Korea Clinical Research Information Service (CRIS): KCT0009358.

Background: Individuals with intellectual disability (ID) exhibit various problems, such as attention, learning, and physical-motor difficulties. The study is aimed at investigating the effects of video game-based therapy programs on cognitive and physical functions in individuals with ID. Methods: The study, conducted through a three-arm randomized trial, involved 45 adults aged 18-30 with mild to moderate ID. Participants were divided into three groups: Group 1 received home-based video game-based therapy, supervised video game-based therapy, and occupational therapy-based activity training. Group 2 received video game-based therapy supervised by a therapist and an occupational therapy-based activity training program. Group 3 received occupational therapy-based activity training only. MOXO d-CPT was used to evaluate attention; sit-to-stand test, joint position sense, and nine-hole peg test were used to assess physical-motor functionality. Results: Results showed significant improvements in attention, functional performance, proprioception, and fine motor skills in all groups (p < 0.05). Group 1 was superior to Group 3 in nondominant JPS-flexion, sit-to-stand test, and nondominant JPS-abduction parameters (p < 0.017). When comparing Group 1 and Group 2, Group 1 was found to be more effective in the sit-to-stand test parameter compared to Group 2 (p < 0.017), while the other parameters of the two groups were similar to each other (p > 0.017). There were no significant differences between groups for different outcome measures (p > 0.017). Conclusion: The study suggests that video-based game exercises combined with occupational therapy interventions can effectively enhance cognitive functions, functional performance, proprioception, and fine motor skills in adults with ID. Trial Registration: ClinicalTrials.gov identifier: NCT06097819.

Introduction: The application of the person-environment-occupation-performance (PEOP) model in occupational therapy education offers valuable insights into the interaction between person, environment, and occupational factors and how these elements influenced the strategies used to adapt and navigate the transformation of health professions education during the COVID-19 pandemic. This study explored how individual characteristics, contextual demands, and the nature of educational occupations shaped the adaptation and performance of educators and students. Materials and Methods: The study used a qualitative, exploratory research design at a public higher education institution (HEI) in South Africa, focusing on the occupational therapy program. Purposive sampling was used to recruit key participants (n = 44), including management, academic educators, clinical supervisors (academics), academic support educators, and occupational therapy students. Data collection occurred via the Zoom platform for 45-60-min semistructured interviews. Thematic analysis, guided by the PEOP model, was employed to analyze qualitative data, which was recorded, transcribed, and coded using NVivo (Version 12 Pro). The study ensured trustworthiness and adherence to ethical principles. Results: The PEOP model was used as a framework to formulate the themes, namely, (1) person, (2) environment, (3) occupation, (4) occupational performance, and (5) occupational performance and participation. In the context of occupational therapy education, particular emphasis was placed on the adaptations and responses of educators and students as they navigated the demands of their educational occupations during the pandemic. Discussion: The curriculum underwent rapid adjustments, requiring theoretical instruction and clinical practice modifications. These changes posed significant challenges and highlighted pre-existing gaps within HEIs, as experienced by educators and students. Conclusions: This study highlighted the importance of supporting optimal occupational performance among educators and students, emphasizing the necessity of providing adequate resources and support. This ensures the well-being of educators and students, enabling effective engagement and participation as they navigate the evolving educational landscape.

Purpose: This study explored the administration of goal attainment scaling (GAS) by entry-level occupational therapy (OT) students, examining their competency following minimal training. While GAS is valuable for measuring progress toward individualized client goals, its implementation requires specific skills and training that may challenge entry-level practitioners. Method: Using retrospective data from a study of sensory garments' effects on children with autism spectrum disorder (ASD), we analyzed GAS administration by five entry-level OT students. Students received both indirect training through their curriculum and 3 h of direct research-specific preparation. Using a modified version of the GAS checklist, we evaluated students' competency through video recordings of GAS administration sessions and written GAS. Results: Analysis revealed variable competency levels among students. While overall performance met 82.4% of checklist criteria, individual student competency varied considerably (54.5%-95.4%). Three of five students achieved the established 75% competency threshold. Students consistently met criteria for conceptual goal construction and timeframe specification but struggled with maintaining single dimensions of change and specifying observable behaviors. Conclusions: Entry-level OT students demonstrated varying levels of competency in GAS administration following minimal training. Our findings suggest the need for more comprehensive training in specific aspects of GAS, particularly in scale construction and behavioral specification. These results have important implications for how OT programs prepare students to implement GAS in clinical practice.