Aim: This commentary discusses the concept of 'gamification' as referred to implicitly or explicitly in the occupational therapy literature. Although occasionally noted to be a new frontier for occupational therapy, our analysis suggests that game mechanics and gamification elements are, in fact, a 'road long traveled' by occupational therapists and that gamification evokes the core aims and vision of occupational therapy. Gamification has been implicitly incorporated into the occupational therapy literature for years, and its benefit of enhancing therapeutic outcomes is evident in many instances. We contend that a more explicit use of the term gamification within the occupational therapy literature will lead to a framework in which both practitioners and researchers can structure and evaluate therapeutic outcomes.
This study aimed to investigate the effects of an oropharyngeal motor training programme on children with Obstructive Sleep Apnea Syndrome (OSAS) in Hong Kong.
In this retrospective study, we reviewed the outcomes of 10 children with OSAS who had received an oropharyngeal motor training programme in Occupational Therapy Department of an acute hospital in Hong Kong over a 1-year programme. Each participant attended an individual oropharyngeal motor training programme plus a follow-up session after 2 months. The training programme consisted of 10 individual mobilization exercises involving the orofacial and pharyngeal area for 45 minutes. Each exercise had to be repeated for 10 times. Three outcome measures were chosen to study the effectiveness of the training programme including tongue strength, tongue endurance level and orofacial function. Tongue strength and tongue endurance level were assessed using the Iowa Oral Pressure Instrument (IOPI). The Nordic Orofacial Test-Screening (NOT-S) Assessment was used to assess the orofacial function. Seven out of 10 participants completed the training programme and attended the follow-up session after two months.
The tongue strength and the scores of NOT-S of the 7 participants were found to have significant improvement after training. However, there was no significant difference in tongue endurance level.
The findings of this study support the role of occupational therapist in oromotor training modalities to improve the respiratory function for children with OSAS in Hong Kong.
Hip fracture is associated with excess mortalities and high rate of hospital re-admission after discharge from the indexed episode. To improve related post-discharge care, we aimed to find out characteristics that were associated with related higher rates of mortality and hospital re-admission.
This was a historical cohort study with following up of 273 patients recruited in a local rehabilitation hospital for 3 years. The outcome of interest was cumulative mortalities and hospital re-admissions in the 1st 3 years after their discharge from the rehabilitation hospital. These outcomes were collected in the hospital data warehouse – the Clinical Data Analysis and Reporting System (CDARS). Eighteen predictors, as proposed by similar studies and our own review, were retrieved from our standard clinical forms as well as from the CDARS. Binary logistic regression was used to test their association with the outcomes and to generate the respective odd ratios.
The cumulative overall mortality rates at 0.5-, 1-, 2- and 3- year after hip fracture were 7.2%, 14.0%, 24.6% and 33.4% respectively, while the cumulative “1st ever hospital readmission” at 0.5-, 1, 2- and 3- years after hip fracture were 29.4%, 41.6%, 59.4% and 71.7% respectively. The most significant predictors i) for mortality at 3- year were: “Being male” (OR 5.33), “Delayed surgery >48 hours” (OR 2.65), “pre-operation albumin level <3.5 g/dl” (OR 2.66), and, ii) for “1st ever hospital readmission” at 0.5-year was “Being Assisted walker or non-walker (after rehabilitation)” (OR 3.83).
Characteristics that define the groups of patients with hip fractures with higher mortality and rate of hospital re-admission were identified. This could help healthcare professionals to focus on target patient groups for closer monitoring and more intensive post-discharge care.
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