Hong Kong Journal of Occupational Therapy最新文献

Background/Objective

Motor coordination impairment is common in children with neurodevelopmental disorders such as autism spectrum disorder (ASD) and attention deficit/hyperactivity disorder (AD/HD). The purpose of this study was to investigate the relationship between motor coordination, cognitive ability, and academic achievement in Japanese children with neurodevelopmental disorders.

Methods

Thirty-four school-age (6–12 years old) children with neurodevelopmental disorders and 34 age-matched typically developing (TD) children were recruited in this study. Correlations between the scores of the Movement Assessment Battery for Children-2 (M-ABC2) and the Kaufman Assessment Battery for Children – Second Edition (K-ABCII) that assesses cognitive abilities, and academic achievement were analyzed.

Results

The children with neurodevelopmental disorders obtained a lower total score and all component scores on M-ABC2 compared to the TD children. In children with neurodevelopmental disorders, M-ABC2 Manual Dexterity score was significantly correlated with K-ABCII Simultaneous Processing (r = .345, p = .046), Knowledge (r = .422, p = .013), Reading (r = .342, p = .048), Writing (r = .414, p = .017), and Arithmetic (r = .443, p = .009) scores. In addition, M-ABC2 Balance score was significantly correlated with K-ABCII Learning (r = .341, p = .048), Writing (r = .493, p = .004), and Arithmetic (r = .386, p = .024) scores.

Conclusion

These findings stress that it is essential to accurately identify motor coordination impairments and the interventions that would consider motor coordination problems related to cognitive abilities and academic achievement in Japanese children with neurodevelopmental disorders.

Background/Objective

Limb activation is one of the behavioural interventions to improve unilateral spatial neglect (USN). However, the effect of passive limb activation on activities of daily living (ADL) is not clear. This study examined the effect of passive limb activation by functional electrical stimulation (FES) on wheelchair driving for patients with USN, and to discuss the possibility of application of this treatment to occupational therapy.

Methods

A single subject design-baseline-intervention-baseline (ABA′), was applied to 2 stroke patients with USN. Phase A and A′ consisted of the wheelchair driving task only. Phase B consisted of the wheelchair driving task with FES. Each phase lasted for 2 weeks. The wheelchair driving task was maneuvering on a square passage in the clockwise and counter clockwise conditions for 8 minutes respectively, and four obstacles were set at each side. FES was applied to the affected forearm extensor muscles. Assessor recorded: 1) The distance participants drove wheelchair for 8 minutes, and 2) The number of collisions with obstacles and the wall, for 10 days.

Results

For one participant, the distance of maneuvering significantly increased in phase B (p < .05.), and USN on the cognitive test in the extrapersonal space indicated a tendency to improve after phase B.

Conclusion

Passive limb activation by FES improved wheelchair driving and cognitive performance for patients with USN. It can be used with instruction from occupational therapists to enhance the performance on ADL.

Objective/Background

Most parents of children with autism spectrum disorder (ASD) have difficulties with the selective eating behaviour of their children. This study aimed to develop a newly designed intervention programme on improving selective eating behaviour for parents of children with ASD and evaluate its effectiveness.

Methods

The participants were 23 parents of children (aged 3–6 years) with ASD. The education programme included a session that addressed approaches to improve selective eating and attitudes at meal times, with a discussion. The intervention aimed to identify the underlying factors and approaches to improve selective eating in children and the self-efficacy of parents.

Results

Significant differences were observed before and after the intervention in the degree of difficulty perceived by parents, their degree of self-efficacy, the number of recommendations conducted by them, their subjective view of the degree of dietary imbalance, and the number of food items consumed by their children.

Conclusion

We developed an interventional programme for parents of children with ASD and this programme was found to be useful. It is important for occupational therapists to consider the factors and approaches for selective eating in children with ASD in order to provide early intervention for their parents.

Background/Objective

Mindfulness-based intervention has received more clinical interest and empirical support for individuals with ADHD especially to improve attention. However, no systematic review has been done to analyze and compare the effectiveness of mindfulness-based intervention on individuals with ADHD in different age groups. This review examined its effectiveness for individuals (children, adolescents and adults) with ADHD to improve attention.

Methods

In 7 databases, totally of 152 studies were identified; 9 met the inclusion and exclusion criteria and were reviewed. Five of the studies recruited adults as the participants, two recruited adolescents as the participants, one recruited both adults and adolescents as the participants and one recruited children as the participants.

Results

It was found that mindfulness-based intervention was comparatively more popularly used in adults with ADHD to improve attention, and the improvement was significant.

Conclusion

It is still unclear whether mindfulness-based intervention is effective for children and adolescence with ADHD due to limited studies available and the limitations of the study design in the reviewed studies. Therefore, more research in the future is required to answer the question.

Objective/Background

Occupational therapy that focuses on servicing clients demands motivated workers for quality service delivery. The objectives of this study were: (a) to determine the level of work motivation among occupational therapy graduates in Malaysia and (b) to determine if there is a difference in work motivation among these graduates based on work sector, job position, length of work experience, and gender.

Methods

This cross-sectional study recruited occupational therapy bachelor’s degree graduates using an online survey. The Work Extrinsic and Intrinsic Motivation Scale (WEIMS) was used to measure level of work motivation.

Results

Responses from 82 (60.3%) graduates (male: 26.8%; female: 73.2%) were analysed. Sixty-two (75.6%) graduates worked locally and 20 (24.4%) worked in foreign countries. The average Work Self-Determination Index (W-SDI) score for WEIMS is +11.38 with 78 (95.1%) of graduates demonstrated a self-determined motivational profile and 4 (4.9%) demonstrated a nonself-determined profile. Graduates in the private sector (13.10 ± 6.47) show significantly higher W-SDI score compared to those in the public sector (9.40 ± 6.06), p = 0.01. W-SDI scores appeared higher among clinician (11.67 ± 6.40), case manager (13.33), and others (14.90 ± 8.23); and those with work experience of 5–6 years (13.11 ± 6.90) and less than one year (12.65 ± 7.12). Male (10.29 ± 6.86) and female (11.79 ± 6.39) graduates shared equally high score. There is no significant difference in W-SDI score based on job position, length of work experience, and gender.

Conclusion

Occupational therapy graduates have high work motivation as evident by their self-determined profile. Only work sector imposes difference in work motivation among these graduates.

Objective/Background

Occupational therapists usually assess hand function through standardised tests, however, there is no consensus on how the scores assigned to hand dexterity can accurately measure hand function required for daily activities and few studies evaluate the movement patterns of the upper limbs during hand function tests. This study aimed to evaluate the differences in muscle activation patterns during the performance of three hand dexterity tests.

Methods

Twenty university students underwent a surface electromyographic (sEMG) assessment of eight upper limb muscles during the performance of the box and blocks test (BBT), nine-hole peg test (9HPT), and functional dexterity test (FDT). The description and comparison of each muscle activity during the test performance, gender differences, and the correlation between individual muscles' sEMG activity were analysed through appropriate statistics.

Results

Increased activity of proximal muscles was found during the performance of BBT (p < .001). While a higher activation of the distal muscles occurred during the FDT and 9HPT performance, no differences were found between them. Comparisons of the sEMG activity revealed a significant increase in the muscle activation among women (p = .05). Strong and positive correlations (r > .5; p < .05) were observed between proximal and distal sEMG activities, suggesting a coordinate pattern of muscle activation during hand function tests.

Conclusion

The results suggested the existence of differences in the muscle activation pattern during the performance of hand function evaluations. Occupational therapists should be aware of unique muscle requirements and its impact on the results of dexterity tests during hand function evaluation.

Objective

To demonstrate the clinical application of the Korean version of the Modified Barthel Index (K-MBI) using Rasch analysis.

Methods

A total of 276 patients with neurological disorders were assessed with the K-MBI in outpatient clinics. The Rasch partial-credit model was used to generate a keyform based on investigating the psychometric properties of the K-MBI, including dimensionality, precision (person strata and reliability), and hierarchical item difficulty. The Minimal Detectable Change (MDC) in item difficulty was used to establish right-challenging treatment goals and long-term treatment plans.

Results

The findings demonstrated that the Korean version of the MBI satisfied the assumption of unidimensionality. It also showed a hierarchical structure in terms of item difficulty, good reliability (Cronbach alpha, 0.92), and approximately five distinct person strata (4.6). The MDC (raw score, 20.1) of the item difficulty of the test items demonstrated equivalent cut-off scores for targeted short-term treatment goals on the keyform, a Rasch-derived display of patient responses. Long-term treatment goals were identified based on the test items of the keyform.

Conclusions

The findings suggest that a Rasch keyform can be applied to clinical practice in Korean settings by identifying clinically and statistically meaningful test items and their step thresholds as short- and long-term goals.

This paper builds upon the first in the series on psychospiritual integration (PSI) and examines the concept of transformative occupations and the process of change underpinning occupational therapy from a PSI perspective. A repertoire of new terms highlighting finer distinctions in the concept of occupation will be introduced and explained, as will the dynamic for transformation inherent in the psychospiritual integration change process. Suggestions for PSI-informed occupational therapy practice will be explored.

Objective/Background

The aim of the paper was to investigate the leisure time physical activity (LTPA) among Polish employed and unemployed women in light of meeting the World Health Organisation (WHO) recommendations and analysed its relationship with employment status. The concept of personal responsibility for a healthy lifestyle plays in the modern times a crucial role here and is an integral part of the prevention process (including the necessity for LTPA).

Methods

A sample (n=527) of Polish women was surveyed by the long form of International Physical Activity Questionnaire (IPAQ-LF), with statistically significant differences between variables (intensity and duration of the activity vs. employment status), in the model being verified by chi-square testing. Multi-variable logistic regression analysis was performed to find the relationship between socio-demographic criteria and the amount of exercise recommended by WHO. The relationship between LTPA and the amount of exercise recommended by WHO was assessed using the log-linear analysis.

Results

Over one-third of the respondents did not engage in any LTPA (employed – 38.6 and unemployed – 36.6%). Employed women engaged in vigorous exercises more often (18.2%) than those who were unemployed (5.8%). The amount of LTPA undertaken by the majority of respondents (58.7% employed and 65.2% unemployed) was not sufficient to maintain their health owing to lack of walking, moderate and vigorous LTPA.

Conclusion

Polish women nowadays (regardless of whether they are employed or not) still do not engage in a sufficient amount of LTPA to maintain their health. Intervention programme in both groups is needed.

Background

Small scale shared housing arrangements (SHAs) is a deinstitutionalized model of care designed to resemble a typical home of <10 people and are increasingly available for persons with neurocognitive disorders of the Alzheimer's and related types (NCD). However, there is little aggregate evidence of their effect on persons with NCD thus, a literature review was performed.

Methods

Database searches were conducted across CINAHL Complete, OTseeker, PubMed, Ovid, Academic One File, ProQuest Nursing and Allied Health, the World Wide Web and Google Scholar using the several key words that included neurocognitive disorders, Alzheimer's, dementia, quality of life, well-being, occupational performance, activities of daily living, small scale shared housing, sheltered housing and group homes. Bibliographic references from final articles were also examined. Selection criteria involved three steps: screening perspective articles by title and abstract, assessing full text for eligibility and finally, reviewing full-texts.

Results

16 studies were selected for final review where most found the association of SHAs with various occupational performance indicators unique to the NCD population better than or equal to controls (traditional models of long term care). A small minority of studies had mixed or inconclusive results. No study found SHAs necessarily worse than controls.

Conclusion

The SHA model has many benefits for person's with NCD and may be especially advantageous for those in the early stages of the disease process. The occupational therapy profession should continue to raise awareness of SHAs and consider ecological theory as a valid basis for their expansion.