Hong Kong Journal of Occupational Therapy最新文献

Adult neurogenesis, defined as the generation of new neurons in adulthood, has been a fascinating discovery in neuroscience, as the continuously replenishing neuronal population provides a new perspective to understand neuroplasticity. Besides maintaining normal physiological function, neurogenesis also plays a key role in pathophysiology and symptomatology for psychiatric conditions. In the past decades, extensive effort has been spent on the understanding of the functional significance of neurogenesis in psychiatric conditions, mechanisms of pharmacological treatment, and discovery of novel drug candidates for different conditions. In a clinical situation, however, long-term rehabilitation treatment, in which occupational therapy is the key discipline, is a valuable, economical, and commonly used treatment alternative to psychotropic medications. Surprisingly, comparatively few studies have investigated the biological and neurogenic effects of different psychiatric rehabilitative treatments. To address the possible linkage between psychiatric rehabilitation and neurogenesis, this review discusses the role of neurogenesis in schizophrenia, major depression, and anxiety disorders. The review also discusses the potential neurogenic effect of currently used psychiatric rehabilitation treatments. With a better understanding of the biological effect of psychiatric rehabilitation methods and future translational studies, it is hoped that the therapeutic effect of psychiatric rehabilitation methods could be explained with a novel perspective. Furthermore, this knowledge will benefit future formulation of treatment methods, especially purposeful activities in occupational therapy, for the treatment of psychiatric disorders.

Background/Objective

The aim of this study was to examine the reliability and validity of the Chinese version of the School Function Assessment (SFA) for primary school students with cerebral palsy (CP) in Guangzhou, China.

Methods

Ninety-three students with CP were recruited by convenience sampling from a special school. The Chinese version of the SFA was administered and an exploratory factor analysis with direct oblique rotation was used to extract the factor structure underlying the Activity Performance scales of the SFA. An intraclass correlation one-way random single measure was performed to study external reliability. Cronbach's alpha was used to study internal consistency.

Results

The findings showed that the Chinese version of the SFA had high internal consistency with test–retest reliability [ICC (1, k) = 0.49–0.97].

Conclusion

This study has established the applicability of the SFA for both clinical and research purposes in the Chinese population, and presented evidence of satisfactory psychometric properties in use with primary school students with CP in special schools.

Background/Objective

Recent evidence showed that golf can develop balance amongst the elderly. This study aimed at evaluating if exergaming, in particular cyber-golfing, can be a feasible and inexpensive alternative to this valuable exercise.

Methods

Twenty healthy community-dwelling elderly were recruited, and they were randomly assigned to either the experimental group (n = 10) or the control group (n = 10). Daily cyber-golfing training for 2 weeks was assigned to the participants of the experimental group, where regular table games with equal lengths and durations were arranged for the control group.

Results

The results revealed that the participants in the experimental group showed significantly better post-training performances in the functional-reach test, F_(2,17) = 5.16, p = .04, and single-leg-stance test, F_(2,17) = 5.32, p = .03, than those in the control group.

Conclusion

The results of this study suggest that cyber-golfing might be an alternative to golfing, which is capable of enhancing balance ability amongst community-dwelling elderly. The potential of exergaming as a clinical tool for geriatric rehabilitation was discussed.

Background/Objective

The Everyday Technology Use Questionnaire (ETUQ), which evaluates the perceived relevance of and the perceived ability in everyday technology (ET) use, has demonstrated acceptable psychometric properties in Swedish studies of older adults. The aim of this study was to examine the reliability and validity of the ETUQ in a Japanese context in older Japanese adults.

Methods

A sample of older Japanese adults (n = 164) including persons with (n = 32) and without (n = 132) cognitive impairment was interviewed with the ETUQ, including original items (ETs) and added Japanese context-specific items. Data were analyzed using a Rasch measurement model.

Results

The analysis demonstrated acceptable functioning of the rating scale, internal scale validity, person response validity, and person-separation reliability of the Japanese ETUQ according to the Rasch model. However, evidence supporting unidimensionality in the Japanese ETUQ was not consistent in this sample. The added Japanese items did not significantly change the estimated individual person measures of perceived ability to use ET.

Conclusion

The Japanese ETUQ seems to be a sensitive tool to evaluate perceived ability in ET use among elderly people in Japan with and without cognitive impairment. Therefore, it could be used in research and clinical practice.

Background/Objective

Pressure injuries are a common yet largely preventable complication of hospitalisation. Whilst occupational therapists commonly prescribe pressure-relieving devices to reduce these risks, evidence to support clinical decision-making is limited. The purpose of this study was thus to examine research literature as to the efficacy of pneumatic cushions for general acute/subacute patient populations.

Methods

A systematic search of various databases was conducted, and the literature was then appraised using standardised inclusion/exclusion parameters.

Results

Three randomised controlled trials were identified that met search criteria.

Conclusion

Whilst there is currently preliminary evidence to support the effectiveness of pneumatic pressure-relieving cushions as compared to standard foam, specific recommendations as to a preferred make/model of cushion for use within general hospital settings are not supported at this time.

Background/Objective

This study reviewed the current evidence on the effectiveness of mirror therapy (MT) on improving the motor functions of the hemiplegic lower extremity (LE) in adult clients with stroke.

Methods

A systematic review was conducted of studies published in English in the 10-year period 2005–2015, retrieved from seven electronic databases: Medline, PubMed, CINAHL, PsychInfo, Science Direct, Cochrane and TBI Rehabilitation. Only articles that focused on the effects of MT on hemiparesis affecting LE function and performance were included. The methodological quality of the studies was appraised using the Physiotherapy Evidence Database Scale (PEDro).

Results

The literature search yielded 14 studies that satisfied the selection criteria, of which five (4 randomised controlled trials and 1 case study) were reviewed after screening. Despite the heterogeneity of the studies, they showed MT to be effective in improving some of the motor functions of the LE at different stages of stroke. However, they offered little evidence on MT's long-term effects and for when is the optimal stage to start MT after stroke onset.

Conclusion

Further research is needed to determine the best treatment regimen and optimal time to initiate MT intervention in terms of the phases of stroke. No firm conclusions can be drawn on the effectiveness of MT on the hemiplegic LE until more evidence is available.

Background/Objective

To evaluate the functional outcomes of moderate to severe burn patients with and without rehabilitation in terms of self-care performance and quality of life (QOL).

Methods

Fifty-five patients with total burn surface area of 30% or more were divided into two groups: rehabilitation and conventional care groups. The rehabilitation group underwent comprehensive rehabilitation interventions (e.g., occupational therapy, physiotherapy, and patient and family education) in addition to standard clinical interventions received by the conventional care group. The outcomes included self-care performance (Modified Barthel Index [MBI]), QOL (World Health Organization Quality of Life-BREF), pain and itchiness (Visual Analogue Scale [VAS]), quality of sleep, and mental health (Self-Rating Depression Scale [SDS] and Self-Rating Anxiety Scale) measured before and 3 months after the intervention.

Results

After the intervention, significant improvements were found in MBI, all dimensions of QOL, pain, and SDS in the rehabilitation group (all p < .05). In the conventional care group, significant improvements were found only in MBI (p < .001), the physical health dimension of QOL (p < .01), and pain (p < .001). Group comparisons showed that the rehabilitation group achieved significantly better outcomes after the intervention in MBI (p < .001), VAS score of itching (p = .009), and the physical health (p = .002), psychological health (p = .021), and social relationships dimensions of QOL (p < .001).

Conclusion

Patients with moderate to severe burn injuries can benefit from rehabilitation interventions in terms of physical health, mental health, performance of daily living, and QOL.

Background/Objective

Functional recovery for stroke survivors begins with rehabilitation. It may not be feasible for therapists to supervise all rehabilitation, especially in the home environment. Therefore, adherence to prescribed exercise programmes is important. The objective of this study was to determine the effect of a written and pictorial home exercise prescription on adherence to a home exercise programme in patients with stroke.

Methods

This was a randomised controlled trial with a blinded assessor. The control group received a home exercise programme with verbal instructions, while the intervention group received the same home exercise programme with verbal instructions but with additional written and pictorial instructions for the exercises. An exercise logbook was used to monitor adherence. The Modified Rivermead Mobility Index (MRMI) and Barthel Index (BI) were used to establish mobility and activities of daily living.

Results

There were a total of 42 participants, with 21 in each group; mean age was 60.8 ± 15.5 years. Forty (95%) of the participants had suffered a stroke less than 4 months prior to the study. Both control and intervention groups had similar outcomes: there was no significant difference between groups with regard to functional ability (MRMI, p = .40; BI, p = .65) and adherence (p = .53). The relationship between functional ability (MRMI and BI) and the level of adherence for both the control and intervention groups was not statistically significant.

Conclusion

The addition of a written and pictorial home exercise prescription does not lead to better adherence to a home exercise programme compared to having no written and pictorial instructions. Possible reasons may be that patients had caregivers as a support system, and the exercise logbook served as a reminder and motivational track record for patients. There also does not appear to be a relationship between functional ability and level of adherence, which may be due to most of the study participants being within the optimal time frame for spontaneous functional recovery. Further study at different time frames in stroke rehabilitation in different contexts is recommended.

Objective/Background

Children with cerebral palsy (CP) need more attention and care, especially from their mothers. This can affect the mothers' quality of life (QOL) adversely. This study aimed to assess the QOL of Iranian mothers who have a child with CP, compared with mothers with a healthy child, focusing on some individual and social underlying factors.

Methods

Using a cluster-sampling approach, two groups of eligible mothers having children aged 4–12 years, with and without CP, from Tehran's randomly selected clinics, were chosen in a convenient way and enrolled in a cross-sectional study. A group of mothers with healthy children whose demographics closely matched with the group of mothers having children with CP were selected and recruited in the study. The group with mothers with children with CP was selected randomly from a convenience sample in 14 rehabilitation and occupational therapy clinics in Tehran, Iran. To collect data on characteristics of interest, mothers were interviewed, and the SF-36 Questionnaire was used to measure their QOL. The relationship between each characteristic and the mothers' level of QOL was assessed, and the crude odds ratios (ORs) and adjusted ORs were measured by logistic regression.

Results

Sixty mothers with CP children, and 60 mothers with healthy children participated in this study. Their mean (±standard deviation) age was 33.79 (±6.02) years, and their children's mean age was 7.11 (±2.71). The two groups were significantly different in QOL mean score (57.35 ± 18.39 vs. 71.7 ± 13.58; p ≤ .001). It was shown that having a child with CP with intellectual disability is significantly related to a worse level of QOL of mothers (adjusted OR = 5.4, p ≤ .001), whereas having full-time jobs is reversely associated with it (adjusted OR = 0.2, p = .02).

Conclusion

Two important factors that lead to a worse QOL of mothers with a CP child are the unemployment of mothers and having a CP child with concurrent intellectual disabilities. To diminish the adverse effects of having a CP child on QOL of mothers, unemployed women who have a CP child with concurrent intellectual disabilities need more psychological support and help.

Objective/Background

Oral-motor and sensory dysfunctions are primary reasons for difficulties with swallowing in children with cerebral palsy (CP). Neuromuscular electrical stimulation (NMES) has been shown to provide positive effects on the swallowing function in adult populations with various neurological disorders. However, there is a lack of studies regarding the effects of NMES in children with dysphagia. The aim of the present study was to investigate the effects of NMES and oral sensorimotor treatment (OST) by occupational therapists in children with CP and dysphagia.

Methods

The present study was a two-group experimental design. Participants were randomly assigned to either the experimental group (n = 10) or the control group (n = 10). The NMES group received both NMES and OST, with NMES on the pharyngeal level for 20 minutes after OST, while the control group received OST and sham–NMES only. The treatment sessions occurred twice a week for 8 weeks.

Results

The experimental group demonstrated a significant improvement in: lip closure while swallowing, ability to swallow food without excess loss, ability to sip liquid, ability to swallow liquid without excess loss, and ability to swallow without cough (p < .05).

Conclusion

This study demonstrated that OST and NMES facilitated swallowing functions than OST and sham–NMES in children with CP and dysphagia. Future studies need to utilise video fluoroscopy swallowing study for outcome measurements in a large participant group.