Changes arising from acquired brain injury may influence how individuals engage in valued community-based occupations such as driving. ‘Lifespace’ describes the area within which a person lives their life and represents opportunity for participation in out-of-home occupations. This study explored lifespace trajectory from pre- to 6 months post-occupational therapy driver assessment, to understand how, why, where, and with whom access and participation in community-based occupations is influenced by assessment outcome.
Adults with acquired brain injury referred for occupational therapy driver assessment were recruited to the mixed methods study involving a travel diary, lifespace assessment, and semi-structured interviews. Qualitative analysis was guided by interpretive description.
No consumer and community involvement
Overall, 38 participants (55.3% male) aged 26 to 65 years reported increased lifespace 6 months following the conduct of an occupational therapy driver assessment. There was increased engagement in leisure pursuits (175%), work (23%), and social participation (21%) with reduced participation in health management (−50%) and instrumental activities of daily living (−15.4%) occupations post-OTDA. However, lifespace was significantly related to driver status, with those who had returned to driving more likely to access their community with greater frequency and less support (p < 0.001). Non-drivers experienced a deteriorating restricted lifespace. Analysis of semi-structured interviews (n = 12) created three broad themes that largely differed according to driver status: (i) ‘Being me’—reconstructing occupational identity, (ii) opportunities for participation and the influence of choice, and (iii) ‘Having connection’ and impacts on wellbeing.
Driver status influences the trajectory of lifespace following participation in an occupational therapy driver assessment after acquired brain injury. Drivers experienced increased lifespace with greater opportunities to control engagement in community-based occupations with flexibility and spontaneity. Non-drivers reported diminished lifespace and occupational participation trajectories and require further support to facilitate occupation
Developmental coordination disorder (DCD) impacts occupational participation in adulthood, yet little is known about its multidimensional pattern (including objective and subjective dimensions). This study explores the participation patterns of adults with DCD.
Fifty-five adults with DCD aged 21–35 (51% women) completed the young adults' daily activities participation scale.
No consumer and community involvement were included in this study.
Imbalanced patterns were noted, with a high frequency of participation but low levels of pleasure and performance in motor-related activities such as driving, cooking, and household-chores. Reduced frequency and low levels of performance, meaning, and pleasure were observed in fitness and sports, health management, shopping, bureaucratic and financial tasks, and spiritual or volunteering activities. Medium-low performance and low pleasure reported in most of the activities examined, except for interpersonal relationships and community and social life that reported with the highest level of performance, meaning, and pleasure.
Individuals with DCD may face participation challenges during adulthood, highlighting their need for occupational therapy services.
This study looked at how developmental coordination disorder (DCD) affects young adults' participation in their daily lives. The findings show that many adults with DCD have trouble with tasks like driving, finding their way, doing household chores, and taking care of themselves. However, even though they take part in social and leisure activities less often, they still enjoy these activities. Understanding these challenges can help create better support services and strategies for them. For example, occupational therapy can help people develop skills to perform daily tasks and enhance their enjoyment levels and confidence in performing these activities, leading to improved wellbeing.
De Quervain's stenosing tendinosis (DQST) is common in new mothers because of awkward wrist postures during repetitive mothering occupations such as nursing and lifting their baby. However, little is known about how DQST affects occupations of first-time mothers. This study aimed to explore the experiences of first-time mothers living with DQST and how it affects performance of their motherhood occupations.
A descriptive phenomenological study design was used. Participants were 15 first-time mothers of a child aged ≤24 months, with a current or previous diagnosis of DQST, and/or non-trauma-related symptoms of pain, tenderness, and/or swelling near the base of the thumb or wrist. Participants completed the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire and participated in semi-structured interviews.
No consumer and community involvement.
Five themes developed from interview data: (1) My everyday life is affected; (2) not being prepared and not knowing what to do; (3) learning to modify, adapt, and carry on; (4) perceived practicality of management options; and (5) the importance of education and early intervention. DASH disability scores ranged from 50 to 80 for participants with active symptoms.
DQST disrupted first-time mothers' occupational performance. Participants felt that until they developed DQST, they received insufficient information about it from health professionals during pregnancy and the first-year post-birth. Pain management options were often not practical when performing motherhood occupations. New mothers would benefit from preventative perinatal education about DQST and treatment options that consider their mothering occupations.
New mothers can develop a common upper limb condition called De Quervain's Stenosing Tendinosis (DQST), also known as ‘mummy's thumb’, which can make daily occupations difficult. This includes bathing, dressing, and helping their babies sleep. Fifteen first-time mothers with babies under 2 years old and DQST were interviewed and filled out a functional questionnaire. The res
There is a limited understanding of therapist acceptance and use of robot-assisted upper limb therapy (RT-ULT) in routine practice. The aim of this study was to explore the factors that influence Australian therapist acceptance and use of RT-ULT.
Two discipline-specific focus groups were conducted involving occupational therapists (n = 5) and physiotherapists (n = 4) who had used RT-ULT. Focus group questions were developed, and transcriptions analysed using the Theoretical Domains Framework (TDF). Additionally, participants scored the overall usability of the RT-ULT device with the System Usability Scale (SUS).
There was no direct involvement from consumers or community in this study.
Nine of the 14 domains of the TDF were covered in depth by participants during the focus groups: environmental context and resources, beliefs about consequences, knowledge, skills, decision-making, reinforcement, social influences, social/professional role and identity (single domain), and beliefs about capabilities. Physiotherapists recorded higher scores of the device on the SUS than the occupational therapists.
Both disciplines were accepting of RT-ULT, but it was physiotherapists who predominantly used RT-ULT in part due to the device being located in the physiotherapy rehabilitation gym. Other factors facilitating RT-ULT acceptance in practice included (1) increase in repetitive, intensive independent practice for stroke survivors, (2) ease of use, (3) strong patient acceptance, and (4) implementation process being clinician-led. Functional-based UL practice took priority over RT-ULT once stroke survivors demonstrated sufficient active movement and RT-ULT was not used in isolation but part of a combination of UL interventions.
There is a little known about what therapists think about using robot-assisted upper limb therapy in their daily practice. The aim of this study was to explore Australian therapist perceptions of the use of robotics.
Focus groups were conducted separately with five occupationa
Young children with unilateral cerebral palsy (CP) received a home-based training program using video coaching for parents. The primary aim of our study was to evaluate the effectiveness of unilateral training on the use of the affected arm and hand during bimanual activities and to explore factors that affect treatment response. Secondary, we evaluated whether effects were retained after an 8-week break, and if data were available, we explored the effects of a second uni- or bimanual training block. Furthermore, adherence was evaluated.
Explorative retrospective clinical study evaluating the effectiveness of the first 8-week training block on the (Mini-) Assisting Hand Assessment ((Mini-) AHA) unit score in 81 children aged 8–36 months. Pre- and post-intervention (T0–T1) and 8-week follow-up measurements (T2) were evaluated, and factors influencing treatment response were explored, using linear mixed models (LMM). Additionally, effects of a second training block were explored in 31 of the original 81 children, contingent upon data availability, with T3–T4 measurements included. Adherence, measured as percentage of treatment duration, was explored.
Mini-AHA and AHA unit scores significantly improved between T0 and T1, but did not change between T1 and T2. In children aged 18 months and older, baseline AHA scores were related to change scores. In children aged <18 months, no predictors of treatment response were identified. LMM showed significant improvement between T1–T3 and T1–T4 in Mini-AHA scores in children with a second training block. Adherence rates were 85% in the first and 81% in the second block.
Our data suggest that upper limb training using video coaching can improve hand use in infants and toddlers with unilateral CP, with retained effects after an 8-week break and further enhancement following a second training block. Individual results differed, and controlled studies are needed to strengthen the evidence. High adherence rates suggest the program's feasibility.
There was no direct consumer and community involvement in the study design.
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