Objective
Compare the effectiveness of a problem-solving, individualised, home-based occupational therapy intervention (ABLE 2.0), to usual occupational therapy, on activities of daily living (ADL) ...ability in persons with chronic conditions.
Design
A single-centre, double-blinded, randomised controlled trial with 10- and 26-week follow-up.
Setting
A Danish municipality.
Subjects
Persons with chronic conditions experiencing problems performing ADL tasks (n = 80).
Interventions
ABLE 2.0 was compared with usual occupational therapy.
Main measures
Coprimary outcomes were self-reported ADL ability (ADL-Interview Performance) and observed ADL motor ability (Assessment of Motor and Process Skills) at Week 10. Secondary outcomes were self-reported ADL ability (ADL-Interview Performance) and observed ADL motor ability (Assessment of Motor and Process Skills) at Week 26, and perceived satisfaction with ADL ability (ADL-Interview Satisfaction) and observed ADL process ability (Assessment of Motor and Process Skills) at Weeks 10 and 26.
Results
In total, 78 persons were randomly assigned: 40 to usual occupational therapy and 38 to ABLE 2.0. No statistically significant nor clinically relevant difference between group mean changes in primary outcomes was identified from baseline to Week 10 (ADL-Interview Performance −0.16; 95% CI: −0.38 to 0.06 and Assessment of Motor and Process Skills ADL motor ability −0.1; 95% CI: −0.3 to 0.1). At Week 26, a statistically significant and clinically relevant difference was found in Assessment of Motor and Process Skills ADL motor ability (LS mean change: −0.3; 95% CI: −0.5 to −0.1) between groups.
Conclusion
ABLE 2.0 was effective in improving observed ADL motor ability at 26 weeks.
Introduction
Handwriting skills play a significant role in all stages of an individual's life. Writing interventions should be considered at a younger age to ensure proper development of writing ...skills. Hence, the aims of this study is to evaluate the current evidence of occupational therapy interventions in handwriting skills for 4–6 year old children.
Methods
Published literature was systematically searched according to PRISMA guidelines using specific key terms. Initial search identified 785 studies; however only seven met the inclusion criteria and were assessed for final review. Studies were methodologically appraised using the McMaster Critical Review Form–Quantitative Studies.
Results
The review found no randomised control trial study design pertaining to the reviewed area. However, it can be seen that occupational therapy interventions for writing skills in 4–6 year old children managed to increase the targeted skills. The results were similar across samples with or without disabilities. An effective integration of occupational therapy interventions into educational curriculum was found to save both time and cost.
Conclusion
The long‐term benefit from these interventions and the effects of these interventions on a broader spectrum of fine motor abilities need to be explored further with stronger research designs. However, the lack of studies adopting high level study designs, i.e., RCT designs means, results need to be approached with caution by occupational therapists when implementing handwriting skills intervention in practice.
Occupational Therapy is among the top interventions for autistic children, hence the need for equitable and effective services in the public and private health and education sectors. Ongoing research ...into the therapies for autism spectrum disorders in different contexts is also required.
To explore and describe occupational therapists' assessment and intervention for autistic children in South Africa.
A descriptive qualitative research design using semi-structured interviews to gather data from purposively recruited OTs (n=20). Data were audio-recorded, transcribed and analysed thematically, and compared across three sectors public health, special needs schools and private practice.
South African practice across all three sectors was similar to international patterns of informal play-based assessment, sensory processing and Ayres Sensory Integration (ASI®) treatment. Developmental frameworks guided specific approaches. Strong team collaboration was present across sectors, with some transdisciplinary teamwork and co-treatment. Undergraduate and postgraduate training opportunities were, however limited.
Occupational therapy assessments had diagnostic value. Informal tools such as developmental checklists were found to have clinical utility, whilst standardised tools were most commonly used to assess sensory processing and visual perception. Recommendations included incorporating ASI® into undergraduate curricula and postgraduate training opportunities with multidisciplinary input to develop ASD professionals in South Africa. It is imperative to advocate for services in under-resourced rural areas and marginalised communities that lack financial and social resources. Occupational therapists need to find new ways of working collaboratively across sectors to ensure effective and comprehensive services in public health and special schools.
BACKGROUNDResearch is limited about how the introduction of new ways of delivering and conducting occupational therapy, in accordance with expected changes in health care, is experienced by ...occupational therapists (OTs).AIMTo explore how OTs experienced use of a new internet-based intervention, 'Strategies for Empowering activities in Everyday life' (SEE), focusing on supporting client resources to manage an active everyday life after stroke.MATERIAL AND METHODSA focus group study with periodical repeated discussion was designed. Four sessions during a period of 22 months were conducted with a total of four OTs.RESULTOverall, the results reflected that the OTs experienced that the use of SEE for persons with stroke was a valuable complement to existing rehabilitation. The process of introducing SEE included a multifaceted transition involving context, intervention process and delivery that renewed occupational therapy.CONCLUSIONThese results indicate how the use of new internet-based interventions such as SEE can influence and support renewal of occupational therapy that extends beyond the particular intervention. Continued research is needed to explore more aspects of SEE feasibility.
Background: Preschoolers with developmental disabilities are referred to occupational therapy due to their decreased participation in daily life occupations. The purpose of this study was to evaluate ...the improvement in preschoolers’ participation and sensory-motor abilities following an occupational therapy intervention. Materials and Methods: A prospective cohort study of 38 preschoolers and their parents was conducted using an interrupted time-series design, including assessments at three time points: base line (upon referral to an occupational therapy assessment), pre-intervention, and post-intervention after 9–12 sessions of occupational therapy interventions. Children were evaluated with the Developmental Test of Visual–Motor Integration, as well as the balance and fine motor precision sub tests of the Bruininks–Oseretsky Test of Motor Proficiency. Parents completed the Children’s Participation Questionnaire and the Child Performance Skills Questionnaire. Each intervention session was documented by the therapists using the Documentation of Occupational Therapy Session Intervention form. Results: Significant improvement in children’s sensory–motor abilities were found in balance, visual integration, and fine motor precision post-intervention. There were also improvements in the measures of diversity, children’s independence, and parental satisfaction. Conclusions: A short-term occupational therapy intervention applied to preschoolers with developmental disabilities is effective in improving their sensory–motor abilities, as well as in promoting their participation in daily activities.
Background: Occupation has been the focus in occupational therapy practice to greater or lesser degrees from a historical viewpoint. This evokes a need to discuss whether concepts that are added to ...our field will enhance or blur our focus on occupation.
Aim: To explore how the concept of participation in the International Classification of Functioning, Disability and Health (ICF) is related to the concept of occupation by reviewing and comparing its use in three models of practice within occupational therapy. The aim was also to generate discussion on possibilities and challenges concerning the relationship of participation and occupation.
Method: The models reviewed were The Model of Human Occupation (MOHO), the Canadian Model of Occupational Performance and Engagement (CMOP-E) and the Occupational Therapy Intervention Process Model (OTIPM).
Results: The concept of participation was related to occupation in different ways in these models. Based on the review some challenges and considerations for occupational therapy were generated.
Conclusion: Relating the concept of participation from the ICF to the concept of occupation in models of practice can be challenging. At the same time, relating the concepts can be a resource to develop occupational therapy and the understanding of occupational issues in society.
•We study the effect of grocery shopping skill training in patients with schizophrenia.•Executive function and instrumental activities of daily living were improved significantly after ...training.•Grocery shopping skill training might be useful in intervention for patients with schizophrenia.
To date, cognitive intervention to improve executive function for patients with schizophrenia has not been ecologically validated. Our main objective was to investigate the effectiveness of grocery shopping skill program on executive function and instrumental activities of daily living (IADL) of patients with schizophrenia. Among 20 patients with schizophrenia who received conventional rehabilitation, 10 patients were allocated to an experimental group and they additionally performed the program to improve grocery shopping skill in a real situation for eight sessions. The rest of participants were assigned to the wait-list group. To identify the effects on executive function, the Korean version of the Executive Function Performance Test (EFPT-K) was used. IADL was evaluated using the Korean Instrumental Activities of Daily Living (K-IADL). After the sessions, the EFPT-K (p < .001) and K-IADL (p < .05) were significantly improved in the experimental group. These results indicate that the program to improve grocery shopping skills might be clinically beneficial to enhance executive function and IADL of patients with schizophrenia.
The onset of bathing disability among older people is critical for a decline in functioning and has implications for both the individuals’ quality of life and societal costs. The aim of this study ...was to evaluate long-term cost effectiveness of an intervention targeting bathing disability among older people. For hypothetical cohorts of community-dwelling older people with bathing disability, transitions between states of dependency and death were modelled over 8 years including societal costs. A five-state Markov model based on states of dependency was used to evaluate Quality-adjusted life years (QALYs) and costs from a societal perspective. An intervention group was compared with a no intervention control group. The intervention focused on promoting safe and independent performance of bathing-related tasks. The intervention effect, based on previously published trials, was applied in the model as a 1.4 increased probability of recovery during the first year. Over the full follow-up period, the intervention resulted in QALY gains and reduced societal cost. After 8 years, the intervention resulted in 0.052 QALYs gained and reduced societal costs by €2410 per person. In comparison to the intervention cost, the intervention effect was a more important factor for the magnitude of QALY gains and long-term societal costs. The intervention cost had only minor impact on societal costs. The conclusion was that an intervention targeting bathing disability among older people presents a cost-effective use of resources and leads to both QALY gains and reduced societal costs over 8 years.
Background The ABLE intervention was developed to enhance the ability to perform activities of daily living (ADL) tasks among persons living with chronic conditions. ABLE is a generic, home-based, ...individualised, 8-week occupational therapy intervention program, developed to be delivered in Danish municipalities. In a previous study, the feasibility of ABLE was evaluated in terms of content and delivery. In this pilot study, the remaining feasibility aspects of a randomised controlled trial including (i) trial procedures (recruitment and retention), (ii) randomisation, (iii) adherence to program, (iv) feasibility of additional outcome measurements, and (iv) access to information on usual occupational therapy were evaluated. Methods The study was conducted in a Danish municipality, using a two-armed parallel randomised controlled design, planning a recruitment strategy including 20 persons living with one/more chronic conditions and experiencing problems performing ADL. The following progression criteria were used to determine if a future full-scale randomised controlled trial was feasible: (i) recruitment (50% met the eligibility criteria) and retention (80%), (ii) randomisation (80% accepted randomisation, procedure was executed as planned), (iii) adherence to program (100% followed the treatment protocol), (iv) outcome measurements (80% of the participants delivered relevantly and fully answered questionnaires), and (v) usual occupational therapy (extraction of needed information was successful). Results Due to the COVID-19 pandemic, the study was truncated resulting in limited but sufficient data to answer most of the study questions. (i) Eighteen of 37 eligible persons (48.6%) were recruited; of those treated (n = 6), all remained (100%); (ii) 18 accepted randomisation (100%), and procedure was effective; (iii) ABLE was delivered with adherence (100%); (iv) 92.3-100% of the participants gave relevant and complete answers in two of three questionnaires; and (v) needed information on usual occupational therapy was extractable in seven of nine aspects. Conclusions Proceeding to full-scale trial is recommendable; however, a few adjustments on outcome measurements, inclusion criteria and extraction of information on usual occupational therapy are needed. Trial registration The study was registered at ClinicalTrials.gov (Identifier: NCT04295837) on December 5th, 2019. Retrospectively registered. Keywords: ADL ability, Everyday life, Goal setting, Complex interventions, Occupational Therapy Intervention Process Model (OTIPM), Rehabilitation
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