Activities Of Daily Living Training Research Articles

#1874 Comparative analysis of rehabilitation outcomes in hospitalized hemodialysis vs. non-hemodialysis patients: a retrospective cohort study

Abstract Background and Aims The hospitalization rate of patients undergoing hemodialysis (HD) is high, due to complications related to renal failure and hemodialysis treatment. Therefore, it is crucial to provide rehabilitation for hospitalized HD patients to improve their activities of daily living (ADL) and physical functions, so as to enable them to be discharged home, resume outpatient dialysis, and avoid re-hospitalization. However, the effectiveness of rehabilitation to improve the ADL and physical functions may differ between hospitalized patients undergoing HD (HD patients) and hospitalized patients not undergoing HD (non-HD patients), depending on their pathological conditions and influence of the HD treatment. The aim of the present study was to compare the outcomes of rehabilitation between hospitalized HD patients and non-HD patients. Method This was a retrospective cohort study. The inclusion criteria were hospitalized patients who received rehabilitation between April 2017 and February 2023. The exclusion criteria were patients who discontinued rehabilitation, were transferred to other hospitals, or died during the rehabilitation period. Rehabilitation consisted of physical therapy and/or occupational therapy provided six times a week, for both hospitalized HD and non-HD patients. The rehabilitation program comprised balance training, aerobic exercises, resistance training, and ADL training to prepare the patients for discharge to their homes. We measured several outcomes in the study, including the daily duration of rehabilitation (min/day), length of hospital stay (days), Barthel index (BI), as the ADL index, at the time of admission and discharge, grip strength and isometric knee extension strength (IKES) as muscle strength indices, and the 10-meter walking speed, timed up and go test (TUG), and short physical performance battery (SPPB) as mobility function indices. For the statistical analysis, missing values were completed by using multiple imputation methods. The inverse probability weighting (IPTW) method was used to match the HD group and non-HD group to adjust for confounding factors. The outcomes between the groups were then compared using a generalized linear model analysis. All procedures in the present study were conducted with the approval of the ethics committee of Seirei Christopher University. Results Of 1002 patients who were registered for the study, 100 patients who discontinued rehabilitation, were transferred to other hospitals, or died were excluded, and the data of the remaining 902 patients (765 of the non-HD group and 137 of the HD group) were included in the analysis in this study. The results of the generalized linear model analysis revealed a lower daily duration of rehabilitation [43.3(0.6) vs. 38.8(1.2) min/day, p=0.0003] and longer length of hospital stay [48.5(0.5) vs. 58.1(2.3) days, p=0.0108] in the HD group. In addition, the 10-meter walking speed [0.75(0.02) vs. 0.66(0.03) m/s, p=0.003] and scores on the TUG [20.8(0.7) vs. 24.3(1.0) sec, p=0.0021] and SPPB [6.3(4.57) vs. 4.7(0.6) points, p=0.0415] at discharge were also significantly lower in the HD group as compared with the non-HD group. There was no difference in the ability for ADL or muscle strength at discharge between the two groups. Conclusion This study was the first to demonstrate a lower daily duration of rehabilitation and longer hospital stay in hospitalized HD patients. Furthermore, rehabilitation had a lower impact on the mobility indices in HD patients as compared with non-HD patients. Although there was no difference in the ability for ADL or muscle strength at discharge between the two groups, HD patients exhibited a significantly lower ability for mobility functions, including a lower gait speed and lower scores on the TUG, and SPPB assessments. Therefore, rehabilitation efforts in HD patients need to be improved by securing more time for inpatient rehabilitation and promoting mobility function improvement.

Longitudinal Association of Health Satisfaction With Functional Status and Income Satisfaction in Stroke Survivors.

Although cross-sectional studies have reported the relationships among performance of activities of daily living (ADLs), income satisfaction, and health satisfaction, longitudinal associations in stroke survivors remain unclear. To examine the effects of ADL function and income satisfaction on health satisfaction over time in stroke survivors. Retrospective longitudinal study designs with latent growth curve models (LGMs) to control for time-varying and time-invariant covariates. Community. A total of 198 stroke survivors. Self-reported ADL performance, income satisfaction, and health satisfaction. The average age of participants was 70.68 yr (SD = 8.09; 107 men, 91 women). Each LGM showed that an increase in ADL score (standardized β = 0.116∼0.296, all ps < .05) and income satisfaction (standardized β = 0.513∼0.726, all ps < .001) positively predicted health satisfaction over time, even after controlling for time-varying annual income, demographics, and behavioral characteristics. The fit results of all LGMs were within the acceptable range: χ2(47) = 66.378, p = .0327; χ2(47) = 57.742, p = .1355; root-mean-square error of approximation, <0.08; comparative fit index and Tucker-Lewis index, >0.90; standardized root-mean-square residual, <0.05. Because ADLs are significant modifiable health satisfaction factors, occupational therapy practitioners would need to focus more closely on ADL training in clinical settings. Furthermore, referring those clients to appropriate vocational rehabilitation to improve their income satisfaction would be necessary. Plain-Language Summary: This study recognizes the unique challenges and opportunities that arise when stroke survivors are preparing to return to their communities by emphasizing the significance of ADL training and income satisfaction during this stage of recovery. The study suggests that the therapeutic use of ADL training and income satisfaction could increase health satisfaction for stroke survivors. Therefore, comprehensive ADL training, as an occupational therapy intervention, could be crucial for stroke survivors who are preparing to return to their community from a clinical setting. Furthermore, connecting with vocational rehabilitation could also be important for improving income satisfaction for stroke survivors who are preparing to return to a community.

The Combined Effect of Robot-assisted Therapy and Activities of Daily Living Training on Upper Limb Recovery in Persons With Subacute Stroke: A Randomized Controlled Trial

ObjectivesTo evaluate the effectiveness of robot-assisted therapy (RAT) followed by activities of daily living (ADL) training in comparison with conventional rehabilitation therapy (CRT) and ADL training in individuals with subacute stroke. DesignA single-blind, 2-arm, parallel-group, open-level, randomized controlled trial. SettingA tertiary care teaching hospital in India. ParticipantsForty-four persons (n=44) with first-ever stroke (in subacute stage) were enrolled from August 2021 to July 2023. InterventionParticipants in the RAT group (n=22) received RAT for 30 minutes, followed by ADL training for 30 minutes. In contrast, participants in the CRT group (n=22) received CRT (30 minutes) followed by ADL training (30 minutes). Both groups received allocated interventions for 15 days over 3 weeks (5 days/week, 3 weeks). Main Outcome MeasuresPrimary outcome: Motor domain score of the Fugl-Meyer Assessment scale for upper extremity (FMA-UE). Secondary outcomes: the other domains scores of FMA-UE (UL -sensation, -joint motions, -joint pain); Modified Ashworth Scale (MAS) (spasticity); hand-function (HF) and ADL-domain scores of the stroke impact scale (SIS); WHOQQL-BREF questionnaires (QOL). Participants were assessed at enrolment and follow-up at 3, 6, and 12 weeks. ResultsPersons who received RAT and ADL training reported significant improvement (P<.05) in UL motor function (mean difference [MD]=3.54;(95% confidence interval [CI]: 1.28 to 5.79]), UL passive joint motions (MD=2.54; [95% CI: 1.56 to 3.52]), SIS-HF (MD=6.37;[95% CI: 4.75 to 7.99]), SIS-ADL (MD=7.13 [95% CI: 3.52 to 8.74]), and in all domains of WHOQOL-BREF (except environmental domain) compared with persons who received CRT and ADL training at 12 weeks. ConclusionsThe findings indicate that RAT followed by ADL training is more effective than CRT followed by ADL training in motor improvement, SIS-HF, SIS-ADL, and QOL at 12 weeks.

Resist-as-Needed ADL Training With SPINDLE for Patients With Tremor.

Individuals with neurological disorders often exhibit altered manual dexterity and muscle weakness in their upper limbs. These motor impairments with tremor lead to severe difficulties in performing Activities of Daily Living (ADL). There is a critical need for ADL-focused robotic training that improves individual's strength when engaging with dexterous ADL tasks. This research introduces a new approach to training ADLs by employing a novel robotic rehabilitation system, Spherical Parallel INstrument for Daily Living Emulation (SPINDLE), which incorporates Virtual Reality (VR) to simulate ADL tasks. The study results present the feasibility of training individuals with movements similar to ADLs while interacting with the SPINDLE. A new game-based robotic training paradigm is suggested to perform ADL tasks at various intensity levels of resistance as needed. The proposed system can facilitate the training of various ADLs requiring 3-dimensional rotational movements by providing optimal resistance and visual feedback. We envision this system can be utilized as a table-top home device by restoring the impaired motor function of individuals with tremor and muscle weakness, guiding to improved ADL performance and quality of life.

Quality of Life of Sepsis Survivors.

To determine the differences between the quality of life for sepsis and nonsepsis survivors, factors affecting the quality of life for sepsis survivors, and their changes over time. A prospective longitudinal study with a quantitative comparative design. A university hospital in the greater Tokyo area of Japan. The study included 41 and 40 patients in the sepsis and nonsepsis groups, respectively. None. Health-related quality of life (HRQOL), independence in activities of daily living (ADL), stress levels, and spirituality were compared between the sepsis and nonsepsis groups at ICU discharge, hospital discharge, and 1 month after discharge. Comparison of HRQOL between the sepsis and nonsepsis groups showed significantly low HRQOL in the sepsis group compared with the nonsepsis group at ICU discharge and hospital discharge. Factors such as stress levels and spirituality affected the HRQOL in the nonsepsis group at ICU discharge. At discharge, stress and spirituality affected HRQOL in both the sepsis and nonsepsis groups. One month after discharge, ADL, stress, and spirituality affected HRQOL in both the sepsis and nonsepsis groups. In terms of changes over time, HRQOL at ICU discharge in the sepsis group was significantly lower than at discharge and 1 month after discharge. The two-way analyses of variance showed no interactions between the groups and time regarding HRQOL. HRQOL of sepsis survivors was significantly lower than that of nonsepsis survivors. ADL and stress influenced HRQOL. The study suggests the importance of ADL training and stress alleviation during the ICU stay.

Efficacy analysis of virtual reality-based training for activities of daily living and functional task training in stroke patients: A single-subject study.

Virtual reality (VR)-based training for functions such as cognition, upper extremities, balancing, and activities of daily living (ADL) has been used on stroke patients, and its efficacy has been reported. However, no comparison has been made between the efficacy of VR-based training for daily activities that exactly reproduces ADL and functional training. Therefore, this study sought to analyze the difference in independency enhancement of VR-based training for daily activities compared to cognitive and motor functional training. This study was conducted on 4 patients who have been diagnosed with stroke and are currently receiving rehabilitation therapy in G hospital located in the city of Gwangju, using A-B-A'-B' design from single-subject experimental designs. Intervention was performed in 2 ways: application of VR-based training for daily activities after the application of cognitive and motor function training; and application of cognitive and motor function training after the application of VR-based training for daily activities. The Assessment of Motor and Process Skills, Computer Cognitive Screening Assessment System, Box and Block Test, and Grip and Pinch Strength Test were used to measure the changes in the performance of daily activities, cognitive function, and upper extremities function. The results confirmed that the performance of daily activities, cognitive function, and upper extremities function was improved after the application of VR-based intervention. In addition, the efficacy of independency enhancement was maximized by the early approach of training for daily activities at the time of VR-based intervention in stroke patients. VR-based intervention of training for daily activities and functional training can be considered to benefit the improvement of the performance of daily activities, cognitive function, and upper extremities function in stroke patients. In addition, although functional training was also effective in enhancing independency and functional improvement in stroke patients, an early approach to training for ADL based on tasks with objectives was deemed to be more effective.

Brain-computer interface combined with mental practice and occupational therapy enhances upper limb motor recovery, activities of daily living, and participation in subacute stroke.

We investigated the effects of brain-computer interface (BCI) combined with mental practice (MP) and occupational therapy (OT) on performance in activities of daily living (ADL) in stroke survivors. Participants were randomized into two groups: experimental (n = 23, BCI controlling a hand exoskeleton combined with MP and OT) and control (n = 21, OT). Subjects were assessed with the functional independence measure (FIM), motor activity log (MAL), amount of use (MAL-AOM), and quality of movement (MAL-QOM). The box and blocks test (BBT) and the Jebsen hand functional test (JHFT) were used for the primary outcome of performance in ADL, while the Fugl-Meyer Assessment was used for the secondary outcome. Exoskeleton activation and the degree of motor imagery (measured as event-related desynchronization) were assessed in the experimental group. For the BCI, the EEG electrodes were placed on the regions of FC3, C3, CP3, FC4, C4, and CP4, according to the international 10-20 EEG system. The exoskeleton was placed on the affected hand. MP was based on functional tasks. OT consisted of ADL training, muscle mobilization, reaching tasks, manipulation and prehension, mirror therapy, and high-frequency therapeutic vibration. The protocol lasted 1 h, five times a week, for 2 weeks. There was a difference between baseline and post-intervention analysis for the experimental group in all evaluations: FIM (p = 0.001, d = 0.56), MAL-AOM (p = 0.001, d = 0.83), MAL-QOM (p = 0.006, d = 0.84), BBT (p = 0.004, d = 0.40), and JHFT (p = 0.001, d = 0.45). Within the experimental group, post-intervention improvements were detected in the degree of motor imagery (p < 0.001) and the amount of exoskeleton activations (p < 0.001). For the control group, differences were detected for MAL-AOM (p = 0.001, d = 0.72), MAL-QOM (p = 0.013, d = 0.50), and BBT (p = 0.005, d = 0.23). Notably, the effect sizes were larger for the experimental group. No differences were detected between groups at post-intervention. BCI combined with MP and OT is a promising tool for promoting sensorimotor recovery of the upper limb and functional independence in subacute post-stroke survivors.

Atuação da terapia ocupacional no treino de atividade de vida diária com pacientes acometidos pela COVID-19 em enfermarias de um hospital universitário

Abstract Introduction COVID-19 causes multisystemic compromises, resulting in functional impairments, mainly related to the Activities of Daily Living (ADLs). Therefore, the occupational therapist is one of the professionals needed to favor the rehabilitation process. Objective To analyze the proportion of ADLs training and the main activities that were trained with patients with COVID-19. Method This is a documental study developed in a teaching hospital in the southeast region of Brazil. Occupational therapy records were analyzed in electronic medical records of patients admitted to COVID-19 infirmaries between June 2020 and January 2021. Results The prevalence of occupational therapy attendances was 53.1%. The patients who were prioritized were those restricted to bed, with worse functionality and longer hospital stay. In all, 413 attendances were performed; the average per patient was three, the minimum was one, and the maximum was 15. The proportion of ADLs training was 76.9%. The most trained activities in the infirmaries by the occupational therapy team were feeding (96.8%), personal hygiene (93.9%), and functional mobility (59.8%). Conclusion The development of this study promoted the discussion of the careful multidimensional analysis performed by occupational therapists to carry out ADLs training with patients diagnosed with Covid-19 hospitalized in wards. Furthermore, it brought important results related to the profile of the patients seen, the proportions of interventions aimed at ADLs training and the elements that guided this practice.

Increasing Functional Performance in Older Women

ABSTRACT The purpose of this study was to evaluate differential effects of a 16-week protocol where participants were randomized into a strength-training (ST) group, Activities of Daily Living (ADL) training group, and a control group. Six physical outcome measures were assessed using the Senior Fitness Test, pre and post study, across ninety women in an assisted living community. A series of repeated measures ANOVA revealed significant group × time interactions across the six physical domains measured (p ≤ .01). Post hoc analysis indicated that ST and ADL groups improved significantly more than the control group across each physical domain. The ST group also outperformed the ADL group in the 30 Second Chair Stand and 30 second arm curl. The key finding is that it is important to incorporate both strength and ADL training sessions because both facilitated significant improvements across all six fitness domains above and beyond controls.

The Effectiveness of Multicomponent Intervention on Daily Functioning among the Community-Dwelling Elderly: A Systematic Review.

The deterioration of physical and cognitive functioning in the elderly is an impairment to their independent self-management and to improving their ability to perform daily functions. Nurses should support the elderly to experience a healthy and a successful aging process by preventing dependence on daily functioning and understanding the care assistance that such persons need. This study aimed to gain insight into the evidence on the effectiveness of multicomponent intervention on the activities of daily living (ADL) and instrumental activities of daily living (IADL) among the community-dwelling elderly without cognitive impairment. The design is a systematic review of a randomized controlled trial. The language of the published literature was English, and the search period was from January 2000 to December 2020. Articles were included under the PICO (population, intervention, comparison, and outcome) framework for: (a) community-dwelling elderly without cognitive impairment; (b) multicomponent intervention; (c) comparison group who did not receive the intervention; and (d) measurement of the effect of ADL and IADL. A total of 4413 references were found, 6 studies were included. Most studies (n = 5) reported that the multicomponent intervention exerted a beneficial effect on ADL and IADL. Only one study showed the highest methodology and reporting quality in the Cochrane review. Common components of the programs included: occupational therapy, physical therapy, exercise, memory training, cognitive–behavioral therapy, interdisciplinary intervention, and cognitive training. Multicomponent intervention may be a beneficial way to improve dependence on ADL and IADL as an important area of functional evaluation in the elderly. Considering the physical condition of the elderly, multicomponent interventions, including physical activity, exercise, occupational therapy, and especially individually customized coaching related to ADL and IADL training, may be useful.

Rehabilitation of Individuals With Cancer.

The survival rate of cancer is increasing as treatment improves. As patients with cancer now live longer, impairments may arise that impact quality of life (QOL) and function. Therefore, a focus on QOL is often as important as survival. An interdisciplinary team can achieve goal-oriented and patient-centered rehabilitation, which can optimize function and QOL, and minimize impairments, restrictions, and activity limitations. In most cases, cancer patients must be active participants in therapy and exhibit carryover. Patients with cancer often have impairments that include fatigue, pain, brain fog, impaired cognition, paresis, mood disorders, difficulty with activities of daily living (ADL), bowel/bladder/sexual dysfunction, and bone and soft tissue involvement. Adaptive equipment, exercise, and ADL training can mitigate restrictions on activity. The trajectory and phase of the disease along the continuum of cancer care may influence the goals of rehabilitation in that time window. QOL is often influenced by participation in vocational, recreational, and home-based activities. A holistic perspective should include an analysis of distress, socioeconomic barriers, and transportation limitations when addressing issues.

Functional independence in left dorsolumbar congenital kyphoscoliosis – An occupational therapy perspective : A case report

Congenital scoliosis is caused by early embryologic errors in formation of vertebral column. The goal of treatment is to improve the children's quality of life and to give them the best chance to develop as an independent adult. The objectives were to assess the effects of occupational therapy (OT) intervention on balance, gait, and activities of daily living (ADL) in a case of congenital scoliosis. A 14-year-old young female studying in 10th standard diagnosed as left-sided dorsolumbar congenital kyphoscoliosis with apex of scoliosis at 11th dorsal segment level was assessed. She presented with lower extremity spasticity, imbalance, and scissoring gait. Assessment was done using the Berg Balance Scale (BBS) and Modified Barthel Index (MBI). Immediate postoperative OT intervention was started inclusive of balance and gait training. Significant improvement was observed on BBS score preoperatively before therapy from score 11 to post therapy score 50 after therapy was initiated and MBI score preoperatively 11 to post therapy 20 after ADL training at 8 months of therapy.

Higher Frequency of Acute Occupational Therapy Services Is Associated With Reduced Hospital Readmissions.

Hospital readmissions are associated with poor patient outcomes, including higher risk for mortality, nutritional concerns, deconditioning, and higher costs. To evaluate how acute occupational therapy service delivery factors affect readmission risk. Cross-sectional, retrospective study. Single academic medical center. Medicare inpatients with a diagnosis included in the Hospital Readmissions Reduction Program (HRRP; N = 17,618). Data were collected from medical records at a large urban hospital in southeastern Wisconsin. Outcomes and Measures: Logistic regression models were estimated to examine the association between acute occupational therapy service delivery factors and odds of readmission. In addition, the types of acute occupational therapy services for readmitted versus not-readmitted patients were compared. Patients had significantly higher odds of readmission if they received occupational therapy services while hospitalized (odds ratio [OR] = 1.18, 95% confidence interval [CI] [1.07, 1.31]). However, patshients who received acute occupational therapy services had significantly lower odds of readmission if they received a higher frequency (OR = 0.99, 95% CI [0.99,1.00]) of acute occupational therapy services. A significantly higher proportion of patients who were not readmitted, compared with patients who were readmitted, received activities of daily living (ADL) or self-care training (p < .01). For patients with HRRP-qualifying diagnoses who received acute occupational therapy services, higher frequency of acute occupational therapy services was linked with lower odds of readmission. Readmitted patients were less likely to have received ADL or self-care training while hospitalized. What This Article Adds: Identifying factors of acute occupational therapy services that reduce the odds of readmission for Medicare patients may help to improve patient outcomes and further define occupational therapy's role in the U.S. quality-focused health care system.

The effect of a 24-week training focused on activities of daily living, muscle strengthening, and stability in idiopathic inflammatory myopathies: a monocentric controlled study with follow-up

BackgroundThe structural and functional changes of the skeletal muscles in idiopathic inflammatory myopathies (IIM) caused by inflammation and immune changes can be severely disabling. The objective of this study was to assess the effect of a 24-week program combining a supervised training of activities of daily living (ADL), resistance, and stability with home exercise for improving muscle function, compared to a daily home-based exercise representing the regular outpatient care.MethodsFifty-seven patients with IIM were consecutively and non-selectively enrolled in an intervention (IG, n = 30) or control (CG, n = 27) group. Both groups were provided a standard-of-care pharmacological treatment and follow-up. Only the IG underwent the supervised intervention twice a week for 1 h per session. At baseline, 12, 24, and 48 weeks, all patients were assessed by an assessor blinded to the intervention for primary outcomes: muscle strength (Manual Muscle Testing of eight muscle groups [MMT-8]) and endurance (Functional Index-2 [FI-2]), and secondary outcomes: stability and body composition. Secondary outcomes also included questionnaires evaluating disability (Health Assessment Questionnaire [HAQ]), quality of life (Short Form 36 [SF-36]), depression (Beck’s Depression Inventory-II [BDI-II]), and fatigue (Fatigue Impact Scale [FIS]), and analysis of the systemic and local inflammatory response and perceived exertion to assess the safety of the intervention.ResultsTwenty-seven patients in the IG and 23 in the CG completed the entire program and follow-up. At week 24, compared to deterioration in the CG, we found a significant improvement in the IG in muscle strength (mean % improvement compared to baseline by 26%), endurance (135%), disability (39%), depression (26%), stability (11%), and basal metabolism (2%) and a stabilization of fitness for physical exercise. The improvement was clinically meaningful (a 24-week change by >20%) in most outcomes in a substantial proportion of patients. Although the improvement was still present at 48 weeks, the effect was not sustained during follow-up. No significant increase in the systemic or local expression of inflammatory markers was found throughout the intervention.ConclusionsThis 24-week supervised intervention focused on ADL training proved to be safe and effective. It not only prevented the progressive deterioration, but also resulted in a significant improvement in muscle strength, endurance, stability, and disability, which was clinically meaningful in a substantial proportion of patients.Trial registrationISRCTN35925199 (retrospectively registered on 22 May 2020).

Improving Occupational Performance in Pediatric Hematopoietic Cell Transplant Recipients.

There is a critical gap in the literature regarding the efficacy of occupational therapy interventions for pediatric hematopoietic cell transplantation (HCT) patients. To demonstrate that occupational therapy 4-5×/wk during inpatient hospitalization positively affects strength, coordination, and independence in activities of daily living (ADLs) of pediatric patients during HCT. Retrospective study. Inpatient bone marrow transplant unit at a children's hospital. Thirty-two pediatric patients admitted for HCT. Patients were seen by an occupational therapist as part of an interdisciplinary program. Interventions included play and leisure engagement, upper extremity therapeutic exercises, fine motor activities, and ADL training. Strength, coordination, and daily living skills data were documented prospectively and analyzed retrospectively to compare differences between patients seen by occupational therapy at high versus low frequency. For grip strength (dynamometer), fine motor dexterity (the 9-Hole Peg Test), and independence in ADLs (an ADL functional measure and the Pediatric Evaluation of Disability Inventory-Computer Adaptive Test Daily Activities), the high-frequency group had a significantly smaller decrease in performance from time of admission at pretransplant (baseline) to peak decline after transplant. Grip strength and ADL scores for the high-frequency group returned to baseline at time of discharge more readily than for the low-frequency group. Participation in occupational therapy 4-5×/wk had positive effects on strength, coordination, and independence in ADLs for patients undergoing HCT. This article provides evidence that occupational therapists are an important part of the interdisciplinary team treating pediatric bone marrow transplant patients. It also demonstrates that occupational therapy interventions delivered at a high frequency can have a positive impact on upper extremity strength and independence in ADLs.

Effects of Virtual Reality-Based Activities of Daily Living Training on Activities of Daily Living and Rehabilitative Motivation in Patients With Traumatic Brain Injury: A Pilot Study

Objective : The purpose of this study was to investigate the effects of virtual reality-based activities of daily living (ADL) training on ADL and rehabilitative motivation in patients with traumatic brain injury. Methods : This study was performed using a pre-post design with seven traumatically brain injured patients. Subjects were subjected to virtual reality-based ADL training for 30 minutes a day, 2 to 3 times a week for 4 weeks. Evaluation was conducted before and after the intervention using the Korean Modified Barthel Index (K-MBI), Cognitive Functional Independence Measure (C-FIM), and Volitional Questionnaire (VQ). Changes before and after intervention were analyzed by Wilcoxon signed-rank test, and correlations were analyzed using Spearman’s coefficient. Results : After intervention, patients with traumatic brain injury showed significant improvements in K-MBI (p .05). Total C-FIM score correlated significantly with VQ score (p<.05, r=.755). The social cognition domain of C-FIM had a significant correlation with VQ score (p<.05, r=826). Conclusions : Virtual reality-based ADL training can improve ADL performance, but further research is needed to determine whether improvements in social cognition and rehabilitative motivation are possible.

Understanding parents' difficulties in executing activities of daily living of children with autism spectrum disorder: A qualitative descriptive study

Background: Activities of daily living (ADLs) refer to the ongoing behaviors that occur on a daily basis. Such behaviors include eating, cooking, bathing, social interactions (such as leisure activities, attending school or work, or assisting with chores), and other activities that one might routinely expect an individual to perform or participate in. Some of the major ADL tasks include personal hygiene, toileting, dressing, and eating. Researchers have documented delayed self-care performance in children with autism spectrum disorder (ASD). Parents report their child to have difficulties with feeding and toileting in particular. Objective: This qualitative pilot study endeavored to understand the difficulties faced by the parents of children with ASD in conducting their children's ADL. Study Design: Qualitative descriptive study was chosen for the research. Methods: The qualitative descriptive study included participants (n = 20) whose children were primarily diagnosed as ASD. Convenient sampling method was used for study sample calculation. The study included parents of children of age group between 5 and 9 years (mean ± standard deviation [SD]: 6.9 ± 1.57 months) with intelligence quotient of ≥80%. The study was conducted in a tertiary care hospital. The parents (fathers = 9 and mothers = 11) were given a semistructured questionnaire to understand difficulties faced by the parents of children with ASD (mean ± SD: 5.56 ± 33.6 months). Results: According to the study, it was observed that most of the parents have reported that their child had maximum difficulties in eating, followed by brushing and grooming and least for toileting. This study also found the priority list of difficulties in ADL. It was noted that early and proper training of the child gives good results in managing a child with ASD. Many parents reported that early training is beneficial. Conclusion: The outcome of this study shows the hierarchy of difficulties in ADL reported by the parents of children with ASD. This study also found that early ADL training gives good results in managing child with ASD.

The effects of movement stimulation on activities of daily living performance and quality of life in nursing home residents with dementia: a randomized controlled trial.

BackgroundNursing home (NH) residents with dementia experience a reduced quality of life (QoL), in part, due to a dependence in performing activities of daily living (ADL). Stimulating movement is associated with improvements in ADL performance. Therefore, movement stimulating interventions, such as ADL training and exercise, focus on optimizing ADL performance to improve QoL. This study aimed to evaluate the effect of three movement stimulating interventions on QoL and ADL performance in NH residents with dementia.MethodsIn this 6-month double parallel randomized controlled trial, the effects of ADL training, a multicomponent aerobic and strength exercise training, and a combined ADL and exercise training were analyzed in 87 NH residents with dementia. The Global Deterioration Scale was used to classify the severity of dementia. Participants were screened at baseline using the 6 minute walk test and Mini-Mental State Examination. The Qualidem, and the Care Dependency Scale and Erlangen ADL test were evaluated at baseline, and after 3 and 6 months to measure QoL and ADL, respectively. Multilevel analyses were adjusted for baseline performance, age, and gender.ResultsA 6-month ADL training positively affected overall QoL (p = 0.004) and multiple aspects of QoL, including care relationship (p = 0.004), positive self-image (p = 0.002), and feeling at home (p = 0.001), compared to care-as-usual. No benefits were observed of exercise on QoL. No benefits were observed of a combined ADL and exercise intervention on QoL. No effects were found of the three movement interventions on ADL performance.ConclusionThe results indicate that ADL training can improve QoL. The results contribute to the limited knowledge regarding the effect of movement stimulation on resident outcomes. Further large-scale studies are recommended.

Skill-building through Task-Oriented Motor Practice (STOMP) intervention for activities of daily living: study protocol for a randomized, single blinded clinical trial.

Progressive disability in activities of daily living (ADL) is inevitable for people with Alzheimer's disease and related dementias (ADRD). Attempts to slow or prevent ADL disability have been unsuccessful despite making progress in behavioral training methods. Missing from this research is an emphasis on how we maximize a patient's engagement during training and the rigorous examination of implementation protocols (dosing and training methods) which may advantage learning in people with ADRD. Our team addressed this gap with the development of the STOMP (Skill-building through Task-Oriented Motor Practice) intervention which creates methods for obtaining ADL goals that support "personhood" and tests high-intensity protocols that appear to advantage learning and sustained learning over time. Through this study, we aim to evaluate differential outcomes by dose levels as well as assess the moderating effects of attention to task during training. Randomized-controlled trial with 32 participants with dementia assigned to either the original, intensive STOMP protocol (3 hours/day, 5 days/week for 2 weeks) or a less-intensive STOMP protocol (1 hour/day, 2 days/week for 2 weeks) delivered by an occupational therapy assistant in the home. ADL training is delivered using motor learning theory techniques of blocked practice, continuous verbal praise, errorless learning and intense dosing schedules. Inclusion criteria: English speaking, adults 50-80 years old that live with a legally-authorized representative that can provide consent, who can follow a one-step command, have three ADL goals they want to address and can participate in an intense therapy protocol. Exclusions include diagnoses of Creutzfeldt-Jakob Dementia, delirium or receptive/global aphasia. Recruitment will occur through direct mailing, physician referral and media/support group presentations. Blinded occupational therapists will complete baseline, post-intervention and 3-month follow-up assessments in the home. Repeated measures ANOVA and graphs will be used to interpret and display results. Through this protocol, we will examine differential outcomes by dose for the STOMP ADL intervention. Our results will inform dosing parameters for future intervention studies for people with ADRD. ClinicalTrials.gov identifier: NCT02356055. This study protocol was approved by the University of Oklahoma Health Sciences Center Institutional Review Board (#4648) and will be performed in accordance with the Declaration of Helsinki.

일상생활활동 훈련이 뇌졸중 환자의 시지각 기능에 미치는 효과

Purpose : The aim of this study was to investigate Activities of Daily Living(ADL) function recovery of repeated measurement of stroke who received ADL training. Method : Twenty stroke patients were treated by ADL program therapy from May to June. All of in twenty stroke patients, 10 stroke patients take part in Occupational Therapy and 10 stroke patients take part in ADL training for 30 min five times a week during four weeks in M- hospital occupational Therapy treatment room, local in Changwon and Geoje. We used two assessment on is Motor Free Visual Perception Test-Third Edition(MVPT-3) for visual perception the other is Modified Barthel Index(MBI) for ADL. Result : First, Visual Short Term Memory(VSTM) score was changed statistical significance OT intervention group than compare with ADL training group(p<.05). Second, Visaul Closure(VC) score was changed statistical significance OT intervention group than compare with ADL training group(p<.05). Third, Spatial Orientation(SO) score was changed statistical significance OT intervention group than compare with ADL training group(p<.05). The fourth Motor Free Visual Perception Test-Third Edition(MVPT-3) score was changed statistical significance OT intervention group than compare with ADL training group(p<.05). The fifth Modified Barthel Index(MBI total) score was changed statistical significance OT intervention group than compare with ADL training group(p<.05). Conclusion : Therefore, ADL training can be on method the visual perception of stroke patients.