There is a critical need for therapeutic water competency (water safety and swim skills) interventions tailored to meet the needs of children on the autism spectrum, a group that is at high risk for drowning. To examine the effect of AquOTic on caregiver- and therapist-based water competency goals for children on the autism spectrum. Pre-post cohort design based on a larger randomized controlled trial. County Board of Developmental Disabilities therapy pool. Children on the autism spectrum (N = 37; 28 boys) ages 5 to 9 yr were recruited from the local community. AquOTic is a manualized 10-wk occupational therapy-based water competency intervention for children on the autism spectrum. AquOTic incorporates evidence-based therapeutic techniques and embeds individualized therapy (interventionist-child dyads) in a group environment. Canadian Occupational Performance Measure (COPM) and Goal Attainment Scaling (GAS) were completed at baseline and post intervention. Children showed significantly higher GAS T scores and COPM Performance and Satisfaction scores post-AquOTic compared with baseline (effect size d = 2.1-2.3). All goals mapped onto the Occupational Therapy Practice Framework (4th ed.), with motor skills emerging as the most common category for both caregiver- and therapist-derived goals, followed by safety awareness in the aquatic environment and sensory functions. Children on the autism spectrum demonstrated improved caregiver- and therapist-based water competency goals following the AquOTic intervention. Plain-Language Summary: This study examined the effect of AquOTic, an occupational therapy-based intervention, on parent/caregiver- and therapist-based goals related to water safety and swim skills among children on the autism spectrum. Caregivers identified goals for their children, and therapists developed goals that guided the intervention. After completing the 10-wk intervention, children showed improvements in both caregiver perceptions of their performance and satisfaction with goals set as well as therapist-rated goals. Our results highlight the value and effectiveness of an occupational therapy-based water competency intervention to improve water competency among children on the autism spectrum.

Effect of web-based progressive muscle relaxation and lifestyle interventions on psychological well-being, occupational performance, and quality of life in women with premenstrual syndrome: A randomized controlled trial with 4-week follow-up.

Community-dwelling individuals with disabilities often face challenges in executive function, instrumental activities of daily living (IADLs), occupational performance, and quality of life. Home-visit rehabilitation based on the Person-Environment-Occupation-Performance (PEOP) model may address these challenges. This study aimed to investigate the impact of a PEOP model-based home-visit rehabilitation program on executive function, IADLs, occupational performance, and quality of life among community-dwelling individuals with disabilities, and to examine whether these effects were sustained over time. A single-group pre-, post-, and follow-up design was used with 13 community-dwelling individuals enrolled in a public health center rehabilitation program. Each participant was supported by three to four undergraduate occupational therapy students, who conducted assessments and interventions under the supervision of a licensed occupational therapist and an occupational therapy professor. The 10-week program included one pre-assessment, eight intervention sessions, and one post-assessment. Additionally, one follow-up assessment was conducted after 3 months of program completion, and 11 participants completed this follow-up. Outcomes were measured using the Executive Function Performance Test-Korean version for executive function and IADLs, the Canadian Occupational Performance Measure (COPM) for occupational performance, and the Korean Version of the World Health Organization Quality of Life (brief version) for quality of life. Executive function and IADLs improved in organization, sequencing, completion, simple cooking and total scores from pre- to post-intervention, and in sequencing, simple cooking, telephone, paying bills and total scores from pre-intervention to follow-up. Occupational performance significantly enhanced pre-post and the significant effect on performance was still observed at follow-up. Quality of life significantly improved in the psychological domain from pre- to post-intervention, and in total scores from both pre-intervention to follow-up and post-intervention to follow-up. PEOP-based home-visit rehabilitation improved executive function, IADL performance, occupational performance and quality of life in community-dwelling individuals with disabilities. Improvements in executive function and IADLs were sustained at follow-up, supporting the clinical value of evidence-based, PEOP-informed interventions.

An effectiveness-implementation trial of home-based early hand therapy for young children with cerebral palsy.

ABSTRACT Background The Hero Arm bionic prosthesis was designed taking into account characteristics that are important to wearers, such as comfort, battery life, cosmesis, and functionality. Whether the Hero Arm meets the expectations of children with congenital below-elbow deficiency (CBED) is not known. Objective The aim of the study was to evaluate 1) whether the Hero Arm met children’s expectations, 2) grasp and functional ability with the prosthesis, and 3) prosthesis use in daily life. Study design This is a retrospective, single-center, cross-sectional study. Methods The Canadian Occupational Performance Measure (COPM) evaluated expectations, the Action Research Arm Test (ARAT) and the 400-Point Test evaluated grasp and functional ability, and a custom-made questionnaire evaluated satisfaction. Evaluations were conducted ≥12 months after fitting. Results Six children were included (4 girls, median age 12 [12–14] years). They stated 23 important activities they wanted the Hero Arm to assist. Mean COPM performance rating was ≥5/10 points for 17 activities and satisfaction ≥5/10 points for 19 activities. Median ARAT score was 54/57 [54–54]. Median unimanual 400-Point Test score was 57.5 [47.1–72.9] and time was 291 [226–382] seconds with the prosthesis vs. 63 [35–67] seconds with the other hand. Bimanual score was 87.5% [79.1–89.6]. Overall satisfaction with the Hero Arm prosthesis was 9/10 [8.25–9]. Two children stopped using the prosthesis, two used it <1 hr/d and two used it >1 hr/d. Conclusions The variability in the level of expectations met and functional ability with the prosthesis show that technical progress is required. Involving the child and family is essential when prescribing the Hero Arm prosthesis to ensure it meets the child’s goals. Clinical Relevance Statement The Hero Arm prosthesis allows children with congenital below-elbow deficiency to perform or enhance performance of specific activities. To improve usability, prosthesis weight needs to be reduced, and finger movement smoothness and speed must be increased.

Purpose To evaluate the feasibility of the Occupational Therapy at Home E-Rehabilitation (OTHER) intervention for persons post-stroke (age > 55) transitioning to home. Methods A mixed-methods feasibility study was conducted. Qualitative data included semi-structured interviews with persons post-stroke (n = 8) and informal caregivers (n = 4), a focus group with occupational therapists (OTs) (n = 4), and logbooks. Inductive thematic analysis explored the experiences of persons post-stroke and OTs, while feasibility was assessed deductively using Bowen’s areas of feasibility. Quantitative data were the Canadian Occupational Performance Measure (COPM), Self-Management Ability Scale (SMAS-30), and the Montreal Cognitive Assessment to assess differences between baseline and 3 months. Results Eight persons post-stroke received OTHER. Inductive thematic analysis resulted in three themes from the perspectives of persons post-stroke and OTs: activity monitoring was appreciated; doing and talking were real supports; and the intervention was inspiring and challenging. Feasibility was acceptable based on Bowen’s areas. A pre-post intervention change was observed on the COPM: 1 on performance and 1.5 on satisfaction, and for SMAS-30, a positive change of 4.67 was observed. Conclusion The OTHER intervention and research protocol are feasible for home-based rehabilitation, and a larger trial is recommended.

Fibromyalgia syndrome (FMS) symptoms affect people's activity behaviors, limiting their daily participation. Integrating activity pacing strategies into occupational therapy may improve chronic pain management. To evaluate the effectiveness of activity management (AM) in improving activity patterns, limitations related to FMS, occupational performance, occupational balance, and quality of life among women with FMS. Randomized controlled trial. University hospital occupational therapy clinic. Thirty-one women with FMS (ages 18-65 yr; 15 intervention, 16 control). The intervention group received individual, online AM sessions twice weekly for 4 wk, including activity pacing, mindfulness and ergonomics training, posture and relaxation exercises, and joint energy conservation techniques. Physical and sociodemographic characteristics were recorded for each participant, and the Patterns of Activity Measure-Pain, Revised Fibromyalgia Impact Questionnaire, Canadian Occupational Performance Measure, Occupational Balance Questionnaire, and Nottingham Health Profile were administered twice, at baseline and at the end of the study, and the results were compared. The intervention group showed decreased overdoing and avoidance and increased pacing (from 6.7% to 60%). Significant improvements were found in activity patterns (p = .012), symptoms (p = .004), occupational satisfaction (p = .001), and quality of life pain (p = .003). AM is effective in reducing symptoms related to FMS among women and maladaptive activity patterns caused by chronic pain. AM can be considered an effective intervention method for FMS. Larger sample sizes and long-term studies are needed to confirm these findings. Plain-Language Summary: Fibromyalgia symptoms limit individuals' participation in activities and reduce their quality of life. This study evaluated the effectiveness of activity management in improving activity patterns, limitations related to fibromyalgia syndrome (FMS), occupational performance, occupational balance, and quality of life among women with FMS. The activity management intervention integrated traditional pain management approaches used by occupational therapists with activity pacing strategies, offering a person-centered, individualized, web-based intervention model. As a result of this study, improvements were observed in maladaptive activity patterns, symptoms, occupational satisfaction, and the pain dimension of quality of life of women with FMS. Our findings suggest that activity management can be considered an effective intervention for women with FMS.

This case-series piloted a novel cognitive rehabilitation approach, i.e., Constraint-Induced Cognitive Therapy (CICT), for improving Instrumental Activities of Daily Living (IADL) in stroke survivors with chronic, mild-to-moderate, cognitive impairment. Four consecutively sampled stroke survivors (mean chronicity=18 months, SD = 10) with mild (n = 3) or moderate (n = 1) cognitive impairment received 35 h of CICT. CICT combined two empirically supported approaches: Speed of Processing Training (SOPT) and behavior change techniques from Constraint-Induced Movement Therapy (CIMT) adapted to transfer gains from in-lab cognitive training to daily life. The latter featured IADL training following shaping principles and a suite of behavioral techniques, called the Transfer Package, to promote participation in cognitively-based functional activities outside of the lab. Outcome measures assessed cognitive processing speed (Useful Field of View, UFOV) and IADL performance outside the treatment setting (Canadian Occupational Performance Measure, COPM). All three participants with valid UFOV data displayed meaningful improvements after treatment in cognitive processing speed (M = 64%, SD = 40, d'=1.6). All three with COPM data reported meaningful improvements in satisfaction with IADL performance (M = 2.87, SD = 1.5, d'=1.9). Values of d' ≥ 0.57 are large. Per structured interviews developed for this study, the IADL improvements present after treatment lasted for at least a year. These promising findings warrant further study.

Improvements in interoceptive sensibility, pain and functional clinical outcome measures after participation in an interdisciplinary pain management program.

To assess the clinical feasibility of lower-limb pediatric exoskeleton-assisted (Trexo Plus) physiotherapy for minimally ambulatory children at an outpatient center and a primary school. Secondary aims were to assess associated functional and goal-based outcomes before and after Trexo-based physiotherapy. Ten children with cerebral palsy participated (five males; mean age 5 years 9 months; Gross Motor Function Classification System level IV). Trexo intervention (twice weekly for 6 weeks) was provided in school (gym class/individual physiotherapy) and outpatient (individual physiotherapy) settings by a physiotherapist two-person team. Independent physiotherapy (motor/functional) assessments occurred pre-intervention, 1-week post-intervention, and 5-weekspost-intervention. Fifteen of 16 clinical feasibility indicators were met. Every participant completed the intervention and Trexo use was found to be safe (two adverse skin events in one child). Children reported high enjoyment and comfort during Trexo-facilitated activities, and exercise-linked fatigue. Canadian Occupational Performance Measure and Goal Attainment Scale functional goals were achieved overall, but there was no meaningful increase in Gross Motor Function Measure (88 items; mean change +1.0). Gait assessments showed no increase in 1-minute walk distance but did show enhanced gait maneuverability and reduced physiotherapist assistance when children used their supported-stepping walker. Exoskeleton-based therapy was safe, feasible, and associated with achieving Trexo intervention-focused goals in school and outpatient settings with physiotherapist team support.

This case report describes the role of occupational therapy (OT) in the recovery of a 33-year-old woman after an abdominal myomectomy due to a large uterine fibroid (a common benign tumor of the uterine muscle). At discharge, her needs to perform daily activities and limitations were identified. Occupational performance was assessed using the Canadian Occupational Performance Measure (COPM) and an occupational profile. She received home-based OT twice weekly for 3 weeks, targeting daily activities, mobility, and pain management. Improvements were observed in COPM scores: functional mobility (performance: from 3 to 9; satisfaction: from 4 to 9) and personal hygiene (performance: from 3 to 8; satisfaction: from 4 to 8). She achieved independence in dressing, bathing, and grooming. This case suggests OT is an essential part of post-myomectomy care. Although based on a single case, the findings highlight the importance of multidisciplinary rehabilitation and the integration of OT in gynecological recovery.

Tetraplegia, often resulting from cervical spinal cord injury, may lead to significant motor and sensory loss, severely impacting independence and quality of life (QoL). Assistive technologies, such as wheelchair-mounted robotic arms (WMRAs), offer potential to enhance autonomy in daily living. However, adoption remains limited due to high costs, complex controls, and insufficient end user involvement. Robust evidence on their real-world effectiveness, particularly post hospitalization, is still lacking. This study aims to explore the feasibility, usability, and user experience of a WMRA for individuals with tetraplegia in real-life posthospitalization settings. It aims to evaluate its support in activities of daily living and conduct a preliminary health economic analysis comparing cost-effectiveness and QoL outcomes with standard care. This mixed methods feasibility study will be conducted in posthospitalization settings in Switzerland. Up to 15 participants with upper limb impairments (SCI C0-Th1, AIS A-D) using powered wheelchairs will be recruited. They will use the robotic arm for 6 consecutive days. An equal number of participants will be recruited for the economic analysis group. Quantitative data will be collected at baseline and postintervention via standardized questionnaires (Post-Study System Usability Questionnaire, National Aeronautics and Space Administration Task Load Index, European Quality of Life 5-Dimension 5-Level questionnaire, Visual Analogue Scale, adapted version of the Canadian Occupational Performance Measure, and Client Socio-Demographic and Service Receipt Inventory-European Version), while qualitative feedback will be gathered through an informal questionnaire and semistructured interviews. Feasibility will be assessed through task performance and health economic analysis. The latter will include quality-adjusted life years, which quantify quality and length of life, and modeling the Incremental Cost-Effectiveness Ratio, which compares the cost-effectiveness of the intervention based on cost per quality-adjusted life years gained. Findings will be integrated in line with the convergent parallel mixed methods design. Recruitment began in April 2025 and is ongoing as planned; full feasibility, usability, and economic results will be reported upon study completion. We expect the robotic system to reduce caregiver time and associated costs, while enhancing autonomy, QoL, and mental well-being. Potential technical and recruitment challenges have been identified and mitigation strategies planned. Evaluating real-life use of a WMRAs, this study could support the wider adoption of assistive robotic technologies. This research offers key insights into the feasibility, usability, and economic value of robotic assistance for individuals with tetraplegia and will help inform future development and scale-up studies.

Cognitive Orientation to daily Occupational Performance Approach using telerehabilitation with parents to improve performance issues in children/adolescents with Dravet Syndrome.

Primary mitochondrial diseases (PMD) are rare heterogeneous disorders caused by defective oxidative phosphorylation, with symptoms varying widely between individuals with PMD. Despite extensive research, no consensus exists on outcome measures that adequately reflect function, activities, and participation for adults with mitochondrial diseases. The Goal Attainment Scale (GAS) offers a personalized, patient-centered way to capture these outcomes. However, its validity and standardized use in trials remain unclear. This study assessed GAS construct validity in a PMD trial, including comparison with the Canadian Occupational Performance Measure (COPM), and provides guidance for future application. Data from a double-blind, randomized, placebo-controlled, exploratory Phase IIA cross-over trial on the safety and efficacy of sonlicromanol (KH176) in 18 adult m.3243A>G patients, were retrospectively analyzed. GAS goals were categorized using the World Health Organization International Classification of Functioning, Disability and Health. Additional outcome measures with overlapping content were selected to evaluate GAS validity. Implementation quality was evaluated using 17 GAS appraisal criteria. Most goals addressed fatigue or lack of energy (85%, 22/26). GAS showed weak to moderate negative correlations with the Checklist Individual Strength (CC=-0.40) and Beck Depression Inventory-II scores (CC=-0.37), indicating higher GAS scores were associated with reductions in fatigue and depressive symptoms. Moderate correlations were observed between GAS and COPM scores (CC=0.50-0.55). No significant correlations were found with the 6-min walk test, 36-item Short Form Health Survey or Newcastle Mitochondrial Disease Scale for Adults. Only 6 out of 17 (35%) implementation criteria were fully met. GAS demonstrated some construct validity in relation to fatigue and depressive symptoms, showed limited overlap with conventional outcome measures and suffered from suboptimal implementation. Although exploratory, these findings suggest GAS may capture patient-relevant change in individuals with PMD. To realize its potential, standardized methodology and further validation are essential for its use as a robust outcome measure in future PMD trials.

ObjectiveIndividuals with stroke frequently experience limitations in activities of daily living, and compensation-based approaches have the potential to enhance functional adaptation. This study aimed to develop and evaluate the feasibility and preliminary effects of a novel intervention, Compensation-Based Problem-Solving Therapy (CBPST), on participation and activities of daily living in individuals with stroke.MethodsCBPST was developed by trained occupational therapists, emphasizing in Occupational Adaptation Model and compensatory strategies. The CBPST was delivered individually in five sessions weekly (during four week and approximately 40 min)and including identifying the problem, developing strategies, selecting strategy and implementing and evaluating the selected strategy. Participants were randomly assigned to intervention or control group. This study involved 50 individuals with stroke assigned to either an intervention (n = 24 and mean age 54.58 ± 7.86) or control group (n = 26 and mean age 54.56 ± 7.09). Outcomes were assessed at baseline and immediately post-intervention using the Functional Independence Measure (FIM), Lawton-Brody Instrumental Activities of Daily Living (Lawton-Brody IADL), Frenchay Activity Indeks (FAI) and the Canadian Occupational Performance Measure (COPM). Statistical analyses included Wilcoxon signed-rank, Mann-Whitney U tests and effect sizes.ResultsBoth groups showed significant improvements (p < 0.05) in participation and activities of daily living. Effect size estimates in the intervention group indicated moderate to large clinical effects across outcome measures (COPM performance and satisfaction: 0.62; FIM: 0.62; Lawton-Brody IADL: 0.53; FAI: 0.55), supporting the preliminary efficacy of CBPST.ConclusionCBPST appears to be a feasible and promising approach to enhance adaptive participation after stroke by integrating problem-solving and compensatory strategies. Larger studies are warranted to confirm its clinical effectiveness.

Creative ability is an important outcome of developmental support programs, as it helps to lay the foundation for better long-term participation and well-being. Children with learning differences risk underdeveloping this potential, especially those in rural, low-resource African settings. This study aimed to determine the potential outcomes of Create2Grow, a new community-based occupational therapy visual arts group intervention for children aged 8 to 12 years with mild to moderate neurodevelopmental disorders, using a case series research design with eight children recruited via convenience sampling. The intervention had a large clinical effect on participants' caregiver-rated Canadian Occupational Performance Measure scores (d = 1.5) and clinician-rated Creative Participation Assessment scores (d = 1.76) from pre- to post-intervention. Create2Grow was also rated as highly in demand, acceptable, and practical for the target group. Low study attrition rates showed that the intervention could be effectively implemented at a local school within the community. Create2Grow is a promising solution to promoting the creative ability of children with learning differences in rural, low-resource settings in Africa.

BackgroundThe Cognitive Orientation to daily Occupational Performance (CO-OP) Approach is an evidence-based intervention that utilizes a problem-solving approach to achieve client-chosen goals. Training is available to support professionals in learning and using the approach effectively. Therapists’ perspectives of using the approach in practice post training has not been reported.MethodsPerspectives of CO-OP trained health professionals were gathered using an international online survey. Closed and Likert scale questions were analyzed using descriptive statistics, and free-text responses were coded using content analysis.ResultsThe dataset compiled responses from 181 participants across 6 continents. CO-OP training was perceived positively, reporting it prepared them well for using CO-OP. However, 66% would like further support to use the approach. Of the recommended 10 individual sessions, only 1/3 of participants provided the recommended dosage. Despite the Canadian Occupational Performance Measure (COPM) and the Performance Quality Rating Scale (PQRS) being prescribed outcome measures in CO-OP, only 63% of respondents used the COPM and 23% the PQRS.ConclusionEducation and training are important to implement evidence-based interventions, but do not always lead to delivering the approach with fidelity. Future research should focus on how to support CO-OP implementation with fidelity, including process evaluation to understand clinical contexts and evaluate its effectiveness when delivered by clinicians.

This case report presents the outcomes of a balance-oriented occupational therapy intervention in an older adult diagnosed with L5-S1 nerve compression. The participant displayed marked limitations in terms of mobility, balance, and cognitive functioning, which had a detrimental effect on daily living activities and overall occupational performance. A comprehensive intervention programme was developed, incorporating task-oriented activities, cognitive stimulation techniques, and balance-focused exercises. These exercises were tailored to the patient's specific needs. The functional outcomes of the participant were assessed using the Canadian Occupational Performance Measurement, the Timed Up and Go Test, the Tinetti Balance and Gait Test, the Tandem Stance Test, and the Fall Efficacy Scale. The cognitive status of the participant was evaluated using the Standardized Mini-Mental Test. The post-intervention results demonstrated clinically meaningful improvements in occupational performance, satisfaction, balance scores, and cognitive functioning. The findings emphasise the efficacy of a holistic and customised balance-oriented occupational therapy approach in promoting functional independence and cognitive capacity in older adults afflicted with nerve compression syndromes.

Late effects of polio (LEoP) are defined as new symptoms, for example, muscle weakness, fatigue, and pain, occurring many years after an acute polio infection. These impairments can lead to difficulties performing everyday activities (ie, activity limitations) that can reduce a person's ability to take part in society (ie, perceived participation restrictions). Yet, no study has explored how activity limitations are associated with participation restrictions in people with LEoP. To explore the association between activity limitations and participation restrictions among people with LEoP. Cross-sectional descriptive study. Outpatient rehabilitation clinic. One hundred two people with LEoP. Not applicable. Canadian Occupational Performance Measure (COPM) assessing performance with everyday activities (COPM Performance) and satisfaction with performance in everyday activities (COPM Satisfaction), and Reintegration to Normal Living Index (RNL-I) assessing perceived participation. The mean scores of COPM Performance and COPM Satisfaction with performance were 5.3 and 5.0, respectively, and the mean score for RNL-I was 71.6, indicating mild to moderate disability among the participants. The linear regressions, adjusted for gender and age, showed significant associations between COPM Performance and RNL-I (β = 0.024, 95% confidence interval [CI] 0.001-0.039, p = .015) and between COPM Satisfaction with performance and RNL-I (β = 0.024, 95% CI 0.003-0.046, p = .029). Significant associations were also found between the COPM subgroup self-care and the RNL-I subscale Daily functioning. The results show that people with LEoP perceive activity limitations as well as participation restrictions and that these concepts are only weakly associated. Therefore, during rehabilitation both activity limitations and participation restrictions need to be addressed in people with LEoP. This new knowledge may assist rehabilitation professionals when developing and implementing targeted interventions for people with LEoP.

Neurocognitive function, psychosocial characteristics, and occupational performance across menstrual phases in young adults with and without primary dysmenorrhea.