Conventional Occupational Therapy Research Articles

Effect of Cognitive Orientation to Daily Occupational Performance (CO-OP) Programme on Playfulness in Children with Attention Deficit Hyperactivity Disorder

Objective: To investigate the effect of cognitive orientation to daily occupational performance (CO-OP) programme on playfulness in children with attention deficit hyperactivity disorder.Material and Methods: Seventy Attention deficit hyperactivity disorder participants (N=70), aged between 6-8 years were recruited from a local community-based setting. The children were divided into an experimental (n=35) and a control group (n=35). The experimental group participants received CO-OP and the control group participants received the conventional occupational therapy programme; for 12 weeks. The test on playfulness was used to measure playfulness in children.Results: There were statistically significant differences between pretest and post-test scores of the test of playfulness (TOP) in the experimental group (p-value≤0.05) components of: Extent, Intensity and Skillfulness, and there were statistically significant differences between pretest and post-test group of TOP in the control group (p-value≤0.05) in Intensity and Skillfulness. There was no statistically significant difference in pretest and post-test scores of TOP in the component of Extent. Further analysis revealed that clinically there was significant differences in the post-test scores of TOP between the control and experimental group components of Extent, Intensity and Skillfulness.Conclusion: CO-OP was effective in improving playfulness in children with attention deficit hyperactivity disorder.

The Effectiveness and Usability of a Rehabilitation Program Using the Nintendo Switch to Promote Healthy Aging in Older People with Cognitive Impairment: A Randomized Clinical Trial.

(1) Background: Healthy aging is the process of developing and maintaining functional capacity and optimizing involvement in order to improve one's quality of life as people age. This study aimed to encourage healthy aging in people with cognitive impairment, as well as a control group, via the use of the Nintendo Switch combined with occupational therapy sessions, aiming to improve gross and fine motor skills, functionality, quality of life, and cognitive status. (2) Methods: A randomized clinical trial was undertaken. The sample was randomized using the OxMar software program Attribution 4.0 International, facilitating the division into a control group (CG), who received conventional occupational therapy sessions, and an experimental group (EG), who received therapy incorporating the Nintendo Switch, in addition to conventional occupational therapy sessions. The intervention period with the Nintendo Switch lasted for 8 weeks. (3) Results: Thirty-two participants were included in the study. Significant differences were found in the vast majority of the variables analyzed, which shows an improvement following the intervention; these improvements were mainly observed in measures of skill and the perception of quality of life. (4) Conclusions: An eight-week intervention with the Nintendo Switch alongside conventional occupational therapy helps to maintain cognitive status and functional independence. Following 8 weeks of intervention with the Nintendo Switch, improvements in gross motor dexterity, fine motor dexterity, and quality of life were observed in older people with cognitive impairment.

Effectiveness of an Occupational Therapy Memory Strategy Education Group Intervention on Memory Difficulties and Activities of Daily Living Performance among the Geriatric Population: A Quasi-experimental Study

Introduction: Memory deficits are one of the common indications of cognitive aging, and they are an essential component for completing day-to-day activities in an effective, timely, and safe manner. Disturbances in memory can have a major impact on an individual’s performance in all areas of occupation. Memory alterations have a substantial influence on numerous elements of everyday living, including sentiments and conceptions of self, connections with others, participation in Activities of Daily Living (ADL), and engagement in leisure activities. Aim: To determine the effectiveness of an occupational therapy Memory Strategy Education Group (MSEG) intervention on memory difficulties and its impact on ADL performance among the geriatric population. Materials and Methods: The present quasi-experimental pre-post-test pilot study was conducted at Department of Occupational Therapy, SRM Institute of Science and Technology, Kattankulathur, Tamil Nadu, India. A total of 10 participants aged 60 years and above were recruited from a community setting through convenience sampling and were divided into an experimental group (n=5) and a control group (n=5). The experimental group participants received MSEG intervention, while the control group participants received conventional occupational therapy memory intervention for three weeks. The Canadian Occupational Performance Measure (COPM), Contextual Memory Test (CMT), and Functional Independence Measure (FIM) were used to measure occupational performance, memory, and ADL. The outcome measure scores within groups were analysed using the Wilcoxon signed-rank test, and the comparison of outcome measures between the groups was analysed using the MannWhitney U test. An alpha level of p=0.05 was considered to be statistically significant. Statistical Package for Social Sciences (SPSS) 24.0 version was used to analyse the data. Results: In the present study, a total of 10 participants from the age group of 60-75 years (mean age=67.4 years) were included, and each group (control and experimental) consisted of five participants (3 males and 2 females). The results showed that there was a significant difference (p<0.05) between the post-test scores of the experimental and control groups in COPM-Performance and CMT (p=0.032; p=0.018, respectively). However, there was no statistically significant difference (p>0.05) in the post-test scores of the experimental and control groups in FIM (p=0.347). Further analysis revealed a clinically significant difference between the control and experimental groups in post-test scores. Conclusion: The results of the study concluded that the MSEG intervention is effective in improving memory difficulties in the geriatric population but had a lesser effect on improving ADL performance.

Three-Dimensional Magnetic Rehabilitation, Robot-Enhanced Hand-Motor Recovery after Subacute Stroke: A Randomized Controlled Trial.

We developed an end-effector-type rehabilitation robot that can uses electro- and permanent magnets to generate a three-way magnetic field to assist hand movements and perform rehabilitation therapy. This study aimed to investigate the therapeutic effect of a rehabilitation program using a three-dimensional (3D) magnetic force-based hand rehabilitation robot on the motor function recovery of the paralyzed hands of patients with stroke. This was a double-blind randomized controlled trial in which 36 patients with subacute stroke were assigned to intervention and control groups of 18 patients each. The intervention group received 30 min of rehabilitation therapy per day for a month using a 3D magnetic force-driven hand rehabilitation robot, whereas the control group received 30 min of conventional occupational therapy to restore upper-limb function. The patients underwent three behavioral assessments at three time points: before starting treatment (T0), after 1 month of treatment (T1), and at the follow-up 1-month after treatment completion (T2). The primary outcome measure was the Wolf Motor Function Test (WMFT), and secondary outcome measures included the Fugl-Meyer Assessment of the Upper Limb (FMA_U), Modified Barthel Index (MBI), and European Quality of Life Five Dimensions (EQ-5D) questionnaire. No participant safety issues were reported during the intervention. Analysis using repeated measures analysis of variance showed significant interaction effects between time and group for both the WMFT score (p = 0.012) and time (p = 0.010). In post hoc analysis, the WMFT scores and time improved significantly more in the patients who received robotic rehabilitation at T1 than in the controls (p = 0.018 and p = 0.012). At T2, we also consistently found improvements in both the WMFT scores and times for the intervention group that were superior to those in the control group (p = 0.024 and p = 0.018, respectively). Similar results were observed for FMA_U, MBI, and EQ-5D. Rehabilitation using the 3D hand-rehabilitation robot effectively restored hand function in the patients with subacute stroke, contributing to improvement in daily independence and quality of life.

Options for stroke survivors: From stroke to conventional therapy

Options for stroke survivors: From stroke to conventional therapy Discovery of novel treatment options for stroke survivors – requirements for implanted systems. In countries with modern healthcare infrastructure, stroke patients are treated in so-called stroke units directly after the stroke occurs. A few days later, the health situation is stable and the patient enters the rehabilitation phase. Stroke survivors are often faced with lost motor functions or speech impairments which are treated using conventional occupational therapy, logopedic therapy or other therapies focusing on the recovery of the patient’s individually compromised functions.

A randomized controlled trial on the effectiveness of the abridged illness management and recovery program for people with schizophrenia spectrum disorders.

This study aimed to investigate the effectiveness of an abridged version of the Illness Management and Recovery Programme (AIMR) that was modified and developed in Hong Kong through a mult-centre randomized controlled trial for patients with schizophrenia spectrum disorders. This study was implemented in 10 occupational therapy departments, psychiatric day hospitals of 7 Hospital Authority clusters in Hong Kong. A total of 211 patients with schizophrenia or schizoaffective disorder was recruited and randomized into either the experimental or the control condition. In the control group, the subjects went through conventional occupational therapy programmes. In the experimental group, the subjects went through an additional 10-session programme of AIMR. were measured at baseline, completion of the AIMR, and 3-month after the AIMR programme. Measures include the expanded version of the Brief Psychiatric Rating Scale (BPRS-E), the client version of the Illness Management and Recovery Scale (IMRS), the Snyder Hope Scale, the Social and Occupational and Occupational Functioning Assessment Scale (SOFAS), the WHO Quality of Life Scale (WHOQOL-BREF), and the Chinese Version of the Short Warwick-Edinburgh Mental Well-Being Scale (C-SWEMWBS). Both the experimental and control cohorts had comparable clinical and socio-demographic characteristics except years of education and duration of illness. These two variables were entered as covariates in the linear mixed model which showed that the experimental group had significantly higher improvement than the control group in terms of illness management (F = 4.82; p = .03; Cohen's d = .45), functional (F = 10.65; p = .001; Cohen's d = .58), and hope (F = 5.52; p = .02; Cohen's d = .08) measures after the completion of treatment. The results supported the effectiveness of the AIMR programm which would be important in the recovery oriented practices in psychiatry.

Effectiveness of Cognitive Orientation to Daily Occupation Performance (Co-Op) Approach in Order to Improve Instrumental Activity of Daily Living (IADL) Skills in Dementia

The main purpose of this study is to determine the effect of Cognitive orientation to activity living of daily occupation Performance (CO-OP) to improve IADL skills among Geriatric patients with dementia. The study was done using a quasi-experimental design and convenient sampling technique was adapted to select the patient with dementia at a mild level in the age group of 60 to 70 years. Totally thirty patients were selected and divided into 15 in the control group and 15 in the experimental group. The experimental group underwent cognitive orientation to daily occupational performance (CO-OP) to improve IADL skills and the control group underwent conventional occupational therapy to improve handwriting. Total intervention is given for 3 months consisting of 30minutes sessions for each 30 sessions, weekly 3 days. To measure IADL for old age people with dementia, Lawton Brody IADL scale has been used. The statistical analysis showed significant changes in the experimental group after CO-OP intervention. Analysis revealed that, Occupational Therapist can provide CO-OP-based activities for the geriatric condition with dementia during the instruction and treatment of IADL, which helps to conduct better results of IADL.

Effect of Upper Limb Function Training Combined with Goal Setting Using the Aid for Decision-Making in Occupation Choice for Hand Application in Patients with Acute Stroke

Background and Purpose: We introduced an intervention that aimed to improve upper limb use in daily life using Aid for Decision-making in Occupation Choice for Hand (ADOC-H), a monitoring and problem-solving technique, in addition to conventional occupational therapy for hospitalized patients with acute stroke. This pilot study examined the effectiveness of this intervention to improve paralyzed upper limb use in daily life and their motor function.

A Smart Glove Digital System Promotes Restoration of Upper Limb Motor Function and Enhances Cortical Hemodynamic Changes in Subacute Stroke Patients with Mild to Moderate Weakness: A Randomized Controlled Trial.

This study was a randomized controlled trial to examine the effects of the RAPAEL® Smart Glove digital training system on upper extremity function and cortical hemodynamic changes in subacute stroke patients. Of 48 patients, 20 experimental and 16 controls completed the study. In addition to conventional occupational therapy (OT), the experimental group received game-based digital hand motor training with the RAPAEL® Smart Glove digital system, while the control group received extra OT for 30 min. The Fugl-Meyer assessment (UFMA) and Jebsen-Tayler hand function test (JTT) were assessed before (T0), immediately after (T1), and four weeks after intervention (T2). Cortical hemodynamics (oxyhemoglobin [OxyHb] concentration) were measured by functional near-infrared spectroscopy. The experimental group had significantly better improvements in UFMA (T1-T0 mean [SD]; Experimental 13.50 [7.49]; Control 8.00 [4.44]; p = 0.014) and JTT (Experimental 21.10 [20.84]; Control 5.63 [5.06]; p = 0.012). The OxyHb concentration change over the ipsilesional primary sensorimotor cortex during the affected wrist movement was greater in the experimental group (T1, Experimental 0.7943 × 10-4 μmol/L; Control -0.3269 × 10-4 μmol/L; p = 0.025). This study demonstrated a beneficial effect of game-based virtual reality training with the RAPAEL® Smart Glove digital system with conventional OT on upper extremity motor function in subacute stroke patients.

Effects of a Cognitive Stimulation Program in Institutionalized Patients with Dementia.

Background: The advances achieved by the available research that focus on understanding memory operation and cognitive functions have helped the development of specific treatment approaches. These can help to maintain or improve the cognitive function and well-being of people with dementia. The use of cognitive stimulation in dementia has a long history. There are multiple studies that have demonstrated its benefits on the cognitive levels of patients with mild to moderate dementia. However, all of the studies on this type of non-pharmacological intervention conclude that there is a need for more clinical trials in order to give more solidity to the evidence already found. The objective of this pilot study was to assess the effects of an occupational therapy cognitive training program on the cognitive function of institutionalized older adults with dementia. Methods: The study was a pilot randomized clinical controlled trial. A total of 58 participants with major neurocognitive disorder or dementia were randomized to the occupational therapy cognitive training program group or to the conventional occupational therapy group twice a week for 5 weeks. The cognitive level was measured with the Global Deterioration Scale (GDS) and the Lobo’s Cognitive Mini Test (LCMT), which is the Mini-Mental Status Examination in Spanish. Measures were taken at baseline (week 0), after 5 weeks of treatment (week 5), and after 6 weeks of follow up (week 12). A value of p < 0.05 was considered as statistically significant. Results: There were no statistical differences between groups in the LCMT global scores at baseline or after the intervention at week 5. However, the analysis of the specific cognitive areas assessed in the Lobo’s Cognitive Mini Test indicated that that the intervention group significantly improved comprehension of verbal commands and praxis (p = 0.021). At the follow-up measure, the differences obtained in relation to verbal commands and praxis maintained the statistical differences significantly (p = 0.009). Conclusions: Occupational therapy based on cognitive training shows positive effects on the maintenance of the global cognitive state of institutionalized older adults with dementia and improves significantly the comprehension of verbal commands and praxis.

Effectiveness of combining robotic therapy and modified constraint-induced movement therapy for moderate to severe upper limb paresis after stroke in subacute phase: Case–control study by propensity score analysis

Introduction: Robotic assisted therapy and modified constraint-induced movement therapy are used evidence-based approach in stroke rehabilitation. However, there is no study showing a combination of robotic assisted therapy and modified constraint-induced movement therapy (combined therapy) in the subacute phase. This study investigated the effectiveness of combined therapy in stroke patients with moderate to severe upper limb paresis compared with conventional occupational therapy at subacute setting. Methods: This research used a case–control study. The intervention group ( n = 15) consisting of patients with moderate to severe upper limb paresis (Brunnstrom recovery stage upper extremity III or IV and above hand III) 4–8 weeks since stroke onset received a combined therapy for 3 weeks (total intervention time: 1440 minutes). The control group ( n = 15) extracted by propensity score matching received a conventional occupational therapy for 4 weeks (total intervention time: 1680–2240 minutes). The primary outcome was the Fugl-Meyer assessment upper limb score change before and after the intervention. Results: The intervention group exhibited significantly greater improvement on Fugl-Meyer assessment upper lim change ( p = 0.005). Conclusion: In the subacute phase, the combined therapy of robotic assisted therapy and modified constraint-induced movement therapy helped improve upper limb motor function more effectively and efficiently than conventional occupational therapy.

Effects of Task-Based LSVT-BIG Intervention on Hand Function, Activity of Daily Living, Psychological Function, and Quality of Life in Parkinson's Disease: A Randomized Control Trial.

Previous studies have demonstrated that the Lee Silverman Voice Treatment-BIG (LSVT-BIG) program can improve motor functions such as balance and gait in Parkinson's disease (PD) patients. However, no study has investigated the effects of a task-based LSVT-BIG intervention on hand function, psychological function, and quality of life in PD patients. Herein, we investigate the effects of a task-based LSVT-BIG intervention, which reflects the needs of PD patients, on hand function, activity of daily living (ADL), psychological function, and quality of life. A total of 14 PD patients were enrolled and randomly assigned to the experimental or control group. The experimental group performed 30 minutes of conventional occupational therapy and 40 minutes of the task-based LSVT-BIG program. The control group performed 30 minutes of conventional occupational therapy and 40 minutes of relaxation and stretching. Both groups underwent the respective interventions once a day 5 times a week for 4 weeks. As a result of the study, the experimental group showed improvement in hand function in both the dominant and nondominant hand, and the control group showed improvement only in the nondominant hand (p < .05). ADL was significantly improved in both groups, but the experimental group showed a more statistically significant difference than the control group (p < .05). Depression and anxiety were significantly decreased in both the experimental group and the control group, and in particular, in the case of anxiety, there was a more statistically significant difference in the experimental group (p < .05). In the case of the experimental group, there was a significant improvement in quality of life in all items, and in the control group, except for the social function item (p > .05), there was a significant improvement in other items (p < .05). The results of this study suggest that the task-based LSVT-BIG program, which consists of activities desired by the participants, may be an effective intervention to improve hand function, ADL, psychological function, and quality of life in PD patients.

Efficacy of metacognitive strategy training on reducing disability of post-stroke survivor: A pilot study

Background: Post-stroke survivors experience significant challenges with their functional health. Despite advances in neuro-rehabilitation, they cannot participate in meaningful daily life activities, leading to disability. Many intervention approaches are applied in stroke rehabilitation to make them independent and lead a quality life. Objectives: The objective of this pilot study was to investigate the effect of the Metacognitive Strategy Training (MCST) on Conventional Occupational Rehabilitation Therapy on improving independence and reducing the disability of post-stroke survivors. Materials and methods: Thirty subjects with post-stroke syndrome participated in an exploratory, double-blind, randomized controlled trial with pre-post and follow-up studies. Subjects were randomized over two intervention groups. Group-1 received MCST with conventional therapy (n=15), and Group-2 conventional therapy only (n=15). The Functional Independence Measure (FIM) measures independence at baseline (Time1), post-intervention (Time2), and after six months (Time3). Results: Changes in Functional Independence Measure scores for the two groups over six months showed significant effects of group (F(1,24)=9.422, p&lt;0.005), time (F(1.160, 27.848)=21.449, p&lt;0.0001) but time and group interaction was not significantly affected (F(1.160, 27.848)=0.172, p=0.719). Post hoc analysis with a Bonferroni adjustment revealed that FIM was statistically significantly increased from pre-intervention to post-intervention (22.597 (95% CI, 34.511 to 10.683), p&lt;0.0001), and from pre-intervention to six month follow up. (24.203 (95% CI,37.554 to 10.853), p=0.0001), but not from post-intervention to six months (1.606 (95% CI, -5.988 to 2.776), p=1.000). Conclusion: MCST has better efficiency in reducing disability and improving the independence of post-stroke survivors in the long term.

Effects of Combining Cognitive Behavioral Therapy with Bilateral Upper Limb Training in Stroke Patients: A Randomized Controlled Trial.

CBT has a beneficial effect on depression and anxiety; however, the number of cases where therapy was used in patients with stroke was rare. In addition, there is still a lack of research on the effects of occupation-based training and the effects of bilateral upper limb training that provides an intervention based on patients' state of hemiplegic upper limb function. This study investigated the effects of combining CBT and occupation-based bilateral upper limb training on the depression, anxiety, upper limb function, and occupational performance. The experimental group was given 30-min cognitive behavioral therapy and occupation-based bilateral upper limb training, while the control group was given 30-min conventional occupational therapy and occupation-based bilateral upper limb training. For both groups, the intervention was given as a 30-min session once a day and five times a week for 4 weeks. Following intervention, the experimental group showed significant within-group variance for automatic thoughts, depression, anxiety, upper limb function, and occupational performance only (p < 0.01). For between-group variance, a significant difference was found for automatic thoughts, depression, anxiety, and occupational performance (p < 0.01), however, not for upper limb function (p > 0.05). In this study, it is meaningful that this author provided good guidelines for therapists and caregivers by organizing and providing actual programs in a very rare situation where cognitive behavioral therapy was applied to stroke patients.

EFFECT OF COMPREHENSIVE APPROACH ON FEEDING ABILITY OF INFANT WITH FACIAL NERVE PALSY &amp; MICROTIA GRADE 4: A CASE REPORT

Facial nerve palsy is a condition with several implications, particularly when occurring in childhood. it can be congenital or acquired. The unilateral facial paralysis can be suspected when, in absence of front and nasolabial groove motility, there is also asymmetry of the face with buccal deviation when crying. The custom-made Facial splint of low-temperature thermoplastic material can support the weak muscle &amp; prevent the deviation. The infant was referred to Occupational Therapy with facial palsy grade IV. The aim of our study is evaluating the immediate functional outcome, while using the custom-made splint. The patient was assessed twice (i.e. Baseline &amp; after 6 weeks) on Neonatal Behavioral Assessment scale (NBAS), Neonatal Oral Motor Assessment Scale (NOMAS), Nonnutritive sucking scoring system, Preterm Infant Feeding Readiness Assessment Scale &amp; Parent stress scale was used to track the feeding readiness &amp; parental stress respectively during intervention. On NBAS, Level 3 to level 5. On NNSS, infant scored 2 to 6 scoring system on non-nutritive sucking &amp; on NOMAS baby scored from 19 to 22. Her ability to initiate suck was improved considerably. Improvement in scores of Preterm Infant Feeding Readiness Assessment Scale at baseline &amp; after 6 weeks. Infant scored 65 to 57 on Parent Stress Scale. In this study, Family Centered approach &amp; the need-based intervention, a custom-made facial splint of low-temperature thermoplastic material along with face strap effective to facial palsy patient, along with conventional Occupational Therapy intervention.

Effects of Mirror Neurons-Based Rehabilitation Techniques in Hand Injuries: A Systematic Review and Meta-Analysis.

Background: Hand trauma requires specific rehabilitation protocol depending on the different structures involved. According to type of surgical intervention, and for monitoring pain and edema, post-operative rehabilitation of a hand that has experienced trauma involves different timings for immobilization. Several protocols have been used to reduce immobilization time, and various techniques and methods are adopted, depending on the structures involved. Objective: To measure the effects of mirror neurons-based rehabilitation techniques in hand injuries throughout a systematic review and meta-analysis. Methods: The protocol was accepted in PROSPERO database. A literature search was conducted in Cinahl, Scopus, Medline, PEDro, OTseeker. Two authors independently identified eligible studies, based on predefined inclusion criteria, and extracted the data. RCT quality was assessed using the JADAD scale. Results: Seventy-nine suitable studies were screened, and only eleven were included for qualitative synthesis, while four studies were selected for quantitative analysis. Four studies were case reports/series, and seven were RCTs. Nine investigate the effect of Mirror Therapy and two the effect of Motor Imagery. Quantitative analyses revealed Mirror Therapy as effective for hand function recovery (mean difference = −14.80 95% Confidence Interval (CI) = −17.22, −12.38) (p < 0.00001) in the short term, as well as in long follow-up groups (mean difference = −13.11 95% Confidence Interval (CI) = −17.53, −8.69) (p < 0.00001). Clinical, but not statistical, efficacy was found for manual dexterity (p = 0.15), while no benefit was reported for range of motion. Conclusions: Mirror neurons-based rehabilitation techniques, combined with conventional occupational and physical therapy, can be a useful approach in hand trauma. Mirror therapy seems to be effective for hand function recovery, but, for motor imagery and action observation, there is not sufficient evidence to recommend its use. Further research on the efficacy of the mirror neurons-based technique in hand injury is recommended.

Effects of a Virtual Reality–Based Mirror Therapy Program on Improving Sensorimotor Function of Hands in Chronic Stroke Patients: A Randomized Controlled Trial

Background. Embedding mirror therapy within a virtual reality (VR) system may have a superior effect on motor remediation for chronic stroke patients. Objective. The objective is to investigate the differences in the effects of using conventional occupational therapy (COT), mirror therapy (MT), and VR-based MT (VR-MT) training on the sensorimotor function of the upper limb in chronic stroke patients. Methods. This was a single-blinded randomized controlled trial. A total of 54 participants, including chronic stroke patients, were randomized into a COT, MT, or VR-MT group. In addition to 20-minute sessions of task-specific training, patients received programs of 30 minutes of VR-MT, 30 minutes of MT, and 30 minutes of COT, respectively, in the VR-MT, MT, and COT groups twice a week for 9 weeks. The Fugl-Meyer motor assessment for the upper extremities (FM-UE; primary outcome), Semmes-Weinstein monofilament, motor activity log, modified Ashworth scale, and the box and block test were recorded at pre-treatment, post-intervention, and 12-week follow-up. Results. Fifty-two participants completed the study. There was no statistically significant group-by-time interaction effects on the FM-UE score (generalized estimating equations, (GEE), P = .075). Meanwhile, there were statistically significant group-by-time interaction effects on the wrist sub-score of the FM-UE (GEE, P = .012) and the result of box and block test (GEE, P = .044). Conclusions. VR-MT seemed to have potential effects on restoring the upper extremity motor function for chronic stroke patients. However, further confirmatory studies are warranted for the rather weak evidence of adding VR to MT on improving primary outcome of this study. Clinical trial registration: NCT03329417.

HOME-BASED OCCUPATIONAL THERAPY INTERVENTION TO IMPROVE FUNCTIONAL INDEPENDENCE IN SPINAL CORD INJURY – A SINGLE CASE STUDY.

Objective: To improve the functional independence in spinal cord injury patient by using home based conventional occupational therapy intervention Methods: The study used a single case study design and used a diagnosed L2 lesion case that had undergone the following assessments: neurological assessment, American spinal cord Association scale, functional independence measure, and sensory examination. For the next three months, he received conventional occupational therapy intervention twice a week. Results: There was a change of score on functional independence measure, muscle strength and sensory examination which shows there was improvement in muscle strength and functional outcome of the client after home based conventional occupational therapy. Conclusion: This study suggest that using conventional occupational therapy home based interventions are benecial in achieving functional independence in L2 spinal cord injury.

Effects of Cognitive Exercise Therapy on Upper Extremity Sensorimotor Function and Activities of Daily Living in Patients with Chronic Stroke: A Randomized Controlled Trial.

This study investigated the effects of cognitive exercise therapy on upper extremity sensorimotor function and daily activity in patients with chronic stroke and compared these effects to those of conventional occupational therapy. The 30 patients with chronic stroke (mean age: 63.6 ± 12.7 years; height: 162.8 ± 8.1 cm; weight: 60.6 ± 7.6 kg; body mass index: 22.8 ± 1.9 kg/m2) were divided into two treatment groups with 15 patients in each. The respective interventions were provided for 30 min per day, five times weekly for 4 weeks. Manual and sensory function tests were conducted to evaluate the sensorimotor function, while the Korean-Modified Barthel Index was used to assess daily activities. All outcome variables were assessed before and after the interventions. A significant interaction was observed in sensory function (p = 0.001) but not motor function or daily activities (p > 0.05). No significant main group effects were found for any outcome variables (p > 0.05). The experimental group showed significant improvements in motor function (p < 0.001), sensory function (p < 0.001), and daily life activities (p = 0.001) after cognitive exercise therapy, whereas the control group showed significant improvement only in daily life activities post-intervention (p = 0.012). These results demonstrated the positive effects of cognitive exercise therapy on upper extremity sensorimotor function and daily life activities and the lack of improvement in motor and sensory function following conventional occupational therapy in patients with chronic stroke. Thus, the combination of cognitive exercise and conventional occupational therapies may be an effective way to improve sensory function and upper extremity motor function in patients with chronic stroke.

Therapeutic Effects of a Newly Developed 3D Magnetic Finger Rehabilitation Device in Subacute Stroke Patients: A Pilot Study.

We developed a magnetic-force-based three-dimensional (3D) rehabilitation device that can perform motor rehabilitation treatment for paralyzed fingers, regardless of upper extremity movement and position, and investigated the therapeutic effects of the device. An end-effector type rehabilitation device that can generate magnetic fields in three directions was developed using electromagnets and permanent magnetics. A double-blinded randomized controlled pilot study was conducted with a total of 12 patients. The intervention group had rehabilitation treatment using the developed magnetic finger rehabilitation device for 30 min a day for four weeks. The control group underwent exercise rehabilitation treatment. The control group received conventional occupational therapy on the upper limbs, including hands, from an occupational therapist, for the same amount of time. Adverse effects were monitored, and the patient’s sensory or proprioceptive deficits were examined before the intervention. No participants reported safety concerns while the intervention was conducted. The Wolf Motor Function Test (WMFT) scores were significantly improved in the intervention group (from 13.4 ± 3.6 to 20.9 ± 4.0 points) compared to the control group (from 13.1 ± 4.0 to 15.2 ± 3.8 points) (p = 0.016). The patients in the intervention group (from 88 ± 12 to 67 ± 13 s) showed greater improvement of WMFT times compared to the control group (from 89 ± 10 to 73 ± 11 s) (p = 0.042). The Manual Function Test and the upper limb score of the Fugl-Meyer Assessment were significantly improved in the intervention group compared with the control group (p = 0.038 and p = 0.042). The patients in the intervention group also showed significantly greater enhancement of the Korean version of the modified Barthel Index than the control group (p = 0.042). Rehabilitation treatment using the 3D magnetic-force-driven finger rehabilitation device helped improve finger motor function and activities of daily living in subacute stroke patients.