Occupational Therapy Intervention Program Research Articles

Intervention in Time Processing Ability and Everyday Functioning for Preschool Children in Need of Special Support: A Randomized Controlled Study

ABSTRACT Children in need of special support in preschool (INS) often exhibit delayed time processing ability (TPA) which can significantly impact their everyday functioning (EDF). This study evaluates whether the MyTime intervention could improve TPA and EDF in preschool children aged five to six-year INS. A registered randomized controlled trial (ISRCTN85136134) using a waiting-list control group investigated the effectiveness of MyTime, an occupational therapy intervention program given to preschool children INS in their classrooms for 8 weeks. Data collection included KaTid-Child® for the assessment of TPA, the Time-Parent scale, the Adaptive Behavior Assessment System, and the Autonomy scale for assessing EDF. To evaluate between-group differences, data were analyzed using linear regression. The results show that both groups improved from baseline to post-intervention in TPA and everyday functioning but at the post-intervention, there were no between-group differences. To summarize, the MyTime intervention, indicated an increase in TPA and EDF but no between-group differences were found. Early cognitive levels of TPA in preschool children INS advocate for a longer intervention period. It is possible that long-term follow-up or additional measuring of the teacher’s attitudes and the children’s engagement in the preschool context could have yielded other results.

Effect of Sensory Integration-Based Occupational Therapy Intervention on Sensory Functions and Neuromotor Performance of a Baby with Down Syndrome: Case Report

The aim of this study was to investigate the effects of a sensory integration-based occupational therapy intervention programme on the sensory functions and neuromotor performance of a 14-month-old baby with Down syndrome (DS). The study evaluated the baby's sensory functions using the Test of Sensory Functions in Infants (TSFI) and neuromotor performance using the Neuro Sensory Motor Development Assessment (NSMDA) after recording demographic information. The infant participated in a 12-week occupational therapy intervention program, receiving 45-minute sessions once a week, and the family was provided with a home program. Evaluations were conducted before and after the intervention. The results showed positive improvements in the infant's sensory functions and neuromotor performance. The baby's NMDA functional level score decreased from 17 to 11, while the TSFI total score increased from 29 to 42. The study found that sensory integration-based occupational therapy intervention could be effective in improving sensory functions and neuromotor performance in a baby with DS. These results suggest that clinical management of sensory and neuromotor function may be of benefit to a significant number of babies with DS.

Development and pilot testing of an occupational therapy intervention program based on Occupational Adaptation Model for caregivers of people with multiple sclerosis

Introduction: Multiple sclerosis (MS) can have negative consequences on caregivers’ level of performance and adaptive process. This study aimed to (i) describe the steps of developing an occupation-based program based on the Occupational Adaptation Model (OAM), and (ii) make a preliminary assessment of the feasibility of the program prepared for caregivers of people with MS. Method: In a mixed-method approach, the occupation-based program of “Adapting to the Occupational Challenges of Caregivers of people with MS” (AOCCMS) was developed in four steps. During Steps 1, 2, and 3 the AOCCMS program was developed and in step 4, the feasibility and acceptability of the program were evaluated. Results: Based on the results of step 1 that have been published in the past; time limitations in occupation implementation; care needs in occupation implementation; psychological reactions affecting occupations were occupational challenges affecting the daily occupations of caregivers. Also, occupational adaptation strategies were strategies to alleviate intrapersonal challenges of occupational adaptation and strategies to alleviate environmental challenges of occupational adaptation. In step 2, the intervention programs of studies on caregivers were reviewed. During step 3, the data obtained from steps 1 and 2 were merged and integrated. Finally, the AOCCMS program was developed. In step 4, during the feasibility and acceptability of the program, 75% caregivers were satisfied with the program content. The quality of the program content was excellent and very good for 100%. Conclusion: The AOCCMS is an occupation-based program which was evaluated to be feasible and acceptable, which may be further addressed in future research and clinical practice.

Life Domains and Lifestyle of Older Adults Living in a Nursing Home: A Pilot Study.

Although the preventive occupational therapy intervention program Lifestyle Redesign® has proven to be effective in maintaining and improving the health and quality of life of older adults, a similar program has not yet been culturally adapted to the Spanish population. As a preliminary step in developing a lifestyle intervention tailored to healthy Spanish older adults living in a nursing home (Lifestyle Choice; originally in Spanish "Elección de Estilo de Vida"), we aimed to identify and describe the life domains of this population and determine overlap with content areas addressed in the Lifestyle Redesign® program. An observational cross-sectional study was carried out using quantitative methods, including 30 healthy older adult residents in the "Virgen del Prado" nursing home in Talavera de la Reina (Toledo), based on the development of a questionnaire and a survey. Six life domains were identified: self-care, sleep and rest, mobility, personal safety, health maintenance, spirituality, and free time usage. The results of this study reveal important overlaps with content areas of Lifestyle Redesign®, suggesting that it may be feasible to develop a lifestyle intervention ("Elección de Estilo de Vida") tailored to the sociocultural features of the healthy Spanish population over 65 years old living in nursing homes.

Development and feasibility testing of an evidence‐based occupational therapy program for adults with both Down syndrome and dementia

AbstractThis paper describes the development of a home‐based occupational therapy intervention program for people with Down syndrome who experience early on‐set dementia causing a decline in their performance skills and increasing care dependency on their informal caregivers. A six‐step methodological process adapted from the Medical Research Council framework for developing and evaluating complex interventions was formulated to develop an evidence‐based occupational therapy program for people with both Down syndrome and dementia and their informal caregivers. The first two steps gathered evidence through systematic reviews of the literature and determined the scope of current occupational therapy practice. The gathered evidence was synthesised in step three to develop a client‐centred occupational therapy intervention program for persons with both Down syndrome and dementia and their informal caregivers. In steps four and five, opinions were sought from occupational therapists working in this area of practice on the content of the developed program and its feasibility within the Australian disability services context. The final testing step can be conducted in the future using a single‐case experimental design study. It is important to use rigorous frameworks and gather comprehensive evidence using multiple methods to develop interventions for small heterogeneous populations. The developed occupational therapy program for persons with both Down syndrome and dementia and their informal caregivers appears feasible to be implemented within the Australian disability services; however, funding limitations imposes barriers for its implementation in clinical practice.

Programa Personalizado de Atividades (TAP-BR): proposição de uma versão ambulatorial e avaliação dos seus impactos na demência - Estudo piloto

Abstract Introduction The Tailored Activity Program (TAP-BR) is an occupational therapy intervention program that presents promising results in reducing the behavioral and psychological symptoms of dementia (BPSD). Objectives To propose adaptations to the TAP-BR to create an outpatient care version of this program and assess its impact and applicability. Methods The TAP-BR was adapted for use and application in an outpatient care setting, and the applicability of this version was assessed according to the perception of occupational therapy interns and family caregivers. The Neuropsychiatric Inventory (NPI) and the Depression, Anxiety and Stress Scale (DASS 21) were used as outcome measures to evaluate the impact of the adapted version. Results The following changes in the application process of the TAP-BR were proposed for its outpatient format: adaptation of terms in the Intervention Manual and in the Documentation Folder; adequacy of the environmental assessment to be carried out based on an interview with the caregiver; reduction in session duration from 90 to 60 min. From the point of view of the interns and family caregivers, the program can be easily applied. The outcome measures showed that there was improvement in caregiver distress in relation to the BPSD of the older persons with dementia (Cohen’s d=0.49) and in their emotional state (Cohen’s d=0.59), especially regarding the variable depression (Cohen’s d=0.81). Conclusion: The outpatient version of TAP-BR can be easily applied, has a positive impact on reducing the BPSD in older people, and improves the emotional state of caregivers, with emphasis on the variable depression.

Early Occupational Therapy Intervention in the Hospital Discharge after Stroke.

Stroke is the leading cause of acquired disability in adults which is a cerebrovascular disease of great impact in health and social terms, not only due to its prevalence and incidence but also because of its significant consequences in terms of patient dependence and its consequent impact on the patient and family lives. The general objective of this study is to determine whether an early occupational therapy intervention at hospital discharge after suffering a stroke has a positive effect on the functional independence of the patient three months after discharge—the patient’s level of independence being the main focus of this research. Data will be collected on readmissions to hospitals, mortality, returns to work and returns to driving, as well as an economic health analysis. This is a prospective, randomized, controlled clinical trial. The sample size will be made up of 60 patients who suffered a stroke and were discharged from the neurology unit of a second-level hospital in west Malaga (Spain), who were then referred to the rehabilitation service by the joint decision of the neurology and rehabilitation department. The patients and caregivers assigned to the experimental group were included in an early occupational therapy intervention program and compared with a control group that receives usual care.

Optik Disk Hipoplazili Bir Çocukta Kanada Okupasyonel Perfomans Modeli’ne Göre Ergoterapi Müdahalesinin Etkinliğinin İncelenmesi: Olgu Çalışması

Optic disc hypoplasia (ODH) is a non-progressive condition that can develop unilaterally or bilaterally, with decreased retinal nerve fiber count and normally developing retinal tissue. Decreased vision, visual field changes and defects in color vision mau be seen in individuals with ODH. A 3-year-old male pediatric case with ODH in the right eye was included in the study. The Canadian Model of Occupational Performance (CMOP) was used for the holistic evaluation of the individual, environmental and ocupational factors of the case, and the Visual Perception Reference Frame was used for the intervention application. The problem areas within the scope of CMOP were determined as difficulty in holding cutlery and therefore eating by spilling food, inability to distinguish small pictures on paper, weakness in perception of color and figure-ground, and weakness in gross motor skills (standing on one leg, jumping in place). The short-term goals in the 8-week intervention plan, development of visual discrimination (recognition, matching, classification) skills, development of color perception and figure perception, increasing the level of independence in eating with the help of auxiliary equipment (thickened cutlery); the long-term goals were determined as the development of figure-ground perception, the development of visual attention and the development of visual motor integration. With the target spesicif occupational therapy intervention program, the case was able to eat independently with the help of thickened cutlery, to be able to combine simple figures, large pieces and brightly colored puzzle pieces, to increase the time to stand on one leg, and to jump on two legs. There is a need for more evidence-based occupational therapy studies including visual perception studies in diagnoses affecting the visual field such as ODH.

Occupational therapy addressing the ability to perform activities of daily living among persons living with chronic conditions: a randomised controlled pilot study of ABLE 2.0

BackgroundThe ABLE intervention was developed to enhance the ability to perform activities of daily living (ADL) tasks among persons living with chronic conditions. ABLE is a generic, home-based, individualised, 8-week occupational therapy intervention program, developed to be delivered in Danish municipalities. In a previous study, the feasibility of ABLE was evaluated in terms of content and delivery. In this pilot study, the remaining feasibility aspects of a randomised controlled trial including (i) trial procedures (recruitment and retention), (ii) randomisation, (iii) adherence to program, (iv) feasibility of additional outcome measurements, and (iv) access to information on usual occupational therapy were evaluated.MethodsThe study was conducted in a Danish municipality, using a two-armed parallel randomised controlled design, planning a recruitment strategy including 20 persons living with one/more chronic conditions and experiencing problems performing ADL. The following progression criteria were used to determine if a future full-scale randomised controlled trial was feasible: (i) recruitment (50% met the eligibility criteria) and retention (80%), (ii) randomisation (80% accepted randomisation, procedure was executed as planned), (iii) adherence to program (100% followed the treatment protocol), (iv) outcome measurements (80% of the participants delivered relevantly and fully answered questionnaires), and (v) usual occupational therapy (extraction of needed information was successful).ResultsDue to the COVID-19 pandemic, the study was truncated resulting in limited but sufficient data to answer most of the study questions. (i) Eighteen of 37 eligible persons (48.6%) were recruited; of those treated (n = 6), all remained (100%); (ii) 18 accepted randomisation (100%), and procedure was effective; (iii) ABLE was delivered with adherence (100%); (iv) 92.3–100% of the participants gave relevant and complete answers in two of three questionnaires; and (v) needed information on usual occupational therapy was extractable in seven of nine aspects.ConclusionsProceeding to full-scale trial is recommendable; however, a few adjustments on outcome measurements, inclusion criteria and extraction of information on usual occupational therapy are needed.Trial registrationThe study was registered at ClinicalTrials.gov (Identifier: NCT04295837) on December 5th, 2019. Retrospectively registered.

Deriving the Components of Lifestyle-Related Occupational Therapy Intervention Program for the Elderly: Through the Delphi Technique

Deriving the Components of Lifestyle-Related Occupational Therapy Intervention Program for the Elderly: Through the Delphi Technique

The effectiveness of a self-management occupational therapy intervention on activity performance in individuals with multiple sclerosis-related fatigue: a randomized-controlled trial.

Purpose to evaluate the effectiveness of an individual self-management occupational therapy intervention program (SMOoTh) versus relaxation on the performance of and satisfaction with relevant daily activities in individuals with multiple sclerosis (MS)-related fatigue. in a single-blind randomized-controlled trial, 31 patients with MS (SMOoTh: n=17, relaxation: n=14) were randomly allocated to three individual sessions focusing on pacing, prioritizing, ergonomics, and self-management (SMOoTh) or on stress management and relaxation (relaxation). Outcomes (blind assessor): Canadian Occupational Performance Measure (COPM) (primary), Modified Fatigue Impact Scale, Checklist Individual Strength and Short-Form Health Measure. COPM improved in the SMOoTh and relaxation group after the intervention and 3 months later (COPM performance: F=13.1, P=0.001 and COPM satisfaction: F=10.4, P=0.001); nonsignificant group differences showed a trend in favor of SMOoTh. Modified Fatigue Impact Scale, Checklist Individual Strength, and most of the Short-Form Health Measure subscales did not change. Clinically relevant changes in COPM performance scores were found in 71 and 27% of patients in the SMOoTh versus the relaxation group. Both interventions seem to be feasible approaches to improve performance of and satisfaction with relevant daily activities in people with MS, with a sustained effect after 3 months. Neither program altered change fatigue (impact) or quality of life. Future studies with larger sample sizes are needed.

A Study on Effect of Occupational Therapy Intervention Program Using Cognitive-Perceptual and Perceptual-Motor Activities on Visual Perceptual Skills in Children with Cerebral Palsy

A Study on Effect of Occupational Therapy Intervention Program Using Cognitive-Perceptual and Perceptual-Motor Activities on Visual Perceptual Skills in Children with Cerebral Palsy

Effectiveness of an occupational therapy intervention in reducing emotional distress in informal caregivers of hip fracture patients: a randomized controlled trial

Objective: To examine the effectiveness of an occupational therapy intervention program in reducing emotional distress in informal caregivers of hip fracture patients. Design: Single-blind randomized controlled trial. Setting: A public Trauma and Rehabilitation Hospital in Granada, Spain. Participants: A total of 186 caregivers and their care recipients with hip fracture (93 in each group) were allocated to an intervention group or a control group using a block system. Intervention: An occupational therapy intervention during patient hospitalization focused on patient handling by caregivers and ergonomic treatment for both. Main measures: The Goldberg General Health Questionnaire was used to measure emotional distress and psychological well-being. The Goldberg Anxiety and Depression Scale was used to measure caregiver affective illness. Results: Among informal caregivers, emotional distress decreased to a greater extent in the intervention group than in the control group from the first assessment to the six-month follow-up (intervention group: 4.16 (SD 4.57) to 2.81 (SD 2.93); control group: 4.61 (SD 4.57) to 4.24 (SD 4.30)), showing significant differences at the first, third and sixth month. As regards anxiety levels, significant differences were only found at the third month (1.54 (SD 2.09) vs. 2.35 (SD 2.53) in the intervention and control groups, respectively (p < 0.05)), although the intervention group always showed lower levels from the first month. Although depression levels decreased in both groups, the decrease was also greater in the intervention group. Conclusion: Occupational therapy training for caregivers of hip fracture patients helps to significantly reduce emotional distress, anxiety and depression in caregivers.

Reliability of Short Gravitational Insecurity (SGI) Assessment among Indian children

The purpose of this study was to examine reliability of Short Gravitational Insecurity (SGI) assessment among Indian Children. Short Gravitational Insecurity assessment consists of 5 items with two behavioural categories. Interrater reliability and test-retest reliability of SGI was examined. Fifty Gravitational Insecurity children participated in the study. Two raters were trained to administer the SGI Assessment by the first author, using demonstration and verbal instruction. Fifty gravitational insecurity children were tested by two raters for interrater reliability. The primary rater re-administered the SGI Assessment to the same 50 gravitationally insecure children after 2 weeks interval to establish test- retest reliability. ICC was used to analyze the interrater reliability and test-retest reilaibility. The results were 0.90, p<0.001 for Emotional Response; 0.93, p<0.001 for Postural Response; 0.96, p<0.001 for Total Score indicating acceptable level of reliability for emotional response, postural response and total score of the SGI assessment. The results were 0.95 for Emotional Response, 0.90 for Postural Response and 0.97 for Total Score indicating good test - retest reliability. Hence, it provides supportive evidence to the stability of SGI assessment over different period of intervals. The result of this study was concluded that SGI assessment has excellent interrater and test-retest reliability. . It can be used as assessment tool as well as outcome measure to evaluate effectiveness of occupational therapy intervention program.

Model of Occupational Empowerment and Gunnarsson’s Tree Theme: Intervention for Mothers in Recovery

In this study the authors investigated Gunnarsson's Tree Theme Method as an occupational therapy intervention program for mothers in recovery from addiction in accordance with Fisher and Hotchkiss's Model of Occupational Empowerment (2008). Each session of this mixed design study consisted of relaxation exercises, discussions on self-help readings, and participation in the Tree Theme Method. Two participants out of three improved their personal growth initiative. Participant reflection provided insight into the women's inner feelings. Fisher and Hotchkiss's model (2008) was supported as the women achieved personal growth. Further research is needed concerning how this may guide occupational therapy practice with disadvantaged populations.

&lt;b&gt;Efeito da intervenção terapêutica ocupacional junto a crianças com déficts de percepção visual, cordenação motora e integração visuo-motora&lt;/b&gt;

To students with special educational needs participate actively at school are required effective and systematic investment, involving the school community as a whole. The occupational therapist is one of the professionals who can facilitate this student inclusion process. This study aimed to discuss the occupational therapy intervention effects with two disability children with deficits in visual perceptual skills, motor coordination and visual motor integration, that was included in regular education. The Beery-Buktenica Developmental Test of Visual Motor Integration was use to evaluate visual perceptual skills, motor coordination and visual-motor integration. Because the deficits presented in the functions investigates was identified the need of an occupational therapy intervention program designed to improve the performance in theses functions. After the program, the test was reapplied. The results pointed to an improvement of all functions considered deficient. These results highlight to the training importance to improve the performance in abilities evaluated.

&lt;b&gt;Efeito da intervenção terapêutica ocupacional junto a crianças com déficts de percepção visual, cordenação motora e integração visuo-motora&lt;/b&gt;

http://dx.doi.org/10.5902/4665Para que o aluno com necessidades educacionais especiais participe ativamente da escola são necessários investimentos efetivos e sistemáticos, envolvendo a comunidade escolar como um todo. O terapeuta ocupacional é um dos profissionais que pode favorecer o processo de inclusão destes alunos. Este estudo teve como objetivo discutir o efeito da intervenção terapêutica ocupacional junto a duas crianças com deficiência incluídas no ensino regular, com déficits de percepção visual, coordenação motora e integração visuo-motora. Para a avaliação das habilidades de percepção visual, coordenação motora e integração visuo-motora foi utilizado o Beery-Buktenica Developmental Test of Visual-Motor Integration. Em virtude dos déficits apresentados nas funções investigadas foi verificada a necessidade de aplicação de um programa de intervenção terapêutico ocupacional visando à melhora dessas funções. Após aplicação do programa, o teste foi reaplicado. Os resultados apontaram para a melhora de todas as funções consideradas deficitárias, sinalizando a importância do treinamento de desempenho. Palavras-chave: Terapia ocupacional; Educação especial; Integração visuo-motora.

Using the Evaluation of Social Interaction in a community-based program for persons with traumatic brain injury

The purpose of this study was to examine the utility of the Evaluation of Social Interaction (ESI) in a community-based program for persons with traumatic brain injury (TBI), as well as its effectiveness in measuring occupational therapy intervention. Ten people who experienced a TBI and were participating in a community-based program were a convenience sample for this study. The Occupational Therapy Intervention Process Model (OTIPM) provided the theoretical framework. The ESI provided a pre-test performance measure and also served as a guide for an eight-week occupational therapy intervention program, and as a post-test to measure intervention effectiveness. This study showed that the ESI was effective in guiding therapist intervention related to social skill performance of participants during their participation in a community-based program. As a group, the difference between pre and post ESI logit measures was also significant (t=4.977, p=0.001). The study provides initial considerations for the utility of the ESI to guide intervention related to social skill performance during daily occupations. It further documents the effectiveness of the ESI in measuring occupational therapy intervention, based on OTIPM, and supports occupational therapy services provided in a community-based program context for those living with TBI.

Effects of occupational therapy intervention on activities of daily living and awareness of disability in persons with intellectual disabilities

Aim: The purpose of this study was to evaluate the effects of an occupational therapy intervention program on activities of daily living (ADL) ability and awareness of disability. Methods: Six persons with intellectual disabilities participated in the study, which was based on a single‐case design. Assessment of Motor and Process Skills and Assessment of Awareness of Disability were used as evaluation tools. Results: Activities of daily living performance improved in five of the six participants after implementation of the program, with improvement across both motor and process skills. However, no clear improvement in awareness of disability was found following implementation of the program. Conclusion: It may be concluded from this study that persons with intellectual disabilities can benefit from occupational therapy interventions to improve ADL ability, even in the absence of any change in their awareness of disability.

Mothers of Children with Disabilities: Occupational Concerns and Solutions

Mothers of children with disabilities have identified multiple challenges associated with achieving occupational balance in their lives. Occupational therapists are just beginning to explore the occupational and time use strategies that mothers use to successfully care for their children and get through the day in a positive manner. The Person—Environment—Occupation model was used to guide an occupational therapy intervention program called “Project Bien Estar,” which was designed to increase the satisfaction, time use, and occupational performance of mothers of school-aged children with disabilities. This article focuses on the rich content of the group discussions and individual reflections, providing insight into the world of women caring for children with disabilities. Thematic analysis was used to identify person, environment, and occupation factors that contribute positively and negatively to the mothers' well-being, and the effects of the occupational therapy intervention are discussed.