Occupational Therapy Intervention Research Articles

The feasibility of occupational therapy using Zones of Regulation™ Concepts in an equine environment

IntroductionThe current paper aimed to assess the feasibility of a modified intervention protocol named “Occupational Therapy using Zones of Regulation Concepts in an Equine Environment” (OT-ZOR Equine).MethodsA single arm A-B feasibility study was conducted, involving 14 autistic youth ages 6-13 years who first received 10-weeks of occupational therapy without horses (OT-ZOR Clinic) followed by 10-weeks of OT-ZOR Equine.ResultsAll participants completed the study and attended 95% of OT-ZOR Equine sessions. Occupational therapists maintained 91% fidelity to the OT-ZOR Equine intervention protocol and there were no serious adverse events. All participants’ caregivers and study occupational therapists rated being satisfied or very satisfied with the OT-ZOR Equine intervention. Youth demonstrated improved self-regulation following participation in the OT-ZOR Clinic and OT-ZOR Equine interventions. However, participants’ social functioning only improved after OT-ZOR Equine.DiscussionThis study demonstrated that OT-ZOR Equine is feasible to implement, acceptable to recipients and providers, and may offer additive benefits in social functioning compared to occupational therapy intervention without horses. The current study provides a foundation for future efficacy research aimed at quantifying additive benefits of integrating horses into occupational therapy for autistic youth.

Community-Engaged Implementation Strategies in Occupational Therapy: A Scoping Review.

Despite the potential of community-engaged implementation research (CEIR) in developing strategies to accelerate the translation of evidence-based interventions (EBIs), there is a noticeable knowledge gap in the current state of CEIR in occupational therapy. A synthesis of the concept, purpose, and operationalization of CEIR is necessary. To identify the contexts, purposes, and operationalization of CEIR, focusing on implementation strategies in occupational therapy. PubMed/MEDLINE, Embase, CINAHL, Scopus, and Web of Science. We included studies that were explicit and intentional about CEIR and that focused on implementation strategies to support the translation of occupational therapy interventions, clinical guidelines, practice models, theories, or assessments. We extracted the research context (e.g., partners, recruitment), purpose (e.g., why community-engaged research was used), and operationalization (e.g., community engagement [CE] activities, how their findings inform the research) using thematic analysis. Of 3,219 records, 6 studies were included. Involved partners were mainly occupational therapy practitioners from existing networks. CEIR that focuses on implementation strategies informs various aspects of research design, ranging from study design to sustainability, by developing community-academia partnerships, building implementation capacity, and creating implementation strategies across diverse research areas. Current research has used various but mostly traditional CE activities (e.g., focus groups). We synthesized evidence on CEIR focused on implementation strategies in occupational therapy. Intentional efforts are needed to collaborate with diverse partners, explore innovative CE activities, produce equitable outputs, and develop multilevel implementation strategies to accelerate the translation of EBIs into practice. Plain-Language Summary: In this review, we synthesize evidence on the contexts, purposes, and operationalization of community-engaged implementation research (CEIR), focusing on implementation strategies in occupational therapy research. We found that current implementation efforts mainly rely on occupational therapy practitioners as community partners and use traditional recruitment methods and community engagement activities. In turn, they develop implementation strategies that mainly target practitioners without comprehensive, multilevel implementation support. We suggest more equitable collaboration with diverse partners to effectively promote the implementation and dissemination of evidence-based interventions in occupational therapy practice.

Real-world occupational therapy interventions for early-stage dementia: Characteristics and contextual barriers.

There is an absence of evidence generated in a UK context to support interventions based on occupational therapists' core skills for people living with early-stage dementia. To inform the development of a programme theory and a future evaluation, this paper aimed to describe real-world (routine) community-based occupational therapy interventions for this population and contextual barriers. Occupational therapy practitioners (n = 21) from five Health Boards in Wales, UK participated in semi-structured interviews (n = 17) which were audio recorded, transcribed, and analysed thematically. The availability of, and access to, real-world community-based interventions was variable, and associated with multilevel contextual barriers (resources, understanding of dementia specialist occupational therapy, professional influence, and evidence base). Where available and accessible, contents comprised a pre-intervention component (relational work, assessment, and goal setting) and intervention component (personalised problem-solving and coping strategies, emotional support, and advice and signposting), to meet needs associated with everyday activities and poor wellbeing. Variation in mode, duration, contents, and who received interventions, was associated with contextual barriers. Findings indicate that the development of an intervention programme theory and future evaluation design, will need to account for the impact context may have on the variability of real-world intervention characteristics, and how this in turn may influence outcomes.

Advances in Cerebral Palsy Treatment

Background: Cerebral palsy is a complex neurodevelopmental disorder with various etiological factors and treatment options. This narrative review aimed to summarize the causes of cerebral palsy, identify areas needing additional research in treatment approaches, and highlight areas requiring further investigation. In order to provide a thorough overview of management techniques to lessen the effects of the illness and its consequences, this review has drawn data from a number of studies. Introduction: Prematurity increases the risk of brain damage during the developing stage and accounts for a sizable fraction of cerebral palsy cases. In a sizable portion of cases, maternal diabetes and hypertension are listed as the main causes. Damage to the brain tissue results from hypoxic-ischemic injuries sustained during pregnancy that upset the equilibrium of oxidants and antioxidants. To alter the oxidative stress pathway and ease related issues, pharmacological treatments, such as therapeutic hypothermia, free radical inhibition therapy, and mitochondrial therapy, have been proposed. Therapeutic strategies, such as physiotherapy, occupational therapy, speech therapy, and surgical interventions, have added quality to the lives of the children. Some of the most recent developments in this area include the development of biomarkers for muscle activity detection, machine learning to predict the types of cerebral palsy and abnormal movements, disease prediction with eye images, wireless inertia measuring unit for spasticity detection, computerbased video analysis of typical and atypical infants, identification of intellectual disabilities with algorithms, and deep learning methods for predicting cerebral palsy. Methods: This narrative review is based on a careful analysis of numerous researches conducted on cerebral palsy, which have served as the basis for statistical distribution. It reviews the causes of cerebral palsy, available treatments, and ongoing research with the goal of providing physicians and researchers in the field with useful information. The objectives, study questions, inclusion criteria, and search approach have all been outlined in a thorough protocol. To find pertinent research published up to September 2021, a literature search was carried out using electronic databases, including Google Scholar, PubMed, Cochrane Library, Scopus, and Web of Science. A combination of pertinent keywords, such as "cerebral palsy," "management," "technology," "wearable technology," "prematurity," and "artificial intelligence," has been used in the search approach. Results: Recent advances in the field include the discovery of biomarkers for the detection of muscle activity, machine learning algorithms to predict the types of cerebral palsy and abnormal movements, disease prediction using eye images, wireless inertia measuring units for the detection of spasticity, computer-based video analysis for the detection of atypical infants, and algorithms to identify intellectual disabilities. Additionally, employing technologies, like virtual reality systems, electrical stimulators, activity trackers, machine learning, and deep learning approaches, has shown promise in evaluating, diagnosing, and predicting treatment outcomes linked to gait, upper limb, and lower limb function. Conclusion: Future research should examine the clinical application of nanomedicine, stem cell therapy, and cutting-edge therapeutic strategies to prevent hypoxic-ischemic damage in the developing brain. Additionally, research is required to effectively assist children with severe speech difficulties using alternate communication modalities and cutting-edge computational tools. The outcomes for people with cerebral palsy can be improved by combining interdisciplinary efforts with cutting-edge technological interventions.

Promoting home safety with older adults: a systematic review of occupational therapy interventions

Purpose Due to the projected increase in the older adult population, occupational therapy providers will have an increasing role in supporting health outcomes for older adults in the coming years. The purpose of this systematic review was to determine the effectiveness of occupational interventions to promote home safety in older adults. Design/methodology/approach This systematic review followed the Preferred Reporting Items of Systematic reviews (PRISMA) guidelines. Articles were double screened by separate researchers, then exported and managed in EndNote. The Risk of Bias Table determined certainty of evidence for themes. Findings Three main preliminary themes were identified from the 17 included articles. Themes include multimodal interventions (n= 6), exercise interventions (n= 9) and home modifications (n = 2). None of the articles explicitly defined home safety, but distal outcomes related to safety included: increased strength, balance improvement and functional mobility. Research limitations/implications Importantly, an absent consensus for a definition of home safety limits the results of this systematic review while at the same time providing opportunity for future research. Practical implications Exercise combined with nutrition provided the strongest intervention evidence for physical functionality. Additionally, home modifications alone may be insufficient to result in improved home safety. Social implications An occupational therapy’s (OT) holistic approach benefits older adults through evidenced-based interventions improving home safety, independence in functional tasks and overall quality of life. Originality/value Findings provide clinicians with information on the effectiveness of interventions within the scope of OT that can be implemented within the home to promote home safety.

Early Occupational Therapy Intervention Programme and Coping Strategies and Burden in Caregivers of People with Sub-Acute Stroke: A Randomised Controlled Trial.

Caregivers of people who have suffered a stroke experience a great burden and may use disengagement coping strategies. We studied the influence of an early occupational therapy intervention programme in the process of hospital-to-home discharge after stroke (EOTIPS) in a Spanish cohort that improved patients' quality of life and caregivers' burden and coping strategies. EOTIPS was delivered by a single occupational therapist. We conducted a prospective randomised controlled trial that included 60 adults who suffered a stroke, of which 91.6% had a caregiver who agreed to be involved in their care (n = 55). Evaluations assessed the caregivers' burden and coping strategies within two weeks post-stroke and after a three-month follow-up. Statistical analyses included intent-to-treat analysis (considering dropouts as failures) and efficacy analysis, considering only end-of-treatment participants. The caregivers in the intervention group showed a significantly better evolution in the main outcome measure of burden (p = 0.019), as well as in the coping strategies of social support (p = 0.037) and social withdrawal (p ≤ 0.001), compared with the control group. EOTIPS was effective in improving the caregivers' burden and two coping strategies, and it could be considered as an applicable tool that can minimise the risk of suffering burden.

Facilitators of and Barriers to Caregiver Adherence to Home Therapy Recommendations for Infants and Children With Neuromotor and Neuromuscular Diagnoses: A Scoping Review.

Caregiver-performed home therapy programs are essential to occupational therapy intervention for infants and children with neuromotor and neuromuscular diagnoses. Factors that facilitate or are barriers to caregiver adherence when making home therapy recommendations should be considered. To identify facilitators of and barriers to caregiver adherence to home therapy recommendations for children with neuromotor and neuromuscular disorders. The review followed the five-step methodological framework developed by Arksey and O'Malley (2005) and was guided by the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. Searches with no language or date range limits were performed in MEDLINE, CINAHL Plus with Full Text, PsycINFO, and SocINDEX on the EBSCO platform, and Scopus on the Elsevier platform from database inception through January 24, 2023. Study inclusion criteria included caregiver adherence to home therapy recommendations for children with neuromotor and neuromuscular diagnoses. Eight hundred seventy-five articles underwent title and abstract screening; 64 articles met the criteria for full review. Twelve articles met the inclusion criteria. Four used qualitative measures, 7 used quantitative measures, and 1 used mixed methods. Qualitative thematic analysis revealed four facilitators: routine, efficacy of caregiver education, positive relationship with therapist, and perceived benefit of treatment. The analysis revealed three barriers: lack of time, lack of confidence, and caregiver stress. The facilitators and barriers identified are central to best-practice occupational therapy. Therapists can use expertise in analyzing routines and context to maximize the fit between family needs and home therapy recommendations. Plain-Language Summary: Home therapy for children with a neuromotor and neuromuscular diagnosis is common and uses some form of caregiver-performed movement activities or techniques. To support caregivers, occupational therapists need to understand what factors facilitate or serve as barriers to following home therapy recommendations. The review found three barriers: lack of time, lack of confidence, and caregiver stress. The review provides strategies to support home therapy based on core principles of occupational therapy practice. It also identifies the need for more research to support home therapy recommendations that fit within the child's and family's routine, that can be taught in a way that meets the child's and family's learning needs, that facilitate self-efficacy and confidence, and that reflect the values and motivators of all participants.

Exploring the impact of early-stage dementia on everyday activities

Introduction: This paper explores the impact that early-stage dementia has on everyday activities from the perspective of people living with dementia, their supporters and occupational therapy practitioners. Method: People living with dementia and their supporters ( n = 10), and occupational therapy practitioners ( n = 21) took part in semi-structured interviews, with transcripts analysed thematically. Findings: Six primary themes were identified across participants, namely: (1) ‘Everybody seems to be different, [but] they are similar’; (2) An awareness of change: ‘Something’s not quite right’; (3) ‘ Changes’ and ‘ difficulties’ associated with complex and unfamiliar activities; (4) Social withdrawal and exclusion: ‘I’ve felt like I was a leper’; (5) Post-diagnostic mental health: ‘. . . a dark place’; and (6) A process of adaptation: ‘I’m still who I am, I can still do things. . .’ Conclusion: Findings indicate that occupational therapy intervention programmes for people living with early-stage dementia should target difficulties associated with a broad range of activity types, and include components that target mental health and motivational needs. The study adds to existing knowledge about the need to personally tailor interventions to ensure that they meet individual needs, experiences, and circumstances. Findings will inform the development of an occupational therapy intervention programme theory (theory of change) for early-stage dementia.

Effect of occupational therapy on the occurrence of delirium in critically ill patients: a systematic review and meta-analysis.

Delirium poses a major challenge to global health care, yet there is currently a dearth of single effective interventions or medications. Particularly, addressing delirium induced by critical illness is a complex process. Occupational therapy is considered to have a high potential for use in the prevention of delirium, as it involves both cognitive training and training in ADL. To comprehensively analyze the effect of occupational therapy on delirium prevention, we evaluated the effects of occupational therapy vs. standard non-pharmacological prevention on incidence and duration of delirium, clinical outcomes and rehabilitation outcomes in critically ill patients. The data sources, including PubMed/Medline, Web of Science, EMBASE, and Cochrane Library, were comprehensively searched from their inception until 15 October 2023. Following the PICOS principle, a systematic screening of literature was conducted to identify relevant studies. Subsequently, the quality assessment was performed to evaluate the risk of bias in the included literature. Finally, outcome measures from each study were extracted and comprehensive analysis was conducted using Review Manager 5.4. A total of four clinical trials met the selection criteria. The pooled analysis indicated no significant difference in the incidence and duration of delirium between the OT group and standard non-pharmacological interventions. A comprehensive analysis of clinical outcomes revealed that OT did not significantly reduce the length of hospital stay or ICU stay. Meanwhile, there was no significant difference in mortality rates between the two groups. It is noteworthy that although grip strength levels did not exhibit significant improvement following OT intervention, there were obvious enhancements observed in ADL and MMSE scores. Although occupational therapy may not be the most effective in preventing delirium, it has been shown to significantly improve ADL and cognitive function among critically ill patients. Therefore, we contend that occupational therapy is a valuable component of a comprehensive multidisciplinary approach to managing delirium. In the future, high-quality researches are warranted to optimize the implementation of occupational therapy interventions for delirium prevention and further enhance their benefits for patients.

The acceptance of the potential use of social robots for children with autism spectrum disorder by Indonesian occupational therapists: a mixed methods study

Purpose Social robots have shown positive effects in treating children with autism spectrum disorder. The development of social robots in Indonesia has enabled their potential use in occupational therapy. This study aimed to investigate the factors influencing the acceptance of the potential use of social robots by Indonesian occupational therapists in clinical practice. Methods This study employed a mixed methods explanatory sequential design. An adapted unified theory of acceptance and use of technology model was utilised for the quantitative phase. The questionnaire explored the acceptance of social robots. The data were analysed using structural equation modelling. In the qualitative phase, semi-structured interviews with reflexive thematic analysis were conducted. The second phase aimed to explain the reasons behind the quantitative results and factors related to the acceptance of social robots in therapy. Results Occupational therapists showed high interest in using social robots in their sessions, as indicated by the significant positive relationship between performance expectancy and potential use. Three influential factors affecting acceptance emerged in the qualitative phase: occupational therapists’ characteristics and competencies, social robots and occupational therapy interventions, and environmental influence. Conclusions Indonesian occupational therapists have shown interest in using social robots. However, there are challenges regarding the practical application of social robots concerning individual differences in the factors that influence acceptance.

Characterizing Occupational Therapy Intervention for Children on the Autism Spectrum.

Occupational therapy is one of the most used interventions for children on the autism spectrum. There is a critical need to develop an operationalized list of key treatment components of usual-care occupational therapy practice for children on the autism spectrum. To identify and develop consensus on definitions and examples of key treatment components of usual-care occupational therapy for children on the autism spectrum, ages 6 to 13 yr. We conducted a Delphi study to obtain feedback from a panel of experts. Electronic survey. 17 occupational therapy panelists with expertise in autism intervention. Panelists rated the definition and example of each treatment component and provided feedback through multiple rounds of survey. On the basis of the panelists' feedback on Delphi Round 1, the criteria rating form was revised to include four questions for the definition and example of each treatment component. Through four Delphi rounds of consensus building, we developed an operationalized list of 20 treatment components with definitions and examples that incorporated elements of usual-care occupational therapy intervention for children on the autism spectrum. This operationalized list of treatment components serves as a foundational framework to improve education, practice, and research of occupational therapy intervention for children on the autism spectrum. Plain-Language Summary: This study identified and developed consensus on definitions and examples of key treatment components used in usual-care outpatient occupational therapy for children on the autism spectrum. Through four rounds of consensus building with 17 occupational therapy experts in autism, we identified 20 key treatment components central to occupational therapy practice. Our results have the potential to serve as a framework to improve education, practice, and clinical research in autism.

Mobile Application Applied for Cognitive Rehabilitation: A Systematic Review.

The COVID-19 pandemic has increased the demand for home rehabilitation services, leading to the development and rising demand for cognitive rehabilitation apps. However, a comprehensive analysis of the content and effectiveness of these apps is needed. This study systematically reviewed and analyzed the literature on mobile apps for cognitive rehabilitation. One researcher and an external expert conducted the study selection, data extraction, and quality assessment following the PRISMA Checklist 2020 guidelines. Our review of 18 studies identified 8 randomized controlled trials (RCTs) (44.44%) of high quality and 10 non-RCT studies (55.56%) of moderate quality. Overall, 16 of the 18 studies (88.88%) demonstrated positive clinical implications for cognitive function after using cognitive rehabilitation apps. Eight studies showed a correlation between app use and improved cognitive function, and four highlighted the potential for cognitive function evaluation through apps. All studies employed various occupational therapy (OT) intervention approaches, with prevention being the most common (100%), followed by establishment and restoration (83.33%), maintenance (77.77%), and creation and promotion (38.88%). This study clinically validates the effectiveness of cognitive rehabilitation mobile applications from an occupational therapy perspective.

The Use of Occupational Therapy Interventions in a Hematology-Oncology Pediatric Intensive Care Unit

The Use of Occupational Therapy Interventions in a Hematology-Oncology Pediatric Intensive Care Unit

Response to intervention: The effects of tier 1 and tier 2 occupational therapy intervention on sensory processing for fifth-grade children

ABSTRACT Sensory processing impacts a student’s ability to participate in the classroom, yet there is a lack of studies analyzing the effect of occupational therapy (OT) services under the Response to Intervention (RtI) model on students’ sensory processing. The purpose of this study is to determine the effect of a manualized OT intervention, using the RtI model, on sensory processing in general education fifth-grade students and teachers’ understanding of sensory processing. This pretest-posttest quasi-experimental study included an experimental group that received OT RtI (n = 17) and a control group that did not receive OT RtI but teachers attended a workshop on sensory processing (n = 27). Pretest and posttest results from the Sensory Processing Measure-2 (SPM-2) School Form and an online survey of teachers’ understanding of sensory processing were collected. The Wilcoxon signed-rank test was used to analyze pre- and post-intervention SPM-2 results for each participant. In the experimental group, one subcategory approached significance, a slight decline approaching significance in the planning subcategory, and no significant changes in the remaining subcategories. In the control group, one subcategory demonstrated significance. Teacher understanding and use of sensory processing strategies showed an overall improvement in both schools. Preliminary evidence suggests teacher workshops have the potential to improve teacher understanding of sensory processing.

Ayres Sensory Integration® Intervention for Autistic Children: A Telehealth Adaptation.

Ayres Sensory Integration® is an evidence-based, manualized occupational therapy intervention for autism that is delivered in person. A telehealth adaptation could bridge service gaps for families who may have challenges accessing services. To create a telehealth adaptation of the evidence-based manualized protocol of Ayres Sensory Integration using best practice for telehealth guidelines and to obtain input on the adaptation from experts. Online survey of U.S. telehealth experts and occupational therapy clinicians in fall and winter 2022. Two telehealth experts and six occupational therapy clinicians. Two Qualtrics surveys focused on perceived feasibility and acceptability, resources included, and clarity of instructions. Telehealth experts and occupational therapy clinicians rated the Ayres Sensory Integration telehealth adapted manual as easy to follow, aligned with telehealth best practices, and feasible for remote delivery. Suggestions for additional adaptations included adding resources for technology troubleshooting, intervention planning, rapport building, and continuing education. Suggested adaptations were made; the manual is ready for feasibility testing. Plain-Language Summary: This report is the first to describe a telehealth adaptation of Ayres Sensory Integration®. The manual provides comprehensive training and resources to support clinicians in delivering sensory integration, telehealth-based interventions to autistic children. Two telehealth experts and six occupational therapy clinicians rated the Ayres Sensory Integration telehealth adapted manual as easy to follow, aligned with telehealth best practices, and feasible for remote delivery. The manual will be available to clinicians after feasibility and pilot testing.

Exploring the Efficacy of a Remote Strategy-Based Intervention for People With Multiple Sclerosis With Everyday Memory Impairments: A Pilot Study.

This pilot study evaluates a remote strategy-based intervention for individuals with multiple sclerosis who experience everyday memory impairments. The intervention can potentially inform cognitive rehabilitation for this population. To investigate the feasibility and efficacy of an intervention (TELE-Self-GEN) to determine whether it can alleviate everyday memory impairments of individuals with multiple sclerosis. Pretest-posttest. Community. Ten adults with multiple sclerosis. Six synchronous treatment sessions were delivered online via Zoom. The treatment protocol embedded a memory strategy (self-generated learning) within a metacognitive framework, including self-awareness and self-management strategies. The treatment emphasizes when and how self-generation should be used. Measurements assessed feasibility and participants' satisfaction with the intervention and its delivery method, as well as memory, everyday memory, and functional performance. Participants expressed high satisfaction with the virtual treatment, highlighting its convenience as a key factor. Treatment resulted in improvements in memory performance, perceived memory ability in daily life, and functional performance. Results provide initial proof of concept in the utilization of a remotely delivered, strategy-based treatment approach to improve memory performance and functional abilities. The pilot data support a larger randomized clinical trial of the TELE-self-GEN. Plain-Language Summary: The results of this pilot study highlight the promising potential of TELE-self-GEN for people with multiple sclerosis (MS), who face memory challenges every day. This remotely delivered, strategy-based occupational therapy treatment approach, TELE-self-GEN, has the potential to significantly improve functional memory. The study participants reported improvements in their memory performance, perceived memory ability in daily life, and functional performance. These encouraging results serve as a foundation for more extensive clinical trials using TELE-self-GEN for people with MS.

Affective Contact in Autism: A Phenomenological Study of the Emotional Experiences of Autistic Adults.

Since the first descriptions of autism, difficulties with affective contact (e.g., interpersonal exchanges of feelings between individuals) have been considered a common feature of autism spectrum disorder, and these difficulties frequently manifest in occupational therapy interventions. To (1) explore how autistic young adults describe their emotions and (2) suggest ways to improve the affective contact between autistic clients and their therapists. Virtual focus group interviews. Online (Qualtrics) survey and Zoom focus groups. Autistic adults (N = 24) who met the following inclusion criteria: self-reported diagnosis of autism spectrum disorder or Asperger syndrome, age 18-35 yr, able to understand English, and able to participate in a focus group or individual interview using verbal or written communication. Two themes were noted and are presented in this article: (1) Autistic people experience complex emotions and (2) autistic people's emotions are often (mis)measured and (mis)understood. The findings indicate that autistic people experience diverse, complex, and intense emotions and that these are connected to occupation. This suggests that occupational therapists must be attuned to the emotional dimension of occupation when working with autistic clients and that autistic clients may benefit from the use of embodied language to reference their emotions. Occupational therapists can help autistic clients recognize their bodily changes when experiencing emotions and to better identify and regulate their emotions. The results also show that there were many cases nonautistic people misinterpreted the emotions of autistic people on the basis of their facial expressions or words. Plain-Language Summary: This article provides information about the emotional experiences of autistic people. The study found that autistic people experience complex emotions and that those emotions are often misinterpreted or misunderstood. The author provides information on how occupational therapists can use a neurodiversity-affirming and person-centered approach to support the emotional experiences of people in the autism community. Positionality Statement: In this article, identity-first language is used when referring to autistic adults. This deliberate choice aligns with the principles of the neurodiversity-affirming movement. Autistic self-advocates have indicated a preference for this style of language over person-first language. The author would also like to acknowledge their positionality. As both a neurodivergent researcher and a self-advocate for the disabled community, this style of language aligns with their own experiences of and beliefs about their disability.

Responsiveness and Minimal Clinically Important Difference of the Canadian Occupational Performance Measure Among Patients With Frozen Shoulder.

Patient-reported outcome measures provide insights into intervention effects on patients. The Canadian Occupational Performance Measure (COPM) emphasizes identifying priorities in daily activity engagement and evaluating an individual's perception of changes over time. To assess the responsiveness of the COPM and the minimal clinically important difference (MCID) among patients with frozen shoulders. Prospective, single-blind, randomized controlled trial. Two physical medicine and rehabilitation clinics. Ninety-four patients with frozen shoulders enrolled in a previous study. Baseline and 3-mo evaluations of the COPM and other measures. Responsiveness was assessed using effect size (ES) and standardized response mean (SRM). The MCID values were determined through a distribution-based approach, which used the 0.5 standard deviation and ES methods, and an anchor-based approach, which used the receiver operating characteristic curve method. The ES and SRM results indicated that the COPM had high responsiveness. The distribution-based MCID values for COPM Performance and COPM Satisfaction were 1.17 and 1.44, respectively. The anchor-based MCID values were 2.5 (area under the curve [AUC] = 0.78, 95% confidence interval [CI] [0.64-0.91]) and 2.1 (AUC = 0.76, 95% CI [0.60-0.91]), respectively. The findings suggest that the COPM is a responsive outcome measure for patients with frozen shoulder. The established MCID values for the COPM can be valuable for interpreting changes in patient performance and satisfaction, thus aiding clinical interventions and research planning. Plain-Language Summary: This is the first study to review the effectiveness of the Canadian Occupational Performance Measure (COPM) to determine the success of occupational therapy interventions for people with a frozen shoulder. The findings suggest that the COPM is an effective and valuable tool for clients with a frozen shoulder to understand their experiences and treatment priorities and to detect meaningful changes in their performance and satisfaction after an occupational therapy intervention.

Occupational therapy interventions to address hospital associated deconditioning among older people: A scoping review protocol

Background Hospital-acquired deconditioning (HAD) is recognised as a state of reduced physiological, psychological, and functional after an acute hospitalization. Older people, particularly those with physical and social complexities are at risk of hospital-associated deconditioning, which is associated with increased length of stay in hospital, institutionalization, mortality, and increased healthcare costs. Thus, identification of effective approaches for the assessment, management, and prevention of HAD are pertinent. Occupational therapy has a potential role to play in prevention and treatment of HAD among older people. This scoping review will identify and map existing occupational therapy interventions which address deconditioning among older people. Methods This scoping review will be conducted using the framework proposed by the Joanna Briggs Institute and the Preferred Reporting Items for Systematic Reviews and Meta-analysis extension for scoping reviews (PRISMA-ScR), will be used to guide the reporting. A comprehensive search strategy using relevant key words and index terms will be developed and applied across Embase (OVID), Medline (OVID), CINHAL (EBSCO), PsychInfo (ProQuest), SCOPUS databases. This will be followed by search of the reference lists of selected sources and hand-search relevant data-hubs. The search will cover studies published in English from January 2014 to the present date. Titles and abstracts will be screened against inclusion criteria. Data will be extracted using a form developed for this review. The Template for Intervention Description and Replication (TIDieR) checklist (Hoffmann et al., 2014) will be applied to papers where specific interventions are reported. Key information on assessment and intervention practices will be categorised and classified in a narrative summary. Conclusion This scoping review will examine current practice internationally regarding the role of occupational therapy in prevention and treatment of HAD among older people.

The perceptions of nurses and physicians in primary care of rehabilitation for frail older adults.

To investigate the perceptions of primary care nurses and physicians of the potential contributions of physiotherapists (PTs) and occupational therapists (OTs) in the treatment of frail older persons, as well as the obstacles to, and opportunities for, collaboration. A qualitative study. Nurses (n = 9) and physicians (n = 8) in primary care in the county council [14 women (82%)] with experience working with older people. Interview study conducted with a semi-structured interview guide. Analyses were carried out with content analysis with an inductive approach. The analysis resulted in six categories: knowledge of physiotherapy and occupational therapy interventions; what triggers the need for physiotherapy and occupational therapy?; the availability of rehabilitation interventions; teamwork opportunities and difficulties; motivating the patient; the site of the rehabilitation. Close and clear collaboration between nurses and physicians and PTs and OTs is an important factor in ensuring that rehabilitation interventions provide the greatest possible benefit to the patient. Improving communication between different healthcare providers and clarifying the contact routes is a prerequisite for patients to be able to get the rehabilitation they need. More research is needed to determine the best approach to achieving this goal.