Occupational Therapy Research Articles

Task-Based Eating and Drinking Interventions in Animal Models: A Narrative Review of Functional Improvements and Neuromuscular Adaptations in Age-Related Dysphagia.

Age-related dysphagia involves sarcopenia and nervous system changes affecting ingestion. The ACT-ING program, a novel task-based occupational therapy intervention, has been developed to improve strength, endurance, and ingestive skills using real-world eating and drinking tasks for older adults with age-related dysphagia. This narrative review evaluates the outcomes and neuromuscular adaptations of task-based eating and drinking interventions in aging animal models to inform potential refinements of the ACT-ING program and interpret results from an ongoing proof-of-concept study. Publications were obtained from PubMed, SCOPUS, CINAHL, and EMBASE, and selected following the PRISMA guideline. Thirteen randomized trials investigated a task-based fluid-licking intervention in rats, combining strength, endurance, and skill training. Results suggested benefits in improving muscle strength, endurance, and swallowing skills in terms of quantity and speed. Although neuromuscular adaptations were less conclusive, the intervention appeared to induce cortical plasticity and increase fatigue-resistant muscle fibers in the involved muscles. While these findings are promising, methodological concerns and potential biases were identified. Therefore, further research is necessary to refine the ACT-ING program, including both clinical studies in humans and preclinical studies in aging animal models that clearly define interventions targeting all aspects of ingestion-related skills within a motor learning and strength training framework.

Examining Leisure Re-Engagement and Its Relationship With Self-Regulation After Traumatic Brain Injury: A Cross-Sectional Study.

Engagement in leisure activities is a significant contributor to health. Individuals with traumatic brain injury (TBI) report not returning to pre-injury levels of leisure participation. Self-regulation (SR) is a possible factor of limited re-engagement. This study aimed to examine leisure re-engagement patterns and the impact of SR on these patterns. Fifty-five adults with TBI were included in a cross-sectional study. Participants completed a leisure activity survey, rating engagement before and after injury. Participants and an informant completed the Frontal Systems Behavior Scale (FrSBe) to assess SR. Leisure was significantly lower after injury than before injury, t(54) = 3.83, p < .001. The FrSBe apathy score was significantly associated with lower re-engagement (eta = 0.42) and may predict engagement after injury (ΔR2 = .09, p < .05). Apathy may contribute to difficulty re-engaging in leisure activities. Re-engagement in leisure activities should be a focus of occupational therapy intervention after TBI.

Exploring Interoceptive Awareness With Adults: Occupational Therapy Practitioner Knowledge, Perception, and Practice Patterns.

As the literature states, interoception is important in health and wellness. Disruption of this system can negatively impact occupational performance. We completed a descriptive study to understand how occupational therapy practitioners working with adults address interoceptive awareness. A researcher-developed survey gathered data on knowledge acquisition of interoception and perceived practice patterns related to assessment, intervention, and outcomes. Participants (N = 44) reported acquiring knowledge of interoception through professional websites, browsing databases, and continuing education as the most common information sources. Client self-report (56.8%) and clinical observation (54.5%) were the most commonly reported assessments. Rehabilitation practitioners (n = 8) reported no use of formal assessments. Most participants (63.89%) reported interoceptive awareness interventions to be effective. Further research is needed on best practices for interoception assessment and intervention related to occupational performance.

Outcomes from a Driving and Community Mobility Intervention Designed for Novice Drivers with Autism from the Perspective of the Participants and Their Parents.

To examine change in driving and community mobility outcomes for teens and young adults with autism as a result of participating in an occupational therapy intervention designed as a Bootcamp as perceived by the participants and their parents. Matched questionnaires were completed by novice drivers with autism as well as their parents prior to and immediately after the intervention. The intervention consisted of a 5-day (32h) intervention using interactive driving simulators, role playing, and highly interactive learning experiences. Sixty-seven participants and their parents completed the pre and post surveys. Of these, 52 (80%) were male and 13 (20%) were female, with a mean age of 17.8 ± 3.03 years. Wilcoxon signed rank tests was used for the Likert scale questions and paired t test for ratio level data. Results demonstrated participants perceived significant improvement in knowledge, skills and abilities related to both driving and community mobility. There were also significant differences in perception from the parents' perspective, but not as evident as the participants. Only a few significant changes were perceived in terms of executive functioning, which support accuracy of the results. Findings also showed significantly improvement in anxiety and confidence.As driving and community mobility is critical for young adults with autism to be successful in adult roles, intervention for improving knowledge, skills, and abilities in this complex daily task is essential. This study demonstrates statistically significant outcomes of a driving and community mobility occupational therapy intervention from the perspective of the participants and their parents.

The effect of family posture control combined with GAME therapy on motor function in children with severe cerebral palsy.

This paper has a purpose to explore the effects of home posture control combined with goal-activity-exercise-environment therapy on motor function in children with severe cerebral palsy (CP). Data of 80 children with severe CP treated from January 2022 to December 2023 were collected. They were divided into experimental group (EG) and control group according to different treatment methods, with 40 people in each group. The controlled group (CG) obtained routine treating means, including occupational therapy, electromyographic biofeedback therapy, and other treatment items. The EG received a combination of home posture control and goal-activity-exercise-environment therapy on the basis of conventional treatment. Meanwhile, parents received professional training to manage their children's posture and received reinforcement training through goal-activity-exercise-environment therapy. The Gross motor function measure-88, Peabody developmental motor scale-fine motor, pediatric balance scale, Fugl-Meyer assessment and other scales were used to evaluate the motor function, balance ability, daily living activity ability, and developmental level of patients. After 3 months of treatment, the Gross motor function measure-88 scores of these 2 groups were 70.96 ± 18.29 and 57.42 ± 21.41, respectively. The Peabody developmental motor scale-fine motor scores were 76.48 ± 14.42 and 59.77 ± 14.89, respectively. The balance ability index, upper limb motor function index, daily living activity ability, and developmental level of the EG were significantly higher than the CG's, and the P-values were all <.05. The combination of home posture control and GAME therapy can significantly improve the motor function and daily living activities of children with severe CP. This helps to maintain the normal growth and development of the child, and has certain clinical value.

Healthy Aging: Interaction of Cognition, Lifestyle, and Instrumental Activities of Daily Living.

Background: The increasing elderly population highlights the importance of comprehending healthy aging by examining the interactions among cognition, daily activities, and lifestyle. This study aims to address this by investigating these relationships within the World Health Organization's Healthy Aging Model. Methodology: A cross-sectional study was conducted with 178 older adults from southern Iran, representing various cognitive levels. Participants underwent assessments to measure cognitive functions, lifestyle preferences, and independence in instrumental activities of daily living (IADL) using the Mini-Mental State Examination, the Lifestyle Assessment Questionnaire for the Iranian Elderly, and the Lawton IADL Scale. Findings: The relationships between the studied variables were identified. Lower cognitive function was found to be associated with decreased engagement in IADL and less-favorable lifestyle choices. Conclusion: Integrating cognition, IADL, and lifestyle into assessments and interventions align with both the domain and process of occupational therapy, thereby enhancing well-being and promoting healthy aging in older adults.

Role of Meaningful Social Participation and Technology Use in Mitigating Loneliness and Cognitive Decline Among Older Adults.

Community social participation aids dementia prevention and alleviates loneliness among older adults. Incorporating occupational therapy using information and communications technology (ICT) could potentially delay dementia onset and reduce loneliness. To quantify how meaningful social participation, participation frequency, ICT use, and expanded social networks influence cognitive function and loneliness among socially active older Japanese adults. Cross-sectional exploratory study using structural equation modeling. Meetings organized by older adults at seven community gathering places in Osaka Prefecture, Japan. One hundred thirteen healthy older adult cohort members. Cognitive function assessed via Mini-Cog; loneliness assessed via the condensed UCLA Loneliness Scale. The final model demonstrated excellent fit, χ2(23) = 28.291, p = .205 (root mean square error of approximation = .045, 90% confidence interval [.000, .094]; confirmatory factor index = .995; Tucker-Lewis Index = .993). ICT use directly affected social networks (β = 0.472), which directly influenced participation frequency (β = 0.324) and meaningful social participation (β = 0.381). The indirect effect of meaningful participation significantly improved cognitive function (β = 0.237). The only indirect effect of meaningful interpersonal participation was a reduction in loneliness (β = -0.235). ICT use contributes to the expansion of social networks among elderly people. Furthermore, the frequency of social participation and the meaningfulness of such participation are related to reduction in loneliness and maintenance of cognitive function. Although the frequency of social participation was not directly related to these outcomes, the results suggest that meaningful social participation may play an important role in reducing loneliness and maintaining cognitive function. Plain-Language Summary: The promotion of social participation among older people is a global phenomenon, driven by the recognition of its positive relationship with cognitive function and the alleviation of loneliness. Nevertheless, older people's social participation is constrained by a combination of physical and social factors. To address this issue, there has been a push to promote social participation based on information and communications technology (ICT). However, no specific study has been conducted on occupational therapists' perspective in capturing social participation and the use of ICT. The findings of this study show that using ICT has the potential to enhance opportunities for social interaction for older adults, thereby improving the quality and quantity of social participation. The quality of social participation was identified as the sole factor that had a positive impact on cognitive function and loneliness. This study suggests the need for occupational therapists to consider means of facilitating the use of ICTs among older adults as well as interventions that use occupational therapy theory to enhance the meaningfulness of existing social participation opportunities.

Understanding hospital rehabilitation using electronic health records in patients with and without COVID-19

BackgroundMany hospitalised patients require rehabilitation during recovery from acute illness. We use routine data from Electronic Health Records (EHR) to report the quantity and intensity of rehabilitation required to achieve hospital discharge, comparing patients with and without COVID-19.MethodsWe performed a retrospective cohort study of consecutive adults in whom COVID-19 testing was undertaken between March 2020 and August 2021 across three acute hospitals in Scotland. We defined rehabilitation contacts (physiotherapy, occupational therapy, dietetics and speech and language therapy) from timestamped EHR data and determined contact time from a linked workforce planning dataset. Our aim was to clarify rehabilitation required to achieve hospital discharge and so we excluded patients who died during their admission, and those who did not require rehabilitation (fewer than two specialist contacts). The primary outcome was total rehabilitation time. Secondary outcomes included the number of contacts, admission to first contact, and rehabilitation minutes per day. A multivariate regression analysis for identifying patient characteristics associated with rehabilitation time included age, sex, comorbidities, and socioeconomic status.ResultsWe included 11,591 consecutive unique patient admissions (76 [63,85] years old, 56% female), of which 651 (6%) were with COVID-19, and 10,940 (94%) were admissions with negative testing. There were 128,646 rehabilitation contacts. Patients with COVID-19 received more than double the rehabilitation time compared to those without (365 [165, 772] vs 170 [95, 350] mins, p<0.001), and this was delivered over more specialist contacts (12 [6, 25] vs 6 [3, 11], p<0.001). Admission to first rehabilitation contact was later in patients with COVID-19 (3 [1, 5] vs 2 [1, 4] days from admission). Overall, patients with COVID-19 received fewer minutes of rehabilitation per day of admission (14.1 [9.8, 18.7] vs 15.6 [10.6, 21.3], p<0.001). In our regression analyses, older age and COVID-19 were associated with increased rehabilitation time.ConclusionsPatients with COVID received more rehabilitation contact time than those without COVID, but this was delivered less intensively and was commenced later in an admission. Rehabilitation data derived from the EHR represents a novel measure of delivered hospital care.

Systematic Review and Meta-Analysis of Intervention Techniques in Occupational Therapy for Babies and Children with Obstetric Brachial Plexus Palsy.

(1) Background: Obstetric brachial plexus palsy (OBPP) is an unpredictable and unpreventable neurological injury, caused by shoulder dystocia during birth, that affects the brachial plexus and leads to motor and sensory deficits in the child's upper extremity. The limited literature on early therapeutic assessment of newborns with OBPP highlights a gap in specialized care that, if filled, could enhance decision-making and support timely treatment. The objective of this paper is to analyze the therapeutic intervention techniques used at an early stage and their functional impact, from the occupational therapy discipline in the treatment of the upper extremity in babies and children with OBPP. (2) Method: Systematic review design and meta-analysis. A systematic review is a comprehensive analysis of existing research on a specific topic, using rigorous methods to identify, evaluate, and synthesize studies. Meta-analysis, often part of a systematic review, combines results from multiple studies to identify overall trends and enhance reliability, providing a clearer summary of evidence. Articles that included pediatric patients (from birth to 12 years of age) with a diagnosis of OBPP were reviewed. The results of the techniques used were analyzed according to each study, with the scale or method of assessment considered by the study for the presentation of data. The articles were assessed for methodological quality using the "PEDro Validity Scale". (3) Results: A total of 2190 articles were found, with 108 analyzed and 22 fully meeting this study's standards. Fourteen had a quantitative design, while the others included clinical guidelines. The most statistically reliable intervention techniques were CIMT (constraint-induced movement therapy) and splinting (dynamic and static), with second-tier techniques like joint manipulation, NMES, early infant management education, and serial casting used when needed. This study focused on children from birth to eight years old, with assessment tools primarily measuring upper limb range of motion, external rotation, supination, and impairment levels, though bimanual activity assessment was less common. (4) Conclusions: The early implementation of the techniques that provide us with the most data are CIMT, splinting, NMES, and joint manipulation linked to health education for families. In second place, we have the use of TB infiltrations and serial casts, when the treatment of the previous techniques fails in some cases.

Effect of Early Intervention on Developmental Domains and Parent-Child Interaction Among Children With Developmental Delay: A Randomized Controlled Study.

The scope of early intervention (EI) programs, which mostly focus on motor skills, needs to be expanded. To examine the effects of an EI on developmental domains and parent-child interactions. Randomized controlled study. Children ages 24-36 mo with developmental delay (DD; intervention group, n = 30; control group, n = 40). Pediatric occupational therapy unit of Hacettepe University. The intervention group received an intervention that used the Goal Activity and Motor Enrichment (GAME) approach and a home program, whereas the control group received a home program only. Both groups received the same intervention dosage. Developmental domains were assessed using the Bayley Scales of Infant and Toddler Development Third Edition (Bayley III) and the Ages and Stages Questionnaires (ASQ). Sensory processing was assessed with the Infant/Toddler Sensory Profile 2 (ITSP-2), social-emotional development with the ASQ:Social-Emotional (ASQ:SE), and parent-child interaction with the Parenting Interactions with Children: Checklist of Observations Linked to Outcomes (PICCOLO™). A compliance checklist was used to determine compliance with the home program. A significant between-groups difference was found on all Bayley III and PICCOLO subscales and on the Gross Motor, Fine Motor, Problem-Solving, and Social-Emotional domains of the ASQ and ASQ:SE in favor of the intervention group (p < .05). The intervention group showed more typification (normal sensory processing) in sensory quadrants and general processing. Both groups were 100% compliant with the home program. The GAME-based intervention for children with DD, including sensory and cognitive activities, is effective in improving developmental domains and parent-child interactions. Plain-Language Summary: The scope of early intervention programs mostly focuses on motor skills and needs to be expanded to include the essential roles of children's sensory and cognitive abilities. This study provides important insights into early interventions by occupational therapists and the impact on children with developmental delay and parent-child interactions. We found that the Goal Activity and Motor Enrichment (GAME) intervention for children with developmental delay, which includes sensory and cognitive activities, is effective in improving developmental domains and parent-child interactions.

Enhancing fieldwork readiness in occupational therapy students with generative AI

The rapid integration of artificial intelligence (AI) into health professions education is revolutionizing traditional teaching methodologies and enhancing learning experiences. This study explores the use of generative AI to aid occupational therapy (OT) students in intervention planning. OT students often lack the background knowledge to generate a wide variety of interventions, spending excessive time on idea generation rather than clinical reasoning, practice skills, and patient care. AI can enhance creative ideation but students must still adhere to evidence-based practice, patient safety, and privacy standards. Students used ChatGPT v. 3.5 in a lecture and assignment to integrate generative AI into intervention planning. Students analyzed a case study, generated ideas with ChatGPT, selected interventions that aligned with the client’s needs, and provided a rationale. They conducted evidence-based searches and wrote an analysis on how the research influenced their decisions. The results demonstrate generative AI’s potential as a valuable tool for OT students, enhancing their comfort with AI and understanding of ethical and safety considerations. Qualitative feedback highlighted AI’s role in boosting efficiency and creativity in intervention planning, with most students expressing strong intent to use ChatGPT in clinical practice due to its ability to reduce cognitive load and generate innovative ideas. These findings suggest that integrating generative AI into the OT curriculum could enhance intervention planning and improve clinical readiness.

Transitioning from specialisation to collaboration: interprofessional clinical simulation, metacognition and the phenomenon of convergence

ABSTRACT Research into metacognitive processes within interprofessional clinical simulation has been largely overlooked in the literature. This study explores how interprofessional simulation may influence cognitive and metacognitive processes across several professional programmes; medicine, nursing, pharmacy, and occupational therapy. This study focused on changes in performance pre- and post-simulation, with undergraduate students from each profession answering a set of questions related to the simulation case, requiring specialized knowledge from each profession. Question scores, item confidence judgment ratings, and calibration values were collected and analyzed. The data revealed a pattern of convergence in post-simulation assessments, where professions initially with lower performance in the pre-simulation phase improved, and those initially performing well demonstrating a decline in performance. Calibration values indicated that medical students developed metacognitive errors from their interactions in the simulation, which were not present pre-simulation, and that occupational therapy students suffered a loss of confidence and calibration in questions within their own field resulting from their experience (being more accurate pre-simulation). The authors anticipate that the phenomenon of convergence may have longer-term consequences, potentially fostering distrust among professions for those with declining performance. The authors propose that expanding awareness of convergence phenomena and conducting repeated simulations (thus facilitating further team development) could mitigate this issue.

Mixed Reality-Based Smart Occupational Therapy Personalized Protocol for Cerebellar Ataxic Patients.

Occupational therapy (OT) is an essential component of patient care, and it is especially beneficial if focused on meaningful activities. For ataxic patients, traditional procedures are currently the most efficient, although without specific guidelines and suggestions for virtual reality integration. In this context, this study proposes Hybrid Smart Rehabilitation (HSR) based on mixed reality (MR) as an aid in overcoming limitations of the traditional OT procedures. MR-HSR is designed specifically for ataxic patients and developed in Unity with the Holographic Remoting setting for run-time intervention on the scene. The subject reaches a book and grabs it with their hand inside a holographic guide with audio-visive feedback. Hand trajectories acquired from eight ataxic patients and eight healthy subjects were compared and new variables were analyzed to evaluate the performance. The Trust in Automation questionnaire was submitted to assess the opinion of the patients. Patients confirmed their trust in the developer and in the improvement that this system can bring to their rehabilitation. The "total time" and "sway area" of the trajectory were statistically significant and, together with the deviation of the trajectory from the main axis of the guide, although not statistically significant, made it possible to build a classifier. The patient-specific MR-HSR can be considered as an integrative tool for assessing the subject's condition by analyzing new quantitative variables which, if matched to the Scale for the Assessment and Rating of Ataxia (SARA), could be the basis of a new index to assess the progressiveness of ataxia.

Unlocking Insights: Exploring the Profiles of School-Based Telefacilitators.

School-based telefacilitators are critical yet underresearched members of telepractice programs. They are the face of the telepractice program and are often telepractice champions in their communities. However, we have little research explaining the typical profile of telefacilitators, making it more difficult to identify personnel characteristics that contribute to the implementation of sustainable telepractice programs. The purpose of this study was to describe the typical profile and preparation of school-based telefacilitators for physical, occupational, and speech therapy in the United States. A cross-sectional survey gathered 21 telefacilitator responses about their primary job title, preparation, confidence, and basic demographics. Survey recruitment followed an adaptive sampling method with three phases: stratified random sampling, purposive sampling, and targeted convenience sampling. Results were analyzed using frequency counts and descriptive statistics where appropriate. Most respondents held the primary job title of paraprofessional, but a diverse range of titles were reported, including superintendents and directors of special education. Half of the respondents received various methods of formal training for the role, whereas the other half were self-taught. Overall levels of confidence in job performance were high, yet self-taught telefacilitators felt that lack of training negatively impacted their performance. Most respondents had a bachelor's degree or higher. There is a high degree of variability in the profile and preparation of telefacilitators. Inconsistency in terminology and lack of agreed-upon job responsibilities are significant barriers to studying the role of telefacilitators and the ability to plan telepractice staffing needs adequately. Clinical implications and opportunities for future investigation are highlighted. https://doi.org/10.23641/asha.27115216.

Clinical diagnosis and management of spinocerebellar Ataxia in a resource-constrained setting: a case report from Eastern Nepal

Introduction: Spinocerebellar ataxias (SCA) are a diverse group of neurodegenerative disorders with autosomal dominant inheritance, primarily affecting the cerebellum and its connections. Diagnosis typically involves genetic testing, but in resource-limited settings, clinical and neuroimaging assessments become critical. This case report highlights the role of non-genetic methods in diagnosing SCA and outlines management strategies in such settings. Case Presentation: A 41-year-old male presented with a two-year history of progressive gait imbalance, headache, and abnormal speech. He had a family history of similar symptoms in two siblings, but no significant past medical history. Clinical examination revealed scanning speech, dysmetria, and a broad-based gait. Clinical and neuroimaging findings, including cerebellar atrophy, led to a diagnosis of SCA in the absence of genetic testing. Patient management with speech, occupational, and physical therapies, showed gradual improvement. Discussion: SCA, characterized by cerebellar atrophy and a range of clinical symptoms, is typically diagnosed through genetic testing, but clinical and imaging assessments are crucial when genetic resources are limited. This case illustrates that a comprehensive clinical evaluation, including neuroimaging, can support the diagnosis of SCA even without genetic testing. Strategic management emphasizing symptomatic relief and functional improvement through a multidisciplinary approach, including regular follow-up and personalized therapy, are crucial, as evidenced by the timely improvement observed in our case. Conclusion: In resource-limited settings, a comprehensive clinical and neuroimaging assessment is essential for diagnosing Spinocerebellar Ataxia when genetic testing is not feasible. Effective management through multidisciplinary therapies can improve patient outcomes, underscoring the need for innovative strategies to enhance diagnostic and treatment capabilities in such environments.

Perspectives on how evidence-based practice changes over time: A qualitative exploration of occupational therapy and physical therapy graduates.

The integration of evidence-based practice (EBP) into rehabilitation education programs has been widespread, but little is known about how graduates' EBP competencies evolve over time. To explore how and why the use of EBP by occupational therapists (OTs) and physical therapists (PTs) evolves during the first 3 years of clinical practice. We used an interpretive description methodology. We conducted semi-structured interviews with OTs and PTs who participated in a minimum of three out of four time points in a previous longitudinal pan-Canadian mixed methods study. Data analysis was guided by Braun and Clarke's approach to thematic analysis. Seventeen clinicians (13 OTs and 4 PTs) participated in the study. Our analysis identified six overarching themes: (1) evolution of "what EBP is and what it means"; (2) over time, evidence takes a back seat; (3) patients and colleagues have a vital and perennial role in clinical decision making; (4) continuing professional development plays a vital role in EBP; (5) personal attitudes and attributes influence EBP; and (6) organizational factors influence EBP. Our study highlights the dynamic nature of EBP use among OTs and PTs in the first 3 years of clinical practice, emphasizing the need for contextualized approaches and ongoing support to promote evidence-informed healthcare in rehabilitation.

Multidisciplinary Home-Based Rehabilitation Program for Individuals With Disabilities: Longitudinal Observational Study.

Disability affects a significant portion of the global population nowadays, necessitating innovative approaches to access rehabilitation processes. Home-based rehabilitation has emerged as a beneficial approach, offering comfort and context-specific therapy. This study aims to evaluate the impact of a multidisciplinary home-based rehabilitation program for individuals with moderate neuromusculoskeletal disabilities in terms of motor function and mood. A total of 270 participants with median age of 66 (IQR 20-98) years were recruited from the National Disability Registry of Chile. The intervention involved a multidisciplinary team composed of 49 health care professionals providing personalized treatment plans over 4 months (32 sessions for physical therapy, 8 sessions for occupational therapy, 4 sessions for nutrition, 8 sessions for psychology, and 4 sessions for nursing and podiatry). This program also included 2 medical evaluations (at the beginning and the end) to monitor clinical progress in terms of motor function and mental health, using the Berg Balance Scale and Beck Depression Inventory, respectively. The home-based rehabilitation program showed significant improvements (P<.001) in motor function and balance with a reduction in fall risk. Specifically, the Berg Balance Scale score decreased close to 15% after the home-based rehabilitation program for all enrolled participants. On the other hand, depression levels showed no significant changes (P=.27), with percentages of variation less than 8% between the 2 assessed conditions. In this sense, participants remained with the same mild depression level (14 of 63) concerning the Beck Depression Inventory score. This study concludes that personalized home-based rehabilitation programs are effective in enhancing motor function and balance, particularly in individuals with neurological conditions. On the other hand, the findings in terms of mood advocate for further exploration of psychological support within such programs to enhance overall patient well-being. ClinicalTrials.gov NCT06537791; https://clinicaltrials.gov/study/NCT06537791.

Environmentally sustainable person-centred care: Occupational therapy students' attitudes, perceptions and self-perceived preparedness for practice.

Climate change threatens the environments in which person-centred occupational therapy occurs. Environmental sustainability is directly linked with the health and wellbeing of current and future generations, presenting occupational therapists with a unique advocacy and activist role. As practitioners of the future, there is an urgent need to understand students' attitudes, perceptions of, and self-perceived preparedness for, dealing with environmental determinants of health and intergenerational occupational and climate justice. A cross-sectional exploratory descriptive survey collected United Kingdom (UK) based allied health professional students' attitudes, perceptions, and self-perceived preparedness for advocating for environmental sustainability in the context of person-centred care. The survey was distributed to 48 gatekeepers in UK institutions with approved allied health professional training programmes (44 offered occupational therapy); 62 occupational therapy students responded. Descriptive and non-parametric inferential statistics were used to analyse quantitative data. Text and short answers were analysed qualitatively via inductive content analysis. The study was co-designed and implemented with MSc (pre-registration) occupational therapy students. Participants (94%) expressed concerns for climate change, with 84% feeling responsible for addressing environmental sustainability in health care. While 64.5% identified climate justice as a top priority, a perceived challenge emerged between person-centred care and sustainability, with only 18% of participants feeling prepared for environmental sustainability in occupational therapy practice. Participants requested education on personal and professional sustainability practices, as well as collective action. Sharing personal climate change experiences, advocating with family and friends, and facilitating connections for collective action were highlighted as potentially transformative educational tools in this area. Occupational therapy curricula should address environmental sustainability through pragmatic, critical, and ethical lenses to enhance students' preparedness for this advocacy and activist role. Reflection and continuous professional development for environmentally sustainable practices is recommended. Occupational therapists believe that it is important to support people to participate in occupations that matter to them. However, the activities that some people choose to participate in may have negative effects on the environment and the planet. It is important to ensure that when occupational therapists support people in their choices of activities, this does not lead to unequal access to healthy and meaningful occupations of others, now or in the future. That is because occupational therapists also have a responsibility to prevent occupational injustice. Occupational therapy students are the professionals of the future, so it is important to include them in research about this topic. They need to develop skills that allow them to simultaneously make sure that they are delivering person-centred care, which is not environmentally detrimental and that does not lead to occupational injustice. Making sure that occupational therapists provide person-centred care while also managing risks of occupational injustice may be seen as a profession-specific dilemma. In this study, occupational therapy students in the UK completed a survey about their feelings, views, and readiness for managing this dilemma. Results showed that most respondents are concerned about climate change, but do not feel that their occupational therapy education sufficiently prepared them to practise in an environmentally sustainable way. They were asked to propose ideas for addressing this issue, and the article discusses how occupational therapy curricula might be changed in accordance.

OCCUPATIONAL THERAPY PRE-ASSESSMENT OF LOW GRADE GLIOMA PATIENT WITH COMPLEX NEEDS ALMOST HALVES POST-OPERATIVE LENGTH OF STAY

Abstract AIMS Due to tumour eloquence, patients with low grade gliomas (LGGs) often have complex Occupational Therapy (OT) needs post-operatively. This need can impact length of stay and OT resource. Limited studies have focused on pre-assessment for this patient group. To address these challenges, we aimed to identify the impact of a newly-introduced Occupational Therapy (OT) pre-surgical assessment service for low grade glioma patients. METHOD Patients (n=16, prospective, consecutive, Jan-Jul 2023) planned for LGG surgery at Leeds Teaching Hospitals NHS Trust were offered an OT pre-assessment. Mixed methods analysis. Assessments and data collected included existing needs and deficits, length of stay, and OT sessions (number/contacts, time spent). Comparison was made to patients (n=16, retrospective, consecutive, Jun-Dec 2022) planned for LGG surgery who had not received this service. Complexity was defined using standardised, clinically-accepted factors (social, cognitive and/or physical deficits). RESULTS Patients with complex needs (4 in each group) benefitted significantly from OT pre-assessment with reductions in: length of stay (11.9 v 6.5 days, 45.4% decrease), median time spent (134 v 95 mins, 29.1% decrease), median number of contacts (5.4 v 3.4, 37.0% decrease). Patient, surgeon, CNS and other AHP feedback was overwhelm-ingly positive. CONCLUSION Patients with complex needs undergoing surgery for low grade gliomas significantly benefit from pre- assessment; reducing length of stay and liberating occupational therapy resource. This also reduces costs and increases productivity/efficiency. Further work in more LGG patients, other brain tumour patients, and the identification of key pre-assessment variables and interventions will guide the development of the service.

Daily living skill support for autistic people through a neurodiversity-affirming practice lens.

Supporting daily living skill (DLS) development for autistic people is a component of occupational therapy practice. DLSs are essential for an increased quality of life (QoL), independent living, and community participation. Autistic young people experience poorer outcomes in terms of QoL and independent living than non-autistic peers. Finding a balance between targeted DLS support to maximise independent living and improve QoL, while avoiding attempts to 'normalise' or 'change' autistic people, presents as a dilemma for therapists striving to align with neurodiversity-affirming practice. This theoretical paper explored literature pertaining to DLS and the neurodiversity movement in the context of occupational therapy values and the Canadian Model of Occupational Participation. Consideration of whether targeted DLS support is neurodiversity-affirming or whether occupational therapists are compelling autistic people to mimic behavioural norms perceived by society was discussed. DLSs are an important factor for maximising QoL, regardless of neurotype. Occupational therapy values align with the core tenets of the neurodiversity movement, and occupational therapists are equipped with the values and skills to support the development of DLSs utilising affirming practice. Occupational therapists should critically reflect on their practice to ensure alignment with the professions core values and recent occupational therapy models, to ensure affirming practice. Further research investigating DLS and neurodiversity-affirming practice would benefit occupational therapists striving to align with neurodiversity-affirming practice. No consumer or community involvement. Consumers have been considered throughout the development of this paper through their representation in the literature. This involved a process of reviewing the literature and considering it in the scope of the questions and how occupational therapy sits within the neurodiversity movement. It is important to help autistic people to learn to do everyday things. Everyday things include activities like showering, cleaning, and cooking. These things are important so that autistic people can live on their own. It has shown that autistic young people are less likely to be able to do everyday activities on their own. It is important that therapists help autistic people learn how to do everyday things; however, do not try and change who they are. This is because completing everyday activities is an important part of QoL for all people.