Traditional Occupational Therapy Research Articles

Incorporating Animal-Assisted Therapy (AAT) to Improve Handwriting Skills in Pediatric Occupational Therapy

Within the field of occupational therapy, animal-assisted therapy (AAT) is becoming more widely recognized and utilized as a supplement to traditional therapeutic interventions. As this area is still an emerging area of practice within occupational therapy, research is necessary to better understand the effect of AAT on children’s progress toward various goals. The purpose of this research study was to analyze the effectiveness of using Animal-Assisted Therapy to improve children's performance with and engagement in handwriting activities in outpatient pediatric occupational therapy. This study utilized a Quasi-experimental design, assigning participants to two groups. One group participated in handwriting activities while using AAT, and the other participated in handwriting activities via traditional occupational therapy. Each participant completed the Evaluation Tool of Children’s Handwriting (ETCH) for a pre-and post-test assessment. For five weeks, each child participated in approximately 15 minutes of handwriting during their occupational therapy sessions. A paired samples t-test found that pre-and post-test assessments indicated significant differences on three subtests on the ETCH for both groups respectively. Additionally, an independent samples t-test determined that both satisfaction scores and time engaged in handwriting activities were significantly different between the AAT group and the therapist-led group. The findings of this research demonstrate that progress toward handwriting-related goals can be made with consistent intervention during occupational therapy sessions regardless of the intervention techniques being used. However, using AAT can greatly increase children’s satisfaction and enjoyment with handwriting and increase the time they are willing to engage in these types of activities.

Effect of Video Modeling With Simulation on Improving Menstrual Hygiene Skills for Adolescents With Autism Spectrum Disorder.

Background Menstruation is a biological process experienced by women every month. This project intends to improve menstrual hygiene skills using video modeling with simulation. Educating adolescent girls with autism spectrum disorder to engage in personal care during their menstrual cycle, particularly sanitation and hygiene, is essential. It is important to develop the knowledge and skills necessary for effective self-care during menstruation to prevent sexual health problems. Additionally, the project aims to provide a safe environment for adolescents to practice their menstrual hygiene routines and relieve the stress from their caregivers. Aimand objective The study aims to evaluate the effect of video modeling with simulation to improve menstrual hygiene skills in adolescents with autism. The ultimate objective of the study is to determine whether video modeling with simulation in the experimental group enhances the practice of menstrual hygiene among adolescent girls with autism, as well as the impact of traditional occupational therapy intervention on improving menstrual hygiene in this population. Methodology This is a quasi-experimental design with convenience sampling and selected samples (n=50), who were then split into two groups: an experimental group (n=25) and a control group (n=25) based on the inclusion and exclusion criteria. The experimental group received video modeling and simulation, while the control group did not receive any specific intervention except parent education and pictorial representations. Pre- and post-tests were conducted to measure the changes. Indian Scale for Assessment of Autism was the screening tool used and the Menstrual Practice Needs Scale (MNPS) was administered. The duration of the study was six months, three sessions per week, lasting 45 minutes to an hour each. The statistical analysis was done with significance at a 1% alpha level using IBM SPSS Statistics for Windows, Version 26 (Released 2019; IBM Corp., Armonk, NY, USA). Results The pre-test and post-test data were analyzed using the Wilcoxon signed-rank test and the Mann-Whitney test. The results demonstrated the comparison of the pre-test and post-test mean scores of the MNPS scores were highly statistically significant (p-value of 0.000) when compared to the control group. Following the implementation of video modeling with simulation, the experimental group's post-test scores were significantly higher than the control group's (p-value of 0.000). Thus, the study showed that video modeling with simulation improved menstrual hygiene in adolescents with autism spectrum disorder. Conclusion The clinical significance of this study was that the adolescents were excited to watch the videos and perform the activities; furthermore, after video modeling with simulation was implemented, there was a significant improvement in the experimental group when compared to the control group. This enhances the practice of the menstrual hygiene skills independently by the adolescents. Video modeling with simulation has paved the way for improving menstrual hygiene in adolescents with autism. Although the findings from the study are positive, more clinical trials are needed to prove that video modeling with simulation can be used as a therapeutic modality.

The Effectiveness of Constraint-Induced Movement Therapy versus Traditional Occupational Therapy on Upper Limb Function after Stroke

Background: Stroke significantly impacts upper limb function, necessitating effective rehabilitation strategies. Constraint-Induced Movement Therapy (CIMT) and Traditional Occupational Therapy (OT) are widely used, yet their comparative effectiveness in improving upper limb function remains to be fully established. Objective: The aim was to compare the effectiveness of CIMT and traditional OT in enhancing upper limb function in stroke survivors. The comparison was based on changes in the Fugl-Meyer Assessment for Upper Extremity (FMA-UE) and the Stroke Impact Scale (SIS). Methods: This randomized clinical trial involved 40 adult stroke survivors, who were assigned to either CIMT (n=20) or traditional OT (n=20). Assessments using FMA-UE and SIS were conducted before and after the intervention. Data analysis was conducted using SPSS 22.0, included within-group and between-group comparisons using repeated-measures ANOVA and paired t-tests. Results: Both CIMT and traditional OT groups showed significant improvements in FMA-UE and SIS scores. The CIMT group's FMA-UE scores improved from a mean of 43.26 to 47.36 (p=0.006), and SIS scores from 43.99 to 49.03 (p=0.009). The traditional OT group displayed more substantial improvements, with FMA-UE scores increasing from 42.71 to 48.89 (p=0.001), and SIS scores from 44.31 to 50.04 (p=0.007). Between-group analysis revealed no significant differences at baseline, but post-intervention, traditional OT showed significantly better outcomes compared to CIMT. Conclusion: Both CIMT and traditional OT are effective in improving upper limb function and reducing stroke impact. Traditional OT, however, demonstrated a slightly greater improvement. These findings underscore the importance of incorporating diverse therapeutic approaches in stroke rehabilitation, tailored to individual patient needs.

Effects of the different intensities of task-oriented training on the upper extremity motor function and self-care ability of stroke survivors: study protocol for a multiarm parallel-group randomised controlled trial in a tertiary hospital in China

IntroductionAlthough task-oriented training (TOT) may provide added therapeutic value to stroke survivors, current TOT guidance offers insufficient advice on standardisation, particularly choices of intensity, for clinical practice. Therefore, this study...

Bringing therapy home: Exploring parents’ experiences of telehealth for children with developmental coordination disorder

Introduction: Developmental coordination disorder (DCD) significantly impacts a child’s motor skills and ability to learn and perform self-care and academic tasks. Telehealth is a rapidly emerging service delivery model, ensuring expanded access to services and continuity of care. Many benefits to the use of telehealth have been identified; yet, there is a dearth of published evidence available on the experiences of parents of children with DCD. Aim: The aim of this study was to explore parents’ experiences of implementing a telehealth motor skills programme for their child with DCD. Method: This study utilised a qualitative descriptive approach to best capture parents’ experiences of a telehealth programme. Data were collected through in-depth, semi-structured interviews with eight participants and analysed using thematic analysis. Measures to ensure the trustworthiness of the study were observed within the naturalistic paradigm comprising criteria of credibility, transferability, dependability and confirmability. Findings: This study uncovered three major themes: (1) Parents in the dark, (2) telehealth in the family and (3) telehealth: what success looks like. Ten further subthemes highlighted the factors for success and parents’ considerations for future service delivery. Conclusion: Challenges for parents in accessing traditional occupational therapy services present an opportunity to explore alternative means of delivery such as telehealth. Parents, however, are clear in their preference for a blended approach for future services.

The Effect of ICF-Core Set-Based Occupational Therapy Interventions on the Function and Satisfaction of Individuals with Chronic Stroke: A Randomized Clinical Trial

Stroke can affect all aspects of a person's health and functioning. Therefore, it is important occupational therapists, have a comprehensive understanding of various levels of function and the factors affecting function. The ICF (International Classification of Functioning, Disability, and Health) and the selections of ICF categories or Core Sets relevant for people with a specific health condition, offer a model for intervention. This study aimed to investigate the effect of ICF-CS-based occupational therapy interventions on the function and satisfaction of individuals with chronic stroke. This study was designed as a randomized, single-blind, parallel-group clinical trial. Twenty-five patients with stroke were randomly assigned to the control group (which received traditional occupational therapy) or the treatment group (Stroke ICF-CS based occupational therapy). Patients were evaluated before and after the intervention (two months, three sessions per week, 45 minutes each session), as well as two weeks after the end of the intervention, using Fugl-Meyer and COPM (Canadian Occupational Performance Measure) tools. The independent T-test, Chi-square, and ANOVA with repeated measures were used to analyze the data. The results showed that the interaction effect of time and group was not significant in none of the Fugl-Meyer test sections (p > 0. 05), but it was significant in the performance and satisfaction of COPM (p < 0.05). The results suggest that ICF-CS-based occupational therapy interventions may assist persons with chronic stroke improve their functional level and satisfaction.

A Tenodesis-Induced-Grip exoskeleton robot (TIGER) for assisting upper extremity functions in stroke patients: a randomized control study

Purpose This study was aimed toward developing a lightweight assisting tenodesis-induced-grip exoskeleton robot (TIGER) and to examine the performance of the TIGER in stroke patients with hemiplegia. Methods This was a single-blinded, randomized control trial with pre-treatment, immediate post-treatment, and 12-week follow-up assessments. Thirty-four stroke patients were recruited and randomized to either an experimental or control group, where each participant in both groups underwent 40 min of training. In addition to a 20-min bout of regular task-specific motor training, each participant in the experimental group received 20 min of TIGER training, and the controls received 20 min of traditional occupational therapy in each treatment session. Primary outcomes based on the Fugl-Meyer Motor Assessment of Upper Extremity (FMA-UE) were recorded. Results Thirty-two patients (94.1%) completed the study: 17 and 15 patients in the experimental and control groups, respectively. Significant beneficial effects were found on the total score (ANCOVA, p = 0.006), the wrist score (ANCOVA, p = 0.037), and the hand score (ANCOVA, p = 0.006) for the FMA-UE in the immediate post-treatment assessment of the participants receiving the TIGER training. Conclusion The TIGER has beneficial effects on remediating upper limb impairments in chronic stroke patients. Clinical trial registration: ClinicalTrials.gov; identifier NCT03713476 Implications for rehabilitation Based on use-dependent plasticity concepts, robot training with the more distal segments of the upper extremities has a beneficial effect in patients with chronic stroke. A novel lightweight assisting tenodesis-induced-grip exoskeleton robot (TIGER) system using a mechanism involving musculotendinous coordination of the wrist and hand was proposed in this study. Between-group differences in changes in the upper limb motor performance were observed in the experimental group as compared to patients in the control group. For patients with chronic stroke, receiving 20 min of TIGER training in conjunction with 20 min of task-specific motor training led to clinically important changes in motor control and functioning of the affected upper limb.

Home mirror therapy: a randomized controlled pilot study comparing unimanual and bimanual mirror therapy for improved arm and hand function post-stroke

Purpose To compare home-based unimanual mirror therapy (UMT) and bimanual mirror therapy (BMT) for upper limb recovery in subacute/chronic stroke individuals with moderate-to-severe arm impairment. Method Twenty-two participants were randomized into 1 of 3 groups: UMT, BMT or traditional occupational therapy (TOT) home-based programs. The intervention was 6-weeks and consisted of OT 2 days a week, weekly sessions with the research OT, and 30-minutes of the home-based program 5 days a week, according to group allocation. The Action Research Arm Test (ARAT), ABILHAND, Fugl-Meyer Assessment (FMA), grip strength, and Stroke Impact Scale (SIS) were used for outcome measures. Results All groups significantly improved over time on all outcome measures and adhered to the prescribed dosage regardless of group (p<0.05). While there were no between-group differences, effect size and 95% confidence interval data suggest a clinical significance in favor of UMT as compared to the other groups. Conclusions All participants, regardless of home-based program, adhered to the prescribed dosage and significantly improved over time. Despite no between-group differences, effect size and 95% confidence interval data suggest that UMT may be more beneficial for individuals with moderate-to-severe arm impairment as compared to BMT or TOT. ClinicalTrials.gov: #NCT02780440 Implications for Rehabilitation Home-based unimanual mirror therapy (UMT), bimanual mirror therapy (BMT), and traditional occupational therapy (TOT), when administered in conjunction with outpatient OT, are helpful for improving upper limb recovery post-stroke. Home-based UMT may be more beneficial than BMT or TOT for improvement in upper limb motor function and activities of daily living of patients with moderate to severe arm impairment post-stroke.

Application of the Kinesio® Taping Method for a Child with Hypotonia: A Pilot Case Study

Background: This study explored the application of the Kinesio® Taping (KT®) method in conjunction with traditional occupational therapy (OT) intervention for a child with hypotonia. Specifically, differences in functional hand outcomes (manual dexterity and grasp pattern) were examined between the sessions with and without the application of the KT® method. Methods: A 9-year and 5-month-old male subject, at the time of enrollment, diagnosed with hypotonia, global developmental delay, and autism spectrum disorder participated in the study. A single-subject alternating treatment design was employed. A total of 14 OT sessions were conducted across baseline (n=3), alternating treatment (n=8), and replication (n=3) phases. During the alternating treatment phase, the subject was randomly applied the KT® method in four out of the eight OT sessions. At the end of each session, the participant was administered standardized assessments. Results: There were no statistically significant differences observed in functional hand outcomes across the baseline, alternating treatment, and replication phases. There were no statistically significant differences observed in manual dexterity and grasp pattern between the sessions with and without the application of the KT® method. Discussion: The results from the study replicated the mixed outcomes reported in the efficacy of the KT® method in addressing functional hand outcomes; OT practitioners are recommended to consider the KT® method as an auxiliary intervention modality. Future research involving the KT® method can consider ways to better control for the confounding variables noted in the current study including the novelty effect, subject’s comorbid conditions, and number and length of sessions allotted across the baseline, alternating treatment, and replication phases.

The Extensor Pollicis et Indicis Accessorius Muscle: Cadaveric Case Analysis and Pertinence to Occupational Therapy

INTRODUCTION & OBJECTIVE Independent movement of the pollex (thumb) and index finger is critical for normal hand function. Accordingly, movements of these digits are controlled by separate muscles; for example, extension of the pollex and index finger is performed by the extensor pollicis longus (EPL) and extensor indicis proprius (EIP) muscles, respectfully. Accessory muscles such as the extensor pollicis et indicis accessorius (EPIA) can develop and inhibit the independent movements of the pollex and index finger by connecting the otherwise autonomous digits. EPIA's attachment to both the pollex and index finger merits special consideration for human occupation and occupational therapy (OT) treatment. The objective of this study was to analyze bilateral EPIA muscles in a human cadaver in regard to occupational therapy. MATERIALS & METHODS The tendons of EPIA were discovered during routine cadaver dissection at the University of Nebraska Medical Center. T1-weighted magnetic resonance imaging (MRI) was used to visualize the entire EPIA's location and relation to surrounding structures. The EPIA was photographed (iPad Pro, Apple Inc.), and deep dissection was performed to identify its origin, insertions, and innervation. The muscle bellies of EPL, EIP, and EPIA were eviscerated, weighed (Ohaus Scale, Model V22PWE1501T), and photographed. Pennation angles and muscle fiber lengths for each of these muscles were measured (ImageJ, 1.52q) to calculate physiological cross-sectional areas (PCSAs) and maximum isometric force (MIF) generating capacities. All calculations were derived from mean values between the bilateral muscles. MIFs for EPL, EIP, and EPIA were compared to substantiate the effect of EPIA on digit movement. RESULTS MRI and gross imaging showed an independent muscle belly of EPIA originating on the posterior ulna and interosseus membrane (distal third) and positioned between EPL and EIP. Its common tendon passed through the fourth extensor compartment of the wrist, bifurcated over the trapezoid, and inserted on the first distal phalanx and extensor expansion of the index finger. The EPIA's 11.77 cm unipennate muscle belly was innervated by the posterior interosseus nerve. The PCSA of the EPL, EIP, and EPIA was 0.76 cm2, 0.68 cm2, and 0.41 cm2, generating MIFs of 17.00 N, 15.21 N, and 9.19 N, respectively. In this regard, MIFEPIA would have increased the collective synergistic MIFs of EPL and EIP by 28.53%. EPIA's split MIF would exert 27.02% and 30.21% more force for independent digit extension by EPL and EIP, respectively. CONCLUSIONS & SIGNIFICANCE While the EPIA would assist simultaneous extension of the first and second digits, it may considerably impact hand function by inhibiting flexion of one digit when extending the other. This outcome could impact range of motion and strength progress during OT treatment following an EPL or EIP injury and require adjusted treatment. Similarly, the traditional OT treatment protocol for EIP or EPL tendonitis may be inadequate with the presence of an unsuspected EPIA or EPIA tendonitis. This study presents radiologic imaging, gross photography, and biomechanics of EPIA, all of which can be used to inform OT and other related healthcare fields about EPIA and the complications it can cause.

The effect of play-based occupational therapy on symptoms and participation in daily life activities in children with cancer: A randomized controlled trial

Introduction This study aimed to investigate the effect of play-based occupational therapy on symptoms and participation in daily life activities in hospitalized children with cancer undergoing chemotherapy. Method A total of 25 children (mean age = 9.28 ± 0.95 years, range = 7–12 years) with cancer undergoing chemotherapy were enrolled and randomly assigned to a play-based occupational therapy group ( n = 12) or control group ( n = 13). The intervention group received eight 1-hour play-based occupational therapy sessions, and the control group received traditional occupational therapy services. Participation in daily life activities, therapy-related symptoms, pain, anxiety, and fatigue were evaluated. Results Total mean scores of participation in daily life activities in the intervention group in the diversity of activities ( p = 0.001, d = 1.39), intensity of participation ( p = 0.001, d = 1.86), with whom done ( p = 0.005, d = 1.22), enjoyment ( p = 0.003, d = 1.33), and parents’ satisfaction ( p = 0.003, d = 1.33) were significantly higher than the control group. Symptoms decreased in both groups; however, this trend had a significant difference in the intervention group for the therapy-related symptom checklist ( p = 0.001, d = 1.68), pain ( p = 0.001, d = 1.61), anxiety ( p = 0.001, d = 1.58), and fatigue ( p = 0.002, d = 1.39) scores. Conclusion A 2-week course of inpatient play-based occupational therapy is an effective approach in the reduction of cancer symptoms, therapy-related symptoms, and the participation facilitation, of children with cancer in daily life activities.

Clinical overlap of functional neurologic symptom disorder and complex regional pain syndrome in pediatrics: A case report

This case study documents a 13-year-old female who presented to our intensive inpatient chronic pain rehabilitation program with complex regional pain syndrome (CRPS) of her left leg, which was significantly interfering with her normal daily functioning. She participated in a full day of traditional interdisciplinary therapies, including physical and occupational therapy for 3 hours daily. As assistive equipment was altered or weaned her physical mobility, balance, and tremors worsened and/or increased. As she began advancing her legs more independently (versus requiring physical assist), she demonstrated more variable functional strength and stability, inconsistent balance reactions, and a more unsteady gait pattern. The team was treating her according to her incoming CRPS diagnosis; however, as treatment progressed, her physical and psychological presentation seemed more aligned with diagnostic criteria of functional neurologic symptom disorder (FND). Staff then treated according to the FND diagnosis resulting in successful long-term outcomes. The clinical impact from this case study includes highlighting the commonalities between CPRS and FND clinically, discussing treatment suggestions depending on the diagnosis, and emphasizing key components of family/patient education.

Occupational therapy utilisation of apps in practice in the United States

Aims The purpose of this cross-sectional research study was to explore the use of apps by occupational therapy practitioners in the United States to gain a more complete overview of utilisation and perceived effectiveness, and assess trends by population served, practice setting, occupation addressed, and client deficit. Methods For this cross-sectional study, 160 self-identified occupational therapy practitioners, 126 occupational therapists and 34 occupational therapy assistants, recruited through snowball sampling on social media participated in this 26-question survey available for two weeks online. Data analysis was conducted through SurveyMonkey and SPSS version 26. Results The majority of respondents (71.9%) reported that they have used apps in practice, most frequently as treatment modalities (84.3%) and as recommendations (71.9%) for clients. Likewise, most respondents who reported using apps considered apps to be as effective (70.5%) or better than (27.3%) traditional practice methods. Use of apps was significantly associated with practice setting X2(9, N = 160) = 46.437, p < .001. Conclusions Occupational therapists are using apps with clients of all age groups, and these apps are being used in all phases of the occupational therapy process. Apps are available that address all eight areas of occupation, and apps are perceived to be as effective or better than traditional occupational therapy interventions. IMPLICATIONS FOR REHABILIATION The majority of occupational therapy practitioners surveyed are using apps in practice. Most therapists are being provided devices by employers that support app use in practice. Neuromusculoskeletal and movement related functions and mental functions related to cognition are the primary client impairments therapists are addressing when using apps. Lack of app knowledge and familiarity with apps were the leading barriers to app use in practice.

A Collaborative and Cognitive-based Intervention for Young People with Cerebral Palsy.

Evidence-based approaches to improve function in individuals with cerebral palsy are needed. To investigate the effectiveness of the Cognitive Orientation to daily Occupational Performance approach™ (CO-OP) to improve performance on self-chosen, functional goals as compared to traditional occupational therapy for cerebral palsy. Crossover design with 12 participants, aged 6-15 years, randomly assigned to CO-OP and traditional intervention groups, followed by crossover and a 3-month follow-up. The participants identified three occupation-based goals for CO-OP and each group received ten 45-minutes intervention twice weekly in clinical context. Occupational performance, manual dexterity and Gross Motor Function Measures were analysed using generalized estimating equations. There were clinical and statistically significant improvements in functional goals following CO-OP and not traditional therapy. There were gains in dexterity but not in gross motor skills. CO-OP was effective to improve functional performance in young people with cerebral palsy and should be more utilized.

Impact of smart force feedback rehabilitation robot training on upper limb motor function in the subacute stage of stroke.

To explore the impact of rehabilitation robot training (RRT) on upper limb motor function and daily activity ability in patients with stroke. Forty patients meeting the inclusion criteria were randomly divided into the treatment group (TRE) and the control group (CON). Group TRE was trained with an upper limb rehabilitation robot and group CON was trained with traditional occupational therapy. The training time was six weeks, and the upper limb function and daily activities were then assessed. (1) There was no statistical significance in the Fugl-Meyer (FM) score, Wolf Motor Function Test (WMFT) score, and Modified Barthel Index (MBI) score between the two groups before treatment (P > 0.05). (2) After treatment, the FM score, WMFT score, and MBI score were significantly higher than before treatment (P < 0.01). (3) There was no significant significance between the two groups after treatment (P > 0.05). Both RRT and traditional occupational therapy training are useful for the recovery of upper limb motor function and daily life ability in the sub-acute stage of stroke.

One intelligent framework for screening and intervention of Mild Cognitive Impairment (MCI)

Mild cognitive impairment (MCI) is a very unstable transition state between normal aging and dementia. Due to lack of accurate treatment and with high risk of dementia transformation, early diagnosis and intervention of MCI has become very important. In view of the limitations of current MCI screening methods dominated by neuropsychological testing and intervention measures dominated by traditional occupational therapy (OT), this paper proposes one intelligent framework based on online chess and cards games, which integrates online behaviour big data's MCI screening and game cognitive OT methods. Thus, a new method of screening and rehabilitation intervention for potential patients with MCI will be realised through the routine tracks of the actions online.

The Influence of Culture on Occupational Therapy Practice in Jordan.

Background Occupational therapy's origins draw from Western culture, values, and beliefs which may impact the application of traditional occupational therapy practice in non-Western cultures. Purpose This study explored how occupational therapists in Jordan facilitate occupational therapy practice within Islamic Eastern culture. Method A phenomenological approach was used in this study. Semistructured interviews were conducted with eleven occupational therapists that work in Jordan and have at least two years of experience. Data were analyzed using thematic analysis methods. Results Three central themes emerged: impact of Jordanian culture and Islamic beliefs about independence and disability on occupational therapy practice, the therapists' notions of ideal occupational therapy practice vs. daily reality, and challenges posed by workspace and the availability of equipment. Conclusion This study highlights the growing need to translate and expand the core values of occupational therapy to align with cultures in non-Western countries and cultures.

Effects of Cognitive Exercise Therapy on Tactile Sensations of the Hands and Activities of Daily Living in Stroke Patients

Background/Objectives: The aim of present study was to evaluate the effects of cognitive exercise therapy (CET) on tactile sensations of the hands and activities of daily living in stroke patients.Method/Statistical Analysis: A total of 14 stroke patients with impaired hand sensations were participated and were randomly assigned to the CET group or the traditional occupational therapy (TOT) group. Patients in the CET group performed cognitive tasks using their spatial and tactile senses, whereas those in the TOT group received traditional occupational therapy. The intervention periods of the two groups were 30 min per day, five-times per week for four weeks. All participations were assessed before and after intervention with light touch sensation using the Mono-Filament, two-point discrimination sensation using the Disk-Criminator (static and dynamic tactile sensations), and the modified Barthel index (MBI) for activities of daily living ability.Findings: The CET group appeared significant improvements in static and dynamic two-point discrimination, and the MBI before and after the intervention. Also, the TOT group showed a significant improvement in MBI after intervention. At post-test, the CET group showed significant improvements in two-point discrimination and light touch compared to the TOT group.Improvements/Applications: These findings suggest that CET can induce improvement of the tactile sensations of the hands in stroke patients. Thus, we suggest that CET can be used for tactile-sensory rehabilitation of patients with stroke in clinic.

Effects of Balance Training Using a Wii Fit Balance Board on Balance, Gait and Activities of Daily Living in Patients with Parkinson Disease: A Pilot, Randomized Controlled Trial

Background/Objectives: This study examined the effects of balance training using a Wii Fit balance board on the balance, gait, and activities of daily living in patients with Parkinson disease.Method/Statistical Analysis: Our study included 15 patients with Parkinson disease who scored 2–3 on the Hoehn and Yahr scale and underwent occupational therapy. Participants were randomly assigned to two groups: the experimental group with 8 patients or the control group with 7 patients. All subjects in two groups received traditional occupational therapy (TOT) for 30 min/day, 3 times a week, for 8 weeks, and the participants in the experimental group additionally received a balance training using a Wii Fit (BTWF) for 30 min per session. All patients in both groups were evaluated using the Berg balance scale (BBS), the time up & go test, and the modified Barthel index.Findings: The experimental and control groups showed significant improvements in all outcome measures after intervention. In particular, the experimental group showed a more significant improvement in the BBS score than the control group.Improvements/Applications: BTWF could be effectively used to improve the balance of Parkinson’s disease patients in the clinic.

Effect of Motor Imagery Training on Somatosensory Evoked Potentials and Upper Limb Function in Stroke Patients

Background: Motor imagery is the mental representation of an action without overt movement or muscle activation. However, few previous studies have demonstrated motor imagery training effects as an objective assessment tool in patients with early stroke. Objective: To investigate the effect of motor imagery training on Somatosensory Evoked Potentials (SSEP) and upper limb function of stroke patients. Design: A quasi-experimental study. Methods: Twenty-four patients with stroke were enrolled in this study. All subjects were assigned to the experimental or control group. All participants received traditional occupational therapy for 30 minutes, 5 times a week. The experimental group performed an additional task of motor imagery training (MIT) 20 minutes per day, 5 days a week, for 4 weeks. Both groups were assessed using the SSEP amplitude, Fugl-Meyer assessment of upper extremity (FMA UE) and Wolf motor function test. Results: After the intervention, the experimental group showed significant improvement in SSEP amplitude and FMA UE than did the control group. Conclusion: These findings suggest that the MIT effectively improve the SSEP and upper limb function of stroke patients.