Systematic review of measurement properties of the Canadian Occupational Performance Measure in geriatric rehabilitation

Frailty and innovative participatory rehabilitation

This Mini-Review showcases the latest evidence on rehabilitation opportunities for older people with multimorbidity and frailty. There is growing evidence, that a person-centered and contextualized rehabilitation approach may offer benefits, not only in the context of preserving mobility, but especially targeting social participation. Modern rehabilitation aligns with the bio-psycho-social model of the International Classification of Functioning, Disability and Health (ICF), emphasizing the individual and collaboratively determined definition of personalized rehabilitation goals at the activity and participation level. Further studies are warranted to evaluate objective outcome-measurement tools within the domains of activity and participation.

Measurement properties of the Spanish COPM in older adult rehabilitation inpatients

AIMS

To analyse the measurement properties of the Spanish version of the COPM (Canadian Occupational Performance Measure) in older adult rehabilitation inpatients.

METHOD

A sample of 172 users from 17 inpatient care facilities for older adults (47% nursing homes) participated in a quantitative prospective study. We examined validity by correlating the COPM with the Barthel Index (BI), the Lawton Instrumental Activities of Daily Living scale (IADL), the EuroQol-five domains-three level questionnaire (EQ-5D-3L), and the Client-Centred Rehabilitation Questionnaire (CCRQ) and by examining associations with demographic variables. Reliability was evaluated through test-retest and responsiveness through differences in change scores in two types of care facilities.

RESULTS

Participants prioritised 637 occupational performance problems, mainly in the area of self-care (70.5%). The COPM scale scores were significantly correlated with BI, IADL, EQ-5D-3L (except the pain dimension), and CCRQ (except the family involvement and continuity dimensions). COPM scores did not show statistically significant differences concerning educational level. Regarding reliability, high test-retest correlations were obtained (>.80). Nursing home users showed less responsiveness to rehabilitation than other users (change score < 2 vs. > 2 points).

CONCLUSION AND SIGNIFICANCE

The Spanish COPM provides satisfactory measurement properties as a client-centred instrument in older adult rehabilitation inpatient.

Occupation-Based Interventions to Improve Occupational Performance Among Older Adults Living in Long-Term Care: A Systematic Review

IMPORTANCE

Evidence for the positive effects of occupation-based interventions on occupational performance is increasing; however, little is known about the impacts of occupation-based interventions on older adults living in long-term care.

OBJECTIVE

To consolidate the evidence on the effectiveness of occupation-based interventions for improving occupational performance among older adults living in long-term care.

DATA SOURCES

MEDLINE, CINAHL, PsycINFO, SCOPUS, Web of Science Core Collection, and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched from journal-database inception to February 2023.

STUDY SELECTION AND DATA COLLECTION

This systematic review is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Included articles were peer-reviewed studies published in English that evaluated occupation-based interventions for older adults living in long-term care and used validated tools to measure occupational performance.

FINDINGS

Seventeen articles, with 2,974 participants, were identified. The reviewed studies included 6 Level 1b randomized controlled trials, 5 Level 2b studies of various study designs, and 5 Level 3b studies with quasi-experimental designs. Across studies, heterogeneous measures were used to assess occupational performance. All studies implemented client-centered, occupation-based interventions designed and/or delivered by occupational therapists. Interventions were tailored to residents' goals, interests, or abilities to improve occupational performance and participation, and inconsistent effects were reported.

CONCLUSIONS AND RELEVANCE

Moderate evidence supports the use of occupation-based interventions tailored to individual residents and incorporation of physical activities for improving the occupational performance of older adults living in long-term care. Currently, evidence for care partner involvement and multilevel occupation-based interventions is limited. Plain-Language Summary: This study adds to the evidence base indicating that occupation-based interventions have the potential to promote the occupational performance of older adults living in long-term care. High-quality randomized controlled trials with longer term follow-up and assessment of clinically meaningful outcomes are critical for developing the evidence base in this practice setting.

Psychometric properties of the Canadian occupational performance measure in older individuals

Background/aim

The Canadian Occupational Performance Measure (COPM) is a person-centered assessment tool frequently used to identify occupational problems in older individuals and establish goals for geriatric rehabilitation. This study aims to assess the validity and reliability of the Turkish version of COPM (COPM-TR) in older people.

Materials and methods

One hundred older people completed the COPM-TR, and 25 of them participated in a retest within two weeks. The convergent construct validity analyses of the COPM-TR included conducting correlation analyses between the COPM-TR and the Functional Independence Measure (FIM) and Lawton Brody Instrumental Activities of Daily Living (Lawton-IADL) scales. The Performance and Satisfaction subscales were subjected to an item analysis for the internal consistency of the COPM-TR. A test-retest analysis was conducted to investigate the reliability.

Results

According to convergent construct validity analysis, it was found that there is a moderate correlation between COPM-TR performance and FIM (r = 0.51), and a strong correlation between Lawton IADL (r = 0.62). Similarly, there was a strong correlation between COPM-TR satisfaction and FIM (r = 0.61) and Lawton IADL (r = 0.61). Test-retest reliability was excellent for performance score and good for satisfaction score (ICC values 0.92; 0.78, respectively). COPM-TR showed excellent-high internal consistency (Cronbach's alpha 0.92 for performance and 0.88 for satisfaction).

Conclusion

COPM-TR is a valid and reliable tool that can be used to assess occupational performance in older people.

Psychological Factors Mediate the Relationship between Physical Activity and Goal Attainment for Occupational Therapy Practice: An Observational Study in Japan

Occupational therapy can improve physical activity, anxiety, and goal achievement after high tibial osteotomy. However, the role of psychological factors in physical activity and goal attainment after high tibial osteotomy is unclear. We examined how psychological factors mediate the relationship between physical activity and goal achievement. Participants included 55 individuals post-high tibial osteotomy. Physical activity and performance and satisfaction in everyday tasks had a significant indirect effect on the anxiety and depression. Anxiety and depression mediated the physical activity-goal attainment relationship. Thus, occupational therapy practices focusing on anxiety and depression may be important in post- high tibial osteotomy rehabilitation.

Protocols and Features of Goal-Setting-Based Intervention for Frail Older Adults in Community Exercise Facilities

Appropriate goal setting for frail older adults is important because it drives effective rehabilitation. However, more insights into the types and degrees of frailty and goal-setting trends should be obtained. We conducted a multicenter prospective study to qualitatively examine the relation between each frailty domain (physical, social, and cognitive) and the goals of 201 subjects (median age: 79, 43.8% male) who began rehabilitation at a long-term care prevention facility. Goal setting was determined by the specific, measurable, achievable, relevant, and time to goal (SMART) framework up to three months, categorized according to the International Classification of Functioning, Disability, and Health. The results showed that approximately 90% of the subjects had frailty in at least one domain, and about half had frailties in two or more domains. In total, 176 (87.6%) subjects had goals corresponding to activities and participation. The tendency to set goals to improve mobility was confirmed when the number of overlapping frailties was high, especially those in the physical and social domains. Those with milder frailties were more likely to establish goals targeting improvements in community, social, and civic life. These findings will lead to the development of practical goal-setting guidelines for frail older adults.