Occupation Based Telerehabilitation Intervention for Adolescents with Myelomeningocele: A Pilot Study

Caregiver Support Role in Occupational Therapy Video Telehealth: A Scoping Review

Caregiver involvement may facilitate patient participation in occupational therapy (OT) video telehealth. However, little is known about the extent to which caregivers participate and what they do. This scoping review aims to, 1) describe the caregiver role supporting patient participation in OT video telehealth, and, 2) identify barriers and facilitators to caregiver involvement. Findings reveal caregiver involvement in a range of OT evaluation and intervention processes, with details on what caregivers did overall lacking. Barriers and facilitators are also described. This study underscores the need for clear and robust descriptions of caregiver participation to increase best practices in video telehealth.

Effects of an Occupation-Based Intervention on Hand and Upper Extremity Function, Daily Activities, and Quality of Life in People With Burn Injuries: A Randomized Controlled Trial

IMPORTANCE

Occupational performance and function are affected in people with burn injuries to the hand and upper extremity; this can lead to the development of some disabilities and endanger quality of life.

OBJECTIVE

To investigate the effects of occupation-based intervention on hand and upper extremity function, daily activities, and quality of life in people with burn injuries.

DESIGN

Randomized controlled trial.

SETTING

Specialized burn hospital in Iran.

PARTICIPANTS

Patients (N = 20) with burn injuries to the hand and upper extremity.

INTERVENTIONS

The control group received only traditional rehabilitation, and the intervention group received traditional rehabilitation and took part in the Cognitive Orientation to daily Occupational Performance (CO-OP) protocol (18 sessions, 45 min/day, for both groups).

MEASURES

Assessments included the CO-OP; Michigan Hand Outcomes Questionnaire; Shortened Disabilities of the Arm, Shoulder and Hand Questionnaire; Modified Barthel Index; World Health Organization Quality-of-Life Scale-Brief; a visual analogue scale; measurements with a goniometer and dynamometer; and the figure-of-eight method. These evaluations were conducted with both groups before the rehabilitation program commenced and at Wk 2, 6, and 14 (follow-up).

RESULTS

The results showed that there were notable changes in all the study variables except edema in both groups. However, these changes (p [V] ≤ .05) were not statistically significant between the two groups.

CONCLUSIONS AND RELEVANCE

According to the results, the occupation-based interventions are as effective as traditional therapeutic interventions for the improvement of hand and upper extremity function, ability to perform daily activities, and quality of life in people with burn injuries. What This Article Adds: The CO-OP protocol, as an occupation-based intervention, can improve hand performance, ability to perform daily activities, and quality of life in people with burn injuries, and thus it can be useful in rehabilitation clinics.

Cognitive orientation to daily occupational performance (CO-OP) approach as telehealth for a child with developmental coordination disorder: a case report

Aim

This study aimed to propose a possible interventional form of occupational therapy through a case study report of the applied Cognitive Orientation to daily Occupational Performance (CO-OP) approach as telehealth for a child with developmental coordination disorder (DCD).

Methods

The intervention method was CO-OP-based tele-occupational therapy for a boy with DCD and his mother; 10 sessions were conducted using a video-conferencing system. This study used the Canadian Occupational Performance Measure (COPM) and the Performance Quality Rating Scale (PQRS) as assessment tools. The PQRS evaluated each occupational performance based on videos recorded during the online sessions and videos taken by the mother of the child.

Results

The CO-OP approach improved COPM performance and satisfaction as well as PQRS scores in the following five goals: (1) handwriting, (2) column addition, (3) jumping rope, (4) playing on the bar, and (5) riding a bicycle.

Conclusions

An online approach based on the CO-OP was realistic and effective, to some extent. Continuing to develop telehealth interventions in the future is recommended.

The Cognitive Orientation to daily Occupational Performance (CO-OP) Approach is superior to ordinary treatment for achievement of goals and transfer effects in children with cerebral palsy and spina bifida - a randomized controlled trial

PURPOSE

Children with cerebral palsy (CP) or spina bifida (SB) often have executive dysfunction affecting activity performance. With the Cognitive Orientation to daily Occupational Performance (CO-OP) Approach, children find their own way to perform activities, using problem-solving strategies and meta-cognitive thinking. The present study aimed to investigate the effectiveness of the CO-OP Approach in children with CP or SB, compared with conventional rehabilitation, in achieving self-identified activity goals, and to explore any generalization and transfer effects.

METHOD

Randomized controlled trial, CO-OP versus treatment as usual, 38 children (7-16 years) participated. Each child identified four goals (to study generalization and transfer, one remained untrained). Primary outcomes: Canadian Occupational Performance Measure (COPM) and Performance Quality Rating Scale (PQRS). Secondary outcomes assessed executive functions and self-rated everyday-life competence.

RESULTS

Self-rated goal attainment (COPM) was significantly greater for both trained and untrained goals in the CO-OP group compared with the control group. The rating of observed performance (PQRS) was significantly higher for trained goals in the CO-OP group. The CO-OP group experienced fewer problems in everyday life after treatment. Executive functions did not differ significantly between groups.

CONCLUSION

CO-OP is more effective than ordinary treatment in achieving both trained and untrained goals.IMPLICATIONS FOR REHABILITATIONCO-OP enables children with CP (MACS levels I-III) or SB without intellectual disabilities to reach self-identified goals.CO-OP shows transfer effects to new activities and situations, which may enhance children's self-efficacy.CO-OP is an important complement to conventional rehabilitation services for children with CP and SB.

Effectiveness of client-centered intervention delivered with face-to-face and telerehabilitation method after total knee arthroplasty—A pilot randomized control trial

Introduction

Total knee arthroplasty (TKA) negatively affects the quality of life, perceived occupational performance, and satisfaction. Face-to-face rehabilitation services have been adversely affected by problems such as time, cost, accessibility, and the COVID-19 pandemic. The telerehabilitation (TR) method is recommended for these problems. This pilot study was planned to examine the comparison of client-centered (CC) intervention with TR and face-to-face (FF) method on quality of life, perceived occupational performance, and satisfaction after TKA.

Methods

Forty-eight older adults that after TKA (13 men and 35 women) were randomized to the TR group ( n = 24; 68.25 ± 3.32 years) or FF group ( n = 24; 68.91 ± 2.56 years). The Nottingham Health Profile (NHP) was used to assess the quality of life, and the Canadian Occupational Performance Measure (COPM) was used to assess perceived occupational performance and satisfaction.

Results

There was no difference in all parameters between the groups before and after the intervention program (p > .05). The intervention consisting of 4 days a week for 4 weeks and 45 min sessions applied with both methods had a strong effect size (p < .001 for all).

Conclusion

As a result, CC intervention applied with both methods in the first postoperative week increased quality of life, perceived occupational performance, and satisfaction. Trail Registration: NCT04969432

A Performance-Based Teleintervention for Adults in the Chronic Stage after Acquired Brain Injury: An Exploratory Pilot Randomized Controlled Crossover Study

This pilot study aimed to investigate the initial effect of a remotely delivered performance-based client-centered intervention on activity performance and participation among adults in the chronic phase after acquired brain injury (ABI). Sixteen participants living at home with little to no assistance in basic daily activities were allocated into intervention or waitlist control groups. Assessments were conducted at the baseline, after the 3-month intervention/wait period, and at a 3-month follow-up. The primary outcomes were activity performance using the Canadian Occupational Performance Measure (COPM) and the Performance Quality Rating Scale (PQRS) and participation using the Mayo-Portland Adaptability Inventory-4 (MPAI-4). The intervention included weekly videoconferencing sessions using the Cognitive Orientation to Daily Occupational Performance approach (tele-CO-OP). The participants identified five functional goals, of which three were directly addressed. Wilcoxon signed-ranks test results showed no significant improvements in the control group at the end of the 3-month wait period. Pooled data from both groups showed significant improvements in COPM scores for trained and untrained goals following the intervention. Significant improvements were also found in the PQRS and MPAI-4 scores. Improvements were partially maintained at follow-up. Our preliminary results suggest that tele-CO-OP may positively impact the lives of adults after ABI who are coping with long-term disability.

Remote Delivery of Service: A Survey of Occupational Therapists’ Perceptions

Background:

Telehealth has been declared an accepted method of occupational therapy (OT) service delivery and has been shown to be effective. However, studies done before the outbreak of coronavirus disease (COVID-19) show that most occupational therapists didn’t use it.

Aim:

The aim of this exploratory study was to examine the perceptions of occupational therapists regarding remote delivery of service following the COVID-19 outbreak.

Material and methods:

An online survey, including 11-item five-point Likert scale, and 2 open-ended questions were distributed to occupational therapists.

Results:

Responses were received from 245 Israeli occupational therapists. The majority of the participants (60%) strongly agreed that remote delivery allows an ecological and effective intervention, while 76% strongly agreed that an ideal treatment is one that would combine telehealth with in-person intervention. Qualitative findings indicated that the most significant advantage was providing care in the natural environment and improving accessibility to the service. The most salient barriers were limitations of the therapeutic relationship and threats on clinical reasoning.

Conclusion:

The study results highlight the complexity of telehealth. Findings indicate that overall occupational therapists perceive remote care as an effective and legitimate service delivery method that cannot be used as an alternative to in-person treatment. These findings can help in developing intervention programs for remote treatment, and their implementation.

The Canadian Occupational Performance Measure: a Feasible Multidisciplinary Outcome Measure for Pediatric Telerehabilitation

This study describes the feasibility of using the Canadian Occupational Performance Measure (COPM) as a multidisciplinary outcome measure for pediatric telerehabilitation (TR). The COPM was administered at monthly time points over four months. A follow-up survey was conducted with the therapists to assess clinical utility of the COPM. Seventy-three percent of the children seen in TR > one month had at least two administrations of the COPM. Eighty percent of therapists agreed or strongly agreed that the COPM was easy to use in a reasonable amount of time, helped identify functional goals, could be used with various children with varied diagnoses, and measured functional change. In 37 children, the median clinical change in performance and satisfaction was two points or greater on the COPM over the episode of TR. The COPM is a feasible measure perceived positively by pediatric therapists for TR use.