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Borges PRT, Sampaio RF, Dias JF, Mancini MC, Ocarino JM, Resende RA. App-based telerehabilitation program for older adults on waiting list for physiotherapy after hospital discharge: a feasibility pragmatic randomized trial. Pilot Feasibility Stud 2024; 10:98. [PMID: 38961470 PMCID: PMC11221181 DOI: 10.1186/s40814-024-01521-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 06/24/2024] [Indexed: 07/05/2024] Open
Abstract
BACKGROUND Inactivity while waiting for outpatient physiotherapy worsens the physical deconditioning of older adults after hospital discharge. Exercise programs can minimize the progression of deconditioning. In developing countries, telerehabilitation for older adults on the waiting list is still in the early stages. This study aimed to evaluate the feasibility of the study procedures of a telerehabilitation program for older adults waiting for outpatient physiotherapy after hospital discharge. METHODS This pragmatic randomized controlled trial recruited older adults (≥ 60 years) with several clinical diagnoses on the waiting list for outpatient physiotherapy in the Brazilian public health system after hospital discharge. The telerehabilitation group (n = 17) received a personalized program of multicomponent remote exercises using a smartphone app. The control group (n = 17) followed the usual waiting list. We assessed recruitment and dropout rates, safety, adherence, and satisfaction. The preliminary effects were verified on clinical outcomes. RESULTS We recruited 5.6 older adults monthly; dropouts were 12%. No serious adverse events were associated with the telerehabilitation program. The weekly adherence was 2.85 (1.43) days, and in 63.3% of the weeks the participants were enrolled, they performed the exercise program at least twice a week. Participants rated the telerehabilitation program as 9.71 (0.21), and the safety of remote exercises without professional supervision as 8.6 (2.2) on a 0-10 scale. CONCLUSIONS The telerehabilitation program using a smartphone app was safe and presented high participants' satisfaction and adequate adherence, recruitment, and dropout rates. Therefore, the definitive study can be conducted with few modifications. TRIAL REGISTRATION Brazilian Registry of Clinical Trials (ReBEC), RBR-9243v7. Registered on 24 August 2020. https://ensaiosclinicos.gov.br/rg/RBR-9243v7 .
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Affiliation(s)
- Pollyana Ruggio Tristão Borges
- Department of Physiotherapy, Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Avenida Antônio Carlos, 6627 - Campus Pampulha, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - Rosana Ferreira Sampaio
- Department of Physiotherapy, Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Avenida Antônio Carlos, 6627 - Campus Pampulha, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - Jane Fonseca Dias
- Department of Physiotherapy, Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Avenida Antônio Carlos, 6627 - Campus Pampulha, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - Marisa Cotta Mancini
- Department of Physiotherapy, Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Avenida Antônio Carlos, 6627 - Campus Pampulha, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - Juliana Melo Ocarino
- Department of Physiotherapy, Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Avenida Antônio Carlos, 6627 - Campus Pampulha, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - Renan Alves Resende
- Department of Physiotherapy, Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Avenida Antônio Carlos, 6627 - Campus Pampulha, Belo Horizonte, Minas Gerais, 31270-901, Brazil.
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Oetjen L, Johannsen A, Bean J, Sim L, Harrison T, Tsai Owens M, Harbeck-Weber C. The Goals and Outcomes of Adolescent and Young Adults with POTS Attending an Intensive Interdisciplinary Treatment Program. Occup Ther Health Care 2024; 38:768-782. [PMID: 36047810 DOI: 10.1080/07380577.2022.2116666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 08/17/2022] [Accepted: 08/20/2022] [Indexed: 10/14/2022]
Abstract
Postural Orthostatic Tachycardia Syndrome (POTS) affects approximately 1% of adolescents, however, little research has been done in this area. This retrospective chart review describes the treatment goals and perceived progress as measured by the Canadian Occupational Performance Measure (COPM) of 111 adolescents and young adults (AYAs) aged 12-22 (M = 15.8, SD = 1.8) diagnosed with POTS who were admitted to an interdisciplinary intensive pain treatment program (IIPT). This study also examined the change in progress and satisfaction in goals over a 3-week intensive pain treatment program, as well as the utility and validity of the COPM as an outcome measure for AYAs attending an IIPT. Results indicated adolescents and young adults endorsed treatment goals focused on self-care, school, and leisure and found that performance and satisfaction scores significantly improved from admission to discharge. The findings also suggest that the COPM is a useful and valid outcome measure for this population.
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Affiliation(s)
- Laurel Oetjen
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota, USA
| | - Amanda Johannsen
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota, USA
| | - Jessica Bean
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota, USA
| | - Leslie Sim
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA
| | - Tracy Harrison
- Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota, USA
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Ohno K, Oi R, Harada A, Tomori K, Sawada T. Response Shifts in the Canadian Occupational Performance Measure: A Convergent Mixed-Methods Study. Am J Occup Ther 2024; 78:7803205100. [PMID: 38709675 DOI: 10.5014/ajot.2024.050487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2024] Open
Abstract
IMPORTANCE A response shift (RS) is a phenomenon in which there is an individual perceptual gap between pre and post assessments. RS effects were not considered in the Canadian Occupational Performance Measure (COPM) development process. OBJECTIVE To detect the effects of RS on the COPM. DESIGN Convergent mixed-methods research. SETTING Subacute rehabilitation hospital in Japan. PARTICIPANTS Nineteen adult patients with a range of neurological and musculoskeletal conditions recruited from a subacute rehabilitation hospital. OUTCOMES AND MEASURES In the qualitative analysis, patients' perceptions regarding occupation identified by the COPM were compared between the initial assessment (Time 1 [T1]) and a reassessment (Time 2 [T2]). In the quantitative study, patients were asked to re-rate the occupations in which the RS had occurred, giving feedback on their perceptions at T1 (T2'). The difference between T2 and T2' was calculated to clarify the magnitude of the RS. RESULTS Of the 19 patients, 18 had an RS in at least one occupation. The RS effects were classified into five categories: Replacing, Adding, Reducing, Unspecified, and Embodiment. Ninety occupations were extracted from all the patients, and 46 (51.1%) were affected by RS. The percentages of occupations for which the change in score due to RS exceeded the minimal clinically important difference (±2 points) was 26.1% (12 of 46) for COPM-Performance scores and 30.4% (14 of 46) for COPM-Satisfaction scores. CONCLUSIONS AND RELEVANCE Diverse RS effects have been identified in the COPM, which also affect score interpretation. Plain-Language Summary: The Canadian Occupational Performance Measure has a potential measurement bias that is due to a response shift in which there is an individual perceptual gap between pre and post assessments. The results of this study reveal a need to establish more accurate measurement methods to reduce the impact of response shifts on COPM scores.
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Affiliation(s)
- Kanta Ohno
- Kanta Ohno, PhD, is Assistant Professor, Department of Rehabilitation, School of Health Science, Tokyo University of Technology, Tokyo, Japan;
| | - Riho Oi
- Riho Oi, BOT, is Occupational Therapist, Department of Occupational Therapy, Gotanda Rehabilitation Hospital, Tokyo, Japan
| | - Ai Harada
- Ai Harada, BOT, is Occupational Therapist, Department of Occupational Therapy, Shizuoka Tokushukai Hospital, Shizuoka, Japan
| | - Kounosuke Tomori
- Kounosuke Tomori, PhD, is Professor, Department of Rehabilitation, School of Health Science, Tokyo University of Technology, Tokyo, Japan
| | - Tatsunori Sawada
- Tatsunori Sawada, PhD, is Professor, Department of Rehabilitation, School of Health Science, Tokyo University of Technology, Tokyo, Japan
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Bouffard J, Lettre J, Campeau-Lecours A, Pacciolla D, Lemelin B, Routhier F. Use of a dynamic arm support to drive a power wheelchair: a case report. Disabil Rehabil Assist Technol 2024; 19:506-515. [PMID: 35867651 DOI: 10.1080/17483107.2022.2102258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 07/11/2022] [Indexed: 10/17/2022]
Abstract
PURPOSE Dynamic arm supports (DAS) can assist individuals with severe upper limb disabilities who use a wheelchair to accomplish their daily activities. The objective of this case series was to assess the potential of a DAS to improve power wheelchair (PWC) control in real-life contexts and to describe the integration process. A secondary objective was to explore factors that may influence the DAS integration process. METHODS This case series includes four participants fitted with the Kinova DAS O110. A one-year follow-up was planned for each participant with qualitative and quantitative data collection to assess DAS outcomes. Assessment methods were selected to cover the three vantages of assistive technology outcomes assessment: effectiveness, subjective well-being, and social significance. RESULTS Among the four participants, one used the DAS to help with his wheelchair control for at least 12 months (successful integration). For him, the DAS led to significantly improved wheelchair skills and an important positive psychosocial impact. He was, however, only able to use the DAS for PWC control (no effects on other daily activities), and could not use it in some contexts because the device increased his PWC width. As for the other participants, they stopped using the DAS for different reasons, including a DAS-related adverse event. CONCLUSION This study demonstrated that a wheelchair-bound DAS has the potential to improve PWC use, but successful integration requires specific factors. The service delivery process and the environmental accessibility are crucial for the successful integration of such a device and to avoid safety issues.IMPLICATIONS FOR REHABILITATIONNo study deeply assessed the impacts of dynamic arm support on power wheelchair control, and the associated facilitators and obstacles.A wheelchair-bound dynamic arm support has the potential to improve power wheelchair control for individuals with upper limb disabilities and to lead to positive psychosocial impacts if some conditions conductive to successful integration are met.The service delivery process and the environmental accessibility appear as crucial aspects for the successful integration of a new device, such as dynamic arm support and avoiding safety issues.
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Affiliation(s)
- Jason Bouffard
- Department of Kinesiology, Université Laval, Quebec City, Canada
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale, Quebec City, Canada
| | - Josiane Lettre
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale, Quebec City, Canada
| | - Alexandre Campeau-Lecours
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale, Quebec City, Canada
- Department of Mechanical Engineering, Université Laval, Quebec City, Canada
| | - David Pacciolla
- Department of Physical Activity Sciences, Université du Québec à Montréal, Montreal, Canada
| | - Bruno Lemelin
- Wheelchair and Posture Unit, Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale, Quebec City, Canada
| | - François Routhier
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale, Quebec City, Canada
- Department of Rehabilitation, Université Laval, Quebec City, Canada
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Capdevila E, Portell M, Penelo E, Rodríguez-Bailón M. Measurement properties of the Spanish COPM in older adult rehabilitation inpatients. Scand J Occup Ther 2024; 31:2377175. [PMID: 39034887 DOI: 10.1080/11038128.2024.2377175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 07/03/2024] [Indexed: 07/23/2024]
Abstract
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.
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Affiliation(s)
- Elisabet Capdevila
- Escola Universitària d'Infermeria i Teràpia Ocupacional de Terrassa (EUIT). Universitat Autònoma de Barcelona (UAB), C/de la Riba, Terrassa, Spain
| | - Mariona Portell
- Departament de Psicobiologia i de Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallès, Spain
| | - Eva Penelo
- Departament de Psicobiologia i de Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallès, Spain
| | - María Rodríguez-Bailón
- Department of Physiotherapy (Occupational Therapy). Facultad Ciencias de la Salud, Universidad de Málaga (UMA). C/Arquitecto Francisco Peñalosa, Málaga, Spain
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Hammelef E, Zakaria SJ, Andersen SH, Kelly TJ, Grampurohit N, Avery M, Napoli A, Mulcahey MJ, Serruya MD. A Pilot Feasibility Trial of an Upper Extremity Assistive System. Arch Rehabil Res Clin Transl 2023; 5:100308. [PMID: 38163018 PMCID: PMC10757169 DOI: 10.1016/j.arrct.2023.100308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024] Open
Abstract
Objective To develop and clinically evaluate a customizable active upper extremity (UE) assistive system with integrated functional electrical stimulation (FES) that improves function and independence of individuals during activities of daily living (ADLs). Design Single-arm, prospective, open-label cohort feasibility trial. Setting An academic research institution. Participants Subjects were 5 adults with a medical history of stroke resulting in distal UE impairment (N=5). The subjects volunteered from recruitment materials that detailed information about the study. Interventions A novel, wearable, lightweight, low-profile, and patient-tailored UE assistive system. It comprises a splint component and FES unit that may each be controlled by electromyography (EMG) signals, inertial measurement units (IMUs), manual control source (joystick), and/or voice control. Main Outcome Measures Several occupational therapy outcome measures were used, including the Canadian Occupational Performance Measure (COPM), Action Research Arm Test (ARAT), The Box and Blocks Test (BBT), the ABILHAND-Manual Ability Measure, and Patient Reported Outcomes Measurement Information System (PROMIS) UE Short Form. Results All participants learned to use our UE assistive system to perform ADLs and were able to use it independently at home. Most participants experienced a clinically meaningful improvement in both performance and satisfaction for the majority of their COPM goals while using the system. All participants experienced improvement in hand grip and release as shown by their baseline and post assessment scores for hand function (BBT, ARAT) and patient-reported outcomes (ABILHAND, PROMIS). Conclusions The clinical outcomes suggest that our UE assistive system improves functional performance in patients with UE impairment, allowing them to engage more actively in ADLs. Further innovation including elbow and shoulder components will allow users to have more degrees of freedom during tasks.
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Affiliation(s)
- Emma Hammelef
- Raphael Center for Neurorestoration, Farber Institute for Neuroscience, Thomas Jefferson University, 130 S 9th Street, Suite 2400, Philadelphia, PA 19107
| | - Saami J. Zakaria
- Raphael Center for Neurorestoration, Farber Institute for Neuroscience, Thomas Jefferson University, 130 S 9th Street, Suite 2400, Philadelphia, PA 19107
| | - Sarah H. Andersen
- Raphael Center for Neurorestoration, Farber Institute for Neuroscience, Thomas Jefferson University, 130 S 9th Street, Suite 2400, Philadelphia, PA 19107
| | - Thomas J. Kelly
- Raphael Center for Neurorestoration, Farber Institute for Neuroscience, Thomas Jefferson University, 130 S 9th Street, Suite 2400, Philadelphia, PA 19107
| | - Namrata Grampurohit
- Center for Outcomes and Measurement, College of Rehabilitation Sciences, Thomas Jefferson University, 901 Walnut Street, Suite 642, Philadelphia, PA 19107
| | - Mikael Avery
- Raphael Center for Neurorestoration, Farber Institute for Neuroscience, Thomas Jefferson University, 130 S 9th Street, Suite 2400, Philadelphia, PA 19107
- Studio Krea, Collingswood, NJ
| | - Alessandro Napoli
- Raphael Center for Neurorestoration, Farber Institute for Neuroscience, Thomas Jefferson University, 130 S 9th Street, Suite 2400, Philadelphia, PA 19107
| | - Mary Jane Mulcahey
- Center for Outcomes and Measurement, College of Rehabilitation Sciences, Thomas Jefferson University, 901 Walnut Street, Suite 642, Philadelphia, PA 19107
| | - Mijail Demian Serruya
- Raphael Center for Neurorestoration, Farber Institute for Neuroscience, Thomas Jefferson University, 130 S 9th Street, Suite 2400, Philadelphia, PA 19107
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Kobayashi E, Himuro N, Mitani Y, Tsunashima T, Nomura K, Chiba S. Feasibility and informativeness of the Canadian occupational performance measure for identifying priorities in patients with Parkinson's disease. Physiother Theory Pract 2023; 39:607-614. [PMID: 34986731 DOI: 10.1080/09593985.2021.2023926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The aim of this study was to examine the feasibility and informativeness of the Canadian Occupational Performance Measure (COPM) for identifying the priorities of patients with Parkinson's disease (PD). METHODS The COPM was administered in patients with PD who were admitted to the hospital. Feasibility was investigated by confirming the acceptability and practicality of the COPM interview. To investigate informativeness, identified priorities were classified according to the International Classification of Functioning, Disability and Health (ICF) and were cross-referenced with data from similar studies using the Patient-Specific Functional Scale (PSFS) and the Patient-Specific Index for PD (PSI-PD). RESULTS All 61 patients who participated in this study completed the COPM, and a total of 197 priorities were identified. The most frequently identified priorities were "Recreation and leisure," "Preparing meals," "Walking," "Doing housework," and "Caring for household objects." The priorities identified using the PSFS and the PSI-PD were less diverse and focused on "Mobility" or "Self-care." CONCLUSIONS The COPM is a feasible and informative tool for identifying priorities in patients with PD. Its informativeness was demonstrated by its ability to identify diverse priorities across the ICF domains of "Activity and participation" that had not been identified in the studies using the PSFS and PSI-PD.
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Affiliation(s)
- Eiji Kobayashi
- Department of Physical Therapy, Faculty of Human Science, Hokkaido Bunkyo University, Eniwa, Japan
| | - Nobuaki Himuro
- Department of Public Health, Sapporo Medical University, School of Medicine, Chuo-ku, Sapporo, Japan
| | - Yuji Mitani
- Department of Rehabilitation, Sapporo Nishimaruyama Hospital, Chou-ku, Sapporo, Japan
| | - Takuya Tsunashima
- Department of Rehabilitation, Sapporo Nishimaruyama Hospital, Chou-ku, Sapporo, Japan
| | - Kyouhei Nomura
- Department of Rehabilitation, Sapporo Nishimaruyama Hospital, Chou-ku, Sapporo, Japan
| | - Susumu Chiba
- Department of Neurology, Neuromedical Center, Sapporo Nishimaruyama Hospital, Chou-ku, Sapporo, Japan
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Gunnarsson AB, Hedberg AK, Håkansson C, Hedin K, Wagman P. Occupational performance problems in people with depression and anxiety. Scand J Occup Ther 2023; 30:148-158. [PMID: 33569993 DOI: 10.1080/11038128.2021.1882562] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Depression and anxiety often reduce people's ability to cope with everyday occupations. There is a lack of knowledge about such problems in people of working age with depression and anxiety. AIM To describe which problems people with depression or anxiety disorders experience when performing everyday occupations and which occupations are affected. MATERIALS AND METHODS Data based on the Canadian Occupational Performance Measure was used in this cross-sectional study. A total of 118 participants aged 18-65 years, with depression or anxiety, were recruited from primary healthcare and general mental healthcare services. The data were analysed with descriptive statistics and directed content analysis. RESULTS The participants rated a low level of occupational performance, and their satisfaction with performance even lower. They described a great number of problems with their everyday occupations. The most frequent problem areas concerned household management, socialization and personal care. Detailed descriptions of which type of problem they experienced during everyday occupations are included. CONCLUSIONS This study provides knowledge of which problems people with depression and anxiety disorders experience in everyday occupations within self-care, productivity, as well as leisure. Furthermore, they rate performance and satisfaction with performance of the five occupations they find the most important to change in everyday life.
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Affiliation(s)
- Anna Birgitta Gunnarsson
- Institute of Neuroscience and Physiology, Section for Health and Rehabilitation, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Research and Development, Region Kronoberg, Växjö, Sweden
| | - Anna-Karin Hedberg
- General Psychiatry Clinic, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Carita Håkansson
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Katarina Hedin
- Futurum, Region Jönköping County and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.,Department of Clinical Sciences in Malmö, Family Medicine Lund University, Malmö, Sweden
| | - Petra Wagman
- Department of Rehabilitation, School of Health and Welfare, Jönköping University, Jönköping, Sweden
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Hayden-Evans M, Milbourn B, D’Arcy E, Chamberlain A, Afsharnejad B, Evans K, Whitehouse AJO, Bölte S, Girdler S. An Evaluation of the Overall Utility of Measures of Functioning Suitable for School-Aged Children on the Autism Spectrum: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14114. [PMID: 36360993 PMCID: PMC9659140 DOI: 10.3390/ijerph192114114] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 10/25/2022] [Accepted: 10/25/2022] [Indexed: 06/16/2023]
Abstract
A diagnosis of an autism spectrum condition (autism) provides limited information regarding an individual's level of functioning, information key in determining support and funding needs. Using the framework introduced by Arksey and O'Malley, this scoping review aimed to identify measures of functioning suitable for school-aged children on the autism spectrum and evaluate their overall utility, including content validity against the International Classification of Functioning, Disability and Health (ICF) and the ICF Core Sets for Autism. The overall utility of the 13 included tools was determined using the Outcome Measures Rating Form (OMRF), with the Adaptive Behavior Assessment System (ABAS-3) receiving the highest overall utility rating. Content validity of the tools in relation to the ICF and ICF Core Sets for Autism varied, with few assessment tools including any items linking to Environmental Factors of the ICF. The ABAS-3 had the greatest total number of codes linking to the Comprehensive ICF Core Set for Autism while the Vineland Adaptive Behavior Scales (Vineland-3) had the greatest number of unique codes linking to both the Comprehensive ICF Core Set for Autism and the Brief ICF Core Set for Autism (6-16 years). Measuring functioning of school-aged children on the spectrum can be challenging, however, it is important to accurately capture their abilities to ensure equitable and individualised access to funding and supports.
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Affiliation(s)
- Maya Hayden-Evans
- Curtin Autism Research Group, School of Allied Health, Curtin University, Perth 6102, Australia
- Telethon Kids Institute, University of Western Australia, Perth 6009, Australia
- Autism CRC, Long Pocket, Brisbane 4850, Australia
| | - Benjamin Milbourn
- Curtin Autism Research Group, School of Allied Health, Curtin University, Perth 6102, Australia
- Telethon Kids Institute, University of Western Australia, Perth 6009, Australia
- Autism CRC, Long Pocket, Brisbane 4850, Australia
| | - Emily D’Arcy
- Curtin Autism Research Group, School of Allied Health, Curtin University, Perth 6102, Australia
- Telethon Kids Institute, University of Western Australia, Perth 6009, Australia
- Autism CRC, Long Pocket, Brisbane 4850, Australia
| | - Angela Chamberlain
- Curtin Autism Research Group, School of Allied Health, Curtin University, Perth 6102, Australia
- Telethon Kids Institute, University of Western Australia, Perth 6009, Australia
- Autism CRC, Long Pocket, Brisbane 4850, Australia
| | - Bahareh Afsharnejad
- Curtin Autism Research Group, School of Allied Health, Curtin University, Perth 6102, Australia
| | - Kiah Evans
- Curtin Autism Research Group, School of Allied Health, Curtin University, Perth 6102, Australia
- Telethon Kids Institute, University of Western Australia, Perth 6009, Australia
- Autism CRC, Long Pocket, Brisbane 4850, Australia
- School of Allied Health, University of Western Australia, Perth 6009, Australia
| | - Andrew J. O. Whitehouse
- Telethon Kids Institute, University of Western Australia, Perth 6009, Australia
- Autism CRC, Long Pocket, Brisbane 4850, Australia
- School of Psychological Science, University of Western Australia, Perth 6009, Australia
| | - Sven Bölte
- Curtin Autism Research Group, School of Allied Health, Curtin University, Perth 6102, Australia
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women’s and Children’s Health, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, 104 31 Stockholm, Sweden
- Child and Adolescent Psychiatry, Stockholm Health Care Services, Region Stockholm, 104 31 Stockholm, Sweden
| | - Sonya Girdler
- Curtin Autism Research Group, School of Allied Health, Curtin University, Perth 6102, Australia
- Autism CRC, Long Pocket, Brisbane 4850, Australia
- School of Allied Health, University of Western Australia, Perth 6009, Australia
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women’s and Children’s Health, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, 104 31 Stockholm, Sweden
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Sawada T, Tomori K, Ohno K, Takahashi K, Saito Y, Levack W. Information bias in the Canadian occupational performance measure: A qualitative study. Br J Occup Ther 2022. [DOI: 10.1177/03080226221079234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose The Canadian Occupational Performance Measure (COPM) is designed to measure outcomes from client-centred occupational therapy. We explored clients’ views and experiences of participating in an initial COPM assessment in order to examine the potential information bias which may influence COPM scores. Material and methods We used qualitative methods to analyse semi-structured interviews (qualitative thematic analysis) on clients at a typical Japanese rehabilitation hospital, to examine the potential information bias affecting their scores in their initial COPM assessment. Results 19 of 20 clients (13 men; 7 women, aged 19–84 years) demonstrated potential sources of information bias in their COPM scores. We identified 15 sources of information bias, grouped into three domains: (1) bias during the selection of occupational areas (Misunderstanding client-centeredness, Misunderstanding meaningfulness, Misunderstanding occupation, and Composite occupations), (2) bias during the scoring of performance and satisfaction (Imaginary scores, Confusing scores of performance or satisfaction with importance, Ambiguous scores, Hopeful scores, Target scores, Emotional scores, Considerate scores and Humbleness scores) and (3) bias interfering future scoring (Changes in selected occupation, Forgotten scores, Ceiling effects). Conclusion This study identifies potential sources of bias affecting COPM scores, and taking account of this result would facilitate better collaboration with clients through COPM.
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Affiliation(s)
- Tatsunori Sawada
- Major of Occupational Therapy, Department of Rehabilitation, School of Health Sciences, Tokyo University of Technology, Ota-ku, Tokyo, Japan
| | - Kounosuke Tomori
- Major of Occupational Therapy, Department of Rehabilitation, School of Health Sciences, Tokyo University of Technology, Ota-ku, Tokyo, Japan
| | - Kanta Ohno
- Major of Occupational Therapy, Department of Rehabilitation, School of Health Sciences, Tokyo University of Technology, Ota-ku, Tokyo, Japan
| | - Kayoko Takahashi
- School of Allied Medical Science, Kitasato University, Sagamihara, Japan
| | - Yuki Saito
- Sendai Seiyo Gakuin College, Sendai, Japan
| | - William Levack
- Department of Medicine, Rehabilitation Teaching & Research Unit, Otago University, New Zealand
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Bloemen B, Pijpers E, Cup E, Groothuis J, van Engelen B, van der Wilt GJ. Care for capabilities: Implementing the capability approach in rehabilitation of patients with neuromuscular diseases. Study protocol of the controlled before-after ReCap-NMD study. PLoS One 2021; 16:e0261475. [PMID: 34932590 PMCID: PMC8691629 DOI: 10.1371/journal.pone.0261475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 11/16/2021] [Indexed: 11/18/2022] Open
Abstract
Background High quality care of patients with neuromuscular diseases requires a personalised approach that focuses on achieving and maintaining a level of functioning that enables them to be in a state of well-being. The capability approach states that well-being should be understood in terms of capabilities, the substantial opportunities that people have to be and do things they have reasons to value. In this Rehabilitation and Capability care for patients with Neuromuscular diseases (ReCap-NMD) study, we want to investigate whether providing care based on the capability approach (capability care) has an added value in the rehabilitation of patients with neuromuscular diseases (NMD). Methods Two groups of 30 adult patients with facioscapulohumeral muscular dystrophy or myotonic dystrophy type 1 will be included. The first group will receive rehabilitation care as usual with a follow-up period of 6 months. Then, based on theory, and experiences of patients and healthcare professionals, capability care will be developed. During the following 3 months, the multidisciplinary outpatient rehabilitation care team will be trained in providing this newly developed capability care. Subsequently, the second group will receive capability care, with a follow-up period of 6 months. A mixed methods approach is used with both qualitative and quantitative outcome measures to evaluate the effect of capability care and to perform a process evaluation. The primary outcome measure will be the Canadian Occupational Performance Measure. Discussion The ReCap-NMD study is the first study to design and implement a healthcare intervention based on the capability approach. The results of this study will expand our knowledge on how the capability approach can be applied in delivering and evaluating healthcare, and will show whether implementing such an intervention leads to a higher well-being for patients with NMD. Trial registration Registered at Trialregister.nl (Trial NL8946) on 12th of October, 2020.
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Affiliation(s)
- Bart Bloemen
- Department for Health Evidence, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, Netherlands
- * E-mail: (BB); (EP)
| | - Eirlys Pijpers
- Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, Netherlands
- * E-mail: (BB); (EP)
| | - Edith Cup
- Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, Netherlands
| | - Jan Groothuis
- Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, Netherlands
| | - Baziel van Engelen
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, Netherlands
| | - Gert Jan van der Wilt
- Department for Health Evidence, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, Netherlands
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Ohno K, Tomori K, Sawada T, Kobayashi R. Examining minimal important change of the Canadian Occupational Performance Measure for subacute rehabilitation hospital inpatients. J Patient Rep Outcomes 2021; 5:133. [PMID: 34928482 PMCID: PMC8688664 DOI: 10.1186/s41687-021-00405-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 12/13/2021] [Indexed: 12/26/2022] Open
Abstract
Background The Canadian Occupational Performance Measure (COPM) is an individualized patient-reported outcome designed to evaluate the self-perceptions of a patient’s occupational performance. Our study aimed to examine the minimal important change (MIC) in inpatients undergoing subacute rehabilitation. The MIC values were calculated using the three different anchor-based analyses with the transition index as an external criterion; the mean change method (MICMeanChange), the receiver operating characteristic (MICROC) analysis, and the predictive modeling method adjusted for the proportion of improved patients (MICadjust). In this study, the MICadjust value was considered as the most valid statistical method. We recruited 100 inpatients with various health conditions from subacute rehabilitation hospitals. Data were collected twice: an initial assessment and a reassessment one month later. The systematic interview format (Five Ws and How) was used for both the initial and second assessments to prevent information bias (response shift). Results Three patients who indicated deterioration on the transition index were excluded from all analyses, and 97 patients were analyzed in this study. The MICadjust values were 2.20 points (95% confidence interval 1.80–2.59) for the COPM performance score and 2.06 points (95% confidence interval 1.73–2.39) for the COPM satisfaction score. The MICMeanChange and MICROC values were considered less reasonable to interpret because the proportions of the improved patients subgroup were more than 50% (82.5%). Conclusions The MICadjust value estimates from this study can help detect whether the patients’ perceived occupational performance improved or did not change. The results support the multidisciplinary use of COPM in clinical practice and research on subacute rehabilitation inpatients.
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Affiliation(s)
- Kanta Ohno
- Major of Occupational Therapy, Department of Rehabilitation, School of Health Science, Tokyo University of Technology, 5-23-22, Nishikamata, Ota-City, Tokyo, 144-8535, Japan. .,Department of Occupational Therapy, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan.
| | - Kounosuke Tomori
- Major of Occupational Therapy, Department of Rehabilitation, School of Health Science, Tokyo University of Technology, 5-23-22, Nishikamata, Ota-City, Tokyo, 144-8535, Japan
| | - Tatsunori Sawada
- Major of Occupational Therapy, Department of Rehabilitation, School of Health Science, Tokyo University of Technology, 5-23-22, Nishikamata, Ota-City, Tokyo, 144-8535, Japan
| | - Ryuji Kobayashi
- Department of Occupational Therapy, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan
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Radomski M, Kreiger R, Anheluk M, Berling K, Darger M, Garcia H, Grabe K, Hopkins S, Morrison M, Zola J, Swenson KK. Cognitive Dysfunction: Feasibility of a Brief Intervention to Help Breast Cancer Survivors. Clin J Oncol Nurs 2021; 25:E69-E76. [PMID: 34800105 DOI: 10.1188/21.cjon.e69-e76] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Many cancer survivors experience cancer-related cognitive dysfunction (CRCD), which is believed to be the result of multiple contributing biologic, situational, and personal factors. Efficacious, clinically implementable interventions addressing the multifactorial nature of CRCD are needed. OBJECTIVES This study evaluated the feasibility of an intervention to help breast cancer survivors mitigate the effects of modifiable factors that contribute to CRCD and improve cognitive functioning. METHODS A single-group pre-/post-test design was used. Treatment fidelity was tracked to evaluate implementability; attendance rates, experience surveys, and homework engagement were used to characterize acceptability. Pre- and post-test cognitive functioning, stress, fatigue, and mood were measured to evaluate preliminary efficacy. FINDINGS The intervention was implementable and acceptable to participants. Participants made statistically significant improvements.
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Ohno K, Tomori K, Sawada T, Seike Y, Yaguchi A, Kobayashi R. Measurement Properties of the Canadian Occupational Performance Measure: A Systematic Review. Am J Occup Ther 2021; 75:23077. [PMID: 34817593 DOI: 10.5014/ajot.2021.041699] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE The Canadian Occupational Performance Measure (COPM) is widely used in clinical practice and research. However, the measurement properties of the COPM were not reviewed using rigorous systematic methodology. OBJECTIVE To evaluate the measurement properties of the COPM. DATA SOURCES MEDLINE, Web of Science, Scopus, OTseeker, and Cochrane Library. Study Selection and Data Collection: We used the updated COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) Risk of Bias checklist to evaluate the measurement properties of the COPM reported in relevant studies. FINDINGS Our search identified 35 articles that reported measurement properties for the COPM with samples that differed in age, country, diagnosis, and disease stage. For content validity, the evidence was inconsistent and of low quality; no studies assessed structural validity. For reliability, the internal consistency was indeterminate and of low quality. One study reported indeterminate and very low quality evidence for cross-cultural validity. According to the evidence reported in these studies, the COPM has inconsistent and moderate reliability, construct validity, and responsiveness and insufficient and high-quality evidence for criterion validity. CONCLUSIONS AND RELEVANCE Our review of the evidence using the COSMIN Risk of Bias checklist indicates that the Canadian Occupational Performance Measure lacks high-quality validation. What This Article Adds: High-quality validation of the Canadian Occupational Performance Measure is lacking. Further examination of its measurement properties using updated relevant guidelines is required.
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Affiliation(s)
- Kanta Ohno
- Kanta Ohno, MS, Major of Occupational Therapy, is Assistant Professor and Occupational Therapist, Department of Rehabilitation, School of Health Sciences, Tokyo University of Technology, Tokyo, Japan, and PhD Student, Department of Occupational Therapy, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan;
| | - Kounosuke Tomori
- Kounosuke Tomori, PhD, Major of Occupational Therapy, is Associate Professor and Occupational Therapist, Department of Rehabilitation, School of Health Sciences, Tokyo University of Technology, Tokyo, Japan
| | - Tatsunori Sawada
- Tatsunori Sawada, PhD, Major of Occupational Therapy, is Professor and Occupational Therapist, Department of Rehabilitation, School of Health Sciences, Tokyo University of Technology, Tokyo, Japan
| | - Yousuke Seike
- Yousuke Seike, PhD, Major of Occupational Therapy, is Assistant Professor and Occupational Therapist, Department of Rehabilitation, School of Health Sciences, Tokyo University of Technology, Tokyo, Japan
| | - Ayana Yaguchi
- Ayana Yaguchi, BS, is Occupational Therapist, Department of Occupational Therapy, Gyoda General Hospital, Gunma, Japan
| | - Ryuji Kobayashi
- Ryuji Kobayashi, PhD, is Professor and Occupational Therapist, Department of Occupational Therapy, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan
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15
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Enemark Larsen A, Wehberg S, Christensen JR. The reliability of the Danish version of the Canadian Occupational Performance Measure. Br J Occup Ther 2021. [DOI: 10.1177/03080226211030090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Introduction This study aims to assess the reliability of the Danish version of the Canadian Occupational Performance Measure (COPM). Method 151 clients, 42.4% male, mean age 66.9 years ( SD: 14.4, range: 16–90), from two hospitals and two rehabilitation centres were interviewed twice with the COPM over a ten-day mean interval ( SD: 4.9, range: 2–27) either by the same (intra-rater) or two different occupational therapists (inter-rater). Data were analysed with intra-class correlation coefficients, coefficient of repeatability, and Bland–Altman plots. Results 823 occupational performance issues were prioritized of which 41%, 338 occupational performance issues (95% CI: 37.7–44.5), were mentioned in both interviews. The intra-class correlation coefficients were 59.8 (95% CI-intra-class correlation coefficients: 49.3–69.5) (COPM), 73.5 (95% CI intra-class correlation coefficients: 65.5-80.2) (COPM-Performance), and 71.8 (95% CI intra-class correlation coefficients: 63.4–78.8) (COPM-Satisfaction). The limits of agreement were −2.83 to 3.05 for the COPM-Performance and −3.50–3.53 for the COPM-Satisfaction. The COPM-Importance scores were highest when obtained by two raters, but opposite for the scores of the COPM-Performance and COPM-Satisfaction. The coefficient of repeatability roughly showed a change in +/- three points (COPM-Importance: 2.67; COPM-Performance: 2.94; and COPM-Satisfaction: 3.52). Correspondingly, Bland–Altman plots showed limits of agreement for the mean values of −2.71 and 3.53, respectively. Conclusions The intra-rater and inter-rater reliability of the COPM were moderate across settings, clients and rater experiences.
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Affiliation(s)
- Anette Enemark Larsen
- Department of Therapist and Midwifery, The Faculty of Health Sciences, Occupational Therapy, Copenhagen University College, Kobenhavn N, Denmark
| | - Sonja Wehberg
- Department of Public Health, Research Unit for General Practice, University of Southern Denmark, Odense, Denmark
| | - Jeanette R Christensen
- Department of Public Health, Research Unit for General Practice, University of Southern Denmark, Odense, Denmark
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Dumas CM, Grajo LC. The Content Validity and Inter-Rater Reliability of the Occupational Therapy Pediatric Inventory of Cognitive Skills (OT-PICS): An Assessment Tool of Functional Cognition in Children. Occup Ther Health Care 2021; 36:84-100. [PMID: 34473001 DOI: 10.1080/07380577.2021.1972381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The Occupational Therapy Pediatric Inventory of Cognitive Skills (OT-PICS) is being developed to evaluate functional cognition skills in children in the domains of play, educational participation, and self-care. This study aimed to determine the content validity and inter-rater reliability of the OT-PICS. Seven content experts agreed that all 15 items of the tool are essential items to examine functional cognition in children (k = 0.71-1.0; I-CVI = 0.71-1.0; S-CVI = 0.96. The OT-PICS also has moderate reliability (ICC = 0.63) between nine trained raters. The tool was then revised and refined for clarity based on therapist's comments and feedback.
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Affiliation(s)
- Christina M Dumas
- Programs in Occupational Therapy, Department of Rehabilitation and Regenerative Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Lenin C Grajo
- Programs in Occupational Therapy, Department of Rehabilitation and Regenerative Medicine, Columbia University Irving Medical Center, New York, NY, USA
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17
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Hansen AØ, Kristensen HK, Cederlund R, Möller S, Tromborg H. An occupation-based intervention in patients with hand-related disorders grouped using the sense of coherence scale-A randomized controlled trial. J Hand Ther 2021; 33:455-469. [PMID: 32156580 DOI: 10.1016/j.jht.2019.12.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 09/20/2019] [Accepted: 12/31/2019] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN A nonblinded randomized controlled trial. INTRODUCTION Occupation-based interventions are superior to physical exercise-based interventions in patients with activity limitations. However, only a few studies have examined the effect in patients with hand-related disorders. Patients recover heterogeneously, which could be due to personal factors, such as sense of coherence (SOC). PURPOSE OF THE STUDY To investigate the effectiveness of an occupation-based intervention for patients with hand-related disorders and whether SOC can give an indication of the expected effects. METHODS A total of 504 patients were stratified into three SOC groups and then randomized to either an occupation-based intervention, including physical exercises (OBI) or a physical exercise-based occupation-focused intervention. The primary outcome, functioning, was measured using the Disability of the Arm, Shoulder and Hand questionnaire. Primary endpoint was at three months. Patients were followed up for a year. RESULTS No significant difference was found in primary outcome analysis. Nevertheless, patients receiving OBI had a statistically significant and greater change in satisfaction with their occupational performance at one, two, and three months follow-up. Patients with a weak SOC had worse functioning and lower health-related quality of life than those in the other groups, at all times. CONCLUSIONS OBI as delivered in this study was not superior to physical exercise-based occupation-focused intervention in this patient group. However, in taking a client-centered approach, we recommend that OBI be based on individual needs, given that patients had a statistically greater change in score regarding satisfaction with their occupational performance. It is evident that patients with a weaker SOC have a lower level of functioning. This knowledge should inform clinical practice.
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Affiliation(s)
- Alice Ørts Hansen
- Department of Clinical Research, University of Southern Denmark, Odense C, Denmark; Department of Orthopaedic Surgery, Odense University Hospital, Odense C, Denmark; Department of Rehabilitation, Odense University Hospital, Odense C, Denmark.
| | - Hanne Kaae Kristensen
- Department of Clinical Research, University of Southern Denmark, Odense C, Denmark; Department of Rehabilitation, Odense University Hospital, Odense C, Denmark; Health Sciences Research Center, University College Lillebaelt, Odense M, Denmark
| | | | - Sören Möller
- Department of Clinical Research, University of Southern Denmark, Odense C, Denmark; OPEN - Odense Patient data Explorative Network, Odense University Hospital, Odense C, Denmark
| | - Hans Tromborg
- Department of Clinical Research, University of Southern Denmark, Odense C, Denmark; Department of Orthopaedic Surgery, Odense University Hospital, Odense C, Denmark
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Veenhuizen Y, Satink T, Graff MJ, Geurts AC, Groothuis JT, van Engelen BG, Nijhuis-van der Sanden MW, Cup EH. Mixed methods evaluation of a self-management group programme for patients with neuromuscular disease and chronic fatigue. BMJ Open 2021; 11:e048890. [PMID: 34433601 PMCID: PMC8388284 DOI: 10.1136/bmjopen-2021-048890] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To obtain insight into experiences of patients with a neuromuscular disease and chronic fatigue and their healthcare professionals regarding content and delivery of a multidisciplinary outpatient self-management group programme to improve social participation. This will inform future implementation. DESIGN A mixed method study alongside a randomised controlled trial. SETTING University hospital, rehabilitation centre and community health centre. PARTICIPANTS 29 patients with a neuromuscular disease and chronic fatigue and 13 healthcare professionals participated in this mixed methods study. INTERVENTION Multidisciplinary group programme, called Energetic, consisted of a 4 months intervention with weekly meetings and covered four modules: (1) individually tailored aerobic exercise training; (2) education about aerobic exercise; (3) self-management training in applying energy conservation strategies and (4) implementation and relapse prevention in daily life. MAIN MEASURES Quantitative data were collected by a questionnaire measuring patients' (n=25, all completed the programme) satisfaction with the perceived results, content and delivery of the programme. Qualitative data were collected by individual and focus group interviews to gain insight in the experiences of patients (n=18), next of kin (n=2) and healthcare professionals (n=13) with facilitators and barriers to programme implementation. RESULTS Patients were satisfied with the number and length of the sessions, the different modules and the therapists. Analysis of the interviews led to five themes: (1) the combination of modules makes a complete picture, (2) the programme is physically and mentally intensive, (3) the group setting is valuable, (4) small variations in delivery occur in different settings, (5) therapists are coaches. Suggestions for programme improvement include a combination of face to face and e-health, enhancement of therapists' skills in guiding group interventions and inclusion of more booster sessions to evaluate and maintain self-management competencies. CONCLUSIONS The Energetic programme could be implemented in different healthcare settings and group settings, and a combination of modules proved to be a facilitator for improving self-management. TRIAL REGISTRATION NUMBER NCT02208687.
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Affiliation(s)
- Yvonne Veenhuizen
- Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, The Netherlands
| | - Ton Satink
- School of Occupational Therapy, HAN University of Applied Science, Nijmegen, The Netherlands
| | - Maud Jl Graff
- Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, The Netherlands
- IQ Healthcare, Research Institute for Health Sciences, Radboud university medical center, Nijmegen, The Netherlands
| | - Alexander Ch Geurts
- Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, The Netherlands
| | - Jan T Groothuis
- Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, The Netherlands
| | - Baziel Gm van Engelen
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, The Netherlands
| | - Maria Wg Nijhuis-van der Sanden
- Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, The Netherlands
- IQ Healthcare, Research Institute for Health Sciences, Radboud university medical center, Nijmegen, The Netherlands
| | - Edith Hc Cup
- Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, The Netherlands
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An exploratory study of the impact of firecracker-induced hand injuries on adolescents and their parents. EUROPEAN JOURNAL OF PLASTIC SURGERY 2021. [DOI: 10.1007/s00238-021-01861-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Abstract
Background
Severe hand injuries due to firecrackers are unfortunately common in the Netherlands. These injuries are expected to have long-term functional and psychological sequalae. We performed a study to assess the long-term impact of such injuries on the victims and their parents.
Methods
Eight sequential adolescent patients that underwent surgery for firecracker-induced severe hand injuries between September 2012 and March 2015 were included. The patient files were assessed for data on hand function. The impact of the injuries was measured by questionnaires and measure instruments: VAS for pain, CHEQ2.0 and COPM-DLV for activities and participation, PedsQL-4.0 for participation and quality of life, RSES for self-esteem, and DT-P for impact on parents.
Results
Seven of the eight patients underwent (partial) hand amputation. Three adolescents still reported pain at a mean of 3.2 years post-trauma. All adolescents required more time than peers performing activities. Seven showed a total of 34 activity and participation problems. One adolescent showed no problems at all. The adolescents showed a mean score of 81 on the PedsQL-4.0, which was not different to healthy adolescents. None had problematic low self-esteem. Six out of eight parents had elevated distress; three parents stated that they still needed psychological support.
Conclusions
Severe hand trauma due to firecrackers has an evident impact on hand function and activities in all adolescents. The injuries have a significant long-lasting psychological impact on the parents. Prolonged psychological help is recommended for the adolescents as well as their parents with a more family-centered approach.
Level of evidence: Level IV, therapeutic study.
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Bianchini E, Della Gatta F, Virgilio M, Alborghetti M, Salvetti M, Giubilei F, Pontieri FE. Validation of the Canadian Occupational Performance Measure in Italian Parkinson’s Disease Clients. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2021. [DOI: 10.1080/02703181.2021.1942392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Edoardo Bianchini
- Dipartimento di Neuroscienze, Salute Mentale e Organi di Senso, Sapienza Università di Roma (RM), Rome, Italy
| | - Francesco Della Gatta
- Dipartimento di Neuroscienze, Salute Mentale e Organi di Senso, Sapienza Università di Roma (RM), Rome, Italy
- Escuela de Doctorado Universidad Catolica de Valencia San Vicente Martir, Valencia, Spain
| | - Miriam Virgilio
- Dipartimento di Neuroscienze, Salute Mentale e Organi di Senso, Sapienza Università di Roma (RM), Rome, Italy
| | - Marika Alborghetti
- Dipartimento di Neuroscienze, Salute Mentale e Organi di Senso, Sapienza Università di Roma (RM), Rome, Italy
- Fondazione Santa Lucia, IRCCS, Rome (RM), Italy
| | - Marco Salvetti
- Dipartimento di Neuroscienze, Salute Mentale e Organi di Senso, Sapienza Università di Roma (RM), Rome, Italy
- INM Neuromed, IRCCS, Pozzilli (IS), Italy
| | - Franco Giubilei
- Dipartimento di Neuroscienze, Salute Mentale e Organi di Senso, Sapienza Università di Roma (RM), Rome, Italy
- Fondazione Santa Lucia, IRCCS, Rome (RM), Italy
| | - Francesco E. Pontieri
- Dipartimento di Neuroscienze, Salute Mentale e Organi di Senso, Sapienza Università di Roma (RM), Rome, Italy
- Fondazione Santa Lucia, IRCCS, Rome (RM), Italy
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ICF linking of patient-reported therapy goals for children with acquired upper extremity impairment. J Hand Ther 2021; 36:74-84. [PMID: 34247881 DOI: 10.1016/j.jht.2021.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 03/23/2021] [Accepted: 05/06/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Patient reported outcome measures are used to evaluate hand therapy outcomes. Yet, limited evidence is available regarding the outcomes children desire from hand therapy. PURPOSE To determine the desired treatment outcomes of children with acquired upper extremity impairments. STUDY DESIGN Descriptive case series METHODS: Two raters independently applied International Classification of Function, Disability and Health (ICF) linking rules to the Canadian Occupational Performance goals of 151 children, age 6-18, receiving occupational therapy for acquired upper extremity impairments. Prevalence of the linked ICF codes was examined using frequency distributions. Kappa and the proportion of positive agreement assessed inter-rater agreement of the linked codes. RESULTS Following consensus, two independent raters linked 894 meaningful concepts to the study population's 501 goals derived from the Canadian Occupational Performance. Ninety-two unique ICF codes were linked to these 894 meaningful concepts. Twenty-three ICF codes account for 77.2% of the most frequently linked codes. For these top 23 codes, the greatest proportion (51.4%) of ICF codes are in the d4 mobility chapter representing specific constructs of hand and arm use. The second largest proportion (14.2%) of linked codes are in the d9 Community, society and civic life chapter aligning with participation in sports, music, performing arts and play. Within the d5 self-care chapter, the study population's top priorities included hair care, fitness and drinking. The primary concerns within the b body functions domain are reduced pain, improved joint mobility and strength. CONCLUSION The study population's top priorities align with specific dimensions of hand and arm use and participation in sports and fitness, performing arts, and play. Further research may elucidate alignment of these patient-desired outcomes and the item banks of commonly used patient reported outcome measurement scales in this population.
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Clare L, Kudlicka A, Oyebode JR, Jones RW, Bayer A, Leroi I, Kopelman M, James IA, Culverwell A, Pool J, Brand A, Henderson C, Hoare Z, Knapp M, Morgan-Trimmer S, Burns A, Corbett A, Whitaker R, Woods B. Goal-oriented cognitive rehabilitation for early-stage Alzheimer's and related dementias: the GREAT RCT. Health Technol Assess 2020; 23:1-242. [PMID: 30879470 DOI: 10.3310/hta23100] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Cognitive rehabilitation (CR) is an individualised, person-centred intervention for people with mild to moderate dementia that addresses the impact of cognitive impairment on everyday functioning. OBJECTIVES To determine whether or not CR is a clinically effective and cost-effective intervention for people with mild to moderate Alzheimer's disease or vascular or mixed dementia, and their carers. DESIGN This multicentre randomised controlled trial compared CR with treatment as usual (TAU). Following a baseline assessment and goal-setting to identify areas of everyday functioning that could be improved or better managed, participants were randomised (1 : 1) via secure web access to an independent randomisation centre to receive either TAU or CR and followed up at 3 and 9 months post randomisation. SETTING Community. PARTICIPANTS Participants had an International Classification of Diseases, Tenth Edition, diagnosis of Alzheimer's disease or vascular or mixed dementia, had mild to moderate cognitive impairment (Mini Mental State Examination score of ≥ 18 points), were stable on medication if prescribed, and had a family carer who was willing to contribute. The exclusion criteria were people with a history of brain injury or other neurological disorder and an inability to speak English. To achieve adequate power, we needed 350 people to complete the trial, with 175 people in each trial arm. INTERVENTION Cognitive rehabilitation consisted of 10 therapy sessions over 3 months, followed by four maintenance sessions over 6 months, delivered in participants' homes. The therapists were nine occupational therapists and one nurse. OUTCOME MEASURES The primary outcome was self-reported goal attainment at 3 months. Goal attainment was also assessed at 9 months. Carers provided independent ratings of goal attainment at both time points. The secondary outcomes were participant quality of life, mood, self-efficacy and cognition, and carer stress, health status and quality of life. The assessments at 3 and 9 months were conducted by researchers who were blind to the participants' group allocation. RESULTS A total of 475 participants were randomised (CR arm, n = 239; TAU arm, n = 236), 427 participants (90%) completed the trial and 426 participants were analysed (CR arm, n = 208, TAU arm, n = 218). At 3 months, there were statistically significant large positive effects for participant-rated goal attainment [mean change in the CR arm: 2.57; mean change in the TAU arm: 0.86; Cohen'sd = 0.97, 95% confidence interval (CI) 0.75 to 1.19], corroborated by carer ratings (Cohen'sd = 1.11, 95% CI 0.89 to 1.34). These effects were maintained at 9 months for both the participant ratings (Cohen's d = 0.94, 95% CI 0.71 to 1.17) and the carer ratings (Cohen's d = 0.96, 95% CI 0.73 to 1.20). There were no significant differences in the secondary outcomes. In the cost-utility analyses, there was no evidence of cost-effectiveness in terms of gains in the quality-adjusted life-years (QALYs) of the person with dementia (measured using the DEMentia Quality Of Life questionnaire utility score) or the QALYs of the carer (measured using the EuroQol-5 Dimensions, three-level version) from either cost perspective. In the cost-effectiveness analyses, by reference to the primary outcome of participant-rated goal attainment, CR was cost-effective from both the health and social care perspective and the societal perspective at willingness-to-pay values of £2500 and above for improvement in the goal attainment measure. There was no evidence on the cost-effectiveness of the self-efficacy measure (the Generalized Self-Efficacy Scale) from either cost perspective. LIMITATIONS Possible limitations arose from the non-feasibility of using observational outcome measures, the lack of a general measure of functional ability and the exclusion of people without a carer or with rarer forms of dementia. CONCLUSIONS Cognitive rehabilitation is clinically effective in enabling people with early-stage dementia to improve their everyday functioning in relation to individual goals targeted in the therapy sessions. FUTURE WORK Next steps will focus on the implementation of CR into NHS and social care services and on extending the approach to people with rarer forms of dementia. TRIAL REGISTRATION Current Controlled Trials ISRCTN21027481. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 23, No. 10. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Linda Clare
- Centre for Research in Ageing and Cognitive Health, University of Exeter, Exeter, UK
| | - Aleksandra Kudlicka
- Centre for Research in Ageing and Cognitive Health, University of Exeter, Exeter, UK
| | - Jan R Oyebode
- School of Dementia Studies, University of Bradford, Bradford, UK
| | - Roy W Jones
- Research Institute for the Care of Older People (RICE), Bath, UK
| | - Antony Bayer
- Division of Population Medicine, University Hospital Llandough, Cardiff University, Cardiff, UK
| | - Iracema Leroi
- Department of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK
| | - Michael Kopelman
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, St Thomas' Hospital, King's College London, London, UK
| | - Ian A James
- Centre of the Health of the Elderly, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Alison Culverwell
- Kent and Medway NHS and Social Care Partnership Trust, St Martin's Hospital, Canterbury, UK
| | | | - Andrew Brand
- North Wales Organisation for Randomised Trials in Health, Bangor University, Bangor, UK
| | - Catherine Henderson
- Personal Social Services Research Unit, London School of Economics and Political Science, London, UK
| | - Zoe Hoare
- North Wales Organisation for Randomised Trials in Health, Bangor University, Bangor, UK
| | - Martin Knapp
- Personal Social Services Research Unit, London School of Economics and Political Science, London, UK
| | | | - Alistair Burns
- Department of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK
| | - Anne Corbett
- Centre for Research in Ageing and Cognitive Health, University of Exeter, Exeter, UK
| | | | - Bob Woods
- Dementia Services Development Centre, Bangor University, Bangor, UK
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Enemark Larsen A, Wehberg S, Christensen JR. Looking into the Content of the Canadian Occupational Performance Measure (COPM): A Danish Cross-Sectional Study. Occup Ther Int 2020; 2020:9573950. [PMID: 32565758 PMCID: PMC7285290 DOI: 10.1155/2020/9573950] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 05/06/2020] [Indexed: 01/10/2023] Open
Abstract
PURPOSE To examine the content validity of the Danish version of the Canadian Occupational Performance Measure (COPM-DK). MATERIALS AND METHODS This cross-sectional study was performed in a hospital and a community rehabilitation centre. The content validity of the COPM was assessed by relating the clients' prioritized occupational performance issues (OPIs) to the conceptual model of the Canadian Model of Occupational Performance and Engagement (CMOP-E) and the levels of the Taxonomic Code of Occupational Performance (TCOP). Six occupational therapy lecturers participated in classifying the OPIs using the TCOP. RESULTS A total of 112 clients from a regional and community-based rehabilitation participated. The 56% regional participants came from a hospital's hand and knee surgery department. The remaining 44% participants came from a community-based rehabilitation centre with in- and outpatient departments. There were 44% males, with a mean age of 65.2 years. They prioritized 495 OPIs, of which 40% concerned self-care, 32% productivity, and 28% leisure. The prioritized OPIs were divided into a total of 224 different OPIs. There were significant differences in which areas were prioritized in the various population groups. Of the OPIs, 64.3% could be classified into the TCOP levels of occupation and activity, i.e., 1/3 of the OPIs were related to tasks and actions, and thus beyond the scope of the COPM. The interrater agreement of the OPI classification was only fair (kappa 0.3). CONCLUSION The content validity of the COPM seems to depend on how and with which clients it is administered. Caution must be taken to secure OPIs on the higher levels of the TCOP, while maintaining the clients' right to nominate OPI preferences. Therefore, an introductory course and on-going support are recommendable. Bearing this in mind, the COPM seems useful to identify individual clients' prioritized OPIs in a Danish context.
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Affiliation(s)
- Anette Enemark Larsen
- Occupational Therapy, Department of Therapist and Midwifery, The Faculty of Health Sciences, Copenhagen University College, Copenhagen, Denmark
| | - Sonja Wehberg
- Research Unit for General Practice, Department of Public Health, University of Southern Denmark, Denmark
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24
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Ransby TB, Hansen AØ, Rolving N. Psychometric properties of the Assessment of Motor and Process Skills in patients undergoing rehabilitation following hand-related disorders. HAND THERAPY 2020. [DOI: 10.1177/1758998320912761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction Assessment of Motor and Process Skills (AMPS) has been proven to be a suitable measurement tool for assessing performance-based ADL ability; however, its reliability and validity have not been tested on patients with hand-related disorders. Methods Patients referred for outpatient hand rehabilitation were assessed with AMPS, The Canadian Occupational Performance Measure (COPM), dynamometer and goniometer at baseline and after eight weeks of hand therapy. Construct validity and responsiveness of AMPS were assessed by hypothesis testing. Construct validity was assessed by correlating the baseline score of AMPS with the baseline score of the other measurement tools. Responsiveness was assessed by correlating the change scores of each measurement tool with a Global Rating Scale. Results Fifty-one patients were recruited. The construct validity of AMPS indicated that the various measurement tools captured different aspects to functioning from the AMPS, as the correlations between AMPS and the other measurement tools were generally weak to low (r < 0.25 to 0.49). AMPS was less responsive than COPM when correlated with the GRS. The correlation between COPM and GRS was r = 0.62 compared with the AMPS motor, r = 0.45 and AMPS process, r = 0.33. Relative responsiveness of AMPS is similar to that of the dynamometer (r = 0.39) and goniometer (r = –0.34). Discussion In a sample of 51 patients, this study found that the construct validity of AMPS seemed to be moderate, while the responsiveness of AMPS seemed to be poor. However, due to the small sample size no conclusions can be made, and should be further assessed in larger studies.
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Affiliation(s)
- Thea Birch Ransby
- Department of Physical and Occupational Therapy, Diagnostic Center Silkeborg Regional Hospital, Silkeborg, Denmark
| | - Alice Ørts Hansen
- Department of Rehabilitation, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Nanna Rolving
- Department of Physical and Occupational Therapy, Diagnostic Center Silkeborg Regional Hospital, Silkeborg, Denmark
- DEFACTUM, Central Denmark region, Aarhus, Denmark
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25
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Gutman SA, Balasubramanian S, Herzog M, Kim E, Swirnow H, Retig Y, Wolff S. Effectiveness of a Tailored Intervention for Women With Attention Deficit Hyperactivity Disorder (ADHD) and ADHD Symptoms: A Randomized Controlled Study. Am J Occup Ther 2020; 74:7401205010p1-7401205010p11. [PMID: 32078512 DOI: 10.5014/ajot.2020.033316] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE Women with attention deficit hyperactivity disorder (ADHD) and ADHD symptoms may experience difficulty carrying out desired life roles and activities. OBJECTIVE To determine whether a 7-wk tailored occupation-based intervention can reduce perceived stress and ADHD symptoms and enhance perceived performance of and satisfaction with daily roles and activities among women with ADHD. DESIGN Randomization to intervention (n = 11) and control (n = 12) groups. SETTING Home and community. PARTICIPANTS Twenty-three participants ages 20-55 yr, English speaking, and with a self-reported diagnosis of ADHD. INTERVENTION The intervention was administered for 7 wk in individual 1-hr sessions and addressed routine establishment, organization, time management, stress management, and sensory regulation in the home and community. OUTCOMES AND MEASURES Adult Attention Deficit Hyperactivity Disorder Self-Report Scale, Perceived Stress Scale, and Canadian Occupational Performance Measure. RESULTS At 1-wk postintervention, statistically significant differences were found between intervention and control groups in perceived stress (Z = -3.838, p < .000, d = -2.66), ADHD symptoms (Z = -3.605, p < .000, d = -2.17), and COPM Performance (Z = -4.074, p < .000, d = 3.04) and Satisfaction change scores (Z = -3.759, p < .000, d = 2.82). CONCLUSION AND RELEVANCE A 7-wk tailored intervention reduced perceived stress and ADHD symptoms and enhanced perceived performance of and satisfaction with desired occupational roles and activities in a sample of women with ADHD. Further research is warranted to determine whether the intervention can be useful to women with ADHD beyond the present sample. WHAT THIS ARTICLE ADDS This intervention may offer an effective nonpharmacological option for women with ADHD symptoms.
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Affiliation(s)
- Sharon A Gutman
- Sharon A. Gutman, PhD, OTR, FAOTA, is Professor, Programs in Occupational Therapy, Rehabilitation and Regenerative Medicine, Columbia University, New York;
| | - Sheetala Balasubramanian
- Sheetala Balasubramanian, MS, OTR, is Occupational Therapist, Programs in Occupational Therapy, Rehabilitation and Regenerative Medicine, Columbia University, New York
| | - Maya Herzog
- Maya Herzog, MS, OTR, is Occupational Therapist, Programs in Occupational Therapy, Rehabilitation and Regenerative Medicine, Columbia University, New York
| | - Elizabeth Kim
- Elizabeth Kim, MS, OTR, is Occupational Therapist, Programs in Occupational Therapy, Rehabilitation and Regenerative Medicine, Columbia University, New York
| | - Hannah Swirnow
- Hannah Swirnow, MS, OTR, is Occupational Therapist, Programs in Occupational Therapy, Rehabilitation and Regenerative Medicine, Columbia University, New York
| | - Yudis Retig
- Yudis Retig, MS, OTR, is Occupational Therapist, Programs in Occupational Therapy, Rehabilitation and Regenerative Medicine, Columbia University, New York
| | - Samantha Wolff
- Samantha Wolff, MS, OTR, is Occupational Therapist, Programs in Occupational Therapy, Rehabilitation and Regenerative Medicine, Columbia University, New York
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26
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Veenhuizen Y, Cup EHC, Jonker MA, Voet NBM, van Keulen BJ, Maas DM, Heeren A, Groothuis JT, van Engelen BGM, Geurts ACH. Self-management program improves participation in patients with neuromuscular disease: A randomized controlled trial. Neurology 2019; 93:e1720-e1731. [PMID: 31570565 DOI: 10.1212/wnl.0000000000008393] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Accepted: 06/06/2019] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To investigate the effectiveness of Energetic, a self-management group program combining aerobic training, energy conservation management, and relapse prevention to improve social participation in patients with neuromuscular disease (NMD) and chronic fatigue. METHODS In this multicenter, assessor-blinded, 2-armed randomized controlled trial with repeated measurements, 53 patients with various types of NMD and chronic fatigue were randomly allocated to Energetic, a 4-month group intervention, or to usual care. The primary endpoint was social participation assessed with the Canadian Occupational Performance Measure (COPM) performance scale immediately postintervention. Secondary outcomes included COPM satisfaction scale, 6-Minute Walk Test (6MWT), and Checklist Individual Strength-subscale fatigue. Participants were followed for 11 months postintervention. Data were analyzed with linear models that account for repeated measurements. RESULTS Directly after intervention, the mean group difference for COPM-performance was 1.7 (95% confidence interval [CI] 1.0-2.4; p < 0.0001) in favor of the intervention group (n = 29), adjusted for baseline, sex, diagnosis, and work status. This effect was retained at 11 months follow-up (0.9; 95% CI 0.0-1.7; p = 0.049). The COPM satisfaction scale and 6MWT improved more in the intervention group compared to usual care. After 3 and 11 months follow-up, most beneficial effects on social participation and functional endurance were retained. CONCLUSION Energetic led to sustainable improvements in social participation and functional endurance compared to usual care in patients with NMD and chronic fatigue.Clinicaltrials.gov IDENTIFIER: NCT02208687. CLASSIFICATION OF EVIDENCE This study provides Class III evidence that a combination of aerobic training, energy conservation management, and relapse prevention improves social participation in patients with NMD and chronic fatigue.
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Affiliation(s)
- Yvonne Veenhuizen
- From the Departments of Rehabilitation (Y.V., E.H.C.C., N.B.M.V., D.M.M., J.T.G., A.C.H.G.) and Neurology (B.G.M.v.E.), Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen; Department of Health Evidence (M.A.J.), Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen; and Rehabilitation Center Klimmendaal (N.B.M.V., B.J.v.K., A.H.), Arnhem, the Netherlands.
| | - Edith H C Cup
- From the Departments of Rehabilitation (Y.V., E.H.C.C., N.B.M.V., D.M.M., J.T.G., A.C.H.G.) and Neurology (B.G.M.v.E.), Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen; Department of Health Evidence (M.A.J.), Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen; and Rehabilitation Center Klimmendaal (N.B.M.V., B.J.v.K., A.H.), Arnhem, the Netherlands
| | - Marianne A Jonker
- From the Departments of Rehabilitation (Y.V., E.H.C.C., N.B.M.V., D.M.M., J.T.G., A.C.H.G.) and Neurology (B.G.M.v.E.), Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen; Department of Health Evidence (M.A.J.), Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen; and Rehabilitation Center Klimmendaal (N.B.M.V., B.J.v.K., A.H.), Arnhem, the Netherlands
| | - Nicoline B M Voet
- From the Departments of Rehabilitation (Y.V., E.H.C.C., N.B.M.V., D.M.M., J.T.G., A.C.H.G.) and Neurology (B.G.M.v.E.), Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen; Department of Health Evidence (M.A.J.), Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen; and Rehabilitation Center Klimmendaal (N.B.M.V., B.J.v.K., A.H.), Arnhem, the Netherlands
| | - Bianca J van Keulen
- From the Departments of Rehabilitation (Y.V., E.H.C.C., N.B.M.V., D.M.M., J.T.G., A.C.H.G.) and Neurology (B.G.M.v.E.), Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen; Department of Health Evidence (M.A.J.), Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen; and Rehabilitation Center Klimmendaal (N.B.M.V., B.J.v.K., A.H.), Arnhem, the Netherlands
| | - Daphne M Maas
- From the Departments of Rehabilitation (Y.V., E.H.C.C., N.B.M.V., D.M.M., J.T.G., A.C.H.G.) and Neurology (B.G.M.v.E.), Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen; Department of Health Evidence (M.A.J.), Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen; and Rehabilitation Center Klimmendaal (N.B.M.V., B.J.v.K., A.H.), Arnhem, the Netherlands
| | - Anita Heeren
- From the Departments of Rehabilitation (Y.V., E.H.C.C., N.B.M.V., D.M.M., J.T.G., A.C.H.G.) and Neurology (B.G.M.v.E.), Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen; Department of Health Evidence (M.A.J.), Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen; and Rehabilitation Center Klimmendaal (N.B.M.V., B.J.v.K., A.H.), Arnhem, the Netherlands
| | - Jan T Groothuis
- From the Departments of Rehabilitation (Y.V., E.H.C.C., N.B.M.V., D.M.M., J.T.G., A.C.H.G.) and Neurology (B.G.M.v.E.), Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen; Department of Health Evidence (M.A.J.), Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen; and Rehabilitation Center Klimmendaal (N.B.M.V., B.J.v.K., A.H.), Arnhem, the Netherlands
| | - Baziel G M van Engelen
- From the Departments of Rehabilitation (Y.V., E.H.C.C., N.B.M.V., D.M.M., J.T.G., A.C.H.G.) and Neurology (B.G.M.v.E.), Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen; Department of Health Evidence (M.A.J.), Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen; and Rehabilitation Center Klimmendaal (N.B.M.V., B.J.v.K., A.H.), Arnhem, the Netherlands
| | - Alexander C H Geurts
- From the Departments of Rehabilitation (Y.V., E.H.C.C., N.B.M.V., D.M.M., J.T.G., A.C.H.G.) and Neurology (B.G.M.v.E.), Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen; Department of Health Evidence (M.A.J.), Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen; and Rehabilitation Center Klimmendaal (N.B.M.V., B.J.v.K., A.H.), Arnhem, the Netherlands
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Pol MC, ter Riet G, van Hartingsveldt M, Kröse B, Buurman BM. Effectiveness of sensor monitoring in a rehabilitation programme for older patients after hip fracture: a three-arm stepped wedge randomised trial. Age Ageing 2019; 48:650-657. [PMID: 31204776 DOI: 10.1093/ageing/afz074] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 04/15/2019] [Accepted: 05/27/2019] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES to test the effects of an intervention involving sensor monitoring-informed occupational therapy on top of a cognitive behavioural treatment (CBT)-based coaching therapy on daily functioning in older patients after hip fracture. DESIGN, SETTING AND PATIENTS three-armed randomised stepped wedge trial in six skilled nursing facilities, with assessments at baseline (during admission) and after 1, 4 and 6 months (at home). Eligible participants were hip fracture patients ≥ 65 years old. INTERVENTIONS patients received care as usual, CBT-based occupational therapy or CBT-based occupational therapy with sensor monitoring. Interventions comprised a weekly session during institutionalisation, followed by four home visits and four telephone consultations over three months. MAIN OUTCOMES AND MEASURES the primary outcome was patient-reported daily functioning at 6 months, assessed with the Canadian Occupational Performance Measure. RESULTS a total of 240 patients (mean[SD] age, 83.8[6.9] years were enrolled. At baseline, the mean Canadian Occupational Performance Measure scores (range 1-10) were 2.92 (SE 0.20) and 3.09 (SE 0.21) for the care as usual and CBT-based occupational therapy with sensor monitoring groups, respectively. At six months, these values were 6.42 (SE 0.47) and 7.59 (SE 0.50). The mean patient-reported daily functioning in the CBT-based occupational therapy with sensor monitoring group was larger than that in the care as usual group (difference 1.17 [95% CI (0.47-1.87) P = 0.001]. We found no significant differences in daily functioning between CBT-based occupational therapy and care as usual. CONCLUSIONS AND RELEVANCE among older patients recovering from hip fracture, a rehabilitation programme of sensor monitoring-informed occupational therapy was more effective in improving patient-reported daily functioning at six months than to care as usual. TRIAL REGISTRATION Dutch National Trial Register, NTR 5716.
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Affiliation(s)
- Margriet C Pol
- ACHIEVE, Centre of Applied Research, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
| | - Gerben ter Riet
- Department General Practice, Amsterdam UMC, University of Amsterdam, The Netherlands
| | - Margo van Hartingsveldt
- ACHIEVE, Centre of Applied Research, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
| | - Ben Kröse
- Research Group Digital Life, Amsterdam University of Applied Sciences, University of Amsterdam, Amsterdam, The Netherlands
- Informatics Institute, University of Amsterdam, Amsterdam, The Netherlands
| | - Bianca M Buurman
- ACHIEVE, Centre of Applied Research, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
- Section of Geriatric Medicine, Department of Internal Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
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Clare L, Kudlicka A, Oyebode JR, Jones RW, Bayer A, Leroi I, Kopelman M, James IA, Culverwell A, Pool J, Brand A, Henderson C, Hoare Z, Knapp M, Woods B. Individual goal-oriented cognitive rehabilitation to improve everyday functioning for people with early-stage dementia: A multicentre randomised controlled trial (the GREAT trial). Int J Geriatr Psychiatry 2019; 34:709-721. [PMID: 30724405 PMCID: PMC6593854 DOI: 10.1002/gps.5076] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 01/28/2019] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To determine whether individual goal-oriented cognitive rehabilitation (CR) improves everyday functioning for people with mild-to-moderate dementia. DESIGN AND METHODS Parallel group multicentre single-blind randomised controlled trial (RCT) comparing CR added to usual treatment (CR) with usual treatment alone (TAU) for people with an ICD-10 diagnosis of Alzheimer, vascular or mixed dementia, and mild-to-moderate cognitive impairment (Mini-Mental State Examination [MMSE] score ≥ 18), and with a family member willing to contribute. Participants allocated to CR received 10 weekly sessions over 3 months and four maintenance sessions over 6 months. Participants were followed up 3 and 9 months post randomisation by blinded researchers. The primary outcome was self-reported goal attainment at 3 months. Secondary outcomes at 3 and 9 months included informant-reported goal attainment, quality of life, mood, self-efficacy, and cognition and study partner stress and quality of life. RESULTS We randomised (1:1) 475 people with dementia; 445 (CR = 281) were included in the intention to treat analysis at 3 months and 426 (CR = 208) at 9 months. At 3 months, there were statistically significant large positive effects for participant-rated goal attainment (d = 0.97; 95% CI, 0.75-1.19), corroborated by informant ratings (d = 1.11; 95% CI, 0.89-1.34). These effects were maintained at 9 months for both participant (d = 0.94; 95% CI, 0.71-1.17) and informant (d = 0.96; 95% CI, 0.73-1.2) ratings. The observed gains related to goals directly targeted in the therapy. There were no significant differences in secondary outcomes. CONCLUSIONS CR enables people with early-stage dementia to improve their everyday functioning in relation to individual goals targeted in the therapy.
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Affiliation(s)
- Linda Clare
- Centre for Research in Ageing and Cognitive HealthUniversity of ExeterExeterUK
| | - Aleksandra Kudlicka
- Centre for Research in Ageing and Cognitive HealthUniversity of ExeterExeterUK
| | - Jan R. Oyebode
- School of Dementia StudiesUniversity of BradfordBradfordUK
| | | | - Antony Bayer
- Division of Population Medicine, Cardiff UniversityUniversity Llandough HospitalPenarthUK
| | - Iracema Leroi
- Department of Neuroscience and Experimental Psychology, Jean McFarlane BuildingUniversity of ManchesterManchesterUK
| | - Michael Kopelman
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, St Thomas' HospitalKing's College LondonLondonUK
| | - Ian A. James
- Centre of the Health of the ElderlyNorthumberland Tyne and Wear NHS Foundation TrustNewcastle upon TyneUK
| | - Alison Culverwell
- Kent and Medway NHS Partnership TrustSt Martin's HospitalCanterburyUK
| | | | - Andrew Brand
- North Wales Organisation for Randomised Trials in HealthBangor UniversityBangorUK
| | - Catherine Henderson
- Personal Social Services Research UnitLondon School of Economics and Political ScienceLondonUK
| | - Zoe Hoare
- North Wales Organisation for Randomised Trials in HealthBangor UniversityBangorUK
| | - Martin Knapp
- Personal Social Services Research UnitLondon School of Economics and Political ScienceLondonUK
| | - Bob Woods
- Dementia Services Development CentreBangor UniversityBangorUK
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Trujillo C, Poach M, Carr M. Exploring the applicability of occupational therapy transition assessments for students with disabilities. WORLD FEDERATION OF OCCUPATIONAL THERAPISTS BULLETIN 2018. [DOI: 10.1080/14473828.2018.1556961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Christopher Trujillo
- Occupational Therapy Program, Midwestern University, Glendale, AZ, USA
- Department of Occupational Therapy, Northern Arizona University, Phoenix, AZ, USA
| | - Meghan Poach
- Department of Occupational Therapy, Northern Arizona University, Phoenix, AZ, USA
| | - Mikaela Carr
- Department of Occupational Therapy, Northern Arizona University, Phoenix, AZ, USA
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McLean B, Blakeman M, Carey L, Ward R, Novak I, Valentine J, Blair E, Taylor S, Bear N, Bynevelt M, Basc E, Rose S, Reid L, Pannek K, Angeli J, Harpster K, Elliott C. Discovering the sense of touch: protocol for a randomised controlled trial examining the efficacy of a somatosensory discrimination intervention for children with hemiplegic cerebral palsy. BMC Pediatr 2018; 18:252. [PMID: 30064388 PMCID: PMC6069953 DOI: 10.1186/s12887-018-1217-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Accepted: 07/09/2018] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Of children with hemiplegic cerebral palsy, 75% have impaired somatosensory function, which contributes to learned non-use of the affected upper limb. Currently, motor learning approaches are used to improve upper-limb motor skills in these children, but few studies have examined the effect of any intervention to ameliorate somatosensory impairments. Recently, Sense© training was piloted with a paediatric sample, seven children with hemiplegic cerebral palsy, demonstrating statistically and clinically significant change in limb position sense, goal performance and bimanual hand-use. This paper describes a protocol for a Randomised Controlled Trial of Sense© for Kids training, hypothesising that its receipt will improve somatosensory discrimination ability more than placebo (dose-matched Goal Directed Therapy via Home Program). Secondary hypotheses include that it will alter brain activation in somatosensory processing regions, white-matter characteristics of the thalamocortical tracts and improve bimanual function, activity and participation more than Goal Directed Training via Home Program. METHODS AND DESIGN This is a single blind, randomised matched-pair, placebo-controlled trial. Participants will be aged 6-15 years with a confirmed description of hemiplegic cerebral palsy and somatosensory discrimination impairment, as measured by the sense©_assess Kids. Participants will be randomly allocated to receive 3h a week for 6 weeks of either Sense© for Kids or Goal Directed Therapy via Home Program. Children will be matched on age and severity of somatosensory discrimination impairment. The primary outcome will be somatosensory discrimination ability, measured by sense©_assess Kids score. Secondary outcomes will include degree of brain activation in response to a somatosensory task measured by functional MRI, changes in the white matter of the thalamocortical tract measured by diffusion MRI, bimanual motor function, activity and participation. DISCUSSION This study will assess the efficacy of an intervention to increase somatosensory discrimination ability in children with cerebral palsy. It will explore clinically important questions about the efficacy of intervening in somatosensation impairment to improve bimanual motor function, compared with focusing on motor impairment directly, and whether focusing on motor impairment alone can affect somatosensory ability. TRIAL REGISTRATION This trial is registered with the Australian New Zealand Clinical Trials Registry, registration number: ACTRN12618000348257. World Health Organisation universal trial number: U1111-1210-1726.
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Affiliation(s)
- Belinda McLean
- School of Adolescent and Child Health, University of Western Australia, Perth, WA Australia
- Kids Rehab Department, Perth Children’s Hospital, Perth, WA Australia
| | - Misty Blakeman
- Kids Rehab Department, Perth Children’s Hospital, Perth, WA Australia
| | - Leeanne Carey
- Department of Community and Clinical Allied Health, School of Allied Health, La Trobe University, Melbourne, VIC Australia
- Neurorehabilitation and Recovery, Stroke Division, Florey Institute of Neuroscience and Mental Health, Melbourne, VIC Australia
| | - Roslyn Ward
- School of Occupational Therapy and Social Work, Curtin University, Perth, WA Australia
| | - Iona Novak
- Cerebral Palsy Alliance, Discipline of Paediatrics and Child Health, The University of Sydney, Sydney, NSW Australia
| | - Jane Valentine
- School of Adolescent and Child Health, University of Western Australia, Perth, WA Australia
- Kids Rehab Department, Perth Children’s Hospital, Perth, WA Australia
| | - Eve Blair
- Telethon Kids Institute, University of Western Australia, Perth, WA Australia
| | - Susan Taylor
- Kids Rehab Department, Perth Children’s Hospital, Perth, WA Australia
- School of Occupational Therapy and Social Work, Curtin University, Perth, WA Australia
| | - Natasha Bear
- Department of Clinical Research and Education, Child and Adolescent Health Services, Perth, WA Australia
| | - Michael Bynevelt
- Kids Rehab Department, Perth Children’s Hospital, Perth, WA Australia
- Sir Charles Gairdner Hospital, Perth, WA Australia
| | - Emma Basc
- Consumer Representative, Perth, WA Australia
| | - Stephen Rose
- Australian e-Health Research Centre, CSIRO, Brisbane, Queensland Australia
| | - Lee Reid
- Australian e-Health Research Centre, CSIRO, Brisbane, Queensland Australia
| | - Kerstin Pannek
- Australian e-Health Research Centre, CSIRO, Brisbane, Queensland Australia
| | - Jennifer Angeli
- School of Adolescent and Child Health, University of Western Australia, Perth, WA Australia
- Kids Rehab Department, Perth Children’s Hospital, Perth, WA Australia
| | - Karen Harpster
- Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio USA
| | - Catherine Elliott
- School of Occupational Therapy and Social Work, Curtin University, Perth, WA Australia
- Department of Clinical Research and Education, Child and Adolescent Health Services, Perth, WA Australia
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Poulsen HS, Hansen AØ. Occupational performance problems identified by 507 patients: An insight that can guide occupation-based hand therapy. HAND THERAPY 2018. [DOI: 10.1177/1758998318784316] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction Several barriers challenge the use of occupation-based interventions in hand therapy. An outpatient clinical setting can be prepared in such a way as to address the most common occupational performance problems which might promote an occupation-based intervention. To this end, more knowledge is needed about which problems patients with hand-related disorders consider most important. Methods Interviews using the Canadian Occupational Performance Measure (COPM)were conducted with 507 patients. Data were entered into Microsoft Excel in the COPM categories: Self-care, productivity and leisure and analysed using descriptive statistics. Data concerning main problem areas were categorized according to the Taxonomic Code of Occupational Performance (TCOP). The analysis included the number of prioritized occupational performance problems (NPOPP) in each COPM category/subcategory; the NPOPP in each category is relative to gender and age and the most frequent problems. Results The total NPOPP was 2384. Problems within productivity and self-care constituted the largest proportion, respectively, 46% and 40%. Gender or age affected the NPOPP in each category to a limited extend. Problems were expressed at all levels in the TCOP, except the lowest level. The most frequently expressed problem was use of utensils when eating. Conclusion The problems mostly concern productivity and self-care, regardless of gender or age. Patients consider problems at the levels of occupation, activities, tasks and actions to be important and meaningful to address in their intervention. This study provides useful knowledge that can be applied when preparing a setting to address the most common problems, which could lead to the promotion of occupation-based interventions.
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Affiliation(s)
- Helle S Poulsen
- Department of Rehabilitation, Odense University Hospital, Odense, Denmark
| | - Alice Ø Hansen
- Department of Rehabilitation, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, Research Unit for Rehabilitation, University of Southern Denmark, Odense, Denmark
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Radomski MV, Giles G, Finkelstein M, Owens J, Showers M, Zola J. Implementation Intentions for Self-Selected Occupational Therapy Goals: Two Case Reports. Am J Occup Ther 2018; 72:7203345030p1-7203345030p6. [PMID: 29689185 DOI: 10.5014/ajot.2018.023135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE We evaluated the feasibility of an intervention combining metacognitive strategy instruction (MSI) with training in implementation intentions for adults with mild traumatic brain injury (mTBI). Implementation intentions are written premade decision statements specifying when, where, and how goal behaviors are to be enacted. METHOD Two participants with mTBI received a six-session intervention that included setting a daily implementation intention for an occupational therapy goal. A scoring rubric was used to evaluate the quality of implementation intentions; goal achievement was measured using the Canadian Occupational Performance Measure (COPM) and goal attainment scaling. RESULTS All implementation intentions received perfect quality scores, suggesting participants learned to correctly craft implementation intentions. Improvements in COPM self-ratings exceeded minimal detectable change values; goal attainment levels indicated better-than-expected goal achievement. CONCLUSION An intervention combining MSI and implementation intention training appears to be feasible. As an adjunct to MSI, implementation intentions may contribute to clients' ability to achieve their own occupational performance goals. Further study is needed.
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Affiliation(s)
- Mary Vining Radomski
- Mary Vining Radomski, PhD, OTR/L, FAOTA, is Senior Scientific Adviser, Courage Kenny Research Center, Minneapolis, MN;
| | - Gordon Giles
- Gordon Giles, PhD, OTR/L, FAOTA, is Professor, Samuel Merritt University, Oakland, CA
| | - Marsha Finkelstein
- Marsha Finkelstein, MS, is Senior Scientific Adviser, Courage Kenny Research Center, Minneapolis, MN
| | - Jenny Owens
- Jenny Owens, OTD, OTR/L, is Research Occupational Therapist, Oak Ridge Associated Universities, Oak Ridge, TN
| | - Mark Showers
- Mark Showers, MSOT, OTR/L, is Lead Occupational Therapist, Fort Campbell Intrepid Spirit, Fort Campbell, KY
| | - Joette Zola
- Joette Zola, OTR/L, is Occupational Therapist, Courage Kenny Rehabilitation Institute, Minneapolis, MN
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Malcolm MP, Roll MC. Self-reported assistive technology outcomes and personal characteristics in college students with less-apparent disabilities. Assist Technol 2018; 31:169-179. [DOI: 10.1080/10400435.2017.1406414] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Matt P. Malcolm
- Department of Occupational Therapy, Colorado State University, Fort Collins, Colorado, USA
- Assistive Technology Resource Center, Colorado State University, Fort Collins, Colorado, USA
- Colorado School of Public Health, Colorado State University, Fort Collins, Colorado, USA
| | - Marla C. Roll
- Department of Occupational Therapy, Colorado State University, Fort Collins, Colorado, USA
- Assistive Technology Resource Center, Colorado State University, Fort Collins, Colorado, USA
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Gutman SA, Raphael-Greenfield EI, Berg J, Agnese A, Gross S, Ashmi S, Ogunye O, Shin C, Weiss D. Feasibility and Satisfaction of an Apartment Living Program for Homeless Adults With Mental Illness and Substance Use Disorder. Psychiatry 2018; 81:228-239. [PMID: 30273110 DOI: 10.1080/00332747.2018.1502555] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVE We assessed the feasibility and satisfaction of an apartment living program for formerly homeless adults with mental health and substance use disorders. METHOD A one-group pretest-posttest design was used with 22 participants who attended a six-week apartment living program. RESULTS Sixteen participants completed the study and demonstrated improvement in the performance of and satisfaction with needed daily life skills (performance: Z = -3.56, p ≤ 0.000, d = -1.86; satisfaction: Z = -2.84, p ≤ 0.004, d = -1.85), interpersonal skills (Z = -3.52, p ≤ 0.000, d = -2.98) and quality-of-life scores (Z = -3.52, p ≤ 0.000, d = -1.34). Participants reported high levels of satisfaction with the program. CONCLUSION This study demonstrates the feasibility and satisfaction of an apartment living program and warrants further research.
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DiZazzo-Miller R, Winston K, Winkler SL, Donovan ML. Family Caregiver Training Program (FCTP): A Randomized Controlled Trial. Am J Occup Ther 2017; 71:7105190010p1-7105190010p10. [PMID: 28809654 DOI: 10.5014/ajot.2017.022459] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE The purpose of this study was to examine the effectiveness of the Family Caregiver Training Program (FCTP) for caregivers of people with dementia. METHOD A random assignment control group research design with a 3-mo follow-up was implemented. RESULTS Thirty-six family caregivers of people with dementia demonstrated an increase in activity of daily living (ADL) knowledge (p < .001) and maintenance of that knowledge 3 mo posttest. Caregiver confidence, regardless of group assignment, improved; however, it was not maintained. Burden, depression, and occupational performance and satisfaction remained unchanged for the intervention group; however, physical health as it pertained to quality of life improved 3 mo posttest (p < .001). CONCLUSION Findings demonstrate that the FCTP can effectively provide knowledge to family caregivers on how to assist people with dementia with ADLs. Even when standard care was provided, there was limited information on ADLs that family caregivers faced daily.
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Affiliation(s)
- Rosanne DiZazzo-Miller
- Rosanne DiZazzo-Miller, PhD, DrOT, OTRL, CDP, is Assistant Professor, Occupational Therapy Program, Wayne State University, Detroit, MI;
| | - Kristin Winston
- Kristin Winston, PhD, OTR/L, is PhD Program Director and Associate Professor, Occupational Therapy Department, Nova Southeastern University, Ft. Lauderdale, FL
| | - Sandra L Winkler
- Sandra L. Winkler, PhD, OTR/L, is Research Health Science Specialist, James A. Haley Veterans' Hospital Center of Innovation in Disabilities and Rehabilitation Research, Tampa, FL
| | - Mary L Donovan
- Mary L. Donovan, PhD, OTR/L, is Owner and Consultant, Positive Dementia Paths, Duluth, MN
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Chaves GDFDS, Oliveira AM, Chaves JADS, Forlenza OV, Aprahamian I, Nunes PV. Assessment of impairment in activities of daily living in mild cognitive impairment using an individualized scale. ARQUIVOS DE NEURO-PSIQUIATRIA 2017; 74:549-54. [PMID: 27487375 DOI: 10.1590/0004-282x20160075] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 04/18/2016] [Indexed: 11/22/2022]
Abstract
Mild impairment in activities of daily living (ADL) can occur in Mild Cognitive Impairment (MCI), but the nature and extent of these difficulties need to be further explored. The Canadian occupational performance measure (COPM) is one of the few individualized scales designed to identify self-perceived difficulties in ADL. The present study investigated impairments in ADL using the COPM in elderly with MCI. A total of 58 MCI patients were submitted to the COPM for studies of its validity and reliability. The COPM proved a valid and consistent instrument for evaluating ADL in elderly MCI patients. A total of 74.6% of the MCI patients reported difficulties in ADL. Of these problems, 41.2% involved self-care, 31.4% productivity and 27.4% leisure. This data further corroborates recent reports of possible functional impairment in complex ADL in MCI.
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Affiliation(s)
| | - Alexandra Martini Oliveira
- Universidade de São Paulo, Faculdade de Medicina, Instituto de Psiquiatria, Laboratório de Neurociências, São Paulo SP, Brasil
| | | | - Orestes Vicente Forlenza
- Universidade de São Paulo, Faculdade de Medicina, Instituto de Psiquiatria, Laboratório de Neurociências, São Paulo SP, Brasil
| | - Ivan Aprahamian
- Universidade de São Paulo, Faculdade de Medicina, Instituto de Psiquiatria, Laboratório de Neurociências, São Paulo SP, Brasil
| | - Paula Villela Nunes
- Universidade de São Paulo, Faculdade de Medicina, Instituto de Psiquiatria, Laboratório de Neurociências, São Paulo SP, Brasil
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Schiavi M, Costi S, Pellegrini M, Formisano D, Borghi S, Fugazzaro S. Occupational therapy for complex inpatients with stroke: identification of occupational needs in post-acute rehabilitation setting. Disabil Rehabil 2017; 40:1026-1032. [DOI: 10.1080/09638288.2017.1283449] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Margherita Schiavi
- Physical Medicine and Rehabilitation Unit, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - Stefania Costi
- Physical Medicine and Rehabilitation Unit, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
- Surgical, Medical and Dental Department of Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Martina Pellegrini
- Physical Medicine and Rehabilitation Unit, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - Debora Formisano
- Research and Statistics Unit, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - Sergio Borghi
- Physical Medicine and Rehabilitation Unit, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - Stefania Fugazzaro
- Physical Medicine and Rehabilitation Unit, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
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Malcolm MP, Roll MC. Assistive technology outcomes in post-secondary students with disabilities: the influence of diagnosis, gender, and class-level. Disabil Rehabil Assist Technol 2017; 12:857-867. [DOI: 10.1080/17483107.2016.1277794] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Matt P. Malcolm
- Department of Occupational Therapy, Colorado State University, CO, USA
- Assistive Technology Resource Center, Colorado State University, CO, USA
| | - Marla C. Roll
- Department of Occupational Therapy, Colorado State University, CO, USA
- Assistive Technology Resource Center, Colorado State University, CO, USA
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Effectiveness of sensor monitoring in an occupational therapy rehabilitation program for older individuals after hip fracture, the SO-HIP trial: study protocol of a three-arm stepped wedge cluster randomized trial. BMC Health Serv Res 2017; 17:3. [PMID: 28049480 PMCID: PMC5209842 DOI: 10.1186/s12913-016-1934-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2016] [Accepted: 12/06/2016] [Indexed: 11/15/2022] Open
Abstract
Background The performance of activities of daily living (ADL) at home is important for the recovery of older individuals after hip fracture. However, 20–90% of these individuals lose ADL function and never fully recover. It is currently unknown to what extent occupational therapy (OT) with coaching based on cognitive behavioral treatment (CBT) improves recovery. The same holds for sensor monitoring-based coaching in addition to OT. Here, we describe the design of a study investigating the effect of sensor monitoring embedded in an OT rehabilitation program on the recovery of ADL among older individuals after hip fracture. Methods/ Design Six nursing homes will be randomized in a three-arm stepped wedge cluster randomized trial. All nursing homes will initially provide standard care. At designated time points, nursing homes, successively and in random order, will cross over to the provision of OT and at the next time point, to sensor monitoring-enhanced OT. A total of 288 older individuals, previously living alone in the community, who after a hip fracture were admitted to a geriatric rehabilitation ward for a short-term rehabilitation, will be enrolled. Individuals in the first intervention group (OTc) will participate in an OT rehabilitation program with coaching based on cognitive behavioral therapy (CBT) principles. In the sensor monitoring group, sensor monitoring is added to the OT intervention (OTcsm). Participants will receive a sensor monitoring system consisting of (i) an activity monitor during nursing home stay, (ii) a sensor monitoring system at home and a (iii) a web-based feedback application. These components will be embedded in the OT. The OT consists of a weekly session with an occupational therapist during the nursing home stay followed by four home visits and four telephone consultations. The primary outcome is patient-perceived daily functioning at 6 months, assessed using the Canadian Occupational Performance Measure (COPM). Discussion As far as we know, this study is the first large-scale stepped wedge trial, studying the effect of sensor monitoring embedded in an OT coaching program. The study will provide new knowledge on the combined intervention of sensor monitoring and coaching in OT as a part of a rehabilitation program to enable older individuals to perform everyday activities and to remain living independently after hip fracture. Trial registration number Netherlands National Trial Register, NTR 5716 Date registered: April 1 2016
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Malcolm MP, Roll MC. The impact of assistive technology services in post-secondary education for students with disabilities: Intervention outcomes, use-profiles, and user-experiences. Assist Technol 2016; 29:91-98. [DOI: 10.1080/10400435.2016.1214932] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Affiliation(s)
- Matthew P. Malcolm
- Department of Occupational Therapy, Colorado State University, Fort Collins, Colorado, USA
- Assistive Technology Resource Center, Colorado State University, Fort Collins, Colorado, USA
| | - Marla C. Roll
- Department of Occupational Therapy, Colorado State University, Fort Collins, Colorado, USA
- Assistive Technology Resource Center, Colorado State University, Fort Collins, Colorado, USA
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Kos D, Duportail M, Meirte J, Meeus M, D’hooghe MB, Nagels G, Willekens B, Meurrens T, Ilsbroukx S, Nijs J. The effectiveness of a self-management occupational therapy intervention on activity performance in individuals with multiple sclerosis-related fatigue: a randomized-controlled trial. Int J Rehabil Res 2016; 39:255-62. [DOI: 10.1097/mrr.0000000000000178] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Hansen AØ, Cederlund R, Kristensen HK, Tromborg H. The effect of an occupation-based intervention in patients with hand-related disorders grouped using the sense of coherence scale: Study protocol. HAND THERAPY 2016. [DOI: 10.1177/1758998316651456] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction High-quality rehabilitation is required if patients with hand-related disorders are to achieve high levels of functioning. Occupation-based interventions are effective in stroke, hip fractures, and for elderly people, but there is limited knowledge of their effect in hand therapy. Sense of coherence may affect rehabilitation outcome, since patients with weak sense of coherence experience lower functioning, are less satisfied with their occupational performance, have inferior quality of life and more pain compared to patients with stronger sense of coherence . Method Following SPIRIT guidelines, we present a randomized, controlled, parallel-grouped trial. It investigates the effect of an occupation-based intervention for outpatients with hand-related disorders and whether sense of coherence influences the outcomes. Patients are stratified into three groups (weak, medium and strong sense of coherence) and randomized to occupation-based or exercise-based hand therapy. Sample size calculation indicates that 70 patients are required in each intervention in each separate sense of coherence group. With an expected drop-out of 20%, a total of 504 participants will be randomized. Primary analysis is score change in functioning measured by the Disabilities of the Arm, Shoulder and Hand from start of rehabilitation to three months’ follow-up. Secondary outcomes are self-evaluated occupational performance and satisfaction with occupational performance. Conclusion This study will add valuable knowledge to the field of hand therapy regarding the therapeutic use of occupations that patients find meaningful. Moreover, it may show which patients will benefit the most from an occupation-based intervention in relation to their sense of coherence.
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Affiliation(s)
- Alice Ø Hansen
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Orthopedic Surgery, Odense University Hospital, Odense, Denmark
- Department of Rehabilitation, Odense University Hospital, Odense, Denmark
| | | | - Hanne K Kristensen
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Rehabilitation, Odense University Hospital, Odense, Denmark
- University College Lillebaelt, Jelling, Denmark
| | - Hans Tromborg
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Orthopedic Surgery, Odense University Hospital, Odense, Denmark
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Sinnott KA, Dunn JA, Wangdell J, Johanson ME, Hall AS, Post MW. Measurement of Outcomes of Upper Limb Reconstructive Surgery for Tetraplegia. Arch Phys Med Rehabil 2016; 97:S169-81. [DOI: 10.1016/j.apmr.2015.10.110] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Revised: 09/18/2015] [Accepted: 10/20/2015] [Indexed: 10/21/2022]
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Marinho FS, Moram CBM, Rodrigues PC, Franzoi ACOB, Salles GF, Cardoso CRL. Profile of disabilities and their associated factors in patients with type 2 diabetes evaluated by the Canadian occupational performance measure: the Rio De Janeiro type 2 diabetes cohort study. Disabil Rehabil 2016; 38:2095-101. [PMID: 26729414 DOI: 10.3109/09638288.2015.1111440] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
PURPOSE To investigate the profile of disability in patients with type 2 diabetes and to evaluate its associated variables. METHOD The Canadian Occupational Performance Measure (COPM) assessed disabilities in 475 type 2 diabetic individuals. The activities were categorised by the International Classification of Functioning, Disability and Health. The Medical Outcomes Study 36-item Short-Form Health Survey (SF-36) was used to evaluate pain, emotional and physical functioning domains of life-quality. Multivariable logistic regression assessed the independent correlates of better/worse performance. RESULTS Median COPM score was 4.5 (interquartile range 3-6). Problems in mobility (53.6%), self-care (21.1%) and daily-life (13.0%) were most frequently self-reported. Presence of restriction/pain in the upper limbs (odds ratio [OR]: 1.66; 95% CI: 1.11-2.47; p=0.013) and of peripheral neuropathy (OR: 1.64; 95% CI: 1.06-2.53; p=0.026) were associated with greater chance of worse performance. Higher values of SF-36 in pain and emotional domains (each 10 point increase; OR: 0.92 95% CI: 0.85-0.98; p=0.011; OR: 0.96; 95% CI: 0.92-1.00; p=0.063, respectively) and physical activity (OR: 0.63; 95% CI: 0.41-0.98; p=0.042) were associated with better performance. CONCLUSIONS Type 2 diabetic patients frequently reported disabilities in mobility, self-care and daily-life domains; and its associated factors were the presence of depression, upper limb pain and diabetic peripheral neuropathy. Implications for Rehabilitation The Canadian Occupational Performance Measure (COPM) instrument can be applied to patients with diabetes, as it identifies several disabilities, mostly in mobility, self-care and domestic life areas. Rehabilitation directed to upper limb pain/limitation and to lower limb peripheral neuropathy shall be implemented and may improve diabetic patients' performance and quality of life. A patient-centered rehabilitation strategy, guided by the COPM, may enable greater independence and autonomy, but this should be confirmed in future intervention studies.
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Affiliation(s)
- Fernanda S Marinho
- a Department of Occupational Therapy , Universidade Federal Do Janeiro , Rio De Janeiro , Brazil
| | - Camila B M Moram
- a Department of Occupational Therapy , Universidade Federal Do Janeiro , Rio De Janeiro , Brazil
| | - Priscila C Rodrigues
- a Department of Occupational Therapy , Universidade Federal Do Janeiro , Rio De Janeiro , Brazil
| | - Ana C O B Franzoi
- b Department of Internal Medicine , School of Medicine, Universidade Federal Do Janeiro , Rio De Janeiro , Brazil
| | - Gil F Salles
- b Department of Internal Medicine , School of Medicine, Universidade Federal Do Janeiro , Rio De Janeiro , Brazil
| | - Claudia R L Cardoso
- b Department of Internal Medicine , School of Medicine, Universidade Federal Do Janeiro , Rio De Janeiro , Brazil
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Effectiveness of Client-Centered Occupational Therapy in Patients With Rheumatoid Arthritis: Exploratory Randomized Controlled Trial. Arch Rheumatol 2015; 31:6-13. [PMID: 29900964 DOI: 10.5606/archrheumatol.2016.5478] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Accepted: 07/25/2015] [Indexed: 11/21/2022] Open
Abstract
Objectives This study aims to examine the effectiveness of client-centered occupational therapy in patients with rheumatoid arthritis (RA). Patients and methods The study included 40 patients (2 males, 38 females; range 39 to 60 years) with RA. Patients were divided into two groups as intervention group (n=20) and control group (n=20) by random sampling method. Each group was given 10 sessions of physical therapy program. In addition, the intervention group received client-centered occupational therapy. Patients were evaluated with Turkish versions of Short-Form McGill Pain Questionnaire, Health Assessment Questionnaire, The Arthritis Impact Measurement Scales 2, RA Quality of Life Questionnaire, and Canadian Occupational Performance Measurement. Results Pain, activity limitation, and participation restriction scores decreased significantly more in the intervention group compared to the control group. Also, quality of life increased significantly in the intervention group (p<0.05). Conclusion Our findings suggest that occupational therapy intervention reduces activity limitation and participation restrictions in patients with RA. Therefore, such interventions may be generalized for this patient group.
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Kos D, van Eupen I, Meirte J, Van Cauwenbergh D, Moorkens G, Meeus M, Nijs J. Activity Pacing Self-Management in Chronic Fatigue Syndrome: A Randomized Controlled Trial. Am J Occup Ther 2015; 69:6905290020. [PMID: 26356665 PMCID: PMC4564796 DOI: 10.5014/ajot.2015.016287] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To evaluate the effectiveness of an activity pacing self-management (APSM) intervention in improving performance of daily life activities in women with chronic fatigue syndrome (CFS). METHOD A total of 33 women with CFS (age 41.1±11.2 yr) were randomly allocated to APSM (experimental group; n=16) or relaxation (control group; n=17). Main outcome measures included the Canadian Occupational Performance Measure (COPM; primary) and Checklist Individual Strength (CIS). RESULTS COPM scores changed significantly over time in both groups (p=.03). The change in Satisfaction scores showed a significant difference in favor only of APSM (effect size=0.74 [0.11, 1.4]). CIS scores decreased significantly in the experimental group only (p<.01). CONCLUSION APSM was found to be feasible and effective in optimizing participation in desired daily life activities in women with CFS. Replication in a larger sample with long-term follow-up is required.
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Affiliation(s)
- Daphne Kos
- Daphne Kos, PhD, OT, is Assistant Professor, Department of Rehabilitation Sciences, Neuromotor Research Group, KU Leuven-University of Leuven, Belgium; Lecturer, Division of Occupational Therapy, Department of Health and Social Care, Artesis Plantijn University College, Antwerp, Belgium; and Member, Pain in Motion Research Group, Brussels, Belgium;
| | - Inge van Eupen
- Inge van Eupen, OT, is Lecturer, Division of Occupational Therapy, Department of Health and Social Care, Artesis Plantijn University College, Antwerp, Belgium
| | - Jill Meirte
- Jill Meirte, PT, is PhD Researcher, Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, Antwerp, Belgium. At the time of the study, she was Lecturer, Artesis Plantijn University College, Antwerp, Belgium
| | - Deborah Van Cauwenbergh
- Deborah Van Cauwenbergh, PT, is PhD Researcher, Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, Antwerp, Belgium. At the time of the study, she was Lecturer, Artesis Plantijn University College, Antwerp, Belgium
| | - Greta Moorkens
- Greta Moorkens, PhD, MD, is Associate Professor, Department of General Internal Medicine of University of Antwerp, Belgium; and Warrant-Manager, University Hospital, Antwerp, Belgium
| | - Mira Meeus
- Mira Meeus, PhD, PT, is Associate Professor, Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, Belgium; Associate Professor, Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium; and Member, Pain in Motion Research Group, Brussels, Belgium. At the time of the study, she was Lecturer, Artesis Plantijn University College, Antwerp, Belgium
| | - Jo Nijs
- Jo Nijs, PhD, PT, is Associate Professor, Departments of Human Physiology and Physiotherapy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit, Brussels, Belgium; Physiotherapist, Department of Physical Medicine and Physiotherapy, University Hospital, Brussels, Belgium; and Member, Pain in Motion Research Group, Brussels, Belgium. At the time of the study, he was Lecturer, Artesis Plantijn University College, Antwerp, Belgium
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Nieuwenhuizen MG, de Groot S, Janssen TWJ, van der Maas LCC, Beckerman H. Canadian Occupational Performance Measure performance scale: validity and responsiveness in chronic pain. ACTA ACUST UNITED AC 2015; 51:727-46. [PMID: 25357091 DOI: 10.1682/jrrd.2012.12.0221] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2012] [Revised: 12/23/2013] [Indexed: 11/05/2022]
Abstract
The construct validity and construct responsiveness of the performance scale of the Canadian Occupational Performance Measure (COPM) was measured in 87 newly admitted patients with chronic pain attending an outpatient rehabilitation clinic. At admission and after 12 wk, patients completed a COPM interview, the Pain Disability Index (PDI), and the RAND 36-Item Health Survey (RAND-36). We determined the construct validity of the COPM by correlations between the COPM performance scale (COPM-P), the PDI, and the RAND-36 at admission. Construct responsiveness was assessed by calculating the correlations between the change scores (n = 57). The COPM-P did not significantly correlate with the PDI (r = -0.260) or with any subscale of the RAND-36 (r = -0.007 to 0.248). Only a moderate correlation was found between change scores of the COPM-P and PDI (r = -0.380) and weak to moderate correlations were found between change scores of the COPM-P and the RAND-36 (r = -0.031 to 0.388), with the higher correlations for the physical functioning, social functioning, and role limitations (physical) subscales. In patients with chronic pain attending our rehabilitation program, the COPM-P measures something different than the RAND-36 or PDI. Therefore, construct validity of the COPM-P was not confirmed by our data. We were not able to find support for the COPM-P to detect changes in occupational performance.
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Duruturk N, Tonga E, Karatas M, Doganozu E. Activity performance problems of patients with cardiac diseases and their impact on quality of life. J Phys Ther Sci 2015; 27:2023-8. [PMID: 26311919 PMCID: PMC4540810 DOI: 10.1589/jpts.27.2023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Accepted: 03/17/2015] [Indexed: 12/21/2022] Open
Abstract
[Purpose] To describe the functional consequences of patients with cardiac diseases and analyze associations between activity limitations and quality of life. [Subjects and Methods] Seventy subjects (mean age: 60.1±12.0 years) were being treated by Physical Medicine and Rehabilitation and Cardiology Departments were included in the study. Activity limitations and participation restrictions as perceived by the individual were measured by the Canadian Occupational Performance Measure (COPM). The Nottingham Extended Activities of Daily Living (NEADL) Scale was used to describe limitations in daily living activities. To detect the impact of activity limitations on quality of life the Nottingham Health Profile (NHP) was used. [Results] The subjects described 46 different types of problematic activities. The five most identified problems were walking (45.7%), climbing up the stairs (41.4%), bathing (30%), dressing (28.6%) and outings (27.1%). The associations between COPM performance score with all subgroups of NEADL and NHP; total, energy, physical abilities subgroups, were statistically significant. [Conclusion] Our results showed that patients with cardiac diseases reported problems with a wide range of activities, and that also quality of life may be affected by activities of daily living. COPM can be provided as a patient-focused outcome measure, and it may be a useful tool for identifying those problems.
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Affiliation(s)
- Neslihan Duruturk
- Department of Physiotherapy and Rehabilitation, Faculty of
Health Sciences, Baskent University, Turkey
| | - Eda Tonga
- Department of Physiotherapy and Rehabilitation, Faculty of
Health Sciences, Baskent University, Turkey
| | - Metin Karatas
- Department of Physical Medicine and Rehabilitation, Baskent
University, Turkey
| | - Ersin Doganozu
- Department of Physical Medicine and Rehabilitation, Faculty
of Medicine, Baskent University, Turkey
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Construct validity of the canadian occupational performance measure in participants with tendon injury and Dupuytren disease. Phys Ther 2015; 95:750-7. [PMID: 25524872 DOI: 10.2522/ptj.20130590] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2013] [Accepted: 11/30/2014] [Indexed: 11/17/2022]
Abstract
BACKGROUND In patient-centered practice, instruments need to assess outcomes that are meaningful to patients with hand conditions. It is unclear which assessment tools address these subjective perspectives best. OBJECTIVE The aim of this study was to establish the construct validity of the Canadian Occupational Performance Measure (COPM) in relation to the Disabilities of Arm, Shoulder, and Hand (DASH) questionnaire and the Michigan Hand Outcomes Questionnaire (MHQ) in people with hand conditions. It was hypothesized that COPM scores would correlate with DASH and MHQ total scores only to a moderate degree and that the COPM, DASH questionnaire, and MHQ would all correlate weakly with measures of hand impairments. DESIGN This was a validation study. METHODS The COPM, DASH questionnaire, and MHQ were scored, and then hand impairments were measured (pain [numerical rating scale], active range of motion [goniometer], grip strength [dynamometer], and pinch grip strength [pinch meter]). People who had received postsurgery rehabilitation for flexor tendon injuries, extensor tendon injuries, or Dupuytren disease were eligible. RESULTS Seventy-two participants were included. For all diagnosis groups, the Pearson coefficient of correlation between the DASH questionnaire and the MHQ was higher than .60, whereas the correlation between the performance scale of the COPM and either the DASH questionnaire or the MHQ was lower than .51. Correlations of these assessment tools with measures of hand impairments were lower than .46. LIMITATIONS The small sample sizes may limit the generalization of the results. CONCLUSIONS The results supported the hypotheses and, thus, the construct validity of the COPM after surgery in people with hand conditions.
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Veenhuizen Y, Cup EHC, Groothuis JT, Hendriks JCM, Adang EMM, van Engelen BGM, Geurts ACH. Effectiveness and cost-effectiveness of a self-management group program to improve social participation in patients with neuromuscular disease and chronic fatigue: protocol of the Energetic study. BMC Neurol 2015; 15:58. [PMID: 25913823 PMCID: PMC4411708 DOI: 10.1186/s12883-015-0314-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Accepted: 04/08/2015] [Indexed: 11/10/2022] Open
Abstract
Background Chronic fatigue is present in more than 60% of the patients with a neuromuscular disease and can be their most disabling symptom. In combination with other impairments, fatigue often results in low levels of physical activity and decreased social participation, leading to high societal costs. ‘Energetic’ is a self-management group program aimed at improving social participation, physical endurance and alleviating fatigue in these patients. The primary aim of this study is to evaluate the effectiveness and cost-effectiveness of the Energetic program. Methods/Design A multicentered, assessor-blinded, two-armed randomized controlled trial is conducted with evaluations at inclusion and four, seven and fifteen months later. The study includes patients with a neuromuscular disease and chronic fatigue and, when present, their caregivers. The participants are randomized (ratio 1:1) to either an intervention group, receiving the Energetic program, or a control group, receiving usual care (i.e., no specific intervention). The Energetic program covers four months and includes four modules: 1) individually tailored aerobic exercise training; 2) education about aerobic exercise; 3) self-management training in applying energy conservation strategies; and 4) implementation and relapse prevention in daily life. Two months after cessation of the program a booster session is provided. The primary outcome is the perceived performance score of the Canadian Occupational Performance Measure (COPM). Secondary outcomes include the COPM-satisfaction score, and measures of fatigue, physical endurance, activity engagement, mood, and self-efficacy. Caregiver burden is also evaluated as a secondary outcome. Health-related quality of life and medical and societal costs are assessed to estimate cost-effectiveness of the program. Discussion The Energetic study is the first randomized controlled trial to evaluate the effectiveness and cost-effectiveness of a combined physical and self-management group training program for improving social participation, physical endurance and alleviating fatigue in patients with neuromuscular diseases. It will generate new insights in (cost-)effective rehabilitation strategies for these incurable conditions. Trial registration Clinicaltrials.gov NCT02208687.
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Affiliation(s)
- Yvonne Veenhuizen
- Department of Rehabilitation, Donders Centre for Neuroscience, Radboud University Medical Centre, Nijmegen, Netherlands.
| | - Edith H C Cup
- Department of Rehabilitation, Donders Centre for Neuroscience, Radboud University Medical Centre, Nijmegen, Netherlands.
| | - Jan T Groothuis
- Department of Rehabilitation, Donders Centre for Neuroscience, Radboud University Medical Centre, Nijmegen, Netherlands.
| | - Jan C M Hendriks
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, Netherlands.
| | - Eddy M M Adang
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, Netherlands.
| | - Baziel G M van Engelen
- Department of Neurology, Donders Centre for Neuroscience, Radboud University Medical Centre, Nijmegen, Netherlands.
| | - Alexander C H Geurts
- Department of Rehabilitation, Donders Centre for Neuroscience, Radboud University Medical Centre, Nijmegen, Netherlands.
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