Self-perceived occupational performance of community-dwelling adults living with stroke

2018 ◽  
Vol 85 (5) ◽  
pp. 378-385
Author(s):  
Ala’a F. Jaber ◽  
Dory Sabata ◽  
Jeff D. Radel

Background. Stroke has long-term consequences for functional performance of daily activities. Evaluating client-perceived occupational performance provides insight for designing stroke-specific programs supporting home and community participation. Purpose. This study describes the personal characteristics and self-perceived occupational performance in community-dwelling adults with stroke. Method. A retrospective chart review was undertaken of 25 stroke survivors who sought services at a community-based centre. The outcome measures were the Canadian Occupational Performance Measure (COPM) to evaluate self-perceived occupational performance and the Montreal Cognitive Assessment (MoCA) to screen for cognitive impairment. The analysis used descriptive statistics. Findings. Mean participant age was 64 years, and most participants were Caucasian males (72%). The mean cognitive function score was 22.1 on MoCA, and the mean COPM performance and satisfaction subscores were 4.1 and 3.9, respectively. The top three challenging daily activities were driving, seeking employment, and functional mobility. Implications. Stroke-specific community programs should emphasize the diverse performance concerns important to stroke survivors.

2020 ◽  
pp. 000841742097112
Author(s):  
Eleonore H. Koolen ◽  
Martijn A. Spruit ◽  
Marianne de Man ◽  
Jeanine C. Antons ◽  
Elieke Nijhuis ◽  
...  

Background. Occupational therapy (OT) may be an important intervention in patients with COPD, but studies show conflicting results. Purpose. To evaluate the effectiveness of home-based monodisciplinary OT in COPD patients Method. We conducted an observational clinical study. Main outcomes were the mean differences in the Canadian Occupational Performance Measure (COPM) performance and satisfaction scores, pre and post intervention. Findings. Pre- and postintervention data were obtained from 41 patients. Statistically significant increases were observed in COPM performance (5.0 ± 1.1 versus 6.9 ± 0.9; P<0.001) and satisfaction (4.6 ± 1.3 versus 6.9 ± 1.0; P<0.001). The most frequently reported occupational performance problems were found in the domains of productivity (47%) and mobility (40%), fewer in self-care (10%) and the least in leisure (3%). Implications. Home-based monodisciplinary OT can contribute significantly to the improvement of daily functioning of patients with COPD. OT should therefore be considered more often as part of the integrated management of these patients.


2010 ◽  
Vol 68 (3) ◽  
pp. 385-389 ◽  
Author(s):  
Danielle dos Santos Cutrim Garros ◽  
Rubens José Gagliardi ◽  
Regina Aparecida Rossetto Guzzo

The performance and the satisfaction of the patient were quantitatively compared with the use of the volar dorsal orthosis in order to position the spastic hand. Thirty patients wearing the orthosis for eight hours daily were evaluated by the Canadian Occupational Performance Measure and the box and blocks test, for a three-month period. Five activities were selected (among daily life activities, productive activities, and leisure activities) by the patients, which were impaired by spasticity. There was an improvement related to performance after use of orthosis, with an average of 1.4±0.5 to 6.3±0.8 (p<0.01). Patient satisfaction average after wearing the orthosis was of 1.7±0.4 to 6.3±0.6 (p<0.01). In this casuistic, the use of orthosis for wrist and finger spasticity has shown an improvement in the functional performance and patient satisfaction.


2019 ◽  
Vol 48 (5) ◽  
pp. 650-657 ◽  
Author(s):  
Margriet C Pol ◽  
Gerben ter Riet ◽  
Margo van Hartingsveldt ◽  
Ben Kröse ◽  
Bianca M Buurman

AbstractObjectivesto 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 patientsthree-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.Interventionspatients 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 measuresthe primary outcome was patient-reported daily functioning at 6 months, assessed with the Canadian Occupational Performance Measure.Resultsa 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 relevanceamong 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 registrationDutch National Trial Register, NTR 5716.


2012 ◽  
Vol 130 (2) ◽  
pp. 97-101 ◽  
Author(s):  
Melina Galetti Prata ◽  
Marcos Eduardo Scheicher

CONTEXT AND OBJECTIVE: As the overall number of elderly people increases there is a corresponding rise in the number of older persons with disabilities. In order to examine whether there is any relationship between balance and activities of daily living, we evaluated balance and daily activities among elderly people living in the community. DESIGN AND SETTING: Cross-sectional study at Universidade Estadual Paulista (Unesp), Marília, São Paulo, Brazil. METHODS: The study included 70 community-dwelling elderly people aged 65 and over. Balance was evaluated using the Berg Balance Scale (BBS) and physical independence in daily activities was evaluated using the Barthel Index (BI). The Spearman correlation coefficient was used to examine the relationship between the parameters evaluated. Significance was set at the level of 5% (P < 0.05). RESULTS: The population's mean age was 70.5 ± 5 years. The mean BBS score was 50.9 ± 4.1, whereas the mean BI score was 98.1 ± 2.8. Statistically significant relationships were found between the BBS and BI (r = 0.41; P = 0.0004); between age and BI (r = -0.24; P = 0.04); and between age and BBS (r = -0.57; P = 0.0001). CONCLUSIONS: The results showed that among elderly people, there are correlations between age, balance and independence level.


2010 ◽  
Vol 35 (7) ◽  
pp. 563-568 ◽  
Author(s):  
J. Wangdell ◽  
J. Fridén

Reconstruction of grip in tetraplegia aims to improve upper extremity performance and control in daily life. We evaluated the effects of surgery and rehabilitation on performance and satisfaction of patient identified activity goals in 20 patients (22 arms) who had grip reconstructions for both finger and thumb flexion. Patients assessed an improvement in both performance and satisfaction after surgery in all groups of activities assessed using the Canadian Occupational Performance Measure (COPM). The mean improvement at 6 and 12 months was 3.5 points better than the 2.5 points before surgery. Before surgery 36% of the goals identified were impossible to perform. After surgery, 78% of these goals were possible. The largest improvement was observed in the basic activity of ‘eating’ but significant improvement was also noted in activities generally regarded as complex and not measured in standard ADL such as ‘doing housework’ and taking part in ‘leisure’.


2021 ◽  
pp. 030802262098847
Author(s):  
Dorothy Kessler ◽  
Nicole D Anderson ◽  
Deirdre R Dawson

Introduction Sustaining a stroke has a devastating, long-term impact on participation in everyday life. Despite the recognition of participation as a key outcome of stroke rehabilitation, there are few effective interventions that address participation. Occupational performance coaching is a promising intervention designed to improve participation among stroke survivors. Delivery of occupational performance coaching using telerehabilitation could improve access. This study examined the feasibility, acceptability and potential efficacy of telerehabilitation occupational performance coaching. Method A single-case experimental design was used. Six community-dwelling stroke survivors received 10 sessions of telerehabilitation occupational performance coaching over 16 weeks. We examined the feasibility and acceptability of telerehabilitation occupational performance coaching, improvement in performance and satisfaction with identified goals. Results Telerehabilitation occupational performance coaching was feasible and acceptable to deliver; participants who started the intervention completed it and reported high satisfaction and a strong therapeutic relationship. All participants experienced technological issues that required resolution. Goal-performance and/or satisfaction improved for five of six participants. Sixty-four percent of goals showed trends for improvement and 43% showed significant improvements. Conclusions Findings support the feasibility and acceptability of telerehabilitation occupational performance coaching, along with its efficacy for improving performance and satisfaction with performance of goals. Further research is needed to prove the effectiveness of telerehabilitation occupational performance coaching and to determine who may benefit most.


Author(s):  
Andressa Ribas Mildner ◽  
Aline Sarturi Ponte ◽  
Miriam Cabrera Corvelo Delboni ◽  
Jodeli Pommerehn ◽  
Kátine Estivalet ◽  
...  

O objetivo do estudo foi identificar as atividades cotidianas comprometidas pela hemiplegia de pessoas acometidas por AVC e verificar a influência do uso de tecnologias assistivas no desempenho ocupacional das mesmas. Para tanto, trata-se de um estudo quantitativo, descritivo, com delineamento transversal. Houve a participação de quatro pessoas acometidas por AVC com sequela de hemiplegia, sendo utilizados como instrumentos uma entrevista semiestruturada e a Medida Canadense de Desempenho Ocupacional. Os participantes foram avaliados e por doze semanas receberam intervenções terapêuticas ocupacionais -- prescrições, confecção e treinamentos dos dispositivos de tecnologias assistivas, sendo reavaliados posteriormente. Como resultados, pode-se observar que todos os participantes apresentavam restrições em atividades envolvendo as áreas do autocuidado, a produtividade e o lazer, principalmente nos cuidados pessoais, tarefas domésticas e na recreação tranquila. Após identificar as principais atividades-problemas, e com as intervenções terapêuticas ocupacionais e inclusão dos dispositivos de tecnologias assitivas nas atividades cotidianas, observou-se melhora no desempenho ocupacional, tanto na percepção do desempenho como da satisfação, tendo um aumento de 2,1 pontos em ambas. Assim, conclui-se que o uso da COPM possibilita identificar atividades-problema para se pensar em estratégias de intervenção como criação de dispositivos de TA. Assim, o uso de TA pode influenciar na melhora do desempenho ocupacional de pessoas com limitações e restrições na realização de atividade cotidianas, sendo coadjuvante da função para minimizar os comprometimentos e facilitar a realização das atividades importantes. AbstractThe objective ofth estudy was to identify daily activities which were compromised by hemiplegia in people who had suffered a stroke, as well as to verify thein fluence of the use of assistive technologie son their occupational performance. For this purpose, a quantitative, descriptive, and cross-sectional study was carried out. The study was conducted with four people who had hemiplegia after having a stroke. A semi-structured interview and the Canadian Occupational Performance Measure (COPM) were used. Participant swere evaluated, and then received occupational therapeutic interventions for 12 weeks -- prescriptions, and making and training of assistive technology devices -- before be ingreassessed. As a result, it could be observed that all participants presented restriction son activities involving self-care, productivity and leisure, especially in personal care, domestic tasks and quietre creation. After identifying them ainim paired activities, and implementing occupational therapeutic interventions and assistive technology devices in daily activities, anim provement was observed in thepatients' occupational performance. The perception of performance as well as the satisfaction of these patients increased 2.1 points. Therefore, it could be seen that the use of COPM makes it possible to identify impaired activities so that intervention strategies and the creation of assistive Technologies devices could be considered. Thus, the use of assistive Technologies can influence and improve the occupational performance of patients with limitations and restrictions in performing daily activities, serving as a support for these functions, minimizing the difficulties and facilitating the execution of importante tasks.Keywords: Cerebral Vascular Accident; Occupational Therapy; Orthopedic Supplies. Resumen El objetivo del estudio fue identificar las actividades cotidianas comprometidas por la hemiplejía de personas acometidas por AVC y verificar la influencia del uso de tecnologías asistivas en el desempeño ocupacional de las mismas. Para ello, se trata de un estudio cuantitativo, descriptivo, con delineamiento transversal. La participación de cuatro personas acometidas por AVC con secuelas de hemiplejía, siendo utilizados como instrumentos una entrevista semiestructurada y la Medida Canadiense de Desempeño Ocupacional. Los participantes fueron evaluados y por doce semanas recibieron intervenciones terapéuticas ocupacionales - prescripciones, confección y entrenamientos de los dispositivos de tecnologías asistivas, siendo reevaluados posteriormente. Como resultados, se puede observar que todos los participantes presentaban restricciones en actividades que involucra las áreas del autocuidado, la productividad y el ocio, principalmente en los cuidados personales, tareas domésticas y en la recreación tranquila. Después de identificar las principales actividades-problemas, y con las intervenciones terapéuticas ocupacionales e inclusión de los dispositivos de tecnologías asitivas en las actividades cotidianas, se observó una mejora en el desempeño ocupacional, tanto en la percepción del desempeño y de la satisfacción, teniendo un aumento de 2,1 puntos En ambas. Así, se concluye que el uso de la COPM posibilita identificar actividades-problema para pensar en estrategias de intervención como creación de dispositivos de tecnologías asistivas. Así, el uso de tecnologías asistivas puede influenciar en la mejora del desempeño ocupacional de personas con limitaciones y restricciones en la realización de actividad cotidiana, siendo coadyuvante de la función para minimizar los compromisos y facilitar la realización de las actividades importantes.Palavras clave: Accidente Vascular Cerebral; Terapia Ocupacional; Aparatos Ortopédicos.


2013 ◽  
Vol 21 (3) ◽  
pp. 241-259 ◽  
Author(s):  
Taís L. Almeida ◽  
Neil B. Alexander ◽  
Linda V. Nyquist ◽  
Marcos L. Montagnini ◽  
Angela C.S. Santos ◽  
...  

Few studies have evaluated the benefit of providing exercise to underprivileged older adults at risk for falls. Economically and educationally disadvantaged older adults with previous falls (mean age 79.06, SD = 4.55) were randomized to 4 mo of multimodal exercise provided as fully supervised center-based (FS, n = 45), minimally supervised home-based (MS, n = 42), or to nonexercise controls (C, n = 32). Comparing groups on the mean change in fall-relevant mobility task performance between baseline and 4 mo and compared with the change in C, both FS and MS had significantly greater reduction in timed up-and-go, F(2,73) = 5.82, p = .004, η2p = .14, and increase in tandem-walk speed, F(2,73) = 7.71, p < .001 η2p = .17. Change in performance did not statistically differ between FS and MS. In community-dwelling economically and educationally disadvantaged older adults with a history of falls, minimally supervised home-based and fully supervised center-based exercise programs may be equally effective in improving fall-relevant functional mobility.


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