Efficacy of a Forearm Rotation Orthosis for People With a Hemiparetic Arm

Importance: Insufficient voluntary forearm movements are associated with ineffective and inefficient functional performance among people poststroke. Although evidence supports the application of the occupational therapy task-oriented (OTTO) approach for this population, the training protocol does not explicitly address the role of forearm rotation movements. In addition, a need exists for theoretical support for orthotic interventions for people poststroke. Objective: To examine the efficacy of (1) a forearm rotation orthosis, (2) the OTTO approach, and (3) the combination of the two with people poststroke with a hemiparetic arm. Design: Stratified, randomized, two-group, single-blinded, repeated-measures design. Setting: Rehabilitation clinic. Participants: Participants (N = 14) with a diagnosis of stroke and at least 10° of voluntary shoulder and elbow movement. Intervention: Participants were stratified into three groups by motor function (mild, moderate, severe) and randomly assigned either to 6 wk of no treatment followed by 6 wk of OTTO or to 6 wk of orthotic intervention followed by 6 wk of orthosis plus OTTO. Outcomes and Measures: Primary outcome measures were the Canadian Occupational Performance Measure (COPM), Wolf Motor Function Test (WMFT), and Motor Activity Log (MAL), administered at baseline (Week 1), at the end of Phase 1 (Week 7), and at the end of Phase 2 (Week 15) by blinded evaluators. Results: Both groups showed clinically important improvements on the COPM. No significant differences were found on the WMFT or MAL. Conclusions and Relevance: The OTTO intervention provides clinically important benefits in self-perceived functional performance to people poststroke. What This Article Adds: The OTTO approach is an occupation-focused intervention that aims at functional performance and emphasizes clients' active engagement throughout the process. The findings suggest that the protocol of the OTTO intervention and its efficacy are appropriate for clinical practice.

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Lifestyle intervention using modified BASNEF model in hypertension management (Preprint)

10.2196/preprints.20297 ◽

2020 ◽

Author(s):

Resti Tito Villarino ◽

Christopher Arcay ◽

Maria Concepcion Temblor

Keyword(s):

Lifestyle Intervention ◽

Repeated Measures ◽

Intervention Program ◽

Phase 1 ◽

Management Technique ◽

Enabling Factors ◽

Educational Models ◽

Stroke Risk Factor ◽

Repeated Measures Design ◽

Lifestyle Intervention Program

BACKGROUND Hypertension is a serious health issue and a major cardiovascular disease and stroke risk factor. In hypertensive patients, various health educational models have been used to improve their lifestyle, but the findings are inconsistent. OBJECTIVE The study assessed the effects of a lifestyle intervention program using modified Beliefs, Attitude, Subjective Standards, Enabling Factors (BASNEF) model among non-adherent hypertensive respondents in relation to the introduction of a lifestyle intervention program in the management of hypertension. METHODS This is a quantitative quasi-experimental research particularly utilizing a repeated-measures design of within-subjects approach on the 50 non-adherent patients diagnosed with essential hypertension at Moalboal, Cebu, Philippines in 2019. The respondents received five sessions of trainings based on modified BASNEF model. The Morisky Medication Adherence instrument was used. The first phase included a demographic questionnaire and the last phase comprised the evaluation of the program. Frequencies, percentages, means and standard deviations for descriptive statistics while t-test, repeated measures, ANOVA, and Pearson product moment correlation for inferential statistics. RESULTS The result indicated that the phase 1 mean (146.5) of the systolic readings differ significantly from the phase 4 mean (134.92) of the systolic readings. However, since these two means came from phases that were not consecutive, the result, as a whole, did not show a significant decrease or change when analyzed chronologically from one phase to the next. CONCLUSIONS The study has established that BASNEF model approach can be an effective BP management technique.

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Evaluation of performance and personal satisfaction of the patient with spastic hand after using a volar dorsal orthosis

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2010000300011 ◽

2010 ◽

Vol 68 (3) ◽

pp. 385-389 ◽

Cited By ~ 1

Author(s):

Danielle dos Santos Cutrim Garros ◽

Rubens José Gagliardi ◽

Regina Aparecida Rossetto Guzzo

Keyword(s):

Patient Satisfaction ◽

Functional Performance ◽

Leisure Activities ◽

Performance Measure ◽

Personal Satisfaction ◽

Occupational Performance ◽

Daily Life Activities ◽

Evaluation Of Performance ◽

Productive Activities ◽

Canadian Occupational Performance Measure

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.

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Training older adults with low vision to use a computer tablet: A feasibility study

British Journal of Occupational Therapy ◽

10.1177/0308022616648172 ◽

2016 ◽

Vol 80 (2) ◽

pp. 117-122 ◽

Cited By ~ 11

Author(s):

Jennifer Kaldenberg ◽

Stacy Smallfield

Keyword(s):

Older Adults ◽

Feasibility Study ◽

Repeated Measures ◽

Research Method ◽

Low Vision ◽

Performance Measure ◽

Daily Activities ◽

Group Training ◽

Adult Women ◽

Repeated Measures Design

Introduction The purpose of this feasibility study was to investigate the potential use of a computer tablet as a low vision device to facilitate performance of and satisfaction with daily activities for older adults with low vision. Method A repeated measures design was used to measure outcomes. Four older adult women with low vision completed 10 weekly sessions of group training in tablet use. The feasibility of this research method and intervention was examined by evaluating recruitment capability, data collection procedures, outcome measures, intervention procedures, resources, and preliminary responses to intervention. Results The four participants were all women, with a mean age of 74.25 years (68–81). Visual acuity ranged from 20/160 to 20/4000. Mean change in performance and satisfaction on the Canadian Occupational Performance Measure were 3.45 and 3.65, respectively. Daily tablet use increased from 15 minutes at pretest to 3 hours at posttest to 4.5 hours at follow-up. Conclusion Group training in computer tablet use for older adults with low vision shows promise to improve performance and satisfaction in a variety of daily activities. With appropriate resources, the research method is feasible for a larger study examining this community-based intervention for older adults with low vision.

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Family Priorities for Activity and Participation of Children and Youth With Cerebral Palsy

Physical Therapy ◽

10.2522/ptj.20090388 ◽

2010 ◽

Vol 90 (9) ◽

pp. 1254-1264 ◽

Cited By ~ 54

Author(s):

Lisa A. Chiarello ◽

Robert J. Palisano ◽

Jill M. Maggs ◽

Margo N. Orlin ◽

Nihad Almasri ◽

...

Keyword(s):

Cerebral Palsy ◽

Motor Function ◽

Age Groups ◽

Performance Measure ◽

Children And Youth ◽

Daily Activities ◽

Gross Motor ◽

School Aged Children ◽

Canadian Occupational Performance Measure ◽

Intervention Plan

Background Understanding family priorities for children and youth with cerebral palsy is essential for family-centered service. Objective The purposes of this study were: (1) to identify family priorities for activity and participation in children and youth with cerebral palsy and (2) to determine differences based on age and Gross Motor Functional Classification System (GMFCS) level. Design Five hundred eighty-five children and youth with cerebral palsy and their caregivers participated at regional children's hospitals. The children and youth were 2 to 21 years of age; 56% were male, and 44% were female. Their caregivers, predominantly mothers (80%), had a mean age of 40.3 years (SD=9.3). The Canadian Occupational Performance Measure was administered to caregivers to identify their priorities for their children. The priorities were coded into 3 categories (daily activities, productivity, and leisure) and 13 subcategories. The GMFCS levels were determined by assessors who met the criterion for reliability. Friedman and Kruskal-Wallis one-way analyses of variance were used to examine differences in priorities. Results Parents of children in all age groups and GMFCS levels II to V identified more priorities for daily activities. Parents of school-aged children and youth had more priorities for productivity than parents of younger children. For parents of children in all age groups and motor function levels, self-care was the most frequent priority subcategory. Sixty-one percent of parents identified at least one priority related to mobility. Limitations The study did not include qualitative analysis of priorities of parents. Conclusions Parents' priorities for their children and youth with cerebral palsy differed depending on age and gross motor function level; however, the most frequent priority for all age groups was daily activities. Interviews with families are recommended for identifying outcomes for activity and participation and developing an intervention plan.

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Efeitos da Prática baseada em ocupações sobre o desempenho ocupacional e a função motora de sobreviventes de AVE/Effects of occupation-based practice on occupational performance and motor function in survivors of stroke

Revista Interinstitucional Brasileira de Terapia Ocupacional - REVISBRATO ◽

10.47222/2526-3544.rbto40187 ◽

2021 ◽

Vol 5 (3) ◽

pp. 306-319

Author(s):

Lorena Costa Branco ◽

Ana Aline Nogueira Da Silva ◽

Amanda Amorim De Souza ◽

Albert Patrick Borcem Alho ◽

Glenda Miranda Da Paixão

Keyword(s):

Occupational Therapy ◽

Social Science ◽

Motor Function ◽

Rating Scale ◽

Therapeutic Process ◽

Performance Measure ◽

Initial Assessment ◽

Occupational Performance ◽

Canadian Occupational Performance Measure ◽

And Performance

Introdução: O Acidente Vascular Encefálico é uma das causas de maior incapacidade em adultos e o processo de reabilitação em Terapia Ocupacional tem preconizado a prática centrada no cliente e a prática baseada em ocupações, a partir das quais o cliente torna-se ativo na escolha das metas e seu engajamento em ocupações é primordial no processo terapêutico. Objetivo: Verificar os efeitos da reabilitação pautada na prática baseada nas ocupações no desempenho ocupacional e a funcionalidade de sobreviventes de Acidente Vascular Encefálico. Métodos: Participaram do estudo seis indivíduos, submetidos a avaliação inicial e reavaliação a cada dez sessões. Foram utilizadas para coleta de dados a Escala de Avaliação de Fugl-Meyer e a Medida Canadense de Desempenho Ocupacional. Os atendimentos ocorreram duas vezes por semana com duração de 60 minutos nos quais eram realizadas simulações e treinos de atividades que compunham as ocupações dos indivíduos. A análise dos dados foi realizada com o teste de Friedman por meio do website Social Science Statistics. Resultados: Através das avaliações foram observadas diferenças na satisfação e no desempenho de Autocuidado e Produtividade. Com os resulados da escala de Fugl Meyer, observou-se diferença especialmente na Função Motora. Conclusões: Os resultados reforçam que a reabilitação baseada nas ocupações, podem melhorar o desempenho ocupacional e as habilidades motoras de sobreviventes de Acidente Vascular Encefálico.Palavras-chave: Terapia Ocupacional. Hemiplegia. Acidente Vascular Cerebral. AbstractIntroduction: Stroke is one of the causes of greater disability in adults and the rehabilitation process in Occupational Therapy has advocated the client-centered practice and the practice based on occupations, from which the client becomes active in negotiating goals and their engagement in occupations is essential in the therapeutic process. Objective: To verify the effects of rehabilitation guided by occupation-based practice on occupational performance and functionality of stroke survivors. Method: Six individuals participated in the study, who were submitted to initial assessment and were reassessed in every ten sessions. The Fugl-Meyer Rating Scale and the Canadian Occupational Performance Measure were used for data collection. The interventions took place twice a week, lasting 60 minutes, in which simulations and training of activities that were part of the individuals' occupations were carried out. Data analysis was performed using the Friedman test through the Social Science Statistics website. Results: Through the assessments, differences were observed in the satisfaction and performance of Self-Care and Productivity. With the results of the Fugl Meyer scale, a difference was observed especially in the Motor Function. Conclusion: The results reinforce that occupation-based rehabilitation can improve the occupational performance and motor skills of stroke survivors.Keywords: Occupational Therapy. Hemiplegia. Stroke. ResumenIntroducción: El accidente cerebrovascular es una de las causas de mayor discapacidad en los adultos y el proceso de rehabilitación en Terapia Ocupacional ha propugnado la práctica centrada en el cliente y la práctica basada en ocupaciones, a partir de la cual el cliente se vuelve activo en la elección de las metas y su participación en las ocupaciones es esencial en el proceso terapéutico. Objetivo: Verificar los efectos de la rehabilitación fundamentada en la práctica basada en las ocupaciones sobre el desempeño ocupacional y la funcionalidad de los supervivientes de accidente cerebrovascular. Método: Seis individuos participaron en el estudio, quienes fueron sometidos a evaluación inicial y reevaluación cada diez sesiones. Para la recopilación de datos se utilizaron la Escala Fugl-Meyer y la Medida canadiense de desempeño ocupacional. Las sesiones se realizaban dos veces por semana, con una duración de 60 minutos, en las que se realizaban simulaciones y entrenamiento de actividades que integraban las ocupaciones de los individuos. El análisis de los datos se realizó mediante la prueba de Friedman a través del sitio web de Estadísticas de Ciencias Sociales. Resultados: Através de las evaluaciones se observaron diferencias en la satisfacción y desempeño del Autocuidado y Productividad. Con los resultados de la escala de Fugl Meyer, se observó una diferencia especialmente en la Función Motora. Conclusión: Los resultados refuerzan que la rehabilitación basada en la ocupación puede mejorar el desempeño ocupacional y las habilidades motoras de los sobrevivientes de accidente cerebrovascular.Palabras clave: Terapia Ocupacional. Hemiplejia. Accidente Cerebrovascular.

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An innovative approach to measuring youth concussion recovery: Occupational performance

British Journal of Occupational Therapy ◽

10.1177/0308022619851415 ◽

2019 ◽

Vol 83 (4) ◽

pp. 220-227

Author(s):

Robyn Chen Sang ◽

Yasira Vawda ◽

Dayna Greenspoon ◽

Nick Reed ◽

Anne W Hunt

Keyword(s):

Repeated Measures ◽

Performance Measure ◽

Occupational Performance ◽

Post Intervention ◽

Concussion Management ◽

Canadian Occupational Performance Measure ◽

Performance Issues ◽

Concussion Recovery ◽

Active Rehabilitation ◽

The Relationship

Introduction Concussion is a common injury in youth. Studies report that active rehabilitation interventions reduce symptoms in these youth. There is no literature that addresses its impact on occupational performance. The purpose of this study was to identify: (a) occupational performance issues experienced by these youth; (b) changes in occupational performance and satisfaction following participation in a 6-week active rehabilitation intervention; and (c) the relationship between changes in occupational performance and symptoms. Method As part of a larger prospective repeated measures study, measures of occupational performance (Canadian Occupational Performance Measure) and self-reported symptoms (Post-Concussion Symptom Inventory) were collected pre and post intervention. Paired t-test, Spearman correlation, and descriptive analyses were conducted. Results Youth (9–18 years; n = 52) reported a range of occupational performance issues in self-care, productivity, and leisure domains. The most frequently reported occupational performance issues were sport (32.70%) and school (31.75%) activities. Positive changes were found in both performance and satisfaction of occupational performance issues post intervention ( p<.001). Correlation analysis revealed that as symptoms decreased, occupational performance improved ( rs = –.359, p = .020). Conclusion Using a measure of occupational performance may provide meaningful insight into the functional recovery of concussion, and can help identify targeted functional approaches to paediatric concussion management.

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LSVT BIG in late stroke rehabilitation: A single-case experimental design study

Canadian Journal of Occupational Therapy ◽

10.1177/0008417419832951 ◽

2019 ◽

Vol 86 (2) ◽

pp. 87-94

Author(s):

Valerie Metcalfe ◽

Mary Egan ◽

Katrine Sauvé-Schenk

Keyword(s):

Experimental Design ◽

Repeated Measures ◽

Stroke Rehabilitation ◽

Single Case ◽

Performance Measure ◽

Occupational Performance ◽

Self Assessment ◽

Canadian Occupational Performance Measure ◽

Improved Performance ◽

Daily Occupation

Background. Late stroke rehabilitation interventions often target impairment with limited carryover to daily occupation. Purpose. This study explored whether the LSVT BIG program could lead to improved performance in client-identified occupations and decreased impairment late poststroke. Method. A single-case experimental design with one repetition was completed. Participants were two adults who had experienced a stroke 3 and 12 years previously. Each participant selected up to six occupational goals, and the intervention was applied to half. Repeated measures were taken using the Canadian Occupational Performance Measure and the Rating of Everyday Arm-Use in the Community and Home. Additional measures of performance and impairment were applied pre- and postintervention. Findings. Performance improved on either self-assessment or blinded-rater assessment for all but one activity (trained or untrained). Implications. LSVT BIG is a promising intervention to improve occupational performance. Further research is required to clarify elements of the program essential to improving occupational performance.

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MISMATCH BETWEEN PERCEIVED AND OBJECTIVE MOTOR IMPROVEMENTS WITH ADAPTED TANGO INTERVENTION IN OLDER ADULTS

Innovation in Aging ◽

10.1093/geroni/igz038.605 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S170-S170

Author(s):

Crystal Bennett ◽

Nathalie Angel ◽

Madeleine Hackney

Keyword(s):

Quality Of Life ◽

Older Adults ◽

Health Education ◽

Motor Function ◽

Repeated Measures ◽

Lower Body ◽

Repeated Measures Design ◽

Body Strength ◽

Lower Body Strength

Abstract The purpose of this secondary analysis was to assess the relationship between objective and subjective perceptions of motor function measures in older adults following a 12 week adapted tango or health education intervention. A quasi-experimental, two-group, repeated-measures design was used. The study took place in diverse senior independent living communities in an urban metropolitan area. 74 older adults participated (Tango: n= 62, age: 82.3 (8.81) years; Education: n=12, age: 84.1 (7.86) years). Participants were assigned to 20 sessions of 90-minute tango (n = 62) or health education (n = 12) classes over 12 weeks. Motor function, depression, mental and physical quality of life were measured before and after intervention. At post-test, participants indicated their level of agreement with statements that they improved in the objectively measured domains of motor function. Correlations were performed between subjectively rated agreement, and changes in motor function and depression/quality of life. Tango subjective ratings were negatively correlated with empirically observed improvements in balance (r= -.423) and endurance (r= -.241); although their ratings moderately correlated positively with coordination (r=.319) and minimally correlated positively with lower body strength (r=.188). In Tango, decreased depression was positively correlated with self-perceived improved lower body strength (r=.271) and endurance (r= .254). Improved mental function was moderately (r=.423) positively correlated with self-perceived improved balance and coordination (r=.306). After rehabilitation, even in the presence of improved depression and quality of life, older adults may not perceive empirically observed motor function improvements, particularly in balance and lower body strength.

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The Efficacy of a Haptic-Enhanced Virtual Reality System for Precision Grasp Acquisition in Stroke Rehabilitation

Journal of Healthcare Engineering ◽

10.1155/2017/9840273 ◽

2017 ◽

Vol 2017 ◽

pp. 1-9 ◽

Cited By ~ 9

Author(s):

Shih-Ching Yeh ◽

Si-Huei Lee ◽

Rai-Chi Chan ◽

Yi Wu ◽

Li-Rong Zheng ◽

...

Keyword(s):

Virtual Reality ◽

Motor Function ◽

Stroke Rehabilitation ◽

Functional Performance ◽

Recovery Of Function ◽

Fine Motor ◽

Dominant Hand ◽

Usability Assessment ◽

Wolf Motor Function Test ◽

Vr Training

Stroke is a leading cause of long-term disability, and virtual reality- (VR-) based stroke rehabilitation is effective in increasing motivation and the functional performance. Although much of the functional reach and grasp capabilities of the upper extremities were regained, the pinch movement remains impaired following stroke. In this study, we developed a haptic-enhanced VR system to simulate haptic pinch tasks to assist the recovery of upper-extremity fine motor function. We recruited 16 adults with stroke to verify the efficacy of this new VR system. Each patient received 30 min VR training sessions 3 times per week for 8 weeks. Outcome measures, Fugl-Meyer assessment (FMA), Test Evaluant les Membres superieurs des Personnes Agees (TEMPA), Wolf motor function test (WMFT), Box and Block test (BBT), and Jamar grip dynamometer, showed statistically significant progress from pretest to posttest and follow-up, indicating that the proposed system effectively promoted fine motor recovery of function. Additionally, our evidence suggests that this system was also effective under certain challenging conditions such as being in the chronic stroke phase or a coside of lesion and dominant hand (nondominant hand impaired). System usability assessment indicated that the participants strongly intended to continue using this VR-based system in rehabilitation.

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Power of Modified Brown-Forsythe and Mixed-Model Approaches in Split-Plot Designs

Methodology ◽

10.1027/1614-2241/a000124 ◽

2017 ◽

Vol 13 (1) ◽

pp. 9-22 ◽

Cited By ~ 1

Author(s):

Pablo Livacic-Rojas ◽

Guillermo Vallejo ◽

Paula Fernández ◽

Ellián Tuero-Herrero

Keyword(s):

Repeated Measures ◽

Statistical Power ◽

Mixed Model ◽

Covariance Structure ◽

Simulation Method ◽

Future Research ◽

Repeated Measures Design ◽

Fixed And Random Effects ◽

Split Plot ◽

High Level

Abstract. Low precision of the inferences of data analyzed with univariate or multivariate models of the Analysis of Variance (ANOVA) in repeated-measures design is associated to the absence of normality distribution of data, nonspherical covariance structures and free variation of the variance and covariance, the lack of knowledge of the error structure underlying the data, and the wrong choice of covariance structure from different selectors. In this study, levels of statistical power presented the Modified Brown Forsythe (MBF) and two procedures with the Mixed-Model Approaches (the Akaike’s Criterion, the Correctly Identified Model [CIM]) are compared. The data were analyzed using Monte Carlo simulation method with the statistical package SAS 9.2, a split-plot design, and considering six manipulated variables. The results show that the procedures exhibit high statistical power levels for within and interactional effects, and moderate and low levels for the between-groups effects under the different conditions analyzed. For the latter, only the Modified Brown Forsythe shows high level of power mainly for groups with 30 cases and Unstructured (UN) and Autoregressive Heterogeneity (ARH) matrices. For this reason, we recommend using this procedure since it exhibits higher levels of power for all effects and does not require a matrix type that underlies the structure of the data. Future research needs to be done in order to compare the power with corrected selectors using single-level and multilevel designs for fixed and random effects.

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