Occupational therapy interventions in pulmonary rehabilitation – an update in the COVID-19 ERA

Background. As symptoms of COVID-19 infection are varying in severity and type, the long-term disability is yet to be established due to a short time-window since the pandemic started. Most survivors will have persistent pulmonary symptoms even after the infection, which raises the awareness of the importance of pulmonary rehabilitation in these patients, as they are mostly young, with severely diminished quality of life as they are unable to perform their basic activities of daily living as before. Occupational therapy is a form of rehabilitation treatment aimed at maximizing functionality and independence in performing activities of daily living, improvement of the patient’s autonomy and prevention of further functional decline. Objective. The purpose of the current work is to review the most important occupational therapy interventions applicable during a pulmonary rehabilitation program for chronic pulmonary pathologies, that can also be applied in COVID-19 survivors with persistent respiratory symptoms. Discussion. The main objectives of occupational therapy in pulmonary rehabilitation are training using breathing techniques at rest and during task performance, upper limbs training to increase exercise tolerance, programming and simplifying daily activities, informing patients of the importance of asking for help, planning the day/week, organizing the environment, educating the patient. All these objectives can be achieved in a simple way and at low-cost. Conclusions. Occupational therapy intervention during comprehensive pulmonary rehabilitation must be promoted to specifically evaluate and solve problems related to respiratory disability. Occupational tasks should be related to symptoms occurring during specific activities. Standardized protocols and definition of outcomes during occupational therapy intervention are lacking. Keywords: occupational therapy, pulmonary rehabilitation, COVID-19, activities of daily living, quality of life,

Early Occupational Therapy Intervention in the Hospital Discharge after Stroke

Stroke is the leading cause of acquired disability in adults which is a cerebrovascular disease of great impact in health and social terms, not only due to its prevalence and incidence but also because of its significant consequences in terms of patient dependence and its consequent impact on the patient and family lives. The general objective of this study is to determine whether an early occupational therapy intervention at hospital discharge after suffering a stroke has a positive effect on the functional independence of the patient three months after discharge—the patient’s level of independence being the main focus of this research. Data will be collected on readmissions to hospitals, mortality, returns to work and returns to driving, as well as an economic health analysis. This is a prospective, randomized, controlled clinical trial. The sample size will be made up of 60 patients who suffered a stroke and were discharged from the neurology unit of a second-level hospital in west Malaga (Spain), who were then referred to the rehabilitation service by the joint decision of the neurology and rehabilitation department. The patients and caregivers assigned to the experimental group were included in an early occupational therapy intervention program and compared with a control group that receives usual care.

Strategies for Empowering activities in Everyday life (SEE 1.0): study protocol for a feasibility study of an Internet-based occupational therapy intervention for people with stroke

Background Rehabilitation after stroke seldom focuses on needs related to an active everyday life and the process of change that people must undergo to adapt to an altered capacity and life situation. In particular, occupational therapy in the late phase needs to support clients in adopting sustainable self-initiated management strategies to regain daily activities and an active everyday life. To improve access to rehabilitation, the use of digital solutions has been suggested. This study aims to evaluate the feasibility of the Internet-based occupational therapy intervention “Strategies for Empowering activities in Everyday life” (SEE, version 1.0). We will investigate the feasibility of the intervention process in terms of acceptability and adherence as well as the most suitable outcome measures to evaluate SEE and improve the knowledge about the potential changes and outcomes of SEE for clients with stroke. Methods This feasibility study is based on a pretest posttest design without a control group. Quantitative and qualitative data will be collected from clients and staff concurrently embedded in a mixed-method design during the entire study. Discussion The project is a first test of a novel Internet-based occupational therapy intervention, and the research will contribute to the continued development and evaluation of the SEE programme. SEE can provide people with strategies in daily activities that can support them to live an active everyday life despite changed capacity and to improve access to rehabilitation interventions. Trial registration NCT04588116. Name of the registry: Strategies Empowering Activities in Everyday Life (SEE 1.0). A Web-based Occupational Therapy Intervention. URL of trial registry record. Date of registry: Trial first posted: October 19, 2020; first submitted: October 2, 2020

Occupational Therapy Intervention Among Older Adults

The article's abstract is not available.

Role of Occupational Therapy While Working with Cerebral Palsy Children Using Orthopedic Assistive Devices

The main aim of the following research paper is to identify and interpret the preconditions and instructions for the implementation of effective Occupational Therapy intervention during the use of orthopedic assistive devices. In trying to highlight the role, professional skills, and perspectives of the occupational therapist, it will be possible to identify the key provisions that, if applied, will encourage the maximum participation of a child with Cerebral Palsy in several activities that are meaningful to him/her, thereby improving his/her quality of life and well-being. The methodology of data collection, processing, and analysis of the research is based on a combined method approach, which allows combining quantitative data collection and use of quantitative methods to later conclude the data obtained through certain numerical patterns. Structural interviews and designed questionnaires were used with 50 children having Cerebral Palsy and their parents or caregivers. The results showed that today in Armenia, due to the problems of obtaining and using orthopedic assistive devices, as well as the lack of professional supervision and monitoring, it is limited or does not ensure the maximum independent participation of children with Cerebral Palsy in community life, self-care, and professional activities.

Effectiveness of Occupational Therapy Intervention in Young Onset Parkinson’s Disease- A Case Report

This is a case study of 32 year old Mrs. M, a case of Young Onset Parkinson's Disease (YOPD) with hypothyroidism. With informed consent, Mrs. M was selected for the case report because Young Onset Parkinson’s Disease is a rare diagnosis. She was assessed using MDS-UPDRS pre- and post-intervention .She was provided Occupational Therapy intervention using the Person-Environment-Occupation Model for a period of three months and has shown significant improvement in UPDRS scores. Her primary diagnosis is Young Onset Parkinson’s Disease, secondary diagnosis being hypothyroidism.The patient, being in her early 30s, many of her life roles were altered. The patient’s main concerns are that she has difficulty in performing her basic and instrumental ADLs and difficulty in caring for her loved ones. Mrs. M was treated on weekly basis for an intervention period of three months using the Person Environment Occupation Model and assessed using the Unified Parkinson’s Disease Rating Scale; pre and post treatment. She was in stage 3 of Hoehn and Yahr scale of classification of Parkinson’s Disease. Scores were assessed on Unified Parkinson’s Disease Rating Scale, pre and post three months of intervention; showed improvement in non motor and motor aspects of experiences of daily living, motor examination and motor complications. Component scores were decreased dramatically especially in the areas of anxious mood, fatigue, tremors, posture and bradykinesia which revealed that functional levels improved following intervention. Keywords: Young Onset Parkinson’s Disease, Unified Parkinson’s Disease Rating Scale, Person Environment Occupation (PEO) based Occupational Therapy Intervention, case report.

Optik Disk Hipoplazili Bir Çocukta Kanada Okupasyonel Perfomans Modeli’ne Göre Ergoterapi Müdahalesinin Etkinliğinin İncelenmesi: Olgu Çalışması

Optic disc hypoplasia (ODH) is a non-progressive condition that can develop unilaterally or bilaterally, with decreased retinal nerve fiber count and normally developing retinal tissue. Decreased vision, visual field changes and defects in color vision mau be seen in individuals with ODH. A 3-year-old male pediatric case with ODH in the right eye was included in the study. The Canadian Model of Occupational Performance (CMOP) was used for the holistic evaluation of the individual, environmental and ocupational factors of the case, and the Visual Perception Reference Frame was used for the intervention application. The problem areas within the scope of CMOP were determined as difficulty in holding cutlery and therefore eating by spilling food, inability to distinguish small pictures on paper, weakness in perception of color and figure-ground, and weakness in gross motor skills (standing on one leg, jumping in place). The short-term goals in the 8-week intervention plan, development of visual discrimination (recognition, matching, classification) skills, development of color perception and figure perception, increasing the level of independence in eating with the help of auxiliary equipment (thickened cutlery); the long-term goals were determined as the development of figure-ground perception, the development of visual attention and the development of visual motor integration. With the target spesicif occupational therapy intervention program, the case was able to eat independently with the help of thickened cutlery, to be able to combine simple figures, large pieces and brightly colored puzzle pieces, to increase the time to stand on one leg, and to jump on two legs. There is a need for more evidence-based occupational therapy studies including visual perception studies in diagnoses affecting the visual field such as ODH.

Occupations creating joy for people living with advanced cancer: A qualitative descriptive study

Introduction For people living with advanced cancer, the possibilities for experiences of joy are seriously influenced by the consequences of the illness. Due to the limited expected lifetime, the need to support such experiences that may entail joy and contribute to quality of life are of importance. Research shows that people with advanced cancer experience quality of life through occupations they are able to perform and enjoy. The aim of this study was to describe which occupations contribute to joy for people living with advanced cancer and explore how they reflect upon these occupations during an occupational therapy intervention. Methods In total, 111 people with advanced cancer from the intervention group in a randomised controlled trial participated in the present study. Thirty-six of these participants were interviewed, and for 10 participants, this was combined with participant observations. A directed and a conventional content analysis were applied. Results 148 occupations contributing to joy were categorised into self-care, leisure and productivity. Most occupations were placed into leisure (89%). Participants had three distinct approaches to occupations contributing to joy: Finding solutions to maintain occupations contributing to joy; having an all or nothing approach; and hoping to resume occupations contributing to joy. Conclusion This study found a wide range of occupations contributing to joy and shows the importance of focusing on enabling leisure occupations for people living with advanced cancer. The wide range of occupations as well as participants’ approaches to occupations may be useful to inform future interventions to enable enjoyment for people living with advanced cancer.