The Effectiveness of Occupation-based Virtual Reality Intervention on Upper Extremity Functional Improvement in Post-stroke Individuals: A Systematic Review

Purpose: Virtual reality (VR)-based therapy is an emerging practice in the clinical setting and still requires research documenting its efficacy. This review analyzed the effectiveness of VR-based therapy on upper extremity (UE) motor recovery in individuals with chronic stroke by analyzing multiple randomized controlled trials. Methods: Search limits for this review consisted of articles published between January 2010 and January 2020 and available in English. Search keywords were based on language in individual databases (e.g. stroke or cerebrovascular accident, upper extremity, occupational therapy). Articles were limited to include only randomized control trials consisting of adult patients (18+) with UE impairment due to chronic stroke (onset at least 3 months prior) and occupation-based virtual reality intervention. Results: 242 articles were screened; eight met the inclusion criteria. Forms of VR within the reviewed articles included traditional gaming systems, mobile-based game devices, and VR combined with real instrument training. These studies showed improved outcomes following VR training such as improvement of UE function, activity participation, and health-related quality of life. Conclusion: The results of this review suggest that VR-based therapy has efficacy equal to or greater than conventional therapy for improving function in the upper extremity of adult patients with chronic stroke. As supported by research, practitioners may incorporate virtual reality-based therapy into conventional clinical sessions to assist in improving UE function and interactions within different environments and to help enhance overall participation in daily tasks and occupational performance in their clients.

Application of the Kinesio® Taping Method for a Child with Hypotonia: A Pilot Case Study

Background: This study explored the application of the Kinesio® Taping (KT®) method in conjunction with traditional occupational therapy (OT) intervention for a child with hypotonia. Specifically, differences in functional hand outcomes (manual dexterity and grasp pattern) were examined between the sessions with and without the application of the KT® method. Methods: A 9-year and 5-month-old male subject, at the time of enrollment, diagnosed with hypotonia, global developmental delay, and autism spectrum disorder participated in the study. A single-subject alternating treatment design was employed. A total of 14 OT sessions were conducted across baseline (n=3), alternating treatment (n=8), and replication (n=3) phases. During the alternating treatment phase, the subject was randomly applied the KT® method in four out of the eight OT sessions. At the end of each session, the participant was administered standardized assessments. Results: There were no statistically significant differences observed in functional hand outcomes across the baseline, alternating treatment, and replication phases. There were no statistically significant differences observed in manual dexterity and grasp pattern between the sessions with and without the application of the KT® method. Discussion: The results from the study replicated the mixed outcomes reported in the efficacy of the KT® method in addressing functional hand outcomes; OT practitioners are recommended to consider the KT® method as an auxiliary intervention modality. Future research involving the KT® method can consider ways to better control for the confounding variables noted in the current study including the novelty effect, subject’s comorbid conditions, and number and length of sessions allotted across the baseline, alternating treatment, and replication phases.

Life Skill Development and its Impact on Perceived Stress, Employment and Education Pursuits: A Study of Young Adults with a History of Homelessness and Trauma

An occupational therapy educational training group for young adults in permanent supported housing was developed, implemented and evaluated with pre-post outcome measures including Goal Attainment Scaling (GAS) and the Perceived Stress Scale-10 (PSS-10). The study explored stress levels and employment-related goals of individuals who have aged out of the foster care system and may also have had a history of chronic homelessness and trauma. Results demonstrated a trend towards significance in perceived stress 9Z=1.689, p=0.91) with 7 of 8 participants surpassing the expected outcome according to GAS. Limitations included a small convenience sample (n=8), inconsistent attendance and use of self-report measures.

Effects of Sherish℠ Connect on older adults in a residential living facility

Personal connection and social interaction are vital components of health throughout the lifespan. Loneliness and social isolation among the older adult population impacts both physical and mental health negatively. Analysis of published research demonstrates the importance of considering the use of different social technology platforms to foster opportunities for social support among family and friends. Researchers noted an increased relevance of the need for social technology in residential living facilities with the emergence of the COVID-19 pandemic and social distancing. The study aims to investigate the impact of social technology, via Sherish℠ Connect on older adults’ reported levels of loneliness and social isolation within a residential living facility. The seven participants used Sherish℠ Connect, a television-based photo-sharing application, for a minimum of one month prior to data collection. Data was collected via survey responses and medical records review to determine the effect of the Sherish℠ Connect intervention on participants’ perceived loneliness. Six participants reported using Sherish℠ Connect weekly or daily. All participants reported Sherish℠ Connect provided comfort. Social technology platforms offer an opportunity for social support among family and friends. Sherish℠ Connect, given a larger sample and increased duration of use, has the potential to combat loneliness and social isolation and provide comfort for older adults. Researchers hope this study provides baseline research that inspires additional studies investigating Sherish℠ Connect. The utilization of social technology adds value to occupational therapy intervention for mental health and social participation, particularly during the unprecedented time of COVID-19.

The Relationship Between Alternative Fieldwork Approaches and Student Competence and Confidence for Occupational Therapy in Behavioral Health

Purpose: The purpose of this case-series study was to assess the relationship between three instructional methods that fall within the parameters of the revised Accreditation Council for Occupational Therapy Education fieldwork objective C.1.9 and perceived student competence and confidence in providing therapy services in a behavioral health setting. Methods: The study included a convenience sample of (n=49) graduate students enrolled in an entry-level Doctor of Occupational Therapy program and a Doctor of Physical Therapy program in the Midwest. The participants attended a presentation on bipolar disorder and were randomly assigned to engage in one of three instructional methods: (a) lived experience academics, (b) problem-based learning, and (c) standardized patients to further learn about bipolar disorder. Results: Analyses revealed no significant interaction effects on competence across instructional methods but did reveal significant main effects of group and time on confidence. Confidence increased across all instructional methods and exhibited a significant difference between the lived experience academics and standardized patient. Significance: The study results demonstrate a need for further research on how to best prepare occupational therapy students for behavioral health settings

A farewell to ears: Hearing the call and answering

A semi-humorous autobiographical account of one first-year MSOT student trying to do their part to support the local healthcare community and its clients during the time of COVID-19 and self-quarantine.

A farewell to ears: Hearing the call and answering

A semi-humorous autobiographical account of one first-year MSOT student trying to do their part to support the local healthcare community and its clients during the time of COVID-19 and self-quarantine.