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American Journal of Occupational Therapy [journal]
- Review of instrument development and testing studies for children and youth. [Journal Article]
- Am J Occup Ther 2013 May-Jun; 67(3):e30-54.
We reviewed 12 articles from 2012 that addressed development and testing of instruments for children and youths and American Journal of Occupational Therapy articles from 2009-2013 that addressed 11 activity and participation instruments to determine how well this group of instruments facilitates the generation of evidence sufficient to support practice in accordance with the Centennial Vision. We observed an increase in the number of instrument development and testing studies and in higher level studies and larger cohorts; funding was provided for almost half of the studies, and attention was given to use of blind testing and transition to adult-age assessments. Further development of performance-based activity and participation instruments; instruments that examine biomedical molecular-cellular, biomedical, and environmental mechanisms; and intervention fidelity measures and increased use of blind testing are necessary for occupational therapy to meet the Centennial Vision.
- Assessing the driving performance of a person with epilepsy presurgery and postsurgery. [Journal Article, Research Support, Non-U.S. Gov't]
- Am J Occup Ther 2013 May-Jun; 67(3):e24-9.
Occupational therapists and certified driving rehabilitation specialists are uniquely skilled to assess functional abilities underlying driving performance. However, little information exists on the utility of clinical assessments to determine driving performance in people with epilepsy. This case study demonstrates how an occupational therapy evaluation battery was used to examine differences in visual and cognitive abilities and simulated driving performance before and after epilepsy surgery. Specifically, a 43-yr-old White man with right anterior lobe epilepsy underwent temporal lobectomy and had his driving-related abilities and simulated driving performance assessed pre- and postsurgery. The occupational therapy evaluation indicated improvements in executive skills, attention, and information processing speed postsurgery. Visuospatial abilities worsened after surgery, likely contributing to the modest increase in vehicle position errors on the driving simulator. Nevertheless, simulated driving performance improved after temporal lobectomy. Reductions in the number of visual scanning, lane maintenance, and speed regulation errors were recorded.
- Ensuring that education, certification, and practice are evidence based. [Journal Article]
- Am J Occup Ther 2013 May-Jun; 67(3):364-9.
The occupational therapy profession has put forth a vision for evidence-based practice. Although many practitioners express a commitment to the provision of services informed by evidence, the reality that tradition still determines much of our education, certification, and practice cannot be ignored. In this article, we highlight the disconnect between the profession's aspirations and actual practices using neurophysiological models as an example. We describe actions to actualize the shift from traditional interventions to evidence-based approaches. We challenge readers to become agents of change and facilitate a culture shift to a profession informed by evidence. It is our hope that this article will provoke critical discourse among educators, practitioners, authors, and editors about why a reluctance to let go of unsubstantiated traditions and a hesitancy to embrace scientific evidence exist. A shift to providing evidence-based occupational therapy will enable us to meet the objectives of the Centennial Vision.
- Occupational therapy for patients with acute lung injury: factors associated with time to first intervention in the intensive care unit. [Journal Article, Research Support, N.I.H., Extramural]
- Am J Occup Ther 2013 May-Jun; 67(3):355-62.
Very early occupational therapy intervention in the intensive care unit (ICU) improves patients' physical recovery. We evaluated the association of patient, ICU, and hospital factors with time to first occupational therapy intervention in ICU patients with acute lung injury (ALI).We conducted a prospective cohort study of 514 consecutive patients with ALI from 11 ICUs in three hospitals in Baltimore, MD.Only 30% of patients ever received occupational therapy during their ICU stay. Worse organ failure, continuous hemodialysis, and uninterrupted continuous infusion of sedation were independently associated with delayed occupational therapy initiation, and hospital study site and admission to a trauma ICU were independently associated with earlier occupational therapy.Severity of illness and ICU practices for sedation administration were associated with delayed occupational therapy. Both hospital study site and type of ICU were independently associated with timing of occupational therapy, indicating modifiable environmental factors for promoting early occupational therapy in the ICU.
- Systematic reviews informing occupational therapy. [Journal Article, Research Support, Non-U.S. Gov't]
- Am J Occup Ther 2013 May-Jun; 67(3):345-54.
We sought to identify and describe the number, topics, and publishing trends of systematic reviews relevant to occupational therapy indexed in the OTseeker database.We performed a cross-sectional survey of the systematic reviews contained in OTseeker in December 2011.Of the 1,940 systematic reviews indexed in OTseeker, only 53 (2.7%) were published in occupational therapy journals. The most common diagnostic categories were stroke (n = 195, 10.1%) and affective disorders (n = 204, 10.5%). The most common intervention categories were consumer education (n = 644, 33.2%) and psychosocial techniques (n = 571, 29.4%). Only 390 (20.1%) of the 1,940 systematic reviews specifically involved occupational therapy.Occupational therapists need to search broadly to locate relevant systematic reviews or, alternatively, to use databases such as OTseeker. Clarity about the involvement of occupational therapy in reports of future research will improve the ability to identify occupational therapy research for all stakeholders. Finally, occupational therapy practitioners need to read systematic reviews critically to determine whether review conclusions are justified.
- Development and preliminary psychometric evaluation of the Self-Perceptions in Rehabilitation Questionnaire (SPIRQ) for brain injury rehabilitation. [Journal Article]
- Am J Occup Ther 2013 May-Jun; 67(3):336-44.
The Self-Perceptions in Rehabilitation Questionnaire (SPIRQ) is a brief measure developed to monitor client self-perceptions, motivation, and emotional reactions throughout rehabilitation. We describe the SPIRQ's development and preliminary psychometric evaluation.One hundred five adults with traumatic brain injury attending two brain injury rehabilitation units completed the SPIRQ during occupational therapy sessions. A subset (n = 33) completed the SPIRQ twice over a 5- to 7-day interval to examine test-retest reliability.Exploratory factor analysis yielded three factors: Changes in Self and Life Plans, Self in Rehabilitation, and Emotional Reactions. Their internal consistency was sound (αs = .72-.83). Test-retest reliability was generally acceptable (rs = .67-.81), and scores did not significantly change between testing occasions (p > .05).We found preliminary support for the SPIRQ scales' reliability and construct validity. Future empirical evaluation and potential clinical applications of the SPIRQ in occupational therapy are discussed.
- Listening to classical music ameliorates unilateral neglect after stroke. [Journal Article]
- Am J Occup Ther 2013 May-Jun; 67(3):328-35.
OBJECTIVE.We determined whether listening to excerpts of classical music ameliorates unilateral neglect (UN) in stroke patients.
METHOD. In this within-subject study, we recruited and separately tested 16 UN patients with a right-hemisphere stroke under three conditions within 1 wk. In each condition, participants were asked to complete three subtests of the Behavioral Inattention Test while listening to classical music, white noise, or nothing. All conditions and the presentation of the tests were counterbalanced across participants. Visual analog scales were used to provide self-reported ratings of arousal and mood.
RESULTS.Participants generally had the highest scores under the classical music condition and the lowest scores under the silence condition. In addition, most participants rated their arousal as highest after listening to classical music.
CONCLUSION.Listening to classical music may improve visual attention in stroke patients with UN. Future research with larger study populations is necessary to validate these findings.
- Detecting differences in activities of daily living between children with and without mild disabilities. [Journal Article, Research Support, Non-U.S. Gov't]
- Am J Occup Ther 2013 May-Jun; 67(3):319-27.
We evaluated whether the Assessment of Motor and Process Skills (AMPS) measures are valid for detecting differences in activities of daily living (ADL) ability among children with and without mild disabilities.Retrospective data from the AMPS database were analyzed using many-facet Rasch analyses and forced regression analyses to evaluate for significant group differences.Regression analyses of data for 10,998 children ages 4-15 who met the inclusion criteria revealed significant Age × Group interaction effects (B ≥ 0.23, T ≥ 6.20, p ≤ .001). Post hoc t tests revealed significant group differences in ADL ability at all ages beyond age 4. ADL process ability effect sizes were moderate to large at all ages, and ADL motor ability was mostly moderate to large at ages 6 or older.These findings support the validity of the AMPS measures when used to identify ADL problems among children with mild disabilities.
- Norm scores of the box and block test for children ages 3-10 years. [Journal Article]
- Am J Occup Ther 2013 May-Jun; 67(3):312-8.
This study provides new norm scores for the Box and Block Test for gross manual dexterity in children ages 3-10 yr. Two hundred fifteen Dutch children performed the Box and Block Test separately with each hand. We found an age effect for the scores; older children obtained higher scores than younger children. Concurrent validity was assessed by means of comparison with the manual dexterity subtests of the Movement Assessment Battery for Children-2; correlations were significant. Intraclass correlation coefficients for test-retest and interrater reliability measures were .85 and .99, respectively. The Box and Block Test is an easy, feasible, valid, and reliable measurement for gross manual dexterity in young children. The obtained norms can be used in clinical settings to compare the gross manual dexterity of atypically developing children with that of age-related peers and to evaluate efficacy of interventions. A larger international reference population is needed to increase generalizability.
- Occupational therapy interventions to improve leisure and social participation for older adults with low vision: a systematic review. [Journal Article]
- Am J Occup Ther 2013 May-Jun; 67(3):303-11.
This systematic review examined evidence regarding the effectiveness of interventions within the scope of occupational therapy practice to maintain, restore, and improve performance in leisure and social participation for older adults with low vision. We identified and reviewed 13 articles that met the inclusion criteria. Four themes related to interventions to improve leisure and social participation emerged from the literature review: using a problem-solving approach, delivering a combination of services, providing skills training, and making home visits and environmental adaptations. The strongest evidence supports using a problem-solving approach to improve leisure and social participation for older adults with low vision. Evidence was moderate supporting the delivery of a combination of services, either by one professional or through an interdisciplinary approach. Results for the effectiveness of skills training and home visits and home adaptations were mixed. Implications for practice, education, and research are discussed.