Rehab Centers: The Meaning of Occupation, Occupational Need, and Occupational Therapy in a Military Context.

The Meaning of Occupation, Occupational Need, and Occupational Therapy in a Military Context.

Filed under: Rehab Centers

Phys Ther. 2013 Jan 17;
Brown HV, Hollis V

Despite occupational therapists having strong historical ties to the Canadian military there are currently no uniformed occupational therapists and only a few permanent occupational therapists employed by Canadian Forces. Occupational therapy is provided, in the main, through civilian occupational therapists. Occupational therapists have unique skills that can contribute to existing Canadian Forces Physical Medicine and Rehabilitation Services. To establish the depth and scope of their work, this paper explains the theoretical underpinnings of occupational therapy. Examples are provided of possible occupational therapy for Canadian Forces members with: transient, intermittent injuries; ‘very serious injuries’ or ‘severe injuries’ returning from overseas missions; and permanent injuries who are transitioning from the Canadian Forces into the civilian workforce. Interventions for mental health issues are interwoven with those targeting physical issues. The paper suggests that occupational therapists employed on a permanent basis by the Canadian Forces, can contribute in a more comprehensive manner to the wider rehabilitation of Canadian Forces members. The paper has applicability to occupational therapy military services in other countries.
HubMed – rehab

 

Combined Statistical Analysis Method Assessing Fast Versus Slow Movement Training in a Single-Case With Cerebellar Stroke.

Filed under: Rehab Centers

Phys Ther. 2013 Jan 17;
Deng H, Kimberley TJ, Durfee WK, Dressler BL, Steil C, Carey JR

BACKGROUND: Gold standards of data analysis for single-case research do not currently exist. OBJECTIVE: To determine whether a combined statistical analysis method is more effective in assessing movement training effects in a single-case with cerebellar stroke. DESIGN: A cross-over single-case research design was conducted. METHODS: The subject was a 69-year-old male with a chronic cerebellar infarct, who received two five-week phases of finger tracking training at different movement rates. Changes were measured with the Box and Block test, the Jebson-Taylor test, finger extension force test, and corticospinal excitability test. Both visual analysis and statistical tests (including split-middle line method, t test, confidence interval and effect size) were used to assess potential intervention effects. RESULTS: The results of the t tests were highly consistent with the confidence interval tests, but less consistent with the split-middle line method. Most results produced medium to large effect sizes. LIMITATIONS: The possibility of an incomplete wash-out effect was a confounding factor in the current analyses. CONCLUSIONS: The combined statistical analysis method may assist researchers in assessing intervention effects in single-case stroke rehabilitation studies.
HubMed – rehab

 

Participation in Community Walking Following Stroke: The Influence of Self-Perceived Environmental Barriers.

Filed under: Rehab Centers

Phys Ther. 2013 Jan 17;
Robinson CA, Matsuda PN, Ciol MA, Shumway-Cook A

BACKGROUND: Community walking is limited among survivors of stroke; however the contributing factors are not clearly understood. OBJECTIVE: This study examined the association of features in the environment with frequency of community walking following stroke. DESIGN: Cross-sectional with frequency of community walking data collected prospectively. METHOD: Thirty survivors of stroke (mean age 67; mean months since stroke 40), and 30 older adults without stroke (mean age 68) participated. Frequency of community walking (number of trips, walking related activities [WRA] and the ratio of WRA to trips) and satisfaction were measured using self-report. The Environmental Analysis of Mobility Questionnaire (EAMQ) was used to determine frequency of encounter with versus avoidance of environmental features during community walking. Negative binomial and linear regression models were used to analyze the association of environmental features with measures of community walking. RESULTS: Survivors of stroke reported reduced community walking and fewer encounters with and greater avoidance of features within eight dimensions of the environment compared to non-stroke controls. Following stroke, avoidance of features in some environmental dimensions was associated with frequency of community walking as measured by number of trips, number of WRA, and the ratio of WRA to trips. Environmental features explained little of the variability in community walking. LIMITATIONS: Limitations included a small sample size and limited diversity among participants. This study examined only physical features in the environment, and did not include other environmental factors, including social support, which may influence participation. CONCLUSIONS: Avoidance of features within some, but not all, environmental dimensions was associated with self-reported frequency of community walking following stroke suggesting that some environmental features may limit community walking more than others.
HubMed – rehab

 

Development of a Computerized Adaptive Test for Assessing Activities of Daily Living in Outpatients With Stroke.

Filed under: Rehab Centers

Phys Ther. 2013 Jan 17;
Hsueh IP, Chen JH, Wang CH, Hou WH, Hsieh CL

BACKGROUND: An efficient, reliable, and valid measure for assessing activities of daily living (ADL) function is useful to improve the efficiency of patient management and outcome measurement. OBJECTIVE: To construct a computerized adaptive testing (CAT) system for measuring ADL function for outpatients with stroke. STUDY DESIGN AND SETTING: Two cohort studies at six hospitals in Taiwan. METHODS: We developed a candidate item bank (44 items) and interviewed 643 outpatients. Then we fitted an item response theory model to the data and estimated the item parameters (e.g., difficulty and discrimination) for developing the ADL CAT. Another sample of 51 outpatients was interviewed to examine the concurrent validity and efficiency of the CAT. OUTCOME MEASURES: The ADL CAT, as the outcome measure, and the Barthel index (BI) and Frenchay Activities index (FAI) were administered on the second group of participants. RESULTS: Ten items did not satisfy the model’s expectations and were deleted. Thirty-four items were included in the final item bank. We set 2 stopping rules (i.e., reliability coefficient >0.9 or =7 items) for the CAT. The patients’ ADL scores had an average reliability of 0.93. The CAT scores were highly associated with those of the full 34 items (Pearson’s r=0.98). The scores of the CAT were closely correlated with those of the combined BI and FAI (r=0.82). The time required to complete the CAT was about 1/5 of the time used to administer both the BI and FAI together. LIMITATIONS: The participants were outpatients living in the community. Further studies are needed to cross-validate the results. CONCLUSIONS: Our results demonstrated that the ADL CAT is quick to administer, reliable, and valid in outpatients with stroke.
HubMed – rehab

 

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