Competency-based assessments for healthcare professionals are critical for safe and effective client outcomes. Rehabilitation clinical skill competency assessments must be validated and revised to produce safe and ski...Competency-based assessments for healthcare professionals are critical for safe and effective client outcomes. Rehabilitation clinical skill competency assessments must be validated and revised to produce safe and skilled practitioners. The revised American Occupational Therapy Association (AOTA) Fieldwork Performance Evaluation (FWPE) instrument measures occupational therapy student performance to determine readiness for practice. The assessment includes thirty-seven competencies that address both profession specific clinical skills and general professional behavior skills. The objective of this study was to use Rasch methods to explore the use of the revised FWPE in actual fieldwork practice and to determine the instrument’s psychometric properties when separating the item components into two distinct subdomains: General Health Professions Competences and Occupational Therapy-Specific Competencies. Internal construct validity and test reliability were analyzed using data from 149 occupational therapy students after completing their initial Level II A fieldwork clinical internship. This study examined the item difficulty hierarchy, item fit, person-fit to model, person separation index, person separation reliability coefficient, strata, ceiling and floor effect, and unidimensionality of the FWPE instrument as a whole and as two separate domains. With the exception of not meeting the criteria for unidimensionality, the full FWPE instrument and the Occupational Therapy-Specific Competencies subdomain showed acceptable item-level psychometrics for reliability and precision. While the General Health Professions Competencies subdomain showed good item-level psychometrics, it was below the criterion for reliability and only separated the sample into two strata. Results support the validity, reliability, and clinical use of the revised FWPE full instrument and the Occupational Therapy-Specific Competencies subdomain to measure entry-level clinical skill competencies in practice.展开更多
Low-frequency repetitive transcranial magnetic stimulation（LF-r TMS） to the contralesional hemisphere and intensive occupational therapy（i OT） have been shown to contribute to a significant improvement in upper li...Low-frequency repetitive transcranial magnetic stimulation（LF-r TMS） to the contralesional hemisphere and intensive occupational therapy（i OT） have been shown to contribute to a significant improvement in upper limb hemiparesis in patients with chronic stroke. However, the effect of the combined intervention program of LF-r TMS and i OT on cognitive function is unknown. We retrospectively investigated whether the combined treatment influence patient＇s Trail-Making Test part B（TMT-B） performance, which is a group of easy and inexpensive neuropsychological tests that evaluate several cognitive functions. Twenty-five patients received 11 sessions of LF-r TMS to the contralesional hemisphere and 2 sessions of i OT per day over 15 successive days. Patients with right- and left-sided hemiparesis demonstrated significant improvements in upper limb motor function following the combined intervention program. Only patients with right-sided hemiparesis exhibited improved TMT-B performance following the combined intervention program, and there was a significant negative correlation between Fugl-Meyer Assessment scale total score change and TMT-B performance. The results indicate the possibility that LF-r TMS to the contralesional hemisphere combined with i OT improves the upper limb motor function and cognitive function of patients with right-sided hemiparesis. However, further studies are necessary to elucidate the mechanism of improved cognitive function.展开更多
COVID-19 has disrupted people’s occupational daily activities with detrimental impact on their daily living performances and quality of life. Occupational therapy contributes toward restoring health by remediating li...COVID-19 has disrupted people’s occupational daily activities with detrimental impact on their daily living performances and quality of life. Occupational therapy contributes toward restoring health by remediating limitation in participation in meaningful occupation with lifestyle redesign interventions. However, the research gap on the area of “participation-limitation” for the field of Occupational Therapy in cancer survivorship during the COVID-19 is largely untapped and unknown. This commentary-review paper discussed the PEO-OT (person-environment-occupation) grid as a conceptual toolkit for stimulating research in the domain of occupational participation—an essential aspect in the field of occupational therapy, for cancer survivors. It applies the expertise finding from a large Delphi study on research priority in the fields and integrating these into evidenced methodology, to provide a structure to guide the novice researchers towards rapid reviews, by selecting evidence-based methods to ensure contextually-relevant enquiry to identify the “occupational-participation issues”—<em>i.e.</em>, an emerging social determinant of health, affecting the daily self-management of cancer survivors with or without comorbidities.展开更多
Occupational Therapy is critically underdeveloped in many developing countries in Asia. There are many internal and external barriers to the growth of the profession, including lack of willpower and lack of profession...Occupational Therapy is critically underdeveloped in many developing countries in Asia. There are many internal and external barriers to the growth of the profession, including lack of willpower and lack of professional representation in the government. This article aims to communicate the postulations for its stagnation across developing countries in Asia. An analytical reflection and historical review of the barriers to the growth of occupational therapy in Malaysia was conducted. Leaders in the field who met the inclusion criteria, collaborated to shape the reconstructions using an occupational reconstruction approach. The reconstruction guided key critical reflections on the roots of daily experiences to relive the cooperative action to problem solve the issues encountered by the profession in Malaysia. Medical hegemony was found as the active suppressor of the health professions, and can be seen as being beyond reproach in the Asian’s medical model that created occupational injustices. These occupational injustices hinder the growth of Occupational Therapy, do not serve the patients, science or the overall healthcare system. Autocratic governance has a debilitating impact on health sciences and its workforce especially around badly oppressed Asian countries. A greater systematic approach is needed to examine the extent, effect, problem solve and remediate the magnitude of injustices over the last decade—to make way for an inclusive and affordable care system.展开更多
Introduction: Africa was noted as a challenging place for allied health care professions including occupational therapy. Those challenges include promotion of occupational therapy and educational program. The Universi...Introduction: Africa was noted as a challenging place for allied health care professions including occupational therapy. Those challenges include promotion of occupational therapy and educational program. The University of Rwanda started the occupational therapy training program in 2014 with support of different stakeholders such as Humanity & Inclusion (HI), Rwanda. Aim: This study aimed to explore the contribution of different stakeholders in the development of occupational therapy programs and impact on the profession in Rwanda. Methods: A survey and mixed method of qualitative and quantitative approach was used. Client satisfaction questionnaire, semi-structured self-generated questionnaire were administered to the participants. Results: The majority of occupational therapists were between 20 and 30 years old and only half of the entire population were employed. Majority of the involved Universities excellently achieved their responsibilities. However, few of them reported to have achieved only 50% of their responsibilities. Other contributors like lecturers reported to have excellently achieved their duties while others reported to have achieved only 50%. Non-Governmental Organizations reported to contribute to enough level however there were some organizations contributed to the lowest level below 50%. The client receiving the Occupational Therapy services showed that they are very satisfied at the level of 73.5%, satisfied at 59% and not all satisfied at 20%. Conclusion: This study concluded that there is need for various stakeholders’ contributions, and a need for further study to explore the impact of occupational therapy profession in rehabilitation healthcare system of Rwanda.展开更多
Of the 700,000 people in the United States who experience a new or recurrent stroke each year,more than 500,000 survive(American Stroke Association,2007)[1]. Occupational therapy practitioners are critical rehabilitat...Of the 700,000 people in the United States who experience a new or recurrent stroke each year,more than 500,000 survive(American Stroke Association,2007)[1]. Occupational therapy practitioners are critical rehabilitation professionals for stroke survivors.展开更多
BACKGROUND Sensory integration intervention is highly related to the child's effective interaction with the environment and the child's development.Currently,various sensory integration interventions are being...BACKGROUND Sensory integration intervention is highly related to the child's effective interaction with the environment and the child's development.Currently,various sensory integration interventions are being applied,but research methodological problems are arising due to unsystematic protocols.This study aims to present the optimal intervention protocol by presenting scientific standards for sensory integration intervention through meta-analysis.AIM To prove the effectiveness of sensory integration therapy,examine the latest trend of sensory integration studies in Korea,and provide clinical evidence for sensory integration therapies.METHODS The database of Korean search engines,including RISS,KISS,and DBpia,was used to search for related literature published from 2001 to October 2020.The keywords,“Children”,“Sensory integration”,“Integrated sensory”,“Sensorymotor”,and“Sensory stimulation”were used in this search.Then,a meta-analysis was conducted on 24 selected studiesRISS,KISS,and DBpia,was used to search for related literature published from 2001 to October 2020.The keywords,“Children”,“Sensory integration”,“Integrated sensory”,“Sensorymotor”,and“Sensory stimulation”were used in this search.Then,a meta-analysis was conducted on 24 selected studies.RESULTS Sensory integration intervention has been proven effective in children with cerebral palsy,autism spectrum disorder,attention deficit/hyperactivity disorder,developmental disorder,and intellectual disability in relation to the diagnosis of children.Regarding sensory integration therapies,1:1 individual treatment with a therapist or a therapy session lasting for 40 min was most effective.In terms of dependent variables,sensory integration therapy effectively promoted social skills,adaptive behavior,sensory processing,and gross motor and fine motor skills.CONCLUSION The results of this study may be used as therapeutic evidence for sensory integration intervention in the clinical field of occupational therapy for children,and can help to present standards for sensory integration intervention protocols.展开更多
Objective:This study is conducted to investigate the effects of occupational therapy(OT) with or without combined acupuncture for upper limb pain and hand functions among children with spastic hemiplegic cerebral pals...Objective:This study is conducted to investigate the effects of occupational therapy(OT) with or without combined acupuncture for upper limb pain and hand functions among children with spastic hemiplegic cerebral palsy.Methods:A total of 90 patients who met the inclusion criteria were enrolled in a three-arm randomized,placebo-controlled trial,and were allocated to mono-occupational therapy(OT) group(patients=30),OT combined with real-acupuncture(ORA) group(patients=30),and OT combined with placeboacupuncture(OPA) group(patients=30),respectively.In addition to receiving the conventional OT program as the basic treatment for total 8 weeks,patients in ORA and OPA group also received corresponding acupuncture treatment 5 days per week for the first two weeks,3 days per week for the next two weeks,2 days per week for another two weeks,and 1 day per week for the last two weeks.Non-communicating children’s pain checklist-revised scale(NCCPC-R) was used for assessing the upper limb pain among patients.Squeeze dynamometry,modified Ashworth scale(MAS),manual muscle testing(MMT),JebsenTaylor hand function test(JTHFT) and box and block test(BBT) were used for assessing various aspects of upper limb and hand functions among patients.Meanwhile,adverse effects were monitored and recorded.Results:After 8-week treatment,NCCPC-R global scores witnessed a dramatic decline in ORA group(P<0.05),but not in either OPA(P> 0.05) or OT group(P> 0.05).Dramatic increases were identified in both squeeze dynamometry scores and MMT scores in all three groups(all P <0.05).Furthermore,the increases of ORA group were more significant than those of another two groups(both P <0.05).There were no significant changes in MAS global scores in each group(all P> 0.05).The BBT global scores of all three groups significantly increased(all P <0.05) after treatment.Among them,the increase of the ORA group was more than that of the other two groups(P <0.05).The 8-week treatment also had a significant impact on several sub-tests of JTFHT in each group.No significant adverse event was reported.Conclusion:ORA is a potential and promising alternative therapy for mitigating upper limb pain as well as improving both upper limb and hand functions among children with spastic hemiplegic cerebral palsy.展开更多
Stroke was one of the leading causes of death in the Chinese population in 2017.Most stroke survivors may suffer from different levels of disabilities,which prevents them from returning to their daily activities.The d...Stroke was one of the leading causes of death in the Chinese population in 2017.Most stroke survivors may suffer from different levels of disabilities,which prevents them from returning to their daily activities.The decreased upper limb function is considered as the principal factor that makes the patients have less access to their activities of daily livings.Occupational therapy(OT),aiming to enhance patients'functional performances and improve the participation in daily activities is usually applied from the onset of stroke.However,conventional OT intervention still has several problems that need to be solved,such as the inefficient use of human resources,inadequate upper limb functional training and non-continuous OT services.To address these difficulties and improve the patients'functional outcomes,intelligent rehabilitation equipment is combined with OT through evaluation and intervention.Based on this combination,OT can be provided in health care facilities,home,and community for patients with all phases of stroke.This combination promotes the transition of OT to digitization,intelligence and homogenization.展开更多
With the visual illusion of the mirror,Mirror Therapy,models the primary somatosensory cortex,cortical and muscular excitability,stimulating cortical reorganization and sensorimotor recovery.Studies have shown to be e...With the visual illusion of the mirror,Mirror Therapy,models the primary somatosensory cortex,cortical and muscular excitability,stimulating cortical reorganization and sensorimotor recovery.Studies have shown to be effective in improving motor function in short and medium term,in activities of daily living,in visuospatial neglect and in reducing pain,especially in patients with complex regional pain syndrome.Objective:To report the perception of Occupational Therapists regarding the application of Mirror Therapy in professional practice.Specifically,what factors lead to its application,what are the effects and benefits of the technique,what are its advantages and limitations.Results:In the perception of Occupational Therapists,the Mirror Therapy technique has the following benefits:significant decrease in pain,improved sensitivity and functionality of the upper limb,unblocking movements in the affected limb,decreased phantom pain;as negative aspects:difficulties in spatial/environmental control,patient's perceptual/cognitive skills,high level of concentration/attention,absence of scientific evidence in neurological conditions.Conclusion:For the interviewed Occupational Therapists,the Mirror Therapy is a safe and useful technique to be applied in your professional practice that has been showing positive results in the functional recovery of patients,however,it lacks studies that identify the appropriate time to start its application and the explanation of an intervention protocol.展开更多
Background: Osteoarthritis (OA) is a disabling disease that can affect 6% to 12% of the adult population and more than a third of people over 65 years of age. Purpose: To assess whether a group of people with hand ost...Background: Osteoarthritis (OA) is a disabling disease that can affect 6% to 12% of the adult population and more than a third of people over 65 years of age. Purpose: To assess whether a group of people with hand osteoarthritis (hOA) who received different types of treatment improved their function after two years of follow-up. Method: The entire sample (n = 97) underwent three follow-up assessments regarding anthropometric parameters of the upper limbs and ability to perform functional activities. Subsequently, the sample was divided into two groups for the intervention periods, called the First Period (n = 73) and the Second Period (n = 24);the First Period kept the same protocol with orientations, and the Second Period went to an intervention with orientation strength exercises and use of orthosis. Findings: In the separate analysis of the three questions of the DASH pain module, no differences were found between the assessment moments for groups of guidelines, treatment, or symptoms. Significant effects were observed for F(2, 162) = 3.5, p = 0.033, η2 = 0.04, and interaction for moments and intervention F(2, 162) = 4.3, p = 0.016, η2 = 0.05. Implications: It can be concluded that only guidance treatment does not benefit patients with hand osteoarthritis. In contrast, guidance, exercise, and orthosis treatment can significantly improve the disease.展开更多
Objective: To assess the satisfaction and occupational performance of women with chronic pelvic pain and to discuss unassisted intervention strategies by the occupational therapist for the care of these patients. Meth...Objective: To assess the satisfaction and occupational performance of women with chronic pelvic pain and to discuss unassisted intervention strategies by the occupational therapist for the care of these patients. Methods: A case-control study was conducted on 75 women with chronic pelvic pain and 75 apparently healthy women. The study was approved by the Research Ethics Committee of the institution and all subjects gave written informed consent to participate. Pain intensity was determined using a visual analogue scale and each patient was submitted to psycho-metric assessment using the Patient Health Questionnaire, the Self-Reporting Questionnaire of Psychiatric Screening and the Tampa Scale of Kinesiophofobia in their Brazilian version. The main outcomes regarding occupational performance and satisfaction were evaluated using the Canadian Measure of Occupational Performance. Results: The performance and satisfaction scores of women with chronic pelvic pain were significantly lower than those of healthy women. The presence of pain and kinesophobia was directly and independently correlated with low performance and satisfaction scores regardless of ethnicity, marital status, schooling, or psychometric scores. Conclusion: women with chronic pelvic pain present significant impairment of satisfaction and occupational performance. Coping is a potential unassisted intervention strategy to be applied to this population by occupational therapists.展开更多
BACKGROUND People suffering from chronic mental illness are sensitive to stressful stimuli,lack coping skills,and have low self-esteem due to problems such as social situations.They also experience depression,isolatio...BACKGROUND People suffering from chronic mental illness are sensitive to stressful stimuli,lack coping skills,and have low self-esteem due to problems such as social situations.They also experience depression,isolation,fear,and frustration.Due to cognitive dysfunction,people suffering from chronic mental illness have inadequate cognitive processes that lead to distorted thinking.AIM To confirm the effectiveness of cognitive rehabilitation therapy in improving cognitive function and alleviating behavioral and psychological symptoms in patients with chronic mental illness,and to identify the cognitive function that had the main effect.METHODS The quality of the studies was evaluated using the Assessment of Multiple Systematic Reviews criteria,and data published from 2011 to December 2022 were searched using PubMed,Cochrane,RISS,KISS,and DBpia.The keywords used in the search were“mental illness,”“cognitive rehabilitation,”“cognition,”and“mental.”A meta-analysis was conducted on the 12 selected papers.RESULTS The level of evidence for the 12 documents was that of a randomized experimental study.Intervention types in cognitive rehabilitation can be divided into cognitive behavior,cognitive training,cognitive rehabilitation,and computerized cognitive programs.Most of the studies were on schizophrenia,and the measurement areas were cognitive functions(e.g.,concentration,memory,and executive function)as well as depression,sociability,and quality of life.As a result of the meta-analysis of each variable,the effect size for cognitive rehabilitation treatment was in the following order:Sociability,memory,concentration,executive function,quality of life,and depression.Particularly,sociability and memory exhibited significant effects.CONCLUSION Cognitive rehabilitation aids cognitive function and sociability in patients with chronic mental illness and can be used as evidence for cognitive rehabilitation in mental health and occupational therapy.展开更多
BACKGROUND Electrical burns are devastating injuries and can cause deep burns with significant morbidity and delayed sequelae.Epidemiological data regarding the etiology,socioeconomic differences and geographic variat...BACKGROUND Electrical burns are devastating injuries and can cause deep burns with significant morbidity and delayed sequelae.Epidemiological data regarding the etiology,socioeconomic differences and geographic variation are necessary to assess the disease burden and plan an effective preventive strategy.These severe injuries often lead to amputations and thus hamper quality of life in the long term AIM To identify the population at maximum risk of sustaining electrical burns.We also studied the impact of electrical burns on these patients in terms of quality of life as well as return to work.METHODS The study was conducted at a tertiary referral teaching hospital over a period of eighteen months.All patients with a history of sustaining electrical burns and satisfying the inclusion criteria were included in the study.All relevant epidemiological parameters and treatment details were recorded.The patients were subsequently followed up at 3 mo,6 mo and 9 mo.The standardized Brief Version of the Burn Specic Health Scale(BSHS-B)was adopted to assess quality of life.Statistical analysis was conducted using IBM SPSS statistics(version 22.0).A P value of<0.05 was considered statistically significant.RESULTS A total of 103 patients were included in the study.The mean age of the patients was 31.83 years(range 18-75 years).A significant majority(91.3%)of patients were male.The mean total body surface area(TBSA)in these patients was 21.1%.In most of the patients(67%),the injury was occupation-related.High voltage injuries were implicated in 72.8%of patients.Among the 75 high voltage burn patients,31(41%)required amputation.The mean number of surgeries the patients underwent in hospital was 2.03(range 1 to 4).The quality of life parameters amongst the patients sustaining high voltage electrical burns were poorer when compared to low voltage injuries at all follow-up intervals across nine domains.In eight of these domains,the difference was statistically significant.Similarly,the scores among the amputees were poorer when compared to non-amputees.The difference was statistically significant in six domains.CONCLUSION Electrical burns remain a problem in the developing world.Most injuries are occupation-related.The quality of life in patients with high voltage burns and amputees remains poor.Work resumption was almost impossible for amputees.These patients could not regain pre-injury status.Steps should be taken to create awareness and to implement an effective preventive strategy to safeguard against electrical injuries.展开更多
BACKGROUND： At present, there are many studies on the rehabilitation therapy of stroke patients with hemiplegia, but there is deficiency of corresponding standardized rehabilitation program. OBJECTIVE： To explore th...BACKGROUND： At present, there are many studies on the rehabilitation therapy of stroke patients with hemiplegia, but there is deficiency of corresponding standardized rehabilitation program. OBJECTIVE： To explore the effects of standardized tertiary rehabilitation on the activities of daily living in stroke patients with hemiplegia within 6 months after attack. DESIGN： A clinical observation. SETTING： Department of Rehabilitation Medicine, Huashan Hospital of Fudan University. PARTICIPANTS： Eighty-two outpatients and inpatients with acute stroke were selected from the Department of Neurology, Shanghai Huashan Hosptial from January 1999 to June 2003, including 49 males and 33 females, 40 - 80 years of age, with a mean age of （65 ±11） years old. Inclusive criteria： According to the diagnostic standards for cerebrovascular diseases set by Fourth National Academic Meeting for Cerebrovascular Disease in 1995, the patients were diagnosed as new attack of cerebral infarction or cerebral hemorrhage, and confirmed by CT or MRI to be initial patients; They should be accorded with the following conditions, including within 1 week after stabilization of life signs, Glasgow coma score 〉 8 points, 40 - 80 years of age, with disturbance of limb function. Informed consents were obtained from all the patients or their relatives. Exclusive criteria： Patients were excluded due to active liver disease, liver and kidney malfunction, congestive heart failure, malignant tumor, history of dementia, failure in respiratory function, tetraplegia; cerebral infarction or cerebral hemorrhage for more than 3 weeks; unable to be followed up due to in other cities and provinces; psychiatric history; deafness and muteness. According to the will of the patients or their relatives, the patients who accepted the standardized rehabilitation program were enrolled as the treatment group （n =42）, and the others as the control group （n =40）. Approval was obtained from the ethical committee of the hospital. METHODS： All the patients were given routine therapies of internal medicine after admission. According to the conditions of Brunnstom recovery 6-phase evaluation, the patients in the treatment group were trained with the pre-designed comprehensive standardized rehabilitation program for corresponding period. At early period （within about 1 month after attack）, the patients received rehabilitative interventions in the Department of Emergency or Department of Neurology, once a day, 45 minutes for each time, 5 times a week; At middle period （about 1 - 3 months after attack）, the patients received rehabilitative interventions in the rehabilitation ward or center, once to twice a day, 30 - 45 minutes for each time, 4 - 5 days a week; At late period （about 3 - 6 months after attack）, the patients received rehabilitative intervention mainly assisted by rehabilitation physician in the community, relatives and volunteers, 3 - 4 times a week, and they were followed in the house or outpatient department once every two weeks. MAIN OUTCOME MEASURES： The patients were evaluated blindly by the same rehabilitation physician using scale of modified Barthel index at admission and 1, 3 and 6 months after attack respectively. RESULTS： Totally 82 patients with acute stroke were enrolled, and 3 cases in the treatment group missed, including 2 cases died at 1 month after admission, and 1 case refused the follow up l0 days later, all the others were involved in the analysis of results. The scores of modified Barthel index at corresponding time points after admission in the treatment group were all obviously higher than those in the control group （P 〈 0,01）, and the score differences were also obviously higher than those in the control group （P 〈 0,01）. The activities of daily living at admission and 1, 3 and 6 months after admission in the treatment group were 22,50%, 46.43%, 75,95% and 89,52% of that of normal people respectively, and those in the control group were 17.09%, 25,77%, 43,38% and 55,00% respectively, The activities of daily Diving at admission and 1, 3 and 6 months in the treatment group were 131.66%, 180.17%, 175.08% and 162.76% of those in the controlgroup. As compared with at admission, the percentage of the score difference to the total score at the ends of the 1^st, 3^rd and 6^th months were 23.93%, 53.45% and 67.02% in the treatment group, while 8.67%, 25.36% and 36.98% in the control group. CONCLUSION： Standardized tertiary rehabilitation can obviously promote the activities of daily living in stroke patients with hemiplegia.展开更多
Human Adaptive Mechatronics(HAM)includes human and computer system in a closed loop.Elderly person with disabilities,normally carry out their daily routines with some assistance to move their limbs.With the short fall...Human Adaptive Mechatronics(HAM)includes human and computer system in a closed loop.Elderly person with disabilities,normally carry out their daily routines with some assistance to move their limbs.With the short fall of human care takers,mechatronics devices are used with the likes of exoskeleton and exosuits to assist them.The rehabilitation and occupational therapy equipments utilize the electromyography(EMG)signals to measure the muscle activity potential.This paper focuses on optimizing the HAM model in prediction of intended motion of upper limb with high accuracy and to increase the response time of the system.Limb characteristics extraction from EMG signal and prediction of optimal controller parameters are modeled.Time and frequency based approach of EMG signal are considered for feature extraction.The models used for estimating motion and muscle parameters from EMG signal for carrying out limb movement predictions are validated.Based on the extracted features,optimal parameters are selected by Modified Lion Optimization(MLO)for controlling the HAM system.Finally,supervised machine learning makes predictions at different points in time for individual sensing using Support Vector Neural Network(SVNN).This model is also evaluated based on optimal parameters of motion estimation and the accuracy level along with different optimization models for various upper limb movements.The proposed model of human adaptive controller predicts the limb movement by 96%accuracy.展开更多
Objective: This study describes the development and use of a specific database supporting personnel within outpatient neurological rehabilitation to reflect on existing interventions and improve future rehabilitation....Objective: This study describes the development and use of a specific database supporting personnel within outpatient neurological rehabilitation to reflect on existing interventions and improve future rehabilitation. Methods: Five outpatient rehabilitation centres in one county council in Sweden were involved in developing and implementing a systematic data collection template within the existing digital medical record system. Data were collected to get more information on the effects of outpatient stroke rehabilitation in patients who received rehabilitation the first year after a stroke (ICD-I64) and patients who received further rehabilitation 1 year or more after a stroke (ICD-I69). Data analysis included evaluation of balance, movement, activity/participation, health-related quality of life, and self-rated health. Results: The ICD-I64 group had positive results after treatment (p < 0.05) for all variables and the ICD-I69 group had positive results for balance and activity/participation. Conclusions: The use of systematic data collection provided a platform for employees and managers to discuss and use clinical results to improve the type and quality of rehabilitation interventions.展开更多
Objective： To observe the clinical effect of acupuncture plus occupation therapy for fine motor functions in children with spastic cerebral palsy. Methods： A total of 80 cerebral palsy kids with fine motor dysfuncti...Objective： To observe the clinical effect of acupuncture plus occupation therapy for fine motor functions in children with spastic cerebral palsy. Methods： A total of 80 cerebral palsy kids with fine motor dysfunction were allocated into two groups by envelop, 40 cases in each group. Cases in the control group were treated with occupation therapy. Based on the therapy given to the control group, cases in the treatment group were supplemented with acupuncture at the points of the three yang meridians of hand. The treatment was done every other day and 10 times for a course. There was a 15-day interval between two courses, and 3 courses in total. The therapeutic efficacies were evaluated using Peabody developmental motor scale 2 （PDMS-2） and modified Ashworth scale （MAS） before and after treatment. Results： After treatment, the standard score for grasping （Grs）, standard score for visual-motor integration （Vis）, fine motor quotient （FMQ） and modified Ashworth scale （MAS） were significantly improved in both groups （P〈0.05）. The improvement in the treatment group was more obvious than that in the control group （P〈0.01）. Conclusion： Acupuncture plus occupation therapy can achieve better effect than occupation therapy alone in improving fine motor functions of upper limbs in cerebral palsy kids.展开更多
Hand injury is the second most common work-related musculoskeletal injury among physical therapists （PTs） and other manual therapy professionals such as osteopaths, physiotherapists, chiropractors, acupuncturists an...Hand injury is the second most common work-related musculoskeletal injury among physical therapists （PTs） and other manual therapy professionals such as osteopaths, physiotherapists, chiropractors, acupuncturists and massage therapists. However, the nature and extent of this problem have not been fully explored yet. Therefore, the objective of this study was to review the existing literature published on the prevalence, risk factors, consequences, and prevention of hand injuries among PTs and similar healthcare professionals. The lifetime prevalence of hand injuries was about 15%-46%, and the annual prevalence was reported as 5%-30%. Thumb injuries were found to be the most prevalent of all injuries, accounting more than 50% of all hand-related problems. The most significant risk factors for job-related hand injuries were performing manual therapy techniques, repetitive workloads, treating many patients per day, continued work while injured or hurt, weakness of the thumb muscles, thumb hypermobility, and instability at the thumb joints. Frs reported modifying treatment technique, taking time off on sick leave, seeking intervention, shifting the specialty area, and decreasing patient contact hours as the major consequences of these injuries. The authors recommend that PTs should develop specific preventive strategies and put more emphasis on the use of aids and equipment to reduce the risk of an unnecessary injury.展开更多
Quality of life and functional recovery after burn injury is the final goal of burn care,especially as most of burn patients survive the injury due to advanced medical science.However,dysfunction,disfigurement,contrac...Quality of life and functional recovery after burn injury is the final goal of burn care,especially as most of burn patients survive the injury due to advanced medical science.However,dysfunction,disfigurement,contractures,psychological problems and other discomforts due to burns and the consequent scars are common,and physical therapy and occupational therapy provide alternative treatments for these problems of burn patients.This guideline,organized by the Chinese Burn Association and Chinese Association of Burn Surgeons aims to emphasize the importance of team work in burn care and provide a brief introduction of the outlines of physical and occupational therapies during burn treatment,which is suitable for the current medical circumstances of China.It can be used as the start of the tools for burn rehabilitation.展开更多
文摘Competency-based assessments for healthcare professionals are critical for safe and effective client outcomes. Rehabilitation clinical skill competency assessments must be validated and revised to produce safe and skilled practitioners. The revised American Occupational Therapy Association (AOTA) Fieldwork Performance Evaluation (FWPE) instrument measures occupational therapy student performance to determine readiness for practice. The assessment includes thirty-seven competencies that address both profession specific clinical skills and general professional behavior skills. The objective of this study was to use Rasch methods to explore the use of the revised FWPE in actual fieldwork practice and to determine the instrument’s psychometric properties when separating the item components into two distinct subdomains: General Health Professions Competences and Occupational Therapy-Specific Competencies. Internal construct validity and test reliability were analyzed using data from 149 occupational therapy students after completing their initial Level II A fieldwork clinical internship. This study examined the item difficulty hierarchy, item fit, person-fit to model, person separation index, person separation reliability coefficient, strata, ceiling and floor effect, and unidimensionality of the FWPE instrument as a whole and as two separate domains. With the exception of not meeting the criteria for unidimensionality, the full FWPE instrument and the Occupational Therapy-Specific Competencies subdomain showed acceptable item-level psychometrics for reliability and precision. While the General Health Professions Competencies subdomain showed good item-level psychometrics, it was below the criterion for reliability and only separated the sample into two strata. Results support the validity, reliability, and clinical use of the revised FWPE full instrument and the Occupational Therapy-Specific Competencies subdomain to measure entry-level clinical skill competencies in practice.
文摘Low-frequency repetitive transcranial magnetic stimulation（LF-r TMS） to the contralesional hemisphere and intensive occupational therapy（i OT） have been shown to contribute to a significant improvement in upper limb hemiparesis in patients with chronic stroke. However, the effect of the combined intervention program of LF-r TMS and i OT on cognitive function is unknown. We retrospectively investigated whether the combined treatment influence patient＇s Trail-Making Test part B（TMT-B） performance, which is a group of easy and inexpensive neuropsychological tests that evaluate several cognitive functions. Twenty-five patients received 11 sessions of LF-r TMS to the contralesional hemisphere and 2 sessions of i OT per day over 15 successive days. Patients with right- and left-sided hemiparesis demonstrated significant improvements in upper limb motor function following the combined intervention program. Only patients with right-sided hemiparesis exhibited improved TMT-B performance following the combined intervention program, and there was a significant negative correlation between Fugl-Meyer Assessment scale total score change and TMT-B performance. The results indicate the possibility that LF-r TMS to the contralesional hemisphere combined with i OT improves the upper limb motor function and cognitive function of patients with right-sided hemiparesis. However, further studies are necessary to elucidate the mechanism of improved cognitive function.
文摘COVID-19 has disrupted people’s occupational daily activities with detrimental impact on their daily living performances and quality of life. Occupational therapy contributes toward restoring health by remediating limitation in participation in meaningful occupation with lifestyle redesign interventions. However, the research gap on the area of “participation-limitation” for the field of Occupational Therapy in cancer survivorship during the COVID-19 is largely untapped and unknown. This commentary-review paper discussed the PEO-OT (person-environment-occupation) grid as a conceptual toolkit for stimulating research in the domain of occupational participation—an essential aspect in the field of occupational therapy, for cancer survivors. It applies the expertise finding from a large Delphi study on research priority in the fields and integrating these into evidenced methodology, to provide a structure to guide the novice researchers towards rapid reviews, by selecting evidence-based methods to ensure contextually-relevant enquiry to identify the “occupational-participation issues”—<em>i.e.</em>, an emerging social determinant of health, affecting the daily self-management of cancer survivors with or without comorbidities.
文摘Occupational Therapy is critically underdeveloped in many developing countries in Asia. There are many internal and external barriers to the growth of the profession, including lack of willpower and lack of professional representation in the government. This article aims to communicate the postulations for its stagnation across developing countries in Asia. An analytical reflection and historical review of the barriers to the growth of occupational therapy in Malaysia was conducted. Leaders in the field who met the inclusion criteria, collaborated to shape the reconstructions using an occupational reconstruction approach. The reconstruction guided key critical reflections on the roots of daily experiences to relive the cooperative action to problem solve the issues encountered by the profession in Malaysia. Medical hegemony was found as the active suppressor of the health professions, and can be seen as being beyond reproach in the Asian’s medical model that created occupational injustices. These occupational injustices hinder the growth of Occupational Therapy, do not serve the patients, science or the overall healthcare system. Autocratic governance has a debilitating impact on health sciences and its workforce especially around badly oppressed Asian countries. A greater systematic approach is needed to examine the extent, effect, problem solve and remediate the magnitude of injustices over the last decade—to make way for an inclusive and affordable care system.
文摘Introduction: Africa was noted as a challenging place for allied health care professions including occupational therapy. Those challenges include promotion of occupational therapy and educational program. The University of Rwanda started the occupational therapy training program in 2014 with support of different stakeholders such as Humanity & Inclusion (HI), Rwanda. Aim: This study aimed to explore the contribution of different stakeholders in the development of occupational therapy programs and impact on the profession in Rwanda. Methods: A survey and mixed method of qualitative and quantitative approach was used. Client satisfaction questionnaire, semi-structured self-generated questionnaire were administered to the participants. Results: The majority of occupational therapists were between 20 and 30 years old and only half of the entire population were employed. Majority of the involved Universities excellently achieved their responsibilities. However, few of them reported to have achieved only 50% of their responsibilities. Other contributors like lecturers reported to have excellently achieved their duties while others reported to have achieved only 50%. Non-Governmental Organizations reported to contribute to enough level however there were some organizations contributed to the lowest level below 50%. The client receiving the Occupational Therapy services showed that they are very satisfied at the level of 73.5%, satisfied at 59% and not all satisfied at 20%. Conclusion: This study concluded that there is need for various stakeholders’ contributions, and a need for further study to explore the impact of occupational therapy profession in rehabilitation healthcare system of Rwanda.
文摘Of the 700,000 people in the United States who experience a new or recurrent stroke each year,more than 500,000 survive(American Stroke Association,2007)[1]. Occupational therapy practitioners are critical rehabilitation professionals for stroke survivors.
文摘BACKGROUND Sensory integration intervention is highly related to the child's effective interaction with the environment and the child's development.Currently,various sensory integration interventions are being applied,but research methodological problems are arising due to unsystematic protocols.This study aims to present the optimal intervention protocol by presenting scientific standards for sensory integration intervention through meta-analysis.AIM To prove the effectiveness of sensory integration therapy,examine the latest trend of sensory integration studies in Korea,and provide clinical evidence for sensory integration therapies.METHODS The database of Korean search engines,including RISS,KISS,and DBpia,was used to search for related literature published from 2001 to October 2020.The keywords,“Children”,“Sensory integration”,“Integrated sensory”,“Sensorymotor”,and“Sensory stimulation”were used in this search.Then,a meta-analysis was conducted on 24 selected studiesRISS,KISS,and DBpia,was used to search for related literature published from 2001 to October 2020.The keywords,“Children”,“Sensory integration”,“Integrated sensory”,“Sensorymotor”,and“Sensory stimulation”were used in this search.Then,a meta-analysis was conducted on 24 selected studies.RESULTS Sensory integration intervention has been proven effective in children with cerebral palsy,autism spectrum disorder,attention deficit/hyperactivity disorder,developmental disorder,and intellectual disability in relation to the diagnosis of children.Regarding sensory integration therapies,1:1 individual treatment with a therapist or a therapy session lasting for 40 min was most effective.In terms of dependent variables,sensory integration therapy effectively promoted social skills,adaptive behavior,sensory processing,and gross motor and fine motor skills.CONCLUSION The results of this study may be used as therapeutic evidence for sensory integration intervention in the clinical field of occupational therapy for children,and can help to present standards for sensory integration intervention protocols.
基金Supported by University’s Scientific Research ProjectShanghai Sanda University:No.2021zz02-yj+1 种基金Special Project for Clinical ResearchShanghai Municipal Health Commission:No.20174Y0009.
文摘Objective:This study is conducted to investigate the effects of occupational therapy(OT) with or without combined acupuncture for upper limb pain and hand functions among children with spastic hemiplegic cerebral palsy.Methods:A total of 90 patients who met the inclusion criteria were enrolled in a three-arm randomized,placebo-controlled trial,and were allocated to mono-occupational therapy(OT) group(patients=30),OT combined with real-acupuncture(ORA) group(patients=30),and OT combined with placeboacupuncture(OPA) group(patients=30),respectively.In addition to receiving the conventional OT program as the basic treatment for total 8 weeks,patients in ORA and OPA group also received corresponding acupuncture treatment 5 days per week for the first two weeks,3 days per week for the next two weeks,2 days per week for another two weeks,and 1 day per week for the last two weeks.Non-communicating children’s pain checklist-revised scale(NCCPC-R) was used for assessing the upper limb pain among patients.Squeeze dynamometry,modified Ashworth scale(MAS),manual muscle testing(MMT),JebsenTaylor hand function test(JTHFT) and box and block test(BBT) were used for assessing various aspects of upper limb and hand functions among patients.Meanwhile,adverse effects were monitored and recorded.Results:After 8-week treatment,NCCPC-R global scores witnessed a dramatic decline in ORA group(P<0.05),but not in either OPA(P> 0.05) or OT group(P> 0.05).Dramatic increases were identified in both squeeze dynamometry scores and MMT scores in all three groups(all P <0.05).Furthermore,the increases of ORA group were more significant than those of another two groups(both P <0.05).There were no significant changes in MAS global scores in each group(all P> 0.05).The BBT global scores of all three groups significantly increased(all P <0.05) after treatment.Among them,the increase of the ORA group was more than that of the other two groups(P <0.05).The 8-week treatment also had a significant impact on several sub-tests of JTFHT in each group.No significant adverse event was reported.Conclusion:ORA is a potential and promising alternative therapy for mitigating upper limb pain as well as improving both upper limb and hand functions among children with spastic hemiplegic cerebral palsy.
基金This work was supported by National Key R&D Program of China[grant numbers 2020YFC2004202].
文摘Stroke was one of the leading causes of death in the Chinese population in 2017.Most stroke survivors may suffer from different levels of disabilities,which prevents them from returning to their daily activities.The decreased upper limb function is considered as the principal factor that makes the patients have less access to their activities of daily livings.Occupational therapy(OT),aiming to enhance patients'functional performances and improve the participation in daily activities is usually applied from the onset of stroke.However,conventional OT intervention still has several problems that need to be solved,such as the inefficient use of human resources,inadequate upper limb functional training and non-continuous OT services.To address these difficulties and improve the patients'functional outcomes,intelligent rehabilitation equipment is combined with OT through evaluation and intervention.Based on this combination,OT can be provided in health care facilities,home,and community for patients with all phases of stroke.This combination promotes the transition of OT to digitization,intelligence and homogenization.
文摘With the visual illusion of the mirror,Mirror Therapy,models the primary somatosensory cortex,cortical and muscular excitability,stimulating cortical reorganization and sensorimotor recovery.Studies have shown to be effective in improving motor function in short and medium term,in activities of daily living,in visuospatial neglect and in reducing pain,especially in patients with complex regional pain syndrome.Objective:To report the perception of Occupational Therapists regarding the application of Mirror Therapy in professional practice.Specifically,what factors lead to its application,what are the effects and benefits of the technique,what are its advantages and limitations.Results:In the perception of Occupational Therapists,the Mirror Therapy technique has the following benefits:significant decrease in pain,improved sensitivity and functionality of the upper limb,unblocking movements in the affected limb,decreased phantom pain;as negative aspects:difficulties in spatial/environmental control,patient's perceptual/cognitive skills,high level of concentration/attention,absence of scientific evidence in neurological conditions.Conclusion:For the interviewed Occupational Therapists,the Mirror Therapy is a safe and useful technique to be applied in your professional practice that has been showing positive results in the functional recovery of patients,however,it lacks studies that identify the appropriate time to start its application and the explanation of an intervention protocol.
文摘Background: Osteoarthritis (OA) is a disabling disease that can affect 6% to 12% of the adult population and more than a third of people over 65 years of age. Purpose: To assess whether a group of people with hand osteoarthritis (hOA) who received different types of treatment improved their function after two years of follow-up. Method: The entire sample (n = 97) underwent three follow-up assessments regarding anthropometric parameters of the upper limbs and ability to perform functional activities. Subsequently, the sample was divided into two groups for the intervention periods, called the First Period (n = 73) and the Second Period (n = 24);the First Period kept the same protocol with orientations, and the Second Period went to an intervention with orientation strength exercises and use of orthosis. Findings: In the separate analysis of the three questions of the DASH pain module, no differences were found between the assessment moments for groups of guidelines, treatment, or symptoms. Significant effects were observed for F(2, 162) = 3.5, p = 0.033, η2 = 0.04, and interaction for moments and intervention F(2, 162) = 4.3, p = 0.016, η2 = 0.05. Implications: It can be concluded that only guidance treatment does not benefit patients with hand osteoarthritis. In contrast, guidance, exercise, and orthosis treatment can significantly improve the disease.
文摘Objective: To assess the satisfaction and occupational performance of women with chronic pelvic pain and to discuss unassisted intervention strategies by the occupational therapist for the care of these patients. Methods: A case-control study was conducted on 75 women with chronic pelvic pain and 75 apparently healthy women. The study was approved by the Research Ethics Committee of the institution and all subjects gave written informed consent to participate. Pain intensity was determined using a visual analogue scale and each patient was submitted to psycho-metric assessment using the Patient Health Questionnaire, the Self-Reporting Questionnaire of Psychiatric Screening and the Tampa Scale of Kinesiophofobia in their Brazilian version. The main outcomes regarding occupational performance and satisfaction were evaluated using the Canadian Measure of Occupational Performance. Results: The performance and satisfaction scores of women with chronic pelvic pain were significantly lower than those of healthy women. The presence of pain and kinesophobia was directly and independently correlated with low performance and satisfaction scores regardless of ethnicity, marital status, schooling, or psychometric scores. Conclusion: women with chronic pelvic pain present significant impairment of satisfaction and occupational performance. Coping is a potential unassisted intervention strategy to be applied to this population by occupational therapists.
文摘BACKGROUND People suffering from chronic mental illness are sensitive to stressful stimuli,lack coping skills,and have low self-esteem due to problems such as social situations.They also experience depression,isolation,fear,and frustration.Due to cognitive dysfunction,people suffering from chronic mental illness have inadequate cognitive processes that lead to distorted thinking.AIM To confirm the effectiveness of cognitive rehabilitation therapy in improving cognitive function and alleviating behavioral and psychological symptoms in patients with chronic mental illness,and to identify the cognitive function that had the main effect.METHODS The quality of the studies was evaluated using the Assessment of Multiple Systematic Reviews criteria,and data published from 2011 to December 2022 were searched using PubMed,Cochrane,RISS,KISS,and DBpia.The keywords used in the search were“mental illness,”“cognitive rehabilitation,”“cognition,”and“mental.”A meta-analysis was conducted on the 12 selected papers.RESULTS The level of evidence for the 12 documents was that of a randomized experimental study.Intervention types in cognitive rehabilitation can be divided into cognitive behavior,cognitive training,cognitive rehabilitation,and computerized cognitive programs.Most of the studies were on schizophrenia,and the measurement areas were cognitive functions(e.g.,concentration,memory,and executive function)as well as depression,sociability,and quality of life.As a result of the meta-analysis of each variable,the effect size for cognitive rehabilitation treatment was in the following order:Sociability,memory,concentration,executive function,quality of life,and depression.Particularly,sociability and memory exhibited significant effects.CONCLUSION Cognitive rehabilitation aids cognitive function and sociability in patients with chronic mental illness and can be used as evidence for cognitive rehabilitation in mental health and occupational therapy.
文摘BACKGROUND Electrical burns are devastating injuries and can cause deep burns with significant morbidity and delayed sequelae.Epidemiological data regarding the etiology,socioeconomic differences and geographic variation are necessary to assess the disease burden and plan an effective preventive strategy.These severe injuries often lead to amputations and thus hamper quality of life in the long term AIM To identify the population at maximum risk of sustaining electrical burns.We also studied the impact of electrical burns on these patients in terms of quality of life as well as return to work.METHODS The study was conducted at a tertiary referral teaching hospital over a period of eighteen months.All patients with a history of sustaining electrical burns and satisfying the inclusion criteria were included in the study.All relevant epidemiological parameters and treatment details were recorded.The patients were subsequently followed up at 3 mo,6 mo and 9 mo.The standardized Brief Version of the Burn Specic Health Scale(BSHS-B)was adopted to assess quality of life.Statistical analysis was conducted using IBM SPSS statistics(version 22.0).A P value of<0.05 was considered statistically significant.RESULTS A total of 103 patients were included in the study.The mean age of the patients was 31.83 years(range 18-75 years).A significant majority(91.3%)of patients were male.The mean total body surface area(TBSA)in these patients was 21.1%.In most of the patients(67%),the injury was occupation-related.High voltage injuries were implicated in 72.8%of patients.Among the 75 high voltage burn patients,31(41%)required amputation.The mean number of surgeries the patients underwent in hospital was 2.03(range 1 to 4).The quality of life parameters amongst the patients sustaining high voltage electrical burns were poorer when compared to low voltage injuries at all follow-up intervals across nine domains.In eight of these domains,the difference was statistically significant.Similarly,the scores among the amputees were poorer when compared to non-amputees.The difference was statistically significant in six domains.CONCLUSION Electrical burns remain a problem in the developing world.Most injuries are occupation-related.The quality of life in patients with high voltage burns and amputees remains poor.Work resumption was almost impossible for amputees.These patients could not regain pre-injury status.Steps should be taken to create awareness and to implement an effective preventive strategy to safeguard against electrical injuries.
基金a grant from the State Science and Technology Department of "the Tenth Five-Year Plan" Tackle Key Problem,No.2001BA703B21
文摘BACKGROUND： At present, there are many studies on the rehabilitation therapy of stroke patients with hemiplegia, but there is deficiency of corresponding standardized rehabilitation program. OBJECTIVE： To explore the effects of standardized tertiary rehabilitation on the activities of daily living in stroke patients with hemiplegia within 6 months after attack. DESIGN： A clinical observation. SETTING： Department of Rehabilitation Medicine, Huashan Hospital of Fudan University. PARTICIPANTS： Eighty-two outpatients and inpatients with acute stroke were selected from the Department of Neurology, Shanghai Huashan Hosptial from January 1999 to June 2003, including 49 males and 33 females, 40 - 80 years of age, with a mean age of （65 ±11） years old. Inclusive criteria： According to the diagnostic standards for cerebrovascular diseases set by Fourth National Academic Meeting for Cerebrovascular Disease in 1995, the patients were diagnosed as new attack of cerebral infarction or cerebral hemorrhage, and confirmed by CT or MRI to be initial patients; They should be accorded with the following conditions, including within 1 week after stabilization of life signs, Glasgow coma score 〉 8 points, 40 - 80 years of age, with disturbance of limb function. Informed consents were obtained from all the patients or their relatives. Exclusive criteria： Patients were excluded due to active liver disease, liver and kidney malfunction, congestive heart failure, malignant tumor, history of dementia, failure in respiratory function, tetraplegia; cerebral infarction or cerebral hemorrhage for more than 3 weeks; unable to be followed up due to in other cities and provinces; psychiatric history; deafness and muteness. According to the will of the patients or their relatives, the patients who accepted the standardized rehabilitation program were enrolled as the treatment group （n =42）, and the others as the control group （n =40）. Approval was obtained from the ethical committee of the hospital. METHODS： All the patients were given routine therapies of internal medicine after admission. According to the conditions of Brunnstom recovery 6-phase evaluation, the patients in the treatment group were trained with the pre-designed comprehensive standardized rehabilitation program for corresponding period. At early period （within about 1 month after attack）, the patients received rehabilitative interventions in the Department of Emergency or Department of Neurology, once a day, 45 minutes for each time, 5 times a week; At middle period （about 1 - 3 months after attack）, the patients received rehabilitative interventions in the rehabilitation ward or center, once to twice a day, 30 - 45 minutes for each time, 4 - 5 days a week; At late period （about 3 - 6 months after attack）, the patients received rehabilitative intervention mainly assisted by rehabilitation physician in the community, relatives and volunteers, 3 - 4 times a week, and they were followed in the house or outpatient department once every two weeks. MAIN OUTCOME MEASURES： The patients were evaluated blindly by the same rehabilitation physician using scale of modified Barthel index at admission and 1, 3 and 6 months after attack respectively. RESULTS： Totally 82 patients with acute stroke were enrolled, and 3 cases in the treatment group missed, including 2 cases died at 1 month after admission, and 1 case refused the follow up l0 days later, all the others were involved in the analysis of results. The scores of modified Barthel index at corresponding time points after admission in the treatment group were all obviously higher than those in the control group （P 〈 0,01）, and the score differences were also obviously higher than those in the control group （P 〈 0,01）. The activities of daily living at admission and 1, 3 and 6 months after admission in the treatment group were 22,50%, 46.43%, 75,95% and 89,52% of that of normal people respectively, and those in the control group were 17.09%, 25,77%, 43,38% and 55,00% respectively, The activities of daily Diving at admission and 1, 3 and 6 months in the treatment group were 131.66%, 180.17%, 175.08% and 162.76% of those in the controlgroup. As compared with at admission, the percentage of the score difference to the total score at the ends of the 1^st, 3^rd and 6^th months were 23.93%, 53.45% and 67.02% in the treatment group, while 8.67%, 25.36% and 36.98% in the control group. CONCLUSION： Standardized tertiary rehabilitation can obviously promote the activities of daily living in stroke patients with hemiplegia.
基金This work was supported by the Deanship of Scientific Research,King Khalid University,Kingdom of Saudi Arabia under research Grant Number(R.G.P.2/100/41).
文摘Human Adaptive Mechatronics(HAM)includes human and computer system in a closed loop.Elderly person with disabilities,normally carry out their daily routines with some assistance to move their limbs.With the short fall of human care takers,mechatronics devices are used with the likes of exoskeleton and exosuits to assist them.The rehabilitation and occupational therapy equipments utilize the electromyography(EMG)signals to measure the muscle activity potential.This paper focuses on optimizing the HAM model in prediction of intended motion of upper limb with high accuracy and to increase the response time of the system.Limb characteristics extraction from EMG signal and prediction of optimal controller parameters are modeled.Time and frequency based approach of EMG signal are considered for feature extraction.The models used for estimating motion and muscle parameters from EMG signal for carrying out limb movement predictions are validated.Based on the extracted features,optimal parameters are selected by Modified Lion Optimization(MLO)for controlling the HAM system.Finally,supervised machine learning makes predictions at different points in time for individual sensing using Support Vector Neural Network(SVNN).This model is also evaluated based on optimal parameters of motion estimation and the accuracy level along with different optimization models for various upper limb movements.The proposed model of human adaptive controller predicts the limb movement by 96%accuracy.
文摘Objective: This study describes the development and use of a specific database supporting personnel within outpatient neurological rehabilitation to reflect on existing interventions and improve future rehabilitation. Methods: Five outpatient rehabilitation centres in one county council in Sweden were involved in developing and implementing a systematic data collection template within the existing digital medical record system. Data were collected to get more information on the effects of outpatient stroke rehabilitation in patients who received rehabilitation the first year after a stroke (ICD-I64) and patients who received further rehabilitation 1 year or more after a stroke (ICD-I69). Data analysis included evaluation of balance, movement, activity/participation, health-related quality of life, and self-rated health. Results: The ICD-I64 group had positive results after treatment (p < 0.05) for all variables and the ICD-I69 group had positive results for balance and activity/participation. Conclusions: The use of systematic data collection provided a platform for employees and managers to discuss and use clinical results to improve the type and quality of rehabilitation interventions.
基金supported by Project of Foshan Health Bureau,Guangdong Province(No.2014279)Medical Key Science and Technology Project of Foshan(No.2014AB000362)~~
文摘Objective： To observe the clinical effect of acupuncture plus occupation therapy for fine motor functions in children with spastic cerebral palsy. Methods： A total of 80 cerebral palsy kids with fine motor dysfunction were allocated into two groups by envelop, 40 cases in each group. Cases in the control group were treated with occupation therapy. Based on the therapy given to the control group, cases in the treatment group were supplemented with acupuncture at the points of the three yang meridians of hand. The treatment was done every other day and 10 times for a course. There was a 15-day interval between two courses, and 3 courses in total. The therapeutic efficacies were evaluated using Peabody developmental motor scale 2 （PDMS-2） and modified Ashworth scale （MAS） before and after treatment. Results： After treatment, the standard score for grasping （Grs）, standard score for visual-motor integration （Vis）, fine motor quotient （FMQ） and modified Ashworth scale （MAS） were significantly improved in both groups （P〈0.05）. The improvement in the treatment group was more obvious than that in the control group （P〈0.01）. Conclusion： Acupuncture plus occupation therapy can achieve better effect than occupation therapy alone in improving fine motor functions of upper limbs in cerebral palsy kids.
文摘Hand injury is the second most common work-related musculoskeletal injury among physical therapists （PTs） and other manual therapy professionals such as osteopaths, physiotherapists, chiropractors, acupuncturists and massage therapists. However, the nature and extent of this problem have not been fully explored yet. Therefore, the objective of this study was to review the existing literature published on the prevalence, risk factors, consequences, and prevention of hand injuries among PTs and similar healthcare professionals. The lifetime prevalence of hand injuries was about 15%-46%, and the annual prevalence was reported as 5%-30%. Thumb injuries were found to be the most prevalent of all injuries, accounting more than 50% of all hand-related problems. The most significant risk factors for job-related hand injuries were performing manual therapy techniques, repetitive workloads, treating many patients per day, continued work while injured or hurt, weakness of the thumb muscles, thumb hypermobility, and instability at the thumb joints. Frs reported modifying treatment technique, taking time off on sick leave, seeking intervention, shifting the specialty area, and decreasing patient contact hours as the major consequences of these injuries. The authors recommend that PTs should develop specific preventive strategies and put more emphasis on the use of aids and equipment to reduce the risk of an unnecessary injury.
文摘Quality of life and functional recovery after burn injury is the final goal of burn care,especially as most of burn patients survive the injury due to advanced medical science.However,dysfunction,disfigurement,contractures,psychological problems and other discomforts due to burns and the consequent scars are common,and physical therapy and occupational therapy provide alternative treatments for these problems of burn patients.This guideline,organized by the Chinese Burn Association and Chinese Association of Burn Surgeons aims to emphasize the importance of team work in burn care and provide a brief introduction of the outlines of physical and occupational therapies during burn treatment,which is suitable for the current medical circumstances of China.It can be used as the start of the tools for burn rehabilitation.
