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Showing papers in "American Journal of Occupational Therapy in 2010"


Journal ArticleDOI
TL;DR: Results suggest the SI approach may result in positive outcomes in sensorimotor skills and motor planning; socialization, attention, and behavioral regulation; reading-related skills; participation in active play; and achievement of individualized goals.
Abstract: Twenty-seven studies were systematically reviewed to identify, evaluate, and synthesize the research literature on the effectiveness of sensory integration (SI) intervention on the ability of children with difficulty processing and integrating sensory information to engage in desired occupations and to apply these findings to occupational therapy practice. Results suggest the SI approach may result in positive outcomes in sensorimotor skills and motor planning; socialization, attention, and behavioral regulation; reading-related skills; participation in active play; and achievement of individualized goals. Gross motor skills, self-esteem, and reading gains may be sustained from 3 mo to 2 yr. Findings may be limited by Type II error because of small sample sizes, variable intervention dosage, lack of fidelity to intervention, and selection of outcomes that may not be meaningful to clients and families or may not change with amount of treatment provided. Replication of findings with methodologically and theoretically sound studies is needed to support current findings.

176 citations


Journal ArticleDOI
TL;DR: It is suggested that simulators could be used to facilitate the evaluation of fitness to drive and reproducibility of simulator assessments using the playback function.
Abstract: We examined the validity and reproducibility of simulator-based driving evaluations. In Study 1, we examined correlations among Trails A and B, demerit points for simulated drives, and simulator-recorded errors. With one exception, correlations ranged from .44 (p = .103) to .83 (p = .001). In Study 2, we examined correlations among Trail Making Test Part A, Useful Field of View, and demerit points for simulated drives; correlations ranged from .50 to .82 (all ps < .001). The correlation between demerit points for on-road and simulated drives was .74 (p = .035). We examined reproducibility of simulator assessments using the playback function; intraclass correlation coefficients ranged from .73 to .87 (all ps < .001). These results suggest that simulators could be used to facilitate the evaluation of fitness to drive.

162 citations


Journal ArticleDOI
TL;DR: The results suggest that children and adolescents with difficulty processing and integrating sensory information do exhibit functional performance difficulties in key areas of occupation, however, further descriptive studies are needed to tie these difficulties to their specific sensory and motor issues.
Abstract: A systematic review of the literature related to performance difficulties for children and adolescents with difficulty processing and integrating sensory information was completed as part of the Evidence-Based Literature Review Project of the American Occupational Therapy Association. The review focused on functional performance difficulties that these children may exhibit in areas of occupation including play and leisure, social participation, activities of daily living, instrumental activities of daily living, rest and sleep, education, and work. The results suggest that children and adolescents with difficulty processing and integrating sensory information do exhibit functional performance difficulties in key areas of occupation. However, further descriptive studies are needed to tie these difficulties to their specific sensory and motor issues. Researchers are encouraged to include functional performance measures and measures of social participation in their studies to further elucidate these relationships.

104 citations


Journal ArticleDOI
TL;DR: The ball chair appeared to have a positive effect on in-seat behavior for the child who had the most extreme-proprioceptive-seeking behaviors and children with poor postural stability were less engaged when sitting on the therapy ball chair.
Abstract: A single-subject design was used to assess the effectiveness of therapy ball chairs on classroom participation in 6 boys with autism spectrum disorder (ASD). The sensory processing pattern of each participant was assessed using the Sensory Processing Measure. Data on in-seat behavior and engagement were collected using digital video recordings during Circle Time. During baseline, participants sat on chairs. During intervention, participants sat on therapy ball chairs. Social validity was assessed by means of a questionnaire completed by the teacher. Each child demonstrated a unique response. The ball chair appeared to have a positive effect on in-seat behavior for the child who had the most extreme vestibular-proprioceptive-seeking behaviors. Children with poor postural stability were less engaged when sitting on the therapy ball chair. The results illuminate the complex nature of children with ASD and the importance of using sound clinical reasoning skills when recommending sensory strategies for the classroom.

100 citations


Journal ArticleDOI
TL;DR: Findings from this study provide initial evidence that sensory processing and context for children with autism are related, suggesting that sensoryprocessing patterns have both universal qualities and context-specific qualities in children with Autism.
Abstract: OBJECTIVE. The purpose of the study was to determine the relationship between sensory processing and context for children with autism. We examined home and school contexts using the Sensory Profile (Dunn, 1999) and the Sensory Profile School Companion (Dunn, 2006a) questionnaires. METHOD. Teachersof49studentswithautismcompletedtheSensoryProfileSchoolCompanion,andparents completed the Sensory Profile. We conducted correlational analyses using the avoiding and seeking quadrant scores from the School Companion and corresponding avoiding and seeking quadrant scores from the Sensory Profile. RESULTS. The avoiding quadrant score coefficient (.59) and the seeking quadrant score coefficient (.45) were statistically significant (p 5 .01) with good and fair correlations, respectively, suggesting that sensory processing patterns have both universal qualities and context-specific qualities in children with autism. CONCLUSION. Findings from this study provide initial evidence that sensory processing and context for children with autism are related. Brown, N. B., & Dunn, W. (2010). Relationship between context and sensory processing in children with autism. American

99 citations


Journal ArticleDOI
TL;DR: Results suggest that mental practice combined with physical practice improves upper-limb recovery after stroke, and when added to physical practice, mental practice is an effective intervention.
Abstract: OBJECTIVE. We sought to determine whether mental practice is an effective intervention to improve upper-limb recovery after stroke. METHOD. We conducted a systematic review of the literature, searching electronic databases for the years 1985 to February 2009. We selected studies according to specified criteria, rated each study for level of evidence, and summarized study elements. RESULTS. Studies differed with respect to design, patient characteristics, intervention protocols, and outcome measures. All studies used imagery of tasks involving movement of the impaired limb. The length of the interventions and number of practice hours varied. Results suggest that mental practice combined with physical practice improves upper-limb recovery. CONCLUSION. When added to physical practice, mental practice is an effective intervention. However, generalizations are difficult to make. Further research is warranted to determine who will benefit from training, the dosing needed, the most effective protocols, whether improvements are retained, and whether mental practice affects perceived occupational performance

97 citations


Journal ArticleDOI
TL;DR: 2 groups of children with and without sensory processing disorders demonstrated generally similar patterns of activity preferences and use of free time but had significant differences in areas related to intensity and enjoyment of involvement and in their social networks.
Abstract: Participation in social aspects of daily life is crucial to children’s development. Although disability status is recognized to affect children’s ability to participate in social activities, little is understood about the impact of sensory processing disorders (SPD) on children’s social participation. We examined the social participation patterns of 2 groups of children (ages 6–9): (1) children with SPD and (2) their typically developing peers. All children participated in a structured interview to report their social participation patterns, including activity patterns and social networks. We used parent and teacher questionnaires to triangulate the data gathered from the children. Results revealed that the 2 groups of children demonstrated generally similar patterns of activity preferences and use of free time but had significant differences in areas related to intensity and enjoyment of involvement and in their social networks. Implications for future research and interventions are discussed.

85 citations


Journal ArticleDOI
TL;DR: Tailoring instruction on the basis of recent symptoms and physical activity may be a more effective symptom management approach than general instruction given the positive effects on fatigue.
Abstract: OBJECTIVE. We examined whether tailored activity pacing intervention was more effective at reducing pain and fatigue than general activity pacing intervention. METHOD. Adults with knee or hip osteoarthritis (N = 32) stratified by age and gender were randomized to receive either tailored or general pacing intervention. Participants wore an accelerometer for 5 days that measured physical activity and allowed for repeated symptom assessment. Physical activity and symptom data were used to tailor activity pacing instruction. Outcomes at 10-week follow-up were pain (Western Ontario and McMaster Universities Osteoarthritis Index) and fatigue (Brief Fatigue Inventory). RESULTS. Compared with general intervention, the tailored group had less fatigue interference (p = .02) and trended toward decreased fatigue severity (p = .09) at 10-wk follow-up. No group differences were found in pain reduction. CONCLUSION. Tailoring instruction on the basis of recent symptoms and physical activity may be a more effective symptom management approach than general instruction given the positive effects on fatigue

84 citations


Journal ArticleDOI
TL;DR: This systematic review found that children with difficulty processing and integrating sensory information and difficulties with the performance of daily occupations can benefit from intervention, but the great variability that characterizes this literature in terms of populations, interventions, and study quality precludes the formation of any firm conclusions regarding specific approaches.
Abstract: This literature review was completed as part of the Evidence-Based Literature Review Project of the American Occupational Therapy Association to explore the effectiveness of occupational therapy interventions with children and adolescents experiencing difficulty processing and integrating sensory information. This part of the review focused on interventions other than the sensory integration approach. Twenty articles (reporting on 21 studies) met the inclusion criteria. This systematic review found that children with difficulty processing and integrating sensory information and difficulties with the performance of daily occupations can benefit from intervention. However, the great variability that characterizes this literature in terms of populations, interventions, and study quality precludes the formation of any firm conclusions regarding specific approaches. There is an urgent need for well-controlled studies examining the effectiveness of frequently used pediatric occupational therapy interventions with well-defined, homogeneous populations on outcomes that target participation in everyday life.

82 citations


Journal ArticleDOI
TL;DR: It is concluded that there was a basis for the assumptions of Ayes' SI theory and the theoretical premise of occupational therapy using an SI framework (OT/SI) to treatment is not feasible.
Abstract: When Ayres first presented the theory of sensory integration (SI), she grounded it in the neuroscience literature. Neuroplasticity was then, and is today, considered to be at the heart of this theory. This evidence-based review sought to critically examine the basic science literature to specifically identify evidence for the assumptions and tenets of Ayres' theory of SI. We reviewed literature between 1964 and 2005, within psychological, physiological, and biomedical areas, addressing neuroplasticity. The review focused on sensorimotor-based neuroplasticity; explored the data that addressed the links among sensory input, brain function, and behavior; and evaluated its relevance in terms of supporting or refuting the theoretical premise of occupational therapy using an SI framework (OT/SI) to treatment. Although direct application from basic science to OT/SI is not feasible, we concluded that there was a basis for the assumptions of Ayes' SI theory.

69 citations


Journal ArticleDOI
TL;DR: Sensitivity to change was demonstrated by significant improvements after intervention for total performance self-ratings on the COPM and GAS Tscores, supporting the clinical utility and treatment validity of the combined use of these tools.
Abstract: OBJECTIVE. We investigated the clinical utility of combined use of Goal Attainment Scaling (GAS) and the Canadian Occupational Performance Measure (COPM) to plan goals and measure progress in a community rehabilitation setting. METHOD. Fourteen participants with traumatic brain injury completed an outpatient, goal-directed 12-wk occupational therapy program; 53 goals were generated. Performance and satisfaction self-ratings and GAS ratings were collected before and after intervention. Self-awareness, motivation to change, and perceived client-centeredness measures were taken before intervention. RESULTS. Sensitivity to change was demonstrated by significant improvements after intervention for total performance self-ratings on the COPM and GAS T scores. CONCLUSION. Combined use of these tools, although time consuming, resulted in goals that were perceived almost unanimously as client centered, despite most participants' having moderate or severe impairment in self-awareness. The process also enabled subjective and objective demonstration of goal achievement, thereby supporting the clinical utility and treatment validity of the combined use of these tools

Journal ArticleDOI
TL;DR: To further establish that post-acute TBI rehabilitation interventions improve CI, future studies should include intervention strategies based on injury severity, a control group, and longer term follow-up.
Abstract: METHOD. We conducted a systematic review of intervention studies on TBI rehabilitation from1990 to2007. RESULTS. We analyzed and summarized 10 studies that met the inclusion criteria. Of 10 studies, 7 found that post–acute TBI rehabilitation benefits CI; all effective studies involved occupational therapy or involved interventions occupational therapists can do. CONCLUSION. Many CI programs show positive results and should be studied more rigorously. Such promising programs should also be considered when decisions about post–acute TBI rehabilitation services for clients are being made. To further establish that post–acute TBI rehabilitation interventions improve CI, future studies should include intervention strategies based on injury severity, a control group, and longer term follow-up. The role of occupational therapy in these effective programs should be further explored. Kim, H., & Colantonio, A. (2010). Effectiveness of rehabilitation in enhancing community integration after acute traumatic brain injury: A systematic review. American Journal of Occupational Therapy, 64, 709–719. doi: 10.5014/ajot.2010. 09188

Journal ArticleDOI
TL;DR: In healthy senior drivers, simulator sickness does not prevent examination of those who need it most (i.e., those with the poorest on-road driving performance) and that cognitive differences are not associated with dropping out because of simulator sickness.
Abstract: We examined whether participants who failed to complete a simulated drive because of simulator sickness (dropouts) differed from those who completed the simulation (completers). Thirteen healthy older adult dropouts (mean age = 74.8 yr) and 12 comparable completers were compared on the following variables: on-road driving performance, the Useful Field of View test, the Attention Network Test, and the Trail Making Test Part A. Results showed that completers scored more demerit points during the on-road drive than did dropouts. In addition, only 1 of 13 comparisons based on participants' cognition was statistically significant. These results suggest that in healthy senior drivers, simulator sickness does not prevent examination of those who need it most (i.e., those with the poorest on-road driving performance) and that cognitive differences are not associated with dropping out because of simulator sickness.

Journal ArticleDOI
TL;DR: In an exploratory study, 207 reports of lost drivers with dementia over 10 yr reported by newspapers and media were examined, finding 70 AD drivers were not found, 32 drivers were found dead, and 116 drivers were finding alive, although of those found alive, 35 people were found injured.
Abstract: Researchers of driving and dementia have reported that drivers with early Alzheimer's disease (AD) may continue to drive for extended periods of time, as long as their driving is evaluated or monitored. The earliest symptoms of AD are known to include loss of recent memory and the inability to recognize familiar environments. In an exploratory study, we examined 207 reports of lost drivers with dementia over 10 yr reported by newspapers and media. Seventy AD drivers were not found, 32 drivers were found dead, and 116 drivers were found alive, although of those found alive, 35 people were found injured. Miles driven and days missing were also reported in some cases, in addition to cause of death (such as drowning or exposure to weather). Becoming lost may have serious consequences. Additional research is needed in this area to more clearly understand the consequences of becoming lost while driving.

Journal ArticleDOI
TL;DR: The SDBM has relevance as a self-report to rate older drivers and future pilot testing of the SDBM comparing results with on-road testing will define criterion validity.
Abstract: OBJECTIVE. We report on item development and validity testing of a self-report older adult safe driving behaviors measure (SDBM). METHOD. On the basis of theoretical frameworks (Precede�Proceed Model of Health Promotion, Haddon�s matrix, and Michon�s model), existing driving measures, and previous research and guided by measurement theory, we developed items capturing safe driving behavior. Item development was further informed by focus groups. We established face validity using peer reviewers and content validity using expert raters. RESULTS. Peer review indicated acceptable face validity. Initial expert rater review yielded a scale content validity index (CVI) rating of 0.78, with 44 of 60 items rated =0.75. Sixteen unacceptable items (=0.5) required major revision or deletion. The next CVI scale average was 0.84, indicating acceptable content validity. CONCLUSION. The SDBM has relevance as a self-report to rate older drivers. Future pilot testing of the SDBM comparing results with on-road testing will define criterion validity

Journal ArticleDOI
TL;DR: A violation-to-error classification based on rater agreement of 5,345 older drivers and expert reviewers is constructed and injury prevention strategies for clinicians and researchers to consider for older drivers, especially older women are suggested.
Abstract: Certain driving errors are predictive of crashes, but whether the type of errors evaluated during on-road assessment is similar to traffic violations that are associated with crashes is unknown. Using the crash data of 5,345 older drivers and expert reviewers, we constructed a violation-to-error classification based on rater agreement. We examined the effects of predictor variables on crash-related injuries by risk probability using logistic regression. Drivers' mean age was 76.08 (standard deviation = 7.10); 45.7% were women. Of drivers, 44.6% sustained crash-related injuries, and female drivers had a higher injury probability (44%) than male drivers (29%). Lane maintenance, yielding, and gap acceptance errors predicted crash-related injuries with almost 50% probability; speed regulation (34%), vehicle positioning (25%), and adjustment-to-stimuli (21%) errors predicted crash-related injuries to a lesser degree. We suggest injury prevention strategies for clinicians and researchers to consider for older drivers, especially older women. Language: en

Journal ArticleDOI
TL;DR: High-intensity occupational therapy using a CIMT or a bilateral approach can improve UE function in people with chronic UE dysfunction after CVA, and treatment intensity rather than restraint may be the critical therapeutic factor.
Abstract: OBJECTIVE. We compared the effectiveness of constraint-induced movement therapy (CIMT) with bilateral treatment of equal intensity for chronic upper-extremity (UE) dysfunction caused by cerebrovascular accident (CVA). DESIGN. We conducted a 2-group, randomized intervention trial with stratification by severity of UE dysfunction. Twelve community-dwelling adults were provided with 6 hr of occupational therapy for 10 days plus additional home practice. Six participants wore a mitt on the unimpaired UE, and 6 participants were intrusively and repetitively cued to use both UEs. The Wolf Motor Function Test (WMFT) and the Canadian Occupational Performance Measure (COPM) were administered before and after treatment and at 6-mo follow-up. RESULTS. Significant improvements were found in WMFT and COPM scores across time in both groups. No significant between-group differences were found on the WMFT. CONCLUSION. High-intensity occupational therapy using a CIMT or a bilateral approach can improve UE function in people with chronic UE dysfunction after CVA. Treatment intensity rather than restraint may be the critical therapeutic factor.

Journal ArticleDOI
TL;DR: UFOV and SDSA are valid assessments of driving ability for stroke and can guide decision making of occupational therapists in stroke driver rehabilitation and in determining those who require further assessment on road because they pose a safety risk.
Abstract: OBJECTIVES: We sought to determine the criterion validity of the Useful Field of View (UFOV) assessment and Stroke Drivers' Screening Assessment (SDSA) through comparison to the results of on-road assessment. METHOD: This was a prospective study with people with stroke. Outcome measures used were UFOV, SDSA, and the results of on-road assessment. RESULTS: Both the results on UFOV (Divided Attention subtest, p Language: en

Journal ArticleDOI
TL;DR: Everyone from practitioners to employers has a role in increasing EBP and transferring knowledge for practice and the article provides implications and recommendations for practitioners, researchers, educators, organizations, and policymakers.
Abstract: Occupational therapy practitioners may encounter challenges when they try to incorporate evidence into practice. To embrace evidence-based practice (EBP), clinicians must have readily available, relevant, and concisely summarized evidence. Although researchers have described the importance and process of EBP, less has been written about how to efficiently integrate evidence into practice. Clinicians may benefit from examples of reasoning, strategies, and resources to successfully integrate evidence. This article reviews the steps of EBP and offers recommendations to overcome common barriers. For EBP to become integrated into practice, greater communication and collaboration among all stakeholders must occur. EBP and knowledge translation require multiple processes and coordinated efforts. Therefore, everyone from practitioners to employers has a role in increasing EBP and transferring knowledge for practice. To encourage discussion and actions, the article provides implications and recommendations for practitioners, researchers, educators, organizations, and policymakers.

Journal ArticleDOI
TL;DR: This study investigated early intervention occupational therapists' use of strategies to teach caregivers, and found that explicit teaching strategies were rarely used during home visits.
Abstract: This study investigated early intervention occupational therapists' use of strategies to teach caregivers A sample of 40 videotapes made by early intervention occupational therapists was randomly selected from an archival videotape data set of provider home visits The sample included 20 videotapes illustrating traditional services and 20 videotapes illustrating therapists providing participation-based services Videotapes were rated using the Teaching Caregivers Scale, which rates three variables on 30-s intervals: (1) routine, (2) provider role, and (3) strategies used to teach caregivers during early intervention home visits Regardless of the model of service, explicit teaching strategies were rarely used during home visits

Journal ArticleDOI
TL;DR: Data suggest feasibility and efficacy of a remotely based, inexpensive approach using functional electrical stimulation for affected arm rehabilitation after stroke and enhanced satisfaction with ability to perform ADLs.
Abstract: Objective We examined the efficacy of a remotely based arm rehabilitation regimen. A 62-year-old man participated in occupation-based, task-specific practice of activities of daily living (ADLs) >3 years after stroke. The entire regimen was administered over the Internet using personal computer-based cameras and free network meeting software. Method Fugl-Meyer Assessment (FM), Action Research Arm Test (ARA), and Canadian Occupational Performance Measure (COPM) were administered before intervention. One week after treatment, FM, ARA, and COPM were readministered. Results The participant exhibited reduced impairment and reduced functional limitation. He also expressed enhanced satisfaction with his ability to perform ADLs and rated his ADL performance better after intervention. The participant could now drive using both hands, use eating utensils, and catch and throw a ball. Conclusion Data suggest feasibility and efficacy of a remotely based, inexpensive approach using functional electrical stimulation for affected arm rehabilitation after stroke.

Journal ArticleDOI
TL;DR: Treatment group participants, compared with control participants, demonstrated significant treatment effects for improved bioimpedance z, arm flexibility, quality of life, mood at 3 months, and weight loss.
Abstract: Evidence-based exercise and relaxation recommendations for people with breast cancer-related lymphedema (BCRL) are needed. We report a randomized controlled study of one program, designed to achieve synergistic improvements in physical and emotional BCRL symptoms. People in the treatment group received an exercise and relaxation program, The Breast Cancer Recovery Program (N=16). The control participants (N=16) continued with health professionals' recommendations. Participants were tested at entry, 2.5 weeks, 5 weeks, and 3 months. Treatment group participants, compared with control participants, demonstrated significant treatment effects for improved bioimpedance z, arm flexibility, quality of life, mood at 3 months, and weight loss. Adherence was high for this safe and effective program, which improved lymphedema physical and emotional symptoms.

Journal ArticleDOI
TL;DR: SPD may be a source of SM, but functional connections between these phenomena will need to be tested in future research.
Abstract: OBJECTIVE. Stereotyped movements (SM) are a defining characteristic of autism but are also present in children with a range of sensory and developmental disorders. We examined whether the severity of sensory processing disorders (SPD) was associated with the severity of SM and whether SPD accounted for between-group differences in SM. METHOD. The Short Sensory Profile and the Stereotyped and Self-Injurious Movements Interview were administered to children with autism, intellectual disability, visual impairment, and hearing impairment and to typically developing children. RESULTS. SPD predicted the severity of SM in all samples and accounted for differences in SM between the groups. Other differences in the severity of SM were the result of diagnosis and the interaction between diagnosis and an intellectual disability. CONCLUSION. SPD may be a source of SM, but functional connections between these phenomena will need to be tested in future research. Implications for occupational performance are addressed

Journal ArticleDOI
TL;DR: Arm-hand use is a novel dimension of hand function measuring the extent of real-life occupational performance in the client's home and it is found that enhanced manual dexterity of the right hand was associated with greater right- hand use.
Abstract: OBJECTIVE. Our objectives were (1) to quantify arm�hand use of older adults without a disability and to determine the effects of hand dominance, gender, and day on hand usage and (2) to determine the factors that predict arm�hand use. This information will enhance understanding of the extent of the client�s occupational performance. METHOD. Twenty men and 20 women, ages 65�85, wore wrist and hip accelerometers for 7 consecutive days. Manual dexterity and grip strength were assessed. A three-way factorial analysis of variance and multiple linear regressions were conducted. RESULTS. The activity kilocounts from both wrist accelerometers revealed a significant interaction effect between hand and gender (F[1, 190] = 24.4, p < .001). Enhanced manual dexterity of the right hand was associated with greater right-hand use. CONCLUSION. Arm�hand use is a novel dimension of hand function measuring the extent of real-life occupational performance in the client�s home

Journal ArticleDOI
TL;DR: The SMS differentiated between passing and failing drivers and can be used to inform clinical decision making.
Abstract: OBJECTIVES: We examined the validity of our on-road driving assessment to quantify its outcomes. METHOD: Older drivers (N = 127) completed a driving assessment on a standardized road course. Measurements included demographics, driving errors, and driving test outcomes; a categorical global rating score (pass-fail); and the sum of maneuvers (SMS) score (0-273). RESULTS: There were significant differences in the SMS (F = 29.9, df = 1, p Language: en

Journal ArticleDOI
TL;DR: This case report illustrates a shift in approach from biomechanical to occupational adaptation (OA) in an orthopedic outpatient clinic and the progress of a client with lupus-related arthritis who was 6 days postsurgery is documented.
Abstract: The investment of time and self to develop therapeutic relationships with clients appears incongruent with today's time-constrained health care system, yet bridging the gap of these incongruencies is the challenge therapists face to provide high-quality, client-centered, occupation-based treatment. This case report illustrates a shift in approach from biomechanical to occupational adaptation (OA) in an orthopedic outpatient clinic. The progress of a client with lupus-related arthritis who was 6 days postsurgery is documented. The intervention initially used a biomechanical frame of reference, but when little progress had been made at 10 weeks after surgery, a shift was made to the more client-centered OA approach. The Canadian Occupational Performance Measure was administered, and an OA approach was initiated. On reassessment, clinically important improvements were documented in all functional tasks addressed. An OA approach provides the bridge between the application of clinical expertise, client-centered, occupation-based therapy and the time constraints placed by payer sources.

Journal ArticleDOI
TL;DR: This preliminary study suggests that the I-HOPE is a psychometrically sound instrument that can be used to examine person-environment fit in the home.
Abstract: OBJECTIVE. We describe the development and preliminary psychometric properties of an assessment to quantify the magnitude of an environmental barrier�s influence on occupational performance. METHOD. The assessment was developed and then piloted on a group of 77 older adults before and after an occupational therapy intervention focused on environmental barrier removal. Refinements were made to the assessment before it was evaluated for interrater reliability in a sample of 10 older adults using 2 raters. RESULTS. The In-Home Occupational Performance Evaluation (I�HOPE) is a performance-based measure that evaluates 44 activities in the home. The 4 subscales of Activity Participation, Client�s Rating of Performance, Client�s Satisfaction With Performance, and Severity of Environmental Barriers are sensitive to change in the environment. The subscales� internal consistency from .77 to .85, and intraclass correlation coefficients ranged from .99 to 1.0. CONCLUSION. This preliminary study suggests that the I�HOPE is a psychometrically sound instrument that can be used to examine person�environment fit in the home.

Journal ArticleDOI
TL;DR: Results suggest that the Do-Eat is a reliable, valid tool for identifying children at risk for DCD.
Abstract: BACKGROUND. The Do�Eat was developed to evaluate daily task performance abilities among children with developmental coordination disorder (DCD). This study investigated the tool�s reliability and validity. METHOD. Participants were 59 children ages 5 to 6.5 years; 30 children diagnosed with DCD according to the DSM�IV�TR; and a control group of 29 children, who were matched for age, gender, and sociodemographic background. RESULTS. Both the Do�Eat and the accompanying Parent Questionnaire yielded high internal consistency (as = .89�.93). Construct validity was demonstrated by significant between-group differences on the Do-Eat (t[57] = 14.09, p < .001) and the Parent Questionnaire (t[57] = 3.64, p < .001). Significant correlations between children�s scores on the sensory�motor component of the Do�Eat and the Movement Assessment Battery for Children final score confirmed concurrent validity (r = -.86, p < .001). CONCLUSIONS. Results suggest that the Do�Eat is a reliable, valid tool for identifying children at risk for DCD

Journal ArticleDOI
TL;DR: In this paper, an occupational therapist evaluated 22 people with hemianopia, 8 with quadrantanopia, and 30 with normal vision for driving skills during naturalistic driving using six rating scales.
Abstract: OBJECTIVE: To examine whether some drivers with hemianopia or quadrantanopia display safe driving skills on the road compared with drivers with normal visual fields. METHOD: An occupational therapist evaluated 22 people with hemianopia, 8 with quadrantanopia, and 30 with normal vision for driving skills during naturalistic driving using six rating scales. RESULTS: Of drivers with normal vision, > 90% drove flawlessly or had minor errors. Although drivers with hemianopia were more likely to receive poorer ratings for all skills, 59.1%-81.8% performed with no or minor errors. A skill commonly problematic for them was lane keeping (40.9%). Of 8 drivers with quadrantanopia, 7 (87.5%) exhibited no or minor errors. CONCLUSION: This study of people with hemianopia or quadrantanopia with no lateral spatial neglect highlights the need to provide individual opportunities for on-road driving evaluation under natural traffic conditions if a person is motivated to return to driving after brain injury. Language: en

Journal ArticleDOI
TL;DR: Intrarater and interrater reliability were determined for middle finger range of motion (ROM) using the Rolyan finger goniometer and provide clinicians with evidence for using this specific goniometers and issues associated with various therapists assessing finger ROM.
Abstract: Intrarater and interrater reliability were determined for middle finger range of motion (ROM) using the Rolyan finger goniometer. Seven raters measured ROM 3 times (trials) on 20 healthy adults. Intraclass reliability analysis and analysis of variance was used to assess the consistency and stability of measures. Level of significance was set at p £ .05. Significant differences (p < .05) existed between raters for metacarpophalangeal, proximal interphalangeal, and distal interphalangeal active finger ROM measurements and for metacarpophalangeal and proximal interphalangeal passive range of motion. Intrarater reliability ranged from .43 to .99 (single measure intraclass coefficient). Interrater reliability ranged from .24 to .95, with passive measures lower than active measures. These results provide clinicians with evidence for using this specific goniometer and issues associated with various therapists assessing finger ROM. Lewis, E., Fors, L., & Tharion, W. J. (2010). Interrater and intrarater reliability of finger goniometric measurements.