SAR: Occupational Therapy: Scholarly Papers
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Item Test-retest reliability of task-based measures of voluntary persistence(2022-07-27) Chen, Yixin; Fulford, Daniel; McGuire, JosephItem Smartphone-based neuropsychological assessment in Parkinson's disease: feasibility, validity, and contextually driven variability in cognition(Cambridge University Press (CUP), 2022-04) Weizenbaum, Emma L.; Fulford, Daniel; Torous, John; Pinsky, Emma; Kolachalama, Vijaya B.; Cronin-Golomb, AliceOBJECTIVES: The prevalence of neurodegenerative disorders demands methods of accessible assessment that reliably captures cognition in daily life contexts. We investigated the feasibility of smartphone cognitive assessment in people with Parkinson's disease (PD), who may have cognitive impairment in addition to motor-related problems that limit attending in-person clinics. We examined how daily-life factors predicted smartphone cognitive performance and examined the convergent validity of smartphone assessment with traditional neuropsychological tests. METHODS: Twenty-seven nondemented individuals with mild-moderate PD attended one in-lab session and responded to smartphone notifications over 10 days. The smartphone app queried participants 5x/day about their location, mood, alertness, exercise, and medication state and administered mobile games of working memory and executive function. RESULTS: Response rate to prompts was high, demonstrating feasibility of the approach. Between-subject reliability was high on both cognitive games. Within-subject variability was higher for working memory than executive function. Strong convergent validity was seen between traditional tests and smartphone working memory but not executive function, reflecting the latter's ceiling effects. Participants performed better on mobile working memory tasks when at home and after recent exercise. Less self-reported daytime sleepiness and lower PD symptom burden predicted a stronger association between later time of day and higher smartphone test performance. CONCLUSIONS: These findings support feasibility and validity of repeat smartphone assessments of cognition and provide preliminary evidence of the effects of context on cognitive variability in PD. Further development of this accessible assessment method could increase sensitivity and specificity regarding daily cognitive dysfunction for PD and other clinical populations.Item Introduction to the special issue on comfort: A review of 26 papers from the International Comfort Congress 2019(IOS Press, 2021) Vink, Peter; Frohriep, Susanne; Mansfield, Neil; Naddeo, Alessandro; Jacobs, KarenVarious aspects related to comfort are described in this special issue. Some papers are focused on the environment, like smell, temperature, light, acoustics, space and some on an artefact touching the human, like the floor angle, the seat, a bed and light. However, in this special issue also topics like modelling and behavior get more attention.Item Rehabilitation treatment specification system: identifying barriers, facilitators, and strategies for implementation in research, education, and clinical care(Elsevier BV, 2022-10) Van Stan, Jarrad H.; Holmes, Jain; Wengerd, Lauren; Juckett, Lisa A.; Whyte, John; Pinto, Shanti M.; Katz, Leanna W.; Wolfberg, JeremyItem Study protocol for the implementation of the Gabby Preconception Care System - an evidence-based, health information technology intervention for Black and African American women(Springer Science and Business Media LLC, 2020-12) Walter, Angela Wangari; Julce, Clevanne; Sidduri, Nireesha; Yinusa-Nyahkoon, Leanne; Howard, Jessica; Reichert, Matthew; Bickmore, Timothy; Jack, Brian W.BACKGROUND: Improving the health of women before pregnancy and throughout a woman’s lifespan could mitigate disparities and improve the health and wellbeing of women, infants and children. The preconception period is important for reducing health risks associated with poor maternal, perinatal and neonatal outcomes, and eliminating racial and ethnic disparities in maternal and child health. Low cost health information technology interventions provided in community-based settings have the potential to reach and reduce disparities in health outcomes for socially disadvantaged, underserved and health disparity populations. These interventions are particularly important for Black and African American women who have a disproportionate burden of pregnancy-related complications and infant mortality rates compared to any other racial and ethnic group in the U.S. METHODS: This is a hybrid type II implementation-effectiveness cohort study aimed at evaluating appropriateness, acceptability and feasibility implementation outcomes, while also systematically examining the clinical effectiveness of a preconception care (PCC) intervention, the Gabby System, for Black and African American women receiving health services in community-based sites. The intervention will be implemented in six Community Health Centers and six Healthy Start programs across the U.S. Each study site will recruit and enroll 25–50 young Black and African American women who will participate in the intervention for a 6-month period. Appropriateness, acceptability and feasibility of implementing the PCC intervention will be assessed using: 1) Qualitative data derived from individual interviews with Gabby System end-users (clients and patients) and site staff; and, 2) Quantitative data from staff surveys, Gabby System usage and uptake. Aggregate health risk and utilization measures collected directly from the Gabby server will be used to examine the effectiveness of the Gabby System on self-reported behavior change. DISCUSSION: This study will examine implementation outcomes and clinical effectiveness of an evidence-based PCC intervention for Black and African American women receiving services in Healthy Start programs and Community Health Centers. Contextual factors that influence uptake and appropriate implementation strategies will be identified to inform future scalability of the intervention. TRIAL REGISTRATION: ClinicalTrials.gov NCT04514224. DATE OF REGISTRATION: August 14, 2020. Retrospectively Registered.Item Using diffusion tensor imaging to identify corticospinal tract projection patterns in children with unilateral spastic cerebral palsy.(2017-01) Kuo, Hsing-Ching; Ferre, Claudio L.; Carmel, Jason B.; Gowatsky, Jaimie L.; Stanford, Arielle D.; Rowny, Stefan B.; Lisanby, Sarah H.; Gordon, Andrew M.; Friel, Kathleen M.AIM: To determine whether diffusion tensor imaging (DTI) can be an independent assessment for identifying the corticospinal tract (CST) projecting from the more-affected motor cortex in children with unilateral spastic cerebral palsy (CP). METHOD: Twenty children with unilateral spastic CP participated in this study (16 males, four females; mean age 9y 2mo [standard deviation (SD) 3y 2mo], Manual Ability Classification System [MACS] level I-III). We used DTI tractography to reconstruct the CST projecting from the more-affected motor cortex. We mapped the motor representation of the more-affected hand by stimulating the more- and the less-affected motor cortex measured with single-pulse transcranial magnetic stimulation (TMS). We then verified the presence or absence of the contralateral CST by comparing the TMS map and DTI tractography. Fisher's exact test was used to determine the association between findings of TMS and DTI. RESULTS: DTI tractography successfully identified the CST controlling the more-affected hand (sensitivity=82%, specificity=78%). INTERPRETATION: Contralateral CST projecting from the lesioned motor cortex assessed by DTI is consistent with findings of TMS mapping. Since CST connectivity may be predictive of response to certain upper extremity treatments, DTI-identified CST connectivity may potentially be valuable for determining such connectivity where TMS is unavailable or inadvisable for children with seizures.Item An interprofessional experience: home & community participation in Bogotá, Colombia(2019-10-25) Tamberrino, Lucy; Greenberg, Kimberly; Jacobs, Karen; Khurshid, Rebecca; Múnera, Marcela; Cifuentes, Carlos; Garzón, AndreaBackground: To create and assess the effectiveness of Assistive Technology (AT) devices for mobility, information must be known about the user (client factors and AT preferences), contexts (physical, social, cultural, and institutional), and activity. Objectives: To examine the environmental, social, and client factors that influence participation in home and community environments for adults with ambulatory impairments in Bogotá, Colombia; and to assess the benefits and limitations of the current forms of AT for individuals that use AT for mobility (i.e. canes, walkers, and wheelchairs). Methods: Two questionnaires were completed by 30 individuals with ambulatory impairments (mean age = 44.3 years). Participants were recruited from an outpatient rehabilitation facility in Bogotá, Colombia. Results: The data suggests that the main environmental barriers that individuals with ambulatory impairments experience in the home/community are: stairs, lack of elevators/chairlifts, uneven sidewalks/pathways, lack of curb cuts, and a shortage of accessible public transportation. Additionally, individuals with ambulatory impairments express that they experience some stigma in the community, but overall, find that people in their home/community are willing to help them. Preferences for specific AT components are dependent on the type of AT device and user. Conclusions: When developing or evaluating AT devices in Bogotá, Colombia, occupational therapy practitioners and engineers should take into account the client factors and the physical and social contexts surrounding the AT device user.Item Rasch analysis of the participation scale (P-scale): usefulness of the P-scale to a rehabilitation services network(BIOMED CENTRAL LTD, 2017-12-08) Souza, Mariana Angelica Peixoto; Coster, Wendy Jane; Mancini, Marisa Cotta; Martins Silva Dutra, Fabiana Caetano; Kramer, Jessica; Sampaio, Rosana FerreiraBACKGROUND: A person’s participation is acknowledged as an important outcome of the rehabilitation process. The Participation Scale (P-Scale) is an instrument that was designed to assess the participation of individuals with a health condition or disability. The scale was developed in an effort to better describe the participation of people living in middle-income and low-income countries. The aim of this study was to use Rasch analysis to examine whether the Participation Scale is suitable to assess the perceived ability to take part in participation situations by patients with diverse levels of function. METHODS: The sample was comprised by 302 patients from a public rehabilitation services network. Participants had orthopaedic or neurological health conditions, were at least 18 years old, and completed the Participation Scale. Rasch analysis was conducted using the Winsteps software. RESULTS: The mean age of all participants was 45.5 years (standard deviation = 14.4), 52% were male, 86% had orthopaedic conditions, and 52% had chronic symptoms. Rasch analysis was performed using a dichotomous rating scale, and only one item showed misfit. Dimensionality analysis supported the existence of only one Rasch dimension. The person separation index was 1.51, and the item separation index was 6.38. Items N2 and N14 showed Differential Item Functioning between men and women. Items N6 and N12 showed Differential Item Functioning between acute and chronic conditions. The item difficulty range was −1.78 to 2.09 logits, while the sample ability range was −2.41 to 4.61 logits. CONCLUSIONS: The P-Scale was found to be useful as a screening tool for participation problems reported by patients in a rehabilitation context, despite some issues that should be addressed to further improve the scale.Item Social participation of families with children with autism spectrum disorder in a science museum(Informa UK Limited, 2016-07-02) Lussenhop, Alexander; Mesiti, Leigh Ann; Cohn, Ellen S.; Orsmond, Gael I.; Goss, Juli; Reich, Christine; Osipow, Allison; Pirri, Kayla; Lindgren-Streicher, AnnaThis article describes a qualitative research study undertaken as a collaboration between museum and occupational therapy (OT) researchers to better understand museum experiences for families with a child or children impacted by autism spectrum disorder (ASD). Inclusion for visitors with ASD is an issue that museums are increasingly considering, and the social dimension of inclusion can be particularly relevant for this audience. The construct of social participation, used in OT, provides a promising avenue for museum professionals to think about inclusion. Social participation situates social and community experiences within the context of peoples’ diverse motivations and the strategies they use to navigate environments. This study took these multiple factors into account when observing families’ museum visits—including analysis of their motivations for visiting, environmental features that influenced their visit, family strategies used before and during the visit, and the families’ definitions of a successful visit. Learning more about these factors that are associated with social participation can inform future efforts to improve museum inclusion for families with children with ASD.Item Adult siblings who have a brother or sister with autism: between-family and within-family variations in sibling relationships(SPRINGER/PLENUM PUBLISHERS, 2018-12-01) Orsmond, Gael I.; Fulford, DanielPrior research on the sibling relationship in the context of autism spectrum disorder (ASD) has included only one sibling per family. We used multi-level modeling to examine aspects of the sibling relationship in 207 adults who have a brother or sister with ASD from 125 families, investigating variability in sibling relationship quality and pessimism within and between families. We found that there was greater variability in aspects of the sibling relationship with the brother or sister with ASD within families than between families. Sibling individual-level factors were associated with positive affect in the sibling relationship, while family-level factors were associated with the sibling’s pessimism about their brother or sister’s future. The findings illustrate the unique experiences of siblings within families.Item Parents' future visions for their autistic transition-age youth: hopes and expectations(2018-11-16) Chen, Jennifer; Cohn, Ellen S.; Orsmond, Gael I.Researchers have documented that young adults with autism spectrum disorder have poor outcomes in employment, post-secondary education, social participation, independent living, and community participation. There is a need to further explore contributing factors to such outcomes to better support successful transitions to adulthood. Parents play a critical role in transition planning, and parental expectations appear to impact young adult outcomes for autistic individuals. The aim of this study was to explore how parents express their future visions (i.e. hopes and expectations) for their autistic transition-age youth. Data were collected through focus groups and individual interviews with 18 parents. Parents' hopes and expectations focused on eight primary domains. In addition, parents often qualified or tempered their stated hope with expressions of fears, uncertainty, realistic expectations, and the perceived lack of guidance. We discuss our conceptualization of the relations among these themes and implications for service providers and research.Item Making connections and promoting the profession: social media use by World Federation of Occupational Therapy member organisations(2016) Jacobs, K.; Hamilton, Anita L.; Burwash, Susan C.; Penman, Merrolee; Jacobs, Karen; Hook, Angela; Bodell, Sarah; Ledgerd, Ritchard; Pattison, MarilynBACKGROUND: World Federation of Occupational Therapists (WFOT) member organisations comprise 77 national occupational therapy organisations across the world. Each national organisation interacts with its members and the public using diverse methods. Increasingly, national organisations are broadening their communication methods. OBJECTIVE: The objective of this study was to examine if and how occupational therapy organisations are using social media for communication, and if so, the types of concerns or barriers they experience and what role they anticipate social media might play in the near future. METHODS: An online survey was developed; 57 of 77 WFOT member organisations responded. FINDINGS: This study identified that WFOT national organisations are using social media, to varying degrees, with or without an individual formally assigned to manage social media. Respondents reported that they used social media to: communicate with members, promote the organisation and promote the profession. Commonly expressed needs included assistance with guide- lines for ethical social media use, developing technical expertise, and recognition of limits of time and competing priorities. Recommendations arising from this research are at the global, national, local and individual levels and incorporate active dissemination and pure diffusion approaches. Taking steps to increase the use of social media could indirectly impact occu- pational therapy practice through enhancing organisations’ abilities to support practitioners to enhance their practice. LIMITATIONS AND RECOMENDATIONS FOR FURTHER RESEARCH: Although 57% of WFOT member organisations returned usable responses, there may be some additional perspectives that were not captured. It would be helpful to contact non-responding organisations to explore their social media use and plans. Further research could examine how future initiatives put in place by WFOT impact social media use by member organisations.Item Effects of additional anterior body mass on gait(2016-05-10) Gill, Simone V.; Ogamba, Maureen; Lewis, Cara L.BACKGROUND: Gradual increases in mass such as during pregnancy are associated with changes in gait at natural velocities. The purpose of this study was to examine how added mass at natural and imposed slow walking velocities would affect gait parameters. METHODS: Eighteen adult females walked at two velocities (natural and 25 % slower than their natural pace) under four mass conditions (initial harness only (1 kg), 4.535 kg added anteriorly, 9.07 kg added anteriorly, and final harness only (1 kg)). We collected gait kinematics (100 Hz) using a motion capture system. RESULTS: Added anterior mass decreased cycle time and stride length. Stride width decreased once the mass was removed (p < .01). Added mass resulted in smaller peak hip extension angles (p < .01). The imposed slow walking velocity increased cycle time, double limb support time and decreased stride length, peak hip extension angles, and peak plantarflexion angles (p < .01). With added anterior mass and an imposed slow walking velocity, participants decreased cycle time when mass was added and increased cycle time once the mass was removed (p < .01). CONCLUSIONS: Gait adaptations may be commensurate with the magnitude of additional mass when walking at imposed slow versus natural velocities. This study presents a method for understanding how increased mass and imposed speed might affect gait independent of other effects related to pregnancy. Examining how added body mass and speed influence gait is one step in better understanding how women adapt to walking under different conditions.Item The relationship between foot arch measurements and walking parameters in children(2016-01-23) Gill, Simone V.; Keimig, Sara; Kelty-Stephen, Damian; Hung, Ya-Ching; DeSilva, Jeremy M.BACKGROUND: Walking mechanics are influenced by body morphology. Foot arch height is one aspect of body morphology central to walking. However, generalizations about the relationship between arch height and walking are limited due to previous methodologies used for measuring the arch and the populations that have been studied. To gain the knowledge needed to support healthy gait in children and adults, we need to understand this relationship in unimpaired, typically developing children and adults using dynamic measures. The purpose of the current study was to examine the relationship between arch height and gait in a sample of healthy children and adults using dynamic measures. METHODS: Data were collected from 638 participants (n = 254 children and n = 384 adults) at the Museum of Science, Boston (MOS) and from 18 4- to 8-year-olds at the Motor Development and Motor Control Laboratories. Digital footprints were used to calculate two arch indices: the Chippaux-Smirak (CSI) and the Keimig Indices (KI). The height of the navicular bone was measured. Gait parameters were captured with a mechanized gait carpet at the MOS and three-dimensional motion analyses and in-ground force plates in the Motor Development and Motor Control Laboratories. RESULTS: Linear regression analyses on data from the MOS confirmed that as age increases, step length increases. With a linear mixed effect regression model, we found that individuals who took longer steps had higher arches as measured by the KI. However, this relationship was no longer significant when only adults were included in the model. A model restricted to children found that amongst this sample, those with higher CSI and higher KI values take longer relative step lengths. Data from the Motor Development and Motor Control Laboratories showed that both CSI and KI added to the prediction; children with lower anterior ground reaction forces had higher CSI and higher KI values. Arch height indices were correlated with navicular height. CONCLUSIONS: These results suggest that more than one measure of the arch may be needed elucidate the relationship between arch height and gait.Item Walking to the beat of their own drum: how children and adults meet timing constraints(2015) Gill, Simone V.Walking requires adapting to meet task constraints. Between 5- and 7-years old, children's walking approximates adult walking without constraints. To examine how children and adults adapt to meet timing constraints, 57 5- to 7-year olds and 20 adults walked to slow and fast audio metronome paces. Both children and adults modified their walking. However, at the slow pace, children had more trouble matching the metronome compared to adults. The youngest children's walking patterns deviated most from the slow metronome pace, and practice improved their performance. Five-year olds were the only group that did not display carryover effects to the metronome paces. Findings are discussed in relation to what contributes to the development of adaptation in children.Item The impact of weight classification on safety: timing steps to adapt to external constraints(2015-03) Gill, S.V.OBJECTIVES: The purpose of the current study was to evaluate how weight classification influences safety by examining adults' ability to meet a timing constraint: walking to the pace of an audio metronome. METHODS: With a cross-sectional design, walking parameters were collected as 55 adults with normal (n=30) and overweight (n=25) body mass index scores walked to slow, normal, and fast audio metronome paces. RESULTS: Between group comparisons showed that at the fast pace, those with overweight body mass index (BMI) had longer double limb support and stance times and slower cadences than the normal weight group (all ps<0.05). Examinations of participants' ability to meet the metronome paces revealed that participants who were overweight had higher cadences at the slow and fast paces (all ps<0.05). CONCLUSIONS: Findings suggest that those with overweight BMI alter their gait to maintain biomechanical stability. Understanding how excess weight influences gait adaptation can inform interventions to improve safety for individuals with obesity.Item New version of the Pediatric Evaluation of Disability Inventory (PEDI-CAT): translation, cultural adaptation to Brazil and analyses of psychometric properties(2016-11) Mancini, Marisa C.; Coster, Wendy J.; Amaral, Maíra F.; Avelar, Bruna S.; Freitas, Raphael; Sampaio, Rosana F.BACKGROUND: The Pediatric Evaluation of Disability Inventory-Computer Adaptive Test (PEDI-CAT), developed with innovative measurement methodologies, evaluates functioning of children and youth, from 0 to 21 years, with different health conditions. It is a revision of an earlier instrument (PEDI) that has been used in national and international clinical practice and research. It was felt to be necessary to make this new version (PEDI-CAT) available in Brazil. OBJECTIVES: Translate and culturally adapt the PEDI-CAT to the Brazilian-Portuguese language and test its psychometric properties. METHOD: This methodological study was developed through the following stages: (1) translation, (2) synthesis, (3) back-translation, (4) revision by an expert committee, (5) testing of the pre-final version, and (6) evaluation of the psychometric properties. The 276 translated PEDI-CAT items were divided into three age groups (0-7, 8-14, and 15-21 years). RESULTS: The PEDI-CAT translation followed all six stages. The adaptations incorporated cultural and socioeconomic class specificities. The PEDI-CAT/Brazil showed good indices of inter-examiner (intraclass correlation coefficient-ICC=0.83-0.89) and test-retest (ICC=0.96-0.97) reliability, good internal consistency (0.99) and small standard error of measurement in all three age groups (0.12-0.17). Factor analyses grouped the items from the three functional skills domains into one factor, and items from the responsibility scale into three factors, supporting the adequacy of these factor solutions to the conceptual structure of the instrument and the developmental model. CONCLUSION: The PEDI-CAT/Brazil is a theoretically consistent, culturally appropriate, and reliable instrument. Its availability in Brazil will contribute to the evaluation and measurement of functional outcomes from clinical interventions, longitudinal follow-up, and rehabilitation research.Item Development of a first-contact protocol to guide assessment of adult patients in rehabilitation services networks(2016-01-19) Souza, Mariana A.P.; Ferreira, Fabiane R.; César, Cibele C.; Furtado, Sheyla R.C.; Coster, Wendy J.; Mancini, Marisa C.; Sampaio, Rosana F.OBJECTIVE: This paper describes the development of the Protocol for Identification of Problems for Rehabilitation (PLPR), a tool to standardize collection of functional information based on the International Classification of Functioning, Disability and Health (ICF). DEVELOPMENT OF THE PROTOCOL: The PLPR was developed for use during the initial contact with adult patients within a public network of rehabilitation services. Steps to develop the protocol included: survey of the ICF codes most used by clinical professionals; compilation of data from functional instruments; development and pilot testing of a preliminary version in the service settings; discussion with professionals and development of the final version. The final version includes: user identification; social and health information; brief functional description (BFD); summary of the BFD; and PLPR results. Further testing of the final version will be conducted. CONCLUSIONS: The protocol standardizes the first contact between the user and the rehabilitation service. Systematic use of the protocol could also help to create a functional database that would allow comparisons between rehabilitation services and countries over time.Item The process for the formulation of the international telehealth position statement for occupational therapy(University Library System, University of Pittsburgh, 2015) Jacobs, Karen; Cason, Jana; McCullough, AnnThe World Federation of Occupational Therapists (WFOT) consists of 84 member organizations representing over 420,000 occupational therapists internationally (WFOT, 2014). In 2014, WFOT published the WFOT Telehealth Position Statement on the use of telehealth in occupational therapy. The process for the formulation of the official document involved reviewing WFOT member organizations' telehealth position statements and data collected from a survey sent to member organizations' delegates in April 2014. Qualitative data from 39 countries yielded factors to consider in five key areas: licensure/registration requirements, the cost of technology, privacy and security, reimbursement/payment models, and other issues (e.g., need for collaboration/transfer of knowledge, client selection, provider competencies, standard of care). The WFOT Telehealth Position Statement addressed each of these areas. The collaborative effort resulting in the development of the WFOT Telehealth Position Statement serves as a model for other international organizations.Item Making Connections and Learning Together: A School-Based Program to Promote Social Participation of Students with an Autism Spectrum Disorder(Boston University, 2009) Kirschenbaum, Robin M.