Standards of Practice for Occupational Therapy

This document defines minimum standards for the practice of occupational therapy. According to the Occupational Therapy Practice Framework: Domain and Process (4th ed.; OTPF–4), occupational therapy is defined as the therapeutic use of everyday life occupations with persons, groups, or populations (i.e., the client) for the purpose of enhancing or enabling participation. . . . Occupational therapy services are provided for habilitation, rehabilitation, and promotion of health and wellness for clients with disability- and non–disability-related needs. These services include acquisition and preservation of occupational identity for clients who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. (American Occupational Therapy Association [AOTA], 2020c, p. 1)

Effects of virtual reality in improving upper extremity function after stroke: A systematic review and meta-analysis of randomized controlled trials

Objective To investigate the effect of virtual reality on arm motor impairment, activity limitation, participation restriction, and quality of life in patients with stroke. To determine potential moderators that affect the efficacy of virtual reality. Data sources CINAHL, Medline, PubMed, EMBASE, Cochrane Library, Chinese National Knowledge Infrastructure, and Wanfang Data from inception to October 23, 2021. Review methods Randomized controlled trials that investigated the effect of virtual reality on arm recovery in adult patients with stroke compared to conventional therapy or sham control were included. Physiotherapy Evidence Database Scale was used to assess the methodological quality of each study. Results Forty studies with 2018 participants were identified. Quality of included studies was fair to high. Virtual reality exhibited better effects on overall arm function ( g = 0.28, p < 0.001), motor impairment ( g = 0.36, p < 0.001) and activity limitation (daily living) ( g = 0.24, p < 0.001) compared with the control group. No significant improvement was observed in participation restriction and activity limitation (specific task). The result for quality of life was described qualitatively. Subgroup analyses demonstrated that immersive virtual reality produced a greater beneficial effect ( g = 0.60, p < 0.001). Patients with moderate to severe arm paresis could make more progress after training ( g = 0.71, p < 0.001). Conclusion Virtual reality is recommended for improving motor impairment and activities of daily living after stroke and is favorable to patients with moderate to severe paresis. An immersive design could produce greater improvement.

Does the global activity limitation indicator measure participation restriction? Data from the European Health and Social Integration Survey in Spain

Purpose The global activity limitation indicator (GALI) is the only internationally agreed and harmonised participation restriction measure. We examine if GALI, as intended, is a reflective measure of the domains of participation; furthermore, we determine the relative importance of these domains. Also, we investigated the consistency of response to GALI by age and gender and compared the performance of GALI with that of self-rated health (SRH). Methods We used Spanish data from the European Health and Social Integration Survey and selected adults aged 18 and over (N = 13,568). Data analysis, based on logistic regression models and Shapley value decomposition, were also stratified by age. The predictors of the models were demographic variables and restrictions in participation domains: studies, work, mobility, leisure and social activities, domestic life, and self-care. The GALI and SRH were the response variables. Results GALI was strongly associated with all participation domains (e.g. for domestic life, adjusted OR 24.34 (95% CI 18.53–31.97) in adult under 65) and performed differentially with age (e.g. for domestic life, adjusted OR 13.33 (95% CI 10.42–17.03) in adults over 64), but not with gender. The relative importance of domains varied with age (e.g. work was the most important domain for younger and domestic life for older adults). The results with SRH were parallel to those of GALI, but the association of SRH with participation domains was lowest. Conclusions GALI reflects well restrictions in multiple participation domains and performs differently with age, probably because older people lower their standard of good functioning.

Predictors of Participation Restriction in Midlife Caregivers: An Exploratory Study

Mid-life family caregivers (CGs) are at risk for participation restrictions (reduced engagement in valued roles and activities) due to competing demands of work, parenting, and family caregiving responsibilities. When CGs experience participation restrictions, quality of care for care recipients (CR) decreases, yet CG burden and risk for poor health increases. The purpose of this study was to identify the factors contributing to decreased participation in mid-life CGs. Participants were CGs aged 45-64 years (n = 677) from the National Study of Caregiving/National Health and Aging Trends Study. We used multivariate logistic regression to determine attributes of CGs, CRs, and the care situation that independently contribute to participation restrictions. We found that negative aspects of caregiving (OR = 1.51, 95% CI = 1.33, 1.71) and CR depression and anxiety (OR = 0.90, 95% CI = 0.83, 0.99) significantly predicted participation restrictions (p &lt; 0.05). Positive aspects of care (OR = 0.87, 95% CI = 0.74, 1.01), frequency of helping with chores (OR = 1.30, 95% CI = 0.98, 1.70), frequency of providing personal care (OR = 1.24, 95% CI = 0.97, 1.59), and frequency of providing help getting around the home (OR = 1.30, 95% CI = 0.97, 1.75) showed trends for association with participation restrictions (p &lt; 0.10). We identified factors that are related to participation restriction in mid-life CGs. Some of these factors (e.g., positive and negative aspects of caregiving, frequency of assistance provided) are potentially modifiable intervention targets that could bolster participation in this at-risk group.

Utility of the Late Life Function and Disability Instrument (LLFDI) in rehabilitation services for older adults

Introduction The Late Life Function and Disability Instrument (LLFDI) is a valid self-report tool that quantifies disability based on activity limitations and participation restrictions in everyday life. Both the original longer tool (LLFDI) and the shorter computer adaptive version (LLFDI-CAT) offer practitioners a method for measuring function independent or in conjunction with performance-based assessment. Objectives: Examine scores of the LLFDI and LLFDI-CAT for measuring disability in older adults who are receiving rehabilitation services in community and institution settings. Method: A secondary data analysis was conducted comparing scores from occupational therapy evaluations with older adults from 3 groups: 1) older adults in primary care using the LLFDI; 2) older adults in primary care using the LLFDI-CAT; older adults in a skilled nursing facility (SNF) using the LLFDI-CAT. Results Mean scores for Activity Limitation and Participation Restriction were lowest for older adults in a SNF indicating greater disability. A one-way Analysis of variance on ranks showed a main effect for Activity Limitation, χ2 (2) = 22.267, p &lt; 0.001, and Participation Restriction, χ2 (2) = 60.372, p &lt; 0.001. Post-hoc analyses revealed significant differences between groups based on tool (i.e. LLFDI vs. LLFDI-CAT) for Activity Limitations and setting (i.e. primary care vs. SNF) for Participation Restriction. Conclusion The LLFDI-CAT may be the preferred instrument to measure disability in older adults across treatment settings. Additional research is warranted to understand how personal and environmental factors influence LLFDI-CAT outcomes.

Is it possible to sort the disability of individuals with migraine based on the International Classification of Functioning, Disability and Health? — A Scoping Review

PurposeTo identify the most frequent outcomes related to disability assessed in individuals with migraine and to correlate these findings with the categories of International Classification of Functioning, Disability and Health.Material and methodThis scoping review was developed based on studies with adult population (18-55 years) of both sexes and assessing the disability generated by migraine. We included studies in which patients had a diagnosis of migraine based on International Classification of Headache Disorders.Results52 articles were found with 42 outcomes related to 17 categories of International Classification of Functioning, Disability and Health, including the four main components of the classification, with seven categories in "Body Functions", one in "Body Structures", four in “Activities and Participation” and five in "Environmental Factors".ConclusionThe findings show that disabilities, activity limitation, or participation restriction generated by migraine can be classified by International Classification of Functioning, Disability and Health. The components "body functions", "environmental factors" and "activities and participation" were the most identified in the present study. Thus, this classification is important to classify the disability caused by migraine and to guide a rehabilitation more focused onthe patient's real demands, as well as directing the research involving this population.

Neuroimaging risk factors for participation restriction after acute ischemic stroke: 1-year follow-up study

The aim of the present study was to determine the neuroimaging predictors of poor participation after acute ischemic stroke. A total of 443 patients who had acute ischemic stroke were assessed. At 1-year recovery, the Reintegration to Normal Living Index was used to assess participation restriction. We also assessed the Activities of Daily Living Scale and modified Rankin Scale (mRS) score. Brain MRI measurement included acute infarcts and pre-existing abnormalities such as enlarged perivascular spaces, white matter lesions, ventricular-brain ratio, and medial temporal lobe atrophy (MTLA). The study included 324 men (73.1%) and 119 women (26.9%). In the univariate analysis, patients with poor participation after 1 year were older, more likely to be men, had higher National Institutes of Health Stroke Scale (NIHSS) score on admission, with more histories of hypertension and atrial fibrillation, larger infarct volume, more severely enlarged perivascular spaces and MTLA, and more severe periventricular hyperintensities and deep white matter hyperintensities. Patients with participation restriction also had poor activities of daily living (ADL) and mRS score. Multiple logistic regression showed that, in model 1, age, male gender, NIHSS score on admission, and ADL on follow-up were significant predictors of poor participation, accounting for 60.2% of the variance. In model 2, which included both clinical and MRI variables, male gender, NIHSS score on admission, ADL on follow-up, and MTLA were significant predictors of poor participation, accounting for 61.2% of the variance. Participation restriction was common after acute ischemic stroke despite good mRS score. Male gender, stroke severity, severity of ADL on follow-up, and MTLA may be predictors of poor participation.Trial registration number ChiCTR1800016665.

PEMBERDAYAAN YAYASAN DISABILITAS BHAKTI SENANG HATI DALAM MENINGKATKAN PENDAPATAN DI DESA SIANGAN GIANYAR

<p><strong><em>Abstract.</em></strong> <em>Difabel or disability is a term that includes interference, activity limitations, and participation restrictions. A disorder is a problem with the body's function or structure; An activity limitation is a difficulty faced by an individual in carrying out a task or action, while a participation restriction is a problem experienced by an individual in involvement in life situations. So disability is a complex phenomenon, reflecting the interaction between the characteristics of a person's body and the characteristics of the society in which he or she lives. This community partnership program aims to increase partners' entrepreneurial motivation and provide skills in the use of internet media to support product marketing functions in the form of proactive marketing strategies in order to increase life independence. The methods used in this service are: lectures, question and answer discussions, and demonstration methods for online marketing training programs. The result of this activity is that participants in this case people with disabilities who are under the Bhakti Happy Hati</em><em> </em><em>Gianyar Foundation are very enthusiastic about listening to counseling related to literacy and motivation to increase the entrepreneurial spirit and understand using social media applications as online marketing as an effort to increase life independence</em><em>.</em><em></em></p><p> </p><p><strong><em> </em></strong></p><p><strong>Abstrak.</strong> Difabel atau disabilitas adalah istilah yang meliputi gangguan, keterbatasan aktivitas, dan pembatasan partisipasi. Gangguan adalah sebuah masalah pada fungsi tubuh atau strukturnya; suatu pembatasan kegiatan adalah kesulitan yang dihadapi oleh individu dalam melaksanakan tugas atau tindakan, sedangkan pembatasan partisipasi merupakan masalah yang dialami oleh individu dalam keterlibatan dalam situasi kehidupan. Jadi disabilitas adalah sebuah fenomena kompleks, yang mencerminkan interaksi antara ciri dari tubuh seseorang dan ciri dari masyarakat tempat dia tinggal. Program kemitraan masyarakat ini bertujuan untuk meningkatkan motivasi kewirausahaan mitra serta memberikan keterampilan dalam penggunaan media internet untuk menunjang fungsi pemasaran produk berupa strategi pemasaran yang proaktif agar dapat meningkaatkan kemandirian hidup. Metode yang digunakan dalam pengabdian ini adalah: ceramah, tanya jawab diskusi, dan metode demonstrasi untuk program pelatihan pemasaran online. Hasil kegiatan ini adalah peserta dalam hal ini penyandang disabilitas yang bernaung dibawah Yayasan Bhakti Senang Hati Gianyar sangat antusias mendengarkan penyuluhan berkaitan dengan literasi dan motivasi untuk meningkatkan jiwa kewirausahaan serta memahami menggunakan aplikasi media sosial sebagai pemasaran online sebagai upaya untuk meningkatkan kemandirian hidup.</p><br /><div id="gtx-trans" style="position: absolute; left: 425px; top: 464px;"> </div>

Comments on dysfunction, activity limitations, participation restriction and contextual factors in South African women with pelvic organ prolapse

No abstract available.