Effects of Occupational Therapy Practice on Patient Outcomes after High Tibial Osteotomy: A Non-randomized Study in Japan.

We examined the effectiveness of occupational therapy intervention combined with standard rehabilitation in patients undergoing high tibial osteotomy (HTO). Overall, 115 patients with HTO for knee osteoarthritis were examined. An intervention group (n = 50), who received occupational therapy and standard rehabilitation, was compared to a control group (n = 65), who underwent standard rehabilitation only (n = 65). Compared with the control group, the intervention group had significantly lower Hospital Anxiety and Depression Scale depression and anxiety scores (both p < 0.05), with between-group differences showing large- and medium-effect sizes, respectively (d = 1.06 and 0.61). Results suggest occupational therapy with rehabilitation during hospitalization improves depression and anxiety rates in patients post-HTO.

Combining goal setting and achievement with occupational therapy to improve pain, psychological factors and physical activity in patients after high tibial osteotomy: A non-randomized controlled study.

BACKGROUND: Psychological factors contribute to chronic pain and may lead to physical inactivity and poor functional outcomes. PURPOSE: We conducted a non-randomized controlled study to evaluate the effectiveness of goal setting and achievement following occupational therapy (OT) intervention to improve pain, psychological factors, and physical activity among patients after high tibial osteotomy (HTO). METHOD: We analyzed the data of 31 patients who underwent HTO, allocated into OT intervention and control groups. Goal achievement was encouraged through OT in the intervention groups; the control groups did not receive OT intervention. Outcome measures included the Canadian Occupational Performance Measure (COPM) score (before and after the OT intervention), walking pain, pain catastrophizing, anxiety, depression, pain self-efficacy, and physical activity level. RESULTS: OT significantly improved the COPM score, depression, and physical activity. At the final assessment, the depression score was lower while the step count and physical activity time were significantly higher in the intervention group than in the control group (p < 0.05). CONCLUSION: Embedding goal setting and achievement as part of an OT intervention improved the outcomes after HTO.

The mediating effect of psychological factors on the relationship between pain intensity and wrist joint function: a longitudinal study with mediation analysis.

PURPOSE: Psychological factors and pain intensity are associated with wrist function. However, the mediating role of psychological factors in the relationship between pain intensity and wrist function in distal radius fractures remains unclear. We performed mediation analysis to investigate how psychological factors mediate the relationship between pain intensity and wrist function. METHODS: Twenty-one patients with distal radius fractures were included in this longitudinal study. Patient-rated wrist evaluation, one pain intensity-related outcome measure (numerical rating scale), and three psychological outcome measures (pain catastrophizing scale, hospital anxiety and depression scale, and pain self-efficacy questionnaire) were assessed. The mediation analysis with a bootstrap sampling procedure was used to assess indirect effects. The level of significance was set at 5%. RESULTS: Mediation analysis showed that the pain intensity, as measured by patient-rated wrist evaluation, had significant indirect effects on the hospital anxiety and depression scale-anxiety (95% bootstrapped confidence interval: 0.96-9.62) and pain self-efficacy questionnaire (95% bootstrapped confidence interval: 0.43-8.11) scores. CONCLUSIONS: The relationship between pain intensity and wrist function was mediated by anxiety and self-efficacy. Our findings suggest that interventions focused on psychological factors, particularly anxiety and self-efficacy, may be important in distal radius fractures rehabilitation.IMPLICATIONS FOR REHABILITATIONIn patients with distal radius fractures, early post-operative pain mediates psychological factors and affects wrist function.Anxiety and self-efficacy are psychological factors that should be noted, and rehabilitation, including self-management, should be considered.Rehabilitative interventions for distal radius fractures should focus on psychological factors and management of post-operative pain.

Effects of using activity diary for goal setting in occupational therapy on reducing pain and improving psychological and physical performance in patients after total knee arthroplasty: A non-randomised controlled study.

BACKGROUND: Psychological factors have been reported to affect chronic pain and may lead to inactivity after total knee arthroplasty. This study aimed to determine whether the use of an activity diary for goal setting during occupational therapy would reduce pain, and improve psychological and physical performance in patients after total knee arthroplasty. METHODS: A total of 41 total knee arthroplasty participants from two cohorts were recruited in the study and allocated by convenience to either the experimental group using an activity diary (n = 20) or the control group (n = 21). Occupational therapy intervention (1-2 weeks postoperatively) to promote goal achievement was performed in both groups, and self-monitoring was performed in the diary group by using the activity diary. The outcome indices were Canadian Occupational Performance Measure, pain (resting pain, walking pain), pain catastrophizing (rumination, helplessness, and magnification), anxiety, depression, pain self-efficacy, and physical activity level. Data were evaluated by using analysis of variance analyses with post hoc tests. RESULTS: A time-by-group interaction emerged for Canadian Occupational Performance Measure, walking pain, pain catastrophizing, anxiety, depression, and physical activity level (p < 0.05), both favouring the diary group. The diary group also showed greater improvement in Canadian Occupational Performance Measure, walking pain, anxiety, and physical activity levels at four weeks postoperatively, compared to the control group (p < 0.05). CONCLUSION: The use of the activity diary in this study increased occupational therapy effectiveness, reduced patients' pain, and prevented a decline in physical performance. We believe that the use of an activity diary is an effective and feasible addition for total knee arthroplasty patients.

Relationship between frontal assessment battery scores and activities of daily living/instrumental activities of daily living ability in older adults.

[Purpose] The present study aimed to investigate the relationship between Frontal Assessment Battery scores and the ability to perform activities of daily living/instrumental activities of daily living based on child development, as well as the ability of Frontal Assessment Battery score to predict functional age. [Participants and Methods] The present cross-sectional study included 85 older adults (mean age: 83.5 years, standard deviation: 7.3; men: 23, women: 62; facility-dwelling: 43, home-based: 42) recruited from nursing homes and day centers in Hiroshima and Hyogo, Japan. All the participants were assessed using the Frontal Assessment Battery and perform activities of daily living/instrumental activities of daily living Cognitive Level Version 2.0 scale (ADL/IADL-COG ver.2.0). Spearman rank correlation coefficients and single regression analyses were performed to determine the relationship between the Frontal Assessment Battery score and functional age. The regression equation was then used to predict functional age based on the Frontal Assessment Battery score. [Results] We observed a strong correlation between the Frontal Assessment Battery score and functional age (rs=0.80). Furthermore, the linear regression equation for functional age exhibited a high predictive accuracy (R 2=0.64). Our results thus indicated that Frontal Assessment Battery scores could be used to predict functional age according to the following equation: functional age (years)=0.56 × Frontal Assessment Battery score + 1.19 and Frontal Assessment Battery score=1.15 × functional age (years) + 1.86. [Conclusion] The present results indicate a significant relationship between Frontal Assessment Battery and perform activities of daily living/instrumental activities of daily living ability based on child development. Functional age, as predicted based on the Frontal Assessment Battery score, may aid rehabilitation practitioners in analyzing the relationship between cognitive function and perform activities of daily living/instrumental activities of daily living ability, setting goals regarding perform activities of daily living/instrumental activities of daily living, and selecting intervention targets in older adults.