An exploratory study on the role of occupational therapists in home-based rehabilitation team in South Korea.

Introduction: Cooperation among rehabilitation team members is essential in the home-based rehabilitation setting. Q-methodology that can quantitatively analyze the subjectivity of members of the rehabilitation team was used to explore the role of occupational therapists (OTs) in home-based rehabilitation. Methods: The Q-methodology process was implemented in five steps: Step 1 - Representative statements about the role of OTs were collected through in-depth interviews, open questionnaires, and literature reviews (Q-sample); Step 2 - A total of 34 rehabilitation team members (physical therapists, OTs, social workers, nutritionists) were recruited (P-sample); Step 3 - The statements were classified according to their subjective perspective (Q-sort); Step 4 - Factor analysis was performed based on the correlation among the responses from the participants (Q-factor analysis); Step 5 - The awareness factor for roles was interpreted (Interpretation of awareness factors). Results: The roles of OTs perceived by members of the home-based rehabilitation team were formed into five factors (A) Adaptation within home environments; (B) Professional development; (C) Reliable service execution; (D) Client needs resolution; and (E) Focus on activity participation. In all factors, perspectives on the role of OTs in helping clients participate in their roles and activities at home were included. These factors included issues and directions addressed in prior literature on the development of occupational therapy. Conclusions: In home-based rehabilitation, OTs must play a professional role in ensuring clients live fully at home, and cooperate with team members for an effective rehabilitation approach.

Rehabilitation Interventions Combined with Noninvasive Brain Stimulation on Upper Limb Motor Function in Stroke Patients.

(1) Background: This systematic review aimed to focus on the effects of rehabilitation interventions combined with noninvasive brain stimulation on upper limb motor function in stroke patients. (2) Methods: PubMed, MEDLINE, and CINAHL were used for the literature research. Articles were searched using the following terms: "Stroke OR CVA OR cerebrovascular accident" AND "upper limb OR upper extremity" AND "NIBS OR Non-Invasive Brain Stimulation" OR "rTMS" OR "repetitive transcranial magnetic stimulation" OR "tDCS" OR "transcranial direct current stimulation" AND "RCT" OR randomized control trial." In total, 12 studies were included in the final analysis. (3) Results: Analysis using the Physiotherapy Evidence Database scale for qualitative evaluation of the literature rated eight articles as "excellent" and four as "good." Combined rehabilitation interventions included robotic therapy, motor imagery using brain-computer interaction, sensory control, occupational therapy, physiotherapy, task-oriented approach, task-oriented mirror therapy, neuromuscular electrical stimulation, and behavior observation therapy. (4) Conclusions: Although it is difficult to estimate the recovery of upper limb motor function in stroke patients treated with noninvasive brain stimulation alone, a combination of a task-oriented approach, occupational therapy, action observation, wrist robot-assisted rehabilitation, and physical therapy can be effective.

Effects of interactive metronome training on upper extremity function, ADL and QOL in stroke patients.

BACKGROUND: Rhythm and timing training is stimulation that substitutes for a damaged function controls muscular movement or temporal element, which has positive impacts on the neurological aspect and movement of the brain. OBJECTIVE: This study is to assess the changes caused by rhythm and timing training using an interactive metronome (IM) on upper extremity function, ADL and QOL in stroke patients. METHODS: In order to assess the effects of IM training, a group experiment was conducted on 30 stroke patients. Twelve sessions of IM training were provided for the experimental group three times a week for four weeks, while the control group was trained with a Bilateral arm Self-Exercise (BSE) for the same period. Both groups were evaluated by pre- and post-tests through MFT, MAL, K-MBI and SS-QOL. RESULT: There were more statistically significant differences (<0.05) in the total score of MFT and the finger control item in the IM Group than in the BSE Group. With respect to ADL, there were more statistically significant differences (<0.05) in the total score of K-MBI and the dressing item in the IM Group than in the BSE Group. CONCLUSION: The study proposes that IM training can be applied as an occupational therapy program in patients with various diseases who need to adjust the time for performing movements as well as stroke patients.

The effects of balance of low vision patients on activities of daily living.

[Purpose] This research investigated the relationship between balance measured by a TETRAX and activities of daily living (ADL) assessed by NEI-VFQ 25. The results should provide basic data for rehabilitation therapy for low-vision patients. [Methods] We used the NEI-VFQ-25 vision-related Activities of Daily Living evaluation, MMSE-K, and TETRAX to evaluate 30 low-vision outpatients at K hospital in Daejeon, South Korea from July 5 to July 23, 2012. We performed linear regression analysis using a statistical significance level of 0.05. [Results] Balance in the normal eyes open (NO) posture correlated with the normal eyes closed posture and age, but showed no correlation with NEI-VFQ 25. The ADL level correlated with monocular vision, female gender, cognition, and NO posture. These variables explained 54.4% of the aspects of their ADL. [Conclusion] This research proves that low vision adversely affects balance ability, and is influenced by type of vision, gender, and cognitive assessment.

Noninvasive treatment strategy for swallowing problems related to prolonged nonoral feeding in spinal muscular atrophy type II.

A 25-year-old patient with spinal muscular atrophy (SMA) type II was referred due to swallowing problems related to prolonged nonoral feeding. Restriction of jaw movement, neck stiffness, absence of oral food intake, and weakness of the oropharyngeal and laryngeal muscles were considered to be the main factors contributing to the deterioration of his swallowing function. Treatment comprised exercises to improve flexibility of the neck and temporomandibular joint, tactile oral stimulation, passive and active oropharyngolaryngeal exercises, and supraglottic swallowing maneuvers. Treatment was performed for 30 min per day, three times a week, for 7 months. On initial videofluoroscopic examination, the patient was unable to safely tolerate any per-oral nutrition. After 7 months of treatment, the patient's swallowing function had improved to the extent that he was able to resume oral intake of food under supervision, and aspiration was no longer evident. These findings suggest that noninvasive treatment is a possible strategy for enhancing the swallowing function of a patient with SMA type II presenting with swallowing difficulties related to prolonged nonoral feeding.