[Effects of a multimodal inpatient treatment for patients with fibromyalgia syndrome at the Rhineland-Palatinate Acute Rheumatology Center]. / Effekte einer multimodalen stationären Behandlung bei PatientInnen mit Fibromyalgiesyndrom im Akut-Rheumazentrum Rheinland-Pfalz.

INTRODUCTION: Fibromyalgia syndrome (FMS) is a complex condition that is often refractory to therapy and is associated with impaired quality of life. In some studies, multimodal rheumatological treatment has been shown to be an effective therapy option for patients with systemic-inflammatory and degenerative rheumatic diseases. However, the effects of this therapeutic approach have not been sufficiently investigated in patients with FMS. Therefore, the aim of this study was to examine the effect of a concise 9­ to 10-day inpatient multimodal fibromyalgia treatment (MFT) using patient-reported outcomes in a German cohort. METHODS: The effects of MFT were assessed using visual analog scales (VAS) for pain (P) and subjective disease activity (DA), questionnaires measuring everyday functional capacity (Health Assessment Questionnaire [HAQ], Funktions-Fragebogen-Hannover [FFbH, Hannover Functional Ability Questionnaire]), and pharmacotherapy at three time points (Visit 1: beginning of multimodal therapy, Visit 2: end of MFT, and Visit 3: 3 months after Visit 2). RESULTS: Sixty-one patients were enrolled in the study at the Rhineland-Palatinate Acute Rheumatology Center. Under MFT, a significant improvement in VAS (P) and VAS (DA) was observed between the start and end of treatment (Visit 2 versus Visit 1: median decrease from 7 to 5, p < 0.001, for both VAS [P] and VAS [DA]). Additionally, comparison of the other two assessment points showed a change in VAS (P) (Visit 3 versus Visit 1: median decrease from 7 to 6, p = 0.041, and Visit 3 versus Visit 2: median increase from 5 to 6, p = 0.004). However, there were no significant differences in FFbH and HAQ parameters among the three visits. Examination of the subgroup of patients whose medication therapy was not intensified during hospitalization also showed significant improvements in VAS (P) and VAS (DA) between the start and end of MFB (Visit 2 versus Visit 1: median decrease from 7 to 4, p < 0.001, for VAS [P] and median decrease from 6.25 to 4, p = 0.002, for VAS [DA]). CONCLUSION: These findings indicate a demonstrable benefit to patients of MFT regarding both pain and subjective disease activity. Furthermore, pain relief was even observed 3 months after the end of therapy. This shows the high value of this therapeutic approach to treating patients with FMS.

Beyond breast cancer: An exploration of the experiences of middle-aged female breast cancer survivors in Australia.

OBJECTIVES: Middle-aged women (i.e., aged 40-65 years) who live with, through and beyond breast cancer (survivors) are an under-researched population, particularly within an Australian context. The unmet needs reported within this population include fatigue, psychological distress, body image concerns, early-onset menopause, and a lack of information on these issues. This study explores how the experiences of breast cancer survivorship impact the lives of Australian middle-aged women. STUDY DESIGN: Qualitative analysis of written comments in an open text field of a survey completed by 644 women reporting breast cancer in the middle-aged cohort of the Australian Longitudinal Study of Women's Health gathered between 1996 and 2013. Data was collected from any participants who reported breast cancer in any survey. Researchers conducted a thematic analysis using consensus coding on data and identified key themes. MAIN OUTCOME MEASURES: Any data where participants described their experiences of breast cancer survivorship. RESULTS: This cohort reported a unique experience of breast cancer survivorship due to their age group. Analysis developed the following themes: the middle-aged context of breast cancer; care and support, body changes, overcoming fears and maintaining balance; and finding a 'new normal'. CONCLUSIONS: Breast cancer survivorship is a diverse experience. For many it involves chronic limitations and challenges. Investigation and application of survivorship care plans in Australia could benefit breast cancer survivors by including multidisciplinary health professionals in their care. Unmet needs and psychological distress were described by participants rather than biomedical concerns. Further recommendations include development of online support groups providing access to rehabilitation professionals, especially for otherwise isolated rural women.

Smooth Return to Work Through Early Rehabilitation and Interdisciplinary Collaboration After Ostomy: A Case Report of a Japanese Patient.

A male patient in his 40s was diagnosed with rectal cancer and underwent abdominoperineal resection (APR) with permanent end colostomy as surgical treatment. He wanted to return to work as soon as possible after discharge. A physical therapist (PT) was involved in the preoperative consultation, and both the PT and occupational therapist started bed rest and activities of daily living (ADL) practice the day after surgery. On the third postoperative day, lightweight trunk exercises were initiated with a gradual increase in load. Stoma management was supervised by a nurse and progress was monitored. The patient's progress in ADLs, postoperative complications, and return to work were evaluated two weeks after discharge. Consequently, the patient was able to continue rehabilitation without early complications related to postoperative stoma. He could lift 20 kg and return to carpentry two weeks after discharge. The stoma quality of life improved from 61 points at two weeks after surgery to 74 points at two weeks after discharge. Early rehabilitation for social reintegration after ostomy creation can be safely performed under PT supervision, and a comprehensive interprofessional collaboration can contribute to smooth social reintegration.

Clinical and Cognitive Characteristics Associated with the Onset of Delirium in Postoperative Cardiovascular Surgery Patients Admitted to the ICU.

Objectives: Occupational therapy (OT) studies of delirium have attempted to test the effectiveness of interventions to reduce the incidence and duration of delirium. Although some cognitive stimulation appears to be important, appropriate approaches to delirium characterized by cognitive dysfunction remain unclear. This study aimed to determine the incidence and duration of delirium in postoperative cardiovascular surgery patients at the initial time of OT to identify characteristics of patient demographics and cognitive function according to the presence or absence of delirium. Methods: This retrospective study included patients judged to have delirium by the Confusion Assessment Method at the first postoperative OT session (after extubation) in the intensive care unit (ICU). Patient data included age, sex, days until extubation, type of hospitalization, outcome at discharge, Sequential Organ Failure Assessment score and Glasgow Coma Scale (GCS) score at the first OT session, presence or absence of delirium, duration of delirium, and Mini-Mental State Examination-Japanese (MMSE-J) score. The Mann-Whitney U test was used to test differences between the delirium and the non-delirium groups, and a binomial generalized linear model (logistic regression model) with Bayesian estimation was adopted to investigate factors characterizing delirium. Results: A Bayesian logistic regression model with delirium as the dependent variable and "days until extubation" and "spatial orientation" as adjustment variables suggested that "spatial orientation" was a significant factor in delirium. Conclusions: For ICU patients with delirium, the provision of information tailored toward spatial orientation during the first day of OT may improve delirium.

El sueño de llagar a ser futbolista. Reflexiones disciplinares para una Terapia Ocupacional híbrida / The dream of becoming a footballer. Disciplinary reflections for a hybrid Occupational Therapy / O sonho de tornar-se um jogador de futebol. Reflexões disciplinares para uma Terapia Ocupacional híbrida

El giro gradual que la Terapia Ocupacional ha tenido, desde posiciones teórico-metodológicas radicadas en las ciencias naturales hacia otras situadas en las ciencias sociales, ha propiciado diversos debates en la disciplina. Uno de los aspectos que se pone en cuestión, se refiere a las formas de comprender al otro, lo que a su vez deriva en métodos específicos de relación para generar conocimiento. Esto ha llevado a reconfigurar un marco epistémico, entendido como un conjunto interconectado de principios que subyacen a la investigación científica y a la propia práctica profesional. Tomando como inspiración una investigación etnográfica que tuvo lugar en la ciudad de Mar del Plata, Argentina, con cuatro clubes infantiles de fútbol, este texto presenta una reflexión acerca de las potencialidades de lo que aquí se denomina Terapia Ocupacional híbrida, como síntesis productiva entre su especificidad disciplinar y profesional y los aportes teóricos y metodológicos de la Antropología Social. Este ejercicio se torna en un llamado al encuentro de saberes que trascienda las fronteras académicas y disciplinares, produzca o alimente nuevos campos de actuación profesional o fortalezca los existentes.

The gradual shift in Occupational Therapy from theoretical-methodological positions rooted in the natural sciences to those situated in the social sciences has sparked various debates within the field. One of the aspects that is questioned refers to the ways of understanding others, which in turn leads to specific methods of relationship to generate knowledge. This has resulted in the reconfiguration of an epistemic framework, understood as an interconnected set of principles underlying scientific research and professional practice itself. Inspired by an ethnographic study conducted in the city of Mar del Plata, Argentina, with four junior football teams, this text presents a reflection on the potentialities of what is here referred to as hybrid Occupational Therapy, a productive synthesis between its disciplinary and professional specificity and the theoretical and methodological contributions of Social Anthropology. This exercise becomes a call for the convergence of knowledge that transcends academic and disciplinary boundaries, produces or nurtures new fields of professional action, or strengthens existing ones

A virada gradual na Terapia Ocupacional, das posições teórico-metodológicas radicadas nas ciências naturais para outras situadas nas ciências sociais, tem promovido diversos debates na disciplina. Um dos aspectos que é questionado refere-se às formas de compreender o outro, o que por sua vez resulta em métodos específicos de relação para produzir conhecimento. Isso levou a uma reconfiguração de um quadro epistêmico, entendido como um conjunto interconectado de princípios que fundamentam a pesquisa científica e a própria prática profissional. Inspirado por uma pesquisa etnográfica realizada na cidade de Mar del Plata, Argentina, com quatro clubes de futebol infantil, este texto apresenta uma reflexão sobre as potencialidades do que aqui se denomina Terapia Ocupacional híbrida, como síntese produtiva entre sua especificidade disciplinar e profissional, além das contribuições teóricas e metodológicas da Antropologia Social. Este exercício torna-se um chamado para a convergência de saberes que transcenda as fronteiras acadêmicas e disciplinares, produza ou alimente novos campos de atuação profissional ou fortaleça os já existentes

"Sin reconocer la historicidad de la comunidad y la propia, no se puede hacer trabajo en y con la comunidad": Entrevista a Lucía Vivanco en sus cuarenta años de ejercicio profesional en Chile / "Without recognizing the community and one's own historicity, work cannot be done in and with communities": Interview with Lucía Vivanco based on her forty years of professional practice in Chile / "Sem reconhecer a historicidade da comunidade e a própria, o trabalho não pode ser feito nas e com as comunidades": entrevista com Lucía Vivanco, em seus quarenta anos de prática profissional no Chile

Lucía Vivanco Muñoz es terapeuta ocupacional, egresada de la Universidad de Chile en 1983 y una de las primeras en incursionar en la Terapia Ocupacional social y comunitaria en Chile. En esta entrevista, realizada por su colega Débora Grandón, analiza el desarrollo de la Terapia Ocupacional social y comunitaria a través de su incursión, a finales de la década de 1980 y durante los años 90, en áreas no tradicionales de la Terapia Ocupacional, como el acompañamiento a personas viviendo con VIH-SIDA, la desinstitucionalización de niñeces vulneradas y la reinserción en sus familias y comunidades. También, colaboró en el diseño de políticas públicas para la superación de la pobreza desde el Estado chileno y en otros países, en su rol de consultora para el Banco Mundial. Actualmente, es académica de la Escuela de Terapia Ocupacional en la Universidad de Santiago de Chile -USACH. Esta experiencia como iniciadora de áreas de práctica hoy instituidas en el ejercicio de la profesión tiene un relevante valor histórico y constituye un aporte significativo al desarrollo de estos campos y a la formación de nuevas generaciones.

Lucía Vivanco Muñoz is an occupational therapist who graduated from the University of Chile in 1983 and is one of the pioneers in the development of a social and community Occupational Therapy in Chile. In this interview, conducted by her colleague Débora Grandón, she analyzes the development of a social and community Occupational Therapy throughout her involvement at the end of the 1980s and during the 1990s in non-traditional areas such as accompanying people living with HIV/AIDS, the deinstitutionalization of vulnerable children, and their reintegration into their families and communities. She also participated in designing public policies for overcoming poverty within the Chilean government and other countries in her role as a consultant for the World Bank. She is currently an academic at the School of Occupatio-nal Therapy at the University of Santiago de Chile -USACH. This experience as an initiator of areas of practice established today in the exercise of the profession has a relevant historical value and constitutes a significant contribution to the development of these fields and the training of new generations

Lucía Vivanco Muñoz é terapeuta ocupacional, formada pela Universidade do Chile em 1983, e uma das primeiras a se aventurar na Terapia Ocupacional social e comunitária no Chile. Nesta entrevista, conduzida por sua colega Débora Grandón, se analisa o desenvolvimento da Terapia Ocupacional social e comunitária por meio de sua incursão no final dos anos 80 e durante os anos 90, em áreas não tradicionais da Terapia Ocupacional, como o acompanhamento de pessoas vivendo com HIV-AIDS, a desinstitucionalização de crianças em situação de vulnerabilidade e a reintegração em suas famílias e comunidades. Além disso, colaborou no desenho de políticas públicas para a superação da pobreza no Estado chileno e em outros países, atuando como consultora para o Banco Mundial. Atualmente, é professora na Escola de Terapia Ocupacional da Universidade de Santiago do Chile - USACH. A experiência da professora como pioneira em áreas de prática, hoje instituídas no exercício da profissão, tem um valor histórico relevante e constitui uma contribuição significativa para o desenvolvimento desses campos e para a formação de novas gerações

Diseño y validación de contenido, por juicio de expertos, de un instrumento para la caracterización laboral y productiva de población con discapacidad visual / Design and content validation by expert judgment of an instrument for the labor and productive characterization of the visually impaired population / Desenho e validação de conteúdo, pela avaliação de especialistas, de um instrumento para a caracterização laboral e produtiva da população com deficiência visual

En Colombia, las tasas de empleo de la población con discapacidad visual están por debajo de las de la población general; sus ingresos también tienden a ser más bajos. Orientar los procesos de inclusión laboral se dificulta por la ausencia de instrumentos adecuados que permitan caracterizar e identificar sus necesidades. Se presenta un estudio dirigido a diseñar y validar el contenido de un instrumento para la caracterización laboral y productiva de esta población. A partir de la experiencia del Instituto Nacional para Ciegos, se diseñó una primera versión que fue sometida a validación de contenido con tres expertos que evaluaron su claridad, coherencia, relevancia y suficiencia, además de aportar observaciones y sugerencias. Se realizaron dos rondas de evaluación. Se estimó el grado de concordancia de las evaluaciones con el Coeficiente Kappa de Fleiss y se consideraron los aportes para ajustar el instrumento. Se obtuvo una versión final con 47 ítems en tres dimensiones: información general, académica y laboral, y productiva. El diseño, validación e implementación del instrumento reúne esfuerzos de la academia y el Estado para caracterizar a la población con discapacidad visual en diferentes ciudades del país y aportar a la reducción de las brechas de empleo e ingresos.

In Colombia, employment rates of the visually impaired population are below those of the general population, and their income also tends to be lower. The absence of adequate instruments to characterize and identify their needs makes orienting labor inclusion processes difficult. A study aimed at designing and validating the content of an instrument for the labor and productive characterization of this population is presented. Based on the experience of the Instituto Nacional para Ciegos (National Institute for the Blind), a first version was designed and submitted for content validation by three experts who assessed its clarity, coherence, relevance, and completeness and provided comments and suggestions. Two rounds of evaluation were carried out. The degree of consistency of the evaluations was estimated with the Fleiss Kappa Coefficient. Contributions were considered to adjust the instrument. A final version was obtained with 47 items in three dimensions: general, academic and employment, and productive information. The instrument's design, validation and implementation combine the efforts of academia and the State to characterize the visually impaired population in different cities of the country and contribute to the reduction of employment and income gaps.

Na Colômbia, as taxas de emprego da população com deficiência visual são inferiores às taxas da população em geral; sua renda também tende a ser menor. A orientação dos processos de inclusão laboral é dificultada pela ausência de instrumentos adequados para caracterizar e identificar suas necessidades. Apresentamos um estudo com o objetivo de elaborar e validar o conteúdo de um instrumento para a caracterização laboral e produtiva dessa população. Com base na experiência do Instituto Nacional para Cegos, uma primeira versão foi elaborada e submetida à validação de conteúdo com três especialistas que avaliaram sua clareza, coerência, relevância e suficiência, além de fornecerem comentários e sugestões. Foram realizadas duas roda-das de avaliação. O grau de concordância das avaliações foi estimado por meio do Coeficiente Kappa de Fleiss e as contribuições foram consideradas para ajustar o instrumento. Foi obtida uma versão final com 47 itens em três dimensões: informações gerais; acadêmicas e ocupacionais; e produtivas. O desenho, a validação e a implementação do instrumento reúnem os esforços do meio acadêmico, bem como do Estado, para caracterizar a população com deficiência visual em diferentes cidades do país e contribuir para a redução das lacunas de emprego e renda

Cuarenta años: un canto a la transformación y la trayectoria de la Terapia Ocupacional / Forty years: An ode to the transformation and trajectory of Occupational Therapy / Quarenta anos: um canto à transformação e à trajetória da Terapia Ocupacional

La Revista Ocupación Humana ha sido un importante medio de divulgación del conocimiento en Terapia Ocupacional y en los estudios sobre ocupación humana. Su primera edición, emitida el 24 de octubre de 1984, significó un hito para Colombia y para Latinoamérica, al constituirse en referente para el ejercicio profesional y el desarrollo disciplinar. Inicialmente, se orientó a comprender las áreas del desempeño profesional, a socializar investigaciones, a promover la discusión y la proyección de la profesión en ciencia y tecnología, y a conocer y difundir la emergente participación en escenarios de incidencia comunitaria, social y política. Después de una pausa editorial de cinco años, en el año 2013, se retoma la publicación. Desde entonces, se ha trabajado en su fortalecimiento, visibilidad y apertura, proceso en el que se ha contado con la participación de colegas de Colombia y otros países hermanos. En este aniversario, el Comité Editorial desea que la revista siga consolidándose como medio fundamental para que las y los terapeutas ocupacionales sigan escuchándose, conociéndose, conectándose con los debates profesionales y fortaleciéndose como gremio. Por eso, celebra e invita a celebrar con un canto estos cuarenta años de retos y a dar la bienvenida a los que vendrán

The Revista Ocupación Humana has been an essential medium in disseminating knowledge in Occupational Therapy and studies on human occupation. Its first edition, released on 24 October 1984, marked a milestone for Colombia and Latin America, becoming a benchmark for professional practice and disciplinary development. Initially, it focused on understanding areas of professional performance, disseminating research, promoting discussion, and projecting the profession in science and technology, and understanding and spreading the emerging participation in community, social, and political-impact scenarios. After a five-year editorial break, in 2013, the publication resumed. Since then, work has been undertaken to strengthen its visibility and openness, with the participation of colleagues from Colombia and other sister countries. On this anniversary, the Editorial Board hopes that the magazine will continue to consolidate itself as a key means for occupational therapists to continue listening to each other, get to know each other, engage in professional debates, and strengthen themselves as a body. As such, it celebrates and invites you to celebrate these forty years of challenges and welcome those that will come.

A Revista Ocupación Humana tem sido um importante meio de divulgação do conhecimento em Terapia Ocupacional e em estudos sobre ocupação humana. Sua primeira edição, emitida em 24 de outubro de 1984, significou um marco para a Colômbia e para a América Latina, ao se constituir como referência para a prática profissional e o desenvolvimento disciplinar. Inicialmente, dedicou-se a compreender as áreas do desempenho profissional, a socializar pesquisas, a promover a discussão e a projeção da profissão em ciência e tecnologia, a conhecer e difundir a emergente participação em cenários de incidência comunitária, social e política. Após uma pausa editorial de cinco anos, em 2013, retomou-se a publicação. Desde então, tem-se trabalhado no seu fortalecimento, visibilidade e abertura, processo no qual se conta com a participação de colegas da Colômbia e de outros países irmãos. Neste aniversário, o Comitê Editorial deseja que a revista continue a se consolidar como meio fundamental para que as e os terapeutas ocupacionais continuem ouvindo-se, conhecendo-se, conectando-se com os debates profissionais e fortalecendo-se no coletivo. Por isso, celebra e convida a celebrar com um canto estes quarenta anos de desafios, bem como a dar as boas-vindas aos que virão.

A scoping review on active vs. passive range of motion approaches to treat heterotopic ossification at the elbow.

Objective: The objective of this scoping review is to synthesize and clarify literature on the effectiveness of active and passive range of motion therapy techniques to address range of motion in people with heterotopic ossification (HO), and to provide guidance to therapists in clinical decision-making based on current evidence. Method: To find articles that included therapeutic interventions to maintain or improve range of motion in people with heterotopic ossification, the authors searched the following databases: Cochrane Database of Systematic Reviews, PubMed, CINAHL, PsychINFO, Web of Science, and OTSeeker. To ensure that the search was comprehensive, the authors also searched Burns and Trauma, Burns Journal, Burns Open, and the Journal of Hand Therapy. Searches were limited to peer-reviewed articles published in the English language. No publication date limits were set. The Physiotherapy Evidence Database PEDro scale was utilized to measure the validity of the methodological quality of each article. Results: Five studies met the inclusion criteria.. Two studies emphasized that passive range of motion was effective in less than 50% of their subjects, while the other three studies utilized active range of motion only, reporting 50% of patients did not require surgery. Discussion/conclusion: There is insufficient evidence to determine effective therapeutic management of HO and the literature that does exist is contradictory and inconclusive. Future research is necessary to determine if any effectiveness of manual therapeutic approaches exists for patients with HO.

Orthopedic Surgery Residents: How Much Do They Know About Occupational Therapy?

Background Orthopedic hand surgeons rely on occupational therapy (OT) as a crucial part of rehabilitation following injury or surgery. Therefore, orthopedic surgeons should understand the full range of OT services. There is limited prior research on orthopedic residents' understanding of OT in the United States. The main goal of this study is to examine how well orthopedic surgery residents grasp and perceive the role of OT, particularly in hand surgery, as integrated into their educational curriculum. Methods The study included all orthopedic surgery residents from a single institution (Columbia University, New York) during 2022-2023. We obtained permission from the Institutional Review Board, Department Chair, and Program Director to recruit participants. Eligible residents who agreed to participate completed questionnaires regarding their understanding of the role of OT in orthopedic surgery. Results Thirty subjects met the inclusion criteria. The total response rate from the residents was 14/30 (47%). The residents reported a mediocre level of familiarity with OT while also rating 4.5/5 the importance of OT in hand surgery without significant difference between postgraduate year groups. 11/14 residents reported no formal training concerning the role of OT in hand surgery. 12/14 residents reported that it would be helpful to spend time with an occupational therapist. Conclusions This study revealed the lack of confidence residents expressed regarding occupational therapists' roles. All residents recognized the importance of OT in hand surgery and expressed interest in shadowing occupational therapists. Residents of all levels acknowledge the crucial partnership between orthopedists and occupational therapists but lack formal education about the therapist's scope and role.

"If I have a limited amount of time left, this is not how I want to spend it": A qualitative descriptive study of factors influencing daily life participation following a cancer diagnosis.

OBJECTIVE: Following a cancer diagnosis, restricted participation in daily life is common. Restricted participation can be temporary or long lasting. The aim of this study was to characterize how daily life participation is impacted following a cancer diagnosis. METHODS: Eligible individuals included adults (>18 years) with any stage/grade brain, breast, colorectal, or lung cancer in any phase of treatment or post-treatment. Participants completed a semi-structured interview about how their life participation was impacted following their cancer diagnosis. Data were analyzed through team-based thematic analysis. RESULTS: Forty adults, 10 per disease category, participated. Four themes were identified that supported or hindered daily life participation: (1) self-expectations, (2) expectations of others, (3) awareness of mortality, and (4) symptoms and side effects of cancer. Participants discussed how their cancer experience resulted in a reprioritization of what they valued doing in their life. However, many survivors struggled to adapt and described a tension between their need to adapt to their current life circumstances and their contrasting desire to stay connected with their pre-cancer selves through daily life participation. The mental health challenges associated with decreased participation were also outlined by participants. CONCLUSIONS: Cancer survivors' daily life participation is influenced by expectations from themselves and others, awareness of mortality, and disease symptoms/side effects. Future interventions can target these domains to supports survivors' life participation.

Impact of postsurgical rehabilitation on outcomes for degenerative cervical myelopathy.

OBJECTIVE: Despite widespread use, there is limited evidence to support postsurgical rehabilitation to enhance neurological recovery after surgery for degenerative cervical myelopathy (DCM). Outcomes research for DCM seldom accounts for the effect of postsurgical rehabilitation. The aim of this study was to quantify the impact of postsurgical rehabilitation on outcomes after surgery for DCM. METHODS: This was a retrospective analysis of prospectively collected data from a single center. The study enrolled 66 patients who underwent spinal surgery for DCM. In addition to patient demographic, imaging, and surgical data, chart review was performed to document the timing, type, duration, and outcomes of postsurgical rehabilitation therapy. Outcomes were collected prospectively, including the modified Japanese Orthopaedic Association (mJOA) score, Neck Disability Index (NDI) score, and SF-36 physical component summary (PCS) score. Linear regression models were created to determine the independent effects of type and timing of postsurgical occupational therapy (OT) and physical therapy (PT) on outcomes. RESULTS: A total of 66 patients were included in the analysis. Multivariate regression analysis showed that postsurgical OT was associated with significantly greater improvement in 12-month SF-36 PCS scores (p = 0.009) and mJOA scores (p = 0.019). In the subset of patients who received therapy, delayed therapy (> 42 days after surgery) compared to early therapy (< 42 days after surgery) was associated with less improvement in SF-36 PCS scores (p = 0.03). CONCLUSIONS: Postsurgical outpatient rehabilitation was independently associated with improved postsurgical outcomes within the 1st year after surgery for DCM, and early therapy (< 42 days) was associated with superior outcomes compared to delayed therapy. This is one of the first studies to use a prospective database to demonstrate an independent effect for postsurgical rehabilitation on outcomes after surgery for DCM.

Early Daily Activity: Development and description of an occupation-based intervention for surgically repaired distal radius Fractures.

OBJECTIVE: To describe the theoretical development and structure of an occupation-based intervention for people with a surgically repaired distal radius fracture. INTERVENTION DEVELOPMENT AND RATIONALE: The Early Daily Activity (EDA) intervention uses the performance of strategically selected daily activities as the primary rehabilitative strategy. Occupation-based interventions are recommended for hand injury rehabilitation but are often poorly described and lack explicit theoretical underpinnings. The EDA-intervention was developed from exploratory research that informed the theory and structure. The theoretical principles are that daily activity performance is (i) safe within defined parameters (ii) appropriately self-determined (iii) produces high ranges and amounts of therapeutic movement, and (iv) builds psychosocial competencies. INTERVENTION DESCRIPTION: The EDA-intervention is designed to be commenced within 2 weeks of surgery. There are three key components. The first is activity-specific education to emphasise the safety, benefits, and therapeutic actions of activity performance. A set of parameters for defining safe activities is described to support education. The second component is patient-therapist collaboration to select a range of daily activities that provide a 'just-right' challenge. Collaboration occurs at regular intervals throughout the rehabilitation period to incrementally increase the challenge of activities. The third component is performance of activities at-home targeted at improving range of movement and function. NEXT STEPS: The EDA-intervention can be used by hand therapists, but it has not yet undergone effectiveness evaluation. A planned study will explore clinician readiness to adopt the EDA-intervention, inform iterative changes to the protocol and the design of feasibility and effectiveness studies.

Perceptions of Hand Surgery Patients About Occupational Therapy.

Purpose: Occupational therapists provide holistic health care and social care and seek to promote health through occupation. This study measured how hand surgery patients who received referrals for occupational therapy perceive occupational therapy and occupational therapists. Methods: A cross-sectional online survey was designed to determine the meaning of an occupation, the role of occupational therapists, the services and benefits provided by occupational therapists, the populations served, and the work settings of occupational therapists. Results: This study included 634 patients who responded to the survey (three-fourths were women). Most participants were uncertain about the professional environment of occupational therapists. Approximately one-third of the respondents believed that occupational therapists work at general hospitals. Most participants believed that occupational therapists manage orthopedic conditions and hand injuries; however, the least participants believed that occupational therapists manage cases involving cardiorespiratory conditions. No significant correlation was noted between the participants' overall awareness of occupational therapy and their sex or age. However, a notable statistical relationship was found between the comprehensive knowledge of occupational therapy and the educational level of the participants. Conclusions: To receive the benefits of occupational therapy, it is necessary for the population to be aware of those benefits. Clinical relevance: Patient perspectives of occupational therapy can help in patient's education and their treatment plan.

Rehabilitation in People Living with Glioblastoma: A Narrative Review of the Literature.

Glioblastoma is the most common primary malignant brain tumor. While preliminary data point to the positive effects of rehabilitation for patients with glioblastoma, there are unique challenges for clinicians working with this population, including limited life expectancy and/or rapid neurological deterioration. The aim of this article is to review the literature on rehabilitation of adults with glioblastoma, including the feasibility of interventions, their effectiveness, as well as the current clinical practice. The reviewed literature suggests that rehabilitation has been found beneficial for improving the functional prognosis and quality of life of adults with glioblastoma and is desired by patients. We summarize the qualitative evidence regarding healthcare professionals' and patients' perspectives on the use of supportive care services. We conclude there is a need for the design of effective rehabilitation programs for patients with glioblastoma, as well as for the development of glioblastoma-specific clinical guidelines for rehabilitation practitioners.

The effect of occupational therapy services on hospital readmission for patients with cancer in acute care settings: a retrospective data analysis.

PURPOSE: This study examined how the use of occupational therapy services affected the likelihood of hospital readmission within 30 days for patients with cancer diagnoses. METHODOLOGY: This was a retrospective observational study. Patient medical records were analyzed from a National Cancer Institute Hospital over a 5-year period with a sample size of 6614 patients included for analysis in an unadjusted logistic regression model and 1920 patients analyzed in an adjusted logistic regression model. Various factors, including the use of occupational therapy services as well as individual factors such as pain levels, cancer stage, and living environment, were considered in relation to readmission status. Logistic regression analyses were used to assess the provision of occupational therapy service's association with 30-day hospital readmissions. RESULTS: Patients who received occupational therapy services had a statistically significant decrease in their risk of a 30-day hospital readmission compared to patients with cancer who did not receive occupational therapy services. In an unadjusted analysis, patients with cancer who had occupational therapy services were 33.5% (OR = 0.665) less likely to be readmitted within 30 days compared to a patient who did not have occupational therapy services (p < 0.001). In an analysis after adjusting for patient health-related factors, patients with cancer who had occupational therapy services were 22.2% (OR = 0.778) less likely to readmit to a hospital compared to a patient who did not have occupational therapy services (p < 0.046). CONCLUSION: The results of the study are intended to contribute to the body of knowledge on the benefits of occupational therapy services on an individual as well as a health systems-based level for patients with cancer diagnoses while hospitalized. IMPLICATIONS FOR CANCER SURVIVORS: The knowledge of the utility of occupational therapy services for patients with cancer diagnoses while in the hospital can assist providers, patients, and hospital leadership in understanding some of the potential benefits for patient care and healthcare systems at large while seeking to avoid the deleterious effects from a hospital readmission.

Impact of Real-World Outpatient Cancer Rehabilitation Services on Health-Related Quality of Life of Cancer Survivors across 12 Diagnosis Types in the United States.

Compared to adults without cancer, cancer survivors report poorer health-related quality of life (HRQOL), which is associated with negative treatment outcomes and increased healthcare use. Cancer-specialized physical and occupational therapy (PT/OT) could optimize HRQOL; however, the impact among survivors with non-breast malignancies is unknown. This retrospective (2020-2022), observational, study of medical record data of 12 cancer types, examined pre/post-HRQOL among cancer survivors who completed PT/OT. PROMIS® HRQOL measures: Global Health (physical [GPH] and mental [GMH]), Physical Function (PF), and Ability to Participate in Social Roles and Activities (SRA) were evaluated using linear mixed effect models by cancer type, then compared to the minimal important change (MIC, 2 points). Survivors were 65.44 ± 12.84 years old (range: 19-91), male (54%), with a median of 12 visits. Improvements in GPH were significant (p < 0.05) for all cancer types and all achieved MIC. Improvements in GMH were significant for 11/12 cancer types and 8/12 achieved MIC. Improvements in PF were significant for all cancer types and all achieved the MIC. Improvements in SRA were significant for all cancer types and all groups achieved the MIC. We observed statistically and clinically significant improvements in HRQOL domains for each of the 12 cancer types evaluated.

[Geriatric ophthalmologic co-management : A case report of interdisciplinary collaboration]. / Geriatrisch-ophthalmologisches Co-Management : Ein Fallbeispiel interdisziplinärer Zusammenarbeit.

This case report details the assessment and interdisciplinary collaboration in the management of an 81-year-old patient presenting with acute visual impairment, dizziness, general weakness, gait disturbances and fear of falling. A holistic geriatric evaluation revealed orthostatic dysregulation and an underlying multifactorial gait disorder exacerbated by visual impairment. Ophthalmological findings included left central retinal artery branch occlusion and cataracts. A comprehensive geriatric assessment showed frailty, impaired mobility and decreased functional abilities. Subsequent patient-centered interdisciplinary approaches included treatment for retinal ischemia, orthostatic testing, medication reconciliation, physiotherapy and occupational therapy. This case emphasizes how interdisciplinary collaboration between ophthalmology and geriatrics enables proactive assessment and intervention to reduce the risk of functional decline and loss of autonomy in visually impaired patients, which is of particular relevance considering the increasing prevalence of visual impairment in the ageing population.

Determining the destination: a co-designed chronic advanced cancer rehabilitation conceptual framework for engagement of individuals with lived experience in rehabilitation research.

BACKGROUND: Individuals living with chronic advanced cancer (CAC) often face distinct physical, functional, and cognitive issues. Their rehabilitation needs are not yet routinely met, warranting further CAC-specific rehabilitation-based research. Given the complexity of functional and symptom presentations, engagement of individuals living with CAC as partners in the research process is encouraged to better understand the lived perspective. Formal engagement requires both structured approaches and iterative processes. The aim was to co-design a conceptual framework to develop and integrate engagement strategies into rehabilitation research focused on CAC populations. METHODS: A multidisciplinary team of authors, including two individuals with lived experience, conducted an implementation-focused descriptive study to inform future research design, including: interviews and follow-up, review of current models and approaches, and development of a co-designed conceptual framework for engaging individuals with lived experience into CAC-specific rehabilitation research. RESULTS: Emergent themes include shared understanding, transparent appreciation, iterative processes and unique partnership needs. A definition, guiding principles and tools for engagement were identified. In consultation with individuals with lived experience, and application of the emergent themes in context, a conceptual framework to guide the engagement process was developed. CONCLUSION: A novel conceptual framework for engaging individuals with lived experience with CAC as partners in rehabilitation research is proposed to facilitate implementation-focused team-based approaches for this population.

Living with chronic advanced cancer (CAC) affects all parts of a person's life. Rehabilitation, such as physiotherapy, can be necessary. Healthcare data shows that rehabilitation needs of people with CAC are not yet being regularly met and that more research in this area is needed. Because CAC is complex and impacts each person differently, having people with CAC included as partners on the research team will likely help researchers better understand and explain rehabilitation needs of people with CAC.Our group of authors include different healthcare professionals, researchers, and two individuals with lived experience. Together, we carried out an implementation study and designed a framework to guide other researchers in including individuals living with CAC on research teams.We found that important themes for individuals with lived experience were: shared understanding, transparent appreciation, iterative processes (such as back and forth communication) and unique partnership needs.We titled the conceptual framework a "Co-designed Chronic ADVanced CANCer Rehabilitation" or "Co-ADVANCE" for short.