Feasibility and efficacy of an early sensory-motor rehabilitation program on hand function in patients with stroke: a pilot, single-subject experimental design.

OBJECTIVE: Hand and upper limb functional impairments following stroke lead to limitations in performing activities of daily living. We aimed to investigate feasibility and efficacy of an early sensory-motor rehabilitation program on hand and upper limb function in patients with acute stroke. DESIGN: A pilot, single-subject experimental, A-B-A study. SETTING: Stroke unit of an educational hospital and an outpatient occupational therapy clinic. PARTICIPANTS: A convenience sample including five people with acute stroke. PROCEDURES: Participants received 3 h of an intensive hand and upper limb sensory and motor rehabilitation program, 5 days per week for 3 months (15-min mental imagery, 15-min action observation, 30-min mirror therapy, 1.5-h constraint-induced movement therapy, and 30-min bilateral arm training). Activities were chosen based on the task-oriented occupational therapy approach. OUTCOME MEASURES: An assessor blinded to intervention program measured sensory and motor functions using action research arm test, box and block test, Semmes-Weinstein monofilaments, and upper extremity section of Fugl-Meyer assessment. RESULTS: Assessment data points in intervention and follow-up phases compared to baseline were in higher levels, sloped upwardly, and increased significantly for all participants in all outcome measures. CONCLUSIONS: The present pilot study showed that a package of nowadays evidence-based rehabilitation methods including mental imagery, action observation, mirror therapy, modified constraint-induced movement therapy, bilateral arm training, and task-oriented occupational therapy approach is able to improve sensory and motor functions of the hand and upper limb in patients with acute stroke.

Occupational therapy and cooking: A scoping review and future directions.

BACKGROUND: Occupational therapy (OT) has historically used cooking as an intervention and assessment approach across settings. Current practices in OT and the emergence of the multidisciplinary field of culinary medicine highlight the relationship between cooking and health. AIMS/OBJECTIVES: To map the current literature on OT and cooking and to identify key factors that may facilitate collaboration within culinary medicine. MATERIALS AND METHODS: We conducted a scoping review using the Joanna Briggs Institute methodology to identify primary contexts and clinical settings. Publications were analysed using framework thematic analysis to identify OT themes and roles. RESULTS: A total of 56 studies met the criteria for inclusion. The majority of studies (n = 29, 53%) represented home/community settings and brain injury was the largest clinical group (n = 15, 27%). Primary themes related to person (n = 47, 43%), occupation (n = 30 (28%), environment (n = 19, 17%), and psychosocial wellbeing (n = 13, 12%). The primary OT role identified was that of interventionist (n = 48, 86%). CONCLUSIONS/SIGNIFICANCE: OT's holistic practice places cooking within a larger context that can help identify and overcome the barriers to participation. Findings support multiple pathways in which OT can contribute to cooking initiatives for health promotion and potentially expand OT practice in population health.

Knowledge Gaps Regarding Indigenous Health in Occupational Therapy: A Delphi Process.

Background. The occupational therapy profession needs to respond to the calls to action from the Truth and Reconciliation Commission (TRC) to engage in the process of reconciliation with Indigenous populations. Purpose. To inform development of a survey intended to determine the knowledge gaps of occupational therapists in relation to Indigenous health. Method. A Delphi process engaging 18 occupational therapists with membership in an Indigenous health network was used to prioritize and refine potential themes identified via literature review. Findings. Results of three consensus rounds and Dunn-Bonferroni post-hoc testing demonstrated three statistically distinct hierarchical tiers of 10 priority themes to inform survey development. Implications. The consensus prioritized themes from the literature to underpin further research on occupational therapists' knowledge in relation to Indigenous health and can provide a learning scaffold for occupational therapists to support a continued response to the TRC calls to action.

Occupational therapists and physiotherapists experiences of using nature-based rehabilitation.

BACKGROUND: Nature-based rehabilitation (NBR) is increasingly used within neurorehabilitation. The theoretical base is rooted in traditional neurorehabilitation professions, especially physiotherapy and occupational therapy, and relate to nature-based approaches.Objective: The objective was to explore the therapists' experiences of and rationale for applying NBR in neurorehabilitation when providing NBR to patients with acquired brain injury (ABI). Patients with ABI often experience severe consequences impacting their rehabilitation, activity, participation and quality of life. METHODS: Qualitative focus group interviews with therapists were conducted at two Danish rehabilitation hospitals, Hammel Neurorehabilitation and Research Center (HNRC) (Hospital 1) and Vejlefjord Rehabilitation (VFR) (Hospital 2). These are highly specialized neurorehabilitation hospitals for patients in the acute-subacute and subacute-chronic phases. HNRC has several sensory gardens and VFR has a park and an inlet nearby. Content analysis was employed to analyze the interviews. RESULTS: An occupational perspective of health was a frame to analyze and conceptualize the results. The analysis produced two main categories: What does nature offer - approach and rationale; Therapeutic rationale for conducting NBR. CONCLUSION: The therapists applied known theories and methods; they perceived the natural environment as an extended room for training and activity, as a means for targeted rehabilitation and beneficial to the patients.

A Qualitative Study of Occupational Therapists' Understanding of Spirituality in South Africa.

Occupational therapy is a holistic profession that assists clients to restore meaning to their lives-a vital spiritual task. Spirituality is a multifaceted and multidimensional construct that occupational therapists need to integrate into everyday practice. In this study, Occupational Therapy educators' and clinicians' understanding of spirituality in their practice was qualitatively explored by purposively selecting 24 participants who attended a workshop based on an appreciative approach, in Gauteng, South Africa. Data were collected through self-report interview schedules and focus group inquiries and were analysed using the creative hermeneutic method. Participants expressed spirituality in occupational therapy as connectedness, meaning of life and client-centred practice.

Occupational therapy lifestyle intervention added to multidisciplinary treatment for adults living with chronic pain: a feasibility study.

OBJECTIVES: To evaluate the feasibility and outcomes of an occupational therapy lifestyle intervention for adults living with chronic pain. DESIGN: This one-group pre-post interventional study investigated the feasibility and outcomes of the Redesign Your Everyday Activities and Lifestyle with Occupational Therapy (REVEAL(OT)) intervention targeting meaningful activities and lifestyle. SETTINGS: The occupational therapist-led intervention was added to standard multidisciplinary chronic pain treatment at a Danish pain centre. PARTICIPANTS: Of the 40 adult participants aged 18-64 (mean 46.6±10.9 years old, 85% females, chronic pain duration ≥3 months), there were 31 completers. INTERVENTION: Three feasibility rounds were carried out in 2019-2021. The intervention focused on meaningful activities, healthy eating habits and daily physical activity. Methods of didactical presentations, group discussions, personal reflection and experiential learning were used in the intervention composed both of individual and group sessions. OUTCOMES: Primary outcomes were predefined research progression criteria evaluated by the red-amber-green method. Secondary outcomes measured pre-post changes in health-related quality of life and occupational performance and satisfaction. RESULTS: The study demonstrated satisfactory programme adherence (77.5%), patients' self-perceived relevance (97%), timing and mode of delivery (97%) and assessment procedure acceptance (95%). No adverse events causing discontinuation occurred. Recruitment rate (n=5.7 monthly), retention (77.5%) and the fidelity of delivery (83.3%) needed improvement. We observed no improvement in health-related quality of life (mean=0.04, 95% CI -0.03 to 0.12) but positive change in occupational performance (mean=1.80, 95% CI 1.25 to 2.35) and satisfaction (mean=1.95, 95% CI 1.06 to 2.84). The participants reached the minimal clinically important difference for occupational performance (≥3.0 points in 13.8%) and satisfaction (≥3.2 points in 24.0%). CONCLUSIONS: The REVEAL(OT) intervention was feasible to deliver and beneficial for the participants' occupational performance and satisfaction. The interventions' recruitment, retention and delivery strategies need optimisation in a future definitive trial. TRIAL REGISTRATION NUMBER: NCT03903900.

Harnessing cognitive strategy use for functional problems and proposed underlying mechanisms in childhood-onset dystonia.

BACKGROUND: There is a significant gap in knowledge about rehabilitation techniques and strategies that can help children and young people with hyperkinetic movement disorders (HMD) including dystonia to successfully perform daily activities and improve overall participation. A promising approach to support skill acquisition is the Cognitive Orientation to daily Occupational Performance (CO-OP) intervention. CO-OP uses cognitive strategies to help patients generate their own solutions to overcome self-identified problems encountered in everyday living. PURPOSE: 1. To identify and categorize strategies used by children with HMD to support skill acquisition during CO-OP; 2. To review the possible underlying mechanisms that might contribute to the cognitive strategies, in order to facilitate further studies for developing focused rehabilitation approaches. METHODS: A secondary analysis was performed on video-recorded data from a previous study exploring the efficacy of CO-OP for childhood onset HMD, in which CO-OP therapy sessions were delivered by a single occupational therapist. For the purpose of this study, we reviewed a total of 40 randomly selected hours of video footage of CO-OP sessions delivered to six participants (age 6-19 years) over ten intervention sessions. An observational recording sheet was applied to identify systematically the participants' or therapist's verbalizations of cognitive strategies during the therapy. The strategies were classified into six categories in line with published literature. RESULTS: Strategies used by HMD participants included distraction, externally focussed attention, internally focussed attention, emotion self-regulation, motor imagery and mental self-guidance. We postulate different underlying working mechanisms for these strategies, which have implications for the therapeutic management of children and young people with HMD including dystonia. CONCLUSIONS: Cognitive strategy training can fundamentally change and improve motor performance. On-going work will address both the underlying neural mechanisms of therapeutic change and the mediators and moderators that influence how change unfolds.

Occupational Therapy Practice Guidelines for People With Parkinson's Disease.

IMPORTANCE: Occupational therapy practitioners address the occupational performance and participation needs of people with Parkinson's disease (PD) and their care partners. OBJECTIVE: This Practice Guideline is informed by systematic reviews on the use of occupational therapy interventions to promote participation in occupations for people with PD and to facilitate their caregivers' participation in the caregiver role. This guideline is meant to support practitioners' clinical decision making when working with people with PD and their care partners. METHOD: We examined and synthesized the results of four systematic reviews and integrated those results into clinical recommendations for practice. RESULTS: Thirty-three articles from the systematic reviews served as the basis for the clinical recommendations in this Practice Guideline. Clinical recommendations are provided for interventions that have strong or moderate supporting evidence. CONCLUSION AND RECOMMENDATIONS: Multidisciplinary, tailored, goal-oriented intervention is recommended for people with PD. Various forms of exercise can be used to improve activities of daily living and instrumental activities of daily living performance and social participation, and interventions should incorporate health behavior change techniques to support adequate physical activity levels in daily life. Mindfulness meditation and exercise can be used to support sleep, and task-oriented training can be used to improve performance of specific tasks. Occupational therapy practitioners should incorporate self-management, coaching, compensatory, cognitive-behavioral, and other approaches into multicomponent treatment plans depending on the client's needs and goals. Additional potentially appropriate intervention approaches or areas to address are discussed on the basis of existing or emerging evidence and expert opinion. What This Article Adds: This Practice Guideline provides a summary and applications of the current evidence supporting occupational therapy intervention for people with PD. It includes case examples and suggested decision-making algorithms to support practitioners in addressing client goals.

[Perception and mindfulness-based occupational therapy in people with mental disorders-A retrospective observational study on the SELWA-treatment]. / Wahrnehmungs- und achtsamkeitsbasierte Ergotherapie bei Menschen mit psychischen Störungen ­ Eine retrospektive Beobachtungsstudie zur Anwendung der SELWA-Behandlung.

During occupational therapeutic treatment of clients with mental disorders, perception and mindfulness-based techniques are used. However, little is known regarding relevant outcomes. Aim of the present study is to describe the results of a perception and mindfulness-based occupational therapeutic intervention (self-control techniques using perception-based methods (SELWA®) by S. Thielen) regarding the outcomes occupational performance and satisfaction in self-care, productivity and leisure, as well as concentration. The data of 28 clients (22 â™€, 6 â™‚; mean age = 42.8 (±SD 14.7) years) with mental disorders, that were collected before and after prescribed occupational therapeutic treatment, were analyzed. The outcomes were quantified using the Canadian Occupational Performance Measure (COPM) and the revision test, respectively. Significance of changes after the intervention was tested using the Wilcoxon-Signed Rank Test (p < 0.05). Effect sizes Cohen's dz and r were determined to evaluate the meaningfulness of changes. The occupational performance as well as the satisfaction in the COPM improved significantly after the therapeutic intervention (p < 0.001; dz = 2.37, r = 0.77 and dz = 2.24, r = 0.75). Moreover, the clients improved significantly in the revision test after the therapeutic intervention (p < 0.001; dz = 0.65, r = 0.31). Clients with mental disorders seem to benefit meaningfully from the SELWA®-treatment by S. Thielen regarding occupational performance and satisfaction in self-care, productivity and leisure. Furthermore, a moderate improvement of concentration seems to occur after the therapeutic intervention.

Understanding the role and importance of occupational therapy in mental health services in Morocco: Perspectives from mental health professionals.

BACKGROUND: Across the global landscape, mental health care still exhibits challenges because of the lack of human and professional resources to face its consequences. In Morocco, mental health problems affect mainly adolescents and young adults, with a clear impact on functional engagement in their daily lives. Occupational therapy, as a holistic and person-centered practice, may be an ideal mental health strategy to promote health and well-being through occupation, thereby enabling individuals to participate in regular daily activities. OBJECTIVE: To understand, from an intercultural perspective, the point of view of mental health professionals regarding the role and importance of occupation-based practices in Errazi Mental Health Hospital in Salé(Rabat) Morocco. METHOD: A qualitative research design was used for this study. Data collection consisted of semi-structured interviews with 12 mental health care professionals (non-occupational therapists). These results were used to gain an understanding of their perspectives regarding the main role of human occupation in mental health services in Morocco, and to incorporate an intercultural outlook in terms of occupational therapy. Data analysis was conducted in three phases, by following the grounded theory methodology. RESULTS: Two categories, "dimensions of occupation in Moroccan mental health" and "the interplay between traditional and western perspectives involving mental health" emerged from this research. Both categories included five subcategories. CONCLUSION: This study identifies how occupation-based services in Moroccan mental health care require considering not only the cultural perspective of mental health, and the sociocultural meaning rooted in occupations, but also the relevance of incorporating a community-centered approach. Moreover, it discusses how occupational therapy education in Morocco must incorporate an intercultural perspective of the therapy's theory and practice.

Apparent Discordance Between the Epidemiology of COVID-19 and Recommended Outcomes and Treatments: A Scoping Review.

OBJECTIVE: Many survivors of COVID-19 experience ongoing signs and symptoms affecting multiple body systems that impair function and negatively affect participation and quality of life. The purpose of this review was to identify and synthesize outpatient rehabilitation assessment and treatment recommendations for adults in postacute COVID-19 stages. METHODS: MEDLINE (Ovid), EMBASE (Ovid), Central, CINAHL, and Scopus were searched from January 1, 2020, to December 7, 2020. Teams of 2 reviewers independently assessed study eligibility and extracted data. All study designs that included rehabilitation recommendations were included. Study design, country, study population, purpose, and rehabilitation recommendations were recorded. Select questions from the Appraisal of Guidelines for Research and Evaluation instrument were used to evaluate the quality of consensus guidelines. RESULTS: Forty-eight articles fit the inclusion and exclusion criteria (11 systematic reviews, 1 scoping review, 6 original research studies, 4 consensus guidelines, 26 narrative reviews, and editorials/commentaries). Recommended outcomes included exercise tolerance, respiratory function, muscle strength, and activities of daily living or functional independence. Recommended treatments included respiratory rehabilitation, exercise therapy, education, psychological support, activities of daily living and gait training, traditional Chinese medicine, and cognitive and vocational rehabilitation. CONCLUSION: There were incongruities between what is known about postacute COVID-19 and what was recommended in the literature. Given the relatively large proportion of survivors who experience ongoing symptomatic COVID-19 or post-COVID-19 syndrome, it is important to quickly develop tools for self-management and access to rehabilitation specialists in multidisciplinary teams. IMPACT: Physical therapists, occupational therapists, and respiratory therapists have an important role to play. Clinicians should focus on epidemiological evidence and emerging information on late sequelae of COVID-19 to inform rehabilitation programming and future research.

Electroencephalogram-based neurofeedback training in persons with stroke: A scoping review in occupational therapy.

BACKGROUND: Neurofeedback training targets the relevant brain response under minimal stress. It could be a promising approach for the treatment of patients with brain injury. OBJECTIVE: This review aimed to examine the existing literature to confirm the effectiveness of applied electroencephalogram (EEG)-based neurofeedback training in the area of occupational therapy for upper limb stroke rehabilitation. METHOD: All relevant literature published until July 1, 2020 in five prominent databases (PubMed, CINAHL, PsycINFO, MEDLINE Complete, and Web of Science) was reviewed, based on the five-step review framework proposed by Arksey and O'Malley. RESULTS: After a thorough review, a total of 14 studies were included in this review. Almost studies reported significant improvements as a result of EEG-based neurofeedback training, but this had not always account for the differences in effectiveness between groups. However, the results of these studies suggested that neurofeedback training was effective as compared to the traditional treatment and more effective in combination with EEG than that with simple equipment application. CONCLUSION: This review demonstrated the effectiveness of the combination of occupational therapy and EEG-based neurofeedback training. Most of these treatments are intended for inpatients, but they may be more effective for outpatients, especially if customized to their requirements. Also, such explorations to assess the suitability of the treatment for patient rehabilitation will help reduce barriers to effective interventions. An analysis of the opinions of participants and experts through satisfaction surveys will be helpful.

Occupational therapists' competencies utilised in Danish job centres.

BACKGROUND: Twenty-nine out of 94 Danish job centres employ occupational therapists (OTs) and numbers are increasing. Occupational therapy (OT) vocational rehabilitations are diverse, and a more specific description of OT practice within this field is lacking. AIMS: To explore how OTs employed at Danish job centres describe their own competencies and what they perceive that their colleagues from other professions request from them. MATERIAL AND METHODS: Firstly, working diaries were obtained from 16 OTs working in job centres and analysed using content analysis. Secondly, semi-structured interviews were performed and analysed using systematic text condensation. RESULTS: The 16 OTs described four areas of competencies to their profession's practice within job centres; client-centeredness; a holistic approach; work ability assessments and ergonomics and adaptation. The OTs perceived that their colleagues requested their work ability assessment skills and their competencies as health professionals. CONCLUSION: The OTs had a client-centered and holistic focus on the citizens' whole life situation and used their health professional education and knowledge of ergonomics and adaptation to strengthen their work ability assessments. SIGNIFICANCE: The OTs perceived that they had competencies that supplemented the competencies of the interdisciplinary team. The results therefore support the inclusion of OTs within job centres.

A concept analysis of creative activities as intervention in occupational therapy.

Background: This article is based on a common understanding of the concept of creative activities as intervention, as described in occupational therapy literature. Historically, creative activities have been used as intervention in occupational therapy. There is, however, a lack of clarity in descriptions of the concept.Aims/Objectives: To investigate and clarify the concept of creative activities as intervention (CaI) and to validate the findings in occupational therapy practice.Material and methods: A selection of articles according to PRISMA resulted in 15 articles, analysed with concept analysis. The results were validated by a reference panel of seven occupational therapists using a questionnaire and data was analysed by descriptive statistics.Results: Five attributes defined CaI: (1) Often consisting of elements of art and craft using mind and body, (2) Being experienced as meaningful, (3) Creating creative processes, (4) Developing skills, enhancing occupational performance and managing everyday life, and (5) Being easy to modify individually or in groups with different approaches. Three cases were generated from the attributes to illustrate the integrity of the analysis.Conclusions and significance: The results led to a description of CaI that could facilitate future research communication and common definition in occupational therapy practice.

Merging Yoga and Occupational Therapy for Parkinson's Disease: A Feasibility and Pilot Program.

The purpose of this study was to assess feasibility and changes in outcome measures following the Merging Yoga and Occupational Therapy for Parkinson's Disease (MY-OT for PD) program: a 14-session program which combined community-based yoga for PD, and fall-risk focused group occupational therapy sessions. Seventeen participants completed an 8-week control period consisting of their normal participation, and an 8-week intervention period (14 MY-OT for PD sessions). There were fewer self-reported falls in the intervention (6) vs. control periods (10). One fall risk factor management scale (the Fall Prevention and Management Questionnaire, p=.02), and balance (p<.01) showed significant improvement between the control and intervention. The MY-OT for PD program is an encouraging occupational therapist-led program, which may improve balance and reduce self-reported falls.

Impact of smart force feedback rehabilitation robot training on upper limb motor function in the subacute stage of stroke.

OBJECTIVE: To explore the impact of rehabilitation robot training (RRT) on upper limb motor function and daily activity ability in patients with stroke. METHODS: Forty patients meeting the inclusion criteria were randomly divided into the treatment group (TRE) and the control group (CON). Group TRE was trained with an upper limb rehabilitation robot and group CON was trained with traditional occupational therapy. The training time was six weeks, and the upper limb function and daily activities were then assessed. RESULTS: (1) There was no statistical significance in the Fugl-Meyer (FM) score, Wolf Motor Function Test (WMFT) score, and Modified Barthel Index (MBI) score between the two groups before treatment (P > 0.05). (2) After treatment, the FM score, WMFT score, and MBI score were significantly higher than before treatment (P < 0.01). (3) There was no significant significance between the two groups after treatment (P > 0.05). CONCLUSIONS: Both RRT and traditional occupational therapy training are useful for the recovery of upper limb motor function and daily life ability in the sub-acute stage of stroke.

Initial Development of the Activity Card Sort-Advancing Inclusive Participation from a Homeless Population Perspective.

METHODS: Develop a new version of the Activity Card Sort-Advancing Inclusive Participation to include occupations experienced by the homeless population, including nonsanctioned occupations. This study occurred in two phases: (1) tool development (item selection, content expert review, line development drawing, and assessment of content validity) and (2) tool use to determine face validity. Participants were selected through a convenience sample at a local homeless shelter and academic institution. Participants experiencing homelessness (phase 1: N = 13, phase 2: N = 10) were required to be seeking services at the homeless shelter, while nonhomeless participants (phase 2: N = 30) worked full-time, resided with a significant other, and had personal transportation. RESULTS: An assessment of 76 occupations, corresponding line drawings, and follow-up questions was created. An initial construct validity study demonstrated differences between occupational participation of those who are homeless and nonhomeless in the areas of social engagement, nonsanctioned occupations, work and education, and home management. Both groups reported previous, current, or desired engagement in the occupations identified in the assessment. Conclusions and relevance. The purpose of this study was to create an inclusive assessment for use in the homeless population and complete a construct validity study of the assessment tool. Although the results indicated some differences in the frequency with which occupations were performed, the results demonstrated that all individuals participate in occupations that many not contribute to their health and wellness. This initial work supports the future development of a tool that is inclusive of all occupations to obtain a holistic picture of an individual's participation.

Music as support to Occupational Therapy.

SUMMARY: Habilitation, rehabilitation and promotion of well-being is the ultimate goal of the occupational therapy process. Occupational therapy interventions take advantages from interdisciplinary approach, implying that classic rehabilitative models are constantly enhanced by updated evidences in rehabilitation literature and enriched with competences from different fields. Recent literature has showed how music interventions can improve clinical and rehabilitative outcomes at different levels. Physical or occupational therapists, caregivers and care staffs are frequently involved in providing music interventions with or without the support of a music therapist. In particular, occupational therapists can use music as support to the rehabilitation of daily living activities and, in general, as a complementary tool of their work. This paper wants to stress the implementation of music and music therapy techniques and related specific training programs in the field of occupational therapy, pointing and summarizing main workable evidence-based approaches with music in occupational therapy settings.

"The connection just happens": Therapists' perspectives of canine-assisted occupational therapy for children on the autism spectrum.

INTRODUCTION: The inclusion of a therapy dog has been suggested as a means of facilitating therapy engagement for children on the autism spectrum within occupational therapy sessions. The aim of this study was to seek an understanding of possible benefits and challenges of this practice from the perspectives of occupational therapists, trained in canine-assisted therapy. METHOD: This study adopted an interpretive descriptive design. Six therapists participated in a semi-structured, telephone interview to describe their experience of working as canine-assisted occupational therapists with children on the autism spectrum. An inductive thematic analysis was used to analyse the data. RESULTS: Two overarching themes emerged. The first captured how therapists incorporated their therapy dog into sessions to accelerate children's initial motivation to engage within the therapy process. Specifically, therapists discussed how involving their therapy dog facilitated the development of a secure relationship, supported autonomous task involvement and increased children's sense of confidence. Second, they identified challenges inherent in their practice, such as the therapist's ability to maintain a goal-directed focus when including a therapy dog. Beyond the challenges within their own practice sessions, therapists reflected on issues thought to impact the occupational therapy profession since starting practice as a canine-assisted occupational therapist. CONCLUSION: Findings from this study contribute to the current understanding of how occupational therapists incorporate therapy dogs into their practice with children on the autism spectrum. The specific challenges noted by the therapists highlighted the importance of canine-assisted occupational therapy being viewed as an advanced scope of practice within Australia and, therefore, the need for training and practice guidelines to be established.

Health-related quality of life changes after the merging yoga and occupational therapy for Parkinson's disease program: A mixed-methods study.

BACKGROUND: To understand changes in health-related quality of life (HRQoL) after the Merging Yoga and Occupational Therapy for Parkinson's Disease (MY-OT for PD) program. MATERIALS AND METHODS: We used a mixed-methods convergent design and administered the Parkinson's Disease Questionnaire-8 (PDQ-8), a measure of HRQoL, with 17 participants. We considered scores 8 weeks before MY-OT for PD, just before, and upon completion. Additionally, we completed two focus groups following the program with 16 participants to assess qualitative changes in HRQoL. RESULTS: There were no significant differences in PDQ-8 scores between time points, F(2,32) = 1.60, p = 0.22, partial η2 = 0.09. Participants did discuss improvements in all 8 HRQoL domains, frequently regarding mobility and activities of daily living. CONCLUSION: Results diverged, with quantitative results showing no significant improvement in HRQoL and qualitative results indicating participant perceived improvements in all domains of the PDQ-8. The program should be explored further, and longitudinal follow-up completed.