Reliability and clinical utility of a novel telehealth-based goniometry approach to measure range of motion of the digits of the hand.

BACKGROUND: Range of motion (ROM) is an outcome measure commonly used when treating acute and chronic hand injuries and conditions. Increased adoption of telehealth service provision in hand therapy practice, influenced by the advent of COVID-19, has led to the need for a valid and reliable approach to measure the range of motion of the digits of the hand when providing hand therapy services using telehealth. PURPOSE: To determine if performing manual goniometry during a livestream teleconsultation is reliable and clinically useful to measure the range of motion of the fifth digit when providing hand therapy services using telehealth. STUDY DESIGN: Clinical measurement, repeated-measures study. METHODS: According to a measurement protocol, 12 independent raters (who currently provide hand therapy services) each obtained several screen-based goniometric range of motion measurements of the fifth digit at 2-time points. Raters were surveyed on the clinical utility of the telehealth-based goniometry approach. Measures of relative and absolute reliability were calculated to evaluate test-retest and inter-rater reliability. Free-text responses were analyzed using content analysis. RESULTS: Inter-rater reliability was excellent for all flexion and extension measures (intraclass correlation coefficient [ICC] ≥ 0.89) but poor for the arc of motion (ICC ≤ 0.67). Test-retest reliability was poor (ICC ≤ 0.43). No statistically significant differences between test and retest measurements were observed (P ≥ 0.24). The overall coefficient of variation indicated good precision (14.69%). Measurement error (≤6.07º) and limits of agreement (≤6.33) had acceptable levels to support clinical use. Content analysis revealed several practical considerations. CONCLUSIONS: This study suggests that performing manual goniometry during a livestream teleconsultation is unreliable for measuring the range of motion of the fifth digit. However, when combined with patient-reported and functional outcomes, this approach may be suitable to facilitate a range of motion assessment for certain functions of telehealth service provision in hand therapy practice.

Occupational therapy scope of practice in the rehabilitation of adults experiencing persistent post-concussion symptoms following traumatic brain injury: a scoping review protocol.

OBJECTIVE: The objective of the review is to identify, categorize, and examine literature describing occupational therapy scope of practice in the rehabilitation of adults experiencing persistent post-concussion symptoms (PPCS). INTRODUCTION: PPCS are symptoms experienced by adults a minimum of 2 to 4 weeks after a traumatic brain injury (TBI), and include vestibular, neuropsychiatric, visual, and cognitive issues. Enduring PPCS may result in disability, affecting a person's independence and/or participation in daily activities. Despite growing recognition of the role occupational therapy can offer in TBI rehabilitation, evidence is limited regarding the scope of practice occupational therapists have in the rehabilitation of adults experiencing PPCS. INCLUSION CRITERIA: Literature that includes adults (aged 18 to 65 years) experiencing PPCS that describes the occupational therapy scope of practice in concussion programs will be considered for inclusion in this review. Sources reporting on participants aged under 18 years, classified with non-persistent symptoms, and receiving care in acute health care settings will be excluded. Non-English publications or gray literature from civil society or disabled persons organizations or other representative bodies in the field of brain injury will also be excluded. METHODS: The scoping review will follow the JBI methodology for scoping reviews. Five electronic databases will be searched for literature published between 2013 and the present: MEDLINE, Embase, Emcare, PsycINFO, and CINAHL. Two reviewers will independently conduct title and abstract screening of the results and, upon consensus, independently screen full texts to confirm final sources for inclusion. Any disagreements will be resolved by discussion with a third reviewer. Data will be extracted from included sources and we will then map occupational therapy scope of practice (inclusive of assessments and interventions) against the World Health Organization's International Classification of Functioning One-Level Classification. Results will be presented in tabular or narrative format. REVIEW REGISTRATION: Open Science Framework osf.io/qxgzj.

Evaluation of the Effectiveness of Assistive Technology for Executive Function Support for People With Acquired Brain Injury: Protocol for Single-Case Experimental Designs.

BACKGROUND: Executive function, including prospective memory, initiating, planning, and sequencing everyday activities, is frequently affected by acquired brain injury (ABI). Executive dysfunction necessitates the use of compensatory cognitive strategies and, in more severe cases, human support over time. To compensate for the executive dysfunction experienced, growing options for electronic mainstream and assistive technologies may be used by people with ABI and their supporters. OBJECTIVE: We outline the study protocol for a series of single-case experimental designs (SCEDs) to evaluate the effectiveness of smart home, mobile, and/or wearable technologies in reducing executive function difficulties following ABI. METHODS: Up to 10 adults with ABI who experience executive dysfunction and have sufficient cognitive capacity to provide informed consent will be recruited across Victoria and New South Wales, Australia. Other key inclusion criteria are that they have substantial support needs for everyday living and reside in community dwellings. On the basis of the participant's identified goal(s) and target behavior(s), a specific electronic assistive technology will be selected for application. Both identification of the target behavior(s) and selection of the assistive technology will be determined via consultation with each participant (and their key support person, if applicable). The choice of SCED will be individualized for each participant based on the type of technology used in the intervention, the difficulty level of the behavior targeted for change, and the anticipated rate of change. For each SCED, repeated measurements of the target behavior(s) during the baseline condition will provide performance data for comparison with the performance data collected during the intervention condition (with technology introduced). Secondary outcome measures will evaluate the impact of the intervention. The protocol includes 2 customizable Microsoft Excel spreadsheets for electronic record keeping. RESULTS: Recruitment period is June 2022 through March 2024. Trial results for the individual participants will be graphed and analyzed separately using structured visual analysis supplemented with statistical analysis. Analysis will focus on important features of the data, including both within- and between-phase comparisons for response level, trend, variability, immediacy, consistency, and overlap. An exploratory economic evaluation will determine the impact on formal and informal support usage, together with quality of life, following the implementation of the new technological intervention. CONCLUSIONS: The study has been designed to test the cause-effect functional relationships between the intervention-in this case, electronic assistive technology-and its effect in changing the target behavior(s). The evaluation evidence gained will offer new insights into the application of various electronic assistive technologies for people who experience executive dysfunction following ABI. Furthermore, the results will help increase the capacity of key stakeholders to harness the potential of technology to build independence and reduce the cost of care for this population. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12622000835741, https://www.anzctr.org.au/ACTRN12622000835741.aspx. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/48503.

An overview & critical review of the Sensory Profile - second edition.

BACKGROUND: The Sensory Profile-2 (SP-2) is the recently revised set of scales that provide information about a child's responses to different types of sensory stimuli. AIM: To examine the methodological quality and psychometric properties of the SP-2 using the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) and Quality Criteria for Health Status Questionnaires (QCHSQ). MATERIALS AND METHODS: The methodological quality and psychometric properties for each of the SP-2 scales were examined by two assessors using the COSMIN and QCHSQ. RESULTS: The COSMIN revealed that the SP-2 demonstrated strengths in patient-related outcome measure design and internal consistency. However, hypothesis testing, cross-cultural validity and structural validity (construct validity) were notable shortcomings. The QCHSQ indicated the SP-2 has merits in its content validity and construct validity. The SP-2 manual reported insufficient evidence of its responsiveness, interpretability and criterion validity. CONCLUSION: Informed assessment selection is fundamental for evidence-based and quality occupational therapy practice provision. Overall, the SP-2 is considered to have adequate psychometric properties, however users should be mindful of the identified shortcomings. SIGNIFICANCE: The review and critique of the SP-2 adds to the body of knowledge about the revised instrument and provides an objective perspective about its strengths and weaknesses.

Baccalaureate occupational therapy students' development of social and emotional competencies.

BACKGROUND: Academic life requiring students to meet academic and professional practice expectations can be stressful. Effective emotional and social competence can assist students in managing feelings, stressful situations and fostering relationships with educators, peers, and clients. Hence this is a helpful professional competence for health students to possess. OBJECTIVE: To compare the emotional and social competence among the baccalaureate occupational therapy students across four academic year levels. METHOD: A quantitative cross-sectional design was used. A total of 360 baccalaureate occupational therapy students completed the Emotional and Social Competency Inventory- University Edition. Regression analysis followed by contrast analysis examined the differences among first-, second-, third- and fourth-year levels. RESULTS: Students demonstrated "satisfactory" or above social and emotional competencies. For all students, the average Emotional and Social Competency Inventory subscale scores on teamwork, empathy and achievement orientation were the highest three competencies. The lowest average scores were systems thinking, inspirational leadership and coach and monitor skills. Fourth year students' emotional self-control (p = 0.03), positive outlook (p = 0.02), and influence (p = 0.02) were significantly lower than first-year students. No other significant differences were found between year levels on the other subscales. CONCLUSION: Overall, students demonstrated good social and emotional competencies, with strengths in teamwork, empathy and achievement orientation competencies, which are fundamental in health service practice. However, fourth-year students demonstrated lower scores in emotional self-control, positive outlook, and influence competencies compared to their first-year peers. This indicates that fourth-year students have developed better self-awareness, can be more reflective and have a better perception of reality. It is recommended that targeted learning opportunities to develop students' emotional and social competencies to nurture final-year students' abilities and confidence be incorporated into the curriculum. Academic and practice education staff working with final year occupational therapy students need to consider the associated stress during this time when providing learning opportunities.