A Sensory Integration Intervention in the School Setting to Support Performance and Participation: A Multiple-Baseline Study.

IMPORTANCE: There is a paucity of research that explores the effectiveness of sensory integration interventions in the school setting. OBJECTIVE: To test the effectiveness of a sensory integration intervention paired with teacher consultation, aligned with the principles of Ayres Sensory Integration® and the Sensory Therapies and Research Frame of Reference, to improve functional regulation and active participation in school for students with sensory integration and processing differences. DESIGN: Concurrent, multiple-baseline, single-subject design. SETTING: Public elementary school in the United States. PARTICIPANTS: Students (N = 3; ages 5-8 yr) whose sensory integration and processing differences were affecting their school occupational performance and were not remediated by integrated support. INTERVENTION: For 15 wk, each student had one-to-one sensory integration intervention 2×/wk for 30 min and a consultation between the occupational therapist and teacher weekly for 10 min. OUTCOMES AND MEASURES: The dependent variables, functional regulation and active participation, were measured weekly. The Short Child Occupational Profile and Behavior Assessment System for Children, Third Edition, were given before and after intervention. Goal Attainment Scaling and semistructured interviews with the teachers and participants were completed after intervention. RESULTS: All 3 students showed meaningful improvement in functional regulation and active participation in the classroom during the intervention period as demonstrated by a 2-SD band method or celeration line analysis. All additional measures noted positive change. CONCLUSIONS AND RELEVANCE: Findings suggest that sensory integration intervention with consultation in the education setting can improve school performance and participation for children with sensory integration and processing challenges. What This Article Adds: This study offers an evidence-based model of service delivery for the school setting that is effective in improving the functional regulation and active participation of students whose sensory integration and processing challenges interfere with occupational engagement and are not mitigated by embedded supports.

A mixed-methods study on the effectiveness of a self-directed online education program on obesity and bariatric care for occupational therapy practitioners and students.

BACKGROUND: Due to the rising rates of obesity in the United States, healthcare professionals will likely be seeing individuals from this population more frequently in service provision settings. OBJECTIVE: The purpose of this study was to examine the effectiveness of a self-directed online education program entitled BOOTH: Bariatrics, Obesity, and Occupational THerapy; How we can help. The educational program was directed to occupational therapy practitioners and occupational therapy students and designed to increase knowledge of obesity and bariatric care. METHODS: A convergent parallel mixed methods design was used in which the quantitative component was a one-group quasi-experiment with pre- and post-measurement. Surveys with Likert-style rating and open-ended questions were administered prior to the program and following completion. RESULTS: Paired samples t-testing revealed significant differences (p < 0.05) between pre- and post-program rated survey questions, which indicated an increase in perceived knowledge in the main topic areas. Qualitative data corroborated these findings, as most of the participants initially expressed concern about not being well-informed on obesity and bariatric care prior to taking the course. CONCLUSION: More education is needed on obesity and bariatric care for occupational therapy practitioners and occupational therapy students. An online education program was demonstrated to be an effective way of increasing knowledge on this important topic to reduce work-related injury.

A pilot study to investigate shoulder muscle fatigue during a sustained isometric wheelchair-propulsion effort using surface EMG.

OBJECTIVE: The primary aim of this pilot study was to develop a testing protocol for gathering shoulder muscle surface electromyography (EMG) data during a sustained submaximal isometric wheelchair-propulsion effort. Of special interest was analysis of the median frequency of the surface EMG signal power spectrum; a negative median frequency shift during a sustained effort is an indicator of muscle fatigue. The long-term goal is to improve our understanding of how fatigue and muscle imbalance might play a role in the development of a broad array of upper-extremity overuse syndromes. METHOD: Participants were a convenience sample of seven male manual-wheelchair users with spinal cord injury and 14 able-bodied males. Surface EMG in six right-side shoulder muscles was recorded while subjects resisted a static force equal to 60% of their maximum wheelchair-propulsion strength until fatigued. Percent of maximum voluntary contraction and the median frequency shift for each muscle were analyzed. RESULTS: The able-bodied group used a higher percent of maximum than the manual-wheelchair group (p< .05), and a more pronounced negative median frequency shift was evident in the able-bodied group (p < .10). CONCLUSION: Patterns that emerged suggest that spectral analysis of the surface electromyographhic signal has promise as a clinically useful tool to authenticate muscle fatigue in the upper extremities during occupational performance. Such data in the future could be used to justify the need for and benefits of adapted performance techniques and assistive technology.

Prenatal detection and postnatal management of double outlet right ventricle (DORV) in 21 singleton pregnancies.

OBJECTIVES: To evaluate the prenatal features, associated anomalies and the postnatal management in fetuses with prenatally detected double-outlet right ventricle (DORV). METHODS: Retrospective analysis of prenatal, pediatric and cardiosurgical records for all fetuses with prenatally diagnosed DORV at a single tertiary referral center. RESULTS: 21 cases were detected prenatally with DORV (average gestational age 23(3/7) weeks). Fetal karyotyping was available in all cases revealing 3 cases with trisomy 18 and one fetus with trisomy 21. 10/21 (47.6%) cases had additional cardiac anomalies only, one fetus (4.8%) had extra-cardiac anomalies only. 8/21 cases (38.1%) presented with both additional cardiac- and extra-cardiac anomalies. A total of 13/21 (61.9%) fetuses were live-born. Average gestational age at delivery was 37(3/7) gestational weeks. There were four Rastelli maneuvers, one Fontan intervention and three children with resection of a coarctation of the aorta among the group of the surviving infants. CONCLUSIONS: Prenatal, sonographic detection of DORV is feasible. The majority of the cases shows a normal karyotype. Outcome strongly depends on the presence and severity of additional anomalies of the fetus. Surgical intervention in DORV can lead to a favorable outcome in simple DORV. DORV not aggravated by additional defects seems to be no contraindication for a vaginal delivery.

Exploratory analysis to identify factors impacting return-to-work outcomes in cases of cumulative trauma disorder.

Current findings suggest that cumulative trauma disorders are multifaceted and have less predictable outcomes than trauma cases. The purpose of this study was to attempt to identify emerging patterns and predictive relationships in this diagnostic group that might be worthy of eventual prospective research. The data source was a comprehensive electronic database containing clinical information collected at point of care over a four-year period. A retrospective analysis was performed on 459 workers' compensation cases with upper extremity cumulative trauma disorders and a subset of 312 with carpal tunnel syndrome. The outcome criterion was return to work as a dichotomous variable. Only two significant correlations with return to work were found: the therapist's estimate of rehabilitation potential and the patient's outcome expectation of the ability to work. Further investigation of the role of beliefs and expectations in the therapeutic process would be a productive area for prospective study.