{"title":"Understanding Occupational Therapists' Knowledge and Confidence When Assessing for Spatial Neglect: A Special Issue Review.","authors":"Holden Gasque, Corey Morrow, Emily Grattan, Michelle Woodbury","doi":"10.5014/ajot.2024.050354","DOIUrl":"10.5014/ajot.2024.050354","url":null,"abstract":"<p><strong>Importance: </strong>Spatial neglect (SN)-failure to respond to stimuli on the side of the body contralateral to a poststroke lesion-is one of the most disabling impairments for stroke survivors, and 80% of stroke survivors may have undetected SN. Occupational therapists' evaluations should include determining the impact of poststroke SN.</p><p><strong>Objective: </strong>To investigate occupational therapists' confidence, knowledge, current practices, barriers, and facilitators when assessing for SN in adult stroke survivors.</p><p><strong>Design: </strong>A 30-item survey was created with guidance from stroke rehabilitation occupational therapists who reviewed the survey for face and content validity.</p><p><strong>Setting: </strong>Online survey.</p><p><strong>Participants: </strong>Occupational therapist survey responders (N = 76).</p><p><strong>Outcomes and measures: </strong>Self-report assessments were used to measure occupational therapists' confidence in identifying SN, SN assessment practices, and barriers to and facilitators of SN assessment. Knowledge of SN signs and symptoms, neuroanatomy, and clinical presentation were measured with a three-question quiz.</p><p><strong>Results: </strong>Eighty-one percent of the respondents reported a high level of confidence in identifying SN, and 70% reported routinely assessing for SN, with 81% using clinical observation rather than standardized tools as the primary assessment method. Barriers to SN assessment included time and resources.</p><p><strong>Conclusions and relevance: </strong>Most respondents, despite reporting high levels of confidence with routine SN assessments, did not use standardized SN measures and demonstrated suboptimal knowledge of SN. These results emphasize the need to increase clinical education about SN and its assessments. Plain-Language Summary: This study gathered baseline information on an underinvestigated topic-occupational therapists' education, confidence, current practices, barriers, and facilitators when assessing for spatial neglect in adult stroke survivors. The study results also contribute to future research on occupational therapists' current confidence and knowledge when assessing for spatial neglect.</p>","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"78 2","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11017737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139940963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Let's Talk About Ethics: Addressing Ethical Tensions and Building Moral Resilience in the Occupational Therapy Profession.","authors":"Regina F Doherty, Olivia Rotelle","doi":"10.5014/ajot.2024.050566","DOIUrl":"10.5014/ajot.2024.050566","url":null,"abstract":"<p><p>Health professionals across all care delivery settings, including occupational therapy practitioners, are experiencing high levels of moral distress. The mental, emotional, and physical consequences of unresolved moral distress are resulting in burnout, decreased quality of care, and poor patient outcomes. Moral resilience is a teachable and learnable skill that can nullify some of the adverse consequences of moral distress. To ensure quality care outcomes and improve the well-being of individual occupational therapy practitioners and the profession, it is essential that occupational therapy practitioners be provided with the education, training, resources, and strategies needed to address moral distress, foster moral resilience, and cultivate the skills necessary to cope with ethical tensions. In this column, we call the profession to action to address the phenomenon of moral distress as it relates to occupational therapy practitioner well-being. We also discuss resources and strategies for addressing ethical tensions and building moral resilience in occupational therapy practice.</p>","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"78 2","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139991519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Comparison of Visual Symptom Frequency and Occupational Issues Between Patients With and Without Concussion.","authors":"Stephanie Schurr, Caitlyn Foy, Tanya Polonenko, Mitchell Scheiman","doi":"10.5014/ajot.2024.050353","DOIUrl":"10.5014/ajot.2024.050353","url":null,"abstract":"<p><strong>Importance: </strong>Occupational therapy practitioners' knowledge of and advocacy for clients with visual symptoms postconcussion can have a considerable impact on recovery.</p><p><strong>Objective: </strong>To compare the frequency of vision symptoms and occupational performance deficits in a sample of participants with and without concussion.</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Setting: </strong>Sports medicine clinic.</p><p><strong>Participants: </strong>Adolescents and adults with concussion (n = 20) and musculoskeletal injuries (n = 19).</p><p><strong>Outcomes and measures: </strong>Measures included monocular amplitude of accommodation, near point of convergence, Binocular Vision Assessment (BVA) computerized screening for phoria, BVA computerized screening for fusional vergence, the Developmental Eye Movement Test, the Canadian Occupational Performance Measure, and the Convergence Insufficiency Symptom Survey-Concussion Version (CISS-CON).</p><p><strong>Results: </strong>We found significant differences between participants with and without concussion using the CISS-CON (p = .001), positive fusional vergence (p = .02), and near point of convergence (p = .02). Participants with concussion scoring above cutoffs on multiple measures reported poorer performance (p = .005) and satisfaction (p = .004) with valued occupations.</p><p><strong>Conclusions and relevance: </strong>Concussion has a detrimental effect on vision and occupation, and occupational therapy practitioners are well-positioned to assess and address issues arising from this relationship. Plain-Language Summary: Vision symptoms commonly experienced after a concussion are associated with reduced occupational performance and satisfaction and can have a considerable impact on recovery. Occupational therapy assessment for clients with concussion should include screening for vision difficulties.</p>","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"78 2","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139997913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jennifer A Weaver, Abby K Richard, Denny Press, Kalpana Gupta, Arlene A Schmid, Jaclyn A Stephens
{"title":"Participants With Acquired Brain Injury Realized They \"Could Still Do Things\" After a Yoga Intervention: A Qualitative Descriptive Study.","authors":"Jennifer A Weaver, Abby K Richard, Denny Press, Kalpana Gupta, Arlene A Schmid, Jaclyn A Stephens","doi":"10.5014/ajot.2024.050409","DOIUrl":"10.5014/ajot.2024.050409","url":null,"abstract":"<p><strong>Importance: </strong>Occupational therapy practitioners use yoga in practice to achieve holistic care, and the American Occupational Therapy Association has provided guidance on the use of yoga in occupational therapy. For people with acquired brain injury (ABI), however, it is unknown whether yoga affects occupational performance.</p><p><strong>Objective: </strong>To explore the perceived impact of an adapted yoga intervention on occupational performance using the Occupational Therapy Practice Framework: Domain and Process (4th ed.; OTPF-4) for participants with ABI.</p><p><strong>Design: </strong>Qualitative descriptive study using virtual, semistructured interviews. An inductive, holistic, open-coding process, followed by a deductive process to map open codes to the OTPF-4.</p><p><strong>Participants: </strong>Nine individuals with ABI were recruited from a yoga intervention study.</p><p><strong>Results: </strong>The theme generated from the data-\"Yoga participants with ABI realized that they could still do quite a bit\"-was supported by two major categories from the OTPF-4: Occupations and Performance Skills. Participants described improvements in their functional performance (i.e., motor skills, process skills) and how these factors were synergistically connected to their occupational performance (i.e., self-care, leisure).</p><p><strong>Conclusions and relevance: </strong>This study provides novel insight into how functional performance improved so participants could \"still do things,\" such as engaging in occupations. When participants described improved performance skills, they simultaneously described re-engagement with their meaningful occupations. Participants also perceived an improvement in their mind-body connection, which should be further explored in future studies. This study generated original findings about participants' perceptions of an adapted yoga intervention as they relate to the OTPF-4. Plain-Language Summary: This study reports individuals' perceptions of their re-engagement with occupations and changes in occupational performance skills after participating in an adaptive yoga intervention. We highlight the distinct contribution that adaptive yoga-an intervention modality that can be used by occupational therapy practitioners-may have, using the OTPF-4 to connect the participants' perceptions about their improvements in occupational performance.</p>","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"78 2","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11017735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139724523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Effectiveness of Activity-Based Task-Oriented Training on Upper Extremity Recovery for Adults With Stroke: A Systematic Review.","authors":"Cheng-Yu Lee, Tsu-Hsin Howe","doi":"10.5014/ajot.2024.050391","DOIUrl":"10.5014/ajot.2024.050391","url":null,"abstract":"<p><strong>Importance: </strong>Interventions for improving upper extremity (UE) recovery have become a priority in stroke rehabilitation because UE disability can undermine a person's capacity to perform daily activities after stroke. A better understanding of the use of activity-based task-oriented training (TOT) will inform the development of more effective UE interventions in stroke rehabilitation.</p><p><strong>Objective: </strong>To examine the effectiveness of activity-based TOT in improving the UE recovery of adults with stroke.</p><p><strong>Data sources: </strong>CINAHL Plus, MEDLINE, and PubMed.</p><p><strong>Study selection and data collection: </strong>Inclusion criteria included quantitative studies published between June 2012 and December 2022 that reported UE recovery as an outcome, including measurements of motor function, motor performance, and performance of activities of daily living (ADLs); a sample age ≥18 yr, with stroke in all phases; and interventions that incorporated real-world daily activities. We assessed articles for inclusion, quality, and risk of bias following Cochrane methodology and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.</p><p><strong>Findings: </strong>Sixteen studies (692 participants, Level 1-4 evidence) were included. Strong to moderate evidence supported the effectiveness of activity-based TOT in UE motor function, motor performance, and ADL performance for adults with stroke. Strong evidence supported the effectiveness of hospital-based TOT, and moderate evidence supported the effectiveness of home-based TOT.</p><p><strong>Conclusions and relevance: </strong>The results not only showed the value of activity-based TOT as an effective UE intervention in stroke rehabilitation but also supported the occupational therapy philosophy of using functional and meaningful activities in practice. Further research on home-based TOT is needed. Plain-Language Summary: This systematic review shows the effectiveness and value of using real-life activities in task-oriented training approaches for adult survivors of stroke. The authors found strong evidence for hospital-based task-oriented training interventions and moderate evidence for home-based interventions for improving upper extremity recovery. This review shows the value of upper extremity task-oriented training as an effective intervention in stroke rehabilitation. The review also supports the occupational therapy philosophy of using functional and meaningful activities in practice as well as the profession's use of evidence-based practice in stroke rehabilitation.</p>","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"78 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139941037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Juliana Bell, Bonnie Decker, Alicia Eichmann, Carly Palkovich, Chelsea Reji
{"title":"Effectiveness of Virtual Reality for Upper Extremity Function and Motor Performance of Children With Cerebral Palsy: A Systematic Review.","authors":"Juliana Bell, Bonnie Decker, Alicia Eichmann, Carly Palkovich, Chelsea Reji","doi":"10.5014/ajot.2024.050374","DOIUrl":"10.5014/ajot.2024.050374","url":null,"abstract":"<p><strong>Importance: </strong>Research on the functional and motor performance impact of virtual reality (VR) as an intervention tool for children with cerebral palsy (CP) is limited.</p><p><strong>Objective: </strong>To understand whether VR is an effective intervention to improve upper extremity (UE) function and motor performance of children diagnosed with CP.</p><p><strong>Data sources: </strong>Databases used in the search were EBSCOhost, One Search, PubMed, Cloud Source, CINAHL, SPORTDiscus, and Google Scholar.</p><p><strong>Study selection and data collection: </strong>Studies published from 2006 to 2021 were included if children had a diagnosis of CP and were age 21 yr or younger, VR was used as an intervention, and measures of UE function and motor performance were used.</p><p><strong>Findings: </strong>Twenty-one studies were included, and the results provided promising evidence for improvements in areas of UE function, motor performance, and fine motor skills when VR is used as an intervention. To yield noticeable UE improvements in children with CP, VR should be implemented for 30 to 60 min/session and for at least 360 min over more than 3 wk. Additional areas of improvement include gross motor skills, functional mobility, occupational performance, and intrinsic factors.</p><p><strong>Conclusions and relevance: </strong>The use of VR as an intervention for children with CP to improve UE function and motor performance is supported. More randomized controlled trials with larger sample sizes focusing on similar outcomes and intervention frequencies are needed to determine the most effective type of VR for use in clinical occupational therapy. Plain-Language Summary: This systematic review explains how virtual reality (VR) has been used as an intervention with children with cerebral palsy (CP). The review synthesizes the results of 21 research studies of children who had a diagnosis of CP and who were 21 years old or younger. The findings support using VR to improve upper extremity performance, motor performance, and fine motor skills. The findings also show that occupational therapy practitioners should use a VR intervention at a minimum frequency of 30 to 60 minutes per session and for at least 360 minutes over more than 3 weeks to yield noticeable improvements in upper extremity, motor performance, and fine motor skills for children with CP.</p>","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"78 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139730750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sook-Lei Liew, Amit Sethi, Jaclyn Stephens, Michelle Woodbury
{"title":"Recovery of Function After Acquired Neurological Injury.","authors":"Sook-Lei Liew, Amit Sethi, Jaclyn Stephens, Michelle Woodbury","doi":"10.5014/ajot.2024.050758","DOIUrl":"https://doi.org/10.5014/ajot.2024.050758","url":null,"abstract":"<p><p>The articles in this Special Issue on Recovery of Function After Neurological Injury include an impressive range of clinical diagnoses, scientific approaches, and theoretical frameworks that demonstrate the breadth and depth of occupational therapy in the restoration of function after neurological injury. An emerging theme throughout is the need for the profession of occupational therapy to identify and use more efficient methods for diagnosing and treating people with neurological injuries to improve their quality of life and the impact of care.</p>","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"78 2","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140860207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Giorgia Ricchetti, Alba Navarro-Egido, María Rodríguez-Bailón, Daniel Salazar-Frías, Jose Antonio Merchán-Baeza, María Patrocinio Ariza-Vega, María J Funes
{"title":"The Breakfast and Dressing Conflict Task: Preliminary Evidence of Its Validity to Measure Online Self-Awareness After Acquired Brain Injury.","authors":"Giorgia Ricchetti, Alba Navarro-Egido, María Rodríguez-Bailón, Daniel Salazar-Frías, Jose Antonio Merchán-Baeza, María Patrocinio Ariza-Vega, María J Funes","doi":"10.5014/ajot.2024.050346","DOIUrl":"10.5014/ajot.2024.050346","url":null,"abstract":"<p><strong>Importance: </strong>Impaired self-awareness (SA) of deficits after an acquired brain injury (ABI) severely affects patients' independence in activities of daily living (ADLs). However, any assessment tool permits an exhaustive evaluation of SA in the context of ADLs.</p><p><strong>Objective: </strong>To study the validity of the Breakfast and Dressing Conflict Task (BD Conflict Task) to assess online SA (awareness of performance in the context of a given task) in patients with ABI; to study its interactions with offline SA (general awareness); and to test the validity of a simplified measure of performance monitoring, the ADL Conflict-Monitoring Index.</p><p><strong>Design: </strong>Convergent validity and correlational study.</p><p><strong>Setting: </strong>Research laboratory, hospitals, and homes.</p><p><strong>Participants: </strong>Thirty patients with ABI and 28 neurologically healthy controls.</p><p><strong>Outcomes and measures: </strong>Using the BD Conflict Task, measures of emergent awareness, self-regulation, anticipatory awareness, and self-evaluation were assessed and their convergent validity and relationship with offline SA were analyzed. The ADL Conflict-Monitoring Index was calculated, and its convergent validity was tested.</p><p><strong>Results: </strong>The online SA variables of the BD Conflict Task showed convergent validity with traditional online SA measures. Offline SA correlated with emergent and anticipatory awareness in the Breakfast Task. The ADL Conflict-Monitoring Index proved to be a valid measure of patients' performance monitoring.</p><p><strong>Conclusions and relevance: </strong>These preliminary findings suggest that the BD Conflict Task is a valid tool to assess online SA in patients with ABI and provide further understanding of the online SA-offline SA interaction. Furthermore, the ADL Conflict-Monitoring Index may be a valid and easy-to-use monitoring measure in clinical settings. Plain-Language Summary: Patients with acquired brain injury (ABI) and reduced awareness of their cognitive deficits face problems performing activities of daily living (ADLs) and may show signs of unsafe behaviors. Being aware of one's own abilities involves anticipating problems before starting a task, detecting and correcting errors during the task, and evaluating performance afterward. This study provides preliminary validity for the Breakfast and Dressing Conflict Task, a new tool that assesses aspects of self-awareness simultaneously in the context of familiar and significant ADLs. Furthermore, the tool simplifies the assessment of detecting and correcting errors with an easy-to-use index, making it suitable for use in clinical settings.</p>","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"78 2","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140111895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sudha Srinivasan, Nidhi Amonkar, Patrick D Kumavor, Deborah Bubela
{"title":"Measuring Upper Extremity Activity of Children With Unilateral Cerebral Palsy Using Wrist-Worn Accelerometers: A Pilot Study.","authors":"Sudha Srinivasan, Nidhi Amonkar, Patrick D Kumavor, Deborah Bubela","doi":"10.5014/ajot.2024.050443","DOIUrl":"10.5014/ajot.2024.050443","url":null,"abstract":"<p><strong>Importance: </strong>Children with unilateral cerebral palsy (UCP) have poor strength and movement control on one side of their body, leading to impaired bimanual coordination skills.</p><p><strong>Objective: </strong>To compare duration and intensity of all-day habitual movement of the dominant and nondominant upper extremities (UEs) in typically developing (TD) children and children with UCP.</p><p><strong>Design: </strong>Two-group observational study.</p><p><strong>Setting: </strong>Children's naturalistic settings.</p><p><strong>Participants: </strong>Convenience sample of 9 TD children and 9 children with UCP.</p><p><strong>Intervention: </strong>Children wore accelerometers on both wrists all day and night for 1 wk.</p><p><strong>Outcomes and measures: </strong>We compared the extent of asymmetry in bilateral arm use (intensity and duration) between the 2 groups.</p><p><strong>Results: </strong>Compared with TD children who use both UEs equally, children with UCP were more likely to use their dominant or unaffected UE than their nondominant or affected UE during daily activities. There were no differences between groups in dominant UE activity. However, children with UCP engaged in lower levels of moderate to vigorous activity and greater levels of light activity with their nondominant or affected UE than their TD peers.</p><p><strong>Conclusions and relevance: </strong>Wrist-worn accelerometry can provide objective information on real-world habitual activity with both arms in children. Accelerometers are nonintrusive, easy to use, and well tolerated by children, and they allow prolonged monitoring of UE activity outside therapeutic contexts. Occupational therapists can use wrist-worn accelerometers as sensitive tools to assess asymmetries in UE use at baseline and as an outcome measure to assess the efficacy of behavioral interventions and carryover into real-world settings among children with UCP. Plain-Language Summary: This pilot study provides promising evidence that supports the use of wrist-worn accelerometry as an accurate, easy-to-use, and objective assessment tool for children with unilateral cerebral palsy (UCP) to detect asymmetries in bilateral real-world arm activity at baseline and after intensive occupational therapy interventions to improve arm function. The authors used wrist-worn accelerometry for one week with 9 typically developing (TD) children and 9 children with UCP to compare dominant or unaffected versus nondominant or affected upper extremity (UE) use for intensity and duration of activity. Compared with TD children, children with UCP had lower relative intensity of activity in the nondominant UE than the dominant UE. Wrist-worn accelerometers seem to be a sensitive measure to detect asymmetries in bilateral all-day UE use in children with UCP. The findings have implications for the use of wrist-worn accelerometers as an outcome measure to assess the efficacy of intensive therapies to improve real-worl","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"78 2","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140121125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jonathan R Allen, Swathi R Karri, Chen Yang, Mary Ellen Stoykov
{"title":"Spinal Cord Stimulation for Poststroke Hemiparesis: A Scoping Review.","authors":"Jonathan R Allen, Swathi R Karri, Chen Yang, Mary Ellen Stoykov","doi":"10.5014/ajot.2024.050533","DOIUrl":"10.5014/ajot.2024.050533","url":null,"abstract":"<p><strong>Importance: </strong>Spinal cord stimulation (SCS) is a neuromodulation technique that can improve paresis in individuals with spinal cord injury. SCS is emerging as a technique that can address upper and lower limb hemiparesis. Little is understood about its effectiveness with the poststroke population.</p><p><strong>Objective: </strong>To summarize the evidence for SCS after stroke and any changes in upper extremity and lower extremity motor function.</p><p><strong>Data sources: </strong>PubMed, Web of Science, Embase, and CINAHL. The reviewers used hand searches and reference searches of retrieved articles. There were no limitations regarding publication year.</p><p><strong>Study selection and data collection: </strong>This review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist. The inclusion and exclusion criteria included a broad range of study characteristics. Studies were excluded if the intervention did not meet the definition of SCS intervention, used only animals or healthy participants, did not address upper or lower limb motor function, or examined neurological conditions other than stroke.</p><p><strong>Findings: </strong>Fourteen articles met the criteria for this review. Seven studies found a significant improvement in motor function in groups receiving SCS.</p><p><strong>Conclusions and relevance: </strong>Results indicate that SCS may provide an alternative means to improve motor function in the poststroke population. Plain-Language Summary: The results of this study show that spinal cord stimulation may provide an alternative way to improve motor function after stroke. Previous neuromodulation methods have targeted the impaired supraspinal circuitry after stroke. Although downregulated, spinal cord circuitry is largely intact and offers new possibilities for motor recovery.</p>","PeriodicalId":48317,"journal":{"name":"American Journal of Occupational Therapy","volume":"78 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11017736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140111894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}