This systematic review examined research related to interventions that addressed handwriting deficits in adults with impaired upper limb motor coordination resulting from central and peripheral nervous system injury or illness. The clinical question was, "Based on current research, what is/are the recommended intervention(s) to improve, augment, or replace handwriting skills among adult clients with upper limb motor deficits?" A research protocol was followed, which was modified to include pediatric literature after an initial search of interventions for adults proved limited. Four studies related to adults and 10 related to pediatrics were included in the review and all were evaluated for quality using standardized procedures. The adult studies addressed the use of voice recognition software and hand dominance transfer training. Available evidence for interventions with children with handwriting deficits centered around these clinical options: Cognition Orientation to Daily Occupational Performance, task-orientated self-instruction, ergonomic modifications to a desk, school-based intervention (emphasis on visual motor skills and practice), sensory diet with therapeutic listening, therapeutic practice, and a graphomotor program. Improvement in handwriting skill emerged from seven of the 10 pediatric studies. Direct practice of handwriting tasks was common to all successful studies and missing in studies that failed to show skill improvement. It may be logical to conclude that intervention strategies should include direct practice of handwriting, whether the client is an adult or a child. Further research on handwriting intervention programs specifically for adult clients and the inclusion of direct practice as intervention is warranted.

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A systematic review of cross-cultural adaptations of the Disability of Arm, Shoulder and Hand into other languages was undertaken focusing on the translation and adaptation process, the problems during the translation process and proposed solutions. Nine articles were selected for analysis. All were written in English and addressed the qualitative issues of the cross-cultural adaptation process. The results demonstrated strong evidence that translation, adaptation and technical issues are most influential in the cross-cultural adaptation process. Awareness, understanding and incorporation of these issues will assist in future translations and adaptations of occupational therapy evaluation tools for use in other countries with different cultures. Implications for occupational therapy education, practice and research are discussed. Copyright (c) 2008 John Wiley & Sons, Ltd.

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The outcomes of feeding training are typically evaluated in terms of feeding skills and swallowing abilities rather than the ultimate goal of feeding, namely, adequate nutritional status. To increase occupational therapy practitioners' awareness of nutritional status as an outcome of feeding training, a systematic review of the research literature was conducted to examine the relationship between nutritional status and self-feeding skills in people with dementia. Studies were evaluated by the strength of their evidence and analyzed to determine the relationships among dementia, nutritional status, and the ability to feed one's self. Results revealed that although nutritional status in people with dementia is variable, there is a tendency for lower body weight, lower measures of body composition, and lower body mass indexes in persons with dementia compared to those with no cognitive impairment. Individuals who feed themselves tend to weigh more compared to those who need assistance for feeding. There is also evidence to support that as feeding status improves or declines, body weight similarly increases or decreases.

Introduction. Non-adherence with therapeutic splinting in acute hand injury can reduce treatment benefits, increase risk of disability and bias assessment of treatment efficacy. This systematic review aims to critically analyse the literature on splinting of acute upper limb injuries to identify key factors that could influence patient adherence with splint wear. Methods. Trials were identified from searches of EMBASE, MEDLINE, CINAHL (to June 2009) and reference lists of articles and relevant reviews. Search terms used were patient compliance/adherence behaviour, splint/s, othosis/es and brace. Where possible, randomized controlled trials or prospective cohort studies were sought, and then cross-sectional and retrospective studies if the former were not available. Studies specifically addressing chronic conditions were excluded. All relevant trials were assessed for methodological quality by the author using explicit criteria. Data were extracted using a standardized form designed by the author. Results. Six studies (one randomized controlled trial, two cross-sectional analytic surveys and three retrospective file reviews) involving 490 people were included. Owing to the heterogeneity of studies synthesis is narrative rather than quantitative. There was no consistent correlation between adherence and age or gender. One study found a correlation with patient perception of positive effect, and one found negative correlations with agitation and brain injury severity. Discussion. Studies found were generally of varied quality and may be susceptible to bias. This is a field with little published scientific evidence, and future research should measure adherence relationships with socioeconomic, health-care system, therapy- and patient-related characteristics.