Primary study

Unclassified

Effect of concurrent peripheral nerve stimulation therapy on upper limb function and improvement in the daily living activities of chronic stage stroke patients undergoing low-frequency repetitive transcranial magnetic stimulation therapy and occupational therapy

Year 2017
Authors [No authors listed]
Registry of Trials UMIN Clinical Trials Registry
Links UMIN-CTR

This article is not included in any systematic review

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INTERVENTION:

Apply one hour per day of PNS therapy to the forearm of the paralyzed side of the body during OT to stroke patients with upper limb paralysis who are undergoing r‐TMS therapy and 2‐week intensive OT.

CONDITION:

Stroke

PRIMARY OUTCOME:

Wolf motor function test

SECONDARY OUTCOME:

Fugl‐Meyer Assessment; Motor Activity Log

INCLUSION CRITERIA:

Aged 20 years or older at the time consent was obtained. Ability to voluntarily extend at least three fingers, including the thumb. Ability to raise the arm on the affected side to the level of the nipple or higher. Six months or more have passed since the onset of stroke. PNS therapy has been prescribed by the patient's physician. Patients who gave voluntary written informed consent after receiving an adequate explanation regarding their participation in the study.

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Primary study

Unclassified

Motivating Occupational Virtual Experiences In Therapy for Kids

Year 2022
Registry of Trials clinicaltrials.gov
Links ClinicalTrials.gov
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A rater-blinded randomized controlled trial (RCT) will be conducted to compare the efficacy of MOVE-IT use in a remotely supervised home exercise program (HEP) to usual care for recovery of upper extremity (UE) function in children with hemiplegia.

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Primary study

Unclassified

Feasibility study of a randomized controlled trial of a telephone-delivered problem-solving-occupational therapy intervention to reduce participation restrictions in rural breast cancer survivors undergoing chemotherapy.

Year 2011
Authors Hegel MT , Lyons KD , Hull JG , Kaufman P , Urquhart L , Li Z - More
Journal Psycho-oncology
Links DOI , Pubmed , PMC

This article is included in 3 Systematic reviews Systematic reviews (3 references)

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OBJECTIVE:

Breast cancer patients receiving adjuvant chemotherapy often experience functional effects of treatment that limit participation in life activities. The purpose of this study was to examine the feasibility of conducting a randomized controlled trial (RCT) of a novel intervention for these restrictions, determine acceptability of the intervention, and preliminarily assess its effects.

METHODS:

A pilot RCT of a telephone-delivered Problem-solving and Occupational Therapy intervention (PST-OT) to improve participation restrictions in rural breast cancer patients undergoing chemotherapy. Thirty-one participants with Stages 1-3 breast cancer were randomized to 6 weekly sessions of PST-OT (n = 15) and usual care (n = 16). The primary study outcome was the feasibility of conducting the trial. Secondary outcomes were functional, quality of life and emotional status as assessed at baseline, 6 and 12 weeks.

RESULTS:

Of 46 patients referred 31 were enrolled (67% recruitment rate), of which 6 participants withdrew (81% retention rate). Twenty-four participants completed all study-related assessments (77%). Ninety-two percent of PST-OT participants were highly satisfied with the intervention, and 92% reported PST-OT to be helpful/very helpful for overcoming participation restrictions. Ninety-seven percent of planned PST-OT treatment sessions were completed. Completion rates for PST-OT homework tasks were high. Measures of functioning, quality of life, and emotional state favored the PST-OT condition.

CONCLUSION:

This pilot study suggests that an RCT of the PST-OT intervention is feasible to conduct with rural breast cancer patients undergoing adjuvant chemotherapy and that PST-OT may have positive effects on function, quality of life, and emotional state.

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Primary study

Unclassified

Impact of Psychosocial Occupational Therapy Combined with Anodal Transcranial Direct Current Stimulation to the Left Dorsolateral Prefrontal Cortex on the Cognitive Performance of Patients with Schizophrenia: A Randomized Controlled Trial.

Year 2021
Journal Hong Kong journal of occupational therapy : HKJOT
Links DOI , Pubmed , PMC

This article is included in 1 Systematic review Systematic reviews (1 reference)

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BACKGROUND:

The most common cognitive dysfunctions in patients with schizophrenia are information processing, memory, and learning. Based on the hypothesis of rehabilitation and brain stimulation in memory and learning, adding a form of neuromodulation to conventional rehabilitation might increase the effectiveness of treatments.

AIMS:

To explore the effects of psychosocial occupational therapy combined with anodal Transcranial Direct Current Stimulation (tDCS) on cognitive performance in patients with Schizophrenia.

METHODS:

Twenty-four patients diagnosed with schizophrenia were randomized into the experimental and control groups. We used The Cambridge Neuropsychological Test Automated Battery (CANTAB) and the Loewenstein Occupational Therapy Cognitive Assessment battery (LOTCA) to assess spatial recognition, attention, visual memory, learning abilities, and high-level cognitive functions like problem-solving. All participants received customized psychosocial occupational therapy activities. Furthermore, the experimental group received 12 sessions of active anodal tDCS for 20 minutes with 2 mA intensity on the left dorsolateral prefrontal cortex (DLPFC) while the patients in the sham group received sham tDCS.

RESULTS:

Combining tDCS to conventional psychosocial occupational therapy resulted in a significant increase in spatial memory, visual learning, and attention.

CONCLUSIONS:

Anodal tDCS on the left DLPFC improved visual memory, attention, and learning abilities. Contrary to our expectations, we could not find any changes in complex and more demanding cognitive functions.

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Primary study

Unclassified

Effectiveness of an individualised occupational therapy intervention programme (ABLE) using adaptational strategies on activities of daily living among persons with chronic conditions: A randomised controlled trial (RCT).

Year 2023
Journal Clinical rehabilitation
Links DOI , Pubmed

This article is not included in any systematic review

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OBJECTIVE:

Compare the effectiveness of a problem-solving, individualised, home-based occupational therapy intervention (ABLE 2.0), to usual occupational therapy, on activities of daily living (ADL) ability in persons with chronic conditions.

DESIGN:

A single-centre, double-blinded, randomised controlled trial with 10- and 26-week follow-up.

SETTING:

A Danish municipality. Subjects: Persons with chronic conditions experiencing problems performing ADL tasks (n = 80).

INTERVENTIONS:

ABLE 2.0 was compared with usual occupational therapy. Main measures: Coprimary outcomes were self-reported ADL ability (ADL-Interview Performance) and observed ADL motor ability (Assessment of Motor and Process Skills) at Week 10. Secondary outcomes were self-reported ADL ability (ADL-Interview Performance) and observed ADL motor ability (Assessment of Motor and Process Skills) at Week 26, and perceived satisfaction with ADL ability (ADL-Interview Satisfaction) and observed ADL process ability (Assessment of Motor and Process Skills) at Weeks 10 and 26.

RESULTS:

In total, 78 persons were randomly assigned: 40 to usual occupational therapy and 38 to ABLE 2.0. No statistically significant nor clinically relevant difference between group mean changes in primary outcomes was identified from baseline to Week 10 (ADL-Interview Performance [−0.16; 95% CI.: −0.38 to 0.06] and Assessment of Motor and Process Skills ADL motor ability [−0.1; 95% CI.: −0.3 to 0.1]). At Week 26, a statistically significant and clinically relevant difference was found in Assessment of Motor and Process Skills ADL motor ability (LS mean change: −0.3; 95% CI.: −0.5 to −0.1) between groups.

CONCLUSION:

ABLE 2.0 was effective in improving observed ADL motor ability at 26 weeks.

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Primary study

Unclassified

Adjuvant occupational therapy improves long-term depression recovery and return-to-work in good health in sick-listed employees with major depression: results of a randomised controlled trial.

Year 2013
Authors Hees HL , de Vries G , Koeter MW , Schene AH
Journal Occupational and environmental medicine
Links DOI , Pubmed
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OBJECTIVES:

To evaluate whether adjuvant occupational therapy (OT) can improve the effectiveness of treatment-as-usual (TAU) in sick-listed employees with major depression.

METHODS:

In total, 117 employees sick-listed for a median duration of 4.8 months (IQR=2.6 to 10.1 months) because of major depression were randomised to TAU (n=39) or adjuvant OT (TAU+OT; n=78). OT (18 sessions) focussed on a fast return to work (RTW) and improving work-related coping and self-efficacy. The primary outcome was work participation (hours of absenteeism+duration until partial/full RTW). Secondary outcomes were depression, at-work functioning, and health-related functioning. Intermediate outcomes were work-related, coping and self-efficacy. Blinded assessments occurred at baseline and 6, 12 and 18 months follow-up.

RESULTS:

The groups did not significantly differ in their overall work participation (adjusted group difference=-1.9, 95% CI -19.9 to +16.2). However, those in TAU+OT did show greater improvement in depression symptoms (-2.8, -5.5 to -0.2), an increased probability of long-term symptom remission (+18%, +7% to +30%), and increased probability of long-term RTW in good health (GH) (+24%, 12% to 36%). There were no significant group differences in the remaining secondary/intermediate outcomes.

CONCLUSIONS:

In a highly impaired population, we could not demonstrate significant benefit of adjuvant OT for improving overall work participation. However, adjuvant OT did increase long-term depression recovery and long-term RTW in GH (ie, full RTW while being remitted, and with better work and role functioning).

TRIAL REGISTRATION DUTCH TRIAL REGISTER:

NTR2057.

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Primary study

Unclassified

Cost-utility analysis of community occupational therapy in dementia (COTiD-UK) versus usual care: Results from VALID, a multi-site randomised controlled trial in the UK.

Year 2022
Authors Pizzo E , Wenborn J , Burgess J , Mundy J , Orrell M , King M - More
Journal PloS one
Links DOI , Pubmed , PMC

This article is not included in any systematic review

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BACKGROUND:

A community-based occupational therapy intervention for people with mild to moderate dementia and their family carers: the Community Occupational Therapy in Dementia-UK version (COTiD-UK); and Treatment as usual (TAU) were randomly assigned to 468 pairs (each comprising a person with dementia and a family carer) in the Valuing Active Life in Dementia (VALID) randomised controlled trial (RCT).

OBJECTIVES:

To compare the cost-utility of the COTiD-UK intervention compared to TAU, using data from the VALID RCT.

METHODS:

We performed a cost-utility analysis estimating mean costs and quality adjusted life years (QALYs) per person with dementia and carer for both treatments over a 26 weeks' time horizon based on resource use data and utility values collected in the trial.

RESULTS:

Taking the National Health Service and Personal Social Services perspective, including costs and benefits to the person with dementia only, measuring Health Related Quality of Life based on Dementia Quality of Life scale (DEMQOL), accounting for missing data and adjusting for baseline values, there was a significant difference in costs between COTiD-UK and TAU (mean incremental cost for COTiD-UK £784 (95% CI £233 to £1334)), but no significant difference in outcomes (mean QALYs gained 0.00664 (95% CI -0.00404, 0.01732)). The Incremental Net Monetary Benefit (INMB) for COTiD-UK versus TAU was negative at a maximum willingness to pay for a QALY of £20000 (mean -£651, 95% CI -£878 to -£424) or £30000 (mean -£585, 95% CI -£824 to -£345). Extensive sensitivity analyses confirmed the results.

CONCLUSIONS:

This community-based occupational therapy intervention has a very low probability of being cost-effective.

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Primary study

Unclassified

Combining goal setting and achievement with occupational therapy to improve pain, psychological factors and physical activity in patients after high tibial osteotomy: A non-randomized controlled study

Year 2021
Journal Hong Kong journal of occupational therapy : HKJOT
Links DOI , Pubmed , PMC

This article is not included in any systematic review

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Background: Psychological factors contribute to chronic pain and may lead to physical inactivity and poor functional outcomes. Purpose: We conducted a non-randomized controlled study to evaluate the effectiveness of goal setting and achievement following occupational therapy (OT) intervention to improve pain, psychological factors, and physical activity among patients after high tibial osteotomy (HTO). Method: We analyzed the data of 31 patients who underwent HTO, allocated into OT intervention and control groups. Goal achievement was encouraged through OT in the intervention groups; the control groups did not receive OT intervention. Outcome measures included the Canadian Occupational Performance Measure (COPM) score (before and after the OT intervention), walking pain, pain catastrophizing, anxiety, depression, pain self-efficacy, and physical activity level. Results: OT significantly improved the COPM score, depression, and physical activity. At the final assessment, the depression score was lower while the step count and physical activity time were significantly higher in the intervention group than in the control group (p < 0.05). Conclusion: Embedding goal setting and achievement as part of an OT intervention improved the outcomes after HTO.

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Primary study

Unclassified

Combination Protocol of Low-Frequency rTMS and Intensive Occupational Therapy for Post-stroke Upper Limb Hemiparesis: a 6-year Experience of More Than 1700 Japanese Patients.

Year 2016
Journal Translational stroke research
Links DOI , Pubmed

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Several years ago, we proposed a combination protocol of repetitive transcranial magnetic stimulation (rTMS) and intensive occupational therapy (OT) for upper limb hemiparesis after stroke. Subsequently, the number of patients treated with the protocol has increased in Japan. We aimed to present the latest data on our proposed combination protocol for post-stroke upper limb hemiparesis as a result of a multi-institutional study. After confirming that a patient met the inclusion criteria for the protocol, they were scheduled to receive the 15-day inpatient protocol. In the protocol, two sessions of 20-min rTMS and 120-min occupational therapy were provided daily, except for Sundays and the days of admission/discharge. Motor function of the affected upper limb was evaluated by the Fugl-Meyer assessment (FMA) and Wolf motor function test (WMFT) at admission/discharge and at 4 weeks after discharge if possible. A total of 1725 post-stroke patients were studied (mean age at admission 61.4 ± 13.0 years). The scheduled 15-day protocol was completed by all patients. At discharge, the increase in FMA score, shortening in performance time of WMFT, and increase in functional ability scale (FAS) score of WMFT were significant (FMA score 46.8 ± 12.2 to 50.9 ± 11.4 points, p < 0.001; performance time of WMFT 2.57 ± 1.32 to 2.21 ± 1.33, p < 0.001; FAS score of WMFT 47.4 ± 14. to 51.4 ± 14.3 points, p < 0.001). Our proposed combination protocol can be a potentially safe and useful therapeutic intervention for upper limb hemiparesis after stroke, although its efficacy should be confirmed in a randomized controlled study.

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Primary study

Unclassified

Combined transcranial direct current stimulation and home-based occupational therapy for upper limb motor impairment following intracerebral hemorrhage: a double-blind randomized controlled trial.

Year 2016
Journal Disability and rehabilitation
Links DOI , Pubmed

This article is not included in any systematic review

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PURPOSE:

To investigate the combined effect of transcranial direct current stimulation (tDCS) and home-based occupational therapy on activities of daily living (ADL) and grip strength, in patients with upper limb motor impairment following intracerebral hemorrhage (ICH).

METHODS:

A double-blind randomized controlled trial with one-week follow-up. Patients received five consecutive days of occupational therapy at home, combined with either anodal (n = 8) or sham (n = 7) tDCS. The primary outcome was ADL performance, which was assessed with the Jebsen–Taylor test (JTT).

RESULTS:

Both groups improved JTT over time (p < 0.01). The anodal group improved grip strength compared with the sham group from baseline to post-assessment (p = 0.025). However, this difference was attenuated at one-week follow-up. There was a non-significant tendency for greater improvement in JTT in the anodal group compared with the sham group, from baseline to post-assessment (p = 0.158).

CONCLUSIONS:

Five consecutive days of tDCS combined with occupational therapy provided greater improvements in grip strength compared with occupational therapy alone. tDCS is a promising add-on intervention regarding training of upper limb motor impairment. It is well tolerated by patients and can easily be applied for home-based training. Larger studies with long-term follow-up are needed to further explore possible effects of tDCS in patients with ICH.Implications for RehabilitationFive consecutive days of tDCS combined with occupational therapy provided greater improvements in grip strength compared with occupational therapy alone.tDCS is well tolerated by patients and can easily be applied for home-based rehabilitation.

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