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CJOT abstracts - Volume 68, Number 1
Clinical description of children with Developmental Coordination Disorder
by Linda T. Miller, Cheryl A. Missiuna, Jennifer J. Macnab, Theresa Malloy-Miller & Helene J. Polatajko
Occupational therapists working within School Health Support Services are receiving increasing numbers of referrals, relative to past rates, for children who are experiencing motor problems and may have developmental coordination disorder. Based upon clinical experience, therapists indicate that these children are typically referred in the early school years and that most have handwriting difficulties; to date, however, there has been little empirical evidence to support these observations. In this paper, descriptive information is presented for 556 children who may be presumed to have developmental coordination disorder and who had been referred to school-based health services in two centres. Typical reasons for referral, co-morbidity information, and assessment practices are presented. Findings confirmed the presence of many occupational performance issues in this population, including handwriting difficulties, and challenge therapists to broaden the current scope of school health assessment and intervention practices.
Key words: Developmental Coordination Disorder · Evaluation process, occupational therapy · Referral and consultation
The use of the Canadian Occupational Performance Measure as an outcome of a Pain Management Program
by Linda Carpenter, Gus A. Baker & Barbara Tyldesley
The last three decades have seen the emergence of measures to assess the efficacy of pain management programs. Recently there has been interest in measures that assess clients perceptions of their own performance. The Canadian Occupational Performance Measure (COPM) (Law et al, 1994, 1998) is an individualized measure designed for use by occupational therapists to detect a self-perceived change in occupational performance problems over time. It may be an important extra dimension to assessing the outcomes of pain management programs. The aim of this study was to ascertain the validity of the COPM as an outcome measure for the Liverpool Pain Management Program. One hundred and six clients were recruited to the study and 87 clients completed a battery of tests including the COPM at baseline, end of program and 3 month follow-up. Results of the study demonstrated that the COPM showed good evidence of concurrent criterion validity and sensitivity to change.
Key words: Canadian Occupational Performance Measure · Outcome assessment (health care) · Pain management
Relationships among three clinical measures of muscle tone at the elbows of individuals after a stroke
by J. Scott Worley
Patterns of associations among three common clinical muscle tone measures were investigated to determine their degree, and patterns of agreement. Data contributing to selection of clinical measures of muscle tone and understanding factors contributing to occupational dysfunctions were also sought. Forty five persons who were admitted after stroke to two occupational therapy rehabilitation programs were randomly selected. Their affected elbow s resting position (EJP), resistance to passive extension (ERM) and the angle where resistance first appeared (EAR) were measured by one, then a second therapist who also measured voluntary muscle function. Correlations among the three measures were calculated for both administrations and among patient subgroups with statistical correction for multiple correlations.Statistically significant associations appeared between ERM and EAR and between EJP and EAR. Highest statistically significant associations appeared among subjects with poor upper extremity function and those with low muscle tone. Patterns of associations were similar for the first and second administrations at both centres, though patterns among subgroups differed between centres. Correlation patterns suggest that biomechanical factors may influence the joint's resting position (EJP) more than ERM and EAR. Measures may be used interchangeably only with selected patient subgroups, which should also be the basis of method selection.
Key words: Cerebrovascular disorders · Evaluation studies · Muscle tonus
Career choices: A comparison of two occupational therapy practice groups
by Seanne Wilkins & Carolyn Rosenthal
The increasing number of elderly people in the population and their greater use of the health care system require an increasing number of health care providers to work with older adults. A shortage of health care professionals to provide this care, as well as a reluctance to provide such care have been reported in the literature. The purpose of this qualitative study was to investigate how occupational therapists decide to work with older adults. Using a comparative approach, 40 occupational therapists were interviewed, 20 working in gerontology and 20 working in paediatrics. The findings indicate that social characteristics and experiences of the individual, as well as the context of work are important influences for practice choice decisions. Mapping of career paths led to the development of a typology to further describe the different influences involved in the career choices of these occupational therapists. Recommendations related to education and practice provide practical means by which to implement change.
Key words : Career choice · Geriatric occupational therapy · Occupational therapy manpower · Paediatric occupational therapy
A Functional Model of Cognitive Rehabilitation in occupational therapy
by Shirley S. Lee, Nancy J. Powell & Susan Esdaile
Persons who sustain cerebral injuries often have cognitive impairments. Occupational therapists are active in providing cognitive rehabilitation that aims to minimize the effects of cognitive deficits in their clients' lives. This paper presents a brief review of the literature in the area of cognitive rehabilitation including major characteristics of existing occupational therapy models related to the treatment of people who need cognitive rehabilitation. A model of cognitive rehabilitation is proposed that emphasizes functional components of occupational therapy in different rehabilitation settings. This model, called the Functional Model of Cognitive Rehabilitation, supports the use of activities in naturalistic settings in treatment, in order to enable those with cognitive impairments to fulfill their occupational roles.
Key words: Cognitive rehabilitation · Models, occupational therapy · Occupational performance
Occupational therapy practice patterns with older Swedish persons at home
by Margareta Lilja & Lena Borell
This paper explores and describes occupational therapy practice patterns during two periods for 89 elderly persons living at home. Occupational therapists working in one social welfare district in Stockholm, Sweden documented and reported every occupational therapy intervention provided. The results revealed that the elderly persons who received occupational therapy services during an extended period had an age span of 30 years, with a mean age over 80 years. They had several medical problems and were living in different types of settings. Occupational therapists provided a wide range of interventions, most frequently categorised as treatment, especially related to leisure activities. Irrespective of level of care, the median of interventions per person increased or was the same over time, and 72% of the elderly persons remained at the same level of care. Enabling occupation for elderly disabled person living in their home involves constantly adjusting to the current situation since the clients' capacities, goals and environment change over time. Therefore, occupational therapists need to have a client-centred approach working in home health community services.
Key words: Aged · Community occupational therapy · Intervention process (occupational therapy) · Reassessment process