Clinical utility of a decision-making aid for upper limb neurorehabilitation: applying the Hypertonicity Intervention Planning Model across cultures

The Hypertonicity Intervention Planning Model (HIPM) is a decision-making aid which guides clinical reasoning in individualizing upper limb (UL) neurorehabilitation. To examine the HIPM’s clinical utility across cultures, using therapists’ perceptions of its usefulness and challenges when applied in clinical practice. Interpretive description methodology guided qualitative data collection and analysis because it produces clinically practical applications. Forty-four occupational therapists working in Australia or Singapore participated. Three group discussions were conducted using a modified nominal group technique. Three themes were: (1) The HIPM guides systematic clinical decision-making for assessment, goal-setting, and intervention; (2) Utility was influenced by systemic or organizational supports and barriers including availability of time, resources, and funding; organizational readiness to change; multidisciplinary and transorganizational collaboration; (3) Therapists’ skills and confidence to apply the HIPM, and openness to changing practice, influenced utility. Therapists strongly support HIPM use for structuring and communicating clinical reasoning in UL neurorehabilitation. However, organizational support is key to optimizing clinical utility. Incorporating decision-making aids into documentation and referral processes may strengthen multidisciplinary and transorganizational teamwork, enhancing clinical use. Different training tiers to suit therapist experience levels, refresher courses, and supplementary resources may improve therapists’ skills and confidence, thereby boosting utility.</p

Rehabilitation goal setting with community dwelling adults with acquired brain injury: a theoretical framework derived from clinicians’ reflections on practice

<p><b>Purpose:</b> The aim of this study was to explore clinicians’ experiences of implementing goal setting with community dwelling clients with acquired brain injury, to develop a goal setting practice framework.</p> <p><b>Method:</b> Grounded theory methodology was employed. Clinicians, representing six disciplines across seven services, were recruited and interviewed until theoretical saturation was achieved. A total of 22 clinicians were interviewed.</p> <p><b>Results:</b> A theoretical framework was developed to explain how clinicians support clients to actively engage in goal setting in routine practice. The framework incorporates three phases: a needs identification phase, a goal operationalisation phase, and an intervention phase. Contextual factors, including personal and environmental influences, also affect how clinicians and clients engage in this process. Clinicians use additional strategies to support clients with impaired self-awareness. These include structured communication and metacognitive strategies to operationalise goals. For clients with emotional distress, clinicians provide additional time and intervention directed at new identity development.</p> <p><b>Conclusions:</b> The goal setting practice framework may guide clinician’s understanding of how to engage in client-centred goal setting in brain injury rehabilitation. There is a predilection towards a client-centred goal setting approach in the community setting, however, contextual factors can inhibit implementation of this approach.Implications for Rehabilitation</p><p>The theoretical framework describes processes used to develop achievable client-centred goals with people with brain injury.</p><p>Building rapport is a core strategy to engage clients with brain injury in goal setting.</p><p>Clients with self-awareness impairment benefit from additional metacognitive strategies to participate in goal setting.</p><p>Clients with emotional distress may need additional time for new identity development.</p><p></p> <p>The theoretical framework describes processes used to develop achievable client-centred goals with people with brain injury.</p> <p>Building rapport is a core strategy to engage clients with brain injury in goal setting.</p> <p>Clients with self-awareness impairment benefit from additional metacognitive strategies to participate in goal setting.</p> <p>Clients with emotional distress may need additional time for new identity development.</p

sj-docx-1-cjo-10.1177_00084174221142184 - Supplemental material for The Multiple Errands Test: A Guide for Site-Specific Version Development

Supplemental material, sj-docx-1-cjo-10.1177_00084174221142184 for The Multiple Errands Test: A Guide for Site-Specific Version Development by Shannon M. Scarff, Emily J. Nalder, Hannah L. Gullo and Jennifer Fleming in Canadian Journal of Occupational Therapy</p

sj-docx-2-cjo-10.1177_00084174221142184 - Supplemental material for The Multiple Errands Test: A Guide for Site-Specific Version Development

Supplemental material, sj-docx-2-cjo-10.1177_00084174221142184 for The Multiple Errands Test: A Guide for Site-Specific Version Development by Shannon M. Scarff, Emily J. Nalder, Hannah L. Gullo and Jennifer Fleming in Canadian Journal of Occupational Therapy</p

Additional file 2: Supplementary file 2. of Building capacity for knowledge translation in occupational therapy: learning through participatory action research

The Knowledge Translation Questionnaire (DOC 134 kb

Additional file 1: Table S1. of Building capacity for knowledge translation in occupational therapy: learning through participatory action research

KT Activities mapped to the KTA action cycle [25] and Participatory Action Research (PAR) cycle- the first 18 months (DOCX 20 kb

Additional file 3: Table S2. of Building capacity for knowledge translation in occupational therapy: learning through participatory action research

Knowledge translation strategies mapped to the domains of the Theoretical Domain Framework [29] (DOCX 19 kb

Sensitivity, specificity and the respective 95% confidence intervals (CI) using different LFT criteria for <i>T. b. gambiense</i> and <i>T. b. rhodesiense</i> infections.

<p>Sensitivity, specificity and the respective 95% confidence intervals (CI) using different LFT criteria for <i>T. b. gambiense</i> and <i>T. b. rhodesiense</i> infections.</p

Additional file 1: of The efficacy of prospective memory rehabilitation plus metacognitive skills training for adults with traumatic brain injury: study protocol for a randomized controlled trial

Participant Information Sheet and Consent Form. (DOC 112 kb

Soluble form VSG ELISA results with pooled human <i>T. b. gambiense</i> infection and control sera.

<p>Sera were pooled from 1^st (blue lines) and 2^nd (red lines) stage <i>T. b. gambiense</i> infected HAT patients and from non-infected patients (green lines) and titrated against ELISA plates coated with sVSG variants 117 (panel A), 118 (panel B), 121 (Panel C) and 221 (Panel D). Results are expressed as means ± 1 standard deviation of triplicate measurements. The y-axis is Relative Luminescence Units (RLU).</p