Development of the Occupational Therapy Stroke Arm and Hand Record: An Upper Limb Treatment Schedule

Introduction: This study aimed to develop a comprehensive occupational therapy treatment schedule of upper limb interventions for stroke survivors with reduced upper limb function. Method: In a three-phased qualitative consensus study, 12 occupational therapists from acute and community settings in North West England contributed to interviews and subsequently group discussions to design and pilot a treatment schedule. Interview data were analysed using thematic analysis; the themes were used to develop a framework for the schedule that was supported by and reflected the International Classification of Functioning, Disability and Health framework. A draft schedule was the subject of a focus group and the resultant schedule was piloted in clinical practice by eight local occupational therapists working in neurological rehabilitation. Findings: Consensus was reached on three themes summarizing aspects of function: interventions that address preparation for activity, functional skills (that is, an aspect of function), and function. Three additional themes summarized other aspects of therapy: advice and education, practice outside therapy sessions, and psychosocial interventions. These themes became the main headings of the treatment schedule. The Occupational Therapy Stroke Arm and Hand Record treatment schedule was piloted and found to be comprehensive and potentially beneficial to clinical practice. Conclusion: The Occupational Therapy Stroke Arm and Hand Record treatment schedule provides a tool for use in stroke research and clinical practice

Automatic Detection of User Abilities through the SmartAbility Framework

This paper presents a proposed smartphone application for the unique SmartAbility Framework that supports interaction with technology for people with reduced physical ability, through focusing on the actions that they can perform independently. The Framework is a culmination of knowledge obtained through previously conducted technology feasibility trials and controlled usability evaluations involving the user community. The Framework is an example of ability-based design that focuses on the abilities of users instead of their disabilities. The paper includes a summary of Versions 1 and 2 of the Framework, including the results of a two-phased validation approach, conducted at the UK Mobility Roadshow and via a focus group of domain experts. A holistic model developed by adapting the House of Quality (HoQ) matrix of the Quality Function Deployment (QFD) approach is also described. A systematic literature review of sensor technologies built into smart devices establishes the capabilities of sensors in the Android and iOS operating systems. The review defines a set of inclusion and exclusion criteria, as well as search terms used to elicit literature from online repositories. The key contribution is the mapping of ability-based sensor technologies onto the Framework, to enable the future implementation of a smartphone application. Through the exploitation of the SmartAbility application, the Framework will increase technology amongst people with reduced physical ability and provide a promotional tool for assistive technology manufacturers

Detecting physical abilities through smartphone sensors: an assistive technology application

Purpose: It is important to promote assistive technologies to improve quality of life. The proposed SmartAbility Android Application recommends assistive technologies for people with reduced physical abilities, by focussing on actions that can be performed independently. Materials and methods: The SmartAbility Application uses Android built-in sensors, e.g., accelerometer and gyroscope and application programming interfaces (APIs) to detect physical abilities, e.g., head movements and blowing and recommend suitable assistive technologies. This is supported by a MySQL database that stores assistive technologies and mappings between abilities. The underpinning research is the SmartAbility Framework that culminates the knowledge obtained during previously feasibility trials and usability evaluations. Results: The Application was evaluated by pupils (n¼18) at special educational needs schools with physical conditions, including cerebral palsy, autism and Noonan syndrome, and assessed through the NASA Task Load Index (TLX) and System Usability Scale (SUS). Analysis using the Adjective Rating Scale highlighted that the Application achieves “Good Usability”. Conclusion: The SmartAbility Application demonstrates that built-in sensors of Android devices and their APIs, can detect actions that users perform, e.g., head movements and speaking. The Application contains a database where assistive technologies are mapped to physical abilities, in order to provide suitable recommendations. It will be disseminated to assistive technology charities and manufacturers and be used by healthcare professionals as part of the rehabilitation process. Future developments of SmartAbility include the creation of a second Application designed specifically to recommend assistive technologies for the education sector, based on users’ physical and cognitive abilitie

A Qualitative Study Exploring the Causes of Boredom for Men with a Psychosis in a Forensic Setting

Boredom is a problem in forensic mental health settings, and is believed to increase levels of violence and be detrimental to health and recovery. Eight men in a forensic unit, all with a psychotic disorder, were interviewed regarding their experiences of boredom. A thematic analysis was used to identify emergent themes. These included: Mental health and motivation; Restrictive environment; Responsibilities; and Nothing to do. These findings provide a greater understanding of factors which may contribute to boredom within forensic settings and can guide occupational therapy interventions to address them

Beyond dressing and driving: Using occupation to facilitate community integration in neurorehabilitation

During the process of community integration, individuals with acquired brain injury may experience difficulties in all areas of occupational performance including self-care, home management, community access, leisure, social activities and vocational pursuits. Community based rehabilitation services provide opportunities to minimise such difficulties by working with clients as they engage in meaningful real-life context-based occupations. The therapeutic use of occupation is at the core of occupational therapy practice. We reflect on the nature and principles of occupation and highlight particular benefits for facilitating community integration after brain injury. This is illustrated using the example of executive dysfunction. Several challenges for the occupational therapy profession arise from the shift in focus from hospital to community based rehabilitation, and the need for further research on community integration after brain injury from an occupational perspective is recognised