Workplace musculoskeletal problems in occupational therapy students

Background: Workplace musculoskeletal disorders are the leading cause of morbidity and disability in the Australian workforce. Over one in five occupational therapists report workplace musculoskeletal disorders, with almost half reporting workplace musculoskeletal symptoms. In other health professions, students and novice clinicians (≤5 years practice) experience greater risk but little is known about occupational therapy students. Methods: In this cross-sectional study, a survey including the self-reported Standardised Nordic Musculoskeletal Questionnaire was administered to occupational therapy students post work-based training. Musculoskeletal problems were defined as aches, pains, numbness or discomfort. Questions explored body sites affected, prevalence, impact on activity, need for medical assistance, demographic and workplace information. Prevalence was reported using descriptive statistics. Factors associated with workplace musculoskeletal problems over the previous 12 months and last 7 days were examined using logistic regression modelling. Results: Response rate was 53% (n = 211/397). One-third of respondents (33.6%, n = 71/211) reported a workplace musculoskeletal problem over 12 months. Nearly half (47.9%, n = 34/71) of these students reported a problem over the last 7 days. Neck was the most commonly affected area reported for musculoskeletal problems over the past 12 months (24.2%, n = 51/211) and shoulder areas affected over the past 7 days (10.9%, n = 23/211). Musculoskeletal problems preventing daily activities were reported most commonly from lower back problems over 12 months (23.9%, n = 17/71) and for shoulder problems over the last 7 days (21.9%, n = 7/32). Shoulders and knees were the most common body areas requiring medical attention. Previous musculoskeletal problems and female gender were associated with reported problems over 12 months and last 7 days (p < 0.05). Non-standard joint mobility (OR = 3.82, p = 0.002) and working in psychosocially focused caseloads (including mental health or case management) (OR = 3.04, p = 0.044) were also associated with reporting musculoskeletal problems over the last 7 days. Conclusions: One in three occupational therapy students already experience workplace musculoskeletal problems impacting daily activities and requiring medical assistance prior to graduation. High prevalence of musculoskeletal problems in this study calls for educators and researchers to find sustainable strategies to address these problems, with particular consideration to the impact of previous disorders and working in psychosocially focused caseloads on musculoskeletal health

The impact of the sensory form on confidence and competence in occupational therapy students : a quasi-experimental study

The Sensory Form is a new assessment and intervention planning tool utilized with occupational therapy students to teach and guide their professional reasoning amidst limited evidence. This study aimed to determine the impact of the use of The Sensory Form on student competence and confidence in assessment and intervention planning for children with atypical sensory processing (ASP). A quasi-experimental study was conducted with 84 third-year undergraduate occupational therapy students from a large multi-campus university in New South Wales, Australia. Tutorial classes were allocated to The Sensory Form or usual teaching conditions. Participants completed pre-class and post-class self-reported confidence rating scales and case study activity to assess their competence as rated by an occupational therapy academic using a set rubric who was blinded to group allocation. Data were analyzed using descriptive statistics as well as univariate ANOVA (self-rated confidence) and independent samples ttests (case study activity) to determine statistical differences between groups. All participants significantly increased in confidence from pre-class to post-class (p < 0.001), however, The Sensory Form group did not increase significantly more than the standard teaching group. The Sensory Form group demonstrated significantly higher competence in sensory processing assessment (p < 0.001). No differences between groups were observed in intervention planning. The Sensory Form has the potential to develop students’ competence in conducting assessments for children with ASP. Future research is needed to determine how The Sensory Form can effectively support students’ overall confidence, and competence in intervention planning

Mountains, Molehills and Milestones: Participant Experiences from the WSU Mentoring Programs

This study uses a series of narratives (stories) of experiences of professional and academic staff participating in mentoring programs at Western Sydney University as either mentors or mentees in the last five years. The narratives, as prompted by open-ended questions through an online survey instrument, reflect on participants’ mentoring goals, the outcomes of the program, any challenges experienced and recommendations for future staff involved in mentoring programs at the university. In addition, the study examines the success of the mentoring program across a range of psycho-social and career development outcomes over a five-year period. The study highlights the practical implications of mentoring programs for staff and provides guidance to future participants. It also considers if there are any notable differences in the experiences of a mentoring program which may be due to demographic factors such as age, discipline, gender and years of experience. Findings suggest that proactivity, risk-taking, time management and trust are the main obstacles that mentees must overcome in order to reap the full benefits of a mentoring program. Academic mentees were found to be successful in applying for research grants, publishing research articles and substantially increasing the number of higher degree research students under their supervision. Some mentees also received awards and recognition that they attributed to being part of the mentoring program. Other less tangible benefits that were reported by mentees include improved networking skills, increased confidence and assertiveness, prioritising of work activities, and navigating ‘office politics’. Mentors participating in the study built lasting friendships with their mentees and found that being a mentor provided them an opportunity to revisit their own career and make improvements/take action where necessary. Some mentors also invited their mentees to so-supervise research students with them and to work with them on research grants and projects. Less tangible achievements of mentors included building both their own and their mentee’s confidence and contributing to succession planning for the University. The findings of this study are important for both professional and academic staff considering mentoring programs to assist in advancing their career and to higher education institutions who seek to offer successful mentoring programs for their staff. The research highlights the practical implications of mentoring programs for staff at higher education institutions and makes recommendations for future programs and participants to ensure that the programs are contributing to the developmental, career and psycho-social needs of staff from all gender groups and provide equal opportunity for all staff to advance careers through promotion and improved performance

Development and feasibility of first- and third-person motor imagery for people with stroke living in the community

Background: Impairment of arm movement occurs in up to 85% of people post-stroke, affecting daily living activities, and quality of life. Mental imagery effectively enhances hand and daily function in people with stroke. Imagery can be performed when people imagine themselves completing the movement or imagine another person doing it. However, there is no report on the specific use of first-person and third-person imagery in stroke rehabilitation. Aims: To develop and assess the feasibility of the First-Person Mental Imagery (FPMI) and the Third-Person Mental Imagery (TPMI) programs to address the hand function of people with stroke living in the community. Methods: This study comprises phase 1—development of the FPMI and TPMI programs, and phase 2—pilot-testing of the intervention programs. The two programs were developed from existing literature and reviewed by an expert panel. Six participants with stroke, living in the community, participated in the pilot-testing of the FPMI and TPMI programs for 2 weeks. Feedback collected included the suitability of the eligibility criteria, therapist’s and participant’s adherence to intervention and instructions, appropriateness of the outcome measures, and completion of the intervention sessions within the specified time. Results: The FPMI and TPMI programs were developed based on previously established programs and included 12 hand tasks. The participants completed four 45-min sessions in 2 weeks. The treating therapist adhered to the program protocol and completed all the steps within the specified time frame. All hand tasks were suitable for adults with stroke. Participants followed the instructions given and engaged in imagery. The outcome measures selected were appropriate for the participants. Both programs showed a positive trend towards improvement in participants’ upper extremity and hand function and self-perceived performance in activities of daily living. Conclusions: The study provides preliminary evidence that these programs and outcome measures are feasible for implementation with adults with stroke living in the community. This study outlines a realistic plan for future trials in relation to participant recruitment, training of therapists on the intervention delivery, and the use of outcome measures

Older drivers in Australia and advanced vehicle technologies : what are their opinions? : a qualitative study

Background: There is limited research on older drivers’ perspectives on advanced vehicle technologies (AVTs). This study investigates what older drivers know and understand about AVTs in the current vehicle market, and identifies what motivates older drivers to use or not use AVTs. Method: Older drivers (≥65 years) living in New South Wales, Australia completed semi-structured telephone interviews guided by the Car Technology Acceptance Model. All interviews were audio-recorded and transcribed verbatim. Content analysis and deductive-inductive thematic analysis were completed on each transcript independently by two researchers, with all themes presented to the investigative team, discussed until consensus was reached. Participant recruitment were ceased after thematic saturation. Results: 24 participants (mean age: 74.5 years; 13 males, 11 females) were interviewed. Eleven different AVTs were mentioned by participants. Attitudes towards these AVTs impacted how much participants understood how these technologies worked. These attitudes and motivation of technology usage could be explained by four major themes; (1) AVTs help with safety but overall responsibility remains with the driver, (2) Lack of clear information and instructions make AVTs look confusing, (3) AVTs need to be more user-friendly for older adults, and (4) Expensive out-of-pocket costs stop AVT usage. Conclusions: Despite understanding the safety benefits of simple, standard AVTs, older drivers perceive barriers that hinder their use of more complicated technologies. Increased consultations to make AVTs more acceptable to older adults are needed. In conjunction, more resources and options aimed at helping older adults better understand and access AVTs need to be developed

Effectiveness of action observation and motor imagery on relearning upper extremity function after stroke : a systematic review and meta-analysis

The effectiveness of action observation (AO) and motor imagery (MI) in high-quality studies with less risk of bias is rarely reported together. This systematic review evaluates the effectiveness of AO and MI on improving upper extremity function among people after stroke by combining evidence of studies with high methodological quality. Randomised controlled trials, with a score of 6 or above in the PEDro Scale, that examined the effects of AO or MI for people with stroke were selected. A narrative analysis and meta-analysis were conducted using the PRISMA guidelines. Ten randomised controlled trials from 11 articles met the inclusion criteria. The results of meta-analysis showed that AO had a small to moderate statistically significant effect on improving upper extremity motor function (standardized mean difference, SMD=0.34; confidence interval, CI=0.08, 0.59; P=0.35; I2=0.00%) and no significant effect on MI (SMD=0.08; CI=-0.26, 0.42; P=0.65; I2=0.00%) when compared with the control intervention. Evidence was found in support of AO and it is recommended for people with acute or sub-acute stroke

Associations between vision impairment and driving and the effectiveness of vision-related interventions : protocol for a systematic review and meta-analysis

Introduction Driving is one of the main modes of transport with safe driving requiring a combination of visual, cognitive and physical skills. With population ageing, the number of people living with vision impairment is set to increase in the decades ahead. Vision impairment may negatively impact an individual's ability to safely drive. The association between vision impairment and motor vehicle crash involvement or driving participation has yet to be systematically investigated. Further, the evidence for the effectiveness of vision-related interventions aimed at decreasing crashes and driving errors has not been synthesised. Methods and analysis A search will be conducted for relevant studies on Medline (Ovid), EMBASE and Global Health from their inception to March 2020 without date or geographical restrictions. Two investigators will independently screen abstracts and full texts using Covidence software with conflicts resolved by a third investigator. Data extraction will be conducted on all included studies, and their quality assessed to determine the risk of bias using the Joanna Briggs Institute Critical Appraisal Tools. Outcome measures include crash risk, driving cessation and surrogate measures of driving safety (eg, driving errors and performance). The results of this review will be reported using the Preferred Reporting Items for Systematic Review and Meta-Analysis guideline. Meta-analysis will be undertaken for outcomes with sufficient data and reported following the Meta-analyses of Observational Studies in Epidemiology guideline. Where statistical pooling is not feasible or appropriate, narrative summaries will be presented following the Synthesis Without Meta-analysis in systematic reviews guideline. Ethics and dissemination This review will only report on published data thus no ethics approval is required. Results will be included in the Lancet Global Health Commission on Global Eye Health, published in a peer-reviewed journal and presented at relevant conferences. PROSPERO registration number CRD42020172153

Behind the wheel: Can education enhance self-regulation among older drivers living in the community? An investigation into safe community mobility in later life

This thesis investigated driving patterns of older Australians and evaluated a safe-transport program designed to enhance self-regulation, while maintaining community participation. A sample of 380 drivers aged 75 years and older (mean age: 80±4 years) from northwest Sydney were recruited and in-vehicle monitoring devices installed in their vehicles. Participants took short trips (≈5km) and drove 100 kilometres in one week, on average. Older drivers with poorer function, and lower confidence took shorter trips, closer to home. Half of the participants were randomised to receive the ‘Behind the Wheel’ program. While there was no significant difference in distance driven per week over 12-months (between-group difference:-5.5km,95%CI:-24.5-13.5km), intervention group participants were more engaged in self-regulatory driving practices than those in the control (OR:1.6,95%CI:1.1-2.3). Importantly there was no difference in community participation (between-group difference:-0.1,95%CI:-0.6-0.3), but older drivers with low function in the intervention group were 3.1 times more likely to report depressive symptoms (95%CI: 1.04-9.2). Taking ownership of the planning process was found to be important to reduced driving exposure in the process evaluation. Women and participants who understood the program content were more likely to take ownership. ‘Behind the Wheel’ had greatest impact with older, lower functioning drivers, suggesting a targeted approach

Behind the wheel: Can education enhance self-regulation among older drivers living in the community? An investigation into safe community mobility in later life

This thesis investigated driving patterns of older Australians and evaluated a safe-transport program designed to enhance self-regulation, while maintaining community participation. A sample of 380 drivers aged 75 years and older (mean age: 80±4 years) from northwest Sydney were recruited and in-vehicle monitoring devices installed in their vehicles. Participants took short trips (≈5km) and drove 100 kilometres in one week, on average. Older drivers with poorer function, and lower confidence took shorter trips, closer to home. Half of the participants were randomised to receive the ‘Behind the Wheel’ program. While there was no significant difference in distance driven per week over 12-months (between-group difference:-5.5km,95%CI:-24.5-13.5km), intervention group participants were more engaged in self-regulatory driving practices than those in the control (OR:1.6,95%CI:1.1-2.3). Importantly there was no difference in community participation (between-group difference:-0.1,95%CI:-0.6-0.3), but older drivers with low function in the intervention group were 3.1 times more likely to report depressive symptoms (95%CI: 1.04-9.2). Taking ownership of the planning process was found to be important to reduced driving exposure in the process evaluation. Women and participants who understood the program content were more likely to take ownership. ‘Behind the Wheel’ had greatest impact with older, lower functioning drivers, suggesting a targeted approach