Kitchen-related tasks used in occupational therapy during rehabilitation of adults with acquired brain injury : a systematic review

Introduction Kitchen-related tasks are widely used in occupational therapy for adults with acquired brain injury. This study aimed to investigate the effectiveness of kitchen-related, task-based occupational therapy interventions for improving clinical and functional outcomes in the rehabilitation of adults with acquired brain injury. Method A systematic review of the literature was conducted with narrative synthesis (PROSPERO registration CRD42019141898), by searching relevant electronic databases (BNI, CINAHL Plus, MEDLINE, DORIS, OT Seeker etc.), registries of ongoing studies (ISRCTN, PROSPERO, etc.), and grey literature (OpenGrey, etc.). English-language studies that evaluated kitchen-related tasks in the rehabilitation of adults with acquired brain injury were included and independently appraised for their methodological quality by two reviewers. Results Seventeen primary studies met the eligibility criteria. Studies were heterogeneous in methods, methodological quality, setting, sample size, purpose, and design of kitchen-related tasks. Fifteen studies evaluated kitchen-related, task-based treatments for improving function, and two studies examined kitchen-related task assessments for safety and task performance. This provides very limited evidence for the effectiveness of kitchen-related, task-based interventions compared to interventions not based on kitchen-related tasks. Conclusion While kitchen-related, task-based occupational therapy interventions in acquired brain injury rehabilitation are common practice, there is currently limited research evidence to support this. Further studies are warranted to strengthen the evidence base

The problem with self-management : problematising self-management and power using a Foucauldian lens in the context of stroke care and rehabilitation

Self-management is a concept which is now firmly established in Western healthcare policy and practice. However, the term remains somewhat ambiguous, multi-faceted and contentious. This is evident in stroke care and rehabilitation, in which a self-management approach is increasingly adopted and advocated, yet interpreted in different ways, resulting in contradictions and tensions around control, responsibility, power and discipline. This paper aims to further our understanding of tensions and contradictions in stroke self-management, by critically examining contemporary self-management practices. We use a Foucauldian theoretical lens to explore the various power dynamics in the operationalisation of self-management, in addition to the complexity of the term self-management itself. Conducting a secondary analysis of interview and focus group data from the Self-Management VOICED study, supplemented with analysis of relevant documentary evidence from policy and practice, we describe the multiple aspects of power in operation. These include rhetorical, hierarchical, personal and mutual forms of power, representing interweaving dynamics evident in the data. These aspects of power demonstrate underlying agendas and tacit and explicit understandings of self-management which exist in clinical practice. These aspects of power also give insight into the multiple identities of 'self-management', acting as a simultaneous repressor and liberator, directly in keeping with Foucauldian thinking. The findings are also consistent with Foucault's notions of bodily docility, discussions around governance and biopower, and contemporary discipline. Our analysis positions self-management as a highly nuanced and complex concept, which can fluctuate in its conceptualisation depending on the structures, routines, and the individual. We encourage healthcare professionals, policymakers and commissioners in the field of self-management to reflect on these complexities, to make transparent their assumptions and to explicitly position their own practice accordingly

Mobile technologies to promote physical activity during cardiac rehabilitation : a scoping review

Promoting regular physical activity (PA) and improving exercise capacity are the primary goals of cardiac rehabilitation (CR). Mobile technologies (mTechs) like smartphones, smartwatches, and fitness trackers might help patients in reaching these goals. This review aimed to scope current scientific literature on mTechs in CR to assess the impact on patients’ exercise capacity and to identify gaps and future directions for research. PubMed, CENTRAL, and CDSR were systematically searched for randomized controlled trials (RCTs). These RCTs had to utilize mTechs to objectively monitor and promote PA of patients during or following CR, aim at improvements in exercise capacity, and be published between December 2014 and December 2019. A total of 964 publications were identified, and 13 studies met all inclusion criteria. Home-based CR with mTechs vs. outpatient CR without mTechs and outpatient CR with mTechs vs. outpatient CR without mTechs did not lead to statistically significant differences in exercise capacity. In contrast, outpatient CR followed by home-based CR with mTechs led to significant improvement in exercise capacity as compared to outpatient CR without further formal CR. Supplying patients with mTechs may improve exercise capacity. To ensure that usage of and compliance with mTechs is optimal, a concentrated effort of CR staff has to be achieved. The COVID-19 pandemic has led to an unprecedented lack of patient support while away from institutional CR. Even though mTechs lend themselves as suitable assistants, evidence is lacking that they can fill this gap

Reference values for fatigued versus non-fatigued limb symmetry index measured by a newly designed single-leg hop test battery in healthy subjects : a pilot study

There is sparse evidence for return to sport criteria after knee injury. Functional performance deficits, particularly in fatigued muscular condition, should be verified prior to the attempt to return to high-risk pivoting sports. The purpose of this study was to generate reference values for the limb symmetry index (LSI) of healthy subjects in fatigued and non-fatigued muscular condition in a newly designed test battery

Experiences and attitudes toward scientific research among physiotherapists in Austria : a cross-sectional online survey

Research is important for the development of physiotherapy practice, but several countries have a rather short history of physiotherapy as an academic profession. This study investigated physiotherapists' experiences and attitudes toward scientific research in Austria, where physiotherapists have only been qualifying at bachelor level since 2009. A convenience sample of 597 qualified physiotherapists completed an anonymous cross-sectional online survey. Most respondents were female (n = 467, 78.2%) and in age groups between: 26-35 years (n = 149, 25.0%); 36-45 years (n = 178, 29.8%); and 46-55 years (n = 173, 29.0%). Seventeen respondents (2.8%) held doctoral degrees, and 61 (10.2%) had substantial research experience beyond undergraduate or master-level student research. More positive research attitudes were observed in participants who were male, younger, without children, had completed their physiotherapy qualification since 2009, were engaged in teaching and education, and held postgraduate degrees. Most frequently reported barriers and/or enabling factors for physiotherapy research were time, training, finances and a "critical mass" of research activity. These findings highlight low levels of research activity among physiotherapists in Austria, despite general appreciation of the importance of research for the profession. The identified attitudinal profiles, barriers, and facilitators may inform initiatives for advancing physiotherapy research in the Austrian context

Physiotherapists' job satisfaction according to employment situation : findings from an online survey in Austria

Background and Purpose: Physiotherapists are commonly working in self‐employed, employed, or in combined employed and self‐employed work arrangements. This study aimed at examining aspects of job satisfaction and predictors of physiotherapists' overall job satisfaction across those three types of work arrangements. Methods: Austrian physiotherapists rated their overall job satisfaction as well as the importance and realisation of aspects of job satisfaction in a cross‐sectional online survey. Multiple linear regression was used to identify predictors of overall job satisfaction, and (for employed therapists only) predictors for planning to change the employer. Results: The sample consisted of 581 physiotherapists working in the public or private sector, of which, 342 were self‐employed, 100 employed, and 139 both employed and self‐employed. Physiotherapists generally indicated high job satisfaction with notable variations according to their work arrangements. Overall job satisfaction and the aspects of recognition and autonomy were higher in self‐employed therapists, when compared to the other two groups. In contrast, self‐employed therapists reported lower satisfaction with mentoring and peer support. Those who were both employed and self‐employed reported the highest gap between the importance and realisation of their work–life balance (r = −0.50, p < 0.001). Recognition was identified as the most important predictor of job satisfaction (ß = 0.52, p < 0.001) and intention to leave (ß = −0.54, p < 0.001) in employed physiotherapists. Discussion: The analysis of job satisfaction according to work arrangements suggests several approaches to increase or maintain a high level of job satisfaction, which may be addressed by employers and physiotherapy professional organisations. For employed physiotherapists, practices that increase their recognition and autonomy seem to be promising, whereas self‐employed physiotherapists could benefit from enhanced opportunities for exchange and networking with colleagues. For those who are both employed and self‐employed, more flexible work schedules may be helpful to integrate the demands of private patients and employer workloads