Promoting Independence Through Effective Interventions For Adults With ALS

PICO Question What are effective occupational therapy interventions for adults with ALS to improve participation in ADLs/IADLs? Objectives Define amyotrophic lateral sclerosis (ALS) and recognize the prevalence Identify and describe evidence-based interventions to promote independence for individuals with ALS in activities of daily living (ADLs) and instrumental activities of daily living (IADLs) Discuss how the current literature on the effective interventions impacts occupational performance and treatment of adults with AL

A Systematic Review: Light Therapy for Individuals with Dementia and Implications for Practice

This systematic review seeks to answer the question: is light therapy an effective intervention for sundowning symptoms experienced by individuals who have dementia

A Systematic Review of the Efficacy of Motivational Interviewing on Occupational Performance

This systematic review aims to review the efficacy of MI to address such performance goals falling within the occupational therapy scope of practice

Trauma-Informed Care in a School Setting: Occupational Therapy Interventions to Promote Emotional Regulation

PICO Question What trauma-informed occupational therapy interventions improve emotional regulation and participation in school-based tasks for students? Objectives Define trauma and note its prevalence among school-aged children Describe principles of Trauma-Informed Care and its importance in a school setting. Describe current research to determine best practice using a Trauma-Informed Care (TIC) approach in schools for OT practitioner

Parents\u27 Goals: An Analysis of Therapist Reasoning

Purpose: Illustrate the use of DDDM to develop parent-identified goals for occupational therapy and to identify underlying sensory integration factors hypothesized to be impacting participation

Interventions for Improving Occupational Performance Post-Concussion in Children and Adolescents: A Scoping Review

Objectives of Presentation: ● Recognize the significant impact of concussion on immediate and long-term mental and physical well being in the pediatric population. ● Identify the need for novel and effective interventions that address the impact of pediatric concussions. ● Describe current concussion interventions and management practices and the gap that exists in the literature. ● Discuss interventions within the scope of OT practice to address occupational performance in children and adolescents post-concussion. Clinical Question: What interventions within the scope of occupational therapy practice are indicated in the current literature to improve occupational performance in children and adolescents who have experienced a concussion? Presentation: 55 minute

Retrain Your Brain: A Systematic Review of Functional Electrical Stimulation’s Effect on ADL Participation Post-Stroke

Primary Focus: Rehab, Disability & Participation Learning Objectives: Learning Objectives: ● Describe the impact of stroke on ADL performance ● Identify the role of OT in stroke rehabilitation ● Explain how Functional Electrical Stimulation (FES) falls within the scope of OT practice ● Interpret the current evidence on how FES influences ADL participation for individuals poststroke Abstract: Stroke is one of the leading causes of long term disability in the United States (Centers for Disease Control and Prevention, 2015). According to HartmanMaeir, Soroker, Ring, Avni, and Katz (2007), 57% of stroke survivors will eventually discontinue their meaningful activities, including activities of daily living (ADLs). Lack of independence in ADLs has a negative psychosocial impact (Kitson, Dow, Calabrese, Locock, & Athlin, 2012), contributes to decreased quality of life, and increased caregiver burden (Rigby, Gubitz, & Phillips, 2009). In this presentation, practitioners will be exposed to the current literature that examines the efficacy of Functional Electrical Stimulation (FES) as an intervention within the scope of occupational therapy practice to improve participation in ADLs in adults with stroke. A systematic review of the literature was conducted by searching PubMed, CINAHL, and Scopus databases. After abstract screening and fulltext rescreening, 13 articles met the inclusion criteria: participants were adults with stroke, the intervention involved electrical stimulation concurrent with a functional task, and ADL performance as an outcome measure. Articles were critically appraised using the Law McDermid Quantitative Review Form and examined for level of evidence. After critical appraisal, 3 themes were evident: FES + additional therapy, location of FES intervention, and frequency of FES intervention. While control groups that received standard therapy demonstrated improvements in ADL performance, treatment groups receiving FES in addition to standard therapy had significantly better ADL performance than control groups (You et al., 2014, Tanovic, 2009, & Tan et al., 2014). Treatments that took place within a clinic demonstrated significantly improved ADL performance (Kowalczewski et al., 2007; Tan et al., 2014; Tanovic, 2009; & You et al., 2014) while homebased treatments did not. Lastly, the only studies that demonstrated a statistically significant improvement in ADL performance consisted of FES conducted 5 or more days a week (Kowalczewski et al., 2007; Tan et al., 2014; Tanovic, 2009; & You et al., 2014). In this session, practitioners will learn how FES can be used in stroke rehabilitation and will apply this insight to guide best practice for clients who have sustained a stroke. Practitioners will understand how setting, frequency and additional therapy influence efficacy of FES for improving ADL participation. Level of material being presented: Introductory Target Audience: OT, OTA, OTS, Researcher References Centers for Disease Control and Prevention. (2015). Stroke Facts. Retrieved from http://www.cdc.gov/stroke/facts.htm Hartman-Maeir, A., Soroker, N., Ring, H., Avni, N., & Katz, N. (2007). Activities, participation and satisfaction oneyear post stroke. Disability and Rehabilitation, 29, 559–566. http://dx.doi.org/10.1080/09638280600924996 Kitson, A. L., Dow, C., Calabrese, J. D., Locock, L., & Athlin, Å. M. (2013). Stroke survivors’ experiences of the fundamentals of care: A qualitative analysis. International journal of nursing studies, 50(3), 392403[ Ma1] . Kowalczewski, J., Gritsenko, V., Ashworth, N., Ellaway, P., & Prochazka, A. (2007). Upperextremity functional electric stimulation–assisted exercises on a workstation in the subacute phase of stroke recovery. Archives of physical medicine and rehabilitation, 88(7), 833839. Rigby, H., Gubitz, G., & Phillips, S. (2009). A systematic review of caregiver burden following stroke. International Journal of Stroke, 4(4), 285292. doi: 10.1111/j.17474949.2009.00289. x Quandt, F., & Hummel, F. C. (2014). The influence of functional electrical stimulation on hand motor recover y i n stroke patients: a review. E xperimental & translational stroke medicine, 6(1), Tan, Z., Liu, H., Yan, T., Jin, D., He, X., Zheng, X., et al. (2014). The effectiveness of functional electrical stimulation based on a normal gait pattern on subjects with early stroke: A randomized controlled trial. BioMed Research International, 2014 doi:10.1155/2014/545408 Tanovic, E. (2009). Effects of functional electrical stimulation in rehabilitation with hemiparesis patients. Bosnian Journal of Basic Medical Sciences / Udruzenje Basicnih Mediciniskih Znanosti = Association of Basic Medical Sciences, 9(1), 4953. You, G., Liang, H., & Yan, T. (2014). Functional electrical stimulation early after stroke improves lower limb motor function and ability in activities of daily living. Neurorehabilitation, 35(3), 381389. doi:10.3233/NRE141129 [doi] Presentation: 38:5

PromOTing Quality of Life for Individuals with Huntington’s Disease

Objectives of Presentation: Describe the symptoms of Huntington’s disease and their impact on functional performance. Recognize the role of occupational therapy in improving quality of life for individuals with Huntington’s disease. Discuss how occupational therapy interventions for individuals with Huntington’s disease can be applied in a variety of settings. Clinical Question: What is the effectiveness of occupational therapy interventions in improving quality of life for individuals with Huntington’s disease? Presentation: 46 minute

Losing a Limb, Regaining Independence: A Systematic Review of Occupational Therapy Interventions for Lower Extremity Amputations

Primary Focus: Rehab, Disability & Participation Learning Objectives: Describe lower extremity residual limb care interventions within the scope of occupational therapy Explain the prevalence of individuals who sustain a lower extremity amputation and understand the impact on the U.S. health-care system Identify lower extremity residual limb care interventions to maximize occupational performance Abstract: The purpose of this presentation is to report findings of a systematic review regarding residual limb care interventions supporting increased occupational performance in adults post lower extremity amputation. A systematic review was completed utilizing PubMed, CINHAL, and OTseeker. Inclusion criteria included articles with a sample of adults (mean age of 18-64 years old) with all levels of lower extremity amputations resulting from various etiologies. In addition, these articles were published within the past 10 years and in the English language. Exclusion criteria included articles that contained interventions outside of the scope of occupational therapy practice, systematic reviews, and meta-analyses. Two million people in the U.S. are currently living with limb loss. Hospital costs associated with amputees in 2009 totaled 8.3 billion dollars. Approximately half of individuals with amputations due to vascular disease will require an additional amputation within 2-3 years (Amputee Coalition, 2016). Although there is evidence on surgical techniques and physical therapy’s role in rehabilitation of lower extremity amputations, there is limited evidence to support occupational therapy’s unique role (Robinson, Sansam, Hirst, & Neumann, 2010). However, occupational therapists can provide valuable interventions to improve participation in all activities of daily living (Klarich & Brueckner, 2014). Critical appraisals of eligible articles were performed to identify themes and clinical implications utilizing quantitative and qualitative critical review forms. Four themes concluded from the literature associated with residual limb care interventions and their impact on occupational performance included education, health-care costs, pain, and skin integrity. These findings present implications for occupational therapy research, education, and practice in regards to advocating for occupational therapy’s role in the continuum of care for individuals with lower extremity amputation, and the implementation of interventions to increase occupational performance and decrease health-care costs. This presentation material is of intermediate level and targeted for an audience of occupational therapists and occupational therapy assistants with experience working with individuals with lower limb amputations. References: Amputee Coalition. (2016). Limb loss statistics. Retrieved from http://www.amputee-coalition/limb-loss-resource-center/resources-by-topic/limb-loss-statistics/limb-loss-statistics/ Robinson, V., Sansam, K., Hirst, L., & Neumann, V. (2010). Major lower limb amputation -- what, why and how to achieve the best results. Orthopaedics & Trauma, 24(4), 276-285 10p. doi:10.1016/j.mporth.2010.03.017 Klarich, J., & Brueckner, I. (2014). Amputee rehabilitation and preprosthetic care. Physical Medicine and Rehabilitation Clinics of North America, 25(1), 75-91. doi:10.1016/j.pmr.2013.09.005 Presentation: 31:5

Occupational Therapy in Preventative Care: Promoting Cardiovascular Health in Underserved Women

Primary Focus: ☝ Health & Wellness Level of session: intermediate, mixed audience Learning Objectives: By the conclusion of this presentation, participants will: Describe how health disparities affect underserved women Identify evidence supporting the inclusion of occupational therapy in preventative care practice Discuss occupational therapy’s role in preventative care as it relates to cardiovascular health and wellness Abstract: Heart disease causes one in three deaths each year in women (AHA, 2012). Increasing healthcare costs disproportionately affect women with low incomes and those from diverse backgrounds (CHUW, 2012). For underserved women, lack of insurance, education and variations in culture may compromise access to care (CHUW, 2012). Traditionally underserved communities are impacted to a higher degree by the burden of cardiovascular disease (CVD) than other members of the population (AHA, 2012). Research demonstrated Hispanic women as least likely to have access to medical care, while about half of African-American women are unaware of signs and symptoms of a heart attack (AHA, 2012). Comparably, 90% of women are reported as having heart disease risk factors despite the fact that 80% of heart disease may be prevented by lifestyle changes and education (AHA, 2012). Thus, preventive care and health promotion services are critical to underserved women’s health (CHUW, 2012). The availability of these services will increase the effectiveness of service delivery for this population (CHUW, 2012). With the impact of CVD among underserved women, there is an opportunity for occupational therapy (OT) services within this population. Health promotion and disease prevention approaches are identified in the Occupational Therapy Practice Framework and OT practitioners are equipped to address cardiovascular (CV) health and wellness. (AOTA, 2014). The purpose of this session is to present a systematic review answering the following clinical question: What is the effectiveness of OT interventions (I) to promote CV health (O) in underserved women (P)? An exhaustive search using CINAHL, Scopus and PubMed retrieved 686 quantitative studies published in English between 2011-2016. Articles were screened using the inclusion criteria: studies with community-dwelling adult women from underserved populations and studies promoting CV health through interventions with methods relating to physical activity, nutrition and weight management. The 16 eligible articles were appraised using a critical review form for quantitative studies (Law & MacDermid, 2014). Synthesis revealed four intervention themes: education, physical activity, nutrition, and coaching. The implications of these results demonstrate that culturally-tailored OT interventions with a focus on lifestyle behavior change in a group format can promote CV health in underserved women. References: American Heart Association [AHA]. (2012). Heart disease statistics at a glance. Retrieved July, 2016, from https://www.goredforwomen.org/about-heart-diseasefacts_about_heart_disease_in_women-sub-category/statistics-at-a-glance/ American Occupational Therapy Association [AOTA]. (2014). Occupational therapy practice framework: Domain & process (3rd ed.). American Journal of Occupational Therapy, 68, S1-S48. http://dx.doi.org/10.5014/ajot.2014.682006. Committee on Health for Underserved Women [CHUW]. (2012). Committee opinion no. 516: Health care systems for underserved women. Obstetrics & Gynecology, 119(1), 206-209. doi:10.1097/01.aog.0000410163.28525.4e Law, M. & MacDermid, J.C. (Eds.). (2014). Appendix D: Quantitative review: form and guidelines. In Evidence-based rehabilitation: A guide to practice (3rd ed.). Thorofare, NJ: SLACK. Presentation: 43:0