Self-Feeding Interventions for Adults with Tremors

This research analysis was completed in collaboration with Carol Schramek, OTR/L, who works at a skilled nursing facility (SNF) in Iowa run by ABCM corporations. A systematic review of literature was conducted to explore the research question: What evidence-based interventions have been shown to be effective for reducing tremors, improving occupational performance, and/or increasing client satisfaction during self-feeding in adults with resting and/or action tremors? After initial review of 73 articles based on title, 33 articles met our inclusion criteria and were included in our critical appraisal of our topic (CAT). We found there to be a lack of research specifically on self-feeding interventions for adults with an upper-extremity tremor. Due to this gap in research, inferences on the effectiveness of the non-functional interventions for occupation-based tasks in our critical appraisal for self-feeding were made. After reviewing the 33 articles, 8 intervention categories prevailed that had positive impacts on occupational performance for clients with tremor including: limb temperature, positioning of the upper extremity, electrical stimulation, vibration, orthoses, muscular therapy, behavioral training, and various eating devices. After meeting with our collaborator to discuss options for disseminating our findings from the CAT analysis, it was determined that a digital booklet containing basic information ( description, methods, cost, photos) on each intervention category would be most useful for Schramek and her occupational therapy (OT) practitioner colleagues to use when learning about and selecting interventions to use. The booklet was created and sent via email in a pdf and Microsoft Word document to reference and print at her convenience. The purpose of providing a Microsoft Word version, was to enable editing of the files for client-centered customization. To measure the efficacy and benefits of the booklet for the OT practitioners, pre and post surveys were created to assess the OT practitioners\u27 current usage, knowledge, and familiarity of self-feeding interventions for adults with tremor before and after reading through our booklet. Results from our surveys and collaborator feedback indicated that the booklet provided useful information for practitioners to utilize and increased their knowledge on options for interventions to address self-feeding in adults with tremor. OT practitioners should consider all supports and barriers the client has for self-feeding when determining if an intervention included in this critical appraisal is appropriate for their clients with tremor. More research is needed to determine if these interventions are appropriate for OT practitioners to implement for clients with tremors