Occupational Therapy International[JOURNAL]
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200 papers
Impact of Caregiver Burden and Care Recipients' Activities of Daily Living Abilities on Caregivers' Occupational Dysfunction.
Fujii K, Yorozuya K, Kagayama S … +4 more , Onaka T, Miyazaki S, Noritake K, Fukumoto Y
Occup Ther Int · 2026 · PMID 42117445 · Full text
INTRODUCTION: Caregiver stress is primarily caused by family and social life disruptions that limit the caregivers' abilities to engage in meaningful activities, leading to occupational dysfunction. We are aimed at deter...
INTRODUCTION: Caregiver stress is primarily caused by family and social life disruptions that limit the caregivers' abilities to engage in meaningful activities, leading to occupational dysfunction. We are aimed at determining the proportion of occupational dysfunction among primary caregivers, its association with caregiver burden, and examining the effects of caregiver burden and care recipients' activities of daily living (ADL) abilities on primary caregivers' occupational dysfunction. METHODS: A cross-sectional, facility-based survey was used to investigate the proportion of occupational dysfunction among primary caregivers and its association with caregiver burden. A path analysis was conducted to assess the impact of caregiver burden and care recipients' ADL on occupational dysfunction among primary caregivers. This study included 75 daycare rehabilitation user/primary caregiver pairs. Occupational dysfunction, caregiver burden, and ADL were assessed using the Classification and Assessment of Occupational Dysfunction scale, Zarit burden interview (Japanese version), and the Barthel index, respectively. The impact of caregiver burden and care recipients' ADL on primary caregivers' occupational dysfunction was assessed using correlation and path analyses. RESULTS: The mean age of the primary caregivers and care recipients was 65.2 ± 9.8 years (72.0% were female) and 82.4 ± 7.1 years (48.0% being female), respectively, and 45.3% of the caregivers exhibited occupational dysfunction. Path analysis indicated that a decline in the care recipients' ADL was associated with an increased caregiver burden and subsequently related to higher occupational dysfunction. The model fit indices were as follows: χ (df = 1) = 0.010, p = 0.091, GFI = 1.000, AGFI = 0.999, CFI = 1.000, and RMSEA = 0.000. CONCLUSIONS: Lower ADL abilities among care recipients were associated with higher caregiver burden and greater occupational dysfunction among primary caregivers. These findings indicate that interventions aimed at reducing caregiver burden and addressing caregiver support needs warrant further investigation.
Sex Differences in Instrumental Activities of Daily Living and Transportation Modes by Driving Status Among Older Adults.
Sasaki T, Ichikawa M, Yamada K … +2 more , Tomari Y, Kobayashi D
Occup Ther Int · 2026 · PMID 42104869 · Full text
INTRODUCTION: Planning for driving cessation is essential to support older adults' well-being and access to alternative transportation. As transportation needs vary by activity and sex, it is important to understand how...
INTRODUCTION: Planning for driving cessation is essential to support older adults' well-being and access to alternative transportation. As transportation needs vary by activity and sex, it is important to understand how these factors influence mobility after driving cessation. This study aimed to clarify sex differences in transportation modes for daily activities among older adults with different driving status. MATERIALS AND METHODS: This study examined transportation modes used for instrumental activities of daily living (IADLs) and the level of engagement (i.e., frequency of participation) among community-dwelling older adults, stratified by driving status (current, retired, never) and sex. Cross-sectional data were obtained from a 2023 self-administered survey of residents aged 75-80 years in Chitose City, Japan, including 916 current drivers, 238 retired drivers, and 281 never drivers. RESULTS: Nearly all participants engaged in shopping and visiting medical facilities. Current drivers showed higher engagement in IADLs, primarily by driving themselves. Retired and never drivers engaged in fewer IADLs, particularly men, who were less likely to receive rides from others. In contrast, women were more often driven by others, especially among nondrivers. Men reported higher bicycle use across driving statuses. Multivariable analyses showed that driving status was strongly associated with essential IADLs, whereas discretionary IADLs were influenced by sex and social support. DISCUSSION: These findings suggest that mobility support for older adults should consider both sex and driving status. Occupational therapists and policymakers should tailor interventions-such as safe bicycle use training and transportation support-to promote equitable community mobility. Supporting meaningful engagement in daily activities is vital for maintaining health, independence, and social participation after driving cessation.
Preschool Hand Function Assessment Instruments: A Scoping Review With Targeted Analysis of Performance-Based Instruments.
Visser M, Smith R, Casteleijn D
Occup Ther Int · 2026 · PMID 42093313 · Full text
Hand function is a critical determinant of preschool children's participation in everyday occupations. Accurate hand function assessment is vital for guiding interventions, yet assessment practices are highly variable. D...
Hand function is a critical determinant of preschool children's participation in everyday occupations. Accurate hand function assessment is vital for guiding interventions, yet assessment practices are highly variable. Despite the abundance of instruments, only a few standardised performance-based tools assess all hand function components. No comprehensive mapping exists of key preschool instrument specifications to guide clinicians and researchers, particularly those working in diverse contexts. The study mapped all published hand function-relevant instruments used with children aged 3-5 years, including pathology-specific measures, proxy-report tools, classification systems, and multidomain developmental assessments. Employing scoping review methodology, 13 databases were searched, and all retrieved sources up to September 2024 were managed on Covidence. Two independent reviewers conducted title, abstract and full-text screenings based on eligibility criteria. The search found 810 sources, with 84 meeting inclusion criteria, identifying 62 instruments. Most were performance-based (n = 46; 74.2%), followed by proxy measures (n = 11), classifications (n = 3) and two unspecified. Over a third targeted children with health conditions, whilst 22 covered both typical and atypical development. Sources from the Global South and LMICs were notably scarce. Performance-based measures were examined in greater depth, with only one addressing all hand function domains. Findings highlight the need for a standardised, culturally adaptable performance-based tool that reflects preschool children's real-world occupations and is applicable across diverse settings. This review offers a structured foundation for developing or adapting such a tool, bridging current gaps in assessment practice in both high- and low-resource environments.
The Participation and Environment Measure-Children and Youth (PEM-CY): Cultural Adaptation, Validity, and Reliability of the Persian Version for 5- to 17-Year-Old Children With Cerebral Palsy.
Pashmdarfard M, Zamiran S, Mirzakhani N … +1 more , Mahmoudi E
Occup Ther Int · 2026 · PMID 42083425 · Full text
BACKGROUND: Participation in daily activities is essential for health and well-being. It helps in physical, mental, and emotional health and plays a significant role in the positive development of children and young peop...
BACKGROUND: Participation in daily activities is essential for health and well-being. It helps in physical, mental, and emotional health and plays a significant role in the positive development of children and young people. As it is a crucial goal for health and rehabilitation services, the purpose of this study was to translate and assess the psychometric properties of the Persian version of the Participation and Environment Measure-Children and Youth (PEM-CY) in 5- to 17-year-old children with cerebral palsy. METHOD: The study involved 150 parents of children with CP (n = 100) and typically developing peers (n = 50), aged 5-17 years. To evaluate face and content validity, we consulted occupational therapists and parents of children with CP. Moreover, the Mann-Whitney test used to assess divergent validity. Internal consistency was assessed using Cronbach's alpha (α), whereas test-retest reliability was evaluated using intraclass correlation coefficients (ICCs). RESULTS: The internal consistency (0.77-0.95) and test-retest reliability (0.85-0.95) of various summary scores ranged from moderate to very strong. The divergent validity of the Persian version of PEM-CY was supported by significant differences between children with and without disabilities on the participation and environment scales (p < 0.05). CONCLUSIONS: The Persian version of the PEM-CY is a valid and reliable tool to determine the participation and environmental factors in the home, at school, and in community settings in Persian children and youth aged 5-17 years, with CP.
Reliability, Validity, and Responsiveness of the Visual Perceptual and Fine Motor Function Tests in School-Aged Children With Mild Intellectual Disabilities.
Chou YC, Chen YW, Wuang YP
Occup Ther Int · 2026 · PMID 42083120 · Full text
INTRODUCTION: Deficits in visual perception and fine motor performance are common in school-aged children with mild intellectual disabilities (MID). Assessment tools with sound psychometric properties are essential for o...
INTRODUCTION: Deficits in visual perception and fine motor performance are common in school-aged children with mild intellectual disabilities (MID). Assessment tools with sound psychometric properties are essential for occupational therapy practice and research. OBJECTIVES: This study examined the reliability (internal consistency and test-retest reliability), criterion validity and responsiveness of three commonly used assessments: the Test of Visual Perceptual Skills, Fourth Edition (TVPS-4), the Jebsen-Taylor Hand Function Test (JTHFT), and the Block and Box Test (BBT) in school-aged children with MID. METHODS: A total of 234 children with MID (134 females, age range: 73-144 months) were assessed at three time points: two preintervention assessments within 14 days (T1 and T2), and one postintervention assessment (T3) following a 4-month occupational therapy program. RESULTS: The TVPS-4 total score demonstrated excellent reliability and good criterion validity. The minimum detectable change (MDC) was 13.89 and the minimal clinically important difference (MCID) was 19.97. The JTHFT showed excellent reliability and criterion validity for both hands. The MDC was 3.66 and 4.67 s for dominant and nondominant hands; the MCID was 8.55 and 6.98 s, respectively. In contrast, the BBT exhibited only fair test-retest reliability and weak validity and responsiveness. CONCLUSIONS: The TVPS-4 and JTHFT demonstrated adequate reliability, validity, and responsiveness at both the group and individual levels, supporting their clinical utility for evaluating intervention outcomes and monitoring meaningful changes in visual-perceptual and hand function among school-aged children with MID. This study was approved by the Institutional Review Board of Kaohsiung Medical University Hospital (KMUHIRB-SV(II)-20190087). TRIAL REGISTRATION: ClinicalTrials.gov: NCT05451238.
Development of an ICF-Based Core Assessment Set for Psychiatric Occupational Therapy in Japan: A Three-Round Delphi Study.
Kawano K, Shiota S, Funatsu K … +5 more , Murai C, Tamura T, Suzuki T, Higashi T, Noto S
Occup Ther Int · 2026 · PMID 42080503 · Full text
INTRODUCTION: People with mental disorders have an increasing need for a comprehensive assessment tool based on the International Classification of Functioning, Disability, and Health (ICF). This study is aimed at identi...
INTRODUCTION: People with mental disorders have an increasing need for a comprehensive assessment tool based on the International Classification of Functioning, Disability, and Health (ICF). This study is aimed at identifying ICF categories relevant to patients with mental health in Japan using a Delphi panel of experts and provide foundational data for developing an occupational-therapy-oriented assessment tool. METHODS: A three-round Delphi survey was conducted with a Japanese expert panel initially composed of 15 specialists (five psychiatrists, 10 occupational therapists). Questionnaires (mailed or web-based) were developed from the ICF Checklist, existing ICF core sets, relevant clinical guidelines, and prior research. Aggregate results were submitted to participants after each round for re-evaluation. Fourteen experts completed all rounds. Data were collected from August 2024 to January 2025. Consensus was determined according to the RAND/UCLA appropriateness method. RESULTS: Based on consensus, 42 ICF categories were selected: 17 body functions, 21 activities and participation, and four environmental factors. The set included a relatively large proportion of activities/participation items, reflecting the emphasis of occupational therapy on engagement and participation. Agreement rates increased across rounds, indicating improving consensus and relative stability of the selected indicators. CONCLUSION: This Delphi study produced a preliminary ICF set applicable to patients with mental health in Japan and offers the first step toward an ICF-based comprehensive assessment tool for occupational therapy. Future work should evaluate the reliability and validity of the extracted core set, assess its clinical utility, and incorporate perspectives of service users and families.
Exploring Occupational Therapists' Sleep Intervention Approaches and Perspectives for Children With Autism Spectrum Disorder: A Malaysian Qualitative Study.
Abu Bakar MRR, Dahlan A, Zaini ZI … +1 more , Mohd Rasdi HF
Occup Ther Int · 2026 · PMID 42046185 · Full text
INTRODUCTION: Children with autism spectrum disorder (ASD) frequently experience significant sleep disturbances, adversely affecting their health and family well-being. Despite the high prevalence, limited research exist...
INTRODUCTION: Children with autism spectrum disorder (ASD) frequently experience significant sleep disturbances, adversely affecting their health and family well-being. Despite the high prevalence, limited research exists on sleep interventions employed by pediatric occupational therapists (OTs) in Malaysia. This study explores the types of sleep interventions used and the perspectives of pediatric OTs in managing sleep disturbances among children with ASD. METHODS: An exploratory qualitative design was adopted. Data were collected through two focus group discussions (FGDs) with 10 pediatric OTs from private rehabilitation centers in northern Malaysia. Thematic analysis followed Braun and Clarke's six-step process, with researcher reflexivity and collaborative coding employed to ensure rigor. RESULTS: Participants identified a multimodal approach including behavioral strategies (e.g., visual schedules), sensory-based techniques (e.g., deep pressure), physical activity, and environmental modifications. A structured clinical decision pathway emerged, prioritizing sensory regulation as a physiological prerequisite for behavioral success. Parental involvement was highlighted as critical, though moderated by socioeconomic and cultural factors such as cosleeping. Notably, therapists perceived improvements in children's sleep quality and reductions in parental stress. CONCLUSION: This study underscores the value of a culturally responsive and modular approach to sleep interventions within the private pediatric OT landscape of northern Malaysia. The findings provide a foundational framework for future quantitative research to establish objective effectiveness. The results advocate for enhanced awareness, specialized training, and framework-aligned assessment tools to support families and therapists.
Integrative Health and Wellness Coaching in Occupational Therapy-A Scoping Review.
Smith AM, Kauffroath K, Westervelt K … +1 more , Priganc V
Occup Ther Int · 2026 · PMID 42026813 · Full text
BACKGROUND: Integrative health and wellness coaching (HWC) is an emerging evidence-based profession that promotes healthy behavioral change to reduce lifestyle disease risk factors. This scoping review identifies paralle...
BACKGROUND: Integrative health and wellness coaching (HWC) is an emerging evidence-based profession that promotes healthy behavioral change to reduce lifestyle disease risk factors. This scoping review identifies parallels between occupational therapy and HWC. PURPOSE: The purpose of this study is to examine the following question: Are HWC practices already being implemented in occupational therapy, and if so, how? DATA SOURCES: Searches were conducted for peer-reviewed articles published from 2013 to 2025. STUDY SELECTION AND DATA COLLECTION: Inclusion criteria included articles published in English and the use of health promotion interventions by occupational therapists or an interprofessional team of healthcare providers including occupational therapists. FINDINGS: Twenty-five articles fit the inclusion criteria. This includes qualitative and quantitative studies highlighting occupational therapists using HWC skills and strategies within their health promotion interventions. Multiple lifestyle disease risk factors were targeted through healthy behavior changes including increasing physical exercise, education regarding nutrition, and goal setting. These health-promoting interventions were provided across a spectrum of diagnoses and clinical settings. CONCLUSIONS: Results demonstrated a connection between HWC and the holistic and health-promoting practices of occupational therapy. This review adds important evidence to the literature supporting the use of HWC skills in occupational therapy practice.
Rasch Validation of the FRTVMI in Arab Adolescents: Cultural and Gender Considerations in Visual-Motor Assessment.
Omara EMN, Al-Huwailah AH, Emam MM … +4 more , Elsherbiny AM, Al-Attiyah AA, Kazem AM, Al Hinai AHS
Occup Ther Int · 2026 · PMID 42002854 · Full text
This study examined the construct validity of the Full Range Test of Visual-Motor Integration (FRTVMI) among adolescents aged 11-16 years in Oman, Qatar, and Kuwait using the Rasch measurement model. A total of 2464 stud...
This study examined the construct validity of the Full Range Test of Visual-Motor Integration (FRTVMI) among adolescents aged 11-16 years in Oman, Qatar, and Kuwait using the Rasch measurement model. A total of 2464 students were selected through cluster random sampling to ensure national representation. Rasch analysis evaluated the unidimensionality, item fit, local independence, scalability, and reliability of the test. Results indicated strong evidence of unidimensionality, high item reliability, and satisfactory person reliability across samples. However, notable discrepancies in item difficulty ordering emerged between countries and relative to the original test manual, suggesting cultural and educational influences on item performance. Differential item functioning (DIF) analysis identified several gender-biased items-most prominently in the Kuwaiti sample-raising concerns about test fairness. While the FRTVMI demonstrates strong psychometric properties, the findings highlight the need for culturally responsive adaptations and further research to enhance its validity and equity across diverse populations in the Gulf region.
Factors Influencing Engagement in Work-Related Activities Among People With Dementia or Mild Cognitive Impairment: A Cross-Sectional Study.
Kamo E, Sonoda Y, Yuri T … +2 more , Yotsumoto K, Kowa H
Occup Ther Int · 2026 · PMID 41999137 · Full text
INTRODUCTION: People with dementia or mild cognitive impairment (MCI) desire social connection and meaningful contribution, despite often being excluded from work-related activities. The impact of engagement in work-rela...
INTRODUCTION: People with dementia or mild cognitive impairment (MCI) desire social connection and meaningful contribution, despite often being excluded from work-related activities. The impact of engagement in work-related activities on the mental well-being of people with dementia or MCI remains underexplored. OBJECTIVE: The aim of this study is to investigate the factors influencing engagement in work-related activities among people with dementia or MCI. DESIGN: Cross-sectional study. SETTING: Seven-day care centers in Japan. PARTICIPANTS: Sixty-three day care center members with dementia or MCI who had participated in work-related activities for at least 6 months. MEASURES: Well-being assessed by the World Health Organization-Five Well-Being Index (WHO-5); engagement evaluated by the Assessment of Quality of Activities (A-QOA), an occupational therapists-developed observational assessment tool; and confounders of engagement. RESULTS: Among the 63 participants (age: median: 83 years, interquartile range [IQR]: 61, 94; Mini-Mental State Examination-Japanese score: median: 19 points, IQR: 4, 27), 74.6% were female. A significant correlation was observed between the WHO-5 and A-QOA (ρ = 0.433, p < 0.001). Stepwise multiple regression analysis revealed a significant association between the A-QOA and WHO-5 (β = 0.480, p < 0.001), frequency of participation (β = 0.337, p = 0.003), and hearing loss-related social limitations (β = 0.286, p = 0.01). CONCLUSION: Greater engagement in work-related activities was associated with better well-being, higher frequency of participation, and hearing loss-related social limitations. Implementation of and support for personalized work-related activities, considering these factors for people with dementia or MCI, could enhance their engagement and promote their mental well-being.
A Scoping Review of Occupational Imbalance Among Korean High School Students: Insights Through the PEO Model.
Choi JE, Jung YJ, Kwon MJ … +3 more , Lee MH, Park SJ, An SL
Occup Ther Int · 2026 · PMID 41998863 · Full text
BACKGROUND: Korean high school students (KHSSs) face immense academic pressures due to the College Scholastic Ability Test (CSAT), a national milestone that determines their future academic and career paths. While extens...
BACKGROUND: Korean high school students (KHSSs) face immense academic pressures due to the College Scholastic Ability Test (CSAT), a national milestone that determines their future academic and career paths. While extensive societal and governmental support is provided to optimize conditions for examinees, the overwhelming focus on exam preparation disrupts students' daily routines, leading to significant occupational imbalances that adversely affect their physical, mental, and emotional well-being. AIM: This study was aimed at analyzing the factors contributing to occupational imbalance among KHSS using the person-environment-occupation (PEO) model and explore occupational therapy interventions and recommendations to address these challenges. METHODS: A scoping review was conducted, synthesizing research published between 2015 and 2024 in Korean and English. Sixteen studies focusing on KHSS were included, retrieved from databases such as KISS, RISS, DBpia, Web of Science, and PubMed. RESULTS: Using the PEO model, two key themes were identified. The first, preparation for the CSAT, includes reliance on after-school private education, nighttime self-study routines, and unhealthy coping mechanisms such as excessive caffeine use and limited leisure. The second, educational and social climate, reflects the influence of Confucian cultural values that emphasize academic achievement and a hypercompetitive environment fostering peer comparison and anxiety. These factors create a misalignment between KHSS' personal needs (person), high-pressure environments (environment), and disrupted daily routines (occupation), resulting in significant physical, emotional, and mental strain. CONCLUSION: Addressing these imbalances requires systemic policy reforms to reduce academic pressures, alongside occupational therapy interventions such as stress management programs, lifestyle redesign, advocacy, education, and training programs. Collaboration with psychologists for additional counseling is crucial to support emotional well-being. These combined strategies can foster resilience, holistic development, and a healthier balance between academic and personal life.
Exploring Vocational Training Interventions for Adults With Autism Spectrum Disorders: A Scoping Review.
Herlitasari HA, Fajariani D, Miyamoto R
Occup Ther Int · 2026 · PMID 41943443 · Full text
Adults with autism spectrum disorder (ASD) continue to face substantial barriers to obtaining and sustaining employment, including challenges related to social communication, understanding workplace expectations, and nav...
Adults with autism spectrum disorder (ASD) continue to face substantial barriers to obtaining and sustaining employment, including challenges related to social communication, understanding workplace expectations, and navigating job interviews, which contribute to underemployment and reduced quality of life. This scoping review mapped the contemporary evidence (2015-2025) on vocational training and employment-related interventions for autistic adults, with particular attention to intervention types, strengths/limitations, professional roles, and contextual factors shaping implementation. Following the Arksey and O'Malley framework and PRISMA reporting guidance, we searched PubMed, MEDLINE and Web of Science in two stages (June 2024; updated November 2025), combining ASD terms with vocational rehabilitation/employment and training terms. Records were deduplicated and screened in Rayyan using predefined eligibility criteria (adults ≥ 18 years with ASD; English-language empirical studies of vocational training interventions). The search identified 1117 records; after removing 434 duplicates, 683 records underwent title/abstract screening, 191 full texts were assessed, and 26 studies were included. Most studies were published from 2019 to 2025 (73.1%) and conducted in the United States (53.8%), followed by Japan (15.4%) and Australia (11.5%). Primary investigators most often represented psychology/psychiatry/clinical sciences (38.5%). Interventions were commonly delivered in workplace/community settings (57.7%), with highly variable dose: Among studies reporting calendar duration, the median was 23.0 weeks (range: 0.71-312), and among those reporting contact hours, the median was 32.0 h (range: 2-900). Qualitative synthesis identified three recurring themes: (1) integrated supported employment and work-based learning pathways (e.g., internship-to-employment models, customized employment, and IPS-informed approaches), (2) targeted work-readiness and discrete skill acquisition interventions (notably job interview and workplace social communication training, including technology-mediated formats), and (3) implementation context, stakeholder perspectives, and sustainability considerations. Overall, the evidence base is expanding but remains heterogeneous in intervention reporting and outcome measurement, underscoring the need for clearer specification of intervention components, professional roles, and occupationally meaningful outcomes.
A Systematic Review of International Evidence to Inform Occupational Therapy Practice Guidelines for Total Knee Replacement in the Korean Health System.
Kim JA, Ha SK, Jung MY
Occup Ther Int · 2026 · PMID 41923488 · Full text
INTRODUCTION: This review synthesizes international evidence on occupational therapy (OT) interventions for total knee replacement (TKR) as part of the project "Developing Occupational Therapy Practice Guidelines for Tot...
INTRODUCTION: This review synthesizes international evidence on occupational therapy (OT) interventions for total knee replacement (TKR) as part of the project "Developing Occupational Therapy Practice Guidelines for Total Knee Replacement," with the goal of informing practice within the Korean healthcare system. It evaluates OT interventions' effectiveness in enhancing recovery pathways amid an aging population, increasing healthcare costs, and the need for patient satisfaction and recovery. METHOD: Centering on OT interventions in Korea for adults with post-TKR, this review adhered to the Royal College of Occupational Therapists' guidelines and PRISMA standards and searched nine electronic databases for literature published between 2000 and November 2021. A broad stakeholder group, including medical professionals and social workers, contributed to refining the research scope of outcomes. RESULTS: From an initial pool of 10,749 articles, 51 studies were selected, predominantly cohort studies. Analysis identified key-OT interventions improving activities of daily living, mental health, community reintegration, patient satisfaction, and notably reducing hospital stay lengths. CONCLUSION: This review highlights the multifaceted contributions of OT in TKR rehabilitation, with benefits observed across physical, mental, and cognitive recovery. It supports the need for policy changes to broaden the role of OT. Future research, particularly high-quality and longitudinal studies, is warranted to further strengthen the evidence base and inform the ongoing development of OT practice across diverse healthcare systems.
The Model of Occupational Self-Efficacy: A Contemporary Model to Enhance Work Skills, Cognitive and Emotional Skills of Individuals With Brain Injury-A Pilot Randomized Control Trial.
Soeker MS, Karachi F
Occup Ther Int · 2026 · PMID 41923468 · Full text
BACKGROUND: Returning to work for survivors of traumatic brain injury (TBI) remains problematic despite them completing treatment programs. OBJECTIVE: The aim of the study was to determine whether the work skills and gen...
BACKGROUND: Returning to work for survivors of traumatic brain injury (TBI) remains problematic despite them completing treatment programs. OBJECTIVE: The aim of the study was to determine whether the work skills and general functioning of brain injury survivors improve after participating in a treatment program that utilizes the Model of Occupational Self-Efficacy (MOOSE) as a framework compared with usual treatment. PARTICIPANTS: Twenty-eight brain injury survivors with a mild to severe brain injury engaged in the study. METHOD: A randomized control design was used in the study. The Work Rehabilitation Questionnaire (WORQ), Beck Anxiety Inventory, Beck Depression Inventory, and Rowland Universal Dementia Assessment Scale (RUDAS) were used to investigate whether the work skills, cognitive functioning, and anxiety and depression symptoms of individuals improve after participating in an experimental treatment. RESULTS: The study suggests that 56% of the individuals in the MOOSE (experimental group) had higher scores on the WORQ when compared to individuals that received usual treatment. Furthermore, 64% of individuals in the MOOSE (experimental group) had higher scores on the RUDAS when compared to individuals who received usual treatment. Regarding the Beck depression test, 64% of individuals in the MOOSE (experimental group) had a decrease in depression symptoms when compared to individuals who received usual treatment. The Beck anxiety test revealed that 57% of individuals in the MOOSE (experimental group) had a decrease in anxiety symptoms when compared to individuals who received usual treatment. The findings of the WORQ, RUDAS, Beck Depression Inventory, and Beck Anxiety Inventory were not statistically significant. Finally, 57.1% of individuals who received the MOOSE intervention returned to competitive employment compared to 28.6% of individuals who received usual treatment. CONCLUSION: Although the findings were not statistically significant, the experimental intervention (MOOSE) did reveal an improvement in work skills and improvement in cognitive skills as well as a reduction in symptoms of depression and anxiety for TBI survivors.
Occupational Performance and Quality of Life in Individuals With Cardiovascular Conditions: A Cross-Sectional Study.
Jaber A, Alzoubi R, Rawashdeh S … +4 more , Oteir A, Nazzal M, Al-Naasan S, Ismael N
Occup Ther Int · 2026 · PMID 41913504 · Full text
INTRODUCTION: Cardiovascular conditions significantly impact individuals' functional abilities. Existing evidence is limited on levels of occupational performance in individuals with cardiovascular conditions and what da...
INTRODUCTION: Cardiovascular conditions significantly impact individuals' functional abilities. Existing evidence is limited on levels of occupational performance in individuals with cardiovascular conditions and what daily life activities are impacted. This study aimed to investigate occupational performance and quality of life in this population. METHODS: This current study utilized a cross-sectional design and convenient sampling. The sample consisted of 52 individuals with cardiovascular conditions. Instruments included Demographic and Health Condition Questionnaire, The Canadian Occupational Performance Measure (COPM), and The World Health Organization Quality of Life-BREF (WHOQOL-BREF). Data analyses included descriptive statistics, analysis of frequencies, Spearman rank-order correlations, and exploratory multivariable linear regression analyses. FINDINGS: Individuals with cardiovascular conditions perceived their occupational performance and satisfaction in the lower moderate range (COPM Performance: mean = 4.74, SD±1.75, range 1-8; COPM Satisfaction: mean = 4.5, SD±2.04, range 1-10). Self-care was the most common domain with occupational performance challenges (66.2% of all reported problems). Functional mobility was the most frequently reported self-care problem. In the WHOQOL-BREF, the physical domain was the lowest (M = 50.17, SD ±18.4, Range = 0-88). Significant predictor of better occupational performance included having higher physical health-related QoL (R = 0.158, p = 0.005). Significant predictors of greater satisfaction with occupational performance included participation in sports and having a better psychological QoL (R = 0.232, p = 0.048). CONCLUSION: Occupational performance in daily life activities in individuals with cardiovascular conditions, and their quality of life are negatively impacted. Individualized interventions for this population should target daily life activities, especially self-care.
An Investigation of Factors Affecting Bowel Movement Hygiene in Autistic Children.
Stacey N, Turtle B, Daly-Lynn J
Occup Ther Int · 2026 · PMID 41902733 · Full text
Bowel movement hygiene is an essential life skill. Autistic children can have difficulties attaining this skill. There is limited research exploring postbowel movement hygiene (PBMH) and autism. This study explores facto...
Bowel movement hygiene is an essential life skill. Autistic children can have difficulties attaining this skill. There is limited research exploring postbowel movement hygiene (PBMH) and autism. This study explores factors of PBMH for autistic children. An online survey was developed, included open and closed questions, and distributed via Facebook groups. It was completed by N = 74 parents. Descriptive statistics and thematic analysis were used to analyze the data. Statistically significant correlations were found between variables related to the sensory and motor aspects of PBMH, scared of sitting on toilet and refusal to engage in PBMH (p ≤ 0.5). Four qualitative themes were identified: toilet paper, difficulties in reaching the bottom, health related factors, and successful strategies used by parents. Future research is needed to strengthen the validity of these findings and produce practice guidelines for occupational therapists working in this area.
Performance of Daily Living Activities of Autistic Children With Sensory Processing Difficulties: Caregivers' Perceptions.
Tazinaffo LS, Wolf BB, Sposito AMP
Occup Ther Int · 2026 · PMID 41882948 · Full text
BACKGROUND: Sensory integration difficulties are common among autistic children and can significantly affect their occupational performance, particularly in activities of daily living (ADLs). Despite the increasing recog...
BACKGROUND: Sensory integration difficulties are common among autistic children and can significantly affect their occupational performance, particularly in activities of daily living (ADLs). Despite the increasing recognition of these challenges, few studies have specifically examined how sensory and praxis difficulties interfere with functional autonomy in daily routines. OBJECTIVE: This study is aimed at analyzing caregivers' perceptions of sensory processing difficulties and their impact on the performance of autistic children in basic ADLs. METHODS: A qualitative, descriptive study was conducted with caregivers of children aged 3-8 years diagnosed with autism spectrum disorder (ASD), recruited from a private pediatric rehabilitation clinic in Brazil. Data were collected through semistructured interviews focusing on children's engagement in and performance of ADLs. Interviews were audio-recorded, transcribed verbatim, and analyzed using thematic content analysis with the support of MAXQDA software to systematically identify and categorize recurring sensory and motor-related difficulties reported by caregivers. RESULTS: Caregivers consistently reported that sensory processing difficulties had a significant negative impact on multiple domains of daily living activities, notably feeding, personal hygiene, dressing, bathing, and toileting, resulting in a restricted active and independent participation. Sensory modulation difficulties, including patterns of hyperresponsiveness and hyporesponsiveness, affected performance across all assessed activities. Sensory discrimination difficulties were particularly evident in dressing and toileting tasks. Praxis-related difficulties were identified in all children and manifested as challenges in ideation, motor planning, and motor execution, which collectively compromised functional performance across daily activities and increased dependence on caregivers during daily routines. CONCLUSIONS: Sensory processing difficulties involving modulation, discrimination, and praxis substantially limit functional independence and occupational engagement in children with ASD. These findings highlight the importance of individualized occupational therapy interventions tailored to each child's sensory and motor profile, with the aim of supporting participation, autonomy, and engagement in everyday activities.
Psychometric Evaluation of the Cross-Culturally Adapted Dutch-Language Version of the Participation and Environment Measure for Children and Youth (PEM-CY).
Kern E, Piškur B, Meuser S … +1 more , Teplicky R
Occup Ther Int · 2026 · PMID 41860169 · Full text
BACKGROUND: Participation in meaningful activities is essential for children's development and well-being, making it a key focus of rehabilitation outcomes. The PEM-CY assesses participation frequency, involvement, and e...
BACKGROUND: Participation in meaningful activities is essential for children's development and well-being, making it a key focus of rehabilitation outcomes. The PEM-CY assesses participation frequency, involvement, and environmental support in home, school, and community settings. While it has been validated in several languages, its psychometric properties have not yet been evaluated in the Dutch context. OBJECTIVES: Therefore, the aim of our study is to assess the internal consistency, test-retest reliability, and construct validity of the Dutch PEM-CY including its ability to differentiate between children with and without disabilities and to examine associations between environmental supportiveness, participation, and parental satisfaction. METHODS: A cross-sectional study involving parents of 161 Dutch children 5-17 years old with and without disabilities was conducted to psychometrically evaluate the Dutch PEM-CY in the Netherlands. Internal consistency was evaluated using Cronbach's alpha, test-retest reliability with intraclass correlation coefficients (ICCs), and construct validity through known-group comparisons and correlations between environmental supportiveness, participation outcomes, and parental desire for change. RESULTS: The Dutch PEM-CY demonstrated acceptable to good internal consistency (α = 0.54-0.68) and good to very good test-retest reliability (ICC = 0.60-0.80). Known-group comparisons revealed significant differences between children with and without disabilities, particularly in involvement and environmental barriers. In addition, higher perceived environmental support was significantly associated with greater involvement and less parental desire for change, but not with participation frequency. These findings support the Dutch PEM-CY's reliability and validity in assessing participation and environmental influences among Dutch children aged 5-17 years old. CONCLUSION: The Dutch PEM-CY is a reliable and valid instrument for assessing participation and environmental influences among Dutch children aged 5-17 years. Its ability to identify both group differences and associations with environmental support underscores its value for guiding tailored occupational therapy interventions and informing inclusive policy development.
Reliability of Ultrasound Muscle Assessment in People With Critical Illness Performed by Occupational Therapy Students and Occupational Therapists.
Barbosa FDS, de Santana RP, Matos MIS … +1 more , Santos ARG
Occup Ther Int · 2026 · PMID 41849157 · Full text
The use of ultrasound as an assessment tool by occupational therapists in the context of intensive care can support the clinical reasoning in identifying the impacts of musculoskeletal alterations on the ability to perfo...
The use of ultrasound as an assessment tool by occupational therapists in the context of intensive care can support the clinical reasoning in identifying the impacts of musculoskeletal alterations on the ability to perform activities of daily living and other meaningful occupations. However, ultrasonography is not part of the core curriculum in occupational therapy education, and the knowledge and technical requirements necessary for its use by these professionals remain unclear. Therefore, the aim of this study was to analyze the intraexaminer and interexaminer reliability of ultrasound muscle assessment among occupational therapy students and occupational therapists after the completion of a standardized training program. Data collection included 8 h of examiner training and image acquisition. Three examiners were trained by an occupational therapist experienced in muscle assessment using ultrasound, including two occupational therapy undergraduate students and one occupational therapist. Each examiner performed two assessments of each muscle group, without knowing the results of their own evaluations or those of the other examiners. Participants were recruited by convenience, including adults and older people who were admitted to the intensive care unit. The sample size of this study was seven participants. For descriptive analyses, categorical variables were expressed in absolute and relative frequency. Continuous variables were presented as median and interquartile range or as mean and standard deviation. For the interobserver and intraobserver reliability analyses, the values of the intraclass correlation coefficient were performed. A total of 280 US images were analyzed. In regards to inter-examiner reliability, excellent results were found for all muscle groups (ICC: 0.785-0.986). For the intraexaminer reliability, excellent results were found in the majority of analyzes performed (ICC: 0.779-0.997), with two exceptions. Occupational therapy students and occupational therapists demonstrated excellent reliability in the ultrasound assessment of muscle thickness. These findings may support the clinical reasoning of occupational therapists to improve outcomes in occupational performance and participation of critically ill survivors.
Digital Cognitive-Motor Occupational Training with QEEG Monitoring in Schizophrenia Rehabilitation: An Exploratory Neurofunctional Study.
Khemthong S, Rueankam M, Chatthong W
Occup Ther Int · 2026 · PMID 41830156 · Full text
INTRODUCTION: Current occupational therapy assessments for schizophrenia rely primarily on behavioral observation, with limited access to objective neurofunctional indicators of cognitive-motor engagement. Digital tools...
INTRODUCTION: Current occupational therapy assessments for schizophrenia rely primarily on behavioral observation, with limited access to objective neurofunctional indicators of cognitive-motor engagement. Digital tools combined with neurophysiological monitoring offer new opportunities to address this gap. This study examined a digital cognitive-motor occupational training application paired with quantitative electroencephalography (QEEG) to explore neurofunctional engagement during task performance. METHODS: Thirty individuals with schizophrenia completed structured occupational tasks under two conditions: with and without QEEG-based Brain Mapping Performance (BMP). Task engagement was characterized using participant-prioritized daily activities grouped into dopaminergic, serotonergic, oxytocinergic, and endorphin-related behavioral domains, conceptualized as theoretical behavioral associations rather than direct neurochemical measures. QEEG indices included theta relative power, beta relative power, and theta/beta ratio recorded from six frontal and temporal scalp sites. RESULTS: Theta relative power was higher at frontal and central sites (Fz and Cz) during BMP-monitored conditions, reflecting executive and motor planning demands. Beta relative power varied across memory- and emotion-related task phases, indicating task-dependent modulation of cognitive effort. Engagement Intensity Scores were consistently higher in the unmonitored condition, while BMP monitoring was associated with longer task completion times and increased neurofunctional engagement. CONCLUSION: QEEG-guided occupational task performance reveals distinct, task-dependent neurofunctional patterns in schizophrenia rehabilitation. The integration of digital task-based assessment with neurophysiological monitoring provides exploratory neurofunctional indicators that may support individualized, functionally informed occupational therapy interventions.
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