Occupational Therapy International[JOURNAL]
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200 papers
Devotion to Family: Coping Strategy to Reduce Burden of Caregiving Stroke Patients.
Khomarun, Subijanto AA, Nurhidayah N … +1 more , Probandari A
Occup Ther Int · 2025 · PMID 40979444 · Full text
Informal caregivers have played a significant role since stroke survivors were discharged from the hospital. Caregivers carry out stroke survivors' daily activities, which can be burdensome. Caregiver coping strategies t...
Informal caregivers have played a significant role since stroke survivors were discharged from the hospital. Caregivers carry out stroke survivors' daily activities, which can be burdensome. Caregiver coping strategies to reduce this burden have not been widely studied, especially in Indonesia. This study was aimed at exploring the act of devotion as a coping strategy to reduce the burden of caring for stroke survivors. This was an exploratory qualitative study of 30 informal caregivers of stroke survivors who live in a community in Surakarta, selected using purposeful sampling. In-depth interviews to explore the act of devoting as a coping strategy and observations of caregivers were conducted from June 2021 to December 2022. The data analysis revealed two primary themes: "family ties" and "physical." The family ties theme emerged with five subthemes: pride, sincerity, resigned, destiny, and responsibility. The physical theme consisted of two subthemes: ability and spirit. Devotion as a coping strategy for stroke informal caregivers in the community plays a crucial role in maintaining the continuity of care. It involves pride, sincerity, resigned, destiny, responsibility, ability, and spirit. Further research on the results of these findings is needed on how caregivers maintain their quality of life as they begin to become caregivers.
Factors Influencing Return to Work Among Women With Acquired Brain Injury.
Darries Z, Soeker MS
Occup Ther Int · 2025 · PMID 40949607 · Full text
Research indicates that women with brain injury have a higher risk of not resuming their work roles. This study investigates the influence of sociodemographic, impairment-related and environmental factors on the return-t...
Research indicates that women with brain injury have a higher risk of not resuming their work roles. This study investigates the influence of sociodemographic, impairment-related and environmental factors on the return-to-work outcomes of women with acquired brain injury in Cape Metropolitan, South Africa. A cross-sectional survey was conducted among 139 women aged 18-65 with acquired brain injury in Cape Metropolitan, South Africa. Participants were conveniently sampled, and the Work Rehabilitation Questionnaire was used for data collection. Data were analysed using IBM SPSS Statistics Version 26, focusing on sociodemographic, impairment-related and environmental factors influencing return to work outcomes. Women with acquired brain injury who participated in this study yielded a postinjury return to work rate of 61.2%. Older women were less likely to return to work (odds ratio: 0.905). Environmental support, particularly from workplace supervisors or managers, significantly enhanced RTW (odds ratio: 5.660). Marital status, impairment-related restrictions, type of vocational intervention and family support were not significant predictors of return to work. These results highlight the necessity for multidimensional and integrative RTW programmes that address both personal and systemic barriers. Such programmes are essential to promoting sustained economic participation and improving the quality of life for women with ABI.
Asian American Occupational Therapy Practitioners' Perspectives on Supporting the Mental Health of Asian American Caregivers for Older Adults.
Bayangos A, AlHeresh R, Bakhsh HR … +1 more , Smith D
Occup Ther Int · 2025 · PMID 40740277 · Full text
Asian American (AA) caregivers have unique cultural values that influence their mental health during caregiving. Occupational therapy practitioners (OTPs) are positioned to serve this population because of their holistic...
Asian American (AA) caregivers have unique cultural values that influence their mental health during caregiving. Occupational therapy practitioners (OTPs) are positioned to serve this population because of their holistic lens and their relationship with care recipients and caregivers. The objective of this study was to examine AA OTPs' perspectives on barriers, facilitators, and interventions to support the mental health of AA caregivers in older adults with chronic conditions. This study used a qualitative phenomenological design. Data were collected through virtual interviews ( = 10) and focus groups ( = 2) and analyzed using thematic analysis. Twelve AA OTPs ( = 12) participated in this study, all were occupational therapists ( = 12); most were female ( = 10) and had a Doctor of Occupational Therapy degree ( = 9). Two domains were found during this study: (1) barriers and facilitators to support the mental health of AA caregivers and (2) OTP strategies to support the mental health of AA caregivers. Barriers and facilitators include AA cultural beliefs, provider identity, and access. OTPs can support this population by utilizing their soft skills, assessment and clinical reasoning skills and through interventions, including caregiver education and social support. This study addressed the literature gap on supporting AA caregivers' mental health through an OTP perspective. OTPs can enhance support by understanding AA culture, examining biases, and refining strategies for caregivers' mental health. Healthcare providers can prioritize caregiver support, boost AA representation in healthcare, improve service accessibility, and involve OTPs in caregivers' mental health support.
Assessing Participation Among Stroke Survivors: A Systematic Review of Patient-Reported Outcome Measures.
Hamid B, Hejazi Shirmard M, Shafighi Kuzani SM … +1 more , Pashmdarfard M
Occup Ther Int · 2025 · PMID 40709076 · Full text
Stroke significantly impacts survivors' lives, affecting their physical, cognitive, and emotional well-being. Understanding how these individuals participate in daily activities and societal roles is crucial for optimal...
Stroke significantly impacts survivors' lives, affecting their physical, cognitive, and emotional well-being. Understanding how these individuals participate in daily activities and societal roles is crucial for optimal rehabilitation and support. Patient-reported outcome measures (PROMs) offer valuable insights into stroke survivors' experiences and perceptions regarding their participation in various life aspects. This systematic review focuses on PROMs specifically designed to evaluate participation following stroke, based on the International Classification of Functioning, Disability and Health (ICF). By analyzing existing measures, this review is aimed at identifying gaps, strengths, and opportunities for enhancing participation assessment in stroke rehabilitation. A comprehensive search of keywords related to stroke, participation, and assessment was conducted across multiple databases, including Scopus, Embase, Medline, Cochrane Library, PEDro, and OTseeker. The review process was conducted based on the PRISMA-Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) guidelines. The COSMIN checklist was utilized to investigate the psychometric properties of the studies, and the results were synthesized narratively. Thirty-seven studies were ultimately included in the review after the full-text evaluation. The review identified 10 PROMs, including the Functional Behavior Profile, Meaningful Activities Participation Assessment, Nottingham Extensive Activities of Daily Living Scale, Rivermead Mobility Index, Reintegration to Normal Living Index, The Subjective Index for Physical and Social Outcome, and Stroke Impact Scales. While these tools are developed with appropriate psychometric properties and focus on varying dimensions of survivors' participation, significant gaps remain in fully addressing their comprehensive needs. Specifically, the tools often overlook contextual differences and fail to adequately assess satisfaction in daily activities. The identified gaps illustrate the need for more comprehensive measures that accurately capture stroke survivors' diverse experiences. Improving these assessments is essential for informing clinical practice and rehabilitation strategies, ultimately enhancing patient engagement, satisfaction, and quality of life and improving rehabilitation outcomes for stroke survivors.
Current Practice of Occupational Therapy for Common Disorders Seen in Rehabilitation Clinics in Saudi Arabia.
Arafah AM, Altherwy S, Alzahrani S … +3 more , Alghamdi G, Alghamdi R, Haddad M
Occup Ther Int · 2025 · PMID 40697823 · Full text
The role of occupational therapy is to provide management for various conditions including neurological, musculoskeletal, and psychological disorders, with the aim of maximizing function and independency in daily occupat...
The role of occupational therapy is to provide management for various conditions including neurological, musculoskeletal, and psychological disorders, with the aim of maximizing function and independency in daily occupations. According to the World Federation of Occupational Therapists (WFOT), occupational therapy is a client-centered health profession concerned with promoting health and well-being through occupation. In Saudi Arabia, there are escalating rates of chronic conditions, which create an increasing demand for occupational therapy services. Yet, occupational therapy practice frameworks, as well as areas of assessment and intervention, are not well explored within the context of Saudi Arabia. The aim of this research is to identify the most common disorders that occupational therapists work with within Saudi Arabia and the approaches used for managing these disorders. This was a cross-sectional study. An electronic survey was distributed to 230 occupational therapists working in Saudi Arabia. The survey consisted of two sections; the first was on educational backgrounds, and the second section was about the common conditions encountered in a clinical setting and the treatment approaches applied. The interventions nominated by participants were mapped to the person-environment-occupation model and to the occupational therapy practice framework. The overall response rate was 57%. Analysis of data of 131 participants revealed that neurological diseases (e.g., stroke, multiple sclerosis, and Parkinson's disease) were the most common conditions managed by occupational therapists (64.3%), while respiratory diseases had the lowest percentage (4.7%). With regard to intervention approaches, "therapeutic exercise" was the most commonly applied approach as was reported by 77.1% of the therapists, while "functional electrical stimulation" was the lowest chosen approach as it was applied by 19.8% of the therapists. Occupational therapists in Saudi Arabia manage a variety of conditions and apply a wide range of rehabilitation approaches, yet gaps still exist in providing a holistic approach. The study emphasizes the importance of redirecting the focus of occupational therapists to core concepts of maximizing functioning and occupational performance and using occupation as a mean and as an outcome of rehabilitation.
A Standardised Car Seat Transfer Test: Reliability and Concurrent Validity.
de Campos TF, Wolden M, March MK … +8 more , Hewawasam D, Boumelhem B, Spurr JJ, Khoury JM, Vertzyas N, Faux SG, Gass GC, Mungovan SF
Occup Ther Int · 2025 · PMID 40692759 · Full text
Transferring effectively into and out of a vehicle seat is required for functional mobility and social participation. Reliable and valid vehicle and simulator car seat transfer tests are limited. The aim of this study wa...
Transferring effectively into and out of a vehicle seat is required for functional mobility and social participation. Reliable and valid vehicle and simulator car seat transfer tests are limited. The aim of this study was to assess the reliability and concurrent validity of a car seat transfer test for application with a vehicle and a simulator car seat. A cross-sectional study was conducted and reported according to the Guidelines for Reporting Reliability and Agreement Studies (GRRAS), the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statements and the National Statement on Ethical Conduct in Human Research 2007. Consecutive healthy adults who expressed interest and met the inclusion criteria were recruited for our study. A standardised vehicle and simulator car seat transfer test was undertaken on two visits, 7 days apart. WOMAC, hip and knee active range of motion assessment, self-selected gait speed measurement and the five-repetition sit-to-stand test were undertaken on the first visit. Complete data collection was performed with 42 healthy adults. There was good interrater (ICC = 0.99; 95% CI 0.99, 1.00), intrarater (ICC = 0.79; 95% CI 0.62, 0.89 to ICC = 0.91; 95% CI 0.76, 0.96) and test-retest reliability (ICC = 0.87; 95% CI 0.77, 0.93 to ICC = 0.94; 95% CI 0.89, 0.96) for car seat transfer test times for getting into and out of the vehicle and the simulator car seat. There were strong and significant correlations ( = 0.84-0.89) between the vehicle and simulator car seat test times; these times correlated significantly with measures of physical function including self-selected gait speed and five-repetition sit-to-stand test results ( < 0.001). A standardised car seat transfer test is reliable and valid for testing car seat transfer ability in a vehicle and a simulator car seat.
Effects of Inline Skating Exercise on Symptoms, Executive Functions, and Motor Proficiency in Children With ADHD: A Randomized Controlled Trial.
Huang CY, Chen WF, Tsai CL … +3 more , Chen PL, Hsu PJ, Pan CY
Occup Ther Int · 2025 · PMID 40688800 · Full text
A growing body of evidence demonstrates that physical exercise training is beneficial in the treatment of attention-deficit/hyperactivity disorder (ADHD). This study is aimed at examining the effects of a 12-week inline...
A growing body of evidence demonstrates that physical exercise training is beneficial in the treatment of attention-deficit/hyperactivity disorder (ADHD). This study is aimed at examining the effects of a 12-week inline skating intervention on ADHD symptoms, executive functions (EFs), and motor proficiency in children with ADHD. This study employed an asymmetric crossover randomized controlled trial (RCT) design. A total of 24 children with ADHD (aged 6-12 years) were recruited from nongovernmental organizations, elementary schools, and parent networks. Participants were paired based on age, medication status, and ADHD presentation and then randomly assigned to either an intervention group (IG) ( = 12) or a wait-list control group (CG) ( = 12). The IG participated in a 12-week inline skating program (80-min sessions, twice weekly), while the CG maintained their regular daily routines and did not participate in any structured physical activity (PA) or skating training during this period. After 12 weeks, the CG underwent the same intervention. ADHD symptoms (parent reported), EFs (inhibition and spatial working memory), and motor proficiency (fine motor control, body coordination, manual coordination, strength, and agility) were assessed at three time points: baseline (T1), posttest (T2), and follow-up (T3). Data were analyzed using mixed-design ANOVA to evaluate the effects of the intervention. Children with ADHD in the current study demonstrated improved symptoms, EFs, and motor proficiency (all < 0.05) after 12-week inline skating intervention. Moreover, the effects appeared to be sustained for at least 12 weeks. This RCT provides preliminary evidence that inline skating may be a feasible and beneficial PA intervention for children with ADHD. However, larger studies are needed to further evaluate its long-term efficacy. Australian New Zealand Registry of Clinical Trials: ACTRN12624000593538.
Occupational Therapy Acute Care Self-Efficacy Scale (OTACSES): Development, Test-Retest Reliability, and Precision.
McGee C, Oldenburg H
Occup Ther Int · 2025 · PMID 40688799 · Full text
Delivering occupational therapy services in the acute care setting requires certain skills and abilities to ensure safety and effectiveness among a variety of medically complex populations. Presently, no standardized too...
Delivering occupational therapy services in the acute care setting requires certain skills and abilities to ensure safety and effectiveness among a variety of medically complex populations. Presently, no standardized tool exists to assess OT students' self-efficacy in this context. In this study, we developed the O () to assess OT student self-efficacy in acute care contexts and tested its test-retest reliability and precision in first-year OT students. Researchers developed the scale items based on literature, expert interviews, and a student population. The OTACSES was then administered to 47 OT students to assess the internal consistency of "abilities" and "knowledge" subscales. Following the process of item reduction, the scale was readministered a week later after a no "intervention" control period. Student test and retest data were analyzed to assess reliability and precision. The finalized knowledge and abilities subscales demonstrated excellent internal consistency. Further, the total and subscale scores demonstrated excellent test-retest reliability and acceptable precision. Finally, changes of five, three, and seven points in the abilities, knowledge, and total scores, respectively, can be assumed to be "meaningful." The OTACSES is a reliable and precise tool for measuring students' self-efficacy in the acute care setting. We present preliminary data on clinically meaningful change. Further research focusing on the tool as an outcome measure of the efficacy of acute care-relevant OT education and its appropriateness for use among practitioners is needed.
Clinical Tools for Assessing One-Handed Skills in Children With Cerebral Palsy: An Umbrella Review.
Boroumand S, Pashmdarfard M, Hamedi D … +1 more , Mehraban AH
Occup Ther Int · 2025 · PMID 40589571 · Full text
This study is aimed at identifying suitable tools capable of evaluating one-handed skills in children with cerebral palsy (CP). In this article, the systematic reviews on upper extremity assessment tools for children wi...
This study is aimed at identifying suitable tools capable of evaluating one-handed skills in children with cerebral palsy (CP). In this article, the systematic reviews on upper extremity assessment tools for children with CP from 2000 to 2024 were identified in databases, including Google Scholar, PubMed, Web of Knowledge, and Scopus. Then, the obtained tools were evaluated, among which only those capable of assessing one-handed skills in children aged 3 years and older in accordance with the activity level of the International Classification of Functioning, Disability, and Health were selected to evaluate the quality of evidence and psychometric properties in children with CP using CanChild Outcome Measure Rating Form. A total of 13 systematic reviews were selected for further analysis. Subsequently, 149 tools were identified for initial evaluation, of which 18 were capable of assessing one-handed skills in children with CP. Among these, COPM, ACHES, and PMAL_R demonstrated excellent evidence for overall clinical utility. This study showed that among the numerous tools available for assessing one-handed skills in children with CP, only a limited number have excellent evidence for overall clinical utility. These findings can serve as a basis for selecting more precise, evidence-based tools in the assessment, and rehabilitation interventions for these children.
Effectiveness of Sound-Based Interventions for Improving Functional Outcomes in Children: A Systematic Review of the Evidence.
Vincent V, Skaczkowski G, Hughes-Barton D … +1 more , Gunn KM
Occup Ther Int · 2025 · PMID 40519630 · Full text
The aim of this review was to examine the evidence for sound-based interventions in decreasing auditory hypersensitivity and improving behavioural and emotional regulation among children. A systematic review was conduct...
The aim of this review was to examine the evidence for sound-based interventions in decreasing auditory hypersensitivity and improving behavioural and emotional regulation among children. A systematic review was conducted of primary research examining the use of sound-based interventions to reduce auditory hypersensitivity and regulate emotion or behaviour. Studies were eligible if they were published in English in a peer-reviewed journal, from January 2010 to March 2023. Studies of any design were included. A total of 4741 titles were identified in the search. Eight papers were eligible, covering six different sound-based interventions. Preliminary evidence highlights improvements in depression and anxiety symptomatology and improved behavioural outcomes including language, listening, and social behaviours. Heterogeneity was high across studies; they varied widely in sample size, population type, study design, and outcomes measured. There is preliminary evidence for the effectiveness of sound-based interventions in improving auditory sensitivity and emotional and behavioural outcomes. However, there is a need for higher quality studies, including randomised controlled trials, and consistency in outcomes across studies to enable a clearer assessment of the evidence.
Identifying Issues in Effective Motor Imagery Training Practice in Children With Developmental Coordination Disorder: A Scoping Review.
Nakashima A, Higasionnna T, Iwanaga Y … +4 more , Okamura R, Fujiwara K, Higashi T, Iwanaga R
Occup Ther Int · 2025 · PMID 40401120 · Full text
Motor imagery training (MIT) has gained attention as an occupational therapy tool for children with developmental coordination disorder (DCD). Although MIT has shown some effectiveness in children with DCD, intervention...
Motor imagery training (MIT) has gained attention as an occupational therapy tool for children with developmental coordination disorder (DCD). Although MIT has shown some effectiveness in children with DCD, intervention methods for DCD can still be improved. Further, occupational therapists should update their knowledge of motor imagery (MI) and MIT for children with DCD and understand their application. The objective of this study is to survey the existing evidence on MI and MIT in children with DCD and comprehensively identify what is known and the problems that have been identified. We used the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Review and American Occupational Therapy Association guidelines for data collection and quality assessment. We searched for articles that included the words "developmental coordination disorder" and "motor imagery, motor imagery training (mental practice)." We searched the PubMed, Scopus, Medline, and the Cochrane Library databases; the search end date was March 12, 2024. In total, 30 articles, including seven clinical studies and 23 fundamental studies, were eligible for this review. We surveyed (1) methods for assessing MI ability or clarity in children with DCD, (2) what is known about MI in children with DCD, and (3) the methodology of MIT for children with DCD. Children with DCD have reduced MI ability compared to that had by typically developing children. Thus, MIT is recommended as a means of reducing the behavioral consequences of internal modeling deficits in children with DCD. On the other hand, information on the methodology used in MIT for children with DCD is inadequate, and no clear intervention measures have been proposed. In the future, it is important to clarify the amount of load when performing MIT and clarify the combination with other programs through more advanced research methods.
Occupation-Based Practice Among Iranian Occupational Therapists: A Cross-Sectional Survey.
Sadeghi E, Khanipour M, Khayatzadeh-Mahani M … +2 more , Abolghasemi J, Hassani Mehraban A
Occup Ther Int · 2025 · PMID 40386042 · Full text
Despite the global focus on occupation-based practice (OBP), limited research exists on its implementation in Iran. There is a lack of evidence on how OBP is practiced and the factors affecting its use among Iranian occu...
Despite the global focus on occupation-based practice (OBP), limited research exists on its implementation in Iran. There is a lack of evidence on how OBP is practiced and the factors affecting its use among Iranian occupational therapists, which is essential for addressing barriers and promoting a more occupation-centered approach in clinical settings. This study is aimed at determining the knowledge, attitudes, interests, usage rates, and environmental factors affecting OBP among Iranian occupational therapists and examining the relationship between sociodemographic factors and OBP. This work is a cross-sectional analytical study. The data collection location of this study is the private and government clinics across Iran. A total of 202 participants completed demographic and OBP questionnaires. Key aspects such as total performance, usage rate, attitudes, knowledge, interest, and environmental factors were evaluated. Data analysis was conducted using SPSS software, employing statistical tests including ANOVA, Pearson's correlation, and -test. The total OBP performance among Iranian occupational therapists is 64%, and 60.7% of them use OBP approaches. They have a positive attitude (83.6%) and high interest (78.3%) towards these approaches. However, environmental factors (44.7%) and an average level of knowledge (65.6%) have hindered the full utilization of these approaches. The average OBP score among occupational therapists in government settings was significantly higher than in private centers ( value < 0.001). Additionally, occupational therapists with a PhD scored higher than those with a bachelor's or master's degree ( value < 0.001). The level of work experience has a significant correlation with the total OBP score ( value < 0.05). This study examines the factors affecting OBP adoption in Iran, showing that while therapists have positive attitudes and interest, environmental barriers and limited knowledge hinder full implementation. Government-employed therapists and those with PhDs engage more, and work experience is crucial. The findings stress the need for targeted education and systemic changes, contributing to global insights on OBP integration.
The Occupational Challenges and Responses of International Graduate Students in South Korea: A Scoping Review.
Amaba EJ, Escuadra CJ, Choi JE … +1 more , An SL
Occup Ther Int · 2025 · PMID 40230784 · Full text
Humans, as occupational beings, are inherently driven to achieve mastery and adaptation. This drive is evident in international graduate students who face unique academic and sociocultural challenges when adapting to unf...
Humans, as occupational beings, are inherently driven to achieve mastery and adaptation. This drive is evident in international graduate students who face unique academic and sociocultural challenges when adapting to unfamiliar environments, such as South Korea. These challenges can hinder their occupational participation, yet there is a notable gap in the literature addressing the specific occupational issues faced by international students in this context. This study is aimed at exploring the unique occupational challenges encountered by international graduate students in Korea and their general adaptive responses, analyzed through the lens of the occupational adaptation (OA) model. Additionally, this study proposed interventions for educational institutions and occupational therapy practitioners to support students in achieving OA. A scoping review was conducted following the PRISMA guidelines. Systematic searches across global (Web of Science, Scopus, and PubMed) and Korean (RISS and KISS) databases identified qualitative studies published in English or Korean over the past 10 years. ChatGPT-4 assisted with data extraction, which was reviewed for accuracy. Study characteristics were summarized using descriptive statistics, and thematic analysis identified key themes related to occupational challenges. The review identified 3 articles and 6 dissertations exploring the occupational challenges of 59 international graduate students in Korea. Most participants were master's students, primarily from China, Uzbekistan, and Laos. Two main themes emerged: (1) the hierarchical nature of Korean culture, which impeded academic and social engagement, and (2) the fast-paced lifestyle, which disrupted occupational balance. These challenges led to stress, isolation, and reduced participation, affecting role competence and quality of life. While students attempted adaptive strategies, they were often insufficient, highlighting the need for targeted interventions. International graduate students in Korea faced significant pressure to achieve mastery in a demanding environment. Culturally sensitive interventions, combined with strategies like cognitive behavioral therapy (CBT) and lifestyle redesign, can improve stress management, self-advocacy, and occupational balance, leading to greater academic success.
Supporting Occupational Therapists in Predischarge Home Visit Decision-Making: Development and Evaluation of a Decision-Making Support Tool.
Aplin T, Godfrey M, De Michele L … +8 more , Hoffman A, Palmer C, McCormack C, Halin C, King M, Nix J, Eldridge A, Eames S
Occup Ther Int · 2025 · PMID 40213083 · Full text
With little evidence to guide practice, the decision to conduct a predischarge home visit poses challenges for occupational therapists. This study is aimed at evaluating the impact of a newly developed support tool for h...
With little evidence to guide practice, the decision to conduct a predischarge home visit poses challenges for occupational therapists. This study is aimed at evaluating the impact of a newly developed support tool for home visit decision-making on therapists' confidence, ease, and accuracy in decision-making and stakeholders' satisfaction in the communication of the decision and examining its clinical utility and reliability. The predischarge home visit decision-making support tool was trialed by occupational therapists from five facilities across an Australian metropolitan health service. Using a pre-post study design, therapists completed a purposefully developed questionnaire on decision-making practice including ease and confidence in decision-making. Accuracy of decision-making was also evaluated using case studies. Clinical utility and reliability data was also gathered. While therapists' confidence and ease in decision-making did not change with use of the tool, accuracy in decision-making improved regardless of therapist's experience in home visiting. The interrater reliability of the tool was moderate, with a Fleiss' kappa value of 0.51. Good internal consistency was demonstrated with the removal of one item ( = 0.83). Clinical utility was supported with therapists rating the tool as timely and easy to use. The developed tool offers therapists a reliable tool to support clinical practice, by providing guidance in clinically reasoning the decision to conduct a home visit.
Circus Use by Occupational Therapists: A Collective Case Study.
Maglio J, McKinstry CA, Fortune TL
Occup Ther Int · 2025 · PMID 40213082 · Full text
Circus use by occupational therapists is an emerging practice area with limited evidence. The study is aimed at exploring occupational therapists' current use of circus and identifying the potential for broader applicat...
Circus use by occupational therapists is an emerging practice area with limited evidence. The study is aimed at exploring occupational therapists' current use of circus and identifying the potential for broader applications addressing both individual and community needs. Purposive sampling was adopted to recruit eight circus-using occupational therapists to participate in this collective case study. Semistructured interviews yielded qualitative data, which were coded and thematically analyzed. Circus is being used primarily to address performance capacity limitations but with an awareness of its potential to address broader community and sociopolitical needs. Analysis yielded two distinct "cases." The first, , exemplifies how circus is used to address performance capacity, while the second, , describes current and envisaged future circus use as community development. There is potential to move toward a more occupation-focused and community-driven use of circus in sociopolitical contexts. Further exploration is needed into the therapeutic benefits of circus use by occupational therapists. The inclusion of educational content that builds students' capacity to adopt community development approaches in practice, alongside enhanced understanding of collaboration benefits between occupational therapists and "activist" disciplines, is paramount, if we are to address occupational injustices and promote occupational rights.
Analyzing Occupational Performance of Children With Handwriting Difficulties: Parent and Teacher Experiences and Perspectives.
Fajariani D, Suyama N, Yamanishi Y … +3 more , Phadsri S, Komariyah DA, Ito Y
Occup Ther Int · 2025 · PMID 40213081 · Full text
Handwriting is a crucial skill for elementary school students that involves complex subskills, including visual coordination, motor planning, cognitive abilities, and self-regulation. To inform intervention plans and sup...
Handwriting is a crucial skill for elementary school students that involves complex subskills, including visual coordination, motor planning, cognitive abilities, and self-regulation. To inform intervention plans and support occupational performance and participation, occupational therapists use occupational profiles and performance analysis to assess children's strengths, weaknesses, handwriting performance, and school and personal contexts. This study is aimed at identifying and assessing the characteristics, as perceived by parents and teachers, that both facilitate and impede the improvement of children's handwriting. We employed a qualitative approach with inductive content analysis and collected data via semistructured individual interviews following purposive sampling of parents and teachers ( = 8) in Indonesia. The initial and subsequent interviews lasted 30-60 min and 20-40 min, respectively. We analyzed the results based on two themes: (1) client factors that enhance handwriting abilities and (2) environmental factors that contribute to improving handwriting abilities. Psychological well-being, cognitive abilities, and motor performance significantly influenced handwriting skills. Children with poor emotional control, boredom, lack of age readiness, and memory difficulties often struggled with writing. Additionally, underdeveloped fine motor skills contributed to impaired handwriting abilities. Our findings have significant implications for occupational therapists. It highlights the impact of motor-related and external factors on handwriting abilities in children. The study suggests that occupational therapists can tailor interventions to children's needs by understanding parents' and teachers' perspectives. Additionally, it underscores the importance of collaboration between parents, therapists, and teachers in improving handwriting skills and emphasizes the critical role of siblings and peers in enhancing children's handwriting performance.
Occupational Therapists' Career Planning, Development, and Progress: An Australian Mental Health Perspective.
Keep G, Bye R, Eriksson C … +1 more , Lim D
Occup Ther Int · 2025 · PMID 40213080 · Full text
Mental health occupational therapy is an expanding workforce due to the increasing demand for services in many countries, including Australia. Due to the nature of the role, therapists can experience unique challenges th...
Mental health occupational therapy is an expanding workforce due to the increasing demand for services in many countries, including Australia. Due to the nature of the role, therapists can experience unique challenges that impact retention and wellbeing, consequently affecting career progression. It is, therefore, important to understand career planning and development for mental health occupational therapists to ensure their professional needs are addressed, which would also benefit service sustainability. This study is aimed at understanding the perspectives of mental health occupational therapists within the Nepean Blue Mountains Local Health District on career planning, development, and progression. This health district spans urban and regional areas and has recently introduced a new career framework underpinned by Benner's career planning model. The practical implications of this study are significant, as the insights gained will inform the development of strategies and policies that support the career progression and wellbeing of mental health occupational therapists, ultimately enhancing the quality and sustainability of service provision in this field. In this qualitative descriptive study, seven occupational therapists shared their perspectives through semistructured interviews. The data were transcribed verbatim, and an inductive qualitative content analysis was employed. Three categories and seven subcategories were identified. The health district career framework was found to be beneficial to support career planning and development, with a few adjustments suggested by participants. Having a career framework offers a structured approach to support career planning, development, and progression for mental health occupational therapists.
Active Play as a Window Into the Worlds of Twins and Triplets With Autism.
Abu Itham M, Kerpan S, Balogh R … +1 more , Lloyd M
Occup Ther Int · 2025 · PMID 40213079 · Full text
Research indicates that play can facilitate communication and emotional connection for children with autism and their parents. Currently, there is no research exploring the perceptions that parents of twins and triplets...
Research indicates that play can facilitate communication and emotional connection for children with autism and their parents. Currently, there is no research exploring the perceptions that parents of twins and triplets with autism have regarding their children's play, despite these parents' unique opportunity to observe and interpret the play behaviours of multiple same-age, same-diagnosis children raised in the same home environment. The purpose of this descriptive phenomenological study was to describe the value that parents of twins and triplets with autism place on active play. The researchers used purposive sampling to recruit abroad sample of mothers ( = 9) of twins and triplets with autism aged 4-11 years old. Participants took part in one semistructured online interview with the researcher which was then thematically analyzed. One central theme emerged from our analysis. This theme is entitled active play as a "window into a child's world" and contains five subthemes: (1) parent perceiving child's strengths and weaknesses in active play, (2) parent facilitating active play experiences, (3) parent perceiving child's intrinsic motivations for active play, (4) parent interpreting child's active play behaviours, and (5) active play experiences as a medium for parent/child communication. These findings suggest that parents value active play because it affords them opportunity to observe their children's characteristics through their active play behaviours (e.g., strengths and weaknesses) and use what they have learned to facilitate new active play experiences that encourage overall development. Through active play, parents also practice communicating verbally and nonverbally with their child.
Association Between Muscle Activity of Upper Limbs and Respiratory Parameters During Functional Performance in People With Chronic Obstructive Pulmonary Disease.
Chen CY, Hsu CH, Tsai SH … +5 more , Lin CF, Lin YC, Hsu HY, Chen CZ, Kuo LC
Occup Ther Int · 2025 · PMID 40171139 · Full text
Few studies have examined the activity of the accessory inspiratory muscles as well as respiratory function simultaneously in individuals with chronic obstructive pulmonary disease (COPD) while performing activities of d...
Few studies have examined the activity of the accessory inspiratory muscles as well as respiratory function simultaneously in individuals with chronic obstructive pulmonary disease (COPD) while performing activities of daily living (ADLs). This cross-sectional study is aimed at understanding the differences in the demands for respiratory expenditure and activity of the upper limbs and accessory inspiratory muscles during functional performance in individuals with and without COPD. Thirteen patients with mild to moderate COPD and 10 healthy adults were enrolled. All participants were asked to complete the requested ADL tasks involving upper limb elevation while recording activities of muscles of the accessory inspiratory muscles, as well as respiratory expenditure via the Delsys Trigno electromyography and Ultima CardiO2 system, respectively. Muscle activity of the pectoralis major (PM) in the COPD group was significantly higher than that in the non-COPD group during washing both sides of the head ( < 0.05) and storing 2- and 4-kg objects on a shoulder-height shelf ( < 0.05). Ventilatory inefficiency and metabolic expenditure were significantly higher during the storage of objects at head height in the COPD group. A positive correlation was observed between sternocleidomastoid muscle activity and metabolic/ventilatory expenditure in the non-COPD group. However, muscle activity of the upper trapezius was significantly correlated with metabolic/ventilatory expenditure in the COPD group. Higher PM muscle activity and ventilatory inefficiency in the COPD group were found during performing ADLs involving upper limb elevation. Individuals with COPD demonstrated increased accessory inspiratory muscle activity, reduced ventilatory efficiency, and higher metabolic expenditure during ADLs involving upper limb elevation compared to healthy controls. The PM in the COPD group was the major accessory inspiratory muscle for performing ADLs involving upper limb elevation. These findings could inform recommendations for individuals with COPD to adjust their strategies for upper limb elevation while performing ADLs. Training of the larger accessory inspiratory muscles in rehabilitation programs has also been considered to enhance ADL performance in individuals with COPD. ClinicalTrials.gov identifier: NCT04146948.
Digital Mirror Therapy and Action Observation Therapy for Chronic Stroke: A Pilot Randomized Controlled Trial.
Hsieh YW, Lee MT, Hsu YC … +2 more , Wu KY, Chen CC
Occup Ther Int · 2025 · PMID 40151488 · Full text
This study is aimed at testing the immediate and retained treatment efficacies of digital mirror therapy (DMT) and digital action observation therapy (DAOT) on clinical outcomes in chronic stroke patients, in comparison...
This study is aimed at testing the immediate and retained treatment efficacies of digital mirror therapy (DMT) and digital action observation therapy (DAOT) on clinical outcomes in chronic stroke patients, in comparison with dose-matched, active control rehabilitation (CR). Nineteen patients were randomly assigned to the DMT, DAOT, or CR for 3 weeks. Outcome measures, including the Fugl-Meyer Assessment of the Upper Extremity (FMA-UE), Chedoke Arm and Hand Activity Inventory (CAHAI), Revised Nottingham Sensory Assessment, Motor Activity Log (MAL), and visual analogue scale of the EQ-5D-5L, were conducted at preintervention (T0), postintervention (T1), and 1-month follow-up (T2). There were no significant differences among the three groups on the outcomes at different time points. However, in the DMT group, scores were significantly higher on the FMA-UE and the CAHAI at T2 than at T0; in the DAOT group, those on the FMA-UE and the quality of movement subscale of the MAL were significantly higher at T2 than at T0. In the CR group, scores on the FMA-UE and the CAHAI were significantly higher at T1 than at T0. Both DMT and DAOT had retained treatment effects on motor function. DMT and DAOT might be feasible as alternative intervention strategies for chronic stroke patients. ClinicalTrials.gov identifier: NCT04441190.
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