|Year : 2019 | Volume
| Issue : 2 | Page : 58-71
|Date of Web Publication||28-May-2019|
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
. OTICON'2019 Abstracts. Indian J Occup Ther 2019;51:58-71
| Oral Competitive Papers|| |
| 1. Plasticity of Cognitive Functioning in Occupational Therapy Students using Holistic Approach for Immediate Training Gains: A Randomized Controlled Trial|| |
Shivani Bhardwaj, Raj Kumar Sharma
Occupational Therapy Department, Santosh Occupational Therapy College, Ghaziabad, Uttar Pradesh, India
Background: Neuroplasticity, also known as brain plasticity, is the ability of the brain to change, throughout an individual's life, for example, brain activity associated with the given function can be transferred to different locations, the proportion of grey matter can change, and synapses may strengthen and weaken over time. Research in the latter half of the 20th century showed that many aspects of the brain can be altered even throughout adulthood. This notion is in contrast with the previous scientific studies that the brain develops during our critical period in the early childhood and then remains relatively unchanged.
Objectives: To find out the impact of yoga, meditation, aerobics, physical activity, and cognitive training as the constituents of occupational therapy protocol on students to gain immediate training effects enhancing plasticity in cognitive functions.
Study Design: This is a randomized controlled trial.
Methods: The total strength of students was 105 of which 70 were volunteered for participation in the research. Of 70 students, only 50 were included based on the inclusion criteria as they had <26 scores in Montreal Cognitive Assessment (MoCA) test. Among them, 25 were randomly assigned to a training group and 25 to a control group. The individuals fulfilling the inclusion criteria were recognized as having into training group. Exclusion criteria were individuals diagnosed with depression, anxiety, or any other psychiatric, surgical, medical, or orthopedic condition. Both the genders were included in the study.
Results: Difference between the experimental and control groups is tested using a paired t-test. Further, independent t-test was used for testing the difference between the two groups with respect to improvement after giving the intervention to the experimental group. The mean improvement in the experiment group is 7.6 (standard deviation = 2.6) and in the control group is 0. The difference between the groups is statistically significant (P < 0.001).
Conclusion: Thus, the results of this study justify that training in basic cognitive skills through holistic approach as an occupational therapy intervention in students can make a significant improvement. This research design did not have within its scope, to analyze which of the skills included in the training is responsible for improvements of cognition. This study concludes that the experimental group receiving holistic approach has shown significant outcomes when measured on parameters of MoCA (cognitive domains visuospatial/executive, naming, memory, attention, language, abstraction, delayed recall, and orientation).
Key Words: Cognition, Executive Functioning, Immediate Training Gains, Holistic Approach, Neuroplasticity, Occupational Therapy
| 2. Effect of Parental Presence during Therapy of Autism Spectrum Disorders|| |
Anant Sharma, Goutam Surage, Khushbu Nim1, Gouri Rao Passi1, Kamna Jain
Choithram Hospital and Research Centre,1Balkrishna Centre for Autism and Rehabilitation, Indore, Madhya Pradesh, India
Background: Usually, it is noticed that parents feel anxious about therapies. Anxiety is obvious because they are handing over their child to an unknown person. Some views say it is better to administer therapy in front of parents whereas some say better to avoid parents in sessions. In tier 2 cities (like Indore), the burden of patient is high and almost all therapy centers avoid parents during the session. The study aims to know whether involvement of parents is beneficial or not.
Objectives: Differing views on benefits and disadvantages of parental presence during their child's therapy session leaves the topic surrounded by controversies. This study aimed to describe and explain parent's experiences of their presence or absence during the session.
Study Design: Qualitative study design was chosen for the research.
Methods: Shortly after the diagnosis of autism spectrum disorder by a pediatrician, 30 semi-structured interviews were conducted with parents of children (2–10 years) who underwent extensive occupational therapy session in Indore. Twenty-five of these parents again participated after 6 months' interview were analyzed using grounded theory methodology.
Results: Analyses resulted in themes that were integrated into a model, summarizing key aspects of parental presence during therapy sessions. These aspects include parental cognitions and emotions (e.g., shared distress), parental abilities and need (e.g., controlling own emotions being responsive and gaining overall control), and role of occupational therapy.
Conclusions: Findings emphasize the distressing nature of nature therapy sessions. Despite distress, the parents expressed their preference to be present. The abilities to control their own emotions and to be responsive to the child's need were considered beneficial for both the child and the parent. Importantly, being present increased a sense of control in parents that helped them to cope with the situation. For parents not present, the professional was the intermediary to provide information about the recovery process that helped parents to deal with the situation. In sum, the proposed model provides avenues for professionals to assess parents' abilities and needs on a daily basis and to adequately support the child and parent during therapy session.
Key Words: Autism, Distress, Occupational Therapy, Parental Presence, Parents
| 3. Play-Based Occupational Therapy Intervention on Social Skills in Children with Autism Spectrum Disorder and Attention Deficit Hyperactivity Disorder: A Case Series|| |
Award: Won Gazala Makda Trophy for Best Scientific Paper in Pediatrics
Kinkuri Sahib Kaur, Ranjit Pathak1
Inspiration Learning Centre, New Delhi,1Teaching Faculty, IAHSET, Government Medical College, Haldwani, Uttarakhand, India E-mail: email@example.com
The profound deficit in social reciprocity skills is the core underlying feature of the autism spectrum disorder. Inattention and impulsivity of attention deficit hyperactivity disorder children interferes with their ability to accurately identify, imitate, and model appropriate social behaviors. Social skill is any skill that facilitates interaction and communication with others, and evidence suggests that they can be acquired with specific training, opportunities, and practices. Literature suggests that in a developmental approach to social skills training, play is used as the primary medium for intervention, especially with younger children. Three children in the age group of 4.5 years were selected for the study. Socialization domain of the Vineland adaptive behavior scales.second edition was used to get the baseline scores. The children participated in the play.based occupational therapy intervention and each session was carried out for 60 min, twice a week. The children were reassessed after 6 months. The scores' data showed an upward trend and the socialization score of child 1, 2, and 3 improved by 11.6%, 14.8%, and 8.3%, respectively.
Key Words: Attention Deficit Hyperactivity Disorder, Autism, Intervention, Play, Social Skills
| 4. Comprehensive Effectiveness Study of Community-Based Inclusion, Rehabilitation, and Interdisciplinary Approach toward Cross-Disabilities in Panchayats of North India|| |
Narender Paul, Balbir Guleria, Sanjeev Gupta
CORD Training Centre, Village and Post Office Sidhbari, Himachal Pradesh, India
Background: Demonstrated interdisciplinary, scalable, and replicable models are much needed in a developing country like India where 70% of cross-disabilities population resides scattered in 250,000 panchayats – a unit of decentralized governance and inclusive development in rural India. Virtually, all literature on disability outlines the shift in policy thinking from the charity and medical model of disability toward social and rights-based models. Comprehensive approach of CORD's community-based inclusion and rehabilitation (CBIR) is striving to bring 1800 persons with disabilities (PWDs) to the center stage of development in 100 panchayats in district Kangra, Himachal Pradesh. This case study explores the process and various facets of this multidisciplinary, inclusive, scalable, and replicable model for effective inclusion of PWDs within existing scenario of resources constraints (both human resources and financial) of governments, policies, and programs in India in spite of having comprehensive legislation, i.e., Rights of Persons with Disabilities Act 2016 in line with the United National Convention on the Rights of Persons with Disabilities (UNCRPD).
Objectives: To share interdisciplinary, scalable, and replicable case study on CORD's CBIR model based on the CBR matrix.
Study Design: The study design is CBR Matrix framework with stratified sample of 10 panchayats with minimum 6 to maximum 15 persons with cross-disabilities.
Methods: Both quantitative and qualitative methods in reference to the CBR matrix framework are performed. Interviews (individual/family/related stakeholders and CORD team), narratives, and focused group discussions are used to supplement the case study outcome.
Results: The experiential CBIR model of CORD empowers the PWDs individually and collectively by holistically addressing both their rehabilitation needs and self-reliance needs comprehensively. This allows the PWD to have informed decision-making and ensures empowerment within existing scenario of grass-root realities of rural India, government policies, and programs.
Conclusion: CORD's case study emphasizes which is “empowering inclusion and development” of PWDs through a comprehensive and interdisciplinary approach into their communities – is scalable and replicable for rural India and it amounts to 70% of total population. This panchayat-based sustainable model blends and incorporates multipronged aspects of the social, economic, medical, and rights-based models to empower PWDs in India within existing policy and program scenario of inclusion and development.
Key Words: CBR Matrix, Center Stage, Empowerment, Holistic, Inclusion, Right Based, United National Convention on the Rights of Persons with Disabilities
| 5. To Analyze the Effect of Person–Environment–Occupation Intervention Model on Stress and Breastfeeding Efficacy on Mothers of Preterm Neonates|| |
SS Patil, SS Jaywant
Occupational Therapy School & Centre, LTMMC and GH, Sion, Mumbai, Maharashtra, India
Background: Parents of infants admitted to the neonatal intensive care unit (NICU) are believed to experience high levels of distress, including increased anxiety, depression, and trauma symptoms, as compared to parents of healthy infants. Mothers nursing infant in the NICU experience stress due to the presence of various equipment and environment in the NICU. This stress also affects breastfeeding ability in nursing mothers. The purpose of occupational therapy intervention is to reduce stressful conditions and improve breastfeeding efficacy. Application of person–environment–occupation (PEO) model as a framework for illuminating the acquisition of parenting occupations in the NICU. The concept of PEO has enhanced the better outcome in the NICU intervention. The study evaluates the effect of PEO on parental stress level and breastfeeding efficacy in mothers of preterm infants.
Objectives: (1) To describe the level and sources of stress experienced by the parents of infants admitted to an NICU, (2) to implement PEO model intervention for examining breastfeeding efficacy, (3) to implement PEO intervention model for preterm neonates.
Study Design: This was an experimental, comparative, randomized controlled trial.
Methods: The study was approved by the institutional ethics committee. The mothers fulfilling the inclusion criteria were included in the study (sample size 52). They were assessed on Edinburg postpartum depression scale and parental stress scales, along with breastfeeding efficacy scale after 7 days of admission of their preterm neonates (gestational age between 28 and 36 weeks). They were allocated into control group and experimental group using lottery method. Control group received regular occupational therapy intervention, whereas experimental group received intervention based on the PEO model. Follow-up was taken after 15 days and at the time of discharge.
Results: The experimental group showed significant improvement in breastfeeding efficacy and reducing stress and thus improved their self-confidence after the PEO intervention program than the control group. The difference on breastfeeding self-efficacy scale was remarkable.
Conclusions: PEO model is efficacious to reduce anxiety and depression of mother of preterm neonate and also improves breastfeeding efficacy. When the PEO model is used, the improvement is faster and good.
Key Words: Breastfeeding, Occupational Therapy, Parent, Person Environment Occupation Model, Preterm, Stress
| 6. Comparison Between Myofascial Release and Myofascial Taping as an Adjunct to Conventional Treatment in The Management of De Quervain's Tenosynovitis: A Randomized Control Trial|| |
Award: Won Kamala V. Nimbkar Trophy for Best Scientific Paper
Taslina Abdulkader, Karuna Nadkarni1
Occupational Therapy Department,1O.T. Training School and Centre, Seth G. S. Medical College and KEM Hospital, Parel, Mumbai, Maharashtra, India
Background: De Quervain's tenosynovitis is the most common overuse injury, involving the wrist, and often occurs in individuals who regularly use a forceful grasp coupled with ulnar deviation of the wrist. There is no consensus in the treatment of De Quervain's tenosynovitis; both surgical and conservative medical management has adverse effects. Myofascial release (MFR) and myofascial taping (MFT) are newer techniques which have been proven effective for other inflammatory and noninflammatory musculoskeletal conditions. Hence, the study was planned to determine and compare the effectiveness of both the above-mentioned adjunct method along with conventional occupational therapy in the treatment of De Quervain's tenosynovitis.
Objective: To compare and study the effectiveness of MFT and MFR as an adjunct to conventional occupational therapy treatment on patients with De Quervain's tenosynovitis.
Study Design: A prospective, comparative randomized control trial was conducted for 18 months in the Department of Occupational Therapy (OT) of the O.T. Training School and Centre, Seth G.S. Medical College and KEM Hospital.
Methods: Thirty-one patients (both males and females aged 20–50 years) diagnosed as De Quervain's tenosynovitis, referred to the OT outpatient department, were randomized into two groups after screening by simple random sampling using a computerized generated table. Patients in Group A (N = 16, 11 females and 5 males) received MFT along with conventional treatment, and patients in Group B (N = 15, 9 females and 6 males) received MFR along with conventional treatment; they followed up for the treatment for 5 weeks, 2 times a week with each session lasting for 30–40 min. Pain level and functional improvement were evaluated by visual analog scale (VAS) score and patient-specific functional scale (PSFS) score, respectively, at the end of the 3rd and 5th week of the 5-week therapy program.
Results: Both the groups showed significant improvement in pain scores on VAS at the 3rd and 5th week. There was no significant difference in the values between the two groups at the3rd week; however, at the end of the 5th week, Group A showed significant improvement in pain than Group B. Both the groups showed significant improvement in functional scores on PSFS at the 3rd and 5th week.
Conclusion: Although both MFT and MFR showed improvement in function and decrease in pain, when compared we could conclude that MFT along with conventional OT yields better outcome measures in terms of decreasing pain and improving function.
Key Words: De Quervain's Tenosynovitis, Myofascial Release, Taping
| 7. A Cross-Sectional Study to Investigate the Relationship between Psychological Factors and Stress in Two Adult Developmental Stages|| |
AG Karnam , SD Sarang
O.T. Training School and Centre, LTMMC and GH, Sion, Mumbai, Maharashtra, India
Background: Stress can cause a significant impact on social and occupational participation to the extent that is significant clinically. This study thus aims to verify any correlation among self-reported mindfulness, perceived stress, and psychological well-being among individuals in intimacy versus isolation (19–40 years) and generativity versus stagnation (40–65 years) stage of Erick Erikson's classification of development.
Objectives: (1) To measure psychological well-being, mindfulness, and perceived stress in people from the two developmental stages. (2) To study the correlation between psychological factors (the six dimensions of psychological well-being and mindfulness) with stress in each group. (3) To compare between these two developmental stages and the relationship between psychological factors and stress.
Study Design: This is a cross-sectional study.
Methods: Males and females belonging to intimacy versus isolation (19–40 years) and generativity versus stagnation (40–65 years) stage of Erick Erikson's classification of development were included in the study. Paper-based version of perceived stress scale, mindful attention awareness scale (MAAS), and Ryff's psychological well-being scale were administered. The scores of perceived stress scale, MAAS, and Ryff's psychological well-being were compared.
Results: individuals belonging to the intimacy versus isolation stage showed higher scores on stress and lower scores on mindfulness as compared to individuals in generativity versus stagnation (40–65 years) stage of development.
Conclusions: Individuals who are more mindful experience less stress. Thus, practicing mindfulness can help deal with stress.
Key Words: Mindfulness, Psychological Well-Being, Stress
| 8. To Investigate the Association between Sleep and Happiness among Nurses with Different Personality Traits: A Cross-Sectional Study|| |
Award: Won Vijay Suple Trophy for Best Scientific Paper in Mental Health
SD Sarang, RB Shitole, AG Karnam
Occupational Therapy Training School and Centre, LTMMC and GH, Sion, Mumbai Maharashtra, India
Background: Sleep and happiness play an important role in the functioning of a person. This study investigated the association between sleep and happiness among nurses and also studied if individual personality traits play a role.
Objectives: To measure perceived stress, sleep, happiness and personality trait among nurses & To analyze the relationship between the sleep, happiness and personality trait.
Study Design: A cross-sectional study design was chosen for the research.
Methods: Thirty nursing staff (females, aged 22–53 years) were selected for the study. The Perceived Stress Scale (PSS) was used for screening stress. Those who scored low (0–13) on the PSS were included in the study. Written informed consent was obtained. Sleep quality, happiness, and personality traits were measured using the Pittsburgh Sleep Quality Index, Oxford Happiness Questionnaire, and Big Five Personality Test, respectively. Scores were analyzed using MedCalc Statistical Software.
Results: The mean age of nursing staff with good sleep was 28 years and that with poor sleep was 36 years. It was found that 63% of nursing staff had poor sleep and 37% had good sleep. Among nursing staff with good sleep, 36% were unhappy and 64% were happy. Among nursing staff with poor sleep, 47.7% were unhappy and 52.6% were happy. The mean score for neuroticism was higher in patients with poor sleep (t-test, P = 0.003, 95% confidence interval: -7.96 to -1.76).
Conclusions: Nursing staff with good sleep were happier compared to nurses with poor sleep though the difference was not significant. Sleep disturbances increased with age among nurses. The personality trait of neuroticism was higher in patients with poor sleep.
Key Words: Happiness, Occupational Therapy, Personality, Quality of Sleep
| 9. Effect of Occupational Therapy on Cognitive and Occupational Performance in Individuals with Mental-Health Disorders|| |
P Mehta Pooja1,2
1Occupational Therapy Department, Topiwala Medical College and BYL Nair Charitable Hospital, Mumbai Central,2Occupational Therapist, Anmol Child Development Clinic, Kandivali, Mumbai, Maharashtra, India E-mail: firstname.lastname@example.org
Background: The most distressing outcome for any mental health disorder is cognitive dysfunction and poor occupational performance (OP), which hinders the daily functioning of the individual and escalates the condition further. Model of human occupation and person–environment–OP, both psychosocial frameworks, emphasize that OP is the outcome of interaction between person and his/her unique environment. This meaningful engagement in activity and environmental interaction, measured through observed general, interpersonal, and task behaviors, is facilitated through cognition. The literature suggests the presence of cognitive dysfunction and poor OP in individuals with mental health disorders. However, empirical evidence of occupational therapy (OT) effect on the same is scarce. OT review study showed few articles in mental health and under-representation of client population in clinical practice in India.1 Hence, this study is aimed to find the effect of OT on cognitive and OP in individuals with mental health disorders, ensuring appropriate representation of client population.
Objectives: To study the effect of OT on (a) cognitive performance and (b) OP.
Study Design: This was a single-system, quasi-experimental, pretest–posttest study.
Methods: Based on the selection criteria, 88 individuals (both males and females, aged 18–55 years) with diagnosed mental health disorders admitted in the hospital were recruited, after screening during their first visit to the OT department. Convenience sampling was done. Individuals recruited are categorized into diagnostic groups – psychotic disorders, neurotic disorders, alcohol and substance use disorders for ancillary findings. Subjects are assessed on mini-mental state examination (MMSE) and comprehensive OT evaluation (COTE) scale pretherapy and administered weekly for 3 weeks or 6 sessions. Client-tailored OT was given twice a week.
Results: Statistical analysis showed highly significant improvement in mean scores of total MMSE and COTE scores and their subtests except for registration and language praxis scores of MMSE for all four diagnostic groups – psychotic disorders, neurotic disorders, mood disorders, and alcohol and substance use disorders.
Conclusion: Statistically highly significant improvement suggests that OT is effective in improving cognitive performance and OP in individuals with mental health disorders.
Key Words: Comprehensive Occupational Therapy Evaluation, India, Mental Health Evidence, Mini-Mental State Examination, Psychosocial Practice
| 10. A Comparison of Hand Dexterity in Students Using Smartphones|| |
Rithisha Shetty, Yash Gupta, Jayashri Kale1, Shilpshree Palsule, Palak Shah
OT School and Center, Seth G.S.M.C. and KEMH,1Department of Occupational Therapy, Seth G.S.M.C. and KEMH, Mumbai, Maharashtra, India
Background: A smartphone is a mobile hand-held device with advanced computing capability. Smartphone owners comprise 56% of American adults, and their average daily use is 195 min. The smartphone overuse/addiction may lead prone individuals to develop Carpal Tunnel Syndrome. It exposes hands to intense stresses that may lead to pain and musculoskeletal disorders of the hand and thumb. Moreover, frequent use of smartphones may affect hand function and pinch strength, possibly resulting in pain in the thumb. Smartphone usage has increased over years; there have not been many studies done on its effects on hand dexterity.
Objectives: To compare the Purdue pegboard test scores of students categorized on smartphone addiction scale (SAS).
Study Design: This was a cross-sectional observational study.
Methods: A pilot study on 20 medical students was performed, in which SAS was administrated and their scores have been categorized in three groups. A total of 324 participants are selected based on convenient sampling method as per the inclusion criteria (medical students in the age group of 18–27 years of age using smartphone and having visual analog scale for pain score <2). After taking informed consent, the students are being scored on the SAS, and Purdue peg board test is also administered. Based on the results of Purdue pegboard test, a comparative analysis of the hand dexterity of the participants in different categories of SAS will be done using both descriptive and inferential statistics.
Results: After the pilot study, the students were divided into three categories based on their SAS scores.
- 33–79/198: Low
- 80–105/198: Moderate
- 106–198: High.
The statistical analysis showed a weak negative correlation between the hand dexterity (dominant) and the SAS scores.
Conclusions: This study concluded that high SAS scores may have no impact/weak impact on the hand dexterity.
Key Words: Addiction, Dexterity, Hand Function, Purdue Pegboard Text, Smartphone
| 11. Comparing the Level of Enjoyment using Physical Activity Enjoyment Scale in Children with Neurodevelopmental Concerns: Comparison between One-on-One Therapy and Group Therapy Emphasizing Enjoyment|| |
Aastha Goel, Himani Khanna, Puja Kapoor, Rajiv Chhabra1
Continua Kids Centre,1Department of Pediatrics, Artemis Hospital, Gurugram, Haryana, India
Background: Enjoyment is both a predictor and outcome of physical activity participation. Anticipation of positive emotions predicts physical activity adoption and maintenance. Children with neurodevelopmental concerns get less opportunity to enjoy physical activities. By comparing the level of enjoyment using physical activity enjoyment scale (PACES) in one-on-one therapy with group therapy emphasizing on enjoyment, one can conclude future interventions to plan for therapy.
Objectives: Comparing enjoyment level of children with neurodevelopmental issues coming for therapy using PACES. The comparison is being done with one-on-one therapy and group therapy emphasizing upon enjoyment.
Study Design: This study was a pre- and post-research design without control group.
Methods: Participants included children aged 4–8 years. The scores were compared with 26 children who received group therapy sessions with children who received one-to-one therapy at Continua Kids Centre every day for an hour, total duration of 3 months. The PACES was used to evaluate enjoyment of children having social communication disorder and autism. The assessment was conducted postintervention by the therapists using a 7-point Likert scale (1 = unpleasurable; 7 = pleasurable). Two items are reverse-coded. The sum of all the items forms a unidimensional measure of enjoyment. Higher values reflect greater levels of enjoyment.
Results: The number of subjects was 26 for individual therapy and group therapy session. The mean score of PACES for occupational therapy sessions is 58.23 ± 7.61 (P < 0.05, 95% confidence interval [CI] 55.16–61.3); however, the results for group sessions (66.15 ± 7.11 [P < 0.05, 95% CI: 63.2–69.02]) showed that enjoyment of physical activity is more in group sessions than in one-on-one occupational therapy sessions, hence comparing the enjoyment level using PACES in two different therapies.
Conclusions: The results support that measures of physical activity enjoyment in children taking group session have a significant importance as enjoyment factor is high in group therapy as compared to individual one-on-one occupational therapy.
Key Words: Group Therapy, Neurodevelopmental, Physical Activity Enjoyment Scale
| 12. Effectiveness of Social Stories in Coping with Bullying among Children with Childhood Psychiatry Conditions|| |
Award: Won KEMOT Youth Talent Trophy for Best Scientific Paper (By Occupational Therapist Graduated After 1st January, 2014)
S Sakthi Srija, S Sugi
Occupational Therapy Department, KMCH College of Occupational Therapy, Coimbatore, Tamil Nadu, India E-mail: email@example.com
Background: In schools, bullying is a regular occurring behavior problem and is also considered as the most common form of violence. According to studies, it is noted that bullying occurs primarily in the peer group, and developmentally, it is evident as early as preschool although it peaks during the middle school years. Higher rates of being bullied have been reported for children with special educational needs and disabilities. For addressing the problems faced by children during bullying and support them to develop adaptive coping responses, requires a teaching intervention. Social story developed based on evaluations and observations of a child targets a problematic behavior and helps in preparing the children to adapt the change calmly in any environment and respond appropriately to a situation.
Objectives: To identify the victims of bullying among childhood psychiatry conditions and to develop coping skills for victims of bullying and determining the effectiveness of social stories in developing coping skills for bullying.
Study Design: This was a quantitative, two-group pretest and posttest quasi-experimental study.
Methods: Children were screened through Illinois bully victim scale. Twenty-two children (both males and females, aged 8–13 years) diagnosed with Attention Deficit Hyperactive Disorders, Learning Disabilities, Intellectual Disabilitieswere randomly assigned to experimental and control groups. Coping strategies were taught to the children in experimental group with the help of social stories for two target behaviors and role play at end of the individual 30 min' session on each targeted behavior for 2–3 days a week for 13 sessions, whereas control group participants underwent regular occupational therapy session along with coping strategies and role play for 30 min individually for 13 sessions. Canadian Occupational Performance Measure and coping with bullying scale for children (CBSC) were administered before and after the intervention as an outcome measure.
Results: Children analyzed in the experimental group (N = 12) and control group (N = 10) revealed that both groups equally improved with their respective interventions. However, students achieved clinically significant scores in their mean values 68.42 ± 61.50 (P < 0.022, 95% confidence interval [CI]: 0.000–0.127) in the level of performance, suggesting that they used more of adaptive responses in coping with a bullying situation inferring to the in CBSC. Typically, children in both the groups showed some amount of maladaptive strategies even after their respective interventions (8.03 ± 6.2 [P = 0.209, 95% CI: 0.000–0.132]), referring that social story was found to have an impact only on adaptive coping responses. This warrants the importance of addressing the awareness of adverse consequences of maladaptive coping strategies through social stories.
Conclusions: Social stories were effective in improving coping skills as well as in enabling the application of learned coping skills (performance) during bullying situation.
Key Words: Coping Skill, Performance, Role Play, School Bullying, Social Stories
| 13. A Study to Compare Efficacy of Test of Visual Perceptual Skills-3 and Rivermead Perceptual Assessment Battery with Performance of Indian Drivers on Driving Simulator for Determining Off-Road Perceptual Skills: A Pilot Study|| |
Sheetal Gupta, Anita Gupta, Sushmita Ahirwal
Occupational Therapy Department, AIIPMR, Haji Ali, Mumbai, Maharashtra, India
Background: Driving simulators are frequently used in traffic research to study the various traffic scenarios with related traffic phenomena. This current pilot study assesses off-road driving skills of Indian drivers using driving simulator and perceptual test batteries such as test of visual perceptual skills-3 (TVPS-3) and Rivermead perceptual assessment battery (RPAB).
Objectives: To compare the efficacy of TVPS-3 and RPAB with performance of Indian drivers on driving simulator to determine off-road perceptual skills.
Study Design: This is a cross-sectional study.
Methods: The sample size was 30. Individuals who met the following inclusion criteria were included:
- Individuals with driving experience of not <1 year
- Age range: 20–60 years
- No obvious visual impairment or other such comorbidities.
Participants underwent evaluation in two phases.
Phase 1: It included screening of participants for inclusion criteria and assessment of screened individuals on driving simulator.
Driving simulator: Participants were tested on “city driving test” for 15 min.
Phase 2: After completing assessment on driving simulator, participants were randomly assigned to either of the perceptual tests.
Perceptual tests: Participants' perceptual abilities were assessed either using TVPS-3 or RPAB.
Statistical analysis was done using Pearson's correlation to compare the visual perceptual tests and performance on driving simulator; unpaired t-test was used to find difference between TVPS-3 and RPAB.
Results: The performance of Indian drivers on perceptual tests and driving simulator is highly correlated.
Conclusion: Driving simulator seems to be a valid and stable assessment tool for assessing driving skills in individuals. Both the assessment scales are can be used for assessing the driving skills of participants.
Key Words: Driving Simulator, Off-Road Driving Skills, Perceptual Abilities
| 14. To Compare the Effects of Preterm Infant Oral Motor Intervention versus Preterm Infant Oral Motor Intervention with Massage Therapy on Social-Emotional Development in Preterm Infants: A Randomized Controlled Trial Study|| |
PS Dandavate, SS Jaywant
Occupational Therapy Training School and Centre, LTMMC and GH, Sion, Mumbai, Maharashtra, India E-mail: firstname.lastname@example.org
Background: The WHO defines Moderate and late preterm birth (MLPT) as infants who are born between 32 and 36 weeks of gestation. They are at greater risk of developmental problems as compared to their term-born peers. MLPT shows delayed oral motor functioning. Infants' primary function of feeding self is frequently affected in MLPT. This has long-term impact on emotional development, social learning, and health. Occupational therapists use a variety of interventions such as preterm infant oral motor intervention (PIOMI) and massage therapy for improving oro-motor control and neurobehavioral status of a preterm infant. PIOMI has shown positive effects on oro-motor functions and growth of preterm infants which contributes to the overall development. Infant massage is recognized as a developmentally supportive intervention that aimed at decreasing infant stress and optimizing the infant's sensory experience to improve long-term development. The current study intends to observe combined effect of these interventions on the development of preterm infants.
Objectives: To evaluate the effect of PIOMI and PIOMI with massage therapy on social-emotional development of preterm infants.
Study Design: This is a prospective, experimental, comparative, randomized controlled trial.
Methods: Preterm infants (aged 32–36 weeks, n = 50) who are hemodynamically stable and satisfying the inclusion criteria were allocated into control group (Group A) (n = 25) and experimental group (Group B) (n = 25) randomly using a lottery method. Control group received PIOMI for 10 min twice a day. Experimental group received PIOMI along with massage therapy (M-technique) for 10 min twice a day until they achieve full oral feeds. The infants were evaluated at 2 and 6 months of corrected age on ages and stages questionnaire social emotional-2 scale.
Results: On analysis of result scores, at the end of 2 months of corrected age and 6 months of corrected age, the experimental group showed that these preterm infants have achieved mean scores similar to typically developing infants, i.e., lower scores on social and emotional problems (18.6 and 28.2, respectively) on ages and stages questionnaire social emotional-2 scale (30.4 and 46.2, respectively), as compared to control group.
Conclusion: Preterm infants who received PIOMI with massage therapy helped in social and emotional development with better neurobehavioral regulation.
Key Words: Massage Therapy, Preterm Infant Oral Motor Intervention, Preterm Infants, Social Emotional Development
| 15. Efficacy of Brain Gym® Exercises as an Adjunct to Occupational Therapy, on the Activities of Daily Living and Motor Aspects of Patients with Parkinson's Disease and Its Reflection on Their Quality of Life|| |
Abhinav Mishra, Odette M Gomes1
Occupational Therapy Department,1O.T Training School and Centre, Topiwala National Medical College and B.Y.L. Nair Hospital, Mumbai Central, Mumbai, Maharashtra, India
Background: Parkinson's disease (PD) is the second most common neurodegenerative disease, exceeded only by Alzheimer's disease. Researches have shown that quality of life (QOL) regresses with the progression of the disease with PD. Brain Gym (BG) which is a newer concept has also shown an improvement in the balance, posture, and handwriting, but there is a scarcity of literature which shows the combined effect of both the functional proprioceptive neuromuscular facilitation patterns and the BG exercises.
Objectives: To study the effectiveness of BG exercises as an adjunct to occupational therapy on activities of daily living (ADL) and motor aspects of patients with PD and its reflection on their QOL.
Study Design: This is a prospective, comparative, and randomized control study.
Methods: In this prospective, comparative, and randomized control study, conducted for 18 months, both males and females were recruited aged between 50 and 75 years diagnosed as a case of idiopathic PD in Stage 1–3 Modified Hoehn and Yahr Stage, with mini-mental state examination score >24 without secondary Parkinsonism More Details and any orthopedic conditions. Twenty-nine individuals who fulfilled the inclusion criteria were recruited for the study. With five dropouts, the study sample was 24. Group A (experimental group) and Group B (control group) were evaluated on The Movement Disorder Society-Unified Parkinson's Disease Rating Scale and 39-item Parkinson's Disease Questionnaire for baseline reading. Group A received BG exercise intervention with functional PNF patterns, whereas Group B received functional PNF pattern. The intervention was given for 6 weeks.
Results: The results indicated that Group A, i.e., experimental group, showed a significant change between the pre- and post-interventional scores in ADL and the motor aspects. Furthermore, the correlation coefficient of Group A between ADL and motor aspects with QOL changed from 0.75 to 0.83, whereas for Group B, it changed from 0.65 to 0.49.
Conclusion: It can be concluded that BG exercises as an adjunct to occupational therapy–functional PNF patterns were effective in improving the ADL and motor aspects of patients with PD, hence improving QOL.
Key Words: Activities of Daily Living, Brain Gym, Occupational Therapy, Parkinson's Disease, Quality of Life
| 16. Understanding Parent's Difficulties in Executing Activities of Daily Living of Children with Autism Spectrum Disorder|| |
Siddhi Naik, Pooja Vajaratkar
Occupational Therapy Department, College of Occupational Therapy, Goa Medical College, Goa, India E-mail: email@example.com
Background: Activities of daily living (ADL) refer to the ongoing behaviors that occur on a daily basis. Such behaviours include eating, cooking, bathing, social interactions (such as leisure activities, attending school or work, or assisting with chores), and other activities that one might routinely expect an individual to perform or participate in. Some of the major ADL tasks include personal hygiene, toileting, dressing, and eating. Researchers have documented delayed self-care performance in children with autism spectrum disorder (ASD). Parents report their child to have difficulties with feeding and toileting, in particular.
Objective: This qualitative pilot study endeavored to understand the difficulties faced by the parents of children with ASD in conducting their children's ADL.
Study Design: This is a qualitative descriptive survey.
Methods: The qualitative study included participants (n = 10) whose children are primarily diagnosed for ASD. The study was done by convenient sampling method which included children of age group between 4 and 9 years (mean age = 68.4 months; standard deviation = 18.8) and IQ 70% and above. The study was conducted in a hospital-based tertiary center. For the study, the parents were given a semi-structured questionnaire to understand difficulties faced by the parents of children with ASD.
Results: According to the study, it was observed that most of the parents have reported that their child has maximum difficulties in eating, following brushing and grooming and least for toileting. This study also found the priority list of difficulties in ADL. It was noted that early and proper training of the child gives good results in managing a child with ASD. Many parents reported that early training is beneficial.
Conclusion: The outcome of this study supports the hierarchy of difficulties in ADL reported by parents of children with ASD. This study also supports that early ADL training gives good result in managing a child with ASD.
Key Words: Activities of Daily Living, Autism, Parent's Difficulties
| 17. Performance of Indian Drivers using a Driving Simulator: A Pilot Study|| |
Sushmita Ahirwal, Anita Gupta, Sheetal Gupta
Occupational Therapy Department, AIIPMR, Haji Ali, Mumbai, Maharashtra, India
Background: Driving is associated with independence, but it also exposes a person to harmful situations while on road. Safety becomes an important aspect while assessing an individual's driving ability. This study examined the driving performance of Indian drivers, both young and old on driving simulator. Following ability tests were selected on the driving simulator:
- Ability test 1: clutch, accelerator, brake, steering assessment
- Ability test 2: stopping, precise stopping, hard stopping, reaction time
- City driving (for 5 min).
Objective: To compare driving performance in Indian drivers, both young and old.
Study Design: This was an observational, analytical study.
Methods: A total number of 30 subjects were included in this study. Among them, 15 were participants who were young drivers of age >20 years and 15 participants were old drivers of age >40 years.
Inclusion criteria: (1) Drivers with experience of driving four-wheeler for not <1 year. (2) either gender, and (3) age >20 years.
Exclusion criteria: Drivers who have readily noticeable visual, cognitive, or locomotors impairment which can compromise on driving ability.
Outcome: Scores from driving simulator software were recorded.
Statistical Analysis: The test scores were analyzed using statistical test unpaired t-test.
Results: There were significant differences in ability 1, ability 2, and advanced driving assessment. Young drivers performed poorly than old drivers.
Conclusion: Driving simulator can measure off-road driving skills of experienced Indian drivers. It can detect the performance of younger and older Indian drivers.
Key Words: Driving Simulator, Indian Drivers, Off-Road Driving Skills
| 18. Risk of Musculoskeletal Disorders Associated with Kitchen Platform Tasks in Middle-Aged Women of Mumbai City: A Cross-Sectional, Observational Study|| |
Sonal Sharma, Farheen Shaikh, Pradyna Bhovad, Jayashri Kale1, Yash Gupta, Mahima Bhuta
OT School and Center, Seth G.S.M.C and KEMH,1Department of Occupational Therapy Seth G.S.M.C and KEMH, Mumbai, Maharashtra, India
Background: Musculoskeletal disorders (MSDs) are one of the prominent causes of physical impairment. Traditional homemaking tasks require substantial and sustained physical repetitive movements. In addition, the presence of awkward work postures and patterns may contribute to musculoskeletal pain. The proposed study aims at quantifying the risks associated for MSDs due to kitchen work in middle-aged women and correlating the contribution of each task and kitchen platform type to the risk of MSDs.
Objectives:(1) To assess participants for pain using Nordic musculoskeletal pain questionnaire, (2) to assess the participants on various kitchen tasks using rapid entire body assessment (REBA), (3) to measure kitchen platform height, height of the participant, waist to toe height, and linear distance the tip of the shoulder to the kitchen platform, (4) to correlate the score of Nordic musculoskeletal pain questionnaire and REBA with kitchen platform height for finding the risk of MSDs.
Study Design: This is a cross-sectional, observational study.
Methods: A total of 200 participants from different areas of Mumbai were selected based on convenient sampling method and fitting the inclusion criteria. They were assessed on Nordic musculoskeletal pain questionnaire and REBA outcome measure for minimum 3 out of 5 meal preparation tasks (chopping, lifting, stirring, mopping the kitchen platform, and washing utensils). In addition, anthropometric measurements (height of the participant, kitchen platform height, waist-level height, and linear distance between the tip of the shoulder to the kitchen platform) were measured using a standard measuring tape at the residence of the participant.
Results: Participants who were participating in the areas of stirring and dishwashing were found to have increased incidence of neck pain, followed by low back pain. Furthermore, lower levels of kitchen platform height (<85 cm vertical height) were associated with awkward neck and upper back postures. Higher kitchen platform height (>85 cm) was found to be associated with awkward shoulder postures of both the upper extremities.
Conclusion: Kitchen platform tasks performed in an awkward repetitive posture, over an improper work surface height, may be associated with increased incidence of MSD among middle-aged women in Mumbai.
Key Words: Kitchen Platform Height, Kitchen Platform Tasks, Meal Preparation, Musculoskeletal Disorders
| 19. Burdened by the Bag: Issue of Heavy Schoolbags|| |
Award: Won M. M. Sangoi Trophy for Best Scientific Paper on Ergonomics, Environment & Access
Grace Elizabeth Muppidi, Ann Salome, MR Angel, MJ Ronald Thomvic, Grace Rebekah1, Sanjeev Manasseh Padankatti
Departments of Occupational Therapy and1Biostatistics, CMC, Vellore, Tamil Nadu, India
Background: The demands of education in our country have led to an increase in the loads children carry on a daily basis to school. Research evidence confirms that excessive load leads to musculoskeletal problems in children predisposing them to chronic back pain in the adulthood. This problem becomes pertinent in primary schoolchildren owing to the development of the spine at this age.
Objectives and Study Design: This school-based, cross-sectional survey aims to assess the magnitude of this problem by measuring schoolbag weights and the factors affecting the ≤10% of body weight recommendation and the children's perception of discomfort and pain.
Methods: Two schools with different syllabi were approached, and the schoolbags of children from grades 1–5 (n = 776) were weighed and were followed up over a week. Children were asked to rate their pain on the visual analog scale (VAS), and teachers' responses were collected through an author assisted questionnaire.
Results: Majority of the children carried a backpack and a separate lunch bag to and from school. 97.8% of schoolbags weighed more than the recommended limit of ≤10% of the body weight. The mean weight of schoolbags carried was 5.9 ± 1.5 kg (range between 2.20 and 17.38 kg). Boys carried on an average 5.91 ± 1.48 kg and girls 5.98 ± 1.55 kg. 48.5% of the children reported that carrying the schoolbag was causing discomfort and musculoskeletal pain. 18.8% reported specific regions for pain of which 14.7% of them reported discomfort at the shoulder region. VAS score for pain ranged from 2 to 9 with 8 as an average intensity. Twenty-two children reported absenteeism from school ranging from 1 to 5 days over the last term. A total of 107 primary school teachers from both schools were interviewed to assess their knowledge and level of control regarding this issue. The perception of teachers regarding the problem of schoolbag weights was mixed.
Conclusion: This study concludes that heavy schoolbags are a problem in both schools. Being forced to carry heavy bags may lead to “Schoolbag syndrome” in children. Thus, stringent measures need to be undertaken to reduce the bag burden and protect the health of children.
Key Words: Loads, Musculoskeletal Problems in Primary Schoolchildren, Pain and Discomfort, Schoolbag, Weight Limit
| Oral Noncompeetitivee Papeers|| |
| 20. Interlimb Coupling in Poststroke Rehabilitation: A Randomized Controlled Trial|| |
Kamal Narayan Arya, Shanta Pandian
Occupational Therapy Department, Pt. Deendayal Upadhyaya National Institute for Persons with Physical Disabilities, New Delhi, India E-mail: firstname.lastname@example.org
Background: Interlimb coordination is an outcome of spatiotemporal coupling of movements that occur between the four limbs. Goal-directed daily tasks need skilful bimanual coordination of both the upper limbs. Human locomotion also needs modulated interlimb coordination between all the four limbs. The interlimb coupling gets hampered in poststroke hemiparesis even at the later stage of recovery.
Objectives: To determine the effectiveness of interlimb neural coupling protocol on motor recovery, gait, and disability of poststroke subjects.
Study Design: This is a randomized controlled, doubled-blinded trial.
Methods: Fifty poststroke hemiparetic subjects (mean age 51 years, average poststroke duration of 15 months) were randomly divided into experimental (n = 26) and control (n = 24) groups. The experimental group received interlimb coupling protocol in addition to the standard rehabilitation for 8 weeks. The experimental intervention comprised activities for bilateral upper limb or lower limb or all four limbs ranging from symmetrical to asymmetrical and isodirectional to antidirectional movements. Activities such as bicycle ergometer, elliptical machine, pedocyle, and rowing machine were utilized for the regimen. The control subject underwent dose-matched conventional management only. The outcome measures used were assessed Fugl-Meyer assessment (FMA), Rivermead visual gait assessment (RVGA), and modified ranking scale (mRS).
Results: Postintervention, the experimental group exhibited highly significant (P < 0.001) improvement than the control group for FMA (mean difference = 8.83, 95% confidence interval [CI] = 7.60–10.06) including FMA upper extremity (mean difference = 3.8, 95% CI = 2.78–4.81) and FMA lower extremity (mean difference = 4.81, 95% CI = 4.20–5.42) and decline in RVGA (mean difference = −6.32, 95% CI = 7.51–5.13). Further, 15% experimental participants could reach to mRS 2 (slight disability) from the moderate or severe disability; no control subjects could accomplish the same level of disability.
Conclusions: The interlimb neural coupling program enhanced motor recovery of the upper and lower limbs and reduced gait deviation and disability level among the poststroke participants. Exploring the coupling concept would provide a new direction in the field of stroke rehabilitation.
Key Words: Bimanual Coordination, Cerebrovascular Accident, Motor Recovery, Upper Limb, Lower Limb
Trial Registration: The study was registered in the Clinical Trial Registry of India (CTRI) as CTRI/2016/09/007258.
Funding: Indian Council of Medical Research, New Delhi, India (Ref. No. 5/4-5/34/ADR/2013-NCD-I), funded the study.
| 21. Validity and Reliability of Postural Reaction Scoring System for Children with Cerebral Palsy|| |
Meenakshi Batra, Vijay Batra1,2
Occupational Therapy Department, PDUNIPPD, Ministry of Social Justice and Empowerment, Government of India,1Occupational Therapy Department, GIPMER, GNCT,2Occupational Therapy Department, ISIC Institute of Rehabilitation Sciences, New Delhi, India
Background: Postural reactions follow the stages of postural ontogenesis and persist as a basis for normal motor behavior. Postural reaction abnormalities eventually can predict accurately the degree of neurologic and functional impairment.
Objectives: To establish validity and reliability of postural reaction scoring system for children with cerebral palsy.
Study Design: This is an experimental, correlational design.
Methods: Three stages, viz.., drafting phase, item generation stage, and validation and reliability phase, were followed to generate postural reaction scoring system, and interrater and intrarater reliability at different timelines was established.
Results: Interclass and intraclass correlational coefficient was observed for the variable primitive reflex grading score (0.992–0.997); righting reaction (0.993–0.997); protective reaction (0.989–0.994); and equilibrium reaction, type of response in supine lying, on slow perturbation – lateral tilt at 10° (0.898–0.968) and 20° (0.921–0.990), forward backward tilt at 10° (0.900–0.980) and 20° (0.894–0.949), fast perturbation lateral tilt at 10° (0.949–0.983) and 20° (0.942–0.992), and forward backward tilt at 10° (0.949–0.979) and 20° (0.942–0.992); sitting position on slow perturbation – lateral tilt at 10° (0.888–0.969) and 20° (0.894-0.969), forward backward tilt at 10° (0.943–0.989) and 20° (0.987–0.988), fast perturbation lateral tilt at 10° (0.913–0.984) and 20° (0.912–0.980), and forward backward tilt at 10° (0.939–0.990) and 20° (0.976–0.989); and quadruped position on slow perturbation – lateral tilt at 10° (0.967–0.984) and 20° (0.950–0.986), forward backward tilt at 10° (0.949–0.993) and 20° (0.942–0.991), fast perturbation lateral tilt at 10° (0.197–0.952) and 20° (0.914–0.967), and forward backward tilt at 10° (0.943–0.990) and 20° (0.942–0.988). The sensitivity and specificity for equilibrium reaction were 88.5% and 62.5%; for righting reaction were 93.1% and 80.0%; and protective reaction were 90.0% and 75.0%, respectively.
Conclusion: Postural reaction scoring system is an effective valid and reliable tool for identifying and measuring postural behavior deficit in children with cerebral palsy.
Key Words: Cerebral Palsy, Postural Behavior, Reliability, Validity
| 22. Psychosocial and Functional Implication of Facial Asymmetry in Facial Palsy|| |
Vijay Batra1,2, Meenakshi Batra3
1Occupational Therapy Department, GIPMER, GNCT,2Occupational Therapy Department, ISIC Institute of Rehabilitation Sciences,3Occupational Therapy Department, PDUNIPPD, Ministry of Social Justice and Empowerment, Government of India, New Delhi, India
Background: Facial palsy is the most frequent affliction of the seventh cranial nerve and may result in a wide range of functional limitations, such as difficulties in eating, drinking, speaking, and ocular problems with associated psychosocial implications.
Objectives: To study the psychosocial and functional (physical and social) implication of facial asymmetry in facial paralysis and its association with recovery process.
Study Design: This was a quasi-experimental control study.
Methods: Three stages, viz., drafting phase, item generation stage, and validation and reliability phase, were followed to generate postural reaction scoring system, and interrater and intrarater reliability at different timelines was established. A total of 32 subjects with facial paralysis were included. They were assessed for their physical and social function. The subjects were allocated to two groups, i.e., Group A (facial taping) and Group B (conventional treatment). The intervention was given for 8 weeks and reevaluation was done at 4-week interval.
Results: Between-group comparison was done and the P value was found to be statistically significant for physical function (P = 0.029, confidence interval difference [CI diff] 0.9–16.2), social function (P = 0.005, CI diff −24.4 to −4.6), and psychosocial status (P = 0.007, CI diff −15.4 to −2.5) at 8 weeks for Group A. Gender-based comparisons were also done and P value was found to be statistically significant for females at baseline for physical function (P = 0.015, CI diff −9.6 to −1.1) and psychosocial status (P = 0.009, CI diff 0.6–4.0).
Conclusion: It can be concluded that facial taping augmented the recovery process, thereby improving the physical function and psychosocial well-being inpatients with lower motor neuron facial paralysis. The psychosocial status, social participation, and physical well-being get altered more adversely among females than males.
Key Words: Facial Asymmetry, Facial Paralysis, Facial Taping, Psychosocial Status
| 23. Impact of Socioeconomic Status on Quality of Life of Cerebral Palsy Children|| |
Shubha Arora, Shivani Singh1
Occupational Therapy Department, Jamia Hamdard University, Hamdard Nagar, Delhi,1SOCH CDC, Gurugram, Haryana, India
Objectives: To find out the impact of socioeconomic status on quality of life of cerebral palsy children.
Study Design: The study design was a survey.
Methods: Ninety-eight subjects aged 4–12 years were selected. They were briefly interviewed by their age, sex, and socioeconomic status. Kuppuswamy socioeconomic status scale and cerebral palsy quality of life questionnaire were used to assess the impact of socioeconomic status on quality of life.
Results: It was statistically analyzed and it was found that there is positive and significant correlation between socioeconomic status and quality of life.
Conclusion: The quality of life of patients with cerebral palsy depends on socioeconomic status of the family.
Key Words: Cerebral Palsy, Cerebral Palsy Quality of Life Questionnaire, Socioeconomic Status
| 24. Going Digital with Online Occupational Therapy|| |
Occupational Therapy Department, Genesis Neurogen, Delhi, India
Faced with tighter budgets and the shift to common core standards, many organizations have had to get creative and do more with less. However, the more with less approach can really backfire in many areas of education, especially for kids that need speech-language pathology or occupational therapy to enable them to access the Gen Ed Curriculum and stay on track with their peers. For these kids, earlier and more intensive interventions can transform their future outlook from grim and good. For these kids, timely interventions of appropriate intensity are absolutely key. Schools' best efforts to provide appropriate levels of services can be hampered by the logistics of serving students in remote locations as well as chronic shortages of qualified professional clinicians such as speech-language pathologist (SLP) and occupational therapists (OTs). It is often seen that on-staff clinicians are burdened with large-scale caseloads, negatively impacting the student outcomes, clinicians' job satisfaction, and legal compliance with the individuals with Disabilities Education Act. To combat these challenges, the schools across the country have discovered that they can use online technology to provide live any time anywhere occupational therapy (OT) too. This is a new area for practicing occupational therapists in India. As with SLPs, there is a persistent shortage of OTs in many areas of our country which affect these types of services. The children with special needs require occupational therapy services but do not get because of scarcity of these professionals who are needed in for such categories in school setups.
Key Words: Digital, Occupational Therapy, Online
| 25. Effect of Early Rehabilitation in a Subject with Conversion Disorder Presented as Paraplegia: A Case Study|| |
Vikas, Chitra Kataria, Divya Parashar, Ruby Aikat
Occupational Therapy Department, ISIC, New Delhi, India
Background: A 13-year-old child presented with an acute motor and sensory paralysis of both lower extremities with partial loss of bowel and bladder control secondary to mild trauma. Multiple differential diagnoses were considered, including traumatic, organic, and psychiatric causes. All medical investigations were normal (spine magnetic resonance imaging [MRI], brain MRI, and nerve conduction velocity).
Objective: To determine the role of multimodal rehabilitation approach in acute stage of conversion disorder presented as paraplegia.
Design: This is a single case study.
Methods: This study was carried out in the Rehabilitation Department, Indian Spinal Injuries Centre.
Intervention: Subject was allocated to receive five sessions of multimodal rehabilitation including physiotherapy, occupational therapy, and psychosocial counseling for 1 week.
Outcome Measure: International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) scale, Walking Index for Spinal Cord Injury Patients (WISCI), Spinal Cord Independent Measure III (SCIM III) were observed. Assessments were done preintervention, postintervention, and 1 week of follow-up.
Results: The subject showed clinically significant improvement on scores of the outcome measures; INCSCI status was improved from complete-A (pre) to motor incomplete-C (post) to normal-E (1 week of follow-up); WISCI was improved from 0 (pre) to 8 (post) to 20 (1 week of follow-up); and SCIM was improved from 23 (pre) to 71 (post) to 100 (1 week of follow-up). The patient also exhibited positive changes on the psychosocial aspects.
Conclusion: Conversion disorder presented as paraplegia is an unusual presentation. Timely diagnosis and rehabilitation are effective in enhancing motor and sensory recovery in lower extremity, in addition to bowel/bladder control and functional ambulation. Psychosocial management plays an important role in recovery procedure.
Key Words: Atypical Paralysis, Hysterical Paralysis, Paraplegia, Spinal Cord Injury
| ePoster Competitive and Noncompetitive Papers|| |
| 26. Modification during In-Patient Phase for Healing as well as Promoted Gait Pattern After Chemical-Induced Flame Burn|| |
Anant Sharma, Rajpal Singh, Shobha Chamania
Choithram Hospital and Research Centre, Indore, Madhya Pradesh, India
E-mail: dr_anant. email@example.com
Burn injuries create severe pain and psychological distress, which are highly variable between patients. Distinct injuries may require some different approach to treat whether it is from a surgeon's perspective or from another team member. Sometimes, standard protocols do not allow a proper rehabilitation care; hence, there is chance of developing further complications. Some adjustment has to be made to match a surgeon's need as well as to rehabilitate a patient properly. These adjustments not only make the patient physically able but also boost his/her confidence to perform routine tasks by his/her own. This is the story of an only bread earner of a family who works in factory and accidentally got burnt badly at his lower limb. All major muscles lost and this is a challenge for multidisciplinary team not only to heal wounds but also to send back him on his job. Sural artery flap with unconventional methods of splinting is used. Simultaneously, spared muscles are being keep intact functioning. After a marathon, 5 weeks of stay and with certain rehabilitation programs, which core muscle strengthening, and splinting, patient was able to stand and walk but in limping pattern. After this recovery, there is a hope of achieving goal of sending back to job. With weekly follow-ups, and scar management (miniaturization, pressure garment, stretch, and splinting), gait pattern improved remarkably. Further, his routine activities, job, and importantly performing roles and responsibilities for family were fulfilled after 6 months of injury, of course, lots of efforts from team as well as caregivers and last but not least by the patient himself.
Key Words: Ambulation Burn, Mobility, Rehabilitation, Scar
| 27. Modified Walking Aid Enhancing Ambulation without Pain Postmachine Injury Where a Surgeon Decides 6-Month Rest to Initiate Ambulation: A Case Study|| |
Anant Sharma, Ekta Misra, Shobha Chamania
Choithram Hospital and Research Centre, Indore, Madhya Pradesh, India
E-mail: dr_anant. firstname.lastname@example.org
Occupational injuries create a lot of trouble not only in the management of wound but also in the process of integration too. Some of the industrial accidents are not life-threatening, but the impact is larger than that, i.e., permanent damage to the body part which reduces one or more major functions. A patient came with occupational injury to us with badly damaged hind foot (mid of foot to heel, tendo achilles, and lower calf) but fortunately forefoot was spared. He was a young man and a bread earner for his family. With multiple surgeries, somehow wounds are managed, but the question arises was the patient is able to walk? As per surgeon, discretion, he estimated at least 6 months to initiate weight bearing for walking. 10 days (postwound healing for rehabilitation), 3 weeks (hospital stay). Sole of the foot was so badly damaged that weight-bearing bulk and muscles are lost, resulting into loss of cushion at sole. The patient could stand with the unconventional splints and modified walking aid on the 3rd day after dressing removal and able to walk by walker on the 5th day. He took 7 days for independent walking and stair climbing. Since the patient was made to walk during hospitalization, he did not require conventional follow-ups. With the use of so, he was quite comfortable in walking. Periodically, change in shoes was required and status of scar has to be monitored every time to ensure proper mobility. It was important to keep hopes alive even in difficult situations. Sometimes, a consultant may not sure about prognosis in rehabilitation, due to low awareness in tier 2 cities about occupational therapy. Here, with the use of optimum knowledge and application, the patient is not only able to walk, but he also resumes his job to earn bread within 45 days of injury. A successful discharge requires a multidisciplinary approach.
Key Words: Occupational Injury, Rehabilitation, Splint, Walking Aid
| 28. Early Management of a Crush Hand Injury Patient with Appropriate Splinting and Conventional Occupational Therapy: A Case Study|| |
R Sharma Ragini, Jain Vaijanti
Occupational Therapy Department, Seth G.S. Medical College and K.E.M Hospital, Parel, Mumbai, Maharashtra, India
We report a case of a 24-year-old male, right dominant, supervisor by occupation, with accidental industrial crush injury of the right hand, who came to the occupational therapy (OT) department with complaints of pain, stiffness of hand, and affectations of hand functions and activities of daily living (ADL). Due to this, he was anxious and depressed. After clinical and objective evaluation, treatment protocol was designed. Preoperatively, we provided him a customized splint which was a combination of static and dynamic splint, along with this conventional therapy which included scar management, stretching, and task-based activities, and functional training was given to improve his range of motion (ROM), hand function, and independence in ADL and maintain his soft tissue integrity until the time his surgery was planned. Reassessment was done periodically; we found that there was improvement in ROM, hand function, and dependency in ADL decreased from moderate to minimal level through therapy and splintage. Achieving optimal hand function and independence in ADL preoperatively in crush injury patient was challenging. However, with early use of appropriate splints, conventional OT and functional training gives good results. Furthermore, it has helped the patient in his occupational role.
Key Words: Crush Injury, Functional Independence, Quality of Life Rom, Splint
| 29. Journey toward Functional Independence in Congenital Pseudarthrosis of Tibia: Occupational Therapy Perspective|| |
Heeral Suresh Savla, Pratibha Vaidya
OT School and Centre, TNMC and BYL Nair Hospital, Mumbai, Maharashtra, India E-mail: email@example.com
Congenital pseudarthrosis of the tibia (CPT) refers to tibia fracture that develops spontaneously or after trauma in tibial diaphysis. An uncommon condition, the incidence is rare with 1: 250,000 being unilateral. This condition signifies a false joint associated with abnormal movements where periosteum of the bone is mainly affected. It has strong association with neurofibromatosis. Recent advanced studies showed that the combination of vascular tubular grafting and bone graft with Ilizarov's fixation showed faster result in bone union along with use of bone morphogenetic protein leading to increase osseous regeneration in CPT. The objectives were to study the effect of occupational therapy intervention in an analytical single case of CPT. A 5-year-old male child diagnosed as case of CPT 3 years ago, complaints of difficulty in walking and climbing stairs and difficulty in performing activities of daily living (ADL) such as bathing and toileting. He was operated with Ilizarov's fixation along fibular bone grafting with corticotomy. He was assessed for following parameters – range of motion, muscle strength, shortening, contracture, gait, ADL, and functional and community mobility. He was assessed for balance and ADL using Berg balance scale and functional independence measure (FIM) scale using restorative and accommodative approach. On evaluation in parameters, he was put on regular occupational therapy exercise regimen for 5 times/week 1-hour session. Following a month, the patient was reassessed using FIM and Berg balance scale. A significant improvement was seen in motor and functional component and balance. Thus, there is a significant improvement at P < 0.05 in effect of occupational therapy intervention in CPT.
Key Words: Balance, Congenital Pseudarthrosis of Tibia, Functional Independence
| 30. Occupational Therapy Intervention to Inspire Self-Efficacy and Enhance Functional Status as well as Role in Society of a Patient with Multiple Sclerosis Through Client-Tailored Program: A Case Report|| |
F Haria, JS Kale1
Occupational Therapy Department, Seth G.S. Medical College and K.E.M. Hospital,1O.T School and Training Centre, Seth G.S. Medical College and K.E.M. Hospital, Mumbai, Maharashtra, India
We report a case of a patient with multiple sclerosis, with moderate dependency in the activity of daily living, decrease quality of life, restrictions in social as well as her role as a homemaker; she was inspired by intervention with appropriate occupational therapy activity. Before occupational therapy intervention, due to her condition, she felt pessimistic and depressed, and her earlier interventions were on maintaining her current status and preventing deterioration, and her small needs were neglected or not given much importance. However, through intervention, small achievements were through small change/modification in the usual task or a different way of doing them considering her ability and capacity and at times challenging it. This inspired her sense of accomplishment as she was now useful, productive, and independent, also could accomplish her role as homemaker as well as increased here social participation. This perception of capability motivated her to participate further in rehabilitation. It enhanced her quality of life. The results suggest that it is important to provide appropriate occupational therapy activity that can inspire self-efficacy in chronic disorders as the perception of capability enhances motivation to improve performance and quality of life. Written consent was taken from the patient for case report.
Key Words: Functional Task, Perception of Capability Motivate, Quality of Life, Small Functional Achievements
| 31. Evidence-Based Clinical Practice in Myotonic Dystrophy Type I: A Single Case Report|| |
PD Lambor, SJ Jahagirdar
O.T. School and Centre, TNMC and BYL Nair Charitable Hospital, Mumbai, Maharashtra, India
A 19-year-old male, right dominant, diagnosed with myotonic dystrophy (MD) Type I was referred to the rehabilitation services in a public hospital. The patient abstained from a job of shopkeeper for the past 3 months due to progressive hand function affectation. Functional evaluation revealed difficulty to release handheld objects and decreased grip strength. Hence, improving hand function was selected as therapeutic goal using client-centered approach. Six full-text articles were retrieved which could guide in planning disease-specific evaluation strategies and occupational therapy interventions. Purdue pegboard hand function test, grip strength using Jamar dynamometer, and pinch strength using pinchometer were performed pre- and post-4 weeks of intervention. Modified hand function training along with vocational counseling was selected as intervention strategy. Posttherapy, Purdue pegboard component scores on preferred hand, nonpreferred hand, and both hands and assembly scores showed 24%, 12%, 12%, and 8% improvement, respectively. Grip strength improved by 2 kg in the right and by 9 kg in the left hand on a dynamometer. Pinch strength improved by 1 kg bilaterally on pinchometer. Hence, Evidence-based clinical practice was found to be effective in the management of MD type I.
Key Words: Hand Training, Myotonic Dystrophy, Occupational Therapy
| 32. Occupational Functional Model for Improving Mobility in School-Going Child with Myelomeningocele|| |
DS Shrivastav, SS Jaywant
Occupational Therapy Department, LTMMC and GH, Sion, Mumbai, Maharashtra, India
Spina bifida is a birth defect may be presented with myelomeningocele. Associated problem includes poor ability to walk, problem with bladder or bowel control, hydrocephalus, and tethered spinal cord. The objective of the case study was to assess improvement in functional mobility on using occupational functioning model in school-going child with myelomeningocele. A 9-year-old male child studying in the third standard was referred to the occupational therapy (O.T.) department for mobility management. The child also presented with bowel and bladder incontinence. Informed consent was taken from the mother. O.T. intervention was planned using task-focused analysis. The child was given various appliances using accommodative approach along with mobility training. The child was assessed pre- and post-intervention, using ICF and pediatric balance scale. The child showed improvement in functional mobility with increased caregivers' satisfaction. The use of occupational functioning model and task-focused analysis of activity resulted in improved functional mobility and thus improved occupational participation.
Key Words: Mobility, Myelomeningocele, Occupational Participation
| 33. Looking Beyond Lesion – Acute-Phase Occupational Therapy in an Adolescent with Stroke: A Single Case Study|| |
Alisha Tembhekar, Pratibha Vaidya, Shriharsh Jahagirdar
OT School and Centre, TNMC and BYL Nair Charitable Hospital, Mumbai, Maharashtra, India
Middle cerebral artery (MCA) aneurysms can rupture causing intracranial hemorrhage leading to frank neurological symptoms, leading to motor deficits, such as hemiplegia, cognitive, sensory, speech, and language systems. A right-handed 15-year-old male came with a history of right-sided weakness and difficulty in performing activity of daily living (ADL) and speech admitted in the neurosurgical intensive unit. He was diagnosed with left MCA aneurysm rupture. Postoperative evaluation revealed decreased tone, poor voluntary control of upper and lower limb, right facial palsy, speech dyspraxia, memory affectation, and functional limitation in ADL. Voluntary control scale, stroke impact by the National Institutes of Health Stroke Scale (NIHSS), and functional independence measure (FIM) score. Treatment strategies included adaptive, remedial, and neurofunctional approach. The period of training was given 45 min each session for 5 days per week and for 15 days' after which reassessment was done and the result was obtained. After 15 days of intervention, improvement was noted in the said areas, i.e., functional ability as reported on FIM scale such as grooming, eating, oral hygiene from completely dependent (1 score) to fully independent (7 score) and dressing lower limb from (1 score to 6 score) modified independence. Voluntary control improved on voluntary control (VC) scale maximum observed value seen in shoulder from 1+ to 2+++ and elbow from 1+ to 3+ and for hip 1+ to 2+++. Impact of stroke on functionality reduced from 9 to 5 score. Occupational therapy in acute intervention helps in improving functionality and reducing severity impact of stroke on day-to-day living.
Key Words: Activity of Daily Living Independence, Middle Cerebral Artery, National Institutes of Health Stroke Scale
| 34. Family-Centered Approach in Terminal Phase of Wilson'S Disease: A Case Report|| |
Pooja R Gaikwad, Dr. Shailaja S Jaywant, Dr. Anuradha V Pai
Occupational Therapy Department, L.T.M.M.C and G.H, Sion, Mumbai, Maharashtra, India
Wilson's disease is a rare inherited disorder of copper metabolism that results in abnormal accumulation of copper in the body. The symptoms appear between 6 and 40 years of age, resulting in functional limitations. A 17-year-old male was referred to the occupational therapy (OT) department with functional difficulties. The objective of the case study was study the effect of family centered intervention in the adolescent with Wilson's disease. It is a single case study. The patient presented with difficulty in self-care and communication skills. Informed consent was taken from mother. Family-centered approach was used while planning OT intervention. Various adaptations utilizing local resources were provided using procedural and pragmatic clinical reasoning. Based on the ICF model, it was observed that the patient had limitations in participation due to body structure and environmental structures, which improved from mean of 4 to 1. Parent's satisfaction level has improved from total of 5 to 13 on Canadian Occupational Performance Measure scale. The use of ICF model to evaluate functional difficulties and resolving problems has improved parent's satisfaction. Thus, the intervention has also improved quality of life of the child.
Key Words: Activity Limitation, Functional Difficulties, ICF Model, Wilson's Disease
| 35. Moving Out from Clinical Settings: A Plot Study of Task- and Context-Specific Training on Balance and Activities of Daily Living in Patients with Parkinson's Disease|| |
Award: Won AIOTA Trophy for Best ePoster
Soumyakanta Sahu, Padmalaya Jali
Plexus Neuro and Stem Cell Research Center, Bengaluru, Karnataka, India E-mail: firstname.lastname@example.org
Background: From all disabling features of physical functioning, postural instability is one of the most troubling features of Parkinson's disease (PD), leading to increased risk to falls and diminished mobility. Participation in the work, family, community, and social activities was limited due to difficulties in balancing, walking, and risk of falling. The associated burden of disease arising from falls and immobility can impact adversely on individuals, their families, and society.
Objectives: This study was attempted with an aim to check the feasibility and potential effect of an individualized task- and context-specific training program on balance and activities of daily living (ADL) performance in patients with PD.
Study Design: The study was pretest and posttest experimental group design.
Methods: Twelve participants diagnosed with idiopathic PD were randomly allocated into two groups in a pretest and posttest experimental study. Balance and ADL were measured by Berg balance scale (BBS) and functional independence measure (FIM), respectively, before training and after training. Each participant in the experimental group was assigned to perform several motor tasks while walking in community such as home, streets, and mall for 3 days per week for 8 weeks. Participants in the control group received gait and balance training in clinical setting for the same duration. Pretest and posttest scores were recorded for both outcomes.
Results: Both the groups showed significant improvement for both BBS and FIM scores, whereas experimental group showed a significant difference (P = 0.000) in the improvements for both outcome measures than control group in between the group analysis.
Conclusion: This task- and context-specific training program improved the balance and thus resulted in improvement in ADL performance in patients with PD.
Key Words: Balance, Context-Specific Training Functional Performance, Parkinson's Disease, Task-Specific Training
| 36. Relationship between Quality of Life and Occupational Performance for Postretired Employees|| |
NS Krishna, SG Praveen
Department of Occupational Therapy, KMCH, Coimbatore, Tamil Nadu, India E-mail: email@example.com
Background: Relationship between quality of life (QOL) and occupational performance in post-retired employees needs research as there is limited research evidence.
Objectives: To find out the physical, psychological, and social relationship, environment, and occupational performance for postretired employees and to find out how do they value their functions and their occupational performance.
Study Design: This is a survey study
Methods: The survey was conducted on individuals of age group between 60 and75 years; both genders were included for this study; and this study was done in and around Coimbatore. A total number of 50 samples were selected according to the inclusion criteria. The World Health Organization Quality of Life Measure Abbreviated Version (WHO-QOL-BREF) was used to measure the QOL, and Canadian Occupational Performance Measure was administered to identify the occupational performance problems, and thereby, performance' satisfaction scores are calculated. The correlation shows a positive correlation; this is significant at level 0.05. Here, on correlating BREF scale and COPM scale, only four components are correlated and the correlation is positive correlation
Results: The correlation between the performance and social relationship showed a significant value (P < 0.05) and the correlation between performance and environment also showed a significant value (P < 0.033). The correlation between satisfaction and psychological (P < 0.042) and the correlation between satisfaction and social relationships also showed a significant value (P < 0.002). The results of this research support the idea that working after retirement affects the QOL with different mechanisms. Therefore, it concludes there is a correlation of QOL and occupational performance and result shows a positive correlation.
Conclusion: The study concluded that there is a positive correlation between QOL and occupational performance. It also concluded that there is a positive correlation between social relationship and environment with performance as well as psychological components and social relationship with satisfaction.
Key Words: Occupational Performance, Quality of Life, Retired Employees, Social Relationship
| 37. Documentation at NeuroGen: Traditional versus E-Health Record Systems|| |
Divya L Deshnehere Hema Biju Niravethu
Department of Occupational Therapy, NeuroGen Brain and Spine Institute, Navi Mumbai, Maharashtra, India E-mail: firstname.lastname@example.org
Background: Medical record keeping is a systematic method of documentation of a single patient's medical history and treatment record over time). It is crucial from multiple perspectives: patients, health care providers, medical research, etc. Conventinally, these records have been made with pen and paper. However, recent advances have led to the development of e-health record systems (EHRS).
Objective: The primary objective is to describe our experiences at NeuroGen, where we have used all methods of patient documentation including traditional paper-pen method, video documentation, and EHRS. The secondary objective is to present the advantages and limitations of the different record keeping methods.
Study Design: This is an interview-based descriptive study.
Methods: We designed and conducted a questionnaire to compare traditional methods versus EHRS that was administered to 40 of our health care providers to obtain their feedback. We hereby present the advantages and disadvantages of traditional and EHRS based on the questionnaire.
Results: The poster highlights that the EHRS when combined with video recording, whcich we are currently using at NeuroGen, vary in benefits and limitations, benefits outweighing the limitations.
Conclusion: We conclude that despite the limitations of EHRS, traditional methods will soon have to be replaced and therefore recommend adaptation to the electronic health record system.
Key Words: Documentation, E-Health Record System, Medical Records, Traditional Paper-Pen Method, Video Recording