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Table of Contents
GUEST EDITORIAL
Year : 2019  |  Volume : 51  |  Issue : 4  |  Page : 119-120

Using research to educate, promote, and advocate for occupational therapy's distinct role in musculoskeletal conditions: Embracing our unique perspective


Department of Occupational Therapy, College of Health and Human Sciences, San Jose State University, San Jose, California, USA

Date of Submission24-Dec-2019
Date of Acceptance24-Dec-2019
Date of Web Publication3-Jan-2020

Correspondence Address:
Dr. Luis de Leon Arabit
College of Health and Human Sciences, San Jose State University, San Jose, California
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijoth.ijoth_36_19

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How to cite this article:
Arabit LL. Using research to educate, promote, and advocate for occupational therapy's distinct role in musculoskeletal conditions: Embracing our unique perspective. Indian J Occup Ther 2019;51:119-20

How to cite this URL:
Arabit LL. Using research to educate, promote, and advocate for occupational therapy's distinct role in musculoskeletal conditions: Embracing our unique perspective. Indian J Occup Ther [serial online] 2019 [cited 2020 Sep 22];51:119-20. Available from: http://www.ijotonweb.org/text.asp?2019/51/4/119/274813



In the 2017 Global Burden of Disease (GBD) study, musculoskeletal conditions were the highest contributor to global disability, accounting for 16% of all years lived with disability.[1] The World Health Organization (WHO) reported that between 20% and 33% of people across the globe live with a painful musculoskeletal condition.[2] Musculoskeletal conditions and injuries are not just conditions of older age; they are prevalent across the life course and most commonly affect people from adolescence through to older age.[2] In the United States, a recent report suggests that one in two adult Americans live with a musculoskeletal condition, the same number as those with chronic respiratory and cardiovascular diseases combined.[3] Musculoskeletal conditions are commonly characterized by pain, mobility limitations, diminished dexterity, and functional ability, helping contribute to a decline in people's ability to engage in daily life and meaningful occupations. In addition, there is an inability to participate in social roles with a concomitant impact on mental health and well-being. The most common and disabling musculoskeletal conditions are osteoarthritis, back and neck pain, fractures associated with bone fragility, injuries, and systemic inflammatory conditions such as rheumatoid arthritis.[2]

Given the significant global disability issue and impact of musculoskeletal conditions, it is critical that occupational therapists and researchers are well prepared and equipped to respond to the anticipated surge of rehabilitation needs of individuals, communities, and populations in this practice area. It is my honor and privilege to introduce this specialty edition of the Indian Journal of Occupational Therapy, which contains research studies that inform, educate, promote, advocate, and evaluate the effectiveness of occupational therapy and its interventions for people, communities, and populations.

Readers of this specialty edition who are particularly interested in the area of health promotion and disease prevention will find the cross-sectional research studies on the issue of heavy school bags by Muppidi GE et al., use of smart phones by Shetty et al., and performance of homemaking tasks by Sharma et al., particularly significant. Muppidi, et al., Shetty, et al., Sharma, et al. provided research studies that sought to protect the health of school-age children, medical students, and young and middle-aged women, respectively, from further future musculoskeletal conditions. In addition, the pilot study by Ahirwal, et al. on the use of a driving simulator as a functional measure in the assessment of driving skills of both young and middle-aged adults informs us of safe driving habits of Indian drivers who may present with potential musculoskeletal conditions in the future. These aforementioned research studies not only inform the role of occupational therapy in health promotion and disease prevention but also educate the public and our stakeholders and advocates for and ensure the future health and safety of specific communities and populations.

Musculoskeletal conditions such as low back pain and wrist pain account for job-related cumulative and repetitive musculoskeletal conditions. Two of the research studies in this special edition of musculoskeletal sciences and work rehabilitation provided experimental and comparative research as well as randomized clinical trials focusing on musculoskeletal diagnoses commonly treated by occupational therapists. The WHO estimated that in some segments of the workforce, ergonomic hazards account for more than 50% of all musculoskeletal disorders.[4] According to the 2017 GBD report, lower back pain remained the single leading cause of disability since it was first measured in 1990.[1] The experimental research study by Mulye and Yeradkar on the effect of dynamic muscular stabilization training versus conventional exercises comes at an opportune time, wherein results showed improvements in the quality of life of office workers with mechanical low back pain injuries. Likewise, the randomized controlled trial research study by Kader and Nadkarni on the comparative use of myofascial release versus myofascial taping as an adjunct to conventional occupational therapy treatment of De Quervain's tenosynovitis concluded myofascial taping yielding significant better outcomes. These two research studies provided evidence of the important use of preparatory methods in occupational therapy in the treatment of musculoskeletal conditions. The need for continued research is needed to evaluate the efficacy of various preparatory methods used in conjunction with occupational therapy interventions. As new adjunctive methods for treatment are introduced, occupational therapists in practice must be vigilant and judicious in applying appropriate evidence-based interventions with a conscientious effort to evaluate and treat clients in a holistic manner using client-centered approaches. Furthermore, it is equally vital for occupational therapists to acknowledge that all types of treatment from preparatory to occupation-based interventions are beneficial and important in the treatment of musculoskeletal conditions to help clients return to productive work as well as improve participation in occupations.

One case study and one case report included in this special edition enlightens us on the important tenets of adaptation and innovation by occupational therapists in helping individuals with musculoskeletal conditions return to their chosen occupations. The demographic trends in India suggests that between the years 2000 and 2050, the population in their 60s and above will increase by 326% while those in the age group of 80+ will increase by 700% - considered the fastest growing group.[5] The first case study by Mani showcased occupational therapy as a valuable service benefitting older adults living at home with osteoarthritis. Provided with skilled training, which includes education, home and activity modifications, and environmental adaptations, occupational therapists can promote participation and independence for older adults who desire to age in place within their own environments. On the other hand, the case report by Saha in this issue examined how the innovative use of a novel corrective static progressive elbow extension splint increased elbow extension range of motion for a client with elbow stiffness resulting in return to leisure pursuits. The role of occupational therapists in interventions with musculoskeletal conditions as gleaned from these two aforementioned case studies ensured a holistic, dynamic, and client-centered approach in helping clients become productive and engaged in and within their chosen occupations.

The vast array of research studies included in this specialty edition on musculoskeletal sciences and work rehabilitation of the Indian Journal of Occupational Therapy addressed the variety of significant roles occupational therapists play in the practice area of musculoskeletal conditions. Occupational therapy has a lot to offer and has tremendous opportunities to be a key player and a prime mover in the future of health care for people with musculoskeletal conditions. Throughout my years of experience in physical rehabilitation, I have learned to embrace and appreciate our unique role in the assessment and intervention of musculoskeletal conditions in relation to the client's daily occupations. In my opinion, this is a privilege that affords us the opportunity to establish rapport, to get to know our clients better, and to approach our interventions from a holistic perspective, taking into consideration not only the physical factors but also the psychological, psychosocial, socioeconomic, and cultural components. This essence of a holistic and client-centered approach separates occupational therapy from other health-care disciplines and highlights our distinct value to the public, our consumers, and stakeholders. Embracing this unique perspective is important in our work as occupational therapy researchers and practitioners for it provides us a platform to educate, inform, promote, and advocate our roles in addressing musculoskeletal conditions.

I would like to take this opportunity to express my sincere gratitude to the editorial board of the Indian Journal of Occupational Therapy for the invitation to write this guest editorial section of the journal's specialty edition on musculoskeletal sciences and work rehabilitation. Special thanks to Dr. Joseph K. Wells, OTD, OTR/L Review Board Member, for connecting me with the editorial board. It is indeed an honor and privilege to share my humble perspectives in this specialized area of practice in the field of occupational therapy.



 
  References Top

1.
James SL, Abate D, Abate KH, Abay SM, Abbafati C, Abbasi N, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017. Lancet 2018;392:1789-1858.  Back to cited text no. 1
    
2.
World Health Organization: Musculoskeletal Conditions. Available from: https://www.who.int/news-room/fact-sheets/detail/musculoskeletal-conditions. [Last retrieved on 2019 Dec 22].  Back to cited text no. 2
    
3.
The Impact of Musculoskeletal Disorders on Americans - Opportunities for Action. Bone and Joint Initiative USA; 2016. Available from: http://www.boneandjointburden.org/docs/BMUSExecutiveSummary2016.pdf. [Last retrieved on 2019 Dec 22].  Back to cited text no. 3
    
4.
National Research Council, Institute of Medicine. Musculoskeletal Disorders and the Workplace: Low Back and Upper Extremities. Washington, DC: National Academy Press; 2001.  Back to cited text no. 4
    
5.
Central Statistics Office. Situation analysis of the elderly in India: Central Statistics Office Ministry of Statistics and Programme Implementation – Governement of India G. New Delhi: Central Statistics Office; 2011.  Back to cited text no. 5
    




 

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