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Table of Contents
Year : 2020  |  Volume : 52  |  Issue : 2  |  Page : 61-78

OTICON'2020 abstracts

Date of Web Publication6-Jun-2020

Correspondence Address:
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0445-7706.286118

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How to cite this article:
. OTICON'2020 abstracts. Indian J Occup Ther 2020;52:61-78

How to cite this URL:
. OTICON'2020 abstracts. Indian J Occup Ther [serial online] 2020 [cited 2023 Jun 7];52:61-78. Available from: http://www.ijotonweb.org/text.asp?2020/52/2/61/286118

  Oral Presentations Top

  1. Category: Competitive Top

  Assessment of Change in Posture Using Upper Back Brace with Auditory Feedback for Forward Head Rounded Shoulder Posture in MCGM Clerks with Chronic Neck Pain: A Pilot Study Top

JR Bankhele1, RS Yeradkar1, MM Mulye2

1Occupational Therapy Training School and Centre, LTMMC and GH, Mumbai,

2Department of Occupational Therapy, School of Occupational Therapy, DY Patil University, Navi Mumbai, Maharashtra, India

E-mail: [email protected]

Background: Ideal posture is described by the positions of the joints and body segments and balance between the muscles crossing the joints. Impairments in the joints, muscles, or connective tissues may lead to faulty postures, or conversely, faulty postures may lead to impairments in joints as well as symptoms of discomfort and pain. Several studies document high incidence of postural abnormalities, such as forward head, rounded shoulders, excessive thoracic kyphosis, and lumbar lordosis. A study has found that application of scapular brace decreased the forward shoulder angle, changing the forward angle posture. Thus, upper back brace with auditory feedback was given for self-correction and correcting the faulty posture.

Objectives: The objective of the study was to assess the change in posture using upper back brace with auditory feedback for forward head rounded shoulder posture (FHRSP) in clerks with chronic neck pain working in MCGM.

Study Design: This was a prospective, experimental study.

Methods: Ten subjects (clerks) with chronic neck pain were included with convenient sampling, and screening for FHRSP was done using shoulder girdle flexibility test. The upper back brace with auditory feedback was used on these 10 clerks. This brace was worn on the upper back. When the clerk slouches, it triggers the electrical circuit and provides the clerk with auditory feedback to correct the posture. The clerks were advised to wear the brace for 6 h/day in continuation for 30 min for 2 weeks. Pre- and post-assessments of the neck disability index, visual analog scale, craniovertebral angle, and scapular index were done at the baseline and after 2 weeks, respectively.

Results: There was a significant reduction (P < 0.05) in the neck disability index and visual analog scale. Further, changes in the craniovertebral angle and scapular index with the use of upper back brace with auditory feedback in clerks with FHRSP were seen.

Conclusion: The results indicate that the upper back brace with auditory feedback improves the FHRSP in clerks with chronic neck pain and also causes reduction in neck pain and neck pain-related disability.

Key Words: Auditory Feedback, Craniovertebral Angle, Forward Head, Neck Disability Index Rounded Shoulder, Scapular Index, Upper Back Brace

  2. Category: Noncompetitive Top

  Poststroke Shoulder Subluxation: A Man-Made Complication Top

Kamal Narayan Arya1, Shanta Pandian1, Manik Mishra2

1Department of Occupational Therapy, Pt. Deendayal Upadhyaya National Institute for Persons with Physical Disabilities,2Indian Spinal Injury Centre, New Delhi, India

E-mail: [email protected]

Background: Shoulder subluxation, a malalignment of the glenohumeral joint, is a common poststroke complication that occurs in up to 80% of the individuals. Most of these patients neither regain adequate motor recovery nor achieve the relocation of the joint. Globally, negligible studies have explored the determinants of the shoulder subluxation in stroke but mostly by cross-sectional analysis or anecdotal clinical experience.

Objectives: The objective of the study is to determine the association between the disease, patient, and therapy, its related factors and occurrence of the shoulder subluxation in poststroke subjects.

Study Design: This was a case-control study. Cases were poststroke hemiparetic individuals with shoulder subluxation, while controls were poststroke hemiparetic individuals without shoulder subluxation.


  • Setting: The study was conducted at the Department of Occupational Therapy, Pt. Deendayal Upadhyaya National Institute for Persons with Physical Disabilities, New Delhi
  • Inclusion criteria: Individuals aged >20 years, with 1 month to 3 years poststroke, with hemiparesis, with/without shoulder subluxation
  • Exclusion criteria: Individuals with musculoskeletal disease or injury of the upper limb before the stroke, secondary concomitant medical illness
  • Outcome measure

    1. Questionnaire: A detailed structure pro forma was utilized to collect the information on (a) demographic profile of the participant, (b) disease-related factors - type of stroke, area of lesion, side of involvement, onset duration, risk factors of the stroke, etc., (c) patient-related factors, and (d) therapy-related factors
    2. Finger-breadth palpation method: The method is used to palpate the space between the acromion process of the scapula and the head of humerus using the finger
    3. Fugl-Meyer assessment: The Fugl-Meyer assessment is the most common and recommended measure to quantify the upper limb recovery in stroke.

Results: Forty-seven individuals (24 with subluxation and 23 without subluxation) completed the study protocol. Malhandling in terms of passive range of motion (overhead shoulder movements), especially in the lower-stage patients, is one of the significant (P < 0.05) factors for the subluxation among the cases in comparison to the controls.

Conclusion: Shoulder subluxation is a common complication among poststroke subjects which could be primarily caused or exaggerated by the malhandling of the therapist, caretakers, and patient himself/herself. Further studies are warranted to formulate specific and stringent guidelines for the upper limb therapy of stroke individuals.

Key Words: Cerebrovascular Accidents, Glenohumeral, Malhandling, Passive Range of Motion

  3. Category: Noncompetitive Top

  Preferential Laterality Based on Posturo-Motor Behavior in Children with Developmental Disabilities Top

Meenakshi Batra1, Vijay Batra2

1Department of Occupational Therapy, PDUIPH,2Department of Neurology, GB Pant Hospital, New Delhi, India

E-mail: [email protected]

Background: The hemispheric or cerebral specialization of the brain differentially controls behavior-promoting lateralization of the brain. It is often expressed in side biases for motor output, perception, and information processing.

Objectives: The objective of this study is to modulate developmental factors that influence the establishment of laterality in children with developmental disabilities.

Study Design: This was an experimental-control study.

Methods: Thirty children with developmental disabilities aged 4-10 years with an IQ 55 and above were included. The baseline evaluation was done using Edinburgh handedness inventory, handedness questionnaire, footedness score, and eye dominance score. The children were randomly allocated to two groups. In Group A defined treatment protocol based on postural ontogenesis for hand function engagement and Group B, conventional activities/strategies were used. The re-evaluation was done after 3 months.

Results: Between- and within-group analysis was done, and P value was found to be significant for Edinburg handedness inventory score on the right side (P ≤ 0.041) and handedness questionnaire (P ≤ 0.046) for Group A.

Conclusion: Postural reactions are the key components that strongly encompass the modulation of preferential laterality during the early years of development. Developmental factors can be modulated influencing the establishment of laterality in children with developmental disabilities.

Key Words: Developmental Disabilities, Laterality, Postural Behavior, Postural Ontogenesis

  4.Category: Competitive Top

  Effectiveness of Occupational Therapy Program in Improving Functional Independence with the Use of Standing Wheelchair after Spinal Cord Injury Top

Monalee Niphadkar, Anita Gupta

Department of Occupational Therapy, All India Institute of Physical Medicine and Rehabilitation, Mumbai, Maharashtra, India

E-mail: [email protected]

Background: Spinal cord injury creates a major impact on person's life leaving the patient disabled for lifetime, thereby limiting his/her functional independence.

Objectives: The purpose of this research is to therefore study the effectiveness of standing wheelchair in achieving and improving functional independence in patients with spinal cord injury.

Study Design: This was an experimental, pre-post-study.

Methods: Individuals with paraplegia resulting from spinal cord injury were included in this study. This study was conducted in a tertiary care rehabilitation center. Outcome measures used were individualized prioritized problem assessment scale, efficiency of assistive technology scale-6D, wheelchair skills test version 5.0, and modified Ashworth scale. Individuals were administered functional tasks including instrumental activities of daily living (IADL) tasks on standing wheelchair.

Results: The acquired assistive technology - standing wheelchair - generally met expectations of person using it. The patient experienced decreased difficulty in achieving functional independence and increased feelings of autonomy with most of the improvements in functional and IADL tasks.

Conclusion: Standing wheelchair is effective in achieving and improving functional independence in paraplegic spinal cord injury patients. Furthermore, it has a significant effect on secondary complications arising out of spinal cord injury, i.e., reduction in the lower limb spasticity.

Key Words: Functional Independence, Occupational Therapy Program, Spinal Cord Injury, Standing Wheelchair

  5. Category: Competitive Top

  A Trend of Cumulative Trauma Disorders in Indian Computer Users: A Comparison of Surveys of the Year 2009 vs. 2019 Top

  Award: Won Kamala V. Nimbkar Trophy for Best Scientific Paper Top

P Mehta Pooja1, O Maru Chandanbala2

1Anmol Child Development Clinic, Mumbai, Maharashtra, India,2Department of Occupational Therapy, University of Southern California, Los Angeles, CA, USA

E-mail: [email protected]

Background: Digitalization has resulted in increased computer-use. Computer-use involves repetitive movements and relatively static posture of neck, limbs and trunk; contributing in cumulative trauma disorders (CTDs). Over a decade, ergonomic awareness has increased, but CTDs have prevailed. Hence, a comparison of 2009 vs. 2019 surveys was done to understand CTD trends and to find the significance of the number of people, affected due to hours-per-day computer-use.

Study Design: A comparison of two surveys was conducted to research trend in occurrences of CTDs.

Methods: The sampling was done using the snow-ball method. Both surveys had identical research methodology and collected data of (n) 100 computer-users of India with age-range 20-50 years, i.e., total of N=200 in combined surveys. Participants filled in the self-explanatory questionnaire on Google-forms that assessed areas of CTD pain, severity of pain and functional performance during pain.

Results: Data analysis showed a higher percentage of pain in neck; eye-strain and back in computer-users in both 2009 and 2019 surveys. There was an overall decrease in the percentage of computer-users affected with CTDs from 86% to 70%, but anatomically, an increase in percentages of pain in upper-limb, headaches and lower-back were reported in 2019. The relation between duration of computer-use and number of computer-users affected was found to be non-significant for both 2009 and 2019 surveys (X2 = 3.5408; P = 1.7027 and X2 = 1.3739; P = 0.5031 respectively, 95% Confidence Interval (CI) (4.605, 7.378). Spearman's Correlation showed no significant correlation between duration of computer-use and severity of pain in both 2009 (r = 0.078; P = 0.443, 95% CI [-0.120, 0.270]) and 2019 (r = -0.085; P = 0.398, 95% CI [-0.277, 0.114]).

Conclusion: The comparison of 2009 and 2019 surveys showed an overall decrease in percent of computer-users affected with CTDs in the 2019 survey. An increase in upper-limb pain, headache and lower-back ache percentages was noted, while upper-back pain, neck pain and eye-strain percent showed a decreasing trend in the 2019 survey. The percent of computer-users affected with pain at neck, back and eye-strain were higher than other CTD areas in both the surveys. The duration of computer-use did not show a significant correlation to presence of CTDs among computer-users in both surveys.

Key Words: Ergonomics, Functional Performance, National Institute of Occupational Safety and Health, Repetitive Stress Injury, Visual Analog Scale

  6. Category: Competitive Top

  Motor Proficiency of Children with Developmental Speech and Language Disorder and Typically Developing Children Aged 4-7 Years: A Comparative Study Top

Rupali B Prajapati1, Pratibha M Vaidya1

1Department of Occupational Therapy, TN Medical College and BYL Nair Charitable Hospital, Mumbai, Maharashtra, India

E-mail: [email protected]

Background: Developmental speech and language disorder (DSLD) is characterized by delay in speech and language development in the absence of mental or physical handicap, hearing loss, emotional disorder, or environmental deprivation. Many nonlinguistic factors contribute to the expression of DSLD; one of them is motor proficiency. Some problems with motor proficiency were observed in children with DSLD when they were compared with typically developing children (TDCs). In this study, we have compared motor proficiency of children having DSLD with TDCs so that treating this patient for motor skills would help to develop these skills.

Objectives: The objective of the study is to find the performance of DSLD children for motor proficiency using the Bruininks-Oseretsky Test of Motor Proficiency-II (BOT-2) and compare it with TDC.

Study Design: This was a noninterventional cross-sectional study.

Methods: The study includes 30 children with DSLD and 30 TDC of age group 4-7 years. Informed consent form was signed by the parents and permission was taken from the institutional ethical committee. All composites of BOT-2 were administered on both the groups (fine manual control, manual coordination, body coordination, and strength and agility) Score obtained were compared between two groups for total motor composite as well as each subtest.

Results: There was significant difference between the performance of DSLD children and TDC on all the four composites of BOT-2 (P = 0.00 for fine manual control, P = 0.00 for manual coordination, P = 0.00 for body coordination, and P = 0.00 for strength and agility).

Conclusion: Motor proficiency is significantly affected in children with DSLD as compared to TDC.

Key Words: Developmental Speech and Language Disorder, Motor Proficiency, Typically Developing Children

  7. Category: Competitive Top

  The Effect of Quality of Sleep and Level of Fatigue on the Breastfeeding Efficacy in Postpartum Lactating Mothers Top

Dnyaneshvari R Giri1, Shailaja S Jaywant1

1Occupational Therapy Training School and Centre, LTMMC, Mumbai, Maharashtra, India

E-mail: [email protected]

Background: Postpartum period is a sensitive and stressful period that is accompanied by fatigue, mood changes, and sleep disorder. Fatigue is common during the first postpartum days and, at times, lasts for months. Sleep has not been previously investigated specifically in association with breastfeeding; however, lactating mothers often report drowsiness following breastfeeding.

Objectives: (1) To study the quality of sleep in postpartum lactating mothers. (2) To study the level of fatigue in postpartum lactating mothers. (3) To find the correlation between sleep duration and fatigue in postpartum lactating mothers.

Study Design: The study is nested in a cross-sectional study.

Methods: The association between quality of sleep and level of fatigue among 140 primigravida postpartum lactating mothers was investigated using the Pittsburgh Sleep Quality Index, Insomnia Severity Index, Multidimensional Assessment of Fatigue Scale, Breastfeeding Self Efficacy Scale, and Edinburgh Postnatal Depression Scale. All scales translated in Marathi and Hindi and validated.

Results: Quality of sleep was affected in 60% of mothers. They had to compromise sleep time due to infants feeding demands. Only few mothers showed signs of fatigability. Quality of sleep showed moderate correlation with breastfeeding efficacy. Increased level of fatigue is observed due to inadequate sleep. Mothers reported decreased sleep due to the infants' frequent feeding time.

Conclusion: Level of fatigue does not impact directly on breastfeeding efficacy of postpartum lactating mothers. The quality of sleep has a positive correlation with breastfeeding abilities of postpartum mothers. Further research is needed considering different sociocultural backgrounds of mothers in India.

Key Words: Fatigue, Lactating, Postpartum, Primigravida

  8. Category: Competitive Top

 Ehlers-Danlos syndrome More Details: A Case Study">  Family-Centered Approach in Ehlers-Danlos Syndrome: A Case Study Top

SS Patil, SS Jaywant

Department of Occupational Therapy, LTMMC and LTMG Hospital, Mumbai, Maharashtra, India

E-mail: [email protected]

Ehlers-Danlos syndrome is a group of disorders that affect connective tissues supporting the skin, bone, blood vessels, and many other organs and tissues. This leads to stress and decreased breastfeeding efficacy in mothers and affects child-mother relationship, for which active occupational therapy intervention is needed. The objective of the study was to analyze the effect of occupational therapy intervention in improving the quality of life of infant and parent. A 26-day-old female child with Ehlers-Danlos syndrome had bilateral upper extremity and lower extremity contracture, who later sustained left femoral fracture was assessed on Infant Neurological International battery (INFANIB) and Neonatal Oral-Motor Assessment Scale (NOMAS). Further, mother's breastfeeding efficacy and stress was assessed on breastfeeding self-efficacy (BFSE) scale and parental stress scale - neonatal intensive care unit (PSS: NICU). Intervention was planned using Model of Human Occupation and Person-Environment-Occupation Model. Family-centered approach along with accommodative approach was given more importance. The follow-up was taken at the end of the 6th and 12th weeks when the patient was attending outpatient department services. Further results were analyzed using outcome measures such as INFANIB, NOMAS, BFSE, and PSS: NICU, which showed marked improvement on INFANIB from 43 preintervention to 50 postintervention, NOMAS from 28 to 42 out of 48, parents showed decreased anxiety and stress, which was reflected in BFSE score from 0 to165 postintervention, and PSS: NICU from 130 preintervention to 124 postintervention.

Family-centered approach has shown to be effective in reducing stress in parents and getting control over their own decision-making. The infant showed positive neurobehavioral cues and reduced irritability, indicating favorable outcomes after routine intervention.

Key Words: Ehlers-Danlos Syndrome, Neonatal Intensive Care Unit, Parental Stress

  9. Category: Competitive Top

  Effect of Mindfulness-Based Stress Reduction Occupational Therapy Program in Parents of Children with Autism Spectrum Disorder Top

AG Karnam1, SD Sarang1, BA Vanmali2, PR Phulpagar1

1Occupational Therapy Training School and Centre, LTMMC and GH,2Autism Intervention Centre, LTMMC and GH, Mumbai, Maharashtra, India

E-mail: [email protected]

Background: Raising a child with autism spectrum disorder (ASD) is highly demanding. Parents of children with ASD show increased parenting stress. This leads to parental mental health problems, such as symptoms of depression. Stress can affect the parents' functioning and also hinder the ASD child's progress. The current study aimed at finding the effect of a mindfulness-based stress reduction occupational therapy (MBSR-OT) program on psychological functioning in parents of children with ASD.

Objectives: To study the effect of MBSR-OT program on stress, anxiety, depression, mindfulness, and psychological well-being in parents of children with ASD.

Study Design: This was an experimental, prospective study.

Methods: Parents of children diagnosed with ASD were included in the study. Parents diagnosed with schizophrenia, intellectual disability, and dementia were excluded. All the participants were scored on perceived stress scale, mindful attention awareness scale, Ryff's psychological scale, and Hamilton anxiety and depression scale, which were used as outcome measures. Data were analyzed using Windows based R-Programming software. A paired t-test was used to analyze the data.

Results: All participants who attended 1-8 sessions showed improvement in the levels of anxiety, depression, stress, mindfulness, and psychological well-being. Participants who attended 5-8 sessions showed a significant decrease in the levels of anxiety, depression, and stress and a significant increase in the levels of mindfulness and psychological well-being as compared to the participants who attended 1-4 sessions.

Conclusion: MBSR-OT program can help reduce stress and anxiety and improve psychological well-being of the parents having children with ASD.

Key Words: Autism Spectrum Disorder, Mindfulness, Parents

  10. Category: Competitive Top

  Prevalence of Cold Intolerance among Patients with Traumatic and Nontraumatic Hand Injuries in Mumbai Top

Aishwarya Parmar1, Rashmi Yeradkar1

1Department of Occupational Therapy, LTMMC and GH, Mumbai,

Maharashtra, India

E-mail: [email protected]

Background: Cold intolerance is defined as abnormal pain after exposure to mild or severe cold, with or without discoloration, numbness, weakness, or stiffness of the hand and fingers. Although cold intolerance is a frequent sequel of upper limb trauma, it is not well documented.

Objectives: The objective of the study is to find out the prevalence of cold intolerance in patients with traumatic and nontraumatic hand injuries.

Study Design: This was a prospective, cross-sectional study.

Methods: In this study, 60 patients with traumatic and nontraumatic hand injuries referred to the occupational therapy department were evaluated using cold intolerance symptom severity (CISS) questionnaire. Its score ranges between 0 and 100, and the cutoff point for the diagnosis of cold intolerance is ≥30. Inclusion criteria were patients with traumatic and nontraumatic hand injury, duration >2 months, and age ≥18 years. Patients with nerve and vascular injuries were excluded.

Results: Mean CISS score for all the patients was: 30.25% of patients (rheumatoid arthritis) had severe cold intolerance, 38% of patients (hand fractures) had moderate cold intolerance, and mild cold intolerance was noted in 25% of tendon injury and 13% of crush injury patients.

Conclusion: Cold intolerance is common after hand injuries, which needs to be treated to overcome limitations.

Key Words: Cold Intolerance, Cold Intolerance Symptom Severity Questionnaire, Nontraumatic, Prevalence Traumatic

  11. Category: Competitive Top

  Effect of Occupational Therapy Action Research on Vocational Profiles of Youth with Intellectual Disabilities Top

Aishwarya Swaminathan1Anuradha Pai2

1Department of Occupational Therapy, School of OT, DY Patil University,2OT Training School and Centre, LTMMC, Mumbai, Maharashtra, India

E-mail: [email protected]

Background: An across the country survey by National Institute for Empowerment of Persons with Multiple Disabilities states that vocational training centers have some limitations in the form of, giving more emphasis to production and profit rather than employable skill development, not providing appropriate supports for success, not enough opportunities for choice/self-determination given, etc., affecting the vocational profiles of youth with intellectual disabilities. Occupational therapists through their knowledge of vocational assessments and interventions can play an important role, in improving this situation through action research, which involves actively participating in a change situation, via an existing organization, while simultaneously conducting research.

Objectives: The objective is to study the effect of occupational therapy action research on vocational profiles of youth with intellectual disabilities.

Study Design: This was a prospective AB design and action research.

Methods: Action research has three steps. (1) Input/Unfreezing: 18 youth with intellectual disabilities, selected using convenient sampling from a vocational center, within the age range of 18-24 years, with matched adaptive behaviors as per the behavioral assessment scales for adult living - mental retardation, were assessed using the National Institute of Mentally Handicapped Vocational Assessment Programming Scale, Support Intensity Scale, and AIRS Self-Determination Scale Parent and Teacher Forms to get the baseline vocational profiles. (2) Transformation/Changing: An action plan was then formulated and implemented, using the dynamic interaction model and restorative or compensatory approaches directed toward the person (vocational trainee), task (vocational activity) and the environment (social, parent, teacher, co-trainees, physical-equipment/vocational training center/organization, and temporal). (3) Output/Refreezing: The effect of this action on the vocational skills was assessed after 6 months using the above-mentioned scales.

Results: Quantitatively, there was an effect of improvement in percentage scores of the above-mentioned scales, i.e., improved independence in vocational skills, decreased intensity of supports required, improved self-determination, i.e., knowledge, ability, and perception of vocational skills among the vocational trainees, and increased opportunities for vocational skills provided by the parents and teachers. Qualitatively, there was an effect at organizational level as described by parents and teachers.

Conclusion: Occupational therapy action research had a positive effect on vocational skills in youth with intellectual disabilities and was helpful in bringing about a positive change at the organizational level.

Key Words: Action Research, Intellectual Disabilities, Occupational Therapy, Vocational Profiles, Youth

  12. Category: Competitive Top

  Effect of Rhythmical Activity on Cognition and Quality of Life among the Elderly Top

Akshay Kumar Joshi1, Raj Kumar Sharma2, Shivani Bhardwaj2

1Department of Occupational Therapy, Max Super Speciality Hospital,2Department of Occupational Therapy, Santosh Occupational Therapy College, Ghaziabad, Uttar Pradesh, India

E-mail: [email protected]

Background: Rhythm and auditory stimuli used in rhythmic movement program influence the movement system by stimulating the sense of rhythm through certain auditory stimuli using music and induce the activation of different areas of the brain by synchronizing the motor region and perceptual region in stable time.

Objectives: The objective of this study was to study the performance of the elderly in cognition and quality of life with Montreal cognitive assessment (MOCA) and World Health Organization Quality of Life (WHOQOL), respectively.

Study Design: This was a pre- and post-experimental study.

Methods: A total of 40 elderly fulfilling the inclusion criteria which mainly include age group between 60 and 75 years with mild cognitive impairment are enrolled for the study. These elderly were randomly allocated between the experimental and control group using computer-generated random number. Assessment tools and outcome measures were MOCA and WHOQOL. The experimental group was given intervention of rhythmical activities, while the control group has to do daily 20-min walk and 10-min breathing exercises for 30 days.

Results: The elderlies in the experimental group showed more improvement in cognition and quality of life than in the controlled group significantly (P < 0.001) from the mean of 17.80 ± 1.322 to 26.50 ± 1.504 in MOCA, whereas in subdomain 1 of WHOQOL score of the experimental group improved significantly (P < 0.001) from the mean of 32.95 ± 8.900 to 77.05 ± 9.434, subdomain 2 of WHOQOL score of the experimental group improved significantly (P < 0.001) from the mean of 53.30 ± 10.584 to 78.85 ± 7.184, subdomain 3 of WHOQOL score of the experimental group improved significantly (P < 0.001) from the mean of 11.20 ± 6.534 to 18.30 ± 4.985, subdomain 4 of WHOQOL score of the experimental group improved significantly (P < 0.001) from the mean of 49.25 ± 15.814 to 58.30 ± 12.938.

Conclusion: The rhythmical activities have a great impact on cognition as well as the quality of life of elderlies. This implicates that in clinical practice, to promote geriatric care with healthy and active aging, the occupational therapy intervention comprising rhythmical activity should be incorporated.

Key Words: Cognition, Elderly, Healthy Aging, Quality of Life, Rhythmic Movement, Rhythmical Activities

  13. Category: Competitive Top

  The Effect of Balance and Coordination Rehabilitation Exercises, On Serving Skills of Students with Special Needs, Undergoing Vocational Training in Hospitality and Catering Department: A Prospective One-Arm Interventional Study Top

  Award: Won AIOTA Trophy for the Best Oral Scientific Paper in Neurosciences Top

Deepa Udiaver1

1Department of Occupational Therapy, SPJ Sadhana School, Mumbai, Maharashtra, India

E-mail: [email protected]

Background: Acquiring good serving skills is prerequisite for placement of special need students undergoing vocational training in hospitality and catering department in vocational school. Many studies have been done on balance and coordination on Down's syndrome and Autistic children, but there are no studies done so far on serving skills in these special need students.

Objective: The purpose of this study was to determine the effect of occupational therapy (OT) program incorporating rehabilitation balance and coordination training exercises in improving serving skills of special need children in catering and hospitality department, as effective serving skills was the prerequisites for securing a placement for internship in the hospitality industry.

Study Design: A prospective one-arm interventional study was chosen for the research.

Methods: A total of 15 students with special needs in the age group of 17–23 years who were to be graduated and had to secure internships were assessed. The study was conducted from June 2018 to March 2019. All students were assessed on Static Balance Test, Standing on Right Leg Scale (SORL) and Standing on Left Leg Scale (SOLL), and Hand to Wall Toss Test (HTWTT) for coordination. They were also assessed by the teachers' feedback form of serving skills which were recorded pre and post rehabilitation training. After the baseline scores were recorded, Phase 1 exercises of balance and coordination were given separately on stable surface for 12 weeks; first follow-up scores were recorded. Then, Phase 2 exercises started after 12 weeks which included combination of balance and coordination given on unstable surface and after 24 weeks the second follow readings were recorded.

Results: At 12-week postexercises training, SORL was P ≤ 0.001, 95% confidence interval (CI) value was 8.79–24.70 and SOLL was P ≤ 0.009 that is less than 0.05; therefore, the test was significant, 95% CI value was 7.59–24.14; HTWTT was P ≤ 0.001, 95%CI value was 12.63–18.83; therefore, the test was significant. At 24 weeks, post exercises training, SORL was P ≤ 0.009 which was less than 0.05, so the test was significant, 95% CI value was 13.34–33.06; SOLL was P ≤ 0. 001, 95% CI value was 11.10–30.90; HTWTT was P ≤ 0. 001, 95% CI value was 15.96–22.44; and teachers' feedback questionnaire was P ≤ 0. 000, 95% CI value (18.81–22.93), and the test was highly significant.

Conclusion: This study shows that OT intervention exercises in the combination of balance and coordination exercise given on unstable surface improve the serving skills of students with special need students in the catering and hospitality department of vocational unit of special need school.

Key Words: Balance, Co-ordination, Serving Skills

  14. Category: Competitive Top

  Patterns of Sensory Processing among Preterm Infants: A Cross-Sectional Study Top

Ester Debora1, KR Banumathe2, Leslie Edward S Lewis3

Department of Occupational Therapy, Manipal College of Health Professions, Manipal Academy of Higher Education,3Department of Paediatrics, Kasturba Medical College, Manipal, Karnataka, India

E-mail: [email protected]

Background: Every year, 15 million babies are born preterm globally, and above 60% of preterm births are reported in Africa and South Asia. In India, approximately 21% have ranked first in the greatest number of preterm birth. Preterm infants are at risk for having sensory processing and behavioral issues in their later life due to the exposure of repeated intervention in the neonatal intensive care unit (NICU), which could lead to sensory processing dysfunction, which alters the child's activities. The literature suggests the need to understand the patterns of sensory processing abilities in preterm infants.

Objectives: The objective was to identify the patterns of sensory processing abilities in preterm infants between the age of 1 and 8 weeks.

Study Design: This was a cross-sectional study.

Methods: The preterm infants aged 1-8 weeks are included in the current study using purposive sampling. The caregivers of those infants were interviewed using Infant/Toddler Sensory Profile after given 2 days of observation of their infant's behaviors. The data are entered and analyzed for patterns of sensory processing abilities.

Results: Descriptive statistics will be used to analyze the demographic profile of the participants and to assess the sensory processing abilities, such as low registration, sensation avoiding, and sensory sensitivity.

Conclusion: The patterns of sensory processing abilities such as low registration, sensation avoiding, and sensory sensitivity will be identified among preterm infants aged 1-8 weeks. This study would help in understanding the sensory processing abilities in preterm infants that would aid in using sensory integration therapy by occupational therapists working with preterm infants. It would also be helpful in planning home program during discharge, and also, the result of this study may pave the way to strengthen our role in the NICU, especially in India.

Key Words: India, Infant/Toddler Sensory Profile, Neonatal Intensive Care Unit, Occupational Therapy, Premature, Sensory Integration, Sensory Processing Difficulties

  15. Category: Competitive Top

  Exploring Social Participation in Families of Individuals with Down Syndrome: A Scoping Review Top

Florance Angelin Newton1, Sumita Rege1

1Department of Occupational Therapy, Manipal College of Health Professional, Manipal, Karnataka, India

E-mail: [email protected]

Background: Social participation is a person's engagement in activities that provide interaction with others to accomplish personal or professional goals. It gives a sense of social connectedness that includes feelings of self-efficacy, meaning and purpose, and positive mental health. Social participation is an important construct for occupational therapy, especially when working with families of children with disabilities such as Down syndrome (DS). For families of individuals with DS, social participation comes with its unique responsibilities, challenges, and stress. This study is designed to explore the scientific literature for an understanding of how family members' social participation, including the various activities they participate in, and the challenges and supports they experience lead to satisfaction and quality of life.

Objectives: The objective of the study is to explore the “family social participation” in families of individuals with DS through a review of the existing literature.

Study Design: This was a scoping review.

Methods: A scoping review using Arksey and O'Malley's prescribed methodology was conducted. Databases and search engines (PubMed, Scopus, Web of Science, and Google Scholar, etc.,) which are subscribed to by our university were used for the search. The articles included were full-text English language articles published from 1999 to 2019, focusing on social participation of families of individuals with DS.

Results: The study findings suggest that the parents of children with DS experienced decreased participation in social activities, which affected their satisfaction and quality of life. In addition, it was found that much of parents' time was spent in childcare, and they did not find time to take care of their health and other relationships, thus resulting in social isolation, leading to decreased social participation and poor health. Most of the literature also focused only on mothers, rather than on families as a whole.

Conclusion: This scoping review demonstrated that not much is known about the social participation of families, especially in countries like India, suggesting a need for more studies that study the same.

Key Words: Down syndrome, Family Members, Quality of Life, Social Participation

  16. Category: Competitive Top

  Implementation of Environmental Modifications in Reducing Fear of Falling and Studying its Relationship with Activity Level and Activity Restriction among Older Adults Living in Old-Age Home: A One-Arm Interventional Study Top

  Award: Won M. M. Sangoi Trophy for Best Scientific Paper on Ergonomics, Environment & Access Top

Hansa Varshneya1, Jay Sonawane1

1Department of Occupational Therapy, JKKMMRF College of Occupational Therapy, Namakkal, Tamil Nadu, India

E-mail: [email protected]

Background: Falls in older adults can cause severe physical injuries leading to activity restriction and subsequently adding to financial burden. Objectives: The objectives of our study were to assess the fear of falling in older adults living in old-age home, to implement cost-effective environmental modifications in old-age home, and to assess the relationship of fear of falling with activity level and activity restriction in older adults.

Study Design: A one-arm interventional study design was chosen for the research.

Methods: In this one-arm interventional study, 32 older adults, both males and females, were recruited from an old-age home, after their written informed consent. All the 32 older adults were assessed on the Survey of Activities and Fear of Falling in the Elderly (SAFFE) at baseline (preintervention), postintervention at 2 months, and at follow-up of 12 months. The architectural barriers in the old-age home were identified, and cost-effective environmental modifications were implemented. Statistical analyses of the SAFFE scores from baseline to follow-up were done.

Results: The results revealed that fear of falling significantly reduced with the implementation of environmental modifications at postintervention at 2 months and at follow-up of 12 months. Fear of falling was positively correlated with the activity restriction (P = 0.0001, 95% confidence interval [CI] = 0.88-0.97) and fear of falling was negatively correlated with activity level (P = 0.0001, 95% CI = −0.97-−0.88) at baseline, postintervention, and follow-up.

Conclusion: Our study showed that with the implementation of cost-effective environmental modifications, there was a significant reduction of fear of falling among older adults.

Key Words: Architectural Barriers, Falls, Geriatrics, Occupational Therapy, Old-Age Home

  17.Category: Competitive Top

  Use of Jebsen-Taylor Hand Function Test to Compare the Hand Functions in People with Carpal Tunnel Syndrome and Healthy Individuals Top

Joshini Sara John1 Anita Gupta2

Department of Occupational Therapy, All India Institute of Physical Medicine and Rehabilitation, Mumbai, Maharashtra, India

E-mail: [email protected]

Background: Carpal tunnel syndrome (CTS) is the most common form of entrapment neuropathy. There are few studies done on the evaluation of hand functions of subjects with CTS.

Objectives: The objective of the study is to demonstrate the validity and responsiveness of the Jebsen-Taylor Hand Function Test (JTT) in measuring hand function in patients with CTS and to compare JTT scores between individuals with CTS and normal individuals.

Study Design: This was a cross-sectional comparative study.

Methods: Fifteen patients who were screened on carpal tunnel questionnaire and who scored more than 2 were included along with 15 healthy subjects. The JTT and the time taken to complete the JTT were recorded along with grip strength and pinch strength.

Results: The scores of JTT subtests and total score of both dominant and nondominant hand were comparable. Subjects with CTS showed difference in time taken than healthy subjects along with the difference in pinch strength and grip strength.

Conclusion: JTT is a reliable assessment tool for assessing the hand function of carpal tunnel subjects. CTS subjects showed difference in time taken to complete the JTT, suggesting the responsiveness of the test.

Key Words: Carpal Tunnel Syndrome, Hand Function, Jebsen-Taylor Hand Function Test

  18.Category: Competitive Top

  Comparative Study of Effectiveness of Installing Ergonomic Equipment Alone versus Ergonomics Training (Individual and Group) for Prevention against Musculoskeletal Disorders Top

Mona Pankaj1

1Ergocure Clinic, Mumbai, Maharashtra, India

E-mail: [email protected]

Background: Companies are becoming increasingly aware of employee health and are investing in ergonomic equipment, such as standing tables and ergonomic chairs, apart from accessories, such as laptop risers and ergonomic mouse. Some companies just install/issue the equipment and hope that employees will start using them appropriately. While some invest in group trainings on the use of this equipment and some others go in for an individual desk adjustment for their employees.

Objectives: The objective of the study is to evaluate whether the installation of ergonomic equipment alone plays a role in preventing musculoskeletal disorders (MSDs) or ergonomics training in group or at individual-level helps.

Study Design: This was a retrospective study design.

Methods: This retrospective study was based on the projects done with clients from two corporate companies. The primary work of all employees studied was computer-based aged 25-45 years. Fifty individuals were studied from each company. Company A preferred to install standing tables and leap chairs for all of their employees and to have one on one desk evaluations and adjustments, while company B installed four standing tables open to be used by rotation by all employees and a group ergonomics training. Data were gathered over 6 months, were analyzed, and were interpreted.

Company A:

  • Individual assessment of existing desk set-up and use by each employee was done. Desk and chair adjustments were done and consultation was given on the right use of equipment, importance of breaks, desk stretches, etc
  • Effect of desk adjustment and change of patterns of usage were reviewed at 3 and 6 months.

Company B:

  • Group training was imparted, after a pretraining survey. Employees were advised to adjust their desks, based on the training. A follow-up survey on symptoms of MSDs was done at 3 months. Help in desk adjustment was done at this point and review was done at 6 months.

Results: The findings are as below in the [Table 1].
Table 1: Number of People Presenting Symptoms

Click here to view

Conclusion: The presence of expensive ergonomic equipment alone did not ensure reduction in MSDs, group training helped, and individual consultation and help on desk adjustments played a bigger role in reduction of MSDs.

Key Words: Desk Adjustment, Ergonomics, Musculoskeletal Disorders

  19. Category: Competitive Top

  Four-Stage Ergonomic-Based Model in Nursing Staff Top

Parag Adsue1, Chaitra Sinai Kudchadkar1

1Department of Occupational Therapy, Goa Medical College, Goa, Bambolim, India

E-mail: [email protected]

Background: In the Indian context, in various setups where nursing staff is working, they are more prone to work-related musculoskeletal (MSK) injuries. The focus of the study was prevention of work-based MSK injuries in nursing staff, by four-stage ergonomic-based model.

Objectives: The objective was to see the effectiveness of four-stage ergonomic-based model in nursing staff.

Study Design: This was a prospective pre-post-study design.

Methods: A sample of 30 nurses was included in the study. The questionnaire of bother index from Short Musculoskeletal Functional Assessment scale (SMFA) was used as outcome measure at day 1 and at 4 weeks; four-stage ergonomic-based program using demonstrations and handouts was given at various stages and intervals. At the end of 4 weeks, they were asked for subjective feedback too.

Results: Data were analyzed by computing of mean, standard deviation, and paired t-test; its shows that statistically significant improvement in SMFA bother index score (P = 0.002). There was good and effective response as per subjective feedback.

Conclusion: The ergonomic-based practice was accepted easily and found its feasibility for implementation in all work settings of the nursing staff. Our results also highlight the importance of ergonomics in nurses and how it helps to prevent musculoskeletal injuries and also improves their function in the workplace. We concluded that the four-stage ergonomic-based model will be very promising to use in different type of work environments to prevent MSK injuries.

Key Words: Bother Index, Ergonomic-Based Intervention, Musculoskeletal Injuries

  20. Category: Competitive Top

  Feeding and Maternal Self-Efficacy for Neonatal Intensive Care Unit Mothers: A Scoping Review Top

Pratikshya Mohanty1, Sumita Rege1

1Department of Occupational Therapy, Manipal College of Health Professional, Manipal, Karnataka, India

E-mail: [email protected]

Background: Feeding is the first process of social exchange between mother and her infant. However, this might not hold true for an infant admitted in the neonatal intensive care unit (NICU), and feeding difficulties of infants further delay this process of social exchange. For NICU mothers, it is challenging to fulfill the role of a mother, due to multiple factors, and how a child's readiness for oral feeding impacts the self-efficacy of the mothers remains unclear so far. Hence, the literature based on this idea was reviewed.

Objectives: The objective of this study was to map and synthesize the evidence regarding the maternal self-efficacy in relation to infant's oral feeding among NICU mothers.

Study Design: This was a scoping review.

Methods: The scoping review followed Arskey and O'Malley's (2005) framework. Relevant studies were identified using the following databases and search engines, including Google Scholar, ProQuest, PubMed, Scopus, and Research Gate, subscribed to by our university. For the purpose of the current study, 20 full-text published articles (2000-2018) are reviewed. The articles published in the predatory journals are excluded. Following this, the data were charted in an excel sheet and then analyzed.

Results: From this review, it is clear that the early introduction of oral feeding facilitates the maturation of oro-motor skills. Difficulties with feeding the infants add stress on the mother, making it difficult for them to fulfill their mothering roles affecting their self-efficacy. Hence, the link between maternal self-efficacy and feeding readiness becomes obvious.

Conclusion: There appears to be an underexplored relationship between the NICU mothers' parenting efficacy and the oral feeding readiness of their infants. As occupational therapists who play an important role in facilitating smooth transitions for families from NICU to their homes, this underexplored relationship suggests a need to work with mothers and infants to ensure a better outcome of feeding interventions.

Key Words: Feeding Readiness, Feeding Problems, Maternal Self-Efficacy, Neonatal Intensive Care Unit Feeding, Self-Efficacy

  21. Category: Competitive Top

  Effectiveness of Positional Release Technique as an Adjunct to Conventional Occupational Therapy Treatment in Upper Trapezitis Top

Sheetal Sureshbhai Patel1, Shashikant Chandanshive1

1OT School and Centre, TNMC and BYL Nair Ch Hospital, Mumbai, Maharashtra, India

E-mail: [email protected]

Background: Trapezitis is an inflammation of the trapezius muscle. As trapezius is one of the postural muscles of neck, it gets highly susceptible to overuse, leading to severe neck spasm and stiffness around the shoulder and upper back. Positional release technique (PRT) is a soft-tissue manual therapy technique which is also called a strain counter strain used for relieving muscle pain and spasm. No study was found which includes PRT as an adjunct to occupational therapy (OT) in upper trapezitis in the Indian population. Hence, the purpose of the study is to find effectiveness of PRT as an adjunct to OT treatment in upper trapezitis.

Objectives: The objectives were (1) to study the effectiveness of PRT as an adjunct to conventional OT in upper trapezitis; (2) to study the effectiveness of conventional OT alone in upper trapezitis; and (3) to compare the effectiveness of PRT as an adjunct to conventional OT and effectiveness of conventional OT alone in the upper trapezitis.

Study Design: This was a prospective, comparative, interventional, randomized control trial.

Methods: Fifty patients, 25 in each group with upper trapezitis, were recruited in the study. Pre- and post-outcomes were measured by neck disability index, range of motion (ROM), and visual analog scale. Group A patients received conventional OT treatment alone and Group B received PRT as an adjunct to conventional OT treatment for 2 weeks (weekly thrice). Assessment was done on the 1st day and at the end of 2nd week (6th session).

Results: Reduction in pain was statistically significant (P = 0.000) within group, cervical ROM-flexion and extension, right and left rotation, side flexion was statistically significant (P < 0.05) within group, and improvement in activities of daily living and functional activities was statistically significant (P = 0.00) within group. Group who received PRT as an adjunct to conventional OT had better results than group who received only conventional OT though not statistically significant.

Conclusion: After analyzing the data and comparing it with existing literature, we can conclude that PRT is an effective technique in pain reduction, improvement in neck movements, and performance in functional activities as an adjunct to OT in upper trapezitis.

Key Words: Conventional Occupational Therapy, Positional Release Technique, Trapezitis

  22. Category: Competitive Top

  Power Issues in Family-Centered Occupational Therapy Practice: A Secondary Analysis of Qualitative Data Top

Sumita Rege1, AmishaVerma1

1Department of Occupational Therapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India

E-mail: [email protected]

Background: Family-centered practices are considered the best practices for working with children with disabilities, and they have rapidly become more popular in occupational therapy practice, in many countries, including India, over the past few years. We conducted a qualitative study to understand Indian occupational therapists and their clients' perspectives on family-centered occupational therapy practice. The data from that study have been secondarily analyzed to explore issues related to power underlying this practice. This analysis used Foucault's ideas related to the social relations of power.

Objectives: The objective of the study is to explore the power issues in therapeutic relationships among occupational therapists and parents of children with cerebral palsy, participating in family-centered occupational therapy.

Study Design: Secondary data analysis: qualitative study design was chosen for the research.

Methods: Data collected for a descriptive qualitative study were secondarily analyzed using Foucault's lens of power. This secondary analysis of qualitative data was conducted using a thematic analysis method including the following steps: reading the interview transcripts, identifying and defining codes, and combining codes into categories and then into themes.

Results: Foucault's ideas regarding the development of power through the interactions rather than power being unilaterally generated are found to be particularly applicable in this study. The results highlighted the complex nature of the power relationship in family-centered occupational therapy. Social structures and the cultural context of the therapy situation were found to be key factors in determining the power dynamics in the relationships between the occupational therapists and the family members. Even though while the therapists commonly acknowledged that families are better able to understand their situations, it was obvious that in many situations, the power dynamic was skewed toward the therapists.

Conclusion: The implementation of family-centered care is compromised by the issues of power, and these issues are developed through an interaction between the therapists and the families.

Key Words: Family-Centered Therapy, Foucault, Power Relationships

  23. Category: Competitive Top

  Effectiveness of Functional Activity-Based Virtual Reality Training to Improve Voluntary Motor Control among Stroke Patients: A Pilot Study Top

S Tribhuvan1

1Department of Occupational Therapy, SRM College of Occupational Therapy, Chennai, Tamil Nadu, India

E-mail: [email protected]

Background: Virtual reality has been used in the field of rehabilitation to improve different functional skills in different conditions. However, we could not find any study that reported the potential of advanced technologies such as virtual reality in the field of occupational therapy due to unavailability of this technology for neurologically affected patients. Hence, there was necessity to perform a study using advanced technologies for the patients having neurological affectations to improve their voluntary control, which can further enhance their independence in daily functional activities.

Objectives: To develop a functional activity-based virtual reality training protocol and to implement the virtual reality training protocol on voluntary motor control of stroke patients.

Study Design: This was an experimental study design was used for this study.

Methods: Ten patients diagnosed as left hemiplegia were selected based on the convenient sampling method and were separated into two groups. The experimental group (n = 5) received the functional activity-based virtual reality training for 12 continuous days, where each session lasted for 1 h each, while the control group received conventional therapy for the same time period. A pre- and post-test evaluation was administered with the Fugl-Meyer examination for the upper extremity.

Results: The study resulted that functional activity-based virtual reality training had significant difference on voluntary motor control among stroke patients (U = −2.023; P < 0.05). Further, the study resulted that the functional activity-based virtual reality-based training had a significant difference on voluntary motor control when compared to conventional therapy (U = 10; P < 0.05).

[Figure 1] shows that there was a significant difference in the mean values of the posttest scores of the control and experimental groups.
Figure 1: Posttest Scores

Click here to view

Conclusion: The results of the study indicated that the functional activity-based virtual reality training was effective among stroke patients on voluntary motor control of upper extremity. Hence, virtual reality can be used as a new therapy modality in treating stroke patients.

Key Words: Functional Activity, Stroke, Virtual Reality, Voluntary Motor Control

  24. Category: Competitive Top

  Parents Experiences of Their Extended Families' Support for Them and Their Child with Autism Spectrum Disorder: A Phenomenological Study Top

Vigya Smriti1, SumitaRege1

1Department of Occupational Therapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India

E-mail: [email protected]

Background: Autism spectrum disorder (ASD) is characterized by impaired social behavior, communication, and language. A diagnosis of ASD impacts not just the children but also their families, specifically the parents. As occupational therapists who work in a family-centered manner, it is within the scope of knowledge and practice for occupational therapists to ensure the well-being of the family as a unit. Among Indian families, parents are usually the primary caregivers and they face challenges in raising a child with ASD. In countries such as India, with its emphasis on family cohesion, and collectivist and interdependent societies, the challenges parents' face are unique as compared to parents in other countries (Chadda and Deb, 2013; Krishnamurthy, 2008).

Objectives: The objective of the study is to explore how parents experience their extended families' support for them and their child with autism.

Study Design: Qualitative: Phenomenology study design was chosen for the research.

Methods: Purposive sampling techniques were used to recruit seven couples, who are parents of a child with ASD, residing in Delhi. The inclusion criteria for the participants included that they speak English and Hindi. Data were collected using in-depth individual interviews with the parents. The data were analyzed using thematic analysis techniques.

Results: The findings from this study showed that many of the participants expressed that the support they received from their extended families was inadequate and caused them to feel isolated and made it difficult for them to cope with their life situations. However, parents whose extended families were accepting of their child with ASD were better adjusted and satisfied in their roles as parents and family members.

Conclusion: This study highlights the importance of extended family members in raising a child with ASD and that their acceptance and support enables parents to perform their parenting roles better.

Key Words: Child with Autism Spectrum Disorder, Families' Support, Occupational Therapy, Parents' Experience

  25. Category: Noncompetitive Top

  Tapping Lumbopelvic Rhythm for Modulating Pain Behavior in Lumbar Prolapsed Intervertebral Disc Top

Vijay Batra1, Meenakshi Batra2

1Department of Neurology, GB Pant Hospital,2Department of Occupational Therapy, PDUIPH, New Delhi, India

E-mail: [email protected]

Background: Lumbar disc herniation (LDH) is a common low back disorder. It is one of the most common diseases that produce low back pain and/or leg pain in adults. A herniated disc begins from failure in the innermost annulus rings and progresses radially outward. Radiating acute lumbar back pain can indicate severe neurologic sequel that can be modulated by restoring lumbopelvic rhythm.

Objectives: The objective of the study was to tap lumbopelvic rhythm for modulating pain behavior in lumbar prolapse intervertebral disc (PIVD).

Study Design: This was an experimental-control design.

Methods: Thirty-six patients with PIVD were included. The preliminary evaluation was done for pain and functional status using Oswestry back pain disability questionnaire. All the patients were randomly allocated to two groups. In group A strategy for restoring lumbopelvic rhythm and Group B, conventional strategies were used. The re-evaluation was done after 8 weeks.

Results: Between- and within-group analysis was done and P-value was found to be significant for Oswestry back pain disability questionnaire score for the variable pain (P ≤ 0.022); lifting weight (P ≤ 0.008); walking (P ≤ 0.013); sitting (P ≤ 0.001); standing (P ≤ 0.001); social life (P ≤ 0.004), and traveling (P ≤ 0.001) and total score (P ≤ 0.009) in group A.

Conclusion: Restoration of lumbopelvic rhythm helps in modulation of pain behavior in lumbar PIVD.

Key Words: Functional Status, Lumbopelvic Rhythm, Pain Behavior

  26. Category: Competitive Top

  Perceptions and Experiences of Individuals with Mental Illness about Vocational Rehabilitation in India: An Exploratory Study Top

  Award: Won Vijay Suple Trophy for Best Scientific Paper in Mental Health Top

Vinita Acharya1, Kritika Amin1, Shardul Abhyankar1, Anshu Kumari1

1Department of Occupational Therapy, Manipal College of Health Professions, MAHE, Manipal, Karnataka, India

E-mail: [email protected]

Background: Employment or gainful occupation is essential for the well-being of individuals and to ensure their productive life participation. However, people with mental illness are often found not to be engaged in work-related activities. Vocational rehabilitation efforts are expected to support individuals with disability for gainful employment.

Objectives: This study aimed to understand the perceptions and experiences of individuals with mental illness regarding vocational rehabilitation in India.

Study Design: This was a qualitative phenomenological study.

Methods: This exploratory qualitative study involved five individuals with diagnoses of bipolar affective disorder and schizophrenia. Semi-structured interviews based on an interview guide were used to collect the data from participants. The audio-taped interviews were then transcribed for further analysis. Thematic analysis approach was used to analyze the transcripts. Rigor was induced using researcher triangulation.

Results: Five main themes emerged related to perceptions about work, experiences at workplace, personal factors, support system, and role of mental health professionals. Symptoms of illness, supportive employer, and continuous support from mental health professionals appeared to be some of the factors influencing their work experiences. Metaphor of “trekking up a mountain” was proposed to explain the vocational journey.

Conclusion: Vocational rehabilitation efforts in India seem to be rather unorganized, and clients often rely upon informal sources for gaining and maintaining employment.

Key Words: India, Mental Illness, Metaphor, Qualitative, Vocational Rehabilitation

  27. Category: Competitive Top

  To Study the Effectiveness of Balance Training on Functional Independence in Guillain-Barre Syndrome: A Randomized Control Trial Top

Ashwini Deepak Sangar1, Jayashri Shripad Kale1

1Occupational Therapy School and Centre, Seth GS Medical College and KEMH, Mumbai, Maharashtra, India

E-mail: [email protected]

Background: Guillain-Barre Syndrome (GBS) is considered as the most disabling neurological condition in the current scenario worldwide. GBS affects nerve roots, peripheral nerves, leading to motor neuropathy and flaccid paralysis with possible sensory and autonomic nervous system effects. All these factors are the major cause of balance, gait impairment, and increase in risk of fall in patients. Therefore, it is important to undergo rehabilitation to increase the likelihood of achieving functional independence in activities of daily living (ADL) and improve muscular fitness. Since there is little evidence documenting the impact of balance training on functional independence, therefore, it becomes important to assess the effectiveness of balance training in GBS, on their pre- and post-ambulatory status, their functional independence in ADL, and risk of fall status.

Objectives: The objectives were (1) to assess the effectiveness of balance training on functional independence in GBS; (2) to assess pre- and post-intervention scores of ADL; and (3) to correlate the pre- and post-intervention scores of balance to the risk of falls.

Study Design: This was a prospective randomized control trial.

Methods: Thirty participants, both male and female with age 20 years and above, diagnosed with GBS and falling in Hughes GBS Disability stage 3 and above were recruited and intervened for 2 months. Group A (control group) received strengthening exercises and Group B (experimental group) received strengthening exercises and balance training. Fifteen eligible participants were randomly allocated in each group and received 45 min of respective training session for 3 days per week. They were assessed on functional independence measure scale (FIM), Berg balance scale (BBS), and lower extremity functional scale (LEFS) as an outcome measures.

Results: Our study showed that there was statistically significant improvement (P < 0.05) in FIM, LEFS, and BBS test scores in Group A and Group B after respective occupational therapy intervention. However, more significant improvement (P < 0.05) in functional independence was observed with the combined effect of balance training and strengthening exercises on experimental Group B.

Conclusion: Our study supports the evidence that balance training is effective and has a positive impact on performance in ADL and thus improves functional independence of patients.

Key Words: Activities of Daily Living, Balance, Functional Independence, Mobility

  28. Category: Competitive Top

  Development and Evaluation of Intervention Module on Sensory Processing Disorders as a Part of Comprehensive Autism Intervention Package Top

Vivek Vajaratkar1, Gauri Divan2

1Department of Orthopaedic Surgery, Goa Medical College, Bambolim,2Child Development Group, Sangath, Bardez, Goa, India

E-mail: [email protected]

Background: Autism spectrum disorders (ASD) is a priority condition in low- and middle-income country (LMIC) settings, with a global prevalence of approximately 1% and a minimal evidence base for community interventions that can be delivered at scale in these settings. As a way to address this “treatment gap” for interventions delivered in the community, Parent-mediated intervention for ASD in South Asia (PASS) intervention, delivered by community-based lay health workers, showed effectiveness in our previous trial. However, the trial also identified considerable unmet needs of families in this context in addressing co-existing conditions known to commonly occur with ASD; for example, sensory processing disorders (SPDs), behavioral and eating problems. This presentation reports systematically developed a module for SPD for the most common comorbidity, which could be integrated efficiently into the core PASS social communication intervention. Using formative research methods, we supplemented the PASS intervention with additional (Plus) modules including module for SPD, to address autism comorbidities.

Objectives: The aim was to create a holistic intervention package of care including module for SPDs for families of children with ASD (PASS Plus), amenable to delivery by a lay health worker in LMIC settings.

Study Design: Literature review and qualitative study design were used for the development of the module and a pilot randomized controlled trial (RCT) was used for the evaluation of module.

Methods: First we identified common comorbidities which families of children with autism experience. Information from the three methods, namely literature review, in-depth interviews, and theory of change workshop, was triangulated to develop the module on SPDs for the Indian context.

Results: We have systematically developed module on SPD, through a series of formative research methods, and the evaluation, through a pilot RCT. The module on SPD was used in the majority of cases, suggesting successful incorporation of this new element into the treatment.

Conclusion: Module on SPD as a part of PASS plus shows good feasibility and adds to the evidence of the effectiveness of task sharing complex autism interventions to lay health workers in India. A positive effect of module on SPD as a part of PASS Plus intervention is encouraging for future larger-scale work.

Key Words: Autism Spectrum Disorders, Community-Based Rehabilitation, Interventions in Low- and Middle-Income Country, Sensory Processing Disorder

  29. Category: Noncompetitive Top

  Role of an Occupational Therapist in Driving Rehabilitation Top

Veena Slaich1

1Freelance Consultant Occupational Therapist, Delhi, India

E-mail: [email protected]

An overlooked but critical component of occupational therapy concerns comprehensive driver rehabilitation and evaluation. With the population, those over 65 years of age roughly on road, the importance of making sure that effective and safe transportation is available to an aging population has never been more pressing. Driving is such a fundamental human action that connects us to virtually everything we do that it can be easy to take its role in society for granted. There is a need to take a closer look at the role that occupational therapists (OTs) play and can play in transportation issues and the challenges faced whilst keeping our seniors and the disabled individuals on the road. This is needed for OTs who specialize and those who do not in driver rehabilitation. This needs a very in-depth and clearer approach in this area specifically to really appreciate the real difficulties of such disabled and old. While I was doing this actively, I realized that each person of the society needs to know the problems of such affected people so as to make them return back to driving without losing much time and difficulties. This is an uphill task in its true meaning.

  30. Category: Noncompetitive Top

  Analysis of Burden (Stress) of Family Caregivers of Admitted Psychiatric Patients Top

Pratibha M Vaidya1, Heena N Patel1

1OT School and Centre, TN Medical College, Mumbai, Maharashtra, India

E-mail: [email protected]

Background: The caregiver's burden refers to people's emotional response to the change in their life roles and the increased responsibilities that they need to deal with when they are expected to care for an ill person. The burden on a family can be due to multitude of reasons - some of which are - increased workload, type of caregiving tasks that need to be performed, the amount of time consumed performing these tasks, the personal sacrifices that need to be made to accommodate these, disruption of family routine, stigmatization by society, etc. The caregiver's gender, age, level of education, employment status, family history of mental illness, family type, etc., are few of the factors considered to evaluate the level of burden on the caregiver in this study.

Objective: The objective of the study is to evaluate/gauge the level of burden of family caregivers of admitted psychiatric patients and determine the influence of various factors on this burden.

Study Design: This was a noninterventional, cross-sectional study.

Methods: The study analyzes the data gathered from 114 family caregivers, 18 years of age and above, who have been caring for admitted psychiatric patients for more than 6 months. Demographic data gathered included age, gender, family history of mental illness, type of family, relationship with the patient, educational qualifications, and employment status. The caregivers were interviewed using Zarit burden scale, which consists of 22 questions. The caregivers were asked to rate each question on a scale of 0-4 in ascending order of occurrence.

Results: The level of burden of family caregivers ranged from moderate (42%) to severe (34%). 77% of the caregivers from nuclear families experienced moderate-to-severe burden as compared to 68% of those from joint family. Younger caregivers aged 18-40 years experienced moderate-to-severe stress. 67% of the caregivers were females while 33% were males and level of burden was more in males. Employed caregivers had higher burden than those who were unemployed.

Conclusion: The level of burden ranges from “moderate” to “severe” among the family caregivers of psychiatric patients evaluated, wherein younger, employed caregivers from nuclear families without a family history of mental illness were significantly more burdened.

Key Words: Burden, Family Caregivers, Psychiatric Patients

  31. Category: Competitive Top

  AVAZ Application (Trial Version) - A Voice for the Nonverbal Children with Autism Spectrum Disorder: A Pilot Study Top

  Award: Won Gazala Makda Trophy for Best Scientific Paper in Pediatrics Top

Jay Vijay Sonawane1, Hansa Varshneya1

1Department of Occupational Therapy, JKKMMRF College of Occupational Therapy, Namakkal, Tamil Nadu, India

E-mail: [email protected]

Background: Children with autism spectrum disorder (ASD) who are nonverbal lack communication skills. These children with ASD are unable to express their needs verbally even if they want to. The introduction of indigenous augmentative and alternative communication system (AAC) can be helpful in improving the social interaction. By using AAC, these children with ASD can easily communicate their needs with parents, teachers, or caregivers.

Objective: The objective of this study is to evaluate the importance and need of AVAZ application in special school-going children with ASD.

Study Design: A pilot study for short term on small sample was conducted.

Methods: A sample of eight special school-going children with ASD was selected. Each child had downloaded AVAZ application trial version on their smartphone from the Google Play Store. The number of sentences formed by the children over a period of 21 days was analyzed. The responses were recorded in the AVAZ application.

Results: Percentage improvement was noted in forming relevant sentences through the application of each child from the 1st to 21st session ranging from 28.5% to 40%; five children showed the improvement but three children did not form any sentence neither relevant nor nonrelevant.

Conclusion: Our study showed that the use of AVAZ application can be helpful in improving social interaction and can be utilized as a supporting tool for functional communication with others and for the better learning process in children with ASD.

Key Words: Augmentative and Alternative Communication System, Autism Spectrum Disorder, Communication, Occupational Therapy, Social Interaction

  32.Category: Competitive Top

  Understanding Occupational Therapy Practices While Working with Children Having Specific Learning Difficulties: A Scoping Review Top

Saniya Sidhesh Nadkarni, Sumita Rege

Department of Occupational Therapy, Manipal College of Health Professionals, Manipal, Karnataka, India

E-mail: [email protected]

Background: Specific learning difficulty is an umbrella term that focuses on a varied range of challenges in the area of education. Occupational therapists work with clients with learning disabilities in schools, community, or private practice. With an assortment of individuals working with these clients, it becomes necessary to understand the role of occupational therapy professional in the team.

Objectives: The aim of this study is to identify the practices of occupational therapy when working with children having learning difficulties.

Study Design: This was a scoping review (qualitative study).

Methods: A scoping review using Arksey and O'Malley's guidelines of different journals was conducted to understand the available literature on learning disabilities over the last two decades, using a combination of internet-mediated and manual methods. The data were analyzed using charting techniques.

Results: Both quantitative and qualitative studies have been conducted. The results suggest that occupational therapists as a part of an educational team may have multiple areas of practice and the role may differ based on the needs of the client and the team, but the results remain inconclusive on a definitive role of an occupational therapist.

Conclusion: The available data discuss the interventions that practitioners use but remain limited as the role itself changes with different settings and over different contexts.

Key Words: Learning Disability, Occupational Therapy, Top-Down Approach

  33. Category: Competitive Top

  Understanding Service Seekers Perspectives of Navigating in a Hospital: A Qualitative Study Top

Pallavi Phulpagar1, Sushant Sarang1, Arthi Karnam1

1Department of Occupational Therapy, OT Training School and Centre, LTMMC and GH, Mumbai, Maharashtra, India

E-mail: [email protected]

Background: Hospitals have complex functions and programs, and thus, their facilities can become mazes of disconnected, disorienting spaces. There are myriad difficulties that new employees, patients, patient family members, and visitors of all sorts have while navigating their ways through large hospital settings. Navigating a large hospital may be overwhelming. Navigation infrastructure in a 1400-bedded tertiary care hospital in a crowded metro needs exploration along with understanding the service seekers' perspectives. This can help the management to plan and design navigation systems to best suit the service seekers. Occupational therapists need to understand the navigation of a hospital as improving accessibility is part of direct OT intervention to improve environment.

Objectives: With respect to navigation in a tertiary care hospital:

  1. To explore the existing infrastructure
  2. To explore patient's perspective.

Study Design: This was a phenomological study.


  1. Field study

    • The investigators collected data regarding existing infrastructure for navigation - signage, maps, enquiry counters, etc
    • Data were collected in the form of field notes and photographs.

  2. Participants' interview

  • Data were collected using a semi-structured interview method in the form of audio recordings
  • Transcribing was done for collected audio recordings
  • Based on an analysis of the gathered data, themes were developed.

Results: The following themes were formed with respect to navigation in the hospital:

  • Inadequate navigation infrastructure
  • Different methods of navigation
  • Dissatisfaction and stress among service seekers.

Conclusion: Participants reported that an inadequate navigation infrastructure in a tertiary care hospital causes stress in patients and their relatives. There is an urgent need to address the navigation problems in large tertiary care hospitals to improve satisfaction and decrease stress among service seekers.

Key Words: Hospitals, Navigation, Tertiary Care

  34. Category: Competitive Top

  Comparative Study of Eye-Hand Coordination among Volleyball Players and Nonvolleyball Players Top

Noor Mohammad1

1Department of Rehabilitation Sciences, School of Nursing Sciences and Allied Health, Jamia Hamdard University, New Delhi, India

E-mail: [email protected]

Background: Eye-hand coordination is the coordinated control of eye movement with hand movement and the processing of visual input to guide reaching and grasping along with the use of proprioception of the hands to guide the eyes. It is part of the mechanisms of performing everyday tasks; in its absence, most people would be unable to carry out even the simplest of actions such as picking up a book from a table or playing a video game. Volleyball is a team sport in which two teams of six players are separated by a net. Each team tries to score points by grounding a ball on the other team's court organized rules. One of the important components is eye-hand coordination. A sportsperson can compete effectively only by coordinative mastery of the technique. Volleyball is a sport activity that has many different movements of the players. It is clear that, to perform these demanding movements, learning of new movements, and for rapid change of one movement with another (Drabik, 1996), coordination is the unavoidable factor for success of one volleyball player.

Objective: The objective of the study is to compare the eye-hand coordination of volleyball players and nonvolleyball players and to compare motor performance of volleyball players and nonvolleyball players.

Study Design: This was a comparative study.

Method: Target population was volleyball players and nonvolleyball players. Sample method was convenience sampling. The sample size was 40. Subjects were categorized into two groups:

  1. Sample A (volleyball players)
  2. Sample B (nonvolleyball players).

Each group will have 20 subjects. Subjects will be selected on the basis of the inclusion criteria.

Results: Data analysis was accomplished with the following software, Statistical Package for the Social Science for Windows (version 20.0 IBM SPSS Inc., Chicago, IL, USA). Descriptive statistics were used to analyze subject's characteristics such as gender, height, weight, BMI, sports interest, and score obtained. Independent t- test was used to compare the eye-hand coordination.

Conclusion: It can be concluded from the result that there is a significant difference between eye-hand coordination among volleyball and nonvolleyball players. Those who were involved in volleyball sports have better eye-hand coordination skills.

Key Words: Coordination, Eye-Hand Coordination, Volleyball

  Eposter Presentation Top

  1. Category: Competitive Top

  The Effect of Person-Environment-Occupation Model in Improving Social Skills: A Case Study Top

  Award: Won AIOTA Trophy for Best ePoster Top

DS Shrivastav1, SS Jaywant1

1Department of Occupational Therapy, LTMMC and LTMG Hospital, Mumbai, Maharashtra, India

E-mail: [email protected]

An adolescent girl with general anxiety disorder with suspected sensory issues showing gravitational insecurity was referred for social skill development and activities of daily living (ADL) issues to the occupational therapy (OT) department. Generalized anxiety disorder (anxiety lasting more than 6 months) is characterized by an insidious onset, usually chronic course which may or may not be punctuated by repeated panic attacks (episodes of acute anxiety). It leads to problems such as difficulty in decision-making and difficulty in performing day-to-day activity. Gravitational insecurity refers to excessive fear of ordinary movement, being out of an upright position. When a person has above two disorders together, it leads to a grave difficulty in performing ADL. It was challenge to an occupational therapist. The problems were analyzed using Person-Environment-Occupation (PEO) Model. The objective of this case study was to analyze the effect of PEO model in improving social skill and quality of life in adolescent school-going girl with generalized anxiety disorder and gravitational insecurity (vestibular dysfunction). A 14-year-old female child diagnosed with anxiety disorder and gravitational insecurities was assessed thoroughly. She had difficulty socializing with peers, dependent on family and physical support for ADL and walking, stair climbing. The child was assessed on Spence children's anxiety scale (SCAS) and pediatric balance scale (PBS), adolescent/adult sensory profile. PEO model was used considering caregiver's complaints and analysis of problem areas; sensory integrative therapy was used along with group therapy program. On assessment, the girl showed sensory sensitivity in vestibular and visual system. After OT intervention, there is marked improvement seen in SCAS (from T-score - 68 indicates high level of anxiety to T score - 55 indicates moderate level of anxiety) and PBS score of 21 out of 56 preintervention to 39 out of 56 postintervention. Improvement in intrapersonal and interpersonal relationship with improvement in ADL: dressing, personal hygiene, bathing, was observed. The use of sensory integration therapy with appropriate use of PEO model has resulted in improvement in social skills. Therapists' skills in scientific and pragmatic reasoning have shown positive effects in planning intervention for challenging cases.

Key Words: Generalized Anxiety Disorder, Gravitational Insecurity, Pediatric Balance Scale, Spence Children's Anxiety Scale

  2. Category: Noncompetitive Top

  Neuromuscular Training Device: Effectiveness on Functional Reach: A Prospective Interventional Single Case Study Top

Hema Biju Niravethu, Divya L Deshnehere

Department of Occupational Therapy, NeuroGen Brain and Spine Institute,

Navi Mumbai, Maharashtra, India

E-mail: [email protected]

Neuromuscular training (NMT) device is a unique, yet simple device invented and patented by Ms. Prachi Rathi, Occupational Therapist. It is a device to assess and treat functional reach in patients with balance disorders - objectively in all the planes and on a calibrated scale. We, at NeuroGen Brain and Spine Institute, bought this device to help cater quality care to our patients. Our objective of the study was to determine functional reachability on NMT device. A middle-aged homemaker with difficulty in standing dynamic balance was selected for this study. A baseline assessment of functional reach was collected objectively using NMT device. Functional reach training was given to the patient during the stay of week. At the time of discharge, ergonomic modification based on the measurements on NMT device was provided to patient to work in a safe environment. Reassessment was done at the time of discharge and at the time of 3 months of follow-up. Adherence to home program and ergonomic modification was obtained through interview with patient. The pre- and post-values were statistically analyzed to determine the significant difference; further, the result was correlated qualitatively with the patient's feedback. We were overwhelmed with the results that NMT device serves it purpose of collecting data of functional reach objectively and its potential to use it interventionally.

Key Words: Balance, Functional reach training, Neuromuscular Training Device

  3. Category: Competitive Top

  Cognitive Rehabilitation: Client-Centered Approach Top

Divya L Deshnehere, Hema Biju Niravethu

Department of Occupational Therapy, NeuroGen Brain and Spine Institute,

Navi Mumbai, Maharashtra, India

E-mail: [email protected]

An occupational therapist helps patients to be independent by considering their abilities and addressing their difficulties to perform their activities of daily living (ADLs) through planning intervention using remedial and compensatory approach. Cognitive and perceptual dysfunctions are considered as hidden disabilities, leading to difficulty performing the occupational performance areas of life: ADL, work, and leisure. The following study aims to identify the difficulties performing work and leisure activities along with ADL due to cognitive-perceptual dysfunction and design a client-centered interventional program. A 50-year-old client-investment consultant by profession, diagnosed with left middle cerebral artery (MCA) infarct, was treated at NeuroGen Brain and Spine Institute for 3 months by our esteemed expert professionals of neurorehabilitation team. The occupational therapist used the Canadian occupational performance measure (COPM) as an outcome measure to address client's concern and reassess the goals planned over 3 months' rehabilitation. A cognitive approach was used as intervention to meet the client's priorities designed using COPM tool. The results of the current study reveal that using COPM, the prescore for performance was calculated to be 13.5/100 which improved to 63/100 and satisfaction score improved from 9/100 to 67.5/100, which shows an improvement in the task listed in priority after cognitive rehabilitation. We conclude that if a client-centered practice is used in treatment planning, it enhances the patient's belief that he is the locus of control and can decide treatment appropriate for self. This in turn will bring an improvement in performance and satisfaction in activities important to him leading to improved quality of life.

Key Words: Canadian Occupational Performance Measure, Client-Oriented Approach, Cognitive Rehabilitation

  4. Category: Noncompetitive Top

  Sensory Deficits in Stroke: A Hidden Challenge for Rehabilitation Top

Kamal Narayan Arya1

1Department of Occupational Therapy, Pt. Deendayal Upadhyaya National Institute for Persons with Physical Disabilities, New Delhi, India

E-mail: [email protected]

Background: Up to 50%-80% of stroke subjects exhibit upper extremity sensory deficits. Sensory loss has implications for poor motor recovery, functions, and quality of life after stroke. Rehabilitation management still focuses on motor impairment ignoring the sensory destruction. Management of sensory deficits is overlooked at the assessment and treatment stage.

Objectives: The objective of the study is to provide an overview of the evidence on sensory deficits and its rehabilitation among poststroke patients.

Study Design: This was a review (nonsystematic).

Methods: Data sources were PubMed, Cochrane database, Google Scholar, OT seeker and PEDro, DORIS. Keywords used were *Sensory deficit, stroke, and rehabilitation. The selected publications were assessed for quality and important findings were extracted, summarized, and interlinked.

Results: Sensory deficits are usually present among stroke patients. Impairment in tactile localization, two-point discrimination, texture discrimination, stereognosis, proprioception, and barognosis are evident. Motor recovery is influenced by the level of sensory impairment. To date, there is some evidence supporting the clinical value of sensory-based approaches to motor therapies. This review outlines the key sensory impairment among stroke subjects, describes how the deficits can influence motor and functional recovery and expected rehabilitation outcomes in stroke, reports on current sensory-based approaches in poststroke motor rehabilitation, and makes recommendations for optimizing motor therapies based on sensory training.

Conclusion: Somatosensory deficits are common though unexplored in poststroke subjects. Sensory input plays a fundamental role in motor and functional recovery poststroke.

Key Words: Rehabilitation, Sensory Impairment, Somatosensory, Stroke

  5. Category: Noncompetitive Top

  Impact of Intermittent Use of Wheelchair in School-Going Children with Duchene Muscular Dystrophy on School Attendance Top

Poonam Sachdev1, R Aruna1

1Composite Regional Centre for Skill Development, Rehabilitation and Empowerment of Persons with Disabilities, Bhopal, Madhya Pradesh, India

E-mail: [email protected]

Background: Duchene muscular dystrophy (DMD) is “X”-linked chromosomal recessive condition caused by the absence of dystrophin. Symptoms generally start at early childhood, between 3 and 5 years of age. Boys are more commonly affected than girls. A diagnosed child gradually loses the ability to walk, sit upright, getting up from the floor, climbing, and arms and hands movements. Due to progressive nature of disease, physical fatigue in children is very common. The children avoid attending the school due to long school hours and reduced endurance. The condition not only affects the schooling but also affects the enjoyment in life. To retain the functional abilities of the child, wheelchair (WC) is recommended to sustain in an environment for long time. Right to Education Act and Rights of Persons with Disabilities Act 2016 focus that the child should have right to education to be taught in an environment which is best suited to his/her learning needs. To work more effectively, the children were provided with WC.

Objectives: The objective is to study the effect of use of WC in DMD children who left schooling due to fatigue.

Study Design: This was a survey.

Methods: Ten beneficiaries diagnosed to have DMD were selected for study. Eight beneficiaries discontinued the school due to early fatigue and difficulty in mobility. Parents were interviewed on a questionnaire and comparison was done.

Results: Comparison of participation factors of child pre- and post-WC distribution was taken into account.

Conclusion: The study concluded that after providing them with WC and therapeutic guidance, the children were improved in school attendance, social leisure activity, and peer group interaction.

Key Words: Duchene Muscular Dystrophy, School Attendance, Wheelchair

  6. Category: Noncompetitive Top

  Getting Back on Their Feet: A Single-Case Study Top

Waradkar Chetna1, Palsule Shilpshree1

1Occupational Therapy Department, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India

E-mail: [email protected]

In this single-case study, a 56-year-old female was a operated case of D6 Koch's spine with complete paraplegia in February 2019. She was apparently alright till January 2019 when she experienced gradual onset of back pain, not able to get up from squat position, fatigue. She was shown to various hospitals which gave her temporary relief. Postoperatively she showed no improvement was in the neuromuscular condition. She was readmitted again after 7 months of surgery and referred to an occupational therapist for rehabilitation (as the patient reported regaining her muscle power). The primary objective of our study was to make patient mobile and locomote as early as possible with the help of assistive devices. She was evaluated using the International Classification of Functioning, Disability and Health (ICF) Model, Canadian occupational performance measure (COPM), and spinal cord independence measure (SCIM) used as outcome measures. An intervention program was planned on a weekly basis. She was observed for over 2 months and evaluated within 15 days' span. Rehabilitation program mainly focused on self-care, functional mobility, and productivity. It was designed using client-centered approach using biomechanical frame of reference, cognitive behavior frame of reference. Postintervention scores were improved in COPM (performance = 14, satisfaction = 15), and SCIM was 70/100. In the end, we can conclude that using ICF as an evaluation method, we were able to found out patient's functional abilities. She come to our department on wheelchair, while going home did not recover completely in all the affected area but could definitely stand on her feet to accomplish her life roles.

Key Words: Disability and Health, Koch's Spine, Motivation, Quality of Life, Spinal Cord Injury, The International Classification of Functioning

  7. Category: Competitive Top

  Client-Centered Approach in an Adult with Postvaricella Purpura Fulminans with Quadruple Amputation: A Case Study Top

Manshi S Chadwa1, Rashmi Yeradkar1

1Department of Occupational Therapy, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, Maharashtra, India

E-mail: [email protected]

Purpura fulminans is a rapidly progressive thrombotic disorder with a high mortality rate. It is due to deficiency or dysfunction of coagulation factors, such as protein C and S. A 25-year-old male presented with chickenpox and developed purpura fulminans. He had painful, nonblanchable, purpuritic lesions that turned necrotic postinfection. Due to progressive ischemia of legs, he underwent surgery with quadruple amputation (bilateral tarsometatarsal amputation with right 2nd, 3rd, 4th, 5th transmetacarpal and left 3rd, 4th, 5th transmetacarpal). He was referred to the occupational therapy department for rehabilitation with complaints of intermittent claudication and difficulty in performing activities of daily living. Two-month rehabilitation program included Beurger's exercise to improve vascularity and reduce pain in the lower extremity. A writing device was designed to improve writing pattern and to improve functional mobility modified footwear was given. Canadian occupational performance model (COPM) was used as an outcome measure to assess the performance and satisfaction of the patient. Pre- and Post-scale used are McGill pain questionnaire, functional independence measure (FIM), and six-min walk test (6-MWT) to assess pain, Activities of daily living, and functional mobility, respectively. Independence level was improved from 90 to 105 on FIM scale. On 6-MWT, patients' score progressed from 50 to 300 m. He showed significant reduction in pain. Patients' performance level improved from 4 to 20 and satisfaction improved from 10 to 30 on COPM. Thus, client-centered approach was effective in improving functional mobility and reducing pain.

Key Words: Beurger's Exercise, Client-Centered Approach, Functional Independence Measure, McGill Pain Questionnaire, Purpura Fulminans, Quadruple Amputation, 6-Min Walk Test

  8. Category: Competitive Top

  Scope and Role for Occupational Therapy in Sexual Health Education Interventions for Children with Disabilities: A Historical Review Top

Payal Unhelkar1, Sumita Rege1

1Department of Occupational Therapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India

E-mail: [email protected]

Background: Occupational therapists have a strong belief that active engagement of their clients in their occupations facilitates their health and participation. The occupation of social participation, according to the occupational therapy practice framework, involves engaging in activities with peers, including engaging in desired sexual activity which is also a basic daily living occupation. Children with disabilities (CWD) are a diverse population with different sexual maturation experiences. They sometimes tend to express their sexual emotions in socially inappropriate manners, hampering their social interactions. Occupational therapists working with CWD are responsible for the facilitation of CWD's engagement in age-appropriate social interaction. However, confusion about the specific role of occupational therapy in this area is evident in practice. Hence, a review of research in this area of occupational therapy will help in understanding its role in facilitating sexual health education for CWD.

Objectives: The objective of this historical review is to trace the journey of occupational therapy in the delivery of sexual health education interventions for CWD.

Study Design: This was a historical review.

Methods: A comprehensive literature search using online databases and manual cross-referencing to select only full-text English language research articles relevant to the topic was carried out.

Results: Five articles will be included in the review. They reinforce the role of occupational therapy in delivering sexual health interventions. Nonetheless, a lack of knowledge about the specific interventions hampers service delivery in this area of occupational therapy practice.

Conclusion: Historically, a role for occupational therapy in delivering sexual health education interventions for CWD has been conceptualized but not clearly defined. Hence, more research and training for occupational therapists working with CWD to deliver sexual health education interventions are needed.

Key Words: Children with Disabilities, Occupational Therapy, Sexual Health Education Intervention

  9. Category: Noncompetitive Top

  Effectiveness of Adaptive Device for Hand Dysfunction in Person with C3-6 Cervical Whiplash Injury: A Single-Case Report Top

Sharda B Sethy1, Helly N Shroff1

1Occupational Therapy Department, Seth GSMC and KEM Hospital, Mumbai, Maharashtra, India

E-mail: [email protected]

This single case study reports a 41-year-old male patient, who was left dominant, clerk by profession, and diagnosed with whiplash injury. The objective is to assess typing speed and handwriting with adaptive device and the other objective is to improve the activities of daily living (ADL) skills by occupational therapy intervention. The outcome measures used were muscle testing, hand function, functional independence measure (FIM) scale, and typing speed. The duration of the study was 3 months in which the patient received 1 month of inpatient rehabilitation and 2 months of home exercise program where therapist visited his home once a week. The patient received vocational training with the help of adaptive device. Typing and writing were tailored to his job demands, and he also received conventional occupational therapy. The results showed an improvement in outcome measures. Adaptive device showed improvement in typing speed and legibility of handwriting. Conventional occupational therapy intervention showed improvement in muscle strength and ADL such as self-care and indoor mobility skills.

Key Words: Adaptive Device, Cervical Whiplash Injury, Hand Dysfunction

  10. Category: Competitive Top

  The Shaking Hand Top

Chhokar Jasvinder Kaur Manjeet Singh1

1OT School and Centre, Seth GS Medical College and Hospital, Mumbai, Maharashtra, India

E-mail: [email protected]

Functional neurological disorder (FND) is a diagnosis made on the basis of symptoms and after ruling out all possible neurological or medical conditions. We followed a case from the point of being diagnosed as “posttraumatic involuntary movement” to “conversion disorder” and the effect of it all on the patient's physical and mental well-being. An interdisciplinary team effort of discussion with the neurologists, plastic surgeons, psychiatrists, and counselor along with occupational therapists and various treatment methods were involved in the management of this patient's condition. Improvement of range of motion and psychological well-being was noted in the patient. Increased independence in activities of daily living and productivity were observed. At the end of the 4 months of therapy, it was concluded that an interdisciplinary team is necessary for the timely diagnosis and treatment of FND. It is important to understand the criteria for diagnosis of this condition; however, clinical skills and observations play an equally important role.

Key Words: Conversion Disorder, Functional Neurological Disorder, Involuntary Movement Disorder, Involuntary Movements, Posttraumatic, Tremors

  11. Category: Noncompetitive Top

  Compliance of Patients Provided with Need-Based Upper Extremity Adaptive Device: A Study on Indian Population Top

Ragini R Sharma1, Shilpshree P Palsule1

1Department of Occupational Therapy, Seth GS Medical College and KEMH, Mumbai, Maharashtra, India

E-mail: [email protected]

Background: Upper extremity plays a major role in performing self-care activities. During the time of recovery of upper extremity injury, many individuals experience difficulties in performing their daily living activities such as dressing, bathing, eating, and grooming. This dependency level can be decreased by providing them with an adaptive device.

Objectives: The objective is to study the compliance of adaptive device on the Indian population who has been provided with need-based upper extremity adaptive device: (1) To evaluate the compliance of adaptive device and (2) to evaluate the difference in functional performance.

Study Design: This was a prospective cohort study.

Methods: Fifty-five patients were recruited in the study who met the inclusion criteria. After taking informed consent, the study was started. The study protocol included two follow-ups within 2 consecutive weeks from the first assessment for 45 min each session. Patients were assessed on case record form, self-designed validated questionnaire, and disability of arm, shoulder and hand scale.

Results: Compliance was found in the use of the adaptive device in our study. Of 55 study subjects, 98.2% (N = 54) were using the adaptive device at the end of 2 weeks. Similarly, of 55 study subjects, 96.4% (N = 53) were using the given adaptive device.

Conclusion: Client-centered approach helps achieve better compliance for the adaptive device.

Key Words: Adaptive Device, Assistive Device, Compliance

  12. Category: Competitive Top

  The Usability Evaluation of the INFORM Mobile Health Platform against Paper-Based INFORM Manual Top

Vivek Vajaratkar1,2, Gauri Divan3

1Department of Orthopaedic Surgery, Goa Medical College, Bambolim,2Sangath, Alto-Porvorim,3Child Development Group, Sangath, Bardez, Goa, India

E-mail: [email protected]

Background: Developmental disabilities (DDs) including cerebral palsy (CP) and intellectual disability are evident from early childhood. Approximately 150 million children worldwide have DD and 90% of them live in developing countries. A recent epidemiological study in India revealed an overall prevalence of any DD is 12%, and the prevalence of neuromotor impairment (NMI) including CP is 1.4%; which means approximately 2 million children with NMI present in India. The vast majority of these children do not have access to evidence-based strategies to promote the development and address impairments, making this a regional health priority as well as global health priority. 90% of children with DD do not have access to evidence-based early interventions due to the limited availability and high costs of specialized therapists in low- and middle-income countries (LMICs). A mobile health platform, INFORM (ImproviNg Functional Outcomes foR Children with IMpairments), was developed to enhance access to such care by disseminating skills to community health workers (CHWs) to deliver evidence-based strategies to parents of children with DD. There is need to measure the efficiency and efficacy of the INFORM mobile platform developed for the CHWs against the traditional paper-based manual.

Objectives: The aim of the study was to measure the efficiency, effectiveness, and satisfaction of the INFORM mHealth platform against paper-based INFORM manual.

Study Design: This was a cross-sectional mixed quantitative and qualitative study.

Methods: The usability evaluation was based on the refined (adapted for mobility) method of ISO 9241-11 usability indicators. This method uses a comparison between usage of technology (mobile and internet) with paper-based approach. The 10 CHWs who participated has no prior knowledge about both the paper based tool or the M-Health Toolkit.

Results: Analysis found that mobile-based approach was more efficient, effective, and satisfactory as compared to paper-based approach.

Conclusion: The data show that if the usability of the toolkit is improved a little more, the mobile-based approach is the most effective, efficient, and satisfying experience for all the users. Hence, the INFORM platform can help disseminate evidence-based practices for children with DD through CHW in low-resource setting.

Key Words: Cerebral Palsy, Community-Based Intervention, Mobile Health

  13. Category: Competitive Top

  Rehabilitation in Congenital Muscular Torticollis Operated with Z-Plasty: A Case Report Top

Vanashree Nalawade1

1Department of Occupational Therapy, DY Patil School of Occupational Therapy, Navi Mumbai, Maharashtra, India

E-mail: [email protected]

Among the musculoskeletal congenital anomalies, congenital muscular torticollis (CMT) is the third most common. This condition presents with fibrosis of sternocleidomastoid muscle with increased lateral flexion on the same side and rotation on the opposite side. The objectives of the study were to reduce cervical deformity, mild facial asymmetry and to improve the range of motion of cervical lateral flexion and rotation. A 5-year-old female child had right torticollis for which she underwent Z-plasty. Evaluations were done on preoperative, postoperative day 1, 1 month, 4 months, and 7 months. Rehabilitation techniques included gradual stretching of the sternocleidomastoid muscle, splintage (static serial), positioning techniques, and play activities. Outcome measures observed were significant improvement in the posture of head tilt, range of motion using cervical goniometer, and facial asymmetry using photographs. This case report describes the importance of multidisciplinary treatment approach involving surgery, exercise therapy, play, and customized static serial splinting in the rehabilitation of CMT.

Key Words: Congenital Muscular Torticollis, Rehabilitation, Splintage, Z-Plasty

  14. Category: Competitive Top

  Neurodiversity at Workplaces: A Q-Methodology Study Top

Aishwarya Swaminathan1, Anuradha Pai2

1Department of Occupational Therapy, School of OT, D Y Patil University, Nerul, Navi Mumbai,2OT Training School and Centre, LTMMC, Mumbai, Maharashtra, India

E-mail: [email protected]

Background: Neurodiversity is a term that evolved from the advocacy movement on behalf of individuals with autism spectrum disorders (ASDs) and has been embraced by other groups of individuals with neurologically-based disabilities. It suggests that these disabilities are a natural variation in brain differences. Literature shows that work opportunities have been catered to majorly high functioning individuals and that too in specific kind of workplaces related to IT/finance, etc., and there is a lack of literature about neurodiversity at varied workplaces.

Objectives: The objectives were (1) to study and understand the viewpoints of neurodiverse individuals with varied diagnosis, with varying levels of functioning, working at varied workplaces such as homes (self-employment), vocational centers (supported employment), or companies (open/competitive employment); (2) to study and understand the viewpoints of related stakeholders such as caregivers, employers, job coaches, and coworkers; and (3) to discuss implications for occupational therapy.

Study Design: A Q-Methodology was used, which draws on both quantitative and qualitative approaches.

Methods: Nineteen statements (Q-Sort Pack) relating to the neurodiversity at workplaces were distilled from literature and from patient narratives. Keeping in line with the Q-Methodology, a diverse, purposive sample of 15 including the above-mentioned neurodiverse individuals and stakeholders sorted the statements into normally distributed 19 cell grid (Q-Sort Grid), according to the extent to which each represented their viewpoints about neurodiversity at workplaces.

Results: Analysis of the data gathered was done by an online software PQMethod for rank-ordering, and then, factor analysis for its meanings was done using principal component analysis and varimax rotation, to find the underlying factors that summarize the pattern of correlations among the Q-Sorts undertaken by the participants. Four factors emerged which were labeled: (A) work readiness, self-determination, and advocacy; (B) transition to work, getting a job and keeping it - adaptations; (c) neurodiversity at workplaces; and (d) self, supported and open/competitive employments.

Conclusion: Through this study, the viewpoints about neurodiversity at workplaces were understood. Implications for occupational therapy were discussed.

Key Words: Neurodiversity, Occupational Therapy, Q-Methodology, Workplace

  15. Category: Competitive Top

  Perception of Parents in Using Messy Play in Sensory-Based Interventions Top

Sheeba Parveen1

1Department of Occupational Therapy, Jamia Hamdard University,

New Delhi, India

E-mail: [email protected]

Background: Despite appearances, messy play can make an enormous contribution to babies' and young children's cognitive and creative development. What do parents think about when they hear the word “messy?” Untidy, muddled, disorganized, confused, cluttered, shambolic, disordered or perhaps the instruction, “don't make a mess.” The word messy is often given negative meanings, and calling an important aspect of play “messy” can lead to it being undervalued. Messy play involves children using all their senses in the process of exploration, especially the sense of touch offering children plenty of opportunities to mold and manipulate materials not having a focus on making or producing something.

Objectives: To explore the perception of parents in regard to messy play questionnaire filled by occupational therapist who works with parents and children having autism spectrum disorder/attention deficit hyperactive disorder.

Study Design: This was a survey.

Methods: Thirty occupational therapists, who are working in an Early Intervention Centre across Delhi, have filled a questionnaire about the perception of parents about messy play in sensory-based programs. The questionnaire was created using Google form, and its reliability and validity were tested.

Results: The results of the study suggest that parents use messy play during sensory-based intervention in home programs occasionally. Seventy percent of parents suggest using other sensory-based equipment in comparison to messy play. 80.7 percent of the occupational therapists feel that only some of the parents actually do the activities related to messy play.

Conclusion: This study shows that messy play though the cheapest form of intervention with the most wide used possibilities of exploration is still not preferred by many parents. Despite all the contributions that messy play can make, to children's learning and development, there does seem to be a reluctance to promote messy play, in the home-based settings. Neglect of such play may be connected with other people's anxieties about children making a mess and its associations with words such as muddled, confused, and shambolic. This has led to this type of play being seen as unimportant and undervalued.

Key Words: Messy Play, Perception, Sensory-Based Intervention


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