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Year : 2021  |  Volume : 53  |  Issue : 1  |  Page : 4-14

Occupational Therapy for Reducing Disabilities in Persons with Disabilities in India: A Systematic Review

1 South Asia Center for Disability Inclusive Development and Research, Public Health Foundation of India, Indian Institute of Public Health; Clinical and Pubilc Health Research, India Alliance (DBT – Wellcome Trust), Bengaluru, Karnataka, India
2 School of Health Sciences, National University of Ireland Galway: Galway, Ireland
3 Centre for Addiction Medicine, NIMHANS, Bengaluru, Karnataka, India
4 Department for Child Development, Smart Sensory Kids, Chennai, Tamil Nadu, India
5 Rehabilitation Research Consultancy, Hyderabad, Telangana, India

Correspondence Address:
Sureshkumar Kamalakannan
Public Health Foundation of India, Indian Institute of Public Health, Plot No. 1, ANV Arcade, Amar Cooperative Society, Kavuri Hills, Madhapur, Hyderabad - 500 033, Telangana
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijoth.ijoth_40_21

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Background: The current evidence for occupational therapy practice, teaching, and research is replicated and implemented significantly from high-income countries in India. Therefore, a systematic review and an evaluation of existing evidence for occupational therapy (OT) to reduce disabilities including impairments, activity limitations, and participation restriction in persons with disabilities (PWD) in India are warranted. Objectives: The objective of this review was to evaluate the effectiveness of OT interventions for reducing disabilities in PWD in India. Study Design: Systematic review. Methods: We searched the Cochrane CENTRAL, MEDLINE, Embase, CINAHL, PsycINFO, AMED, and Web of Science. A hand search was also carried out in selected Indian journals, OT-specific databases, and repositories, such as Indian Journal of Occupational Therapy, Indian Journal of Physiotherapy and Occupational Therapy, OT Seekers, World Federation of Occupational Therapy Bulletin, Asia Pacific Occupational Therapists Regional Group, and clinical trials registers. The search was restricted to published studies conducted in India during 2000–2021. We included randomized controlled trials (RCTs) of an occupational therapy intervention delivered by OTs for PWD, where the effects of the intervention were evaluated using any relevant disability outcome measure. Studies without access to full text were excluded. Two review authors independently completed screening, and one author reviewed the full text of the screened studies. Another pair of authors extracted data from included studies for prespecified disability outcomes, and two authors assessed the risk of bias in the included studies. Results: We identified seven RCTs of occupational therapy interventions for PWD in India with 305 participants in total. All seven studies were very different in terms of their objective, participants, comparison, and outcomes. Allocation concealment and blinding and risk of bias were high in five trials. All the trials reported impairment outcomes with a statistically significant difference between the experimental arm and the control arm in terms of their primary outcomes except one. Given the sample size and the risk of bias in each of the included trials, the effect size has to be understood and interpreted with utmost caution. Conclusion: Overall, this review establishes the paucity of evidence for occupational therapy for PWD in India. Building the capacity for rigorous and relevant scientific research in occupational therapy would enable bridging the gaps in evidence for occupational therapy in India.

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