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   Table of Contents - Current issue
January-March 2022
Volume 54 | Issue 1
Page Nos. 1-35

Online since Friday, March 25, 2022

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The Indian journal of occupational therapy in national and international abstracting and indexing databases and in university grants commission's consortium for academic and research ethics list p. 1
Punita V Solanki, Anil K Srivastava, Lakshmanan Sethuraman
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Culturally competent occupational therapy practice for south asians in the United States of America: A narrative review p. 4
Shivani Bharti Vij, Michelle L Webb
Background: The concept of cultural competence in health care has gained significant attention in the past few decades due to increased diversity in the United States (US) population. However, studies suggested that occupational therapists in the US are not prepared for this cultural shift. Several research articles indicated that practicing clinicians are either not aware of the need for culturally competent practices or need the training to enhance knowledge on cultural competence to cater to people from South Asian backgrounds. Objectives: This study aims to understand cultural beliefs, the perception of health and illness, the meaning of occupations from the viewpoint of the South Asian clients to help explore culturally competent strategies for occupational therapy (OT) professionals in the US to ensure they provide applicable and culturally appropriate services to South Asian clients. Study Design: A narrative review. Methods: Keyword searches of databases such as PubMed and EBSCO, and the American Journal of OT were performed. The literature search identified and reviewed qualitative/quantitative studies (n = 13) and other articles/resources (n = 9) on cultural competency for South Asians in the United States of America from 2009 to 2021 in English language literature. Manual searches of other relevant journals and reference lists of primary articles were also done. Results: Analysis of the results of studies reviewed revealed three main themes, (1) role of critical thinking and self-awareness that promote or inhibit the use of culturally competent interventions, (2) prior experiences of OT practitioners with ethnically diverse communities, (3) cultural considerations such as common belief, family hierarchy, traditional medicines, and the use of educational material or therapy resources in the native language that may improve therapy outcomes for South Asian clients. Conclusion: Empowering cultural competency requires complex skills such as critical thinking, self-awareness, problem-solving, understanding the dynamics of discrimination, and understanding the service delivery systems. The background information on common behaviors, beliefs, and cultural considerations of South Asians will help devise meaningful client-centered interventions that match the social and cultural norms of South Asian clients, which can improve OT practice for this clientele in the US.
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Motor proficiency of children with developmental speech and language disorder and typically developing children aged 4–7 years: A comparative cross-sectional study p. 10
Rupali Prajapati, Pratibha Milind Vaidya
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 (TDC). Objective: The objective of the study was to assess the performance of DSLD children for motor proficiency using the Bruininks-Oseretsky Test of Motor Proficiency Second Edition (BOT-2) and compare it with TDC. Study Design: A comparative, noninterventional, cross-sectional study. Methods: The study included 30 children with DSLD and 30 TDC aged 4–7 years. The study protocol was approved by the Institute Ethical Committee (ECARP/2017/21). A written informed consent form was signed by parents. All composites of BOT-2 were administered on both groups (fine manual control, manual coordination, body coordination, strength and agility). Scores obtained were compared between two groups for total motor composite as well as each subtest. Results: There was a significant difference between the performance of DSLD children and TDC on all the four composites, namely Fine Manual Control, Manual Coordination, Body Coordination, and Strength and Agility of BOT-2. Total motor composite score of DSLD children was significantly different from the scores of TDC at P = 0.000. Conclusion: Motor proficiency is significantly affected in children with DSLD as compared to TDC.
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Effect of the coronavirus disease 2019 pandemic on academics of students pursuing masters of occupational therapy in Maharashtra state: An observational cross sectional study p. 14
Shilpshree Prashant Palsule, Henna Vijaypal Khanna
Background: Masters in occupational therapy (OT) is a 3-year course offered by the Maharashtra University of Health Sciences. Maharashtra was one of the worst affected states by the pandemic in 2020 and thus its impact on academics might show greater ill effects. This study was conducted with an objective to understand the health-care students' perspective of how the coronavirus disease 2019 (COVID-19) pandemic affected their present academic and clinical reasoning skills and what they think about their future career in OT. The literature also suggests that health-care students experienced stress during the COVID-19 pandemic, but hardly any study was conducted on OT students. Hence, this study was conducted to identify the students' perspectives on perceived stress and academics due to the pandemic situation. Objectives: The objective of this study is to understand students' perspective on academics and clinical reasoning skills and future career implications, and their stress levels. To understand how teaching/academics can or has bettered/improved during such time. Study Design: An observational cross-sectional study design was chosen for the research. Methods: The study protocol was approved by the Institutional Ethics Committee. A validated semi-structured questionnaire was circulated through Google Forms to all 56 2nd-and 3rd-year students pursuing Master of OT in Maharashtra. The form consisted of 17 questions. Questions were based on how the pandemic affected their academics and the major academic and clinical concerns that the students faced during this period. Student's written and informed consent was attached to the online questionnaire. In addition to this, students were asked to respond to the Perceived Stress Scale to understand their stress levels. Results: The pandemic had an impact on clinical assignment in all 29 (100%) students. Not having enough opportunity to explore their clinical posting during the pandemic was experienced by all 29 (100%) students. The students found a gap in transforming theory into the clinical assignments. Having additional time for academics was stated by 14 (48.2%) students. Severe stress was perceived by 5 (17.2%) students and moderate stress was perceived by 24 (82.7%) students. Conclusion: The study concluded that all students had an effect on their clinical assignments, which may be due to reduced footfall of patients among the first wave of COVID-19 pandemic. Students claimed to have additional time for academics due to reduced patient load.
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Does the informed consent document in allied health research follow the national guidelines? A retrospective analysis of proposals submitted to an institutional ethics committee of a tertiary care hospital p. 19
Shilpshree Prashant Palsule, Jaimala Vijay Shetye, Manasi Subhash Lad
Background: Informed consent process forms an essential component of the research process. It protects participants' autonomy to decide whether or not to participate in the research freely. It is expected that the informed consent document (ICD) should explain the nature and content of the research to a participant in simple terminology and in the language that the participant understands. The researcher's responsibility is to obtain informed consent from every participant before his/her participation in the research. Objectives: The objective is to evaluate whether the informed consent process documents of research studies submitted for initial review by allied health branches of a tertiary care hospital follow the Indian Council of Medical Research (ICMR) guidelines and whether they relate to the protocol submitted for initial review. Study Design: This was a retrospective study. Methods: After institutional ethics committee (IEC) approval, all research studies submitted by allied health branches to the ethics committee of Seth GS Medical College and KEM Hospital, a tertiary care hospital in Mumbai, from November 1, 2018, to October 31, 2019, were reviewed. Thirty-five protocols were found to meet the inclusion criteria. The ICDs of these studies were evaluated for adherence to the ICMR 2017 guidelines. Ethics committee comments related to the ICDs were noted and analyzed. Results: 34 out of 35 research studies submitted had included all the ten mandatory points of the informed consent process, as per the Biomedical Health Research norms of the ICMR 2017. Seven protocols did not complete the review process and did not receive a letter of permission. IEC queries were mostly related to use of technical language, short forms of medical terms, improper mention of risks and discomforts, and sample size. Conclusion: This study concluded that the ICDs reviewed were complete in terms of sections recommended by the ICMR 2017 guidelines. However, there were certain lapses on the part of both the investigators and IEC, wherein the submitted ICDs did not convey the true nature of the study and the IEC did not correctly point out all these lapses at the time of the review.
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Proprioceptive neuromuscular facilitation exercises versus lumbar stabilization exercises for chronic low back pain patients: A randomized interventional study p. 23
Sunita Koutarapu, Dipti Ghumare
Background: Chronic low back pain causes discomfort and disturbance in the mechanoreceptor and proprioception centers. Exercises improve muscle strength, flexibility, endurance, and ability to perform life activities. Proprioceptive neuromuscular facilitation (PNF) involves stretching, resisted movements which improves muscle disharmony, atrophy, and joint movement limitation. Lumbar stabilization exercises (LSE) develop the awareness of muscle contraction and control from simple to complex patterns. Both exercises are effective individually in chronic low back pain patients. This study was conducted to find out which technique is better. Objectives: The objective of the study is to determine the efficacy of PNF versus LSE program in chronic low back pain patients. Study Design: A Randomized study was conducted. Methods: A prospective, interventional study was conducted on patients with mechanical low back pain of more than 3 months, in both males and females, of age 20–45 years. Patients having systemic illness, central or peripheral neurologic signs, and specific causes of low back pain were excluded. Individuals having systemic illness and psychiatric illness were also excluded from the study. Twenty-two patients were selected and divided into two groups. Patients were assessed on the Visual Analog Scale (VAS), modified Schober's test, Modified Oswestry Low Back Pain Disability Questionnaire (ODI), Roland and Morris Low Back Pain and Disability Questionnaire (RMDQ). Patients in the PNF Group received concentric and eccentric contractions of agonist and antagonist muscles, patterns such as chopping, lifting, bilateral leg, and trunk lateral flexion. LSE Group received core strengthening exercises. Both group received 3 treatment sessions per week for 4 weeks, each session lasting for 45 min. Results: PNF group showed significant improvement in pain on VAS (P = 0.003; 95% confidence interval [CI[, 2.15–3.01), in disability on ODI (P = 0.001, 95% CI, 12.09–20.1), and in lumbar flexibility Modified Schober's test (P = 0.000, 95% CI, 5.15–5.93) On RMDQ, there was no statistically significant difference between PNF and LSE groups (P = 0.061, 95% CI, 6.87–8.97). Conclusion: There was a significant improvement seen in the pain and disability which was assessed on VAS and ODI in the PNF group over LSE. Hence, PNF exercises can be incorporated with LSE in the treatment of LBP.
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Functional independence in left dorsolumbar congenital kyphoscoliosis – An occupational therapy perspective : A case report p. 29
Poornima Raikar, Pratibha M Vaidya, Kshitij S Chaudhary
Congenital scoliosis is caused by early embryologic errors in formation of vertebral column. The goal of treatment is to improve the children's quality of life and to give them the best chance to develop as an independent adult. The objectives were to assess the effects of occupational therapy (OT) intervention on balance, gait, and activities of daily living (ADL) in a case of congenital scoliosis. A 14-year-old young female studying in 10th standard diagnosed as left-sided dorsolumbar congenital kyphoscoliosis with apex of scoliosis at 11th dorsal segment level was assessed. She presented with lower extremity spasticity, imbalance, and scissoring gait. Assessment was done using the Berg Balance Scale (BBS) and Modified Barthel Index (MBI). Immediate postoperative OT intervention was started inclusive of balance and gait training. Significant improvement was observed on BBS score preoperatively before therapy from score 11 to post therapy score 50 after therapy was initiated and MBI score preoperatively 11 to post therapy 20 after ADL training at 8 months of therapy.
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Hoodwinking hope p. 33
Vinita A Acharya
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News and Information p. 34

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