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   Table of Contents - Current issue
October-December 2022
Volume 54 | Issue 4
Page Nos. 135-171

Online since Tuesday, June 6, 2023

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Seventy years of the existence of the All India Occupational Therapists' Association: From the year 1952 to 2022 p. 135
Anil Kumar Srivastava, Punita V Solanki, Lakshmanan Sethuraman, Jyothika Nand Bijlani
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Exploring the potentials through activities and occupation p. 138
Harsh Vardhan
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Innovative occupational therapy methods for supporting students with disabilities during coronavirus disease 2019: A scoping review p. 140
Sarju Moirangthem, Gita Jyoti Ojha
Background: As the world continues facing the coronavirus disease 2019 (COVID-19), life has been challenging. Throughout the world, the most commonly practiced method of prevention from COVID-19 infection has been isolation and social distancing. Since January 2020, most of the countries started implementing lockdowns locally or nationwide as a containment measure. Consequently, there has been a closure of schools. Although there exist several studies on how challenges are being met in mainstream education during COVID-19, little focus has been toward students with disabilities who need supportive services like occupational therapy to aid in their learning. It is imperative to look at the gaps and the methods in which occupational therapists can provide creative and innovative solutions to aid students with disabilities. Hence, this scoping review was undertaken for the innovative occupational therapy methods for supporting those students with disabilities during COVID-19. Objectives: The objectives of this study were to identify barriers in the context of learning for students with disabilities in COVID-19 and to identify innovative methods in occupational therapy to aid learning for students with disabilities. Study Design: This was a scoping review. Methods: The methodological framework for scoping reviews by Arksey and O'Malley was used in reporting findings. The overarching question: “What are the innovative occupational therapy strategies used to support students with disabilities during COVID-19” was addressed. Using the search terms related to “occupational therapy,” “students with disabilities/special needs” and COVID-19” for the duration of December 2019 to August 2021 in various databases such as PubMed, Google Scholar, Web of Science, and Cochrane Library were searched. Only those studies pertaining to learning outcomes within school occupational therapy were included. The data collected were charted. Finally, it was collated and summarized and the results were reported. Results: As per the guidelines of the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews, 1188 studies related to the topic were found. After using filters such as full text, English language, and gray literature, 115 studies were identified. Finally, after full-text screening and selecting studies pertaining to learning outcomes within school OT, 5 studies were identified for synthesis. Conclusion: There are a number of studies which prove that telehealth OT in health-related context is successful. In this study, it has been found that telehealth is also emerging as a crucial method of service delivery in occupational therapy for students with disabilities in the learning context.
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Current occupational therapy and physiotherapy services for children with cerebral palsy in India: A survey on focus and gaps p. 147
Sujata Missal, KM Bidhya
Background: Cerebral palsy (CP) is a common cause of chronic childhood disability and constitutes a substantial portion of paediatric occupational therapy (OT) and physical therapy (PT) practices. An analysis of current rehabilitation practices is necessary to use more recent, evidence-based, and effective treatment modalities. This study intends to explore the current rehabilitation trends in assessing and planning interventions for children with CP in India and finding the focus and gaps in treatment. Objectives: To describe the focus of therapy practices in OT and PT for children with CP and better understand whether it is congruent with recommended practices. Study Design: A cross-sectional survey. Methods: An India-wide web-based survey on “Rehabilitation services for children with CP: A survey of what we do and how we individualize treatment for different children” (self-designed questionnaire) was completed by 50 occupational and 12 physical therapists to identify assessments and treatment interventions based on their clinical practice. Data were coded using the International Classification of Functioning, Disability, and Health (ICF) definitions for “body functions and structure,” “activity and participation,” and “environment.” Descriptive and quantitative statistics were used to identify the focus and gaps. Results: Both professions focused primarily on body structure and function assessment (OT: 28 [56%] and PT: 8 [66.7%]) when assessing and intervening. “Activity and participation” related assessment was focussed more by physiotherapists 4 (33.3%) than occupational therapists 15 (30%). Majority 44 (71.09%) of the therapists chose interventions that came under the ICF category: Activity and participation. While the percentage of therapists focussing on body structure and function and contextual factors interventions were 28 (45.02%) and 32 (52.27%), respectively. Attention, however, was mainly directed toward task-oriented activities such as activities of daily living and mobility 49 (79%). Participation in leisure or community-based activities received comparatively least attention 35 (56.5%). The environment received limited attention for assessments, although it was an important focus of intervention (environment modifications: 47 [75.8%]).OTs focused more on sensory components (U = 173.000, P = 0.019, 95% confidence interval [CI]: 0.017 to 0.022, mdn = 1.00) and, PTs focused more on gait (U = 192.000, P = 0.046, 95% CI: 0.0.039 to 0.047, mdn = 2.00) and trunk impairment (U = 129.000, P = 0.001, 95% CI: 0.0.000 to 0.001, mdn = 1.00). Conclusion: While body functions and structure are well-addressed, other ICF elements, specifically participation, are poorly integrated into practice. The emerging focus on the environment in therapy intervention, by modifying the context rather than changing aspects of the child, is consistent with current approaches and evidence. Knowledge translation implementation initiatives are recommended to bridge identified gaps.
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Occupational therapy for a child with aplasia cutis congenita with congenital Volkmann's ischemic contracture: A case report p. 161
Poornima Raikar, Pratibha Vaidya, Mangesh Pawar
Aplasia cutis congenita is a rare malformation characterized by focal or extensive absence of epidermis, dermis, and occasionally subcutaneous tissue. Congenital Volkmann's ischemic contracture is a rare neonatal compartment syndrome caused by intrauterine ischemia and external compression. This is a challenging case for an occupational therapist (OT) focusing on the improvement of hand deformities and function in a child. The objective was to assess the effectiveness of occupational therapy intervention in correcting contracture and improving hand movement. A 4-day-old male child from the neonatal intensive care unit, presented with absence of skin over the right forearm with contracture of right hand, ulnar deviation, and skin discoloration over right hand. Patient was assessed for movement, strength, and level of contracture. Treatment was focused on correcting contracture, improving hand movements, and maintaining skin integrity with the help of splinting and therapeutic exercises. A significant improvement was seen in finger ranges, wrist ranges, hand movements, and skin color. To conclude, splinting techniques helped to stretch out contracture and correct the position of the hand and improvement in hand function.
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Dyspnea management in chronic obstructive pulmonary disease using occupation-based interventions: A case report p. 165
Shivani Bharti Vij
Demand for occupational therapy (OT) practitioners is increasing to help the growing population of adults with chronic conditions. Dyspnea, the feeling of shortness of breath or difficulty breathing, is the primary reason patients with chronic obstructive pulmonary disease (COPD) seek medical services. The case report focused on occupation-based OT interventions for an 84-year-old female suffering from COPD for the past 20 years. She was a homemaker, and her main symptoms were dyspnea and weakness that affected her sleep, leisure, and self-care task participation. The patient had consulted for ten OT sessions, including the follow-up. The interventions used were participation in leisure occupation, dyspnea management using controlled breathing and energy conservation techniques, aerobic training to promote overall well-being and activity tolerance, and sleep management. Significant improvement at discharge was noted in all areas mentioned above, evident from scores improvement in all four standardized tests, 15% improvement in Modified Barthel Index Shah Version, 14% improvement in Geriatric Depression Scale, 29% improvement in Pittsburgh Sleep Quality Index, and 40% improvement in Borg Rating for Perceived Exertion Scale.
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Caste and occupation: A perspective p. 169
Raviraj Shetty, Aditi Brahmabhatt, Shoba Nayar
Access to, and participation in, occupation is necessary for human health and well-being. However, humans exist in a socio-political-cultural context, which has the potential to systemically and structurally impede occupational engagement. Within the Indian milieu, caste is one dimension of the socio-political context impacting people's occupational participation, depriving them of the choice for agency in their occupation. We begin with a brief history of the caste system in India, before considering the effects of caste on everyday occupation within the domains of education, media, and manual scavenging. Drawing on these examples, it is argued that caste creates a context that perpetuates occupational injustice. Taking learnings from the anti-racism movement, suggestions are offered for how occupational therapists and researchers might bear witness to and respond to caste in their work, both with clients and in their own lives.
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