Delivery of rehabilitation services: Opportunities and threats during a global pandemic

BACKGROUND@#This presentation articulated a personal perspective of an Occupational Therapy (OT) practitioner regarding the changes already happening within the field of rehabilitation before the COVID-19 pandemic and its cataclysmic role that accelerated changes in the delivery of rehabilitation services, specifically in advancing the application technologies and innovative practices in the clinics, renewed focus on strengthening and supporting OT and rehabilitation professionals’ health and well-being, and use of transformational instructions to prepare students for future healthcare challenges. Included in this presentation is the global response to ensure the delivery of rehabilitation services, the exemplar of local innovations and resilience among Filipino OT and the rehabilitation community, emerging opportunities and threats brought about by the pandemic, and the lessons and innovations we bring forward as part of the new normal post-COVID-19 pandemic, and beyond.

Psychosocial experiences of selected pediatric occupational therapists in the Philippines on the shift to Telehealth Practice during the COVID-19 pandemic

BACKGROUND@#At the beginning of the COVID-19 pandemic, healthcare professionals including pediatric occupational therapists (OTs) mandatorily had to shift to the practice of telehealth in the absence of a safe in- person setup caused by the outbreak.@*OBJECTIVE@#This study aims to determine the psychosocial experiences encountered by selected pediatric OTs in the Philippines brought by the shift to telehealth practice during the COVID-19 pandemic@*METHODOLOGY@#Purposive sampling was used in the study to gather six (6) licensed pediatric OTs who provide occupational therapy (OT) services via telehealth in the Philippines, and the respondents were not personally connected to any of the researchers. A semi-structured one-on-one interview with the participants through a Zoom call was conducted to obtain their psychosocial experiences. A thematic analysis was used and four (4) themes emerged by the end of the study: consequences of the shift to telehealth practice, changes during telehealth provision, increased resilience, and increased psychological strain.@*CONCLUSION@#In conclusion, the transition to provision of telehealth services to pediatric clients has challenged the practices of the selected pediatric OTs in terms of preparing for the session, where one of the main prevalent concerns was toward collaboration and communication with the caregivers; conducting of telehealth sessions, where communication interruption was one of the main concerns; and in ethical considerations, where OTs made it a point that they rectified ethical dilemmas amidst telehealth provision. These experienced challenges also included increased workload and psychological distress, while improved occupational balance and adaptability were most commonly experienced by OTs

An integrative review of assessments used in occupational therapy interventions for children with cerebral palsy / Revisão integrativa de avaliações utilizadas em intervenções de terapia ocupacional para crianças com paralisia cerebral

Abstract Introduction: Children with cerebral palsy (CP) experience a wide range of deficits and symptoms. When undergoing occupational therapy (OT) interventions, it is essential that the OT select assessments that can accurately reflect the outcome measures of the targeted domains. Objective: To identify the assessment tools most frequently reported in research studies as measures for OT interventions when treating children with CP. Method: Pubmed and Ovid databases were systematically searched by using key terms "cerebral palsy," "assessments," and "occupational therapy". Assessment tools were explored and extracted from articles contingent on the following inclusion criteria: (1) children birth to 18 years diagnosed with cerebral palsy; (2) use of assessment(s) as a measure of OT intervention; (3) published in English between 2007 and 2017. In the preliminary search, Pubmed yielded 151 records and Ovid yielded 571. Out of these, only 76 met the inclusion criteria. From the remaining 76 articles, a total of 88 assessment tools were retrieved and included in this literature review. Results: Ten assessments were found to be of importance based on frequency of use. The Assisting Hand Assessment (AHA) and Pediatric Evaluation of Disability Inventory (PEDI) were the most commonly used. Conclusion: This study helps to determine which assessments are frequently used in OT practice with children with CP. The findings of this study play an important role in addressing the challenge of assessment selection faced by occupational therapists and provide a basis for future research to expand on with regards to treating children with CP.

Resumo Introdução: Crianças com Paralisia Cerebral (PC) apresentam uma ampla gama de déficits e sintomas. Quando submetidos a intervenções de terapia ocupacional (OT), é essencial que as avaliações utilizadas reflitam com precisão as medidas de resultados dos domínios visados. Objetivo: Identificar os instrumentos de avaliação mais utilizados como medidas para intervenções no TO no tratamento de crianças com PC. Método: Bancos de dados Pubmed e Ovid foram sistematicamente pesquisados ​​usando os termos-chave "paralisia cerebral", "avaliações" e "terapia ocupacional". Avaliaçoes foram exploradas e extraídas de artigos contingentes aos seguintes critérios de inclusão: (1) crianças de até 18 anos com diagnóstico de paralisia cerebral; (2) uso da(s) avaliação (ões) como medida de intervenção do TO; (3) publicado em inglês entre 2007 e 2017. Na pesquisa preliminar, foram encontrados 151 artigos em Pubmed e 571 em Ovid. Destes, apenas 76 foram inlcuidos devido aos critérios de inclusão. Dos 76 artigos restantes, um total de 89 avaliaçoes foram encontradas e incluídas nesta revisão da literatura. Resultados: Dez avaliações foram consideradas importantes com base na frequência de uso. A "Assisting Hand Assessment" (AHA) e o Inventário de Avaliação Pediátrica de Incapacidade (PEDI) foram os mais utilizados. Conclusão: Os achados deste estudo desempenham um papel importante no e do desafio de seleção de avaliação enfrentado pelos terapeutas ocupacionais e fornecem uma base para futuras pesquisas para expandir no que diz respeito ao tratamento de crianças com PC.

Vocational Status of Occupational Therapists in Five Countries / 中国康复理论与实践

After retrieving the databases, as well as the official websites of institutes and administrations of occupational therapists, the qualifications, working conditions and career development in different countries, such as the United States, Canada, Australia, New Zealand and England, were collected and analyzed, which may provide reference frame for the development of the profession in China.

Spinal manipulation therapy: Is it all about the brain? A current review of the neurophysiological effects of manipulation / 中西医结合学报

Spinal manipulation has been an effective intervention for the management of various musculoskeletal disorders. However, the mechanisms underlying the pain modulatory effects of spinal manipulation remain elusive. Although both biomechanical and neurophysiological phenomena have been thought to play a role in the observed clinical effects of spinal manipulation, a growing number of recent studies have indicated peripheral, spinal and supraspinal mechanisms of manipulation and suggested that the improved clinical outcomes are largely of neurophysiological origin. In this article, we reviewed the relevance of various neurophysiological theories with respect to the findings of mechanistic studies that demonstrated neural responses following spinal manipulation. This article also discussed whether these neural responses are associated with the possible neurophysiological mechanisms of spinal manipulation. The body of literature reviewed herein suggested some clear neurophysiological changes following spinal manipulation, which include neural plastic changes, alteration in motor neuron excitability, increase in cortical drive and many more. However, the clinical relevance of these changes in relation to the mechanisms that underlie the effectiveness of spinal manipulation is still unclear. In addition, there were some major methodological flaws in many of the reviewed studies. Future mechanistic studies should have an appropriate study design and methodology and should plan for a long-term follow-up in order to determine the clinical significance of the neural responses evoked following spinal manipulation.

Identidad profesional en Terapia Ocupacional: una revisión bibliográfica desde España / Professional identity in Occupational Therapy: a bibliographical review from Spain / Identidade profissional na Terapia Profissional: uma revisão bibliográfica desde Espanha

Contexto: La identidad profesional en Terapia Ocupacional (TO) ha atravesado por diversos procesos de construcción y reconstrucción a lo largo de su historia. En el camino, se han registrado una serie de discusiones al respecto y aún el debate se encuentra abierto. Objetivo: Identificar el estado actual de las discusiones sobre la identidad profesional en la TO, a nivel internacional y en España. Metodología: se realiza una revisión bibliográfica narrativa en diferentes bases de datos y otras fuentes de publicación de la profesión. Resultados y análisis: Tras la obtención del material bibliográfico (24 artículos), se agruparon los documentos por temas, identificándose las siguientes categorías: (a) contribuciones de la identidad profesional a la disciplina (10 artículos); (b) conceptualizaciones de la identidad profesional en TO (11 artículos); (c) identidad profesional en España (4 artículos). Conclusiones: se pone de manifiesto la importancia de fomentar la adquisición y construcción de una identidad profesional durante el periodo de formación universitaria. Se hace necesaria la realización de investigaciones que permitan comprender mejor cómo se construye la identidad profesional en diferentes contextos y la influencia de la formación universitaria en este proceso.

Context: Professional identity in Occupational Therapy (OT) has undergone various construction and reconstruction processes throughout its history. Along the way, there have been a number of discussions on the subject and the debate is still open. Objective: To identify the current state of discussions on professional identity in OT, at an international and Spanish level. Methodology: a narrative revision is done in different databases and other publication sources of the profession. Results and analysis: After obtaining the bibliographic material, the documents were grouped by topic, identifying the following categories: (a) contributions of the professional identity to the discipline; (b) conceptualizations of professional identity in OT; (c) professional identity in Spain. Conclusions: the importance of promoting the acquisition and construction of a professional identity during the period of university education is highlighted. It is necessary to carry out research to better understand how professional identity is constructed in different contexts and the influence of university education in this process.

Contexto: A identidade profissional em Terapia Ocupacional (TO) passou por vários processos de construção e reconstrução ao longo de sua história. Ao longo do caminho, houve várias discussões sobre o assunto e o debate ainda está aberto. Objetivo: Identificar o estado atual das discussões sobre identidade profissional em OT, no nível internacional e espanhol. Metodologia: uma revisão narrativa é feita em diferentes bancos de dados e outras fontes de publicação da profissão. Resultados e análise: após a obtenção do material bibliográfico, os documentos foram agrupados por tópico, identificando as seguintes categorias: (a) contribuições da identidade profissional para a disciplina; (b) conceituais de identidade profissional em TO; (c) identidade profissional na Espanha. Conclusões: a importância de promover a aquisição e construção de uma identidade profissional durante o período de ensino universitário é destacada. É necessário realizar pesquisas para entender melhor como a identidade profissional é construída em diferentes contextos e a influência da educação universitária neste processo.

Occupational hand injuries: a current review of the prevalence and proposed prevention strategies for physical therapists and similar healthcare professionals / 中西医结合学报

Hand injury is the second most common work-related musculoskeletal injury among physical therapists (PTs) and other manual therapy professionals such as osteopaths, physiotherapists, chiropractors, acupuncturists and massage therapists. However, the nature and extent of this problem have not been fully explored yet. Therefore, the objective of this study was to review the existing literature published on the prevalence, risk factors, consequences, and prevention of hand injuries among PTs and similar healthcare professionals. The lifetime prevalence of hand injuries was about 15%-46%, and the annual prevalence was reported as 5%-30%. Thumb injuries were found to be the most prevalent of all injuries, accounting more than 50% of all hand-related problems. The most significant risk factors for job-related hand injuries were performing manual therapy techniques, repetitive workloads, treating many patients per day, continued work while injured or hurt, weakness of the thumb muscles, thumb hypermobility, and instability at the thumb joints. PTs reported modifying treatment technique, taking time off on sick leave, seeking intervention, shifting the specialty area, and decreasing patient contact hours as the major consequences of these injuries. The authors recommend that PTs should develop specific preventive strategies and put more emphasis on the use of aids and equipment to reduce the risk of an unnecessary injury.

Terapeutas ocupacionales: influencia del género en su desempeño laboral / Occupational therapies: gender influence in their work performance

Esta investigación se fundamenta desde una perspectiva y enfoque de género. Su objetivo fue analizar la influencia del género en el desempeño laboral de los Terapeutas Ocupacionales en la ciudad de Temuco, basándose en las percepciones y vivencias de dichos profesionales. La metodología utilizada corresponde al enfoque cualitativo, utilizando como sustento teórico la fenomenología. La muestra del estudio fue intencional y estuvo constituida por 10 profesionales, siendo elnúmero de hombres y mujeres iguales en cantidad. Se utilizó la entrevista semiestructurada como instrumento de recolección de datos analizando la información obtenida a través del análisis de contenido y análisis de discurso. Los tópicos abordados consideran la relación entre trabajo y género y hacen referencia a: diferencias salariales, costos laborales, manejo de poder y estatus de minoría. Los resultados obtenidos señalan que existe influencia del género en el desempeño laboral de los Terapeutas Ocupacionales en todas las determinantes analizadas, principalmente en costos laborales y estatus de minoría. Con respecto al impacto en el desempeño existen opiniones divididas, y a que el 80 por ciento de la muestra femenina considera que existe influencia de género en el desempeño laboral, frente al 60 por ciento masculino que no visualiza influencias en su quehacer determinados por la variable de género. Sin embargo, se hace necesario destacar que lo anterior no está determinado por la disciplina, sino que por las construcciones culturales de la sociedad, por lo que debemos ser más críticos con los fenómenos derivados de género, considerando que es una categoría de análisis inherente al ser humano.

This research is based on a gender perspective and approach. Its objective was to analyze the gender’s influence on the performance of Occupational Therapists’s work in the city of Temuco, based on the perceptions and experiences of these professionals. The methodology used corresponds to the qualitative approach, using the phenomenology as theoretical support. The sample of the study was intentional and was constituted by 10 professionals, being the number of men and women equal in quantity. The semi - structured interview was used as an instrument of data collection by analyzing the information obtained through content analysis and discourse analysis. The topics covered consider the relationship between work and gender and refer to: wage differences, labor costs, power management and minority status. The results obtained indicate that there is gender influence in the occupational therapists’ workperformance in all the determinants analyzed, mainly in labor costs and minority status. With regard to the impact on performance, there are divided opinions, since 80 percent of the female sample considers that there is gender influence in the labor performance, compared to the male 60 percent that does not visualize influences in their work determined by the gender variable. However, it is necessary to emphasize that the above is not determined by the discipline, but by the cultural constructions of the society, reason why we must be more critical with the phenomena derived from gender, considering that it is a category of analysis inherent to the human being.