Use of occupations and activities in a modified constraint-induced movement therapy program: a musician's triumphs over chronic hemiparesis from stroke.

OBJECTIVE: This case report addresses the use of therapeutic occupations and activities within a modified constraint-induced movement therapy (mCIMT) approach for a 52-yr-old female violinist 4 yr after ischemic stroke. METHOD: Analysis of occupational performance was completed before and after intervention using a modified version of the Fugl-Meyer Sensorimotor Evaluation, the Motor Functioning Assessment, the Arm Improvement and Movement Checklist, and information obtained from a client journal maintained throughout treatment. The mCIMT protocol included use of constraint of the affected arm, with emphasis placed on participation in meaningful occupations and activities. RESULTS: Improved function in the affected extremity was noted at the conclusion of mCIMT. After completion of therapy, the client reported a return to playing violin. DISCUSSION: The findings from this case report suggest that use of meaningful occupations and activities integrated into a mCIMT protocol may be effective in addressing skills deficits for clients with upper-extremity chronic hemiparesis.

Healthy lifestyles through an Adaptive Living Program: a pilot study.

This study examined the effects of an Adaptive Living Program (ALP) on quality of life and life satisfaction of 19 low-income adults living in a city-subsidized apartment complex in Michigan. The ALP included 12 modules and three community outings over a 12-week period, two times a week, with each session lasting 1.5 hours. Occupational therapy students conducted the groups under faculty supervision. The RAND SF-36 and a non-standardized tool were used to collect data. Results obtained from the participants' RAND SF-36 pre-test and post-test scores demonstrated no significant difference in the physical, social and emotional health variables. Qualitative information gathered in a 60-minute semi-structured focus group held on the final day of the programme indicated that participants reported that they had increased their quality of life and life satisfaction through developing better social skills, increased knowledge of nutrition and improved interpersonal skills. Methodological limitations included a small sample, limited ethnic population, occasional absences during the group sessions, abbreviated length of programme and application of a non-standardized assessment. Recommendations include a larger sample size of diverse ethnic population with varying ages, an established cut-off date for new evaluations, a lengthened programme, a standardized qualitative questionnaire and alternative quantitative assessment.

The use of occupation-based treatment with a person who has shoulder adhesive capsulitis: a case report.

This article describes a case report of the occupational therapy management of a 53-year-old woman diagnosed with primary shoulder adhesive capsulitis. The occupation-based interventions are described through the framework of occupation-as-means. Compensatory occupation, preparatory methods, and purposeful activities are demonstrated as being critical to minimizing connective tissue deformation associated with this condition. This case report indicates that occupation-based intervention should be initiated as soon as a diagnosis is identified to prevent the downward spiral of forced disuse associated with the affected upper extremity. As illustrated by the case report, occupation-based treatment that was provided in a timely manner immediately decreased pain, improved range and quality of motion, and enhanced occupational performance.