OBJECTIVE. Relatively few men are occupational therapy practitioners in the United States. Little research has examined issues germane to men working in the profession. The objective of this study was to investigate perceptions, issues, and factors surrounding male occupational therapy practitioners. METHOD. A survey link was emailed to 9,467 licensed occupational therapy practitioners in Ohio; 699 participants responded, yielding a response rate of 7.66%. RESULTS. Male and female participants provided both similar and significantly different responses to the survey questions. Differences generally involved responses to questions on personal finances and client education. Themes were identified from the open-ended questions regarding gender stereotypes. CONCLUSION. Although male and female practitioners differed in opinion on several issues and perceptions related to the profession, in general they were happy with their career choice. Specifically, participants expressed that they enjoyed their job, contributed to society, and had a sense of job security, regardless of gender.

Date Presented 4/16/2015 Back injury in health care workers is common. Little evidence suggests a biomarker for this type of injury. In this study, we look for correlations between trunk performance and back injury in employees at a Midwestern teaching hospital using the Turning Point 4.0 Rotational Spine System^TM.

Date Presented 4/17/2015 This study investigates the forces required when transferring a patient using different caregiver physical heights and body mass indexes (BMI) combined with different patient heights and BMIs. Results may lead to better clinical reasoning when handling patients.

We examined the effect that long-handled shoehorn (LHSH) length and body mass index (BMI) have on hip range of motion (ROM) in female adults. Thirty-eight female participants were asked to don a shoe using 18-, 24-, and 30-in. LHSHs. Significant differences in hip flexion were found between the 18- and the 24-in. shoehorns and between the 18- and the 30-in. shoehorns. A significant positive relationship was found between BMI and internal rotation for each of the LHSHs. The results suggest that healthy women with low BMIs using a 24- or 30-in. LHSH have the greatest chance of not violating hip flexion or hip internal rotation ROM precautions. Implications suggest that therapists consider individual BMI and available hip ROM before prescribing an LHSH. A follow-up study is needed involving populations who would likely benefit from using LHSHs.

OBJECTIVE. We investigated motor control and muscle activation when reaching for and grasping objects with a reacher compared with the unaided hand. METHOD. In a repeated-measures counterbalanced design, 41 healthy participants with no previous experience using a reacher were randomly assigned to a sequence of four conditions. Movements of the wrist and fingers were recorded using a three-dimensional Qualisys camera system for assessing reach and grasp. Muscle activations from finger and arm flexors and extensors were recorded by surface electromyography. RESULTS. Participants exhibited a smaller grasp aperture, longer reaching time, and more muscle activity when they used a reacher. CONCLUSION. Efficient motor control, which requires both time and practice, is needed to successfully use a reacher. Clients presented with reachers without sufficient time to develop motor skills unique to reacher use may be more likely to abandon this assistive device and fail to benefit from its function.

OBJECTIVE. To investigate whether the performance of a multisegment motor task is influenced by reading a segment-specific action word. METHOD. Twenty-four participants performed tasks that involved reaching for a bottle, grasping it, lifting and placing it on a shelf, and returning their hand to the starting position. At the initiation of each task, participants read either aloud or silently five randomly provided, task-related words (reach, grasp, lift, place, and return). RESULTS. Reading task-related words significantly affected the reach and lift/place segments in the direction of the hypothesis (p < 0.05) but not the return segments. Grasp times were shorter and grasp velocities were higher when participants read aloud or silently the words grasp and place for the grasp segment (p < 0.05). CONCLUSION. The results suggest that in young adults, motor performance may be influenced by precuing or priming the brain with performance-related words. A meaning of a motor performance can be manipulated by contextually relevant language, which can facilitate performance.

OBJECTIVE. A common practice in occupational therapy is to have clients choose an object that they prefer to be used during treatment. This practice assumes that a preference for chosen items will hold greater meaning and result in higher quality of movement. Little research has been conducted that specifically addresses the effect that preference has on quality of movement. Therefore, the purpose of this study was to contribute to the knowledge by determining whether preference affects quality of movement. METHOD. Forty-three healthy right-hand-dominant adult women between the ages of 18 and 60 years in Northwest Ohio engaged in this study. Each participant rank-ordered 15 magazines from most preferred to least preferred. The participant then reached for her most preferred, neutrally preferred, and least preferred magazines. RESULTS. When participants reached for the neutrally preferred magazines, movement time was significantly slower and movement units were significantly greater (less smooth) than when they reached for a magazine perceived as being the least preferred (p < .017). No differences were found between the three conditions in terms of displacement, peak velocity, or percentage of time to peak velocity, nor between the most preferred and the other two preferences. CONCLUSION. This study has shown that preference may not be an influential factor when performing simple reaches for magazines. Although there was a difference between the neutrally preferred and least preferred conditions, the goal when reaching during the neutrally preferred condition may have been different (i.e., to glean more information from the magazine cover) than when reaching in the least preferred condition (e.g., to reach for and discard the magazine as quickly as possible). These results reflect the complexity involved in the formation of meaning, of which preference is a part. Further exploration of individual preferences as well as personal goal formation and their impact on success in occupations of daily living is needed.

OBJECTIVE. Developing useful movement with the affected extremity in persons with cerebrovascular accidents (CVAs) is a common occupational therapy goal. The purpose of this study was to examine the effects of perceived risk in an occupational form on upper-extremity movement dynamics in persons who have had CVAs. METHOD. Twenty-eight persons (M = 69.6 years, SD = 15.6 years) with post-CVA participated in the randomly assigned, repeated measures counterbalanced study. In the higher risk condition, participants reached for and grasped a raw egg in an egg carton, transported it, and placed it in a bowl with other raw eggs. The same procedure was completed in the lower risk condition with weight-matched plastic eggs. Participants completed both conditions with their affected and unaffected upper extremities. Dependent variables included total movement time and movement units. RESULTS. The higher risk condition produced statistically significantly longer movement times (p ≤ .001), but no difference in movement units (p > .05) compared to the lower risk condition. The affected extremity had significantly longer overall movement times (p ≤ .001), but no difference in movement units (p > .05) compared to the unaffected extremity. CONCLUSION. When higher levels of perceived risk are present in an occupational form, slower movements are elicited among persons who have had a CVA. The occupational therapist can grade tasks from relatively lower risk to tasks with relatively higher risk to help patients achieve desired variability in their movement patterns. By doing this, the patient will be better prepared for everyday situations that vary widely in degree of risk.

OBJECTIVE. Occupational therapists are routinely involved in upper-extremity rehabilitation in persons with stroke. Recently we have reported that self-speech can be used to facilitate simple reach in young and older adults. The purpose of this study is to examine whether self-speech-induced facilitation of simple reach can be translated in persons with stroke. METHOD. Following a counterbalanced repeated-measure design, seven persons with right brain stroke performed reaching and placing a glass on a cabinet shelf under four concurrent speech conditions of vocalizing the word “yeah” with both hemiplegic and nonhemiplegic sides. These four conditions are self-vocalization, external vocalization, imaginary vocalization, and no vocalization. Consistent with our previous study, in this study we also recorded the movement kinematics of angular movement of the upper arm. RESULTS. Reaching velocity was significantly higher under self-vocalization conditions compared to the reaching velocity under no vocalization or other vocalization conditions (p < .05). Motor performance in terms of velocity, nonhemiparetic side was significantly better than hemiparetic side (p < .05). CONCLUSION. The results suggest that self-speech can be used in facilitating movements in patients with stroke. When working with patients with right hemispheric stroke, therapists might explore possibilities of using patient’s self-speech to enhance the quality of movement performance.

OBJECTIVE. The purpose of this study was to investigate upper-extremity kinematics and range of shoulder motion while wearing a wrist extension orthosis compared to the free hand at initial testing and after a week’s wear. METHOD. A convenience sample of healthy women, ages 20–50 years, performed a stacking task and a pouring task, freehanded and splinted, at two times, 1 week apart in this counterbalanced, repeated measures design. A Motion Analysis 3-D system measured quality of movement and range of motion variables. A 2 by 2 analysis of variance (splinted vs. freehanded by time of testing) was used to analyze each variable. RESULTS. In both tasks, participants tended to move more slowly (p = 0.005) with less direct movements (p < .001) when wearing the orthosis. In stacking, splinted movements were also less smooth than when freehanded (p < .0001). When splinted both tasks required more shoulder abduction (p < .0001) and pouring required more shoulder flexion (p < .0001). Participants demonstrated several improvements in quality of movement and amount of shoulder motion used after a weeks’ orthotic wear, indicating some adaptation to the orthosis with use. CONCLUSION. In this study, a wrist extension orthosis interfered with the quality of upper-extremity movement and required more range of shoulder movement compared to the free hand. Future research is needed to determine whether persons with upper-extremity conditions (i.e., arthritis, carpal tunnel syndrome) respond similarly to wrist orthoses. Therapists should consider discussing with patients how their wrist splint could affect their hand performance and help patients learn techniques to reduce stress on their proximal joints.

OBJECTIVE. This study investigated the effects of qualitative and quantitative knowledge of results (KR) on the acquisition of a motor skill. It was hypothesized that there would be differences in performance during skill acquisition and retention, depending on the type of feedback given. Qualitative KR was in the form of verbal encouragement and quantitative KR was in the form of an algebraic number representing an error score. METHODS. Seventy-seven adults were randomly assigned to one of four feedback conditions, Quantitative, Qualitative, Quantitative and Qualitative, and no feedback (Control). Participants learned an isometric force production skill. Data were collected during skill acquisition and retention phases. Computer hardware and custom software were used to collect data and administer the feedback conditions of the independent variable. RESULTS. There was a statistically significant difference in the Acquisition Phase for the main effect of Condition F (3,73) = 6.35, p < .05, and for Block F (9,657) = 2.07, p < .05, but there was no statistically significant Condition X Block interaction F (27,657) = 1.02, p > .05. Pair-wise comparisons revealed statistically significant differences between conditions containing qualitative feedback and conditions containing no qualitative feedback (p < .05). The main effect of condition was significant F (3,73) = 3.00, p < .05 in the retention phase, however there were no significant pair-wise comparisons (p > .05). CONCLUSION. The results of this study suggest that in a healthy adult population, qualitative feedback, by itself and when combined with quantitative feedback, resulted in superior skill acquisition, but not in the retention of that skill. The artificiality of the task along with differing modes of feedback (audible versus visual) are two potentially limiting factors to this study. Future research that controls for these factors may yield more definitive findings about the role that qualitative feedback has in improving motor performance and learning.

OBJECTIVE. This study extended previous work of Rice, Leonard, and Carter [AJOT, 52(8), 621–626] and examined the relationship between grip and pinch strengths and the forces produced while accessing common household containers in healthy, elderly persons. METHOD. Forty-two women and 9 men 60 years of age and older were assigned randomly to one of four order groups in a counterbalanced, repeated-measures design. Grip strength was measured via a dynamometer and pinch strength via a pinch meter. The forces required to access six common household containers were measured with force sensing resistors applied to each container. Data analysis included Pearson product-moment correlations between the dependent variables of grip and pinch strength and force produced on the containers. Analyses of variance were used to determine differences by gender on the dependent measures and order of presentation of containers. RESULTS. A fair relationship (r = .31 to .44) was found between grip and pinch strength and the ability to open three containers. Little or no relationship was found between grip and pinch strength and the ability to open the remaining three containers (r = −.03 to .25). Significant gender differences existed on overall strength and the force used to access two of the six containers. No order effects were found. CONCLUSIONS. Strong relationships did not exist between the grip and pinch strength and the amount of force the elderly participants used to open the containers, which is similar to what Rice et al. found for younger persons. The participants appeared to use a greater proportion of their available strength when accessing the containers than did their younger counterparts previously studied. Further research is needed to determine at what level of weakness one would expect to see performance deficits in common daily occupations.

Objective. The purpose of this study was to investigate whether practicing a complex self-care occupation in a contextually relevant environment would enhance the learning and transfer of skill. Method. The design consisted of an acquisition phase, a rest period, and a transfer phase. Fifty-six women were recruited for this study and randomly assigned to one of three groups: (a) a contextually relevant (CR) group that practiced tying a necktie knot onto a mannequin, (b) a non-contextually relevant (NCR) group that practiced tying the same type of knot with a rope onto a wooden pole, and (c) a control group that did not practice at all during the acquisition phase. Participants in all three groups tied a necktie onto themselves during the transfer phase. Dependent variables were movement time, movement units, and the quality of the necktie knot. Results. No difference in the rate of performance change was found during the acquisition phase between the CR and NCR groups. The difference among the CR, NCR, and control groups’ initial transfer phase performance was near significance for movement time and movement units. A significant difference in the rate of performance change was found among the three groups in movement time and movement units during the transfer phase but not in the quality of necktie knot measures. Conclusion. The degree of similarity during the acquisition of a dressing skill may influence the rate of performance improvement in a similar dressing skill during a transfer phase. Until further research has been established, generalization of these results to special populations should be done conservatively.

Objective. Cross-transfer effects were investigated during an occupationally embedded task that involved learning a fine motor skill. Cross-transfer is a phenomenon that occurs when an untrained limb receives some of the same benefits in performance from unilateral training that the contralateral limb received. It was hypothesized that cross-transfer would occur after a unilateral training regime using an occupationally embedded task. Method. Forty-eight participants (mean age = 24.4 years) volunteered for this repeated-measures study. Participants were randomly assigned to a training or control group and were asked to complete a toy maze with their right and left hands for the pretest and posttest. Whereas participants in the control group did not train, participants in the training group completed a toy maze three times a day for 7 days with their left hands. All participants returned in 1 week to complete the posttest portion of the experiment. Dependent variables included movement time, movement units, force oscillations, and average force. Results. Significant decreases in movement time and force oscillations were found for the untrained limbs (p < .0125) in the training group. No significant differences were found in movement units or average force. The improved movement time and force oscillations in the untrained limb provides evidence suggesting that cross-transfer occurred. Conclusion. This study indicates that with a population without impairments, cross-transfer can occur during an occupationally embedded task. This phenomenon may prove useful to the field of occupational therapy to rehabilitate immobilized extremities. Further research is needed to test this phenomenon with special populations.

Objective. Occupational therapists are interested in quality of movement under different environmental conditions. It has been shown that during reaching tasks, the physical aspects of the objects to be grasped can influence the quality of movement. This study investigated whether perceived risk (water temperature) affected the quality of movement during a pouring task. Method. In a counterbalanced, repeated measures design, 56 participants (M =27.1 years, SD =7.4 years) poured hot, then cold water to prepare hot and cold beverages. Dependent variables included movement time, displacement, peak velocity, percentage of movement time to peak velocity, and movement units. Data were analyzed with paired t tests. Results. Participant performance in displacement and movement time was significantly different when considering the entire pouring task for both the hot and the cold conditions (ps < .05). In addition, significant differences were found in the discrete movement “sub-portions” of the pouring task (ps < .05). Conclusion. Perceived risk is an element of meaning that the occupational therapist can consider in providing the person with just enough challenge to facilitate successful performance. By varying the amount of perceived risk in the occupational form, the therapist can help the person experience and develop the range of movement strategies required by everyday occupations. Future research is needed to corroborate these findings in simple and more complex occupations as well as to examine perceived risk in special populations.

Objective. A commonly adhered to operating principle in occupational therapy clinics is that a person must exhibit 20 lb of grip strength before his or her hand is considered “functional” This study examined the relationship between hand and finger grip performances with the forces required to open common household containers. Method. The grip and pinch strengths of 49 college students were obtained using dynamometry. The forces required to open six common household containers were measured using Force Sensing Resistors^® attached to each container. Results. Weak correlations were found (r = −.179 to r = .333) between grip and pinch strength performances and the forces used to operate the accessing mechanisms of the containers. Analyses of variances demonstrated significantly greater grip and pinch strength performances in men than in women (ps < .05) but no significant difference between the genders in the forces generated to open the containers (ps > .05). Conclusions. In a normal population of college students, the premise that greater hand strength affords greater performance in accessing everyday household containers was not supported. Implications suggest that grip and pinch dynamometry are not conclusive evaluative tools for predicting hand function while opening a select group of containers. The relationship between traditional dynamometry and hand performance during a variety of functional tasks needs to be examined in clinical populations as well.