OBJECTIVE. This study established motor function cutoff values for dressing independence in inpatients with stroke. METHODS. Ninety-eight first-time inpatients with stroke were divided into groups on the basis of independence level in dressing, and receiver operating characteristic curves were determined for balance, motor function of affected limbs, trunk function, motor function of unaffected upper limb, and cognitive function. RESULTS. Area under the curve for the Berg Balance Scale (BBS) was highest for the different motor functions. In distinguishing independence group and supervision or less level group, the cutoff value for the BBS was 44 points (sensitivity = 85%, specificity = 93%). In distinguishing supervision or higher level group and dependence group, the cutoff value for the BBS was 32 points (sensitivity = 94%, specificity = 79%). CONCLUSION. Balance was strongly correlated with the level of dressing independence, and cutoff values for the BBS were indicators of the balance required to reach independent and supervision levels of dressing.

After traumatic brain injury (TBI), many people experience significant motor function impairments. To help occupational therapy practitioners make informed decisions in choosing treatment strategies to improve clients’ motor function, we undertook a systematic review and synthesized applicable findings of intervention studies. Of 2,306 articles identified in the literature search, we reviewed 47 full-text articles, of which 16 met approved criteria. We found moderate evidence that various exercise programs increase motor function and limited evidence that people with TBI can benefit from rehabilitation and computer-based programs. We offer implications for practice, education, and research.

OBJECTIVE. We evaluated the effects of occupation-based intervention on poststroke upper-extremity (UE) motor recovery, neuroplastic change, and occupational performance in 1 research participant. METHOD. A 55-yr-old man with chronic stroke and moderately impaired UE motor function participated in 15 sessions of occupation-based intervention in a hospital setting designed to simulate a home environment. We tested behavioral motor function (Fugl-Meyer Assessment, Stroke Impact Scale, Canadian Occupational Performance Measure) and neuroplasticity (transcranial magnetic stimulation [TMS]) at baseline and at completion of intervention. We collected descriptive data on occupational participation throughout the study. RESULTS. All behavioral outcomes indicated clinically relevant improvement. TMS revealed bihemispheric corticomotor reorganization. Descriptive data revealed enhanced occupational performance. CONCLUSION. Occupation-based intervention delivered in a hospital-based, homelike environment can lead to poststroke neuroplastic change, increased functional use of the affected UE, and improved occupational performance.

OBJECTIVE. We explored the efficacy of robotic technology in improving handwriting in children with impaired motor skills. METHOD. Eighteen participants had impairments arising from cerebral palsy (CP), autism spectrum disorder (ASD), attention deficit disorder (ADD), attention deficit hyperactivity disorder (ADHD), or other disorders. The intervention was robotic-guided three-dimensional repetitive motion in 15–20 daily sessions of 25–30 min each over 4–8 wk. RESULTS. Fine motor control improved for the children with learning disabilities and those ages 9 or older but not for those with CP or under age 9. All children with ASD or ADHD referred for slow writing speed were able to increase speed while maintaining legibility. CONCLUSION. Three-dimensional, robot-assisted, repetitive motion training improved handwriting fluidity in children with mild to moderate fine motor deficits associated with ASD or ADHD within 10 hr of training. This dosage may not be sufficient for children with CP.

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. The purpose of this study was to determine the effects of a specific intervention, the Interactive Metronome^®, on selected aspects of motor and cognitive skills in a group of children with attention deficit hyperactivity disorder (ADHD). Method. The study included 56 boys who were 6 years to 12 years of age and diagnosed before they entered the study as having ADHD. The participants were pretested and randomly assigned to one of three matched groups. A group of 19 participants receiving 15 hr of Interactive Metronome training exercises were compared with a group receiving no intervention and a group receiving training on selected computer video games. Results. A significant pattern of improvement across 53 of 58 variables favoring the Interactive Metronome treatment was found. Additionally, several significant differences were found among the treatment groups and between pretreatment and posttreatment factors on performance in areas of attention, motor control, language processing, reading, and parental reports of improvements in regulation of aggressive behavior. Conclusion. The Interactive Metronome training appears to facilitate a number of capacities, including attention, motor control, and selected academic skills, in boys with ADHD.