Importance: Interventions that promote function, medication reconciliation, and skin integrity assist occupational therapy practitioners in demonstrating professional value, improving quality, and reducing health care costs. Objective: In this systematic review, we focus on three outcome areas of the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014: functional status, medication reconciliation, and skin integrity. Data Sources: We conducted a search of the literature published between 2009 and 2019 in CINAHL, Cochrane, MEDLINE, PsycINFO, OTseeker, and Scopus. We also hand searched the systematic reviews and meta-analyses in our search results for articles that met our inclusion criteria. Study Selection and Data Collection: This study used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Findings: We found 47 articles that address the three outcome areas. Regarding functional status, low strength of evidence is available for cognition and functional mobility interventions to support functional performance, moderate strength of evidence supports interventions for vision, and moderate evidence supports task-oriented and individualized interventions to promote activities of daily living (ADL) outcomes among people with neurological conditions. Strong strength of evidence supports individualized occupational therapy interventions focusing on medication adherence. Low strength of evidence was found for occupational therapy interventions to reduce pressure ulcers and promote skin integrity. Conclusion and Relevance: The evidence supports occupational therapy interventions to improve functional status in ADLs and medication management. Additional research is needed that examines the outcomes of occupational therapy interventions for other areas of function and skin integrity. What This Article Adds: We found evidence to support occupational therapy interventions that align with value-based measures in the three outcome areas of interest. The effectiveness of these interventions highlights the viability of occupational therapy as an essential profession and the worth of occupational therapy to the public, potential clients, and payers.

Date Presented 04/13/21 Literature indicates a decline in musculoskeletal (MSK) fitness in school-age children. This study explored changes in Indiana schools over the generations that have impacted MSK performance. Rapid integration of technology was the primary change, with no corresponding adjustments in physical activity or physical environment. OTs can lead educational initiatives on ergonomics in the schools to promote MSK health and reduce risk of musculoskeletal disorders in students. Primary Author and Speaker: Priya Bakshi Additional Authors and Speakers: Sherrilene Classen, James Wersal Contributing Authors: Virginia Sisiopiku

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. The PRESS to Function Approach is designed to provide a systematic method of evaluating upper extremity function of musculoskeletal disorders. It is based on six constructs: pain, range of motion, edema, strength, sensibility, and functional ability. The approach avoids rendering incomplete hand and upper extremity evaluations and reassessments. The acronym is catchy enough for the novice therapist to make a mental check of what areas may be relevant during the session. Primary Author and Speaker: Phyllis Ross Additional Authors and Speakers: Felecia Banks

Date Presented 04/04/19 National Ambulatory Medical Care Survey OT referral data provides objective description of the patients referred to OT: 29% had a musculoskeletal condition and 42% had a history of injury. This data can be used when planning a primary-care OT practice and supports further outpatient OT utilization research beyond patients who are currently being referred to OT. Primary Author and Speaker: Anne Fleischer Contributing Authors: Alan Fleischer

Date Presented 04/04/19 Musculoskeletal disorders, including the elbow, wrist, and hand, are very common disabilities worldwide. Patients who experience elbow, wrist, and hand musculoskeletal pain are frequently seen in outpatient therapy. Using a sample of 89,422 patients from 3,400 outpatient clinics, this session will identify immutable and mutable factors that are the best predictors of a high functional recovery. Primary Author and Speaker: Jason Hughes Additional Authors and Speakers: Teal Benevides, Pamalyn Kearney, Michael Iwama, Leigh Lehman Contributing Authors: Ying-Chih Wang

Evidence Connection articles provide a clinical application of systematic reviews developed in conjunction with the American Occupational Therapy Association’s (AOTA’s) Evidence-Based Practice Project. In this Evidence Connection article, we describe a case report of a person who underwent a total knee replacement due to severe osteoarthritis of his left knee. The occupational therapy assessment and intervention process both before and after surgery in the home setting is described. Findings from the systematic review ( Dorsey & Bradshaw, 2017 ) on this topic were published in the January/February 2017 issue of the American Journal of Occupational Therapy and in AOTA’s Occupational Therapy Practice Guidelines for Adults With Musculoskeletal Conditions. Each article in this series summarizes the evidence from the published reviews on a given topic and presents an application of the evidence to a related clinical case. Evidence Connection articles illustrate how the research evidence from the reviews can be used to inform and guide clinical reasoning.

Occupational therapists are at risk of work-related injuries (WRIs) because of the demanding nature of their work. However, information about WRIs and musculoskeletal disorders among occupational therapists is limited. For comparison, research indicates that up to 91% of physical therapists experience work-related musculoskeletal disorders (WMSDs) and pain. The purpose of this study was to gather new information about the prevalence, severity, and characteristics of work-related musculoskeletal symptoms and injuries among occupational therapists and to compare this information with physical therapists in the state of Wisconsin. Investigators mailed surveys to 3,297 randomly selected physical and occupational therapists living in Wisconsin. Results indicated a 2006 annual incidence rate of 16.5 injuries per 100 full-time workers among occupational therapists and 16.9 injuries per 100 full-time workers among physical therapists, a rate similar to workers employed in heavy manufacturing. Occupational therapists and physical therapists face similar and significant risks of injury and WMSDs.