Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. This research examined how client and health care factors affected OT outcomes for clients. A quantitative study was conducted with consecutive sampling of more than 200 participants with upper extremity (UE) conditions over an 18-month period. UE therapy outcomes were assessed every 4 weeks using Global Rate of Change (GROC) and QuickDASH scores, which both improved significantly. This study can inform OTs working with outpatient clients about factors that can affect decisions regarding treatment implementation. Primary Author and Speaker: Cindy Hayden

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. This is a retrospective study defining routine OT interventions in the treatment of children with somatodyspraxia and examining the effectiveness of those interventions on improving motor skills. Text mining was used to examine narrative data from therapy notes, and pretest–posttest data from a standardized motor assessment were used to examine effectiveness of interventions. Results revealed three common interventions and statistically significant improvement of motor coordination. Primary Author and Speaker: Aimee Piller

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. This descriptive, qualitative study describes the OT process used by expert practitioners for adults with persistent mild traumatic brain injury symptoms in outpatient concussion clinics. OTs are uniquely trained to return persons to their everyday activities, without requiring a military or sport background. This evidence empowers practitioners to advocate for the client and for the professional to be part of the rehabilitation team and raise the perceived value of the profession. Primary Author and Speaker: Mary Ann B. Roelke Contributing Authors: Vanessa Jewell

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. The purpose of this study was to evaluate gaps between parent and provider perceptions of the family-centeredness of services and the contribution of the service setting (outpatient versus schools) to these gaps. Findings indicated significant gaps between parents and providers, and between practice settings, in all assessed domains. These gaps suggest areas of opportunity for OTs to enhance their practice in order to foster more effective partnerships with parents. Primary Author and Speaker: Liat Gafni-Lachter Additional Authors and Speakers: Ayelet Ben-Sasson, Shaimaa Alsaaed

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. Presently, there is no research examining the efficacy of home OT evaluations done prior to the start of therapy, as a means to support the therapeutic process. A new service model is warranted that provides contextual information that supports care and promotes skill transference to natural environments. Clients and OT students within a student-led, faculty-supervised OT center were interviewed to determine the impacts of a piloted initial in-home OT evaluation program. Primary Author and Speaker: Margaret Flynn Additional Authors and Speakers: Mary Hildebrand

Prolonged symptoms from the novel coronavirus disease 2019 (COVID-19), otherwise known as long COVID, postacute sequelae of COVID-19 (PASC), or post-COVID syndrome, are affecting an increasingly high number of patients after severe, moderate, and mild acute COVID-19 infections. Using evidence-based practice strategies, this case report describes occupational therapy evaluation and treatment approaches, plan of care, and associated outcomes for one client experiencing long COVID symptoms in the outpatient setting.

Importance: People with Parkinson’s disease (PD) commonly experience difficulty in performing activities of daily living (ADLs), which affects their perceived quality of life. Objective: To examine the evidence for the effectiveness of interventions within the scope of occupational therapy to improve performance and participation in ADLs, rest, and sleep in adults with PD. Data Sources: Databases searched were MEDLINE, PsycINFO, CINAHL, OTseeker, and Cochrane Collection. Included articles were published between January 2011 and December 2018. Study Selection and Data Collection: Articles describing Level 1b, 2b, and 3b studies that examined outcomes related to ADLs, rest, and sleep in people with PD were included following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Findings: Forty-five articles (10 Level 1b, 27 Level 2b, and 8 Level 3b) met the inclusion criteria. Conclusions and Relevance: Strong strength of evidence was found to support inpatient multidisciplinary intensive rehabilitation treatment (MIRT) to improve ADLs, and moderate strength of evidence that MIRT improves sleep performance. Low strength of evidence was present for outpatient occupational therapy to improve ADL and sleep outcomes. Low strength of evidence was found for resistance exercise programs to improve ADLs, but moderate strength of evidence indicates that multimodal exercise programs and targeted exercise programs can improve ADLs. Low to moderate strength of evidence suggested that alternative therapies and cognitive–behavioral therapy have a positive impact on ADLs and sleep. These results can be used to inform evidence-based occupational therapy practice. What This Article Adds: This article provides information for practitioners on the effectiveness of interventions within the scope of occupational therapy practice to improve ADLs and sleep.

Evidence Connection articles provide 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 an older adult who was referred to outpatient occupational therapy services due to chronic back pain from herniated discs. Findings from the systematic review of occupational therapy for community-dwelling older adults were published in the July/August 2018 issue of the American Journal of Occupational Therapy ( Berger et al., 2018 ; Elliott & Leland, 2018 ; Hunter & Kearney, 2018 ; Liu et al., 2018 ; Smallfield & Lucas Molitor, 2018a , 2018b ) and in the American Occupational Therapy Association’s Occupational Therapy Practice Guidelines for Productive Aging for Community-Dwelling Older Adults. Each article in the Evidence Connection series summarizes the evidence from the published reviews on a given topic and presents an application of the evidence to a related clinical case. These articles illustrate how the research evidence from the reviews can be used to inform and guide clinical decision making.

OBJECTIVE. This article describes the cost of occupational therapy by provider, insurance status, and geographic region and the number of visits allowed and out-of-pocket costs under proposed therapy caps. METHOD. This retrospective, population-based study used Medicare Provider Utilization and Payment Data for occupational therapists billing in 2012 and 2013 (Ns = 3,662 and 3,820, respectively). We examined variations in outpatient occupational therapy services with descriptive statistics and the impact of therapy caps on occupational therapy visits and patient out-of-pocket costs. RESULTS. Differences in cost between occupational and physical therapists were minimal. The most frequently billed service was therapeutic exercises. Wisconsin had the most inflated outpatient costs in both years. Under the proposed therapy cap, patients could receive an evaluation plus 12–14 visits. DISCUSSION . Wide variation exists in potential patient out-of-pocket costs for occupational therapy services on the basis of insurance coverage and state. Patients without insurance pay a premium.

OBJECTIVE. This study explored how upper-extremity (UE) functional capacity and daily performance change during the course of outpatient rehabilitation in people with stroke. METHOD. Fifteen participants receiving outpatient occupational therapy services for UE paresis poststroke were enrolled. UE motor capacity was measured with the Action Research Arm Test (ARAT), and UE performance was measured using bilateral, wrist-worn accelerometers. Measurements were taken at or near the start of therapy, at every 10th visit or every 30 days throughout the duration of services, and at discharge. RESULTS. Three patterns were observed: (1) increase in ARAT scores and more normalized accelerometry profiles, (2) increase in ARAT scores but no change in accelerometry profiles, and (3) no change in ARAT scores or in accelerometry profiles. CONCLUSION. UE performance in daily life was highly variable, with inconsistencies between change in UE capacity and change in UE performance. UE capacity and performance are important constructs to assess separately during rehabilitation.

OBJECTIVE. We investigated the effects of an explicit problem-solving skills training program using a meta componential approach with 33 outpatients with moderate acquired brain injury, in the Hong Kong context. METHOD. We compared an experimental training intervention with this explicit problem-solving approach, which taught metacomponential strategies, with a conventional cognitive training approach that did not have this explicit metacognitive training. RESULTS. We found significant advantages for the experimental group on the Metacomponential Interview measure in association with the explicit metacomponential training, but transfer to the real-life problem-solving measures was not evidenced in statistically significant findings. Small sample size, limited time of intervention, and some limitations with these tools may have been contributing factors to these results. CONCLUSION. The training program was demonstrated to have a significantly greater effect than the conventional training approach on metacomponential functioning and the component of problem representation. However, these benefits were not transferable to real-life situations.