Importance: Premature infants are not prepared developmentally, physically, or cognitively with the multiple survival skills of the typical newborn. Objective: To determine whether physical activity generated spontaneously by premature infants stretching against the resistance of “prepod” garments is as effective as exercises provided by therapists in slowing bone density loss. Design: Preterm very low birth weight infants were placed in two nonrandomized parallel groups according to birth age. Setting: Infants routinely started in a traditional intense intervention setting and graduated to a special care section with private rooms that allowed parents to remain with their child. Participants: Healthy infants without medical complications, born between 28 and 32 wk postmenstrual age. Intervention: The control group received traditional exercises. The experimental group wore a prepod almost 24 hr a day. Outcomes and Measures: An ultrasound of the tibia was obtained at 31 to 32 wk and 4 wk later. Weight gain, head circumference growth, and length of stay (LOS) were also measured. Results: Although not statistically significant, the ultrasound results showed that the prepod group had less loss of bone density than the traditional therapy exercise group. The desired outcome was for pods to be as effective at reducing bone loss as traditional exercise, so the results exceeded expectations. The unexpected, and more notable, finding was a striking drop in LOS for the prepod group. Conclusions and Relevance: Spontaneous exercise by premature infants decreases bone loss and LOS. Better bone health and increased developmental maturity increase the chances of a positive developmental outcome and save the hospital significant expense. What This Article Adds: The prepod is a simple, cost-effective, noninvasive treatment tool occupational therapy practitioners can use to support a premature infant’s development. This study has considerable potential to affect how infants are served, both developmentally and financially.

During the coronavirus disease 2019 (COVID-19) pandemic, health care practitioners’ primary focus has been on its physical consequences. Yet, the emotional strain of the pandemic exposed the mental health needs of survivors and society as a result of forced changes in occupational choices, habits, and roles. These forced changes caused a collective confusion, fear, loss, and grief. This column focuses on occupational therapy’s critical contributions to supporting society’s mental health and wellness. Occupational therapy has a unique opportunity to provide interventions to address population-wide mental health and wellness, targeted prevention of mental health concerns for people at risk, and intensive intervention for people with COVID-19–induced mental health diagnoses.

Importance: The recovery model in mental health involves person-driven care and informed decision making to enhance engagement in meaningful activities and inclusion in society. To facilitate the recovery process, occupational therapy practitioners must support their clients in understanding how their participation in meaningful occupation is intimately related to their health and well-being. Objective: To explore whether engaging in an occupational reflection intervention on an inpatient psychiatric unit can support the recovery of adults living with serious mental illness (SMI). Design: Using a phenomenological design, we conducted semistructured interviews to assess whether participation in an occupational reflection intervention supported recovery. Setting: An inpatient psychiatric unit at a university medical center. Participants: We recruited 10 adults living with SMI using purposive sampling. Intervention: Participants engaged in a structured occupational reflection intervention using the Occupational Experience Profile (OEP). The OEP is a time-use diary that captures respondents’ subjective experiences of pleasure, productivity, restoration, and connection in relation to their participation in occupations over 24 hr. Study participants engaged in collaborative analyses regarding their OEP results to explore their subjective experiences in relation to their occupational participation. Outcomes and Measures: Participant self-report during interviews. Results: Engaging in structured reflection affected participants’ experiences of recovery by promoting insight into and awareness of how occupations affect mental health, encouraging positive reframing of occupational experience, and facilitating identification of strategies to support recovery and meaningful participation after discharge. Conclusions and Relevance: Occupational reflection can promote the recovery of adults living with SMI. What This Article Adds: A structured occupational reflection intervention can help adults living with SMI in inpatient psychiatric units to understand the close relationship between their participation in occupations and their health. This process provides valuable insight to clients regarding how to support their recovery through engagement in meaningful occupation.

Importance: Occupational performance limitations (OPLs) are poorly understood sequelae of concussion. This study aimed to establish the need for occupational therapy services for people who have sustained a concussion and to support the profession’s role in facilitating occupational performance for college students experiencing signs and symptoms after concussion. Objective: To describe the types and frequency of, and assess risk factors for, OPLs in college students after concussion. Design: Cross-sectional descriptive study. Setting: Web-based survey on Qualtrics. Participants: A total of 220 participants completed the survey; of those, 52 (23.6%) self-identified as having sustained a concussion and were further asked about OPLs after the concussion. Results: Eighty-nine percent (n = 46) of the participants reported an OPL in at least one area, and higher OPL scores were associated with the number of concussion symptoms (r = .34, p = .02) and increased recovery time (≥3 days vs. <3 days, p = .006). Conclusions and Relevance: College students reporting concussions with more symptoms that persisted for longer periods were more likely to experience occupational performance loss. Frequent OPLs were reported in occupations associated with the participants’ primary role of student. These results indicate a unique need for occupational therapy intervention with students to facilitate their continued success in academic pursuits. What This Article Adds: People who have sustained a concussion experience OPLs. Occupational therapy has a role in facilitating a return to occupational performance during recovery, especially in helping college students with concussion return to the classroom.

Importance: Occupational therapy use in the neurological critical care unit (NCCU) may relate to patient factors, but data about these relationships remain unpublished. Objective: To examine how patient factors predict NCCU occupational therapy use and intervention types. Design: Retrospective cohort study of electronic health records data from adults admitted to the NCCU between May 2013 and September 2015. Setting: NCCU in a large, urban academic hospital. Participants: Adults (age ≥18 yr; N = 1,134) admitted to the NCCU. Measures: Using length of stay (LOS), number of comorbidities, Glasgow Coma Scale (GCS) score, gender, age, and racial–ethnic minority status as independent variables, separate regression models identified predictors for each dependent variable: receipt of NCCU occupational therapy, occupational therapy onset (days after admission), and receipt of self-care or home management (ADL–Home); functional activities or cognitive training (Func–Cog); and therapeutic exercise (Ther-Ex). Results: Four hundred twenty patients (37.0%) received occupational therapy in the NCCU. Receipt of occupational therapy was positively associated with LOS, number of comorbidities, GCS score, and age. Earlier occupational therapy onset was associated with higher GCS score and shorter LOS. Receipt of ADL–Home or Func–Cog interventions was significantly predicted by number of occupational therapy sessions, but patients with longer LOS were less likely to receive ADL–Home interventions. Receipt of Ther-Ex interventions became less likely as GCS score increased. Conclusions and Relevance: Patients are more likely to receive occupational therapy services if they are older and have a longer NCCU LOS, more comorbidities, and a higher level of consciousness. What This Article Adds: A patient’s level of consciousness is clearly associated with occupational therapy utilization and hospital outcomes, but it should not be the only factor considered when prioritizing patients for NCCU occupational therapy services. Compared with patients who were more awake and alert, patients with a lower level of consciousness had a later onset of occupational therapy, which suggests an opportunity for NCCU occupational therapists to collaborate with physicians in the modification of sedation protocols to enable early rehabilitation.

This case report describes occupational therapy services provided in consultation with a primary care practice for a community-dwelling older adult dyad with mild coronavirus disease 2019. The occupational therapy evaluation included administration of the Canadian Occupational Performance Measure through telehealth to identify priority areas for intervention; the clients selected participation during activities of daily living and mealtime, fall prevention, cooking together, and leisure participation. The intervention process focused on addressing the dyad’s identified priorities as well as managing caregiver stress and preventing hospitalization. Positive outcomes were achieved while adhering to social distancing guidelines set forth by state and national agencies.

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.