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.

Importance: Spanish-speaking populations represent a significant percentage of occupational therapy clientele globally. Culturally appropriate Spanish translations of assessments are therefore imperative. This study describes the process of a culturally adapted translation of a set of tests for use with Spanish-speaking pediatric populations. Objective: To produce a culturally adapted Spanish translation of the Evaluation in Ayres Sensory Integration^® (EASI) for international use. Method: We used cultural adaptation methodology that included direct and back translations of the EASI by bilingual translators and interviews with pediatric occupational therapists and children ages 3–6 yr from Spain. Linguistic experts helped revise the translations, and pediatric occupational therapy leaders in five Spanish-speaking North and South American countries reviewed the translations for comprehensibility and cultural appropriateness. Results: Back translations demonstrated equivalence with the original EASI tests except for a few test instructions and scoring criteria. Interviews with occupational therapists and children in Spain revealed some comprehension difficulties for several tests, which were revised in consultation with a linguistic expert. Additional adaptations were made on the basis of recommendations to address cultural differences by occupational therapy leaders from five North and South American countries. Most changes in wording were made in one EASI test (Praxis: Following Directions) that is heavily dependent on language comprehension. Conclusions and Relevance: We used currently recommended methodologies to develop and adapt a Spanish translation of the EASI for use across diverse cultures. What This Article Adds: A Spanish translation of the EASI has been developed for use in culturally diverse Spanish-speaking countries around the world.

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 Program. In this Evidence Connection article, I describe a case report of a young child receiving early intervention services and outline the occupational therapy evaluation and intervention processes for supporting this child’s activities of daily living in the home and early childhood education setting. Findings from the systematic reviews on this topic were published in the March/April 2020 issue of the American Journal of Occupational Therapy and in AOTA’s Occupational Therapy Practice Guidelines for Early Childhood: Birth–5 Years. 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 decision making.

The coronavirus disease 2019 (COVID-19) pandemic has presented unique challenges for occupational therapy practitioners working in acute and critical care settings. Using the best available evidence, this case report overviews a prototypical COVID-19 disease course and discusses key aspects of clinical reasoning for practitioners working with this novel population. Following a single patient admitted to a tertiary academic medical center, the authors review the occupational profile and medical history, common impairments, the intervention plan, and strategies to align the occupational therapy and medical goals of care.

This case report examines the role of occupational therapy in the recovery of a client who became critically ill with severe acute respiratory syndrome coronavirus 2. In it, we describe evaluation and treatment methods, functional impairments, and special considerations when working with a client with severe coronavirus disease 2019 infection. The client was a 43-yr-old Hispanic man treated in a long-term acute-care hospital. Client-centered treatment sessions focused on activities of daily living (ADLs), self-feeding, medication management, and leisure and were implemented in 30- to 45-min sessions 3 times per week for 5 wk. The Activity Measure for Post Acute Care Daily Activities Short Form was used to measure basic mobility, daily activities, and applied cognition in the acute setting. A manual dynamometer was used to measure grip strength, and the Nine-Hole Peg Test was used to measure digit dexterity. Both were used in the context of occupational engagement. Data were collected at evaluation, every 2 wk, and at discharge. The client achieved his goals and demonstrated marked improvement in independence with basic ADLs, leisure activities, bilateral grip strength, and manual dexterity.

This case report describes the distinct value of occupational therapy services in the treatment of a pediatric patient with coronavirus disease 2019 (COVID-19) and multisystem inflammatory syndrome in children in an acute care setting. Practice-based evidence was used to design the treatment plan for this patient throughout the course of his hospital stay. Interventions addressed range of motion, strength, functional endurance, activities of daily living (ADLs), instrumental activities of daily living (IADLs), and functional cognition. Occupational therapy goals focused on the progression toward return to baseline functioning and participation in ADLs and IADLs.