OTJR: Occupational Therapy Journal of Research

This systematic review examined research related to interventions that addressed handwriting deficits in adults with impaired upper limb motor coordination resulting from central and peripheral nervous system injury or illness. The clinical question was, “Based on current research, what is/are the recommended intervention(s) to improve, augment, or replace handwriting skills among adult clients with upper limb motor deficits?” A research protocol was followed, which was modified to include pediatric literature after an initial search of interventions for adults proved limited. Four studies related to adults and 10 related to pediatrics were included in the review and all were evaluated for quality using standardized procedures. The adult studies addressed the use of voice recognition software and hand dominance transfer training. Available evidence for interventions with children with handwriting deficits centered around these clinical options: Cognition Orientation to Daily Occupational Performance, task-orientated self-instruction, ergonomic modifications to a desk, school-based intervention (emphasis on visual motor skills and practice), sensory diet with therapeutic listening, therapeutic practice, and a graphomotor program. Improvement in handwriting skill emerged from seven of the 10 pediatric studies. Direct practice of handwriting tasks was common to all successful studies and missing in studies that failed to show skill improvement. It may be logical to conclude that intervention strategies should include direct practice of handwriting, whether the client is an adult or a child. Further research on handwriting intervention programs specifically for adult clients and the inclusion of direct practice as intervention is warranted.

This study examined the impact of participation in a wellness assignment on healthy habit changes in pre-professional undergraduate students. Participants consisted of 58 students enrolled in an undergraduate occupational science health and wellness course. Students were given an assignment to alter three to five habits that would improve their wellness over the semester, and follow-up surveys tracked their adherence to the changes. The assignment and outcomes were retrospectively analyzed using social cognitive and self-determination theories. Students believed that participation in the assignment increased (1) their own wellness status, (2) their understanding of how to impact their own wellness, and (3) their ability to understand client and therapist perspectives on making habit changes. The outcomes suggest that using the principles of social cognitive and self-determination theories appears to support the success of and adherence to healthy habit changes. Implications for occupational therapy educators and practitioners in the use of these theoretical models to support behavior changes are discussed.

Visual perceptual skills of adults are often assessed by occupational therapists using standardized tests. The Motor-Free Visual Perception Test—Third Edition (MVPT-3) is a frequently used test, although its construct validity has not been thoroughly evaluated. The purpose of the study was to consider the construct validity of the MVPT-3 by evaluating its scalability/interval level measurement, unidimensionality, lack of differential item functioning (DIF), and hierarchical ordering of its items when completed by a group of adult participants. The visual perceptual performance scores from a sample of 221 participants 20 years or older (49 adults with neurological impairment and 172 adults without) were used to complete a Rasch analysis (RA) of the MVPT-3. When analyzed using RA, the MVPT-3 exhibited adequate measurement properties. However, several MVPT-3 scales exhibited RA misfit (items 40, 45, 54, 56, 61, 64) or DIF (items 57, 60, 61). The construct validity, scalability, unidimensionality, hierarchical ordering, and lack of DIF requirements were met by most (87.7%; 8 of 65 items) of the MVPT-3 scale items. When using the MVPT-3 to assess adult clients, clinicians should consider the items that exhibited RA misfit or DIF when interpreting scores.

This study investigated how individuals in the community 1 to 5 years after spinal cord injury characterized their occupational and social participation, life satisfaction, and aspects of their occupational therapy that influenced their participation. Semi-structured, open-ended interviews were conducted with 11 individuals referred by occupational therapists who specialize in spinal cord injury rehabilitation and/or are regarded as practicing from an occupation-based perspective. Narrative analysis of data revealed that the participants went through an adaptive process, using many strategies to adjust their attitudes about disability, manage identity, participate in the community, and belong socially. Several approaches were used by therapists to promote the individuals' participation in occupations and social life.

Approximately 23.6 million people in the United States are living with diabetes, a disease that is a leading cause of disabling conditions including blindness, kidney failure, amputations, heart disease, and stroke. Although these complications of diabetes can be delayed or prevented through intensive diabetes self-management (DSM), maintaining control of the disease can be burdensome and negatively impact quality of life. Occupational therapy has a largely untapped potential to assist individuals who struggle with managing diabetes in the context of everyday life, yet there is little discussion of DSM in the occupational therapy literature. The author conducts a systematic review of the existing occupational therapy literature on diabetes, examines the current state of DSM interventions, and discusses a potential role for occupational therapy using programs such as Lifestyle Redesign®.

This study examined the validity of the Postrotary Nystagmus (PRN) test as a measure of vestibular functioning by examining the relations of scores from the PRN test with those from other variables measuring similar functions and through conducting a group comparison study. The PRN test is one of 17 tests included in the Sensory Integration and Praxis Tests (SIPT). Using SIPT scores from 575 children, sensory motor performance among children with depressed, average duration, and prolonged nystagmus was compared. The results indicated that children with low-duration postrotary nystagmus scored more poorly than children with average or prolonged postrotary nystagmus on other SIPT tests measuring aspects of vestibular function. Statistically significant, although weak correlation, coefficients were also obtained, demonstrating low-duration postrotary nystagmus may be associated with sensory motor deficits. The results of this study contribute to evidence supporting the PRN test's validity as a measure of some aspects of vestibular functioning.