Joyce R. MacKinnon

Hand Splints and Cerebral Spasticity: A Review of the Literature

The literature pertaining to the use of hand splints to treat cerebral spasticity is reviewed. Splinting patients with hand dysfunction as a result of spasticity remains a controversial treatment technique because of a paucity of research, methodological weakness in study designs, and contradictory results from investigations. The various splint designs commonly used, the corresponding neurophysiological rationale and research examining splinting and spasticity are discussed. Suggestions incorporating sound research methodology are offered to further explore this treatment technique.

The manpower shortage in occupational therapy: implications for Ontario.

A consistently increasing imbalance between the supply of and demand for occupational therapists has led to a critical manpower shortage in occupational therapy. Based on a review of various government reports and related literature, this paper provides an overview of the extent of this manpower problem, identifies factors affecting retention and attrition of occupational therapists and discusses strategies to improve retention and reduce attrition. To address the supply-demand imbalance, recommendations in relation to education, employment, immigration and service delivery for the occupational therapy profession in Ontario are proposed.

The Effects of Splinting on the Spastic Hemiplegic is Hand: Report of a Feasibility Study

Hand splints are used by occupational therapists as a method of reducing the increased muscle tone of the upper extremity following stroke. However, the paucity of research and inconsistent findings examining the effects of splinting on spasticity has resulted in this technique being a controversial one. Many parameters of splinting need to be investigated, such as the type of splint, the duration of use, and wearing schedules. This feasibility study was conducted to pretest instruments and procedures investigating the effects of a finger spreader on the spastic musculature of the wrist and to examine trends in spasticity associated with variables, including a splint wearing schedule, expectations and satisfaction with the splint, and compliance. Nine subjects were randomly assigned to three groups defined by wearing schedules of twenty-two, twelve, and six hours per day. The greatest change in the level of spasticity was noted in the group wearing the splint for twenty-two hours. However, this trend was not statistically significant. A statistically significant relationship was found between expectations of the splint and compliance to the wearing schedule. Satisfaction with the splint outcome and therapeutic interaction was also observed to have a statistically significant relationship with compliance. This indicates that the procedures and measures designed for this study are worth pursuing in future research.

Occupational Therapy Graduate Education: The Scientist-Practitioner Model

The development of a scientific based practice is essential if occupational therapists are to defend their practice against scepticism and budget cuts. In order to equip the profession with the skills necessary to develop a scientific basis for practice, it is generally considered that graduate programs in occupational therapy should be initiated. This paper argues that to be most effective a specific kind of graduate program is required — one based on the scientist-practitioner model. This model provides for the dual education of professionals as clinicians and researchers. In occupational therapy the undergraduate curricula already provide excellent education in clinical interventions. Thus, it is the role of the graduate curricula to provide education in methods of scientific inquiry and their application to clinical practice. The composition of such a curriculum is described.

Occupational Therapy Research in Canada. Report from the Association of Canadian Occupational Therapy University Programs

The Association of Canadian Occupational Therapy University Programs held a workshop in May, 1988. The purpose of that discussion was to describe the current status and needs of occupational therapy research and to consider principles to direct further research. Currently, research in occupational therapy is very limited. The reasons for this lack of development are the isolation of present researchers, the small number of trained researchers, difficulty in obtaining external funding, and the inadequacy of quantitative research methodologies to answer questions in occupational therapy. This group presented a number of strategies intended to further the development of research in our profession. These strategies include increasing the number of trained researchers through the development of graduate programs in occupational therapy, use of varied methodologies, including quantitative and qualitative means, which fit the types of research questions asked. More collaboration is recommended which should increase successful procurement of external funding. Finally, occupational therapists are encouraged to focus research efforts on the specification and support of the scientific basisof our practice. The purpose of this paper is to describe the current status and needs of occupational therapy research in Canada, to bring forward for discussion principlesto direct future occupational therapy research and to state the position of the Association of Canadian Occupational Therapy University Programs (ACOTUP) on strategies to increase research productivity in occupational therapy.

Computerized Fieldwork Data Base: Applications and Implications

Fieldwork placement is a complicated and involved task. On the one hand, it requires insightful, professional judgement, but on the other hand, it includes numerous routine administrative and clerical tasks. To deal with fieldwork placement more efficiently and effectively it was decided to computerize the fieldwork placement system at the University of Western Ontario, London, Ontario. This paper describes the system developed and the resultant data base. The potential applications of the data base and the implications for students, facilities, educational programs, professional governing bodies and research are discussed.