Martin S. Rice

Interlimb Coupling and Left Hemiplegia Because of Right Cerebral Vascular Accident

This study examined interlimb coupling in a left hemiplegic population. Participants were 20 healthy individuals and 18 individuals who were status post right cerebral vascular accident with left hemiparesis. Participants oscillated each elbow at both preferred-unilateral and preferred-symmetrical bilateral rates. One-tailed paired t-tests using frequency of oscillation and peak velocity supported the hypothesis that the unaffected limb would adapt its movement dynamics from the unilateral to the bilateral movement conditions (ps < .0125), while the affected limb did not differ its performance across the unilateral and bilateral conditions (ps > .0125). No significance (p > .0125) was found between the unilateral and bilateral performances for either of the normal groups limbs. This study suggests that during bilateral movements, the affected limb may constrain the unaffected limb. More research is needed to examine the coupling relationship between the affected and unaffected limbs and how occupation may facilitate the ability to adapt to novel situations.

Alterations in stride-to-stride variability during walking in individuals with chronic ankle instability

The aim of this study was to evaluate stride-to-stride variability of the lower extremity during walking in individuals with and without chronic ankle instability (CAI) using a nonlinear analysis. Twenty-five participants with self-reported CAI and 27 healthy control participants volunteered for this study. Participants walked on a motor-driven treadmill for 3 min at their selected speed. Lower extremity kinematics in the sagittal and frontal planes were recorded using a passive retroreflective marker motion capture system. The temporal structure of walking variability was analyzed with sample entropy (SampEn). The CAI group produced lower SampEn values in frontal-plane ankle kinematics compared to the control group (P=.04). No significant group differences were observed for SampEn values of other kinematics (P>.05). Participants with CAI demonstrated less stride-to-stride variability of the frontal plane ankle kinematics compared to healthy controls. Decreased variability of walking patterns demonstrated by participants with CAI indicates that the presence of CAI may be associated with a less adaptable sensorimotor system to environmental changes. The altered sensorimotor function associated with CAI may be targets for clinical interventions, and it is critical to explore how interventions protocols affect sensorimotor system function.

Comparison of required operating forces between floor-based and overhead-mounted patient lifting devices †

This study investigated the differences in required push, pull and rotating forces for moving fully loaded, floor-based and overhead-mounted full body patient lifting devices with simulated patients of varying weight on a floor of optimal design (i.e. level vinyl tile over concrete). A single person operated the lifting devices for all of the tests. Eighteen male and female volunteer participants, ranging in weight from 51 to 146 kg, acted as patients during the lifting tests. For each test, the simulated patients were pushed and pulled for 3.7 linear metres and were rotated while sitting in the lift slings. Force measurements were acquired using two single axis dynamometers affixed to the lifting devices. Results revealed that, in general, operator input force and torque increased with patient weight category and floor-based lifts required greater force and torque compared to the overhead-mounted lift. Comparison of the required forces with published force limits reveals that the required push and pull force from the various patient lift systems, across all weight categories, were generally acceptable to 90% of the female population. The required forces for these patient transfer tasks, however, could exceed maximum acceptable force limits if the floor surfaces were less than ideal, such as floors composed of carpet, wood, or inclined surfaces. Additional research is needed to assess these conditions.

Effect of Choice Making on a Self-Care Activity in Mentally Retarded Adult and Adolescent Males

Of central importance to occupational therapy is the issue of motivation in activity. The purpose of this study was to look at the effects of choice on motivation during an activity undertaken by mentally retarded adult and adolescent males Each subject was given a choice of five wrinkled T-shirts that had sports logos on them. The subject chose one and was asked to iron the T-shirt before he took it to keep. Counterbalancing for order of presentation, we designed the study so that each subject also experienced not having a choice between five T-shirts and then having to iron the one given to him. The amount of ironing was measured by calculating the amount of water evaporation A one-tailed t test indicated that with this population, choice in an activity was a significant motivator for increased participation in a subsequent activity (p < .05). Results are discussed in terms of the need for research to build a theoretical base upon which practice directed to developing a sense of efficacy in mentally retarded and other populations can be founded.

A Questionnaire of Musculoskeletal Injuries Associated With Manual Patient Lifting in Occupational Therapy Practitioners in the State of Ohio

ABSTRACT The purpose of this study is to investigate the prevalence and type of musculoskeletal injury due to patient handling as well as to ascertain current safe patient handling practices in occupational therapy within the state of Ohio. A questionnaire focusing on safe patient handling issues was e-mailed to 1,113 occupational therapy practitioners in the state of Ohio, with an overall response rate of 26%. Sixty-four percent indicated they were required to transfer patients manually. Of these respondents, 8% indicated receiving an injury, 11% missed days away from work in connection with sustaining an injury, and 12% considered leaving the profession early due to patient handling concerns. The study demonstrated that this sample of occupational therapy practitioners was exposed to occupationally based high-risk situations regarding patient handling with moderate to high incidence rates for musculoskeletal injuries. Additional research is needed to ascertain the status of safe patient handling among occupational therapy practitioners nationwide.

Safe patient handling curriculum in occupational therapy and occupational therapy assistant programs : a descriptive study of school curriculum within the United States of America

The purpose of this study was to identify safe patient handling (SPH) curricular content in accredited occupational therapy and occupational therapy assistant programs in the United States of America. A survey was emailed to 155 accredited occupational therapy and 137 accredited occupational therapy assistant programs. With a 39% response rate, most programs addressed SPH curricula by including lectures and lab-based experiences with gait belts, slide boards, and manual transfers while stressing ‘safe’ body mechanics. There were limited responses regarding curricular-based hands-on experience, evaluation of sit-to-stand lifts, how to safely transfer bariatric persons, and information on “no-lift” policies. While occupational therapists have a central role in teaching SPH to caregivers, it is important to enhance SPH curricula to reduce exposure to musculoskeletal risk, thereby, increasing the health and safety of the occupational therapy workforce as well those whom the profession serves.

Motor Learning Strategies for Well Elderly: A Pilot Study

Although motor learning strategies have been studied throughout the 20th century, relatively little is known about motor learning strategies that are specifically effective for older adults. The purpose of this study was to compare the skill acquisition, retention, and transfer of motor skills in older persons on relatively easy and relatively difficult tasks across varying frequencies of knowledge of results (KR). It was hypothesized that there would be a significant interaction upon task learning between frequency of KR and task difficulty for the acquisition, retention, and transfer phases. Participants included 61 right-hand dominant, well, elderly individuals, aged 60 to 87 years. The task involved turning a knob that controlled the height of a bar on a computer screen to match the height of a target bar. The target bar height and the time interval of the target bar were manipulated into four groups including the 100% KR/easy task, the 100% KR/hard task, the 33% KR/easy task and the 33% KR/hard groups. Participants were randomly assigned to these four groups. Although there was no significant interaction between group and time for the retention phase (p >.05), there were significant interactions in the acquisition and transfer phases between group and time (p <.05). The acquisition phase had a large disparity during the initial performance with the reduced KR groups having greater error that was eliminated in the final acquisition trials. In the transition phase, the 33% feedback/hard group demonstrated better performance across the trials than the other three groups. Based on these results, it may be beneficial to employ a reduced frequency feedback schedule when learning relatively difficult tasks for subsequent generalization of those learned skills by an elderly population, though more research beyond this pilot study is needed to corroborate these findings.

Degree of Preference and Its Influence on Motor Control When Reaching for Most Preferred, Neutrally Preferred, and Least Preferred Candy

The objective of this study was to determine whether reaching for objects with varying levels of preference associated with them elicited influenced motor control in a reaching task. Forty healthy adults were asked to reach for seven different types of candy, which they ranked by personal preference from being the most preferred to the least preferred. In this repeated measures design, data were analyzed on 39 participants who tended to demonstrate greater movement efficiency in movement time and movement units when reaching for candy in which they associated with greater preference (p < .0167). Although no differences were found between conditions with peak velocity and percentage of movement time to peak velocity (p > .0167), these dependent variables appeared to trend in the direction of similar movement efficiency. Therapists can use this knowledge to help guide clinical reasoning when designing treatment plans and approaches. Future research is needed to further examine intensity along the continuum of preference and its implications for occupational therapy practice.

Choice as a Strategy to Enhance Engagement in a Colouring Task in Children with Autism Spectrum Disorders

This study investigated the effect of choice on a colouring task in children with autism spectrum disorders (ASD). Children with ASD typically have difficulty engaging in purposeful activities, which makes progress toward skill development difficult in therapeutic or educational settings. Participants included 26 male and female children with ASD, aged 8 to 15 years. In this counterbalanced design, participants either chose which picture to colour or were given a picture to colour. When given a choice, participants spent more time colouring (p=0.005) and used more coloured markers (p=0.016), but did not colour more of the page (p=498). This study demonstrated that when offering a choice in a colouring activity, children with ASD participated and engaged in the colouring task for a longer period of time and used a larger array of markers while doing so. However, associated small effect sizes require caution with generalization. Future research should focus upon offering choice with other age-appropriate activities to determine its efficacy as a useful strategy for facilitating activity engagement for children with ASD.

Perceived Risk and its Effects on Quality of Movement in Occupational Performance of Well-Elderly Individuals

The purpose of this study was to determine whether elderly individuals would demonstrate differences in quality of movement when completing a water-pouring task under different levels of perceived risk (i.e., pouring hot water vs. pouring cold water during beverage preparation). Fifty individuals over the age of 65 (M=72.1 years, SD=6.3) participated in the repeated measures, counterbalanced design. Results indicated that participants used less efficient movement dynamics when pouring hot water (higher risk) than when pouring cold water (lower risk). Elders tended to take longer and make more adjustments when pouring hot water than when pouring cold water. Occupational therapists can use this information to better understand the movement dynamics needed during everyday occupations and design therapeutic interventions that appropriately challenge clients.