The standard one-on-one constraint-induced movement therapy (CIMT) recently gained widespread acceptance as a means of effective stroke rehabilitation, but inherent issues associated with cost-effectiveness, safety, lack of dynamic group interaction, and compliance hampered this novel approach. This preliminary study highlights the effect of the group community-based CIMT, which integrated the concepts of the standard CIMT regimen. Eight participants were recruited from a local city community center and trained in the usage of mittens and safety management on the affected upper extremity for 90% of the hours when awake. The community-based CIMT was provided for 2 hours a day over 10 days. Outcome measures include motor recovery, strength, amount of use and quality of movement, self-perceived occupational performance and satisfaction as well as other psychological factors such as motivation, compliance, and enjoyment. These results all showed significant improvement after intervention and were maintained even after the 6-month follow up (P<0.05).
This study aimed to characterize outcome measures used in trials of rehabilitation for stroke patients using the "International Classification of Functioning, Disability, and Health (ICF)". We investigated descriptions of randomized controlled trials (RCTs) published between 1996 and 2005. We then identified and classified outcome measures into three ICF-based categories: "body functions and structure," "activities and participation," and "other." Within rehabilitation RCTs, 21 focused on community residents and 20 focused on hospitalized patients. We identified 215 mentions of the measures in total and 103 types were used in 41 stroke rehabilitation RCTs from 1996-2005. Of the 41 articles, 7 were RCTs of occupational therapy while 6 RCTs focused on community residents. The percentage of outcome measures in the domain of "body functions and structures" has increased since ICF adoption. It is necessary to demonstrate evidence that outcome measures are useful in patient-oriented decision-making in occupational therapy and rehabilitation.
The Standards for the Education of Occupational Therapists were based upon three documents fundamental to international educational, cultural and human rights. This presentation will describe the documents; discuss how they are embedded in the Standards and through the use of a case study illustrate how the Standards support the building or rebuilding occupational therapy communities among WFOT member countries.
All the WFOT member countries endorsed and welcomed the resurgence of discussion about occupation that has been demonstrated in pivotal WFOT documents, such as the minimum standards (WFOT, 2003), definition of OT (WFOT, 2004a) and the Community Based Rehabilitation (CBR) position paper (WFOT, 2004b). These documents confirm that occupational therapists are well placed to facilitate community development, health promotion and participation in community through occupation. Occupational Therapists use a people-centered process applying an enabling occupation approach which integrates medical and social knowledge and skills in tune with the WHO's ICF and the underlying philosophy of occupational therapy.
The World Federation of Occupational Therapists (WFOT), with 65 country members, is a dynamic and proactive organization as demonstrated by the tremendous level of activity and project work presently taking place. Reflections on international involvements of WFOT as well as present and future global projects taking place within the WFOT are described.
Natural disasters are common place in the world but the 2004 tsunami created a critical mass of WFOT member countries confronted by the monumental destructive forces of nature. Destroyed were environments and the natural occupations central to the lifestyle of citizens. Working within the WFOT Disaster Preparedness and Recovery Framework, two Indonesia occupational therapists one working in Aceh, Sumatra and the other responding to a major earthquake in south central Java (2006) were confronted by psychosocial and cultural issues which affected their assistance efforts. The unique cultural perspectives of these two distinct Indonesian geographic areas presented some very different and unique challenges. The first author worked with the two therapists to identify the critical phenomena experienced in accommodating psychosocial barriers. The analysis serves to increase knowledge transfer. Highlighted is the important contribution the profession makes to interpreting more sensitively social phenomena and its impact on disaster recovery process.