Table 2.

Occupational Therapy Intervention Studies Published in the American Journal of Occupational Therapy From May 2010 to October 2011

Author	Study Objectives	Level/Design/Participants	Intervention and Outcome Measures	Results	Study Limitations
Beckelhimer, Dalton, Richter, Hermann, & Page (2011)	To test the efficacy of computer-based training implementing rhythm and timing in chronic, severe, stroke-induced hemiparesis	Level IV	Intervention Computer-based timing intervention with metronome; 60 min × 3 days/wk for 4 wk; total sessions = 12; total hr therapy = 12	Some improvement seen in all outcome measures.	Case series design with 2 participants
		Single-subject design			No statistical analysis
		N = 2, <12 mo poststroke
		Age >21, <75	Outcome Measures UE section of FMA AMAT COPM Stroke Impact Scale
Hardy et al. (2010)	To examine the effect of functional training, bracing, and electrical stimulation on reducing UE spasticity	Level IV	Intervention Clinic treatment: Electrical stimulation while wearing brace followed by repetitive task-specific training	Reduction in finger spasticity level seen on Modified Ashworth Scale.	Small sample
		Single-subject design			Poor generalizability
		N = 2; chronic stroke >6 mo		Slight improvement in Box and Block test and AMAT.
			Home-based treatment: Two 30-min sessions of electrical stimulation in brace, followed by overnight wearing of brace without stimulation 45–60-min sessions 2 days/wk for 5 wk; total hr = 10
			Outcome Measures Modified Ashworth Scale (UE portion) FMA (UE portion) Box and Block test AMAT
Hayner, Gibson, & Giles (2010)	To compare the effect of mCIT with bilateral therapy of equal intensity in improving motor function after stroke	Level II	Intervention mCIT group wore a mitt and practiced functional activities with affected arm	Both groups improved performance; no differences were seen between groups.	Well-designed study
		Stratified, randomized trial			Small sample size
		N = 12; >6 mo poststroke	Bilateral group were given repetitive and intrusive cues to use both arms in functional activities		Results not presented clearly
			Both groups: 6 hr/day for 10 days; total hr = 60
			Outcome Measures WMFT COPM
Henshaw, Polatajko, McEwen, Ryan, & Baum (2011)	To provide description of new cognitive approach to lay groundwork for a future clinical trial	Level IV	Intervention Cognitive approach involving dynamic performance analysis and problem-solving strategy of goal–plan–do–check	Performance and satisfaction improvement seen in both cases after treatment. Cases tolerated treatment procedure.	Case series design with 2 participants
		Single-subject design			No statistical analysis
		N = 2; mild to moderate stroke; age >40 yr
			Outcome Measures Performance quality rating scale Descriptive outcomes
Kim & Colantonio (2010)	To examine whether rehabilitation is effective in community integration of survivors of traumatic brain injury (TBI)	Level I	Intervention Multidisciplinary rehabilitation or intensive cognitive rehabilitation program	Of 3 Level I studies, only 1 showed improvement. The Level II study did not demonstrate benefits.	Comprehensive review of 17-yr period
		Systematic review			Review included non-RCT studies
		N = 10 studies: 3 Level I; 1 Level II; 6 Level III	Outcome Measures Community Integration Questionnaire Brain Injury Community Rehabilitation Outcome–39	Of the 6 Level III studies, 3 showed benefit of rehabilitation. Benefit of multidisciplinary rehabilitation in community integration is unclear.	Effectiveness not specific to occupational therapy
		Adults with TBI of varying severity and time since injury			Included patients with mild TBI
Maitra et al. (2010)	To understand how occupational therapy interventions enable patients with multiple sclerosis to improve function in an inpatient setting	Level IV	Intervention Occupational therapy intervention (self-care, therapeutic exercise, occupation-based therapeutic activities) was correlated with FIM scores	Poor correlation between occupational therapy intensity and UE dressing and memory. Poor correlation between self-care training and independence in ADLs.	Poor correlation between occupational therapy intervention and improvement in FIM score
		Retrospective chart review
		N = 193			No control over additional interventions
			Outcome Measure FIM
McCall, McEwen, Colantonio, Streiner, & Dawson (2011)	To examine the efficacy of a mCIT protocol on participation, activity, and impairment in the older adult subacute stroke population	Level IV	Intervention mCIT, 2 hr/day for 10 days; total sessions = 10; total hr = 20. Treatment included shaping during functional activity; constrained by mitt.	COPM and CAHAI scores improved for 4 of 4 participants.	Case series design
		Interrupted time series			No statistical analysis
		N = 4; age >65 yr; 43–81 days poststroke		FIM self-report improved for 3 of 4 participants.	Small sample size
			ARAT scores improved.	Outcome Measures COPM FIM self-report Chedoke Arm and Hand Activity Inventory (CAHAI) ARAT
Nilsen, Gillen, & Gordon (2010)	To examine whether mental practice is effective in improving UE function after stroke	Level I	Intervention Mental practice alone or in combination with CIMT and functional training	Level I and II studies reported improvement after mental and physical practice.	Comprehensive review of studies over 25 yr
		Systematic review			Review included RCT and non-RCT studies
		N = 15 studies: 4 Level I; 2 Level II; 1 Level III; 6 Level IV; 2 Level V	Outcome Measures FMA WMFT Motor Activity Log ARAT Jebsen–Taylor Test Motricity Index Kinematic analysis Pegboard test Pinch strength Stroke Rehabilitation Assessment of Movement Chedoke-McMaster Stroke Assessment		Selection bias
		Chronic stroke			Poor rating system for studies
Page, Murray, & Herman (2011)	To examine whether mCIT intervention is retained 3 mo after intervention in stroke rehabilitation	Level IIb	Intervention mCIT for 0.5 hr, 3×/wk for 10 wk (total hr of therapy = 15); treatment included shaping during functional activity; unaffected arm restrained in sling	No differences in ARAT or FMA scores seen between posttreatment and 3-mo follow-up.	Design not RCT
		Nonrandomized cohort study			No information on what participants did postintervention
		N = 13 adults >3 mo poststroke; minimal cognitive impairment; minimal spasticity			Small sample size
			Outcome Measures ARAT FMA, Motor Recovery		Outcomes only impairment level
Wu, Radel, & Hanna-Pladdy, (2011)	To test performance and perception after combined physical and mental practice in a patient with hemiparesis and apraxia	Level IV	Intervention Practice of reaching to grasp a cup and turning pages; physical practice followed by mental practice; 60 min × 3 days/wk × 6 wk; total number of sessions = 18; total hr therapy = 18	Performance and time taken to complete task improved after intervention.	Single-subject design
		Single-subject design			Poor generalizability
		N = 1; mild to moderate stroke <6 mo
			Outcome Measures AMAT COPM

Note. ADLs = activities of daily living; AMAT = Arm Motor Activity Test; ARAT = Action Research Arm Test; CIMT = constraint-induced movement therapy; COPM = Canadian Occupational Performance Measure; FMA = Fugl-Meyer Assessment; mCIT = modified constraint-induced therapy; RCT = randomized controlled trial; WMFT = Wolf Motor Function Test; UE = upper extremity.