Occupational Therapy Services

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    Exploration of implementation, financial and technical considerations within allied health professional (AHP) telehealth consultation guidance: a scoping review including UK AHP professional bodies’ guidance.
    (BMJ Publishing Group, 2021-12-27) Eddison, Nicola
    Objectives The COVID-19 pandemic has resulted in a shift to remote consultations, but telehealth consultation guidelines are lacking or inconsistent. Therefore, a scoping review was performed to chart the information in the articles exploring telehealth for the UK Allied Health Professionals (AHPs) and compare them with the UK AHP professional bodies’ guidelines. Design Scoping review following Aksey and O’ Malley methodological framework. Data Sources CINHAL and MEDLINE were searched from inception to March 2021 using terms related to “telehealth”, “guidelines” and “AHPs”. Additionally, the UK AHP professional bodies were contacted requesting their guidelines. Study selection: Articles exploring telehealth for patient consultations, written in English and published in peer-reviewed journal or guidelines available from UK AHP professional bodies/their websites, were considered eligible for review. Data extraction: One reviewer extracted data concerning three overarching domains: implementation, financial and technological considerations. Results 2,632 articles were identified through database searches with twenty-one articles eligible for review. Eight guidelines were obtained from the UK AHP professional bodies with a total of twenty-nine included articles/guidelines. Most articles were published in the last two years, there was variety in telehealth terminology, and most were developed for occupational therapists, physiotherapists and speech and language therapists. Information was lacking about the assessment of telehealth use and effectiveness, barriers and limitations, the logistical management, the family’s and caregiver’s roles, and the costs. There was lack of clarity on the AHPs’ registration requirements, costs and coverage, and legal aspects. Conclusion This study identified gaps in current guidelines, which showed similarities as well as discrepancies with the guidance for non-AHP healthcare professionals and revealed that the existing guidelines do not adequately support AHPs delivering telehealth. Future research and collaborative work across AHP groups and the world’s leading health institutions are suggested to establish common guidelines which will improve AHP telehealth services.
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    Developing physical therapy protocols for the lower limb post-stroke utilising a modified Nominal Group Technique.
    (Mark Allen Group, 2017-05-09) Aries, Alison
    Despite being a part of conventional clinical practice, sensory stimulation/retraining of the lower limb post-stroke has neither been clearly described nor standardised to enable evaluation in clinical trials. The aim of this study was to develop protocols for: Mobilization and Tactile Stimulation for the lower limb; sensory augmentation using a textured insole; and task specific gait training.
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    Mobilisation and tactile (sensory) stimulation for the foot post stroke: opinions and perceptions of experienced therapists.
    (Mark Allen Group, 2019-07-01) Aries, Alison
    Background/Aims Intensive proprioceptive stimulation applied to the paretic hand post-stroke, using a complex hands-on intervention known as mobilisation and tactile stimulation, has reduced motor impairment and improved hand function in sub-acute and chronic stroke. While, anecdotally, mobilisation and tactile stimulation is also applied to the paretic foot to prepare it for standing, its use in stroke rehabilitation and effects on standing and balance have not been evaluated. Therefore, expert clinicians' experiences, opinions and perceptions of using mobilisation and tactile stimulation in routine clinical practice were explored to inform a subsequent feasibility study of mobilisation and tactile stimulation for the paretic foot post-stroke. Methods Following ethical approval, focus groups were undertaken: using purposive sampling, physiotherapists and occupational therapists with >12 months experience of stroke rehabilitation were recruited from a regional special interest group. A pilot study (n=4) and main study (n=7) explored content and application of hands-on therapy for the paretic foot, and the perceived impact of sensory loss on lower limb function. Data were audio-taped and transcribed verbatim. Thematic analysis was undertaken. Results All 11 therapists had previous experience of using mobilisation and tactile stimulation for the foot post-stroke. Three main themes were identified: (1) therapeutic intervention (sub-themes: therapy content, sensation, adjuncts, the foot as an active base of support and preparation for function); (2) 24-hour care; and (3) analysis (sub-themes: outcome measures, response to treatment). The most common adjuncts to mobilisation and tactile stimulation were orthotics and task-specific training. The importance of mobilisation and tactile stimulation in restoring foot alignment, sensory feedback and progression of the patient towards weight bearing and ambulation in the clinical setting was highlighted. Conclusions Mobilisation and tactile stimulation is a complex intervention used in stroke rehabilitation to enhance weight bearing and ambulation post stroke. Further research into its effects on the foot and lower limb is warranted in order to evaluate it and determine its evidence base for inclusion in routine clinical practice. Alternative methods of applying proprioceptive stimulation should also be considered, for example use of textured insoles, and relative effectiveness of these explored in clinical trials.
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    #Nogoingback: Embracing digital technology in response to the COVID-19 pandemic.
    (The Royal Wolverhampton NHS Trust, 2020-10-21) Hadley-Barrows, Tina
    Remote consultations have successfully provided an alternative method of accessing physiotherapy and occupational therapy services and will continue to be an option for patients in the future. Ongoing service evaluation including patient and therapist feedback is essential to continually improve our services and deliver high quality, safe and effective patient care.
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    Groups - a lifeline to community integration: increasing participation in community activities.
    (The Royal Wolverhampton NHS Trust, 2019-11-20) Bisiker, Jane; Day-Smith, Sarah; Millinchip, Kay
    An important part of stroke rehabilitation is facilitating participation in community activities, work, education, volunteering or leisure activities, yet this has become increasingly challenging with cuts to social support. The occupational therapy stroke service in Wolverhampton has started a range of supported group activities in order to: increase social interaction and reduce depression; build confidence and increase exercise levels These groups are predominately run by volunteers, with money raised used to fund gym, swimming and cycling instructors. Therapists assess the patient for suitability for the group(s) and attend the first session with them to discuss the individual goals with the group leader. Their progress is reviewed at intervals and patients moved through the groups as appropriate.