ImportanceSleep disturbances are highly prevalent among veterans and negatively impact mental health and occupational performance. Occupational therapy (OT) practitioners are well equipped to address sleep as a core occupation through interventions that target habits, routines, and environmental contexts.ObjectiveTo examine the feasibility and acceptability of a community-based, OT-led modified cognitive behavioral therapy for insomnia (CBT-I) program for veterans with self-reported sleep disturbances and to explore associated changes in sleep, occupational performance, and mental health outcomes.DesignSingle-arm, pre-post pilot feasibility study with exploratory quantitative analysis.SettingCommunity-based veteran organization in Montana.ParticipantsNine veterans enrolled; seven completed the 5-week program.InterventionA 5-week OT-led modified CBT-I program consisting of weekly group education and individual OT sessions.Outcomes and MeasuresSleep quality and disturbance (PROMIS-SD, PSQI), occupational performance and satisfaction (COPM), depression (PHQ-9), anxiety (GAD-7), and quality of life (SF-12). Feasibility outcomes included recruitment, attendance, retention, and acceptability as assessed via postintervention feedback survey.ResultsParticipants demonstrated improvements in sleep, occupational performance, and mental health, with no changes in health-related quality of life. Attendance and retention were high, and all participants who completed the intervention reported positive acceptability and willingness to recommend the program.Conclusions and RelevanceOT-delivered, modified CBT-I appears feasible and acceptable in community-based settings and may be associated with improvements in sleep, occupational performance, and mental health among veterans. These findings highlight the potential role of OT in expanding access to sleep interventions, particularly in rural contexts where specialized sleep services are limited.
ImportanceSelf-care is increasingly promoted in occupational therapy as a response to practitioner stress, burnout, compassion fatigue, and professional exhaustion. Although self-care may support practitioner wellbeing, it may also individualize problems that are partly produced by organizational and systemic conditions.ObjectiveTo examine self-care in occupational therapy as a paradoxical extension of the care imperative and to develop a reflexive, paradox-oriented understanding of self-care practice.DesignConceptual analysis drawing on form theory and systems-theoretical observation. The analysis examines how self-care becomes observable through the distinction between self-care and non-self-care and how this distinction shapes professional expectations.FindingsThe paradox of self-care lies in its attempt to relieve the burden of care by extending the care imperative to practitioners themselves. Self-care supports recovery and professional sustainability, yet it may also add another layer of responsibility by requiring practitioners to care for their own capacity to care. In doing so, it can individualize exhaustion and background the organizational and systemic conditions that make self-care necessary. Self-care can therefore function both as a necessary resource and as a problem-generating solution that stabilizes stress as an expected feature of occupational therapy work.Conclusions and RelevanceA paradox-oriented understanding does not reject self-care but keeps its ambivalence visible. Occupational therapy practitioners, educators, and organizations should approach self-care not only as an individual competency but also as information about the conditions under which care work is performed. Reflexive self-care includes caring for oneself, questioning when care has become too expansive, and setting limits to the care imperative itself.
ImportanceIdentifying factors associated with sustained engagement in harm reduction-oriented occupational therapy may help inform more accessible interventions for individuals with substance use disorders (SUDs).ObjectiveTo examine participant characteristics associated with sustained engagement in the Real-Life Program (RLP), a harm reduction-oriented outpatient occupational therapy program for individuals with SUDs, and to explore changes in occupational and psychosocial outcomes among participants who continued the program.DesignRetrospective cohort study.SettingSingle-site outpatient occupational therapy program.ParticipantsFifty-five individuals with SUDs enrolled in the RLP. Participants were classified into continued (≥47% attendance) and noncontinued (<47%) groups based on the median participation rate.Outcomes and MeasuresCanadian Occupational Performance Measure (COPM), Rosenberg Self-Esteem Scale-Japanese version, Shitsu-Taikan-Sho Scale, and visual analog scales for craving intensity and perceived connectedness to others.ResultsPrior self-help group experience was significantly associated with continued participation. Older age showed a nonsignificant association. No other demographic or clinical characteristics differed significantly between groups. Among participants who continued the program, COPM Satisfaction improved significantly, whereas COPM Performance, self-esteem, alexisomia, craving intensity, and perceived connectedness did not.Conclusions and RelevancePrior self-help group experience was associated with sustained engagement in the RLP. Among participants who continued the program, satisfaction with daily occupations improved, although the clinical significance of this change remains uncertain. The RLP may provide a feasible harm reduction-oriented occupational therapy option for individuals with SUDs who have difficulty engaging in abstinence-based treatment programs.
ImportanceIndividuals with Down syndrome experience multiple conditions requiring occupational therapy intervention, but no review papers have explored the research literature to support such intervention.ObjectiveTo map the literature on occupational therapy interventions for individuals with Down syndrome across the lifespan and identify gaps in the evidence base for future research and education that require attention.Data SourcesSix databases were searched: OTSeeker, PubMed, PsychINFO, PEDro, CINAHL, and Cochrane Library for studies published on or before June 19, 2025.Study Selection and Data CollectionThis review was conducted according to PRISMA-ScR and Joanna Briggs Institute methodology for scoping reviews. Included studies had participants with Down syndrome, were published in English, contained an OT intervention, and were peer-reviewed. Excluded studies lacked participants with Down syndrome, were not in English, did not have an OT intervention, or were not peer-reviewed.FindingsWe retrieved 421 records and included 21 articles in this review. While most studies utilized rigorous designs (n = 16), none were designated "High Quality" due to multiple methodological flaws, such as failure to assess treatment fidelity or lack of random assignment to condition.Conclusions and RelevanceThis review suggests a need for studies with more methodological rigor, that address adults with Down syndrome, and that detail a greater variety of interventions. Practitioners and scholars should emphasize data-driven decision making, implementation of practice guidelines for Down syndrome, and the promotion of continuing education opportunities on Down syndrome.
ImportanceCollaboration between occupational therapists (OTs) and occupational therapy assistants (OTAs) supports coordinated client-centered care. Although the Intraprofessional Collaborative Practice Survey (ICPS) has been used to document progress in occupational therapy, Rasch-based psychometric evidence is limited.ObjectiveTo evaluate the ICPS psychometric properties using Rasch analysis and examine differential item functioning (DIF) between master of occupational therapy (MOT) and doctor of occupational therapy (OTD) students.DesignCross-sectional psychometric validation study.SettingAccredited occupational therapy programs across the United States.ParticipantsIn total, 444 occupational therapy students (272 MOT [mean age = 24.55 years; 7.4% male] and 172 OTD [mean age = 24.84 years; 8.7% male]).Outcomes and MeasuresIntraprofessional Collaborative Practice Survey (ICPS)-Occupational Therapist version, a 20-item survey with Perceived Importance and Perceived Ability modules across four domains: Intraprofessional Teamwork, Roles and Responsibilities for Collaborative Practice, Communication for Intraprofessional Practice, and Values and Ethics for Intraprofessional Practice.ResultsUnidimensionality was confirmed for the four domains within both the Perceived Importance and Perceived Ability modules. Response categories advanced monotonically, supporting appropriate functioning of the 3-point rating scale. Item fit was acceptable. Ceiling effects were observed across both modules; no floor effects were found. Item separation indicated stable item ordering. Two Perceived Importance items demonstrated meaningful DIF between MOT and OTD students.Conclusions and RelevanceThe ICPS demonstrated satisfactory construct validity, and most items functioned comparably across MOT and OTD programs. Ceiling effects in the Perceived Importance items may limit sensitivity to change at higher endorsement levels. Two DIF items warrant further examination.
ImportanceThe cause of idiopathic toe walking (ITW) remains unclear, though impaired sensory processing has often been hypothesized to be linked to ITW.ObjectivesThe objective of this article is to review the literature on toe-walking to identify how sensory processing contributes to ITW.Data SourcesFour databases (CINAHL, Pubmed, PsychINFO, and SCOPUS) were searched for papers related to sensory processing and ITW published prior to July 2024. References of retrieved papers were reviewed for additional sources.Study Selection and Data CollectionThe PRISMA guidelines for scoping review were used to abstract the data following Joanna Briggs Institute methodology. Inclusion criteria were examined and papers included at least one sensory system related to ITW was studied. Papers were excluded if toe walking was due to diagnosed neurological, orthopedic, or genetic conditions.FindingsOur scoping review identified 13 published articles relevant to examining sensory processing in children with ITW. Studies explored differences in vibration perception, light touch, proprioception, vestibular, visual processing, sensorimotor functional assessments, and parental surveys of sensory processing. Six of the papers were included in a meta-analysis on vibration perception threshold that failed to reach significance (p = .12). Despite heterogeneity across studies in participants, methods, and outcomes, a meta-analysis for atypical scores from parent-report sensory processing survey data yielded significant differences between children with ITW and typical controls (p < .0068).Conclusions and RelevanceChildren with ITW demonstrate impairments across multiple domains of sensory processing and sensory-motor function suggesting an underlying relationship between ITW and sensory differences. Children with ITW, however, represent a diverse group of individuals with significant between-subjects variability in which senses are impaired, and which outcome measures best capture these differences.
ImportanceMetacognitive Reflection and Insight Therapy for Occupational Therapy (MERIT-OT) is a novel adaptation of an evidence-based psychotherapy model designed to enhance metacognitive capacity and support recovery. Its philosophical alignment with occupational therapy-particularly the emphasis on meaning-making and life participation-makes it a promising intervention for Veterans with serious mental illness. However, to date no implementation studies of MERIT-OT have been conducted.ObjectiveTo evaluate the implementation of MERIT-OT within a Veterans Affairs (VA) occupational therapy setting and to explore preliminary findings regarding clinical effectiveness.DesignPilot study evaluating the implementation and preliminary effectiveness of MERIT-OT when delivered by occupational therapists in a VA setting.SettingOne VA Medical Center across four occupational therapy practice areas: psychosocial rehabilitation, outpatient mental health, home health, and women's health.ParticipantsFive occupational therapists; three implemented MERIT-OT with nine Veterans over 37 sessions.Outcomes and MeasuresImplementation outcomes were assessed using the Consolidated Framework for Implementation Research when analyzing interviews and chart review data. Clinical outcomes were measured using the Metacognition Assessment Scale-Abbreviated (MAS-A).ResultsFacilitators included perceived relative advantage and tension for change. Barriers included competing priorities and documentation challenges. Quantitative analysis showed early gains in metacognitive mastery; other subscales showed limited change.Conclusions and RelevancePreliminary findings suggest ongoing consultation, additional training, and improved tools and resources may facilitate MERIT-OT implementation in VA outpatient mental health.What This Article AddsMERIT-OT offers a structured, recovery-oriented approach aligned with occupational therapy values and shows promise for enhancing metacognitive outcomes in mental health settings.
This article provides a lens through which occupational therapy practitioners (OTPs) can support immigrants seeking asylum in the United States. We argue that navigating legal services is a critical entry point where OTPs can collaborate with asylum seekers and legal aid organizations. While existing literature addresses occupational therapy assessments and interventions for this population, few studies emphasize how OTPs can assist asylum seekers in navigating the legal system to secure rights that enable safe participation in essential occupations such as work, education, social engagement, and leisure. To address this gap, we propose three strategies: (1) building partnerships with legal aid organizations, (2) conducting ongoing needs assessments with legal organizations and asylum seekers, and (3) collaborating to provide occupation-based resources and care. Partnerships among OTPs, asylum seekers, and legal professionals foster knowledge exchange and holistic, client-centered, evidence-based support. Legal experts offer insight into structural barriers; asylum seekers contribute lived experience and personal strengths; OTPs bring expertise in promoting participation and wellbeing through meaningful activity. Recognizing that asylum seekers often face systemic obstacles to daily engagement, we position legal navigation as a critical focus for OTPs. By outlining actionable strategies, this article equips OTPs to deliver responsive, justice-oriented care tailored to asylum seekers' lived realities.
ImportanceAge-related declines in hearing and vision are common among older adults and are increasingly recognized as key determinants of functional independence. However, limited evidence exists on how sensory function (vision and hearing) shapes longitudinal trajectories of daily functioning over time.ObjectiveTo examine longitudinal associations between hearing and vision function and the trajectories of activities of daily living (ADLs) and instrumental activities of daily living (IADLs) among community-dwelling older adults.DesignLongitudinal cohort study using latent growth curve modeling.SettingCommunity-based sample.Participants2,961 adults aged ≥ 65 years.Outcomes and MeasuresSelf-reported sensory function, and functional performance in ADLs and IADLs.ResultsThe mean age of participants was 73.637 years (SD = 5.990; 1,207 men, 1,754 women). Both ADL and IADL performance declined over time, with a steeper declines observed for IADLs (slope = -0.517, p < .001) than for ADLs (slope = -0.317, p < .001). Poorer hearing and vision function were associated with lower functional performance across waves, with stronger associations observed for IADL trajectories (β = 0.063-0.119). All latent growth models demonstrated acceptable fit.Conclusions and RelevanceSensory function was associated with adverse longitudinal functional trajectories, particularly for IADLs. These findings highlight the importance of routine sensory screening in occupational therapy (OT) practice and support older adults across the life span in order to help promote functional independence via stage-specific, individualized OT interventions that target the sensory impairment.
ImportancePreterm infants frequently experience difficulty with the transition from full tube to independent oral feeding. The influence of extrinsic environmental factors, defined as causes external to the infant, that may affect this transition remains poorly understood.ObjectiveTo examine the association between extrinsic environmental factors and attainment of independent oral feeding in preterm infants.DesignA retrospective cohort study was conducted.SettingData were collected from a tertiary care, level II/III neonatal intensive care unit. Guided by the Oral Feeding in Preterm Infants Conceptual Model, extrinsic environmental factors were selected for analysis.ParticipantsA total of 282 preterm infants (31.2 ± 2.4 weeks gestation) were included.MethodologyFactors including maternal medical history, type of medical condition, maternal substance use, non-nutritive sucking, skin-to-skin contact, feeding therapy, and days of hospitalization prior to initiating oral feeding were extracted from electronic medical records. Simple linear regressions identified potential external variables, which were entered into a multiple linear regression model.ResultsIn the final multiple linear regression model, maternal medical history, non-nutritive sucking, and skin-to-skin contact were significant predictors of time to independent oral feeding. Maternal age, substance use, feeding therapy, and days in hospital prior to starting oral feeds were not significant.Conclusion and RelevanceMaternal health and engagement, reflected in maternal medical history, opportunities for non-nutritive sucking, and skin-to-skin contact, are key extrinsic environmental factors influencing the transition to independent oral feeding. Integrating these maternal factors into occupational therapy management may enhance the attainment of independent oral feeding in preterm infants.
ImportanceFor smart home modification (SHM) to translate into routine practice, clinicians need evidence that occupational therapist (OT)-led workflows are clinically useful, feasible, and scalable in community settings.ObjectiveTo evaluate the clinical utility of an OT-led SHM program and to identify implementation barriers and strategies that support adoption and sustainment in community practice.DesignSequential explanatory mixed-methods study.SettingCommunity-based practice settings.ParticipantsTen licensed OTs who implemented the SHM program in community services. Therapists' implementation experience included delivering the program to 40 community-dwelling adults with physical disabilities (effectiveness outcomes reported separately).Outcomes and MeasuresOTs rated the clinical utility of 31 program recommendations using a structured evaluation form across appropriateness, applicability, and effectiveness (9-point scale) and documented whether each recommendation was applied. Semistructured interviews were conducted to explain rating patterns and to explore implementation barriers and improvement needs. Interview data were analyzed using thematic analysis by two coders with consensus procedures and an audit trail. Mixed-methods integration mapped themes to recommendation-level ratings.ResultsOverall, OTs rated the recommendations as highly clinically useful across domains. Applicability was comparatively lower for budget planning and for developing/implementing automation scenarios. Interviews indicated that cost constraints and technical complexity reduced feasibility, whereas OT-led goal prioritization, partial automation, simplification of operational steps, context-based training, and caregiver-inclusive education supported adoption. Revisits were most commonly linked to predictable maintenance events (e.g., unplugged power, device resets, battery depletion), underscoring the need for platform-based self-management resources and a triage pathway separating clinical OT tasks from technical support.Conclusions and RelevanceOT-led SHM shows strong clinical utility in community practice when delivered through occupation-centered assessment, tailored training, and iterative refinement. Scalable implementation may be strengthened by feasible automation strategies, caregiver-inclusive education, and structured support pathways that reduce preventable follow-up.Article ContributionThis study provides clinically grounded evidence for the utility of a manualized, OT-led SHM workflow and offers implementation strategies (partial automation, caregiver-inclusive training, platform-based self-management with triage) to support sustainable community delivery.
ImportanceIndividuals with disabilities may require adaptations and modifications during swimming instruction.ObjectiveThe purpose of this scoping review is to summarize the literature on adapted swim instruction including the following: (1) identifying adapted swim strategies; (2) determining which populations have received adapted swim instruction; and (3) identifying gaps in the research.Data SourcesSix databases were searched for records published on or before September 29, 2025, including: PubMed, Excerpta Medica Database (EMBASE), Cumulative Index of Nursing and Allied Health Literature (CINAHL), SportDiscus, Web of Science, and Education Resources Information Center (ERIC).Study Selection and Data CollectionStudies were included in this review if they were peer-reviewed, written in English, focused on beginner swimming skill instruction, included participants with disabilities and/or instructors/caregivers of individuals with disabilities, and consisted of original research studies. Studies were excluded if they were not peer-reviewed, not written in English, or not focused on beginning swim instruction.FindingsFifty-five studies met inclusion criteria and described interventions for individuals with disabilities. Studies discussed 26 adaptive strategies utilized for swimming instruction. Two studies were Oxford Level 2 studies, indicating randomized-controlled trials and definitive observational studies.Conclusions and RelevanceThere is a lack of robust, high-quality studies on adapted swim instruction, indicating a need for future studies to strengthen the evidence base.
Occupational therapy practitioners are increasingly likely to encounter clients who intentionally view sexually explicit media (i.e., pornography). Pornography use may be adaptive, neutral, or maladaptive depending on several variables: whether its use is causing the client distress; whether it is affecting their daily occupations and relationships; its degree of congruence with their values; and environmental constraints, such as client privacy, isolation, and disability. In this column, we argue that all occupational therapy practitioners should be prepared to work with clients who use pornography and to recognize how pornography use as a health management or leisure activity may support or interfere with participation, routines, roles, safety, and client well-being.
School-based occupational therapy practitioners must practice in alignment with federal legislation, state licensure requirements, and the Occupational Therapy Practice Framework and have adapted their practice for the U.S. public school system. The recent emergence of literature that advocates for and attempts to justify Ayres Sensory Integration® (ASI®) implementation in schools through Multi-Tiered Systems of Support is misaligned. There are potential licensure ramifications should school-based practitioners follow the recent Call to Action by ASI® advocates to implement direct, pull-out occupational therapy without meeting the due process requirement of the Individual with Disabilities Education Improvement Act, that is, obtaining parental consent prior to evaluation of student need. School-based occupational therapy practitioners choose occupation-based and activity-based interventions that allow adherence to the procedural, ethical, and legal mandates of the governing entities of this practice area to deliver positive proximal impacts for student participation at school.
ImportanceDriving facilitates independence and community engagement, especially in Saudi Arabia, where most people rely on cars. Medical conditions can impair driving ability, and occupational therapists play a key role in evaluation and rehabilitation. However, guidance and services to support safe return to driving in Saudi Arabia remain limited.ObjectiveTo explore current practices and challenges in driver assessment and rehabilitation as perceived by occupational therapists in Saudi Arabia.DesignThis descriptive qualitative research involved semi-structured individual interviews with participants. Data were analysed using reflexive thematic analysis, guided by the Behaviour Change Wheel (BCW) framework.SettingInterviews were conducted either in-person or virtually at each participant's preferred time and location.ParticipantsThirteen licensed occupational therapists with at least one year of experience in a rehabilitation setting in Saudi Arabia.ResultsSix themes were identified: (1) insufficient knowledge and practical skills, (2) lack of training and supporting infrastructure, (3) motivation [but it is hard], (4) recommended interventions, (5) recommended changes in policies and (6) collaboration.Conclusions and RelevanceAddressing the identified gaps in knowledge, skills and infrastructure through the suggested interventions and policy changes could enable occupational therapists in Saudi Arabia to contribute effectively to driver assessment and rehabilitation services for at-risk drivers, as well as promote road safety for all within Saudi Arabia. Collaborative efforts of occupational therapists and other stakeholders are essential to further leverage study findings in co-creating solutions to address safe return to driving and improving road safety in general.
ObjectiveTo investigate the effectiveness of rehabilitation interventions on increasing leisure participation in adult survivors of stroke.Data SourcesDatabases (Medline, EMBASE, CINAHL, and Cochrane Central Register of Controlled Trials) were searched from inception to September 2025.Study Selection and Data CollectionIncluded studies were randomized and nonrandomized controlled trials investigating leisure rehabilitation for community-living adults with stroke, which include a measure of leisure participation. Data extraction was performed using a predetermined data extraction form. The PEDro Scale was used to assess the risk of bias.FindingsA total of 6,813 records were retrieved, 46 were assessed at full-text review, and 8 studies were included. The meta-analysis included four studies, and another four studies were synthesized narratively. Leisure participation was higher in the intervention groups at the end of the intervention compared with the control (standardized mean difference = 0.80, 95% confidence interval 0.03 to 1.56). There was low certainty for this evidence due to the small number of studies and high heterogeneity. Subgroup analysis indicated possible benefits when intervention is provided earlier poststroke, and that leisure rehabilitation increases the number of leisure activities, but not the regularity of participation. It remains unclear whether any one intervention approach is more effective.Conclusions and RelevanceLeisure rehabilitation may improve leisure participation; however, the quality of evidence is low. Further well-designed trials are needed to address leisure participation following stroke, investigating the optimal timing of leisure rehabilitation and identifying the effective elements of the intervention.
ImportancePathways and Resources for Engagement and Participation (PREP) is an evidence-based, environmental intervention to improve an individual's participation in activities of choice. However, the specific intervention strategies employed have not been systematically examined.ObjectiveTo identify and describe PREP strategies used to promote the participation of youth and young adults with disabilities in community-based self-chosen occupations.DesignA descriptive qualitative study was employed. Data were extracted from PREP Intervention Forms documenting step 3 of the interventions ("Make it Happen") for 65 youth and young adults with physical disabilities. PREP Forms included 524 strategies to enhance participation in 127 goals set by the youth (e.g., taking cooking classes, playing badminton, playing a musical instrument, and volunteering in a radio station). Inductive content analysis was conducted.SettingCommunity.ParticipantsSixty-five youth and young adults with physical disabilities aged 12 to 25 (mean=18, SD = 3.67) who received the PREP intervention.ResultsTwenty-eight actions organized by four overarching strategy categories were identified: (1) reach out to community resources and partners, (2) set the stage for an accessible and adaptable context for participation, (3) engage partners in learning and education to foster their agency and enable feasible and supportive participation, and (4) monitor the process and consider new solutions.Conclusions and RelevanceFindings provide new knowledge about the practical application of the PREP approach, highlighting strategies that can enhance the participation of youth and young adults with physical disabilities. Findings can also redirect occupational therapists' attention toward engaging youth and community partners to build capacity for future participation.
Postsecondary institutions around the world are grappling with how best to respond to what is described as a crisis in student mental health, with urgent calls for evidence-based advocacy, campaigning, and global action. In response to this call to action, in this article we advocate for a stronger role for occupational therapy in supporting student mental health in postsecondary settings through the enactment of the Okanagan Charter: An International Charter for Health Promoting University and Colleges, which celebrated its tenth anniversary in 2025. We share examples of innovative occupational therapy services and developments from the United States and Ireland specifically addressing the growing mental health needs of postsecondary students; highlight advocacy efforts and international collaborations and offer suggestions for how occupational therapy practitioners can work to consolidate and expand this vibrant and necessary emergent practice area through the basic tenets of the Okanagan Charter: An International Charter for Health Promoting University and Colleges.
ImportancePoor prosthetic satisfaction in individuals with upper limb loss has been linked to delayed or nonspecific rehabilitation. The Suitcase Packing Activity (SPA) is a functional outcome measure which has been validated in healthy individuals and assesses bimanual and unilateral upper limb function through a goal-directed task.ObjectiveTo validate the SPA by investigating the relationship between SPA scores and patient-reported outcomes (PROs).DesignCross-sectional cohort study.SettingMilitary treatment facilities, community events, and prosthetic clinics.ParticipantsIndividuals over the age of 18 with major upper limb loss or limb difference who could speak/read English.Outcomes and MeasuresParticipants completed the SPA and questionnaires on patient characteristics, Patient-Reported Outcomes Measurement Information System (PROMIS®), and Disabilities of the Arm, Shoulder and Hand (DASH). SPA categories are time, accuracy, and efficiency. Pearson correlations evaluated relationships between SPA subscales and continuous variables. Linear regression determined if DASH score and age could predict SPA scores. Commonality analyses determined the unique, common, and total variance of SPA subscales explained by predictor variables.ResultsTwenty-nine individuals with upper limb loss and limb difference (18 M, age:37.8 ± 12.0, time since amputation:15.7 ± 14.7years) participated in this study. Age, PROMIS® Social Subscale, and DASH were associated with SPA scores. Age and DASH predicted SPA Time and Efficiency.Conclusions and RelevanceSPA scores align with better PRO scores and demonstrate that the SPA has sufficient concurrent validity to evaluate function in patients with limb loss. Further investigation is warranted to use this measure to compare baseline function or changes over time.
