Objectives Performance-based cognitive assessments may function differently across sociocultural contexts because language, experience, and culturally acquired representational systems influence task performance. This study examined the psychometric characteristics and culturally informed interpretation of selected Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) visual subtests among adults in Taiwan. Methods A cross-sectional design was used. A total of 101 community-dwelling Taiwanese adults with intact global cognition completed selected LOTCA visual subtests. Internal consistency, content validity, exploratory factor analysis, ordinal logistic regression, and qualitative content analysis of video-recorded assessment sessions were conducted. Results Internal consistency was low at the domain level. Exploratory factor analysis identified a two-factor solution that did not reproduce the original visual perception and visuomotor construction structure. Factor 1 comprised Shape Identification (SI), Object Identification (OI), Reproduction of a Two-Dimensional Model (TM), and Puzzle Reproduction (RP), whereas Factor 2 was represented primarily by Drawing a Clock (DC). Age was associated with SI and TM, and gender was associated with TM after Bonferroni correction. Demographic influences were concentrated in SI and TM (Nagelkerke R 2 = .630 and .582, respectively). Qualitative findings identified linguistically mediated categorization, experiential familiarity, stimulus-based misidentification, and strategy-based task regulation as influences on score interpretation. Conclusions LOTCA visual subtest performance reflected interactions among perceptual demands, language, education, experience, and culturally acquired representational systems. Score variation should not be interpreted solely as evidence of cognitive limitation. Culturally informed interpretation and response-process levels may inform more accurate interpretation for visual perception performance in occupational therapy cognitive assessments.
Aim:To determine the minimal clinically important difference (MCID) of the Extended Barthel Index (EBI) in patients with stroke. Methods:In total, 209 patients with stroke were enrolled from a rehabilitation hospital. The EBI was administered at baseline, day 1, and week 4 after enrolment. At week 4, occupational therapists, patients, and expense payers independently rated the perceived ability change in activities of daily living. The MCID was estimated using distribution-, receiver operating characteristic (ROC) curve-, anchor-, and regression-based methods. Results:Distribution-based estimates produced small to moderate effect sizes. ROC curve analysis yielded optimal cutoffs around 2.5-3.5 points depending on the roles; sensitivity was high, whereas specificity was low. Anchor-based and regression methods produced separate thresholds for deterioration and improvement across stakeholders. Based on the anchor-based method, the recommended MCID for deterioration ranged from -2.0 to 0 points and for improvement from 4.0 to 6.0 points, varying by rater perspective. Conclusion:Anchor-based MCID values are recommended for clinical use to distinguish improvement from deterioration, directly reflecting the perspectives from patients, therapists, and payers. The established thresholds can guide therapists' goal setting, progress monitoring, and rehabilitation policy decisions.
Background/ Objective:Occupation generates better health outcomes, yet practitioners are unaware of their use its use in practice. The profession needs a psychometrically strong measure of occupation in practice. This study aimed to measure the interrater reliability of the Occupation-Based Practice Assessment (OBPA) and reliability between observer and self-administration. Methods:The study took place in a 356-bed acute care teaching hospital in an urban midwestern U.S. city. Data collection captured all therapeutic interactions during full days of practice. This methodological design was used to establish the psychometric properties of the OBPA. Study participants included two volunteer full-time occupational therapists employed at least 6 months. Any therapists delivering group therapy or supervising students were not eligible to participate.The OBPA measures the use of occupation in practice and is grounded in the Dynamic Model of Occupation-Based Practice. The tool includes several scales to measure different aspects of practice. Preliminary research revealed excellent interrater reliability so researchers hypothesized favorable interrater reliability outcomes in this in-vivo study. Results:Fifty-four assessment interactions were measured yielding strong interrater reliability between observers at ICC = .843; p < .001. Self - observer reliability was good to excellent at ICC = .856, p < .001 for immediate self-assessment and ICC = .937; p < .001 for delayed self-assessment. Conclusions:The OBPA is psychometrically strong for use in self-assessment, professional development, program evaluation, academia, and scientific inquiry, all in support of promoting increased use of occupation in practice.
Background:Current assessments of electric-powered wheelchair (EPW) driving, such as the Wheelchair Skills Test (WST), rely on observational scoring and lack validation in outdoor environments. Occupational Therapists require standardized, quantitative measures to evaluate driving performance and monitor training progress. Objective:This pilot study examined: (1) the influence of cognitive, physical, and sensory components on EPW driving, (2) the validity of sensor-derived jerk metrics relative to WST scores, and (3) the feasibility of these metrics as outcome measures in an EPW training program. Methods:Seven adults with mobility impairments (six novice wheelchair drivers; mean age 59.4 years) completed baseline assessments. Sensors mounted on the EPW and joystick captured jerk during seven WST tasks with Apps displayed. Three metrics-median jerk, time above threshold, and the Jerk Index-were computed and correlated with WST scores. Pre/post comparisons were conducted following four training sessions. Results:Sensor-derived metrics demonstrated strong inverse correlations with WST scores (ρ = -0.750 to -0.857, p < 0.05), indicating that lower jerk values reflected higher skill. The Jerk Index correlated significantly with WST scores in outdoor tasks (ρ = -0.786, p < 0.05). After training (N = 4), WST scores improved by 21.3% and the Jerk Index decreased by 20.6%, though changes did not reach statistical significance. Conclusions:Jerk-based metrics, particularly the Jerk Index, show promise as objective measures of EPW driving performance. They demonstrated concurrent validity with WST scores and applicability in outdoor contexts. Larger studies are warranted to confirm reliability, establish clinical thresholds, and support integration into rehabilitation practice.
Introduction The aims of the World Federation of Occupational Therapists (WFOT) include the promotion of research for advancing public protection and access to quality evidence-informed occupational therapy. As a Federation of occupational therapy organisations, WFOT was requested by national member associations to conduct a global consultation to assist them in engaging occupational therapists in research in their country by identifying priority issues and sharing research participation strategies. Method A two-phase mixed methods study involving an online needs analysis survey of representatives of each national member organisation of WFOT; followed by a consultation with WFOT member organisation representatives attending a WFOT Council meeting to identify strengths, weaknesses, opportunities and threats (SWOT) for research engagement. Results Strengths for research engagement were identified as the broad scope of practice of occupational therapy; growing research capacity; and increasing access to evidence. Weaknesses included the availability of time and resources; and access to external supports. SWOT participants identified opportunities for developing a robust research culture within the profession, as well as strategies to continue to promote access to research evidence. Threats to occupational therapist research engagement centred upon low expectations among some occupational therapy stakeholders regarding the use and generation of research. Conclusions Findings suggest a culture change is needed to better involve occupational therapists in research. Building research capacity is dependent not only upon nurturing individual research skills and motivation, but also on advocating for organisations involved with the profession to foster, produce and use research. Recommendations for key occupational therapy stakeholders were identified from the findings to create not only the required research competence and confidence, but also the environments and supports that are conducive to such involvement.
Background/Objectives One possible effect of mental disorders among general workers is their impact on cardiovascular health. This study aimed to investigate the relationship between mental disorders—specifically depression, anxiety, depression-anxiety, and post-traumatic stress disorder (PTSD)—and heart disease in workers. Methods This systematic review and meta-analysis followed PRISMA guidelines. A comprehensive search was conducted across five electronic bibliographic databases. Two independent researchers screened and selected studies by examining titles and abstracts. Data was independently extracted by two reviewers from the chosen studies. Moreover, a meta-analysis was performed focusing on the odds ratio values. Results Thirty-four studies were included in the analysis. Of these, 29 focused on myocardial infarction, 2 on heart failure, and 2 on ischemic heart disease. Among the reviewed studies, 30 out of 34 demonstrated a significant association between depression, anxiety, and post-traumatic stress disorder with heart diseases. Based on the results of meta-analysis, pooled values of odds ratio related to association between depression, anxiety, and PTSD with heart disease were 1.53 (95% CI: 1.26–1.80), 1.87 (95% CI: 0.13–3.61), and 1.70 (95% CI: 1.34–2.05), respectively. Conclusions The findings suggest that depression, anxiety, depression-anxiety, and PTSD may contribute to the development of heart disease in workers. However, the high heterogeneity warrants cautious interpretation. Consequently, it is imperative that preventive measures, such as workplace mental health programs, stress management interventions, occupational therapy programs, and policies targeting occupational risk factors, are implemented.
Background:Mindfulness-based interventions (MBIs) applied in the field of occupational therapy (OT) have shown promising results, particularly in enhancing emotional well-being, stress regulation, and pain management. However, to the best of our knowledge, a systematic review of the existing research on MBIs in the context of OT is lacking. This review aims to: (1) outline the types and components of MBIs applied in OT; and (2) summarize the current empirical evidence on their effectiveness in OT practice, focusing on health-related and OT-related outcomes. Methods:Seven databases were searched with key terms related to mindfulness and OT, including PubMed, Web of Science, Embase, Cochrane Library, CINAHL, PsychInfo and Medline. The review included randomized controlled trials (RCTs) and quasi-experimental studies published in English covered the period from the inception of the databases to October 2024. Exclusion criteria included articles that were not peer-reviewed, lacked outcome data, or were not applied in OT. The Joanna Briggs Institute methodology was employed for the systematic review, which included critical appraisal and narrative synthesis. Results:A total of 10 studies were included in this review. The critical appraisal scores ranged from 50 to 91.67 (mean = 74.31), with RCTs scoring between 50 and 91.67 (mean = 73.33), and quasi-experimental studies between 62.5 to 88.89 (mean = 75.28). The interventions categorized were creative and art-based mindfulness activities (n = 2), structured MBIs (n = 3), and multi-modal MBIs (n = 5). MBIs demonstrated significant effectiveness in improving mental health, particularly overall mental health levels, and may offer potential benefits in promoting activity and participation. However, no significant additional benefits were observed for physical health, cognitive function, or health-related quality of life. Conclusion:MBIs are evidence-based interventions that can effectively improve mental health, particularly in overall health levels, and may promote activity and participation. Occupational therapists can incorporate approaches, such as creative and art-based mindfulness activities, structured MBIs, and multi-modal MBIs, in their daily practice. Further exploration and integration of these interventions into OT education and practice should be encouraged.
Background:Spatial neglect, a disorder of lateralized spatial attention, is often considered to be a hidden condition because symptoms do not appear unless comprehensive assessment is completed. The Kessler Foundation Neglect Assessment Process (KF-NAP®) is a standardized method using the Catherine Bergego Scale (CBS) to detect and measure spatial neglect during daily activities. It is a frequently used tool because it assesses spatial neglect during functional activities, meaning it is comprehensive and applied. Since it was introduced in 2012, the KF-NAP has been adopted in numerous inpatient and outpatient settings and gone through several revisions. The latest and most used version is the 2015 edition. Methods:Users have been providing the developers of the assessment informal feedback and suggestions during training sessions, lectures, and professional conferences. In addition, as part of a multisite implementation project, the developers asked KF-NAP users to provide their comments about the tool. Results:Using this qualitative information, the developers made changes to the KF-NAP Manual by adding detail to the observation and scoring procedures, a "questions to consider" section to each item-specific instruction, and highlighted instructions based on practice setting. For example, clarification about how to assess the personal belongings category in an outpatient setting is provided, which includes more details on what items to ask and directions about setup. Conclusions:This article aims to inform health professionals working with the neurological population about the KF-NAP 2023 Manual. The goal is to help users improve their experience and consequently improve practice.
Objective The Contextual Memory Test-2 (CMT-2) is an updated version of the CMT, which is a standardized occupational therapy assessment to evaluate an individual’s memory, awareness and strategy use to guide occupational therapy interventions. This study aimed to examine, amongst younger adults (<40 years old) and middle-to-older adults (>40 years old) in Singapore, (1) the relationship between strategy use and memory performance (2) the relationship between online awareness and memory performance, and (3) explore the relationship of memory performance and online awareness with age. The secondary objective was establishing preliminary normative data on CMT-2 for the Singapore adult population. Methods One hundred and thirty-two healthy participants aged 18–71 were recruited via convenience sampling and underwent virtual or face-to-face assessment. CMT-2 was administered to assess their immediate recall (IR), delayed recall (DR), total recall (TR), strategy use, and online awareness of performance through prediction and estimation discrepancies. Results Higher recall scores were found for efficient strategies as compared to inefficient (IR: p = .012; DR: p = .003; TR: p = .003). For different strategy types, ‘context’ yielded higher recall scores than ‘limited association’ (IR: p < .001, DR: p = .016). During IR, ‘association’ also obtained a higher recall score than ‘limited association’ ( p = .007). Significant strong negative correlation of IR prediction discrepancy with recall score was found (r s (130) = -.611, p < .001). Conclusion The preliminary normative data of CMT-2 among healthy adults in Singapore highlighted the role of effective memory strategies and online awareness in memory recall performance, suggesting the prioritization of these areas during interventions.
Objectives:Legible handwriting is crucial for academic success, especially among elementary school students. However, there is limited research on handwriting interventions for logographic languages. The purpose of this study was to develop a Geometric-Based Handwriting Intervention (GBHI) Program for improving Chinese handwriting and to investigate its feasibility and preliminary outcomes. Methods:The intervention program was created using psycho-geometric, developmental, and motor learning theories, along with cognitive principles specific to Chinese character writing. Comprising 4 course modules, it was designed to systematically incorporate the geometric structure of Chinese characters into activities targeting fundamental handwriting skills. A two-phase feasibility study was conducted. In Phase 1, eight typically developing elementary students participated in a single 3-h course module to assess their satisfaction with the program. In Phase 2, four elementary students completed all four course modules to evaluate the feasibility and explore potential benefits, as measured by the Chinese Handwriting Evaluation Form (CHEF), the Chinese Handwriting Legibility Assessment for Children (CHLAC), and assessments of handwriting-related fundamental skills. Results:In Phase 1, participants reported high satisfaction with the problem, with an average rating of 4.40 on the 5-point Likert-type satisfaction questionnaire. In Phase 2, participants demonstrated improvements in handwriting performance following completion of the GBHI program. Conclusion:This study contributes to the growing body of research on handwriting interventions, particularly within the context of logographic language education. The program introduces a novel approach to teaching Chinese character writing, and the successful delivery of the 4-module intervention supports its feasibility for implementation.
Background:In occupational therapy, various accessible and effective interventions have been used to improve social skills and participation of individuals with Autism Spectrum Disorder (ASD). The objective of this systematic review was to examine whether virtual, augmented, and mixed reality (VAMR) training affect the development of social skills in individuals with ASD. Methods:A literature search was conducted across MEDLINE, EMBASE, ERIC, and Web of Science databases. Full articles were reviewed and meticulously screened. Data were extracted from the studies, statistical heterogeneity was evaluated, and effect size was calculated. Results:Using these criteria, 2,929 articles were identified and seven studies were selected. In total, seven studies with 417 individuals with ASD were included. All studies were judged to have an unclear risk of bias concerning the randomization process as they failed to report sufficient information about the selection of the reported results. When analyzed by developmental period, interventions applied to individuals with ASD for social skills were most common from middle childhood to early adolescence. Conclusion:Current evidence is insufficient to support effectiveness, and further research is needed to better understand the scope of VAMR training that can provide social skills to individuals with ASD. Nevertheless, this review is significant in that it concluded an intervention combining cognitive behavioral training and VAMR training is useful for individuals in the developmental age group from mid-childhood to early adolescence for their social skills development.
A core philosophy of occupational therapy is adopting a holistic approach, considering individuals' cultural and societal values. While occupational therapy is rooted in modern Western cultures, which contrasts with traditional Chinese medicine (TCM) health beliefs, TCM conceptualizes health as multidimensional-a notion akin to occupational therapy's philosophy. This article attempts to explore the relationships between TCM health culture and occupational therapy perspectives by integrating culturally relevant activities and traditional Chinese Wellness practices into clinical occupational therapy. Using the Occupational Therapy Practice Framework, the study aims to develop a reference that recommends culturally relevant activities and integrates TCM health culture into clinical occupational therapy.
Objective:This study assessed changes in attitudes towards mental illness and physical disabilities in occupational therapy (OT) students after an anti-stigma course (AS group) and compared the changes in attitudes with a control (CT group) attending a sociology course. Methods:A quasi-experimental design was used in this study with 65 OT students across two academic years (AS group: n = 33; CT group: n = 32). Stigmatizing attitudes and social distance towards mental illness and physical disabilities were measured before and after course completion. Results:Compared with the CT group, the AS group showed a significantly greater reduction in social distance towards mental illness (t = 1.974, p = .027) and decreases in stigmatizing attitudes (t = 2.087, p = .021) and social distance (t = 2.512, p = .008) towards physical disabilities. In addition, both groups reported greater social distance towards mental illness than towards physical disabilities in both the pretest and posttest. Conclusions:A multimodal anti-stigma course may decrease social distance towards mental illness as well as stigmatizing attitudes and social distance concerning physical disabilities among OT students. However, further refinement of the anti-stigma course, with a particular emphasis on mental health stigma, is warranted.
Introduction:Aging-in-place facilitate seniors to stay in their homes throughout the aging process. Place-based Occupational Therapy is a proposed service delivery model aimed at facilitating this. This study explores community occupational therapists' perspectives on how place-based Occupational Therapy could facilitate aging-in-place and the perceived enablers and barriers to this model of care. Method:The participants were occupational therapists working in the community setting. Data was collected through semi-structured interviews. An aging-in-place capability framework was employed to guide the interviews. A generic descriptive-interpretive qualitative research approach was used for the analysis. Results:Data saturation was reached at the seventh interview (n = 7). Six major themes were generated to explore the perspectives of occupational therapists on a place-based strategy to deliver Occupational Therapy services: (i) maintaining health and function, (ii) partnering with caregivers, (iii) ideal location within neighborhoods, (iv) understanding clients' environment strengthens intervention, (v) facilitating social connections and cognitive wellness, and (vi) enablers for service set-up. Besides financial support, key enablers include clinical expertise and program management experience. Conclusion:Findings from this study can facilitate future planning of place-based Occupational Therapy services. The services should be fuss-free, short-term and affordable. The service should be sited where many older adults gather in their neighbourhoods, within walkable distance from their homes. Occupational therapists can contribute to program planning to maintain health and function and facilitate relationship building between older adults. There is potential for place-based occupational therapists to contribute to health promotion due to the profession's unique focus on habits and environment.
Background:Community occupational therapy forms a critical primary health service in supporting the development of young children. This study aims to explore characteristics of service provision, parent rated outcomes and the relationship between dosing and service outcomes. Methods:A retrospective file review was completed to examine the services received by 60 children, aged 0-6 (mean age 3.8 years). Characteristics of service provision were described. Parent-reported performance and satisfaction scores of the Canadian Occupational Performance Measure (COPM) before and after the intervention were compared. Spearman rank order correlation was used to explore the relationship between intervention "dose" and therapy outcomes. Results:Most children (n = 51; 85%) received individual therapy for handwriting and motor skills. The average wait time was 26.4 weeks (SD = 19.0). Results of COPM showed improvements in both performance and satisfaction scores (ps < 0.001). Spearman rank order correlation showed no relationship between dosing and outcomes. This study has reported the predominant service provision around handwriting and motor skills with a long wait time. Conclusion:Findings may assist in future service development, including the service to be provided, considering wait times and equity considerations. Further work is needed to explore what dosage yields the best outcomes.
Background/Objectives:During the COVID-19 pandemic, workforce across the globe had experienced an unprecedent change in work mode under the quarantine and social distancing policies. Shift work workers, who were at higher risk of burnout, upheld their roles and kept the essential operation of society maintained amidst the pandemic time. The objectives of this study are to evaluate the association between impact of COVID-19 and burnout among shift workers in Hong Kong, and to investigate if there is any association between the infection history and burnout among shift workers. Methods:Five hundred and thirty eight shift workers (297 males and 241 females of age 33+9) were recruited in this cross-sectional study. Self-administered questionnaire addressing respondents' demographic information, shift characteristic, anxiety level, perception towards COVID-19 and the burnout situation of the respondent were distributed. Results:The prevalence of burnout among shift workers during pandemic was 39.4%. Engagement in more shifts (aOR = 2.608), 9 to 15-night shift/month (aOR = 1.654), history of frequent infection of COVID-19 (aOR = 2.076), high anxiety level (aOR = 8.599) was associated with higher probability of burnout. Increase in anxiety level correlated to increase in exhaustion (β 0 = 0.042) and decrease in personal efficacy. ( β 0 = -0.081). Conclusion:Impacts by COVID-19 were associated with burnout of shift workers in terms of older age, single status, long shift pattern, night shift, anxiety level as well as infection history. Although World Health Organization has declared the end of COVID-19 pandemic, the post-pandemic burnout situation emerged as an alarming occupational hazard.
Objective: This study examined the associative relationships among age, cognition, anxiety, and participation in explaining the number of Assistive Technology Devices (ATDs) used by stroke survivors through path analysis. Methods: A cross-sectional study was conducted with 196 community-dwelling stroke survivors. Data on ATD usage, cognitive function (Montreal Cognitive Assessment), anxiety (Beck Anxiety Inventory), and participation (Utrecht Scale for Evaluation of Rehabilitation-Participation) were analyzed using SPSS 22.0 and Amos 24.0. Results: The modified path model demonstrated a good fit to the data. Age, anxiety, and participation had direct effects on the number of ATDs used, while cognition did not show a statistically significant effect. Anxiety also had an indirect effect through participation, indicating a dual role of participation in either increasing or reducing ATD reliance. Age influenced anxiety and participation both directly and indirectly. Conclusions: This study identified the pathways through which age, anxiety, and participation influence ATD usage among stroke survivors. Given the complexity of interplay of psychological and functional factors, ATD prescriptions should adopt a user-centered approach, considering participation levels, psychological responses, and environmental factors to optimize effectiveness and long-term use.
This study aimed to evaluate the effect of repetitive peripheral magnetic stimulation on edema of the hemiparetic hand in patients with stroke. This single-center, open-label, crossover, randomized controlled trial was registered with the Japan Registry of Clinical Trials, included 18 post-stroke patients in the convalescent rehabilitation ward. Patients were randomly assigned to two groups and received either conventional rehabilitation (control) or conventional rehabilitation plus repetitive peripheral magnetic stimulation (intervention) for 2 weeks, followed by 2 weeks of the other treatment. The repetitive peripheral magnetic stimulation intervention consisted of 6,000 pulses per day at a frequency of 30 Hz, 5 days per week. The primary outcome was changes in hand edema. The secondary outcomes were circumference of the hand, passive range of motion of flexion and extension of the metacarpophalangeal joint, hand pain and numbness, and grip strength. The outcomes were analyzed using mixed-effects models for repeated measures. Sixteen patients who completed the whole phase were included in the analysis. The changes in hand edema showed significant differences between the groups (p < .01). Metacarpophalangeal joint flexion also had significant differences between the groups (p < .01). The left-right difference in hand volume increased from 48.8 ± 27.6 mL to 59.1 ± 26.3 mL after the control but significantly decreased from 56.3 ± 31.6 mL to 39.7 ± 30.2 mL after the intervention (p < .01). Repetitive peripheral magnetic stimulation is effective in reducing hemiparetic hand edema and increasing metacarpophalangeal joint flexion after stroke.
Objective:Achieving both the social functioning and personal recovery as treatment outcomes for individuals with schizophrenia remains challenging, despite their recognition as key treatment goals beyond symptom reduction. These interrelated constructs require precise examination to inform effective rehabilitation strategies including occupational therapy. This study explores the relationships between subdomains of social functioning and personal recovery. Methods:This cross-sectional study included 98 outpatients with schizophrenia. Social functioning was assessed using the Japanese version of the Specific Levels of Functioning Scale (SLOF), and personal recovery with the Japanese version of the Recovery Assessment Scale (RAS). Correlational and hierarchical multiple regression analyses examined their associations. Results:The Interpersonal Relationships domain of social functioning correlated significantly with the RAS subdomains Trust in Others (r = 0.34, p < .01) and Willingness to Ask for Help (r = 0.26, p < .01). Hierarchical multiple regression analysis identified Interpersonal Relationships as a significant predictor of Trust in Others, but not Willingness to Ask for Help. Discussion:These findings highlight the crucial role of interpersonal relationships in fostering trust, a key aspect of personal recovery. The results support integrated interventions addressing both social functioning and personal recovery to help reduce loneliness in individuals with schizophrenia.
Background:In occupational therapy clinical practice there is often varied practice regarding thumb immobilization in a cast for nonsurgical management of nondisplaced or minimally displaced scaphoid fractures. The objective was to determine whether immobilization of the thumb in addition to the wrist for nonsurgical management of nondisplaced scaphoid fractures in adults is required to support good clinical outcomes including fracture union, hand function, wrist range of motion, pain, grip strength and scaphoid stability. Methods:A systematic review of Embase, Medline, ProQuest, Scopus, Web of Science and a manual reference list search of retrieved studies was completed. Studies were included if participants were aged 16 years or older, received conservative treatment of the scaphoid fracture with immobilization, and evaluated the outcome measures of interest. Results:Six articles were identified including four randomized control trials and two were one group pre-test-post-test crossover study designs, with methodological quality ranging from limited to strong. Limited evidence was found to support inclusion of the thumb in a cast for scaphoid management. Thumb inclusion did not promote better clinical outcomes regarding union rate and hand function. Thumb inclusion had no advantage over a no-thumb cast in relation to improving pain, grip strength, wrist range of movement and scaphoid stability. Conclusion:Current evidence does not support immobilization of the thumb in addition to the wrist for nonsurgical management of nondisplaced scaphoid fractures by occupational therapists.
