Abstract Background: Spinal cord injury (SCI) significantly impacts individuals’ physical, psychological, and social well-being. Among the many challenges, sexual health is a critical yet often overlooked component of quality of life. SCI can disrupt sexual function, alter roles, and cause psychological distress, affecting both individuals and their partners. These sexual concerns are multifaceted, involving physiological impairments (e.g., genital sensation, arousal, and reproductive function) and psychosocial factors (e.g., body image, self-esteem, and relationship dynamics). Despite their prevalence, sexual health concerns are rarely addressed adequately in clinical settings. While physical rehabilitation is commonly discussed, literature addressing sexual health in SCI is limited and often underreported. Objective: The objective of this study is to systematically review the existing literature on sexual concerns in individuals with SCI. Study Design: A Systematic Review. Methods: A systematic literature search was conducted using PubMed, Research Gate, Google Scholar, and Semantic Scholar. Free full-text cross-sectional, qualitative, and interventional studies published between 2013 and 2023 were included. Reporting followed Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Results: Twenty-four articles met the inclusion criteria. Of these: The findings show that most studies concentrated on female sexual health after SCI ( n = 17 [70.83%]) and the psychological effects of reduced sexual intimacy ( n = 15 [62.5%]). However, fewer studies looked at male sexual concerns ( n = 10 [41.66%]) or the lower quality of life related to sexual problems ( n = 12 [50%]). Less than half of the studies ( n = 11 [45.83%]) covered how to include sexual rehabilitation in therapy. Notably, only one study ( n = 1 [4.16%]) involved the LGBTQ+ community, highlighting a significant gap in inclusivity. Overall, the results suggest that while sexual health is recognized in the context of SCI, it is not consistently addressed. There are major gaps in inclusivity, male representation, and rehabilitation methods. Conclusion: Cord injury which are less commonly explored. Overall, the findings reveal uneven attention across key areas, suggesting the need for a more balanced and inclusive approach in future clinical practice and patient care.
Abstract Background: Joint attention, the shared focus of two individuals on an object or event, is a foundational component of early communication, play, and social development. Children with autism spectrum disorder (ASD) often display deficits in joint attention skills, which are recognized as early indicators of autism. Occupational therapy (OT) interventions designed to target joint attention may significantly enhance social communication skills in these children. Objective: The purpose of this study was to assess the efficacy of OT intervention in improving joint attention skills in children with autism. Study Design: A one-arm interventional study. Methods: This study was conducted with 50 children aged 2–6 years, diagnosed with ASD at the Department of Child Psychiatry, Egmore, Chennai. Joint attention skills were assessed using the Early socio communication scale (ESCS) before and after a 3-month OT intervention program. The program included structured activities focused on initiating joint attention (IJA), responding to joint attention (RJA), and overall engagement. Statistical analysis was conducted using paired sample t -tests, confidence intervals (CIs), and Cohen’s d for effect size. Results: Significant improvements were observed in all measured domains. For IJA, the pretest mean was 3.76 (standard deviation [SD] =1.49) and the posttest mean was 8.56 (SD = 2.53), t (49) = −14.91, P < 0.001, d = 2.31, 95% CI (−5.49, −4.14). For RJA, the pretest mean was 6.86 (SD = 1.40) and the posttest mean was 10.82 (SD = 1.44), t (49) = −14.00, P < 0.001, d = 2.79, 95% CI (−4.53, −3.42). For total joint attention, the pretest mean was 10.58 (SD = 2.38) and the posttest mean was 19.36 (SD = 3.41), t (49) = −18.55, P < 0.001, d = 2.99, 95% CI (−10.12, −8.45). Conclusion: The OT intervention demonstrated statistically significant and clinically meaningful improvements in joint attention skills among children with ASD.
Abstract Zhu–Tokita–Takenouchi–Kim (ZTTK) syndrome is a rare genetic disorder caused by mutations in the SON gene. This study is unique as it highlights the role of a multidisciplinary approach that has so far not been documented. A 6.5-year-old girl was diagnosed with ZTTK syndrome. Clinical features included dysmorphic facial characteristics, developmental delay, seizures, and congenital cardiac anomalies. A case study was conducted in a clinical setting in Delhi, India, where a multidisciplinary team provided intervention. Progress was monitored using standardized assessments such as Behavioral Assessment Scales for Indian Children with Mental Retardation, Vineland Social Maturity Scale, Assessment of Language Development – A Manipal Manual, and Brief Autism Mealtime Behavior Inventory at three intervals. She demonstrated consistent improvements in anthropometric measures, skill domains, and reduction in problem behaviors. These results suggest that a multidisciplinary rehabilitation is beneficial for individuals with ZTTK syndrome, supporting gains in independence and behavioral outcomes.
Abstract Background: Occupation-based interventions (OBIs) are a core component of occupational therapy (OT), emphasizing engagement in meaningful and purposeful activities relevant to an individual’s daily life, roles, and interests. Although several studies have explored factors influencing OT practice, such as patient adherence, ethical behavior, and clinical reasoning, there remains a gap in the literature regarding factors affecting the use of OBIs in clinical practice. Objectives: This study examined the strategies used under each intervention type and the influence of various factors on the implementation of OBIs in daily practice among Indian and global OTs. Study Design: Observational, cross-sectional, online survey. Methods: A validated questionnaire, as published in the OT interventions survey study-I, was administered through comprehensive sampling. Of 225 responses, 201 met eligibility criteria (India: n = 84; Global: n = 117). Data were analyzed using descriptive and inferential statistics to find significant differences among the strategies used, and principal component analysis (PCA) to identify major factors influencing OBI implementation. Results: There are significant differences among certain strategies used among each of the types of interventions. During PCA, 39 initial variables were reduced to 24 key factors, grouped into six categories with strong sampling adequacy (Kaiser–Meyer–Olkin >0.7). Of which, four categories were common to both groups: (1) client/patient factors, (2) physical/environmental factors, (3) therapist-related factors, and (4) tools and technology. While two context-specific categories were included (5) referral-related and financial factors, and (6) social support and relationships for Indian OTs, versus (5) insurance-related and financial factors and (6) organizational protocols for global OTs. Conclusion: OBI practice among OTs is multifactorial and context dependent. Addressing these influencing factors may enhance the consistent use of OBIs, thereby strengthening the profession’s core identity and improving client-centred outcomes.
