BACKGROUND: Continued and frequent use of the affected arm can result in increased function after stroke. However, long-term access to therapy is often limited, and home exercise compliance is low. While rehabilitation gaming is becoming increasingly prevalent, concerns about therapeutic method, safety, and usability for independent home use remain largely unaddressed. OBJECTIVE: The following paper presents usability evaluation of a game based home therapy program called Home Arm Movement Stroke Training Environment (HAMSTER), which is focused on retraining normal arm kinematics and preventing compensation strategies that limit recovery. METHODS: Kinect games were created with special consideration for the stroke population and retraining normal movement kinematics. Ten individuals with stroke evaluated the games in focused interviews and one individual with chronic stroke completed one month of independent HAMSTER use in the home. RESULTS: The focused interviews showed the need for motivational upper extremity home interventions. Usability evaluation showed the ability for individuals with stroke to interact with the kinematics focused Kinect games after a short exposure time. The single participant evaluation of home use showed good compliance and improvement on all of the clinical outcome measures after the one month of HAMSTER use. CONCLUSIONS: These positive results merit further evaluation of kinematic-focused home gaming interventions like HAM-STER to reduce the use of compensation strategies during home exercise and provide a supplement to conventional care to improve exercise compliance and upper extremity function after stroke.
The findings have implications for injury prevention in office settings and suggest that ergonomics education may yield positive knowledge and behavioral changes among computer workers.
Written reflections of 113 occupational therapy clinical doctoral students who graduated from an online program between 2007 and 2013 were analyzed for themes which reflected transformative learning and characteristics of curricular design which promoted transformative learning. Qualitative analyses of written reflections were performed. Several themes emerged which are presented using the framework of Person/Learner, Environment/Learning Context, and Occupation/Engagement in Learning Activities. Strategies such as active learning; assignments that directly apply to students' work settings; implementation of a cohort model; and use of reflection, dialog, and project implementation appear to be effective in facilitating transformative learning in an online clinical doctoral program.
Maintaining instrumental activities of daily living independence is an important component of successful aging in place. Meal preparation is an essential occupation and aspect of self-identity for many women. The aim of this study was to learn which meal preparation occupations are perceived to have high activity demands, the source of these activity demands, and the coping strategies developed to mitigate the press of these activity demands. Eight community dwelling American women, 73 years old or more, participated in this study. Using the Canadian Occupational Performance Measure, each woman identified meal preparation occupations that were important to her but which she felt were performed unsatisfactorily. The author completed an activity analysis based on the Person-Environment-Occupation Model to validate each participant's identified source of high activity demands. The results suggest that the activity demands are not solely due to a decline in functional capacity but also due to environmental barriers.
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