Chih-Huang Yu, Virgil Mathiowetz; Systematic Review of Occupational Therapy–Related Interventions for People With Multiple Sclerosis: Part 2. Impairment. Am J Occup Ther 2014;68(1):33-38. doi: 10.5014/ajot.2014.008680.
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This article is the second part of a systematic review of studies on occupational therapy–related intervention for people with multiple sclerosis (MS). The objective of this systematic review was to critically appraise and synthesize the applicable findings to address the following focused question: What is the evidence for the effectiveness of interventions within the scope of occupational therapy practice for people with multiple sclerosis? Part 1 (Yu & Mathiowetz, 2014) reviewed evidence for the effectiveness of activity- and participation-based interventions for people with MS. In contrast to the top-down approach, enabling occupational performance can be achieved through remediating impaired personal abilities. Therefore, Part 2 focuses on occupational therapy interventions targeting impairment. Studies included in this review focused on improving client factors and performance skills in people with MS, including cognition, emotional regulation, and motor and praxis skills.
Specific mental functions, including cognition (2 Level I and 6 Level II) and emotional regulation (5 Level I and 1 Level II)
Motor and praxis skills, including exercise (14 Level I, 2 Level II, and 7 Level III) and motor training (3 Level I, 1 Level II, and 1 Level III; American Occupational Therapy Association, 2008).
Occupational therapy practitioners should encourage people with MS to develop strategies for recall of task steps and can use individualized and computerized telerehabilitation programs as an extension of cognitive training.
Practitioners can use group CBT-based intervention to improve depression and self-efficacy in participants with MS. Additional improvement can be expected when CBT-based intervention is combined with goal setting, education, multidisciplinary programs, home assignments, and discussion forums.
Evidence supports exercise interventions to improve endurance, lower-extremity muscle strength, and walking performance. Occupational therapists may incorporate exercise concepts such as gradual increase, low intensity, and repetition to develop a program involving the whole body for people with MS.
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