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Occupational therapy intervention addressing weight gain and obesity in people with severe mental illness: A scoping review.
Conn, A, Bourke, N, James, C, Haracz, K
Australian occupational therapy journal. 2019;(4):446-457
Abstract
BACKGROUND Individuals diagnosed with severe mental illness have higher rates of obesity than the general population due to a range of factors, including: medication side effects, poor nutrition and reduced physical activity. Obesity is associated with increased mortality and reduced quality of life. Evidence suggests that lifestyle interventions can be effective in addressing this issue. While such interventions would appear to fit within the scope of practice of occupational therapy, there is no publication synthesising the existing literature regarding occupational therapy interventions addressing lifestyle factors associated with obesity. AIM: To determine what is known from the existing literature about occupational therapy interventions addressing weight gain and obesity in adults diagnosed with severe mental illness. METHODS A scoping review was conducted. Searches were performed in online databases, occupational therapy journals and grey literature databases. Thematic analysis occurred across all articles included in the review. RESULTS A total of 14 articles were included in the review. Analysis revealed a central theme of supporting occupational performance and participation in health promoting occupations. This central theme consisted of four categories; facilitating client-centred practice, addressing personal performance issues, addressing environmental barriers and providing the 'just right' challenge. CONCLUSION/SIGNIFICANCE These findings suggest occupational therapists are providing occupation focused interventions that are aligned with current clinical guidelines. However, more research is required to strengthen evidence-based occupational therapy practice in this important area.
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2.
Effectiveness of Interventions for Weight Loss for People With Serious Mental Illness: A Systematic Review and Meta-Analysis.
Brown, C, Geiszler, LC, Lewis, KJ, Arbesman, M
The American journal of occupational therapy : official publication of the American Occupational Therapy Association. 2018;(5):7205190030p1-7205190030p9
Abstract
OBJECTIVE We examined the effectiveness of weight loss interventions in community-based settings for people with serious mental illness (SMI). METHOD Four databases were searched for randomized controlled trials published in 2008 or later that met the criteria for the research question and used weight loss as an outcome measure. Data were extracted, and weight loss was analyzed using a meta-analysis. Similarities and differences in interventions were analyzed qualitatively. RESULTS Seventeen studies and a total of 1,874 participants with various diagnoses of SMI were included in the meta-analysis. The various lifestyle-focused interventions had a significant effect on weight loss with an overall effect size of -0.308 (p < .001). CONCLUSION Community-based interventions for people with SMI are effective for weight loss. Occupational therapists can be involved in the provision of weight loss interventions and in the development and study of intervention components that are most effective.
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3.
Sensory symptoms in autism spectrum disorders.
Hazen, EP, Stornelli, JL, O'Rourke, JA, Koesterer, K, McDougle, CJ
Harvard review of psychiatry. 2014;(2):112-24
Abstract
The aim of this review is to summarize the recent literature regarding abnormalities in sensory functioning in individuals with autism spectrum disorder (ASD), including evidence regarding the neurobiological basis of these symptoms, their clinical correlates, and their treatment. Abnormalities in responses to sensory stimuli are highly prevalent in individuals with ASD. The underlying neurobiology of these symptoms is unclear, but several theories have been proposed linking possible etiologies of sensory dysfunction with known abnormalities in brain structure and function that are associated with ASD. In addition to the distress that sensory symptoms can cause patients and caregivers, these phenomena have been correlated with several other problematic symptoms and behaviors associated with ASD, including restrictive and repetitive behavior, self-injurious behavior, anxiety, inattention, and gastrointestinal complaints. It is unclear whether these correlations are causative in nature or whether they are due to shared underlying pathophysiology. The best-known treatments for sensory symptoms in ASD involve a program of occupational therapy that is specifically tailored to the needs of the individual and that may include sensory integration therapy, a sensory diet, and environmental modifications. While some empirical evidence supports these treatments, more research is needed to evaluate their efficacy, and other means of alleviating these symptoms, including possible psychopharmacological interventions, need to be explored. Additional research into the sensory symptoms associated with ASD has the potential to shed more light on the nature and pathophysiology of these disorders and to open new avenues of effective treatments.
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4.
Stroke: posthospital management and recurrence prevention.
Silver, B, Wulf Silver, R
FP essentials. 2014;:28-38
Abstract
There is no defined duration of therapy for stroke patients, who may continue to experience recovery for several months after the event. Physical, occupational, and speech therapy should be offered as long as benefit is experienced. Patients may benefit from self-directed therapy. Constraint-induced movement therapy, a rigorous program for upper extremity weakness, has been proven effective for improving arm function. Other areas of investigation include repetitive transcranial magnetic stimulation, cellular management, robotic therapy, and pharmacologic strategies to enhance recovery. OnabotulinumtoxinA (formerly botulinum toxin A) is effective for treating spasticity in the arm after stroke. Depression, experienced by at least one-third of patients after stroke, should be managed, and selective serotonin reuptake inhibitors may offer an additional advantage of improved motor recovery. Proven interventions for secondary prevention after stroke include carotid revascularization, anticoagulation for patients with atrial fibrillation, aggressive medical management for those with significant intracranial atherosclerosis, statin treatment for patients with atherosclerotic stroke and low-density lipoprotein cholesterol levels of 100 to 190 mg/dL, antiplatelet therapy for nonatrial fibrillation stroke, and blood pressure reduction. Vitamin and dietary supplements are of unproven benefit for stroke patients. Exercise, smoking cessation, and a healthful diet should be encouraged. Return to driving and sexual activity also should be addressed during outpatient follow-up.
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5.
Occupational therapy and obesity: an integrative literature review.
Haracz, K, Ryan, S, Hazelton, M, James, C
Australian occupational therapy journal. 2013;(5):356-65
Abstract
BACKGROUND/AIM: Obesity is a significant public health concern globally. It is associated with poor physical health, mental health and subjective well-being and limitations on occupational participation. With its focus on the relationship between occupation, health and well-being, occupational therapy would appear to be well placed to address both the causes and consequences of obesity. The aim of this review was to explore the scope of the role of occupational therapy practice in this field and the supporting evidence base. METHODS Searches were conducted in four online databases and nine occupational therapy journals. Articles were included if they were theoretical, quantitative or qualitative research, explicitly related to occupational therapy and obesity, published in peer-reviewed journals, in English between 2002 and 2012. All research articles were critically reviewed and thematic analysis was conducted across all of the articles in the review. RESULTS Eight theoretical articles, 12 quantitative and two qualitative research studies were included. Only three were outcome studies. Thematic analysis identified four categories of focus of occupational therapy intervention: health promotion and prevention, increasing physical activity participation, modifying dietary intake and reducing the impact of obesity. Four categories of intervention strategies were also identified; assessment, modifying the environment, education and introducing and adapting occupations. CONCLUSION AND SIGNIFICANCE The findings of this review suggest a comprehensive role for occupational therapy in addressing obesity. However, the paucity of outcome studies mean that significantly more research is required to further define and provide a strong evidence base for occupational therapy practice in this emerging field.