CRITICALLY APPRAISED PAPER (CAP)

Size: px
Start display at page:

Download "CRITICALLY APPRAISED PAPER (CAP)"

Transcription

1 CRITICALLY APPRAISED PAPER (CAP) Biggs, Q. M., Fullerton, C. S., McCarroll, J. E., Liu, X., Wang, L., Dacuyan, N. M.,... Ursano, R. J. (2016). Early intervention for post-traumatic stress disorder, depression, and quality of life in mortuary affairs soldiers postdeployment. Military Medicine, 181(11), e1553 e CLINICAL BOTTOM LINE Troop Education for Army Morale Troop Education for Army Morale (TEAM) is an early intervention for mortuary affairs (MA) soldiers postdeployment. MA soldiers are exposed to high levels of stress when recovering and identifying fallen soldiers. This group of soldiers particularly has been known to experience psychological difficulties and psychiatric disorders after their return home from duty. These problems may extrapolate to the soldiers functioning in their home and community, influencing their behaviors and perceptions of the events that occur in their daily life. This could place them at an increased risk for participating in harmful behaviors, which might affect them and the people around them as well. Because no intervention has been designed for this specific branch of the army, TEAM was developed on the basis of the principles of psychological first aid (PFA) and integrates other psychosocial principles to reduce stress and facilitate adaptation among these soldiers. By promoting safety, calmness, connectedness, self-efficacy, hope, and optimism, TEAM s goal is to minimize postdeployment posttraumatic stress disorder (PTSD) and depression symptoms and enhance the overall quality of life (QOL) of MA soldiers. According to a randomized controlled design, MA soldiers (N = 126) were randomized into TEAM or a comparison group (receiving no treatment) 1 month postdeployment, with four sessions occurring at 2, 3, 4, and 7 months. At completion of the intervention and follow-up, no differences were found between the two groups. High attrition rates were documented in both groups, particularly with men. Implications for Occupational Therapy Given the large number of soldiers returning home from active duty, occupational therapists 1

2 need to be cognizant of the psychological effects of deployment, in particular for MA soldiers. Early intervention is important in the recovery and reintegration of the soldier into active duty or into his or her family environment. Occupational therapists need to be aware of the tools they can use in early intervention to facilitate this transition and help minimize the psychological effects of war. Although TEAM, the first known postdeployment intervention for MA soldiers, was found to be ineffective overall, it informs occupational therapy practice by encouraging the design and implementation of other postdeployment early interventions. Occupational therapists may work toward finding an intervention that is effective in reducing MA soldiers negative psychological responses to active combat by using the findings of this study. A possible floor effect might have occurred during the TEAM intervention, which indicates that MA soldiers with milder psychological symptoms might be limited in the reduction of their symptoms. Because of the unique and individualized needs of soldiers returning from active duty, the development of interventions targeted at specific subgroups may be beneficial, including the refinement of TEAM to potentially target soldiers with more severe psychological symptoms. In addition, because increased attendance was associated with increased benefits from the intervention, occupational therapists may serve an essential role in further determining how the intervention may be individualized to support adherence to the protocol or how future interventions may be adapted to better meet the needs of MA soldiers postdeployment. Future research is needed to help design effective interventions that meet the needs of these specific subgroups. RESEARCH OBJECTIVE(S) Examine the effectiveness of TEAM, a postdeployment early intervention based on the principles of PFA, on PTSD, depression, and QOL among MA soldiers DESIGN TYPE AND LEVEL OF EVIDENCE Level I: Longitudinal randomized controlled trial PARTICIPANT SELECTION How were participants recruited and selected to participate? U. S. Army MA soldiers were given the opportunity to voluntarily join the study 1 month after their return from deployment. These soldiers were recruited in 10 cohorts over 5 years. Inclusion criteria: For soldiers to be included in this study, they needed to be a part of the MA branch of the U.S. 2

3 Army and voluntarily join the study within 1 month of their return from deployment in the Middle East. Exclusion criteria: No exclusion criteria explicitly reported PARTICIPANT CHARACTERISTICS N= 126 #/ % Male: 85/68% #/ % Female: 41/32% Ethnicity: 72 (57.6%) White Disease/disability diagnosis: Not applicable INTERVENTION AND CONTROL GROUPS Group 1: TEAM intervention Brief description of the intervention How many participants in the group? Where did the intervention take place? Who delivered? How often? For how long? Group 2: Comparison group Brief description of the intervention Each TEAM intervention consisted of an interactive group session that lasted 2 hours and incorporated informational handouts, dedicated website access, , and a phone-line service to support the participants and their success in the program. The TEAM interventions were designed to reduced distress and facilitate adaptation, on the basis of the principles of PFA. To help facilitate this change among the MA soldiers, the intervention used five principles of PFA: safety, claiming, connectedness, self-efficacy, and hope and optimism. 68 MA soldiers (22 by Month 10) Not reported Two trained psychologists or psychiatrists ran each of the TEAM sessions. TEAM sessions were held at 2, 3, 4, and 7 months postdeployment. The intervention occurred over a 10-month period. The comparison group did not receive postdeployment intervention. Soldiers completed assessments at 1, 2, 3, 4, 7, and 10 months. How many participants 58 MA soldiers (26 by Month 10) 3

4 in the group? Where did the intervention take place? Who delivered? How often? For how long? Not applicable Not applicable Not applicable The study occurred over a 10-month period. INTERVENTION BIASES Contamination: NO Co-intervention: NO Timing of intervention: Site of intervention: NR Although direct contamination was not reported, the authors did not report whether soldiers in the control group received any similar group therapy over the period of the study. The authors did not report any cointervention for the TEAM group. They did not, however, report whether the TEAM intervention group was instructed not to use other services or interventions while participating in the TEAM intervention postdeployment. The study was conducted over a 10-month period, so general improvement of symptomatology might have contributed to the results. Psychological symptoms have been found to have a natural increase in the first 4 months after deployment, which might explain the spike in symptoms for intervention-group men during the 3rd month of the study. The comparison group did not have the same increase in symptoms, however. The site of intervention was not reported in the study. Use of different therapists to provide intervention: Two psychologists or psychiatrists ran each of the TEAM sessions. Baseline equality: At baseline, no significant differences were found between the two groups. NO The authors noted, however, that more MA soldiers in the intervention group 4

5 MEASURES AND OUTCOMES had a spouse or significant other on active duty. Measure 1: Posttraumatic Stress Disorder Checklist Name/type of measure used: What outcome is measured? Is the measure reliable (as reported in the article)? Is the measure valid (as reported in the article)? When is the measure used? 17-item Posttraumatic Stress Disorder Checklist (PCL-17) PTSD symptom total scores and Criteria B, C, and D of the Diagnostic and Statistical Manual of Mental Disorders (fourth ed.; DSM IV) diagnosis of PTSD First assessed at Month 1 (baseline) to use as a reference; then used with both groups at 2, 3, 4, 7, and 10 months Measure 2: Patient Health Questionnaire Depression Scale Name/type of measure used: What outcome is measured? Is the measure reliable as reported in the article? Is the measure valid as reported in the article? When is the measure used? Nine-item Patient Health Questionnaire Depression Scale (PHQ-9) Symptom severity score and probable major depression First assessed at Month 1 (baseline) to use as a reference, then used with both groups at 2, 3, 4, 7, and 10 months Measure 3: World Health Organization Quality of Life Assessment Brief Version Name/type of measure used: What outcome is measured? Is the measure reliable as reported Psychological Health and Environmental domains of the 26-item World Health Organization Quality of Life Assessment Brief Version (WHOQOL BREF) QOL (psychological health and environmental domains) 5

6 in the article? Is the measure valid as reported in the article? When is the measure used? Measure 4: Combat Experiences Scale Name/type of measure used: What outcome is measured? Is the measure reliable as reported in the article? Is the measure valid as reported in the article? When is the measure used? First assessed at Month 2, and month 10 was used as a reference; also assessed at Months 3, 4, and 7 Adapted 27-item Combat Experiences Scale, with two mortuary-specific items added Exposure to traumatic events (for DSM IV Criterion A) in the past 12 months, more than 1 year ago, or never Only at baseline MEASUREMENT BIASES Were the evaluators blind to treatment status? NO Was there recall or memory bias? Self-report measures were not blinded: MA soldiers were aware of whether they were receiving the intervention. When MA soldiers completed assessments on their QOL, they had to recall events from the previous 4 weeks. Also, to assess exposure to traumatic events, MA soldiers had to report whether each event occurred in the past 12 months, more than 1 year ago, or never. Last, because this was a qualitative assessment, recall and memory bias cannot be completely avoided. Other measurement biases: (List and explain) RESULTS List key findings based on study objectives: Traumatic Events 6

7 No difference was found in the traumatic events experienced between groups. The intervention group had an average of 7.6 events (SD = 2.5), and the comparison group had an average of 7.7 events (SD = 2.6). Attendance In all, 71.6% (n = 48) of the intervention group attended at least two intervention sessions, but men attended fewer sessions than women (men: M = 1.97, SD = 1.03; women: M = 2.70, SD = 1.9; p =.02). The number of intervention sessions attended was correlated with the soldiers PCL-17 total score (p =.04), PHQ-9 score (p <.01), WHOQOL BREF Psychological Health score (p =.02), and WHOQOL BREF Environmental score (p =.03). PTSD At baseline, there was no difference between groups, and 25% of all participants had probable PTSD. Although the two groups did not differ significantly in PCL-17 scores throughout the six time points, at Months 2 and 3, there was a significant Time Treatment interaction (p =.04 for Month 2; p =.01 for Month 3) that resulted in the intervention group displaying higher scores. This indicated that the main effects of time and treatment were meaningful for the analysis. When the authors examined men and women separately, PCL-17 scores were significantly higher for intervention men than comparison men at Months 2 (p.05) and 3 (p.01). There were no significant differences at any points between women in the two groups. Intrusion, Avoidance, and Hyperarousal A Time Treatment interaction occurred at Month 2 for avoidance (p.05) and hyperarousal (p =.02) and again at Month 3 for all subscales (intrusion: p =.03; avoidance: p.05; hyperarousal: p =.03). Significant effects of time for the hyperarousal subscale occurred at Month 2 (p =.04) and Month 10 (p =.04). Scores on all PCL-17 subscales were higher for those in the intervention group. Depression There was no significant difference between the two groups at baseline for probable depression, nor did PHQ-9 scores differ between the two groups throughout the six time points. At Month 3, however, male soldiers displayed a Time Treatment interaction (p =.03) and an overall effect of time (p =.04), and higher scores were displayed in the intervention group (p <.01). QOL At baseline, no difference was found between the two groups QOL on the basis of the two WHOQOL BREF subscales. It was found, however, that the treatment did affect the results of the Psychological Health subscale (p =.04), with lower scores in the intervention group (p =.04). 7

8 Intervention Evaluation While evaluating the intervention, 88.7% of soldiers reported that, overall, the TEAM training was helpful. In particular, soldiers rated the following content as helpful: communicating with others (90.6%), having a positive outlook on things (88.7%), relaxation techniques (84.9%), providing support to a buddy (84.9%), and problem solving (81.1%). Soldiers who rated the intervention more positively also had lower symptoms of PTSD (p <.01) and depression (p =.03) and higher QOL for both subscales (p <.001). Was this study adequately powered (large enough to show a difference)? NO Because of the small sample size, the effect size shown in the study was small (<0.3). Also, the low number of female participants might have affected the power to find differences across the intervention and control groups for gender. Were the analysis methods appropriate? The authors conducted preliminary analyses that tested for equivalence of groups at baseline to ensure random assignment. They then completed crosssectional analysis at each time point for each of the variables using appropriate methods. Were statistics appropriately reported (in written or table format)? The results were clearly stated in written format and also through the use of graphs and tables. Was participant dropout less than 20% in total sample and balanced between groups? YES NO Although 67 soldiers in the intervention group and 58 soldiers in the control group were included in the analysis, by Month 10 of the study, both groups had lost more than 20% of their participants. What are the overall study limitations? Multiple biases were found throughout the duration of the study that limit the results. First, one limitation of this study is the self-selection for enrollment. Because MA soldiers had the choice to join the study, participants who believed that the intervention would be successful might have rated it as so, even if no true difference was seen, which would have caused the potential of selection bias to influence the results. In addition, the study s findings are limited by the attrition rates, with both the comparison and the intervention group losing more than 20% of their participants by Month 10. Although these participants dropped out of the study at any time from Month 1 to Month 10, their information was still included in the analysis. Last, the TEAM intervention might be limited to change only among MA soldiers who experience high PTSD symptoms, rather than less-severe symptoms, so 8

9 floor effects might occur. Future research on the effects of early interventions for this population is needed. CONCLUSIONS State the authors conclusions related to the research objectives. Although TEAM is the first known early intervention designed for MA soldiers postdeployment, the intervention had no overall effect on PTSD, depressive symptoms, or QOL for the participants. Throughout the study, PTSD symptoms varied among the groups, but at Month 3, the intervention-group men showed an increase in all measures of PTSD and depression and a decrease in psychological QOL. This might be explained by the fact that PTSD and depression have been found to increase in the first 4 months postdeployment. In addition, the increase of symptoms in the intervention group might be explained by the soldiers increased awareness of symptoms. Furthermore, throughout the study and across all measures, significant differences were found between intervention-group and comparison-group men. Such differences did not exist between groups for women. Overall, although the measures were not significant, the majority of the MA soldiers reported TEAM to be helpful in increasing communication skills, maintaining a positive outlook, using relaxation techniques, and providing support. This work is based on the evidence-based literature review completed by Lauren Lange, OTS (author), and Karla Ausderau, PhD, OTR/L, faculty advisor, University of Wisconsin. CAP Worksheet adapted from Critical Review Form Quantitative Studies. Copyright 1998, by M. Law, D. Stewart, N. Pollack, L. Letts, J. Bosch, & M. Westmorland, McMaster University. Used with permission. For personal or educational use only. All other uses require permission from AOTA. Contact: 9

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) Sharp, W. G., Burrell, T. L., & Jaquess, D. L. (2014). The Autism MEAL Plan: A parent-training curriculum to manage eating aversions and low intake among children with

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) Johnson, C. R., Foldes, E., DeMand, A., & Brooks, M. M. (2015). Behavioral parent training to address feeding problems in children with autism spectrum disorder: A pilot

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) Desrosiers, J., Noreau, L., Rochette, A., Carbonneau, H., Fontaine, L., Viscogliosi, C., & Bravo, G. (2007). Effect of a home leisure education program after stroke: A

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) Lengacher, C. A., Reich, R. R., Paterson, C. L., Ramesar, S., Park, J. Y., Alinat, C., &... Kip, K. E. (2016). Examination of broad symptom improvement resulting from mindfulness-based

More information

RESEARCH OBJECTIVE(S)

RESEARCH OBJECTIVE(S) Bearss, K., Johnson, C., Smith, T., Lecavalier, L., Swiezy, N., Aman, M.,... & Scahill, L. (2015). Effect of parent training vs parent education on behavioral problems in children with autism spectrum

More information

CRITICALLY APPRAISED PAPER (CAP) FOCUSED QUESTION

CRITICALLY APPRAISED PAPER (CAP) FOCUSED QUESTION CRITICALLY APPRAISED PAPER (CAP) FOCUSED QUESTION In military veterans, what is the effect of virtual reality exposure therapy (VRE) on posttraumatic stress disorder (PTSD) and depressive symptoms, as

More information

CRITICALLY APPRAISED PAPER (CAP) FOCUSED QUESTION

CRITICALLY APPRAISED PAPER (CAP) FOCUSED QUESTION CRITICALLY APPRAISED PAPER (CAP) FOCUSED QUESTION Is mindfulness-based cognitive therapy for children (MBCT-C) an effective treatment in decreasing attention problems, anxiety symptoms and behavior problems

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) FOCUSED QUESTION What is the outcome of an outpatient, client-centered leisure for young adults with highfunctioning autism spectrum disorder (ASD) in relation to developing

More information

CRITICALLY APPRAISED PAPER (CAP) FOCUSED QUESTION

CRITICALLY APPRAISED PAPER (CAP) FOCUSED QUESTION CRITICALLY APPRAISED PAPER (CAP) FOCUSED QUESTION Is a modified social skills program, parent psychoeducation, and parent training program in a 2-week therapeutic summer day camp an effective intervention

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) Kapadia, N. M., Zivanovic, V., Furlan, J. C., Craven, B. C., McGillivray, C., & Popovic, M. R. (2011). Functional electrical stimulation therapy for grasping in traumatic

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) Taso, C. J., Lin, H. S., Lin, W. L., Chen, S. M., Huang, W. T., & Chen, S. W. (2014). The effect of yoga exercise on improving depression, anxiety, and fatigue in women

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) Meléndez-Moral, J., Charco-Ruiz, L., Mayordomo-Rodriguez, T., & Sales-Galán, A. (2013). Effects of a reminiscence program among institutionalized elderly adults. Psicothema,

More information

CRITICALLY APPRAISED PAPER (CAP) FOCUSED QUESTION:

CRITICALLY APPRAISED PAPER (CAP) FOCUSED QUESTION: CRITICALLY APPRAISED PAPER (CAP) FOCUSED QUESTION: For adults who have an acquired brain injury, what is the effect of personal assistant devices on memory, compared with standard occupational therapy?

More information

Dominican Scholar. Dominican University of California. Jennifer Borcich Dominican University of California

Dominican Scholar. Dominican University of California. Jennifer Borcich Dominican University of California Dominican University of California Dominican Scholar Occupational Therapy Critically Appraised Papers Series Occupational Therapy 2016 Critically Appraised Paper for Occupational therapy intervention:

More information

CRITICALLY APPRAISED PAPER (CAP) FOCUSED QUESTION

CRITICALLY APPRAISED PAPER (CAP) FOCUSED QUESTION CRITICALLY APPRAISED PAPER (CAP) FOCUSED QUESTION Does occupational therapy have a role in assisting adolescents and young adults with difficulties that arise due to psychological illnesses as a part of

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) Wu, W., Wang, C., Chen, C., Lai, C., Yang, P., & Guo, L. (2012). Influence of therapy ball seats on attentional ability in children with attention deficit/hyperactivity

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) FOCUSED QUESTION Is an individualized occupational therapy program more effective in modulating mood disturbances and functional deficits than general skills training for

More information

RESEARCH OBJECTIVE(S) List study objectives.

RESEARCH OBJECTIVE(S) List study objectives. CRITICALLY APPRAISED PAPER (CAP) Zickefoose, S., Hux, K., Brown, J., & Wulf, K. (2013). Let the games begin: A preliminary study using Attention Process Training-3 and Lumosity brain games to remediate

More information

CRITICALLY APPRAISED PAPER

CRITICALLY APPRAISED PAPER CRITICALLY APPRAISED PAPER Kesler, S., Hadi Hosseini, S. M., Heckler, C., Janelsins, M., Palesh, O., Mustian, K., & Morrow, G. (2013). Cognitive training for improving executive function in chemotherapy-treated

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) Tsang, M. H., Sze, K. H., & Fong, K. N. K. (2008). Occupational therapy treatment with right half-field eye-patching for patients with subacute stroke and unilateral neglect:

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) FOCUSED QUESTION For consumers on the autism spectrum, does supplementing with alternative treatments, when compared to using only traditional treatments and therapies,

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) FOCUSED QUESTION What is the effect of community occupational therapy on mood, quality of life, and health status of dementia patients and their informal caregivers, as

More information

CRITICALLY APPRAISED PAPER (CAP) FOCUSED QUESTION

CRITICALLY APPRAISED PAPER (CAP) FOCUSED QUESTION CRITICALLY APPRAISED PAPER (CAP) FOCUSED QUESTION Does cognitive treatment for illness perceptions increase patient-specific physical activity levels of patients with chronic low back pain when compared

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) Breedland, I., Scheppingen, C. V., Leijsma, M., Verheij-Jansen, N. P., & Weert, E. V. (2011). Effects of a group-based exercise and educational program on physical performance

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) Gantman, A., Kapp, S. K., Orenski, K., & Laugeson, E. A. (2012). Social skills training for young adults with high-functioning autism spectrum disorders: A randomized controlled

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) Loh, S. Y., Packer, T., Passmore, A., Yip C. H., Tan, F. L., & Xavier, M. (2010). Psychological distress of women newly diagnosed with breast cancer: Relationship with

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) Kasari, C., Lawton, K., Shih, W., Barker, T. V., Landa, R., Lord, C.,... Senturk, D. (2014). Caregiver-mediated intervention for low-resourced preschoolers with autism:

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) Ehab, G., Barnsley, S., & Chellappa, R. (2012). Effect of physical exercise movement strategies programme on mobility, falls, and quality of life in Parkinson's disease.

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) Drahota, A., Wood, J. J., Sze, K. M., & Van Dyke, M. (2011). Effects of cognitive behavioral therapy on daily living skills in children with high-functioning autism and

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) Pitkälä, K. H., Pöysti, M. M., Laakkonen, M.-L., Tilvis, R. S., Savikko, N., Kautiainen H., & Strandberg, T. E. (2013). Effects of the Finnish Alzheimer Disease Exercise

More information

CLINICAL BOTTOM LINE Early Intervention for Children With Autism Implications for Occupational Therapy

CLINICAL BOTTOM LINE Early Intervention for Children With Autism Implications for Occupational Therapy Dawson, G., Rogers, S., Munson, J., Smith, M., Winter, J., Greenson, J.,... Varley, J. (2010). Randomized, controlled trial of an intervention for toddlers with autism: The Early Start Denver Model. Pediatrics,

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) Twamley, E. W., Jak, A. J., Delis, D. C., Bondi, M. W., & Lohr, J. B. (2014). Cognitive Symptom Management and Rehabilitation Therapy (CogSMART) for Veterans with traumatic

More information

Critically Appraised Paper for Efficacy of occupational therapy for patients with Parkinson's disease: A randomized controlled trial

Critically Appraised Paper for Efficacy of occupational therapy for patients with Parkinson's disease: A randomized controlled trial Dominican University of California Dominican Scholar Occupational Therapy Critically Appraised Papers Series Occupational Therapy 2017 Critically Appraised Paper for Efficacy of occupational therapy for

More information

DESIGN TYPE AND LEVEL OF EVIDENCE: Level I: Pilot randomized controlled trial. Limitations (appropriateness of study design):

DESIGN TYPE AND LEVEL OF EVIDENCE: Level I: Pilot randomized controlled trial. Limitations (appropriateness of study design): CRITICALLY APPRAISED PAPER (CAP) FOCUSED QUESTION Does the Cognitive Orientation to daily Occupational Performance (CO-OP) approach increase clients performance on goals more than a standard occupational

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) Pinniger, R., Brown, R. F., Thorsteinsson, E. B., & McKinley, P. (2012). Argentine tango dance compared to mindfulness meditation and a waiting-list control: A randomised

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) Couillet, J., Soury, S., Lebornec, G., Asloun, S., Joseph, P., Mazaux, J., & Azouvi, P. (2010). Rehabilitation of divided attention after severe traumatic brain injury:

More information

DESIGN TYPE AND LEVEL OF EVIDENCE: Randomized controlled trial, Level I

DESIGN TYPE AND LEVEL OF EVIDENCE: Randomized controlled trial, Level I CRITICALLY APPRAISED PAPER (CAP) Hasan, A. A., Callaghan, P., & Lymn, J. S. (2015). Evaluation of the impact of a psychoeducational intervention for people diagnosed with schizophrenia and their primary

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) FOCUSED QUESTION For community-dwelling older adults with functional limitations, does an occupational therapy home modification intervention program that includes the

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) Blanche, E. I., Chang, M. C., Gutiérrez, J., & Gunter, J. S. (2016). Effectiveness of a sensory-enriched early intervention group program for children with developmental

More information

RESEARCH OBJECTIVE(S) List study objectives. To evaluate effectiveness of an intensive day-treatment program on the dietary diversity and

RESEARCH OBJECTIVE(S) List study objectives. To evaluate effectiveness of an intensive day-treatment program on the dietary diversity and CRITICALLY APPRAISED PAPER (CAP) Sharp, W. G., Jaquess, D. L., Morton, J. F., & Miles, A. G. (2011). A retrospective chart review of dietary diversity and feeding behavior of children with autism spectrum

More information

CRITICALLY APPRAISED PAPER (CAP) FOCUSED QUESTION

CRITICALLY APPRAISED PAPER (CAP) FOCUSED QUESTION CRITICALLY APPRAISED PAPER (CAP) FOCUSED QUESTION For consumers on the autism spectrum, does supplementing with alternative treatments, when compared to using only traditional treatments and therapies,

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) Acarturk, C., Konuk, E., Cetinkaya, M., Senay, I., Sijbrandij, M., Cuijpers, P., & Aker, T. (2015). EMDR for Syrian refugees with posttraumatic stress disorder symptoms:

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) Li, R., Cooper, C., Barber, J., Rapaport, P., Griffin, M., & Livingston, G. (2014). Coping strategies as mediators of the effect of the START (strategies for RelaTives)

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) Logan, D. E., Carpino, E. A., Chiang, G., Condon, M., Firn, E., Gaughan, V. J.,... Berde, C. B. (2012). A day-hospital approach to treatment of pediatric complex regional

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) Yu, J., Kang, H., & Jung, J. (2012). Effects of modified constraint-induced movement therapy on hand dexterity, grip strength and activities of daily living of children

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) Clemson, L., Fiatarone Singh, M. A., Bundy, A., Cumming, R. G., Manollaras, K., O Loughlin, P., & Black, D. (2012). Integration of balance and strength training into daily

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) Passalacqua, S. A., & Harwood, J. (2012). VIPS communication skills training for paraprofessional dementia caregivers: An intervention to increase person-centered dementia

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) Crain, A. L., Enstad, C. J., Hanson, L. R., Kreitzer, M., Lewis, B. A., & Whitebird, R. R. (2012). Mindfulness-based stress reduction for family caregivers: A randomized

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) Shin, J., Bog Park, S., & Ho Jang, S. (2015). Effects of game-based virtual reality on healthrelated quality of life in chronic stroke patients: A randomized, controlled

More information

CRITICALLY APPRAISED PAPER

CRITICALLY APPRAISED PAPER CRITICALLY APPRAISED PAPER FOCUSED QUESTION For individuals with memory and learning impairments due to traumatic brain injury, does use of the self-generation effect (items self-generated by the subject)

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) FOCUSED QUESTION Does the Tailored Activity Program (TAP) for dementia patients reduce caregiver burden and neuropsychiatric behavior compared to a wait-list control group

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) Bower, J. E., Crosswell, A. D., Stanton, A. L., Crespi, C. M., Winston, D., Arevalo, J.,... & Ganz, P. A. (2015). Mindfulness meditation for younger breast cancer survivors:

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) Yasukawa, A., Patel, P., & Sisung, C. (2006). Pilot study: Investigating the effects of Kinesio Taping in an acute pediatric rehabilitation setting. American Journal of

More information

RESEARCH OBJECTIVES List study objectives.

RESEARCH OBJECTIVES List study objectives. CRITICALLY APPRAISED PAPER (CAP) Dunn, W., Cox, J., Foster, L., Mische-Lawson, L., & Tanquary, J. (2012). Impact of a contextual intervention on child participation and parent competence among children

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) FOCUSED QUESTION What are the effects of office ergonomics training when combined with a sit-stand workstation on performance and visual, behavioral, and musculoskeletal

More information

CRITICALLY APPRAISED PAPER (CAP) FOCUSED QUESTION

CRITICALLY APPRAISED PAPER (CAP) FOCUSED QUESTION CRITICALLY APPRAISED PAPER (CAP) FOCUSED QUESTION For patients with hip or knee osteoarthritis, does occupational therapy focusing on tailored activity pacing interventions, when compared with generalized

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) Prosser, R., Hancock, M. J., Nicholson, L., Merry, C., Thorley, F., & Wheen, D. (2014). Rigid versus semi-rigid orthotic use following TMC arthroplasty: A randomized controlled

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) Söderlund, G. B. W., Björk, C., & Gustafsson, P. (2016). Comparing auditory noise treatment with stimulant medication on cognitive task performance in children with attention

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) Horng, Y. S., Hsieh, S. F., Tu, Y. K., Lin, M. C., Horng, Y. S., & Wang, J. D. (2011). The comparative effectiveness of tendon and nerve gliding exercises in patients with

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) Taylor, D., Hale, L., Schuler, P. Waters, D., Binns, E., McCracken, H.,...Wolf, S. L. (2012). Effectiveness of tai chi as a community-based falls prevention intervention:

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) Siedentopf, F., Utz-Billing, I., Gairing, S., Schoenegg, W., Kentenich, H., & Kollak, I. (2013). Yoga for patients with early breast cancer and its impact on quality of

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) Gellis, L. A., Arigo, D., & Elliott, J. C. (2013). Cognitive refocusing treatment for insomnia: A randomized controlled trial in university students. Behavior Therapy,

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) Park, H., Chun, Y., & Gang, M. S. (2015). Effects of the Patient-Centered Environment Program on behavioral and emotional problems in home-dwelling patients with dementia.

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) FOCUSED QUESTION Is mirror therapy more effective in a, or individually, on sensorimotor function, activities of daily living, quality of life, and visuospatial neglect

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) FOCUSED QUESTION What are the effects of protective factors and developmental assets on the emotional resiliency of high-risk youth? Jain, S., Buka, S. L., Subramanian,

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) Masiero, S., Boniolo, A., Wassermann, L., Machiedo, H., Volante, D., & Punzi, L. (2007). Effects of an educational-behavioral joint protection program on people with moderate

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) Donoyama, N., Suoh, S., & Ohkoshi, N. (2014). Effectiveness of Anma massage therapy in alleviating physical symptoms in outpatients with Parkinson's disease: A before-after

More information

CRITICALLY APPRAISED PAPER

CRITICALLY APPRAISED PAPER CRITICALLY APPRAISED PAPER FOCUSED QUESTION Does wearing a weighted vest improve in-seat behavior, task completion speed, and attention-to-task in learners diagnosed with attention deficit hyperactivity

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) Wu, C., Huang, P., Chen, Y., Lin, K., & Yang, H. (2013). Effects of mirror therapy on motor and sensory recovery in chronic stroke: A randomized controlled trial. Archives

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) Kwon, J., Park, M., Yoon, I., & Park, S. (2012). Effects of virtual reality on upper extremity function and activities of daily living performance in acute stroke: A double-blind

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) FOCUSED QUESTION For children with developmental delay who are nonverbal, does the use of augmentative and alternative communication (AAC) increase social participation

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) Smania, N., Gandolfi, M., Paolucci, S., Iosa, M., Ianes, P., Recchia, S., & Farina, S. (2012). Reduced-intensity modified constraint-induced movement therapy versus conventional

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) FOCUSED QUESTION What type of prevention is most effective for improving fall risk knowledge and prevention in older adults to prevent lower extremity fracture? What type

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) FOCUSED QUESTION For stroke patients, in what ways does robot-assisted therapy improve upper extremity performance in the areas of motor impairment, muscle power, and strength?

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) FOCUSED QUESTION: Will use of low-level functional electrical stimulation improve accuracy of active reaching with the upper extremity better than traditional occupational

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) FOCUSED QUESTION What are the observed effects on pain and fatigue when comparing two occupational therapy activity-pacing interventions in adults with osteoarthritis?

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) Friedmann, E., Galik, E., Thomas, S. A, Hall, P. S, Chung, S. Y., & McCune, S. (2015). Evaluation of a pet-assisted living intervention for improving functional status

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) FOCUSED QUESTION What is the effectiveness of a 12-week family-centered evaluation and intervention program for children with attention deficit hyperactivity disorder (ADHD)

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) Cui, B. J., Wang, D. Q., Qiu, J. Q., Huang, L. G., Zeng, F. S., Zhang, Q.,... Sun, Q. S. (2015). Effects of a 12-hour neuromuscular electrical stimulation treatment program

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) FOCUSED QUESTION Does occupational therapy with sensory integration (OT-SI) better improve attention, cognitive and social, sensory, or behavioral problems than an activity

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) FOCUSED QUESTION CRITICALLY APPRAISED PAPER (CAP) Will adults diagnosed with rheumatoid arthritis who participate in an intensive hand exercise program improve in areas of hand strength, joint mobility,

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) Dahl, A., Askim, T., Stock, R., Langørgen, E., Lydersen, S., & Indredavik, B. (2008). Short- and long-term outcome of constraint-induced movement therapy after stroke:

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) Rosenberg, L., Maeir, A., Yochman, A., Dahan, I., & Hirsch, I. (2015). Effectiveness of a cognitivefunctional group intervention among preschoolers with attention deficit

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) FOCUSED QUESTION Is occupational therapy s promotion of lifestyle change more effective in weight loss as compared to bariatric surgery and/or pharmacotherapy? Martins,

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) Wu, C. Y., Wang, T. N., Chen, Y. T., Lin, K. C., Chen, Y. A., Li, H. T., & Tsai, P. L. (2013). Effects of constraint-induced therapy combined with eye patching on functional

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) Yin, C., Sien, N., Ying, L., Chung, S., & Leng, D. (2014). Virtual reality for upper extremity rehabilitation in early stroke: A pilot randomized controlled trial. Clinical

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) Kaltsatoui, A., Mameletzi, D., & Douka, S. (2011). Physical and psychological benefits of a 24- week traditional dance program in breast cancer survivors. Journal of Bodywork

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) Kim, E. S., Berkovits, L. D., Bernier, E. P., Leyzberg, D., Shic, F., Paul, R., & Scassellati, B. (2013). Social robots as embedded reinforcers of social behavior in children

More information

Dominican Scholar. Dominican University of California. Jason Ichimaru Dominican University of California

Dominican Scholar. Dominican University of California. Jason Ichimaru Dominican University of California Dominican University of California Dominican Scholar Occupational Therapy Critically Appraised Papers Series Occupational Therapy 2017 Critcally Appraised Paper for: Is modified constraint-induced movement

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) Kwon, J. Y., Chang, H. J., Yi, S. H., Lee, J. Y., Shin, H. Y., & Kim, Y. H. (2015). Effect of hippotherapy on gross motor function in children with cerebral palsy: A randomized

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) FOCUSED QUESTION Is the combination of occupational therapy (OT) and mental practice (MP), from either an internal or an external perspective, an effective intervention

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) FOCUSED QUESTION Does the addition of mirror therapy to a traditional hand rehabilitation program, when compared to a traditional rehabilitation program alone, increase

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) Padula, W. V., Nelson, C. A., Padula, W. V., Benabib, R., Yilmaz, T., & Krevisky, S. (2009). Modifying postural adaptation following a CVA through prismatic shift of visuo-spatial

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) Gitlin, L. N., Winter, L., Dennis, M. P., Corcoran, M., Schinfeld, S., & Hauck, W. W. (2006). A randomized trial of a multicomponent home intervention to reduce functional

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) Svens, B., Ames, E., Burford, K., & Caplash, Y. (2015). Relative active motion programs following extensor tendon repair: A pilot study using a prospective cohort and evaluating

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) FOCUSED QUESTION What is the effectiveness of a modified constraint-induced therapy (mcit) intervention compared to conventional rehabilitation methods for the rehabilitation

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) FOCUSED QUESTION Is early mobilization safe and more effective than usual care in promoting recovery and functional independence in clients in the intensive care unit (ICU)

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) Amen, A., Fonareva, I., Haas, M., Lane, J. B., Oken, B. S., Wahbeh, H., & Zajdel, D. (2010). Pilot controlled trial of mindfulness meditation and education for dementia

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) FOCUSED QUESTION For nurses with low back pain and poor body posture, will a spinal training program (Back School), as compared to passive physiotherapy treatment, decrease

More information

CRITICALLY APPRAISED PAPER (CAP)

CRITICALLY APPRAISED PAPER (CAP) CRITICALLY APPRAISED PAPER (CAP) Holmes, J. D., Gu, M. L., Johnson, A. M., & Jenkins, M. E. (2013). The effects of a home-based virtual reality rehabilitation program on balance among individuals with

More information