BACKGROUND: Despite drug and surgical therapies for Parkinson's disease, patients develop progressive disability. It has both motor and non-motor symptomatology, and their interaction with their environment can be very complex. The role of the occupational therapist is to support the patient and help them maintain their usual level of self-care, work and leisure activities for as long as possible. When it is no longer possible to maintain their usual activities, occupational therapists support individuals in changing and adapting their relationship with their physical and social environment to develop new valued activities and roles. OBJECTIVES: To compare the efficacy and effectiveness of occupational therapy with placebo or no interventions (control group) in patients with Parkinson's disease. SEARCH METHODS: Relevant trials were identified by electronic searches of MEDLINE (1966-April 2007), EMBASE (1974-2000), CINAHL (1982-April 2007), Psycinfo (1806-April 2007), Ovid OLDMEDLINE (1950-1965), ISI Web of Knowledge (1981-April 2007), National Library for Health (NLH) (April 2007), Nursing, Midwifery and Allied Health (NMAP) (April 2007), Intute: Medicine (December 2005), Proquest Nursing Journals (PNJ, 1986 - April 2007); rehabilitation databases: AMED (1985-April 2007), MANTIS (1880-2000), REHABDATA (1956-2000), REHADAT (2000), GEROLIT (1979-2000); English language databases of foreign language research and third world publications: Pascal (1984-2000), LILACS (1982- April 2007), MedCarib (17th Century-April 2007), JICST-EPlus (1985-2000), AIM (1993-April 2007), IMEMR (1984-April 2007), grey literature databases: SIGLE (1980-2000), ISI-ISTP (1982-April 2007), DISSABS (1999-2000), Conference Papers Index (CPI, 1982-2000) and Aslib Index to Theses (AIT, 1716- April 2006), The Cochrane Controlled Trials Register (Issue 2, 2007), the CenterWatch Clinical Trials listing service (April 2007), the metaRegister of Controlled Trials (mRCT, April 2007), Current controlled trials (CCT) (April 2007), ClinicalTrials.gov (April 2007), CRISP (1972-April 2007), PEDro (April 2007), NIDRR (April 2007) and NRR (April 2007) and the reference lists of identified studies and other reviews were examined. SELECTION CRITERIA: Only randomised controlled trials (RCT) were included, however those trials that allowed quasi-random methods of allocation were allowed. DATA COLLECTION AND ANALYSIS: Data was abstracted independently by two authors and differences were settled by discussion. MAIN RESULTS: Two trials were identified with 84 patients in total. Although both trials reported a positive effect from occupational therapy, all of the improvements were small. The trials did not have adequate placebo treatments, used small numbers of patients and the method of randomisation and concealment of allocation was not specified in one trial. These methodological problems could potentially lead to bias from a number of sources reducing the strength of the studies further. AUTHORS' CONCLUSIONS: Considering the significant methodological flaws in the studies, the small number of patients examined, and the possibility of publication bias, there is insufficient evidence to support or refute the efficacy of occupational therapy in Parkinson's disease. There is now a consensus as to UK current and best practice in occupational therapy when treating people with Parkinson's disease. We now require large well designed placebo-controlled RCTs to demonstrate occupational therapy's effectiveness in Parkinson's disease. Outcome measures with particular relevance to patients, carers, occupational therapists and physicians should be chosen and the patients monitored for at least six months to determine the duration of benefit. The trials should be reported using CONSORT guidelines.

BACKGROUND: For persons with rheumatoid arthritis (RA) the physical, personal, familial, social and vocational consequences are extensive. Occupational therapy (OT), with the aim to facilitate task performance and to decrease the consequences of rheumatoid arthritis for daily life activities, is considered to be a cornerstone in the management of rheumatoid arthritis. Till now the efficacy of occupational therapy for patients with rheumatoid arthritis on functional performance and social participation has not been systematically reviewed. OBJECTIVES: To determine whether OT interventions (classified as comprehensive therapy, training of motor function, training of skills, instruction on joint protection and energy conservation, counseling, instruction about assistive devices and provision of splints) for rheumatoid arthritis patients improve outcome on functional ability, social participation and/or health related quality of life. SEARCH STRATEGY: Relevant full length articles were identified by electronic searches in Medline, Cinahl, Embase, Amed, Scisearch and the Cochrane Musculoskeletal group Specialised Register. The reference list of identified studies and reviews were examined for additional references. Date of last search: December 2002. SELECTION CRITERIA: Controlled (randomized and non-randomized) and other than controlled studies (OD) addressing OT for RA patients were eligible for inclusion. DATA COLLECTION AND ANALYSIS: The methodological quality of the included trials was independently assessed by two reviewers. Disagreements were resolved by discussion. A list proposed by Van Tulder et al. () was used to assess the methodological quality. For outcome measures, standardized mean differences were calculated. The results were analysed using a best evidence synthesis based on type of design, methodological quality and the significant findings of outcome and/or process measures. MAIN RESULTS: Thirty-eight out of 58 identified occupational therapy studies fulfilled all inclusion criteria. Six controlled studies had a high methodological quality. Given the methodological constraints of uncontrolled studies, nine of these studies were judged to be of sufficient methodological quality. The results of the best evidence synthesis shows that there is strong evidence for the efficacy of "instruction on joint protection" (an absolute benefit of 17.5 to 22.5, relative benefit of 100%) and that limited evidence exists for comprehensive occupational therapy in improving functional ability (an absolute benefit of 8.7, relative benefit of 20%). Indicative findings for evidence that "provision of splints" decreases pain are found (absolute benefit of 1.0, relative benefit of 19%). AUTHORS' CONCLUSIONS: There is evidence that occupational therapy has a positive effect on functional ability in patients with rheumatoid arthritis.

BACKGROUND: Multiple sclerosis (MS) patients are referred to occupational therapy with complaints about fatigue, limb weakness, alteration of upper extremity fine motor coordination, loss of sensation and spasticity that causes limitations in performance of activities of daily living and social participation. The primary purpose of occupational therapy is to enable individuals to participate in self-care, work and leisure activities that they want or need to perform. OBJECTIVES: To determine whether occupational therapy interventions in MS patients improve outcome on functional ability, social participation and/or health related quality of life. SEARCH METHODS: We searched the Cochrane MS Group trials register (January 2003), the Cochane Central Register of Controlled Trials (CENTRAL)The Cochrane Library Issue 4, 2002, MEDLINE (January 2003), EMBASE (December 2002), CINAHL (December 2002), AMED (December 2002), SciSearch (December 2002) and reference lists of articles. SELECTION CRITERIA: Controlled (randomized and non-randomized) and other than controlled studies addressing occupational therapy for MS patients were eligible for inclusion. DATA COLLECTION AND ANALYSIS: Two reviewers independently assessed the methodological quality of the included trials. Disagreements were resolved by discussion. A list proposed by Van Tulder 1997 was used to assess the methodological quality. For outcome measures, we calculated standardized mean differences. We analysed the results using a best-evidence synthesis based on type of design, methodological quality and the significant findings of outcome and/or process measures. MAIN RESULTS: One randomized clinical trial was identified and two other included studies were a controlled clinical trial and a study with a pre-post test design. The three studies involved 271 people in total. Two studies evaluated an energy-conservation course for groups of patients and one study evaluated a counseling intervention. The results of the energy conservation studies could be biased because of the designs used, the poor methodological quality and the small number of included patients. The high quality RCT on counseling reported non-significant results. AUTHORS' CONCLUSIONS: On basis of this review no conclusions can be stated whether or not occupational therapy improves outcomes in MS patients. The lack of (randomized controlled) efficacy studies in most intervention categories of occupational therapy demonstrates an urgent need for future research in occupational therapy for multiple sclerosis. Initially, a survey of occupational therapy practice for MS patients, including the characteristics and needs of these patients, is necessary to develop a research agenda for efficacy studies.

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INTRODUCTION: The study of clinical reasoning is a valid approach to endeavour knowing and describing the strategies and skills that are applied during intervention, knowledge implied in the process and the existing factors between knowledge and action. Channeling clinical reasoning can improve its effectiveness and optimize the quality of the Occupational Therapy intervention. Methodology: Bibliographic revision on clinical reasoning and Occupational Therapy since 1999 to the present date was undertaken. Data base were consulted (PUBMED, EMBASE), the Open Access Journal Directory (DOAJ); thematic portals; monographs and books. RESULTS: This document evidences progress in this research area, emphasizing the analysis of different aspects of clinical reasoning and its relevance for the Occupational Therapy clinician. Emphasis is placed on the need to potentiate the study of clinical reasoning to develop and improve professional competence. CONCLUSIONS: This reasoning facilitates decision making, through consideration of aspects involved in the approach to each client. Besides, it underpins the practice that supports our clinical competence

INTRODUCTION: 'Occupational experience' (OE) is widely used within the occupational therapy profession. However, it lacks a clear and unified definition in the profession's consensus practice frameworks and seminal models. Therefore, this study aimed to examine how OE has been defined and described in both occupational therapy and occupational science literature. METHODS: A scoping review was performed, with a search conducted in ProQuest, PsycINFO, EMBASE, PubMed, Academic Research Premier, Scopus and Web of Science. The search strategy included a combination of the terms 'occupational experience' and either 'occupational therapy' or 'occupational science'. Inclusion criteria consisted of research articles in English that included OE as one of the central foci. Articles were chosen by the research team in collaboration with a medical librarian. CONSUMER AND COMMUNITY INVOLVEMENT: No consumer and community involvement was included in this study. RESULTS: Seventy-three articles were included, mostly investigating OE in a targeted group or a specific aspect of experience, primarily among Western high-income-countries. Only 14 articles provided definitions of OE, with the most frequent being 'subjective dimension of occupation/participation'. Six themes emerged: (1) OE as a subjective component of occupation, (2) OE consisting of interrelated experiential facets, (3) OE in relation to meaning, (4) OE in relation to self-identity, (5) OE in relation to context and environment and (6) OE in relation to health outcomes. CONCLUSIONS: The results point to largely incongruous definitions and descriptions of OE in the literature. PLAIN LANGUAGE SUMMARY: This study looked at how "occupational experience" (OE) is described in occupational therapy and occupational science. We reviewed 73 research articles. Most of these articles focused on OE in specific groups, like asylum seekers, or on types of experiences, like the feeling of "flow." Most of the research was done in Western countries. The most common definition of OE was "a person's experience of doing an activity." We also found six main ideas about OE. These show that OE is personal, can include several experiences at once, connects to a person's identity and environment, and affects health.

Occupational therapists prevent dysfunction and maintain and restore function for people with HIV/AIDS in the areas of work, selfcare and play/leisure. These occupational areas are assessed and treated from psychosocial, physical and environmental perspectives. This article examines occupational therapy assessment and treatment for people with HIV/AIDS with the primary focus on adaptive equipment, energy conservation, habits and time management, and work.

OBJECTIVES: This study updated Reed's 1999 "Mapping the Literature of Occupational Therapy." An analysis of citation patterns and indexing coverage was undertaken to identify the core literature of occupational therapy and to determine access to that literature. METHODS: Citations from three source journals for the years 2006 through 2008 were studied following the common methodology of the "Mapping the Literature of Allied Health Project." Bradford's Law of Scattering was applied to analyze the productivity of cited journals. A comparative analysis of indexing was conducted across three bibliographic databases. RESULTS: A total of 364 articles cited 10,425 references. Journals were the most frequently cited format, accounting for 65.3% of the references, an increase of 4.1% over the 1999 study. Approximately one-third of the journal references cited a cluster of 9 journals, with the American Journal of Occupational Therapy dominating the field. An additional 120 journals were identified as moderately important based on times cited. CINAHL provided the most comprehensive indexing of core journals, while MEDLINE provided the best overall coverage. CONCLUSIONS: Occupational therapy is a multidisciplinary field with a strong core identity and an increasingly diverse literature. Indexing has improved overall since 1999, but gaps in the coverage are still evident.

Abstract Introduction Childhood occupations are central to understanding child development as an occupational development. Objective This study aimed to identify how occupational therapists have approached children as occupational beings and which occupations have been described as children's typical occupations. Method We searched the Web of Science, Eric, Sage and CAPES Portal of Periodicals databases for this literature review, using the descriptors 'children's occupations', 'occupational development' and 'occupational therapy', between 1997 and 2016. Data were analysed using the content analysis technique. Results We identified 38 articles, of which 21 were selected for analysis, based on four classifications involving: 1) theoretical foundations for the study of children's occupations; 2) childhood occupations and typical development; 3) childhood occupations and atypical development; and 4) occupational therapy interventions to enhance the participation of children in occupations. Quantitative studies predominated, and most studies reflected the perspective of family members on child occupations. Conclusion The relationship between child development and children's occupations involves occupational development. The existing limited research and reviews into children's occupational development, as well as the absence of Brazilian studies in this area, reveal opportunities for further research to provide greater knowledge concerning occupational therapy and childhood occupations.

BACKGROUND: There is a lack of evidence-based knowledge in paediatric occupational therapy about the effectiveness of interventions using daily activities as a treatment modality in improving children's participation. OBJECTIVE: This study aimed to evaluate the effectiveness of occupation-based and occupation-focused interventions in improving participation in everyday occupations for young children with a disability. MATERIAL AND METHODS: A systematic review based on Joanna Briggs Institute methodology and critical appraisal tools was conducted. Six databases were searched for quantitative intervention studies aimed at improving participation in everyday occupations of young children with a disability through the use of everyday occupation. RESULTS: The search yielded 3732 records, of which 13 studies met inclusion criteria. Ten studies met methodological quality criteria and were included in the synthesis, five randomised controlled trials and five quasi-experimental studies, involving a total of 424 children with a mean age of 6.5 years. The studies were classified into cognitive (n = 5), context-focussed (n = 2) and playgroup interventions (n = 3). Study quality ranged from low to moderate, only one study was rated high quality. CONCLUSIONS AND SIGNIFICANCE: Occupation-based and occupation-focused interventions may have a positive effect on participation in everyday occupations for young children with a disability, but study design, risk of bias and insufficient reporting limit confidence in the body of evidence.