Occupational therapy (OT) makes a unique contribution to chronic pain (CP) management due to its overarching focus on occupation. The aim of this scoping review was to describe current knowledge about this contribution by documenting OT roles, models, assessments, and intervention methods used with adults living with CP. A systematic search exploring 10 databases and gray literature from 2006 to 2017 was conducted. Fifty-two sources were retained and analysed. Results bring forward the main role of OT being improving activities and participation (76.9 %), the Canadian Model of Occupational Performance (9.6 %), and the Canadian Occupational Performance Measure (21.2 %). Within the 30 reported interventions, 73.3% related directly to the person, 20% pertained to occupation (activities and participation), and 6.7% addressed environmental factors. The distinction and complementarity between the bottom-up and the top-down approaches to OT intervention were discussed. This review highlights OT specificity in adult CP management.
We found no added value of tDCS combined with GMI treatments for reducing pain in patients with chronic CRPS. However, given that GMI+sham tDCS induced no significant change, further studies comparing GMI+tDCS and tDCS alone are needed to further document tDCS's effect in CRPS.
Although community services support ageing-in-place, older adults often report feelings of loneliness and social isolation. Unmet emotional needs are associated with poorer health, reduced functional abilities and increased mortality in this population. Pet ownership is an avenue worth exploring to reduce these adverse outcomes. This scoping review maps main findings and identifies key gaps with respect to the pros and cons of pet ownership in community-dwelling older adults pertaining to psycho-social, physical and functional outcomes. Scientific and grey literature published from January 2000 to July 2018 was searched. Data selection and extraction were performed by the first author and a sub-sample was co-validated by two co-authors. A total of 62 sources were included for descriptive and thematic analysis. A variety of pros (increased physical activity, wellbeing) and cons (grief, risk of falls) pertaining to psycho-social and physical outcomes were identified. Not many functional outcomes (support for daily routines) were mentioned, and few studies explored the simultaneous balance between the pros and cons of pet care. Further research exploring both clinicians’ and older pet owners’ perspectives is needed to deepen our understanding of the importance of considering companion animals in older adults’ daily lives and to strike a balance between perceived risks and benefits.
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