The importance of neurorehabilitation services for people with disabilities is getting well-recognized in low- and middle-income countries (LMICs) recently. However, accessibility to the same has remained the most significant challenge, in these contexts. This is especially because of the non-availability of trained specialists and the availability of neurorehabilitation centers only in urban cities owned predominantly by private healthcare organizations. In the current COVID-19 pandemic, the members of the Task Force for research at the Indian Federation of Neurorehabilitation (IFNR) reviewed the context for tele-neurorehabilitation (TNR) and have provided the contemporary implications for practicing TNR during COVID-19 for people with neurological disabilities (PWNDs) in LMICs. Neurorehabilitation is a science that is driven by rigorous research-based evidence. The current pandemic implies the need for systematically developed TNR interventions that is evaluated for its feasibility and acceptability and that is informed by available evidence from LMICs. Given the lack of organized systems in place for the provision of neurorehabilitation services in general, there needs to be sufficient budgetary allocations and a sector-wide approach to developing policies and systems for the provision of TNR services for PWNDs. The pandemic situation provides an opportunity to optimize the technological innovations in health and scale up these innovations to meet the growing burden of neurological disability in LMICs. Thus, this immense opportunity must be tapped to build capacity for safe and effective TNR services provision for PWNDs in these settings.

Background The current evidence for occupational therapy practice, teaching, and research is replicated and implemented significantly from high-income countries in India. Therefore, a systematic review and an evaluation of existing evidence for occupational therapy (OT) to reduce disabilities including impairments, activity limitations, and participation restriction in persons with disabilities (PWD) in India are warranted. Objectives The objective of this review was to evaluate the effectiveness of OT interventions for reducing disabilities in PWD in India. Study Design Systematic review. Methods We searched the Cochrane CENTRAL, MEDLINE, Embase, CINAHL, PsycINFO, AMED, and Web of Science. A hand search was also carried out in selected Indian journals, OT-specific databases, and repositories, such as Indian Journal of Occupational Therapy , Indian Journal of Physiotherapy and Occupational Therapy , OT Seekers, World Federation of Occupational Therapy Bulletin, Asia Pacific Occupational Therapists Regional Group, and clinical trials registers. The search was restricted to published studies conducted in India during 2000–2021. We included randomized controlled trials (RCTs) of an occupational therapy intervention delivered by OTs for PWD, where the effects of the intervention were evaluated using any relevant disability outcome measure. Studies without access to full text were excluded. Two review authors independently completed screening, and one author reviewed the full text of the screened studies. Another pair of authors extracted data from included studies for prespecified disability outcomes, and two authors assessed the risk of bias in the included studies. Results We identified seven RCTs of occupational therapy interventions for PWD in India with 305 participants in total. All seven studies were very different in terms of their objective, participants, comparison, and outcomes. Allocation concealment and blinding and risk of bias were high in five trials. All the trials reported impairment outcomes with a statistically significant difference between the experimental arm and the control arm in terms of their primary outcomes except one. Given the sample size and the risk of bias in each of the included trials, the effect size has to be understood and interpreted with utmost caution. Conclusion Overall, this review establishes the paucity of evidence for occupational therapy for PWD in India. Building the capacity for rigorous and relevant scientific research in occupational therapy would enable bridging the gaps in evidence for occupational therapy in India.

Approximately 6.2% of the world's population (466 million people) suffer from disabling hearing impairment [1]. Hearing impairment impacts negatively on one's education, financial success [2] [3], cognitive development in childhood [4], including increased risk of dementia in older adulthood [5]. Lack of or reduced social interaction due to hearing impairment affects creating or maintaining healthy relationships at home, school and work [5]. Hence, hearing impairment genuinely affects the overall quality of life and wellbeing. The cocktail party effect, which is a healthy hearing individual's ability to understand one voice in a cacophony of other voices or sounds, is an important ability lacking in people with hearing impairment. This inability results in difficulties with simple daily activities such as partaking in group discussions or conversing in noisy restaurants [6]. This smart hearing aid aims to provide much-needed assistance with understanding speech in noisy environments. For example, if a person wants to partake in a group discussion, he/she needs to place the microphone array based unit on a flat surface in front of him/her, such as a table. When conversations take place, the microphone array will capture and process sound from all directions, intelligently prioritise and provide the lead speaker's voice by suppressing unwanted noises, including speeches of other people. This device selects and alternates voices between speakers automatically using voice algorithms. Additionally, the user has the option of further fine-tuning the acoustic parameters as needed through a smartphone interface. This paper describes the development and functions of this new smart hearing aid.

Introduction:Hand splinting after stroke is a common practice despite inadequate evidence. This warrants a better understanding of the therapists’ splinting practice, to develop clinically meaningful treatment options.Aims:The study examined the nature and prevalence of the factors associated with therapists’ hand splinting practice and their perceived splinting efficacy.Settings and Design:A cross-sectional national survey of hand-splinting practice among inpatient occupational therapists (OTs) in Ireland.Materials and Methods:Sixty-two therapists participated in this national survey.Statistical analysis usedA number of factors were analyzed to explore their relationship with therapists’ perception of splint efficacy using Spearman's rank order correlation.Results:53(85.5%) out of 62 survey respondents prescribed splints to their clients at the time of taking the survey. To reduce spasticity, to correct contractures and thus increase range of motion (ROM) were the commonly used splinting goals. These were the goals that were significantly associated with the therapists’ splinting efficacy too.Conclusions:Hand-splint prescription following stroke was found to be a common practice among OTs who perceive splints to be quite effective. A custom-made, volar forearm-based wrist-hand splint is the preferred splint among therapists to achieve a number of clinical aims such as improving ROM, stretching soft tissue contractures and reducing spasticity in the upper extremity. A wide variety of splinting regimens is currently practiced, reflecting the lack of a universally accepted and comprehensive practice guideline to regulate therapy. Methodologically valid clinical trials evaluating the efficacy of therapist-preferred splints in achieving their favored outcomes are needed. Development of common, universally accepted therapeutic guidelines based on comprehensive scientific review of such studies is thus needed.

The new National Commission for Allied and Health Care professions (NCAHCP) bill 2020 is introduced by the Government of India on September 15, 2020, to streamline the cadres in the country for allied and health-care professions within its health systems for the greater public good. It is very pertinent to understand the implications of the NCAHCP bill for All India Occupational therapists Association (AIOTA) and occupational therapists in India. The implications for AIOTA are (1) development of state councils and enabling their functioning in all the states of India, (2) radical revision of the OT curriculum incorporating policies and programs of the Indian health system, and (3) developing and strengthening the existing systems for OT practice. For occupational therapists, the implications are (1) registering to independently practice OT in India and (2) documenting professional practice for ethical integrity. Forming an advisory board to develop strategies for a smooth transition to the opportunities that the NCAHCP bill provides, must hold the top-most priority for AIOTA.