Occupational Therapy Interventions for Instrumental Activities of Daily Living for Adults With Parkinson’s Disease: A Systematic Review

Abstract

Importance: Instrumental activities of daily living (IADLs) are important for independence, safety, and productivity, and people with Parkinson’s disease (PD) can experience IADL limitations. Occupational therapy practitioners should address IADLs with their clients with PD. Objective: To systematically review the evidence for the effectiveness of occupational therapy interventions to improve or maintain IADL function in adults with PD. Data Sources: MEDLINE, CINAHL, PsycINFO, OTseeker, and Cochrane databases from January 2011 to December 2018. Study Selection and Data Collection: Primary inclusion criteria were peer-reviewed journal articles describing Level 1–3 studies that tested the effect of an intervention within the scope of occupational therapy on an IADL outcome in people with PD. Three reviewers assessed records for inclusion, quality, and validity following Cochrane Collaboration and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Findings: Twenty-two studies met the inclusion criteria and were categorized into four themes on the basis of primary focus or type of intervention: physical activity, specific IADL-focused, cognitive rehabilitation, and individualized occupational therapy interventions. There were 9 Level 1b, 9 Level 2b, and 4 Level 3b studies. Strong strength of evidence was found for the beneficial effect of occupational therapy–related interventions for physical activity levels and handwriting, moderate strength of evidence for IADL participation and medication adherence, and low strength of evidence for cognitive rehabilitation. Conclusions and Relevance: Occupational therapy interventions can improve health management and maintenance (i.e., physical activity levels, medication management), handwriting, and IADL participation for people with PD. Further research is needed on cognitive rehabilitation. This review is limited by the small number of studies that specifically addressed IADL function in treatment and as an outcome. What This Article Adds: Occupational therapy intervention can be effective in improving or maintaining IADL performance and participation in people with PD. Occupational therapy practitioners can address IADL function through physical activity interventions, interventions targeting handwriting and medication adherence, and individualized occupational therapy interventions.

Olfactory functional covariance connectivity in Parkinson’s disease: Evidence from a Chinese population

“…The present finding that ROI14 is closely associated with multiple Parkinson’s disease clinical scales and that this brain region predicts disease severity has clinical significance. In addition, these targeted locations and functional connectivity could potentially provide some cues for the PD treatment in view of occupational therapy ( Foster et al, 2021 ) and occupational neuroscience ( Yan et al, 2016 ; Shi et al, 2017 ; Shi et al, 2017 ; Wang et al, 2017 , 2018 ; Wu et al, 2020 ).…”

Neuropsychiatric Treatments for Parkinson's Disease: Nonpharmacological Approaches

“…58 59 72 Similarly, occupational therapy has been shown to reduce fall frequency with home modifications and improve activities of daily living. 73 74 Speech and language therapy has been shown to improve hypophonia and speech intelligibility. 68 75…”

“…58,59,72 Similarly, occupational therapy has been shown to reduce fall frequency with home modifications and improve activities of daily living. 73,74 Speech and language therapy has been shown to improve hypophonia and speech intelligibility. 68,75 More recently, there has been an emerging interest in exploring the role of rehabilitation and its therapeutic value in better managing neuropsychiatric symptoms in PD.…”

Deriving Implications for Care Delivery in Parkinson’s Disease by Co-Diagnosing Caregivers as Invisible Patients

“…Within the scientific literature four main reasons for care recipients’ and informal caregivers´ preference of home care are observable: First, a perceived lack of quality of nursing homes; second, the excessive costs of outpatient or inpatient care; third, to the care recipients wish to remain in their homes as long as possible; fourth, the care recipients preference to receive care from a familiar person [ 11 , 12 ]. Although most informal caregivers have no formal care qualifications, their care activity is well valued and highly appreciated by the PwPDs [ 13 , 14 ]. However, PD related changes often require challenging adaptation in activities of daily living, not only by the patient itself, but also by the informal caregiver.…”