Special Issue: Neurological conditions (II)

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When the call for submissions for a BJOT special issue on neurological conditions was announced, we hoped for a strong response, and possibly enough high-quality articles for a two-part issue. In fact, we had more than enough accepted articles for two parts, and will also include some others in later issues of the journal. The evident interest in the topic and the quality of submissions received is testament to the potential for occupational therapy’s contribution to the lives of people with neurological conditions and to the kind of care that they receive.

The first part of this issue was published in October 2017. Like it, this part includes papers addressing several key areas of concern: here, lived experience (Jones and Nasrin, 2018; Lutz et al., 2018; Turpin et al., 2018, Zwicker et al., 2018), measurement (Austin et al., 2018; Bryant et al., 2018), and intervention (Stark et al., 2018).

Those researchers examining the experiences of people living with neurological conditions have all applied qualitative approaches to enhance our understandings of what it is like, either on a daily basis or in particular situations, to live with Parkinson’s (Lutz et al., 2018), multiple sclerosis (Turpin et al., 2018), stroke (Jones and Nasrin, 2018), or developmental coordination disorder (Zwicker et al., 2018). Although the specific methods and participants vary, what is striking about these articles is the common themes: negotiating a new reality, finding new meanings, and coming to terms with differences – either differences from a past existence or expectations of self or others about performance. The data (quotations from participants) shared in these papers are powerful, and offer occupational therapists and students important insights into the positive and challenging experiences of different people with neurological conditions. Occupational therapists can use the findings from these studies to deepen history-taking interviews with clients, and to expand their understanding of what it may be like to live with these conditions.

Austin et al. (2018) and Bryant et al. (2018) offer important information about outcome measures that occupational therapists may be considering for use in practice. Austin’s study indicates that the United Kingdom Functional Independence Measure and Functional Assessment Measure (UK FIM + FAM) is responsive to change over time, both internally and externally, among children and youth with acquired brain injury. While some floor effects were identified at both admission and discharge, the findings point to the potential of this measure and the need for further evaluation of its measurement properties. Bryant and colleagues compared the activity engagement of adults with Parkinson’s disease with age- and sex-matched controls using the Activity Card Sort (ACS) – Australia (18–64 years), filling a gap in knowledge about this population. Their findings indicated no differences between the groups in overall activity retention, daily life or recreation and relaxation activity retention. Only physical activity retention differed, with more retained activity in the Parkinson’s group. The authors discuss their findings, and point to the value of the ACS for developing an occupational profile.

The final paper in this issue, by Stark et al. (2018), presents the findings of randomized parallel-group pilot examining the feasibility of a complex intervention that included tailored compensatory strategies, motivational enhancement and self-management strategies for people with stroke transitioning out of inpatient care. The overall goal of the intervention was to improve participation outcomes. The intervention was found to be safe, feasible to deliver and to produce promising changes in community participation. While the authors acknowledge limitations, the study supports further development and testing of this manualized intervention.

Together, the papers in this two-part special issue and those that will follow illustrate the diversity of neurological populations with whom occupational therapists work, and the value that our profession places on our clients’ voices, our ability to accurately evaluate their abilities and our efforts to support their participation in community life.

For information on forthcoming special issues, or to submit a proposal, please visit the journal web page at http://journals.sagepub.com/page/bjo/call-for-papers