AOTA

Lily L. Lai, MD, is Associate Clinical Professor, Department of Surgery, City of Hope, Duarte, CA.

Heather Player, MD, is Assistant Clinical Professor, Department of Surgery, City of Hope, Duarte, CA.

Sherry Hite, MOT, OTR/L, is Occupational Therapy Manager, Department of Rehabilitation Services, City of Hope, Duarte, CA.

Vikas Satyananda, MD, is Surgical Oncology Fellow, Department of Surgical Oncology, Roswell Park Cancer Institute, Buffalo, NY.

Jennelle Stacey, BA, is Rehabilitation Aide, Department of Rehabilitation Services, City of Hope, Duarte, CA. Virginia Sun, PhD, RN, is Associate Professor, Department of Population Sciences, City of Hope, Duarte, CA.

Veronica Jones, MD, is Assistant Clinical Professor, Department of Surgery, City of Hope, Duarte, CA.

Jennifer Hayter, MA, OTR/L, CLT-LANA, is Executive Director, Department of Rehabilitation Services, City of Hope, Duarte, CA

CE Credit: .1 CEU (1 credit hour/1.25 PDU)

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.

Objectives:

1. List typical side effects in women recovering from breast cancer.

2. Understand how a telehealth platform can be used for occupational therapy clients recovering from breast cancer

3. Discuss interventions used in occupational therapy for individuals recovering from breast cancer to support occupational performance and participation 

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.