Priority 11 from the Occupational Therapy PSP

UNCERTAINTY: How does the amount of occupational therapy received affect outcomes for people who access services? (JLA PSP Priority 11)
Overall ranking 11
JLA question ID 0100/11
Explanatory note In the context of limited resources and services, it is important to acknowledge that while withdrawing services too early may restrict the benefits of occupational therapy for people who access services, it is possible that continuing to provide services beyond a certain point might not lead to any further gains. In these circumstances, others who might benefit from occupational therapy might unnecessarily miss out on or have delayed access to services.
This question therefore aims to explore how the frequency and duration of a range of occupational therapy interventions influences the outcomes for people, and whether an optimal amount can be identified for maximal effectiveness for each. 

There is limited evidence addressing this question. This is an area of uncertainty.
Abdullahi, A., et al. (2015). "Determination of Optimal Dose of Tasks Practice during Constraint Induced Movement in a Patient with Severe Shoulder Pain following Stroke: a Case Report." Indian Journal of Physiotherapy & Occupational Therapy 9(1): 198-203.
Brusco, N. K., et al. (2019). "Feasibility of increasing the dosage of inpatient occupational therapy and physiotherapy rehabilitation via independent tasks and exercises: 'My Therapy'." Australian Occupational Therapy Journal 66(6): 739-752.
Ciro, C. A. (2016). "Examining dose-specific outcomes in the skill-building through task-oriented motor practice (STOMP) intervention for dementia." Alzheimer's & dementia 12(7): P343‐.
Hayward, K. S. (2016). Higher-dose, higher-repetition upper limb motor rehabilitation program after stroke is not superior to dose-matched or usual-dose customary occupational therapy [commentary]. New York, New York, Elsevier B.V. 62: 226-226.
Imms, C., et al. (2015). "Robot assisted upper limb therapy combined with upper limb rehabilitation was at least as effective on a range of outcomes, and cost less to deliver, as an equal dose of upper limb rehabilitation alone for people with stroke." Australian Occupational Therapy Journal 62(1): 74-76.
Prescott, M., et al. (2015). "How much, how often, when and where? A description of NHS routine occupational and physical therapy from the DARS trial." International journal of stroke. Conference: UK stroke forum 2015 conference. Liverpool united kingdom. Conference start: 20151201. Conference end: 20151203. Conference publication: (var.pagings) 10: 57.
Sakzewski, L., et al. (2016). "Translating Evidence to Increase Quality and Dose of Upper Limb Therapy for Children with Unilateral Cerebral Palsy: A Pilot Study." Physical & Occupational Therapy in Pediatrics 36(3): 305-329.

Health Research Classification System category Generic Health Relevance
Extra information provided by this PSP
Original uncertainty examples How often should a person be seen by an OT to get the most benefit from their services?  ~ when/how often to do home exercise programmes ~ Why my son doesn’t get regular OT to help with his motor controls  ~ What number of sessions is optimal /effective for children's Occupational Therapy interventions (ie after how long should we say that it isn't working?) ~ Do 10 sessions have more impact than 8 etc etc. This applies to all types of children's OT interventions (eg CO-OP, bimanual therapy, CIMT, handwriting interventions). ~ WHat do parents regard as "enough" / "too much" in terms of their commitment to bringing child to therapy? ~ Why do they only visit once or twice when they are trying to work with me on long term things ~ How does the amount of occupational therapy received affect results and outcomes?
Submitted by Occupational therapists, Carers, Service Users 
PSP information
PSP unique ID 0100
PSP name Occupational Therapy
Total number of uncertainties identified by this PSP. 66  (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop 27 July 2020