Search Results (356)

Background: Acquired brain injury (ABI) affects manual dexterity (MD) and cognitive functions, limiting daily activity performance. Occupational therapy aims to improve functionality and quality of life. Objective: To examine and describe the available evidence on the impact of MD training on cognitive processes and functional performance in adults with stroke, as well as to identify the most commonly used assessment tools and intervention techniques. Methods: Scoping review. A systematic literature search was conducted in PubMed and Scopus to identify experimental studies from the last 10 years involving adults with ABI who participated in interventions targeting upper-limb, MD, and cognitive function. A three-phase screening was carried out by two authors with duplicates removed using Zotero version 7.0. Results: Ten articles published between 2016 and 2023 were included. The most frequent interventions involved robotics and virtual reality. Eight studies were conducted by occupational therapists or included occupational therapy involvement, while two were conducted by physiotherapists. Training MD and upper-limb motor skills led to improvements in attention, memory, and executive functions. Conclusions: Findings support combined motor–cognitive interventions carried out by occupational therapists or physiotherapists to optimize rehabilitation outcomes, although further research is needed to strengthen the evidence. Full article

Stroke is a leading cause of long-term disability worldwide, and new technologies such as Fully Immersive Virtual Reality (FIVR) are being explored to promote functional recovery as well as optimize rehabilitation outcomes. The aim of the present study was to explore Greek OTs’ perspectives on the use of FIVR in rehabilitation of the upper limb after stroke. Two focus groups took place with six experienced OTs, who were recruited from diverse clinical settings across Greece. The interviews were facilitated using a semi-structured guide and inductively coded using thematic analysis following Braun and Clarke’s six-stage process. Six theme-rich findings were elicited. Therapists identified FIVR’s potential to enable patient involvement, motivation, and recovery of function through the use of immersion and feedback-based practice. They reported significant barriers, however, in terms of technical challenges, safety issues, and costly equipment. OTs also highlighted the fact that occupation-based, culturally sensitive task design is central to ensuring ecological validity and transfer to naturalistic settings. There is a high potential for FIVR in stroke rehabilitation, but it requires user-centered design, cultural adaptation, adequate training, and systemic support towards long-term implementation. Full article

This narrative review examines how immersive virtual and mixed-reality (VR/MR) technologies, combined with AI-driven virtual agents, can support the prevention and long-term management of chronic illness. Chronic diseases represent a significant global health burden, and conventional care models often struggle to sustain patient engagement, motivation, and adherence over time. To address this gap, we conducted a narrative review of reviews and meta-analyses. We selected empirical studies published between 2020 and 2025, identified through searches in PubMed, Web of Science, and Google Scholar. The aim was to capture the state of the art in the integrated use of VR/MR and AI in chronic illness care, and to identify key opportunities, challenges, and considerations relevant to clinical practice. The reviewed evidence indicates that VR/MR interventions consistently enhance engagement, motivation, symptom coping, and emotional well-being, particularly in rehabilitation, pain management, and psychoeducation. At the same time, AI-driven conversational agents and virtual therapists add adaptive feedback, personalization, real-time monitoring, and continuity of care between clinical visits. However, persistent challenges are also reported, including technical limitations such as latency and system dependence, ethical concerns related to data privacy and algorithmic bias, as well as psychosocial risks such as emotional overattachment or discomfort arising from avatar design. Overall, the findings suggest that the most significant clinical value emerges when VR/MR and AI are deployed together rather than in isolation. When implemented with patient-centered design, clinician oversight, and transparent governance, these technologies can meaningfully support more engaging, personalized, and sustainable chronic illness management. Full article

Background: Children with autism spectrum disorder (ASD) commonly experience persistent difficulties in social communication, emotional regulation, and social engagement. In recent years, artificial intelligence (AI)-based technologies, particularly socially assistive robots and intelligent sensing systems, have been explored as complementary tools to support psychosocial interventions in this population. Objective: This systematic review aimed to critically evaluate recent evidence on the effectiveness of AI-based interventions in improving social, emotional, and cognitive functioning in children with ASD. Methods: A systematic literature search was conducted in PubMed following PRISMA guidelines, targeting English-language studies published between 2020 and 2025. Eligible studies involved children with ASD and implemented AI-driven tools within therapeutic or educational settings. Eight studies met inclusion criteria and were analyzed using the PICO framework. Results: The reviewed interventions included humanoid and non-humanoid robots, gaze-tracking systems, and theory of mind-oriented applications. Across studies, AI-based interventions were associated with improvements in joint attention, social communication and reciprocity, emotion recognition and regulation, theory of mind, and task engagement. Outcomes were assessed using standardized behavioral measures, observational coding, parent or therapist reports, and physiological or sensor-based indices. However, the studies were characterized by small and heterogeneous samples, short intervention durations, and variability in outcome measures. Conclusions: Current evidence suggests that AI-based systems may serve as valuable adjuncts to conventional interventions for children with ASD, particularly for supporting structured social and emotional skill development. Nonetheless, methodological limitations and limited long-term data underscore the need for larger, multi-site trials with standardized protocols to better establish efficacy, generalizability, and ethical integration into clinical practice. Full article

This qualitative study explored the experiences of caregivers of people with dementia who received home-based occupational therapy from the Modena Memory Clinic. Five participants were interviewed through semi-structured conversations analyzed using thematic analysis. Results identified three main mechanisms underlying the effectiveness of the intervention: education, empowerment, and collaboration. Therapist-tailored interventions helped caregivers recognize remaining abilities, improve problem-solving, and enhance daily care strategies. The home environment supported comfort and engagement, while collaboration with professionals strengthened continuity of care. These findings highlight occupational therapy as a key component of community-based and person-centered dementia care. Full article

Background/Objectives: Introducing a demanding home-based program (HBP) of Vojta therapy (VT) into their daily activities is a life-altering event for parents of children with global developmental delay (GDD). This study aims to document the experiences of parents of children with GDD administering a HBP of VT. Methods: A multicentre study with a qualitative case design based on an interpretative approach is presented. Interviews were conducted with 10 parents using photo-elicitation (PE). Inductive and thematic analyses were used. Results: Four common experiential themes were identified. Firstly, crying was identified as the most significant barrier to administering therapy (despite parents accepting that crying was not pain-related). Secondly, parents described the intense and variable emotional impact of being responsible for the therapy and its effects on their child. Thirdly, parents unanimously felt that their involvement was worthwhile, with the developmental results they perceived outweighing the emotional, physical and time demands of administering the VT. Finally, parents developed a narrative of hope stemming from the therapy and its observed effects. Conclusions: The physical, emotional and time demands on parents when administering a HBP of VT are very significant. The main barriers to adherence to the program are identified as the child’s crying during therapy and time management. Intense emotional experiences, both positive and negative, arise while administering a HBP of VT. Parents are not only able to overcome all emotional and logistical challenges when they recognize improvements in their child, but they also begin to hope for further improvement. Implications for the professional design of HBPs of VT include the following: advanced warning that crying is normal, part of the therapy and not pain-related; training and ongoing support from a qualified therapist; training in recognising developmental improvement; and psychological support to deal with the emotional journey. Full article

Background/Objectives: Intensive care units (ICU) immobility and weakness impair recovery, yet practice for Physical Therapist (PT)-led therapeutic exercise and mobility varies in definitions, dosing, safety, and documentation, which limits comparability and complicates quality assessment. This study aims to integrate adult ICU evidence and present PT-led operational definitions, dose progression principles, safety parameters, outcome measurement, and a documentation minimum dataset. Methods: A scoping review following PRISMA-ScR is used. Eligibility used Population, Concept, and Context: adults in ICU; PT-led therapeutic exercise or mobility; and ICU-initiated or directed care. Primary studies and prespecified quality-improvement reports were included. Data were extracted with a standardized form and summarized descriptively without meta-analysis. Results: Sixty studies were included. Based on the extracted data, this review synthesizes current evidence to propose standardized PT-led operational definitions and a graded progression from in-bed exercise to ambulation. While the individual components are derived from the literature, the conceptual framework for safety parameters and the stop rules were integrated and elaborated to guide clinical decision-making. Adverse events were uncommon and manageable. Outcome measurement centered on validated mobility and function measures at prespecified time points. A concise electronic record minimum dataset specifies provider attribution, timing and duration, activity level with assistance or device, planned and delivered dose with progression, in-session responses, and adverse events, supporting unit-level quality review and comparisons across ICU. Conclusions: A PT-led, graded program that applies shared thresholds, uses validated outcome measures, and employs standardized electronic documentation is feasible and supports safe delivery, clinically meaningful change, and quality improvement across adult ICU. Full article

Background: Worldwide, cancer is a leading cause of morbidity and mortality, with symptoms of pain and emotional distress, associated with the disease and its treatment. Art therapy and art making are promising adjuncts to pharmacotherapy for these symptoms. However, current studies do not support replacing pharmacotherapy with these methods. Research Question: Is there evidence supporting the use of art therapy and/or art making interventions for managing cancer-related pain (primary outcome) and emotional distress (secondary outcome) among adult cancer survivors, during and following active treatment? Methods: We searched six databases, including PubMed, CINAHL, Scopus, ProQuest (library’s version), and Google Scholar, using the search terms “cancer pain” AND “art therapy” OR “art making.” Inclusion criteria included English language, peer-reviewed studies, on adult cancer survivors. The search yielded 1305 results, with 23 meeting the inclusion criteria. Because emotional distress was frequently discussed in the context of cancer-related pain in the included studies, it was added as a secondary outcome. Results: The efficacy of art therapy/art making to manage cancer-related pain and emotional distress was difficult to determine due to the heterogeneity of study designs and interventions. Of the studies reviewed in which pain was a primary outcome, eight found significant pain reductions, three found small or no effects, and three reviews described art making as a non-verbal method of communicating about pain, but did not address changes in pain levels. The terms “art therapy” and “art making” were sometimes used interchangeably. The choice of therapeutic approach was sometimes financially driven, and was also impacted by the availability of certified art therapists. Discussion: Methodological shortcomings of the existing research include small sample sizes, lack of standardized intervention protocols, and inconsistent outcome measures, underscoring the need for more rigorous and generalizable studies. Future research should consider neuroimaging evidence linking aesthetic experiences with activation of the brain’s “reward network” by utilizing fMRI to study brain activity during art therapy and art making interventions. Full article

Background: Augmented reality (AR)-based exercise offers a low-cost option for home training, but the lack of supervision increases the risk of incorrect performance. Therefore, AR systems must demonstrate accuracy and effectiveness comparable to therapist-led training. To address this need, this study examined whether an AR-supported multi-component exercise program improves six key components of physical fitness. Methods: Twenty-eight healthy adults from South Korea were recruited and randomly assigned to either the AR group or the physical therapist (PT) group. Participants were assessed for six components of physical fitness: muscular strength, muscular endurance, balance, cardiorespiratory endurance, flexibility, and coordination. Each group performed the exercise program three times per week for four weeks, with each session lasting at least 30 min. Statistical analyses were conducted using paired t-tests to evaluate pre- and post-intervention effects within each group and independent t-tests to compare differences between the two groups. The level of statistical significance was set at p < 0.05. Results: Exploratory analyses showed that both groups demonstrated post-intervention improvements in muscular endurance, balance, flexibility, and coordination, while cardiorespiratory endurance and grip strength showed no notable changes. Between-group comparisons revealed significant differences only in right-hand relative grip strength at both baseline and post-intervention, with no other domains differing between groups. Conclusions: First, the AR-based intervention significantly improved muscular endurance, balance, flexibility, and coordination. Second, there were no significant differences between the AR-based and therapist-led interventions. Consequently, AR-based exercise programs may enhance specific components of physical fitness and could be effectively utilized to complement and extend therapist-led training sessions. Full article

This meta-analysis synthesized 34 published single-case design studies on functional communication training (FCT) for young children with autism spectrum disorder (ASD). A systematic search of electronic databases and reference lists identified studies published between 1996 and 2021 involving 79 children with ASD aged 2 to 8. Quality evaluation using What Works Clearinghouse standards revealed that only 29.4% of studies met standards with or without reservations, primarily due to insufficient data points per phase. Most studies were conducted in home or school settings with therapists/researchers as primary implementers, followed by parents or caregivers. Low reporting rates were found for preference assessment, treatment fidelity, social validity, and maintenance and generalization effects. Overall, FCT demonstrated large effects for reducing challenging behavior (Tau-BC = 0.97) and moderate-to-large effects for increasing replacement behavior (Tau-BC = 0.78). Moderator analyses revealed significantly larger effect sizes in school versus home settings (p < 0.05). These findings further support FCT as an evidence-based practice for young children with ASD, although methodological rigor must be improved. Future research should systematically evaluate maintenance and generalization effects, develop effective parent training and support strategies, and report intervention dosage parameters to strengthen the evidence base and guide clinical implementation. Full article

Introduction: Manual therapists routinely evaluate changes in pain, movement, and function through clinical tests that support clinical reasoning. The Prone Hip Extension Test (PHET) is commonly used as a self-perturbation task to assess lumbopelvic control and hip motion patterns related to gait. Performing the PHET actively and passively may reveal how voluntary activation and passive structures influence joint kinematics and contribute to force production. This study aimed to compare active and passive PHET execution and investigate how initial (IP) and final hip positions (FP) correlate with lower-limb neuromuscular function. Methods: Seven healthy volunteers (24.3 ± 3.4 years; 173.1 ± 7.5 cm; 72.1 ± 9.5 kg) without musculoskeletal conditions participated. Hip kinematics were recorded using a 12-camera Qualisys Oqus system (200 Hz) with 22 reflective markers, processed in Qualisys Track Manager 2.13 and exported to Visual3D. Participants performed three PHET trials in both IP and FP, with mean an-gles considered for analysis. Knee isokinetic performance was assessed on a Biodex System 4 at 180°/s and 300°/s for flexion and extension. Results: Significant differences between active and passive PHET emerged in the FP for rotational movements bilaterally (p = 0.02) and in IP adduction/abduction for both hips (right p = 0.03; left p = 0.02). No side-to-side differences were observed. Passive FP of the right hip showed multiple significant correlations with isokinetic flexion and extension parameters at 180°/s and 300°/s, particularly with torque/body weight, acceleration and deceleration times, and agonist/antagonist ratios (ρ ranging from −0.86 to 0.90). Conclusions: Meaningful differences exist between active and passive PHET performance, especially in frontal-plane IP and rotational FP measures. Additionally, passive FP strongly correlates with several neuromuscular variables, suggesting that PHET kinematics may reflect lower-limb isokinetic function. Full article

Objectives: This systematic review seeks to provide an in-depth overview of current research on tele-music interventions in supportive cancer care and identifies key areas where further research is warranted. Methods: A comprehensive search was conducted across four electronic databases (Scopus, Embase, Web of Science, and PubMed) without any data restrictions and according to the PRISMA guidelines. The primary outcome measure was the effect of tele-music interventions on psychosocial functioning. Results: Of the 2.043 articles initially identified, nine studies met the inclusion criteria and were selected for qualitative analysis. Among the music interventions, considerable variation was observed regarding delivery format and techniques employed. Most interventions were delivered remotely through Zoom, and in all but one study, a music therapist was involved. Outcome measures addressed various psychosocial and physical symptoms, most frequently anxiety, for which findings were mixed: three studies reported significant reductions, whereas two others observed no or only limited improvement. Conclusions: The results suggest that tele-music interventions are effective in reducing a range of cancer-related symptoms, including stress, anxiety, depression, and pain. However, the heterogeneity in study designs and methodological limitations hampered direct comparison and overall effectiveness assessment. Additionally, digital technologies hold considerable potential for the accessible and cost-effective delivery of music interventions. Full article

Forest therapy, guided by clinical professionals (psychologists or psychotherapists), is increasingly recognized as a preventive and complementary health practice with evidence-based therapeutic potential; however, the specific contribution of therapist guidance compared to self-guided immersion remains unclear. This retrospective study evaluated the short-term mental health outcomes of therapist-guided (TG) compared to self-guided (SG) forest immersion, based on the validated State–Trait Anxiety Inventory and Profile of Mood States questionnaires. Data were collected from 282 adults participating in eight paired TG–SG sessions conducted at the same forest sites across Italy. The results showed that TG sessions were associated with greater improvements in state anxiety, self-esteem, and total mood disturbance, with statistically significant effects in most cases. Therapist-led guidance also occasionally reduced interindividual variability, suggesting enhanced emotional regulation. An illustrative economic assessment, based on standardized psychometric improvements translated into quality-adjusted life years (QALYs), indicated that the TG sessions yielded approximately 1.7 times the annual per-person economic value of the SG sessions, outweighing the associated therapist-related costs. These findings suggest that TG forest therapy interventions deliver significant and economically quantifiable added value compared to SG experiences, supporting their inclusion in preventive health and mental well-being programs and justifying further longitudinal and cost-effectiveness investigations. Full article

Background/Objectives: Avoidant/Restrictive Food Intake Disorder (ARFID) frequently co-occurs with Autism Spectrum Disorder (ASD), yet its detection and assessment remain challenging. This study aimed to analyze terminology and professionals’ views on features and indicators related to ARFID among Spanish professionals working with autistic individuals, identifying potential gaps and training needs. Methods: A cross-sectional study was conducted with 194 professionals (62 speech therapists, 62 psychologists, and 70 occupational therapists) from different regions of Spain, who completed a 13-item questionnaire on their familiarity with terminology, definitions, and features they consider indicative to ARFID. Descriptive analyses and chi-square tests were applied to explore interprofessional differences. Results: Significant differences emerged across disciplines (p < 0.001). Psychologists showed greater familiarity with DSM-5 diagnostic criteria (78%), while speech-language therapists (72%) and occupational therapists (69%) more frequently endorsed sensory, oromotor, and behavioral features as relevant. Across all groups, 61% reported uncertainty about ARFID diagnostic criteria, and only 34% reported familiarity with validated assessment tools. Conclusions: Spanish professionals working with ASD populations demonstrate heterogeneous and generally limited understanding of the features they associate with ARFID, with discipline-specific approaches to assessment. These findings provide initial evidence in Spanish-speaking contexts and underscore the need for structured training and validated Spanish-adapted instruments to support early and accurate ARFID identification. Full article

Background/Objectives: In the treatment of autism spectrum disorders, families express the need for dedicated clinical spaces to manage emotional overload and to develop effective relational skills. Parent training addresses this need by supporting the parent–child relationship and fostering the child’s development. This study proposes a clinical protocol designed for psychotherapists and behavior analysts, based on the Autism Open Clinical Model (A.-O.C.M.), which integrates the rigor of Applied Behavior Analysis (ABA) with a phenomenological and embodied perspective. The model acknowledges technology—particularly artificial intelligence—as an opportunity to structure adaptive and personalized intervention tools. Methods: A multi-level prompt design system was developed, grounded in the principles of the A.-O.C.M. and integrated with generative AI. The tool employs clinical questions, semantic constraints, and levels of analysis to support the clinician’s reasoning and phenomenologically informed observation of behavior. Results: Recurrent relational patterns emerged in therapist–caregiver dynamics, allowing the identification of structural elements of the intersubjective field that are useful for personalizing interventions. In particular, prompt analysis highlighted how the quality of bodily and emotional attunement influences readiness for change, suggesting that intervention effectiveness increases when the clinician can adapt their style according to emerging phenomenological resonances. Conclusions: The design of clinical prompts rooted in embodied cognition and supported by AI represents a new frontier for psychotherapy that is more attuned to subjectivity. The A.-O.C.M. stands as a theoretical–clinical framework that integrates phenomenology and intelligent systems. Full article