Intervention for Musculoskeletal Conditions

A group of occupational therapists provides intervention services for adults with rheumatoid arthritis, osteoarthritis or after total joint replacements. They want to find an outcome measure that is specific to occupational therapy and assesses changes in daily occupations (self-care, productivity and leisure). Their goal is to use only one outcome measure across the range of services they provide. In their literature search, they find information about the use of the COPM for adults with musculoskeletal conditions.

The COPM has been used to evaluate outcomes after intervention for persons with musculoskeletal conditions. For example, Kjeken and colleagues (2011) compared an assistive technology intervention to information provision in 70 clients who had hand osteoarthritis. Findings indicated that the provision of information, assistive devices and splints was more effective than information only. Changes in COPM scores for the assistive technology group were 1.8 in performance and 1.7 in satisfaction, and effect size of 0.9. Van der Linden and colleagues (2012) measured the impact of total knee arthroplasty with the COPM for 55 clients. One year after surgery, average change on the COPM was 2.6 points. In a randomized trial focused on work disability for clients with rheumatoid arthritis, Macedo and colleagues (2009) used the COPM to compare an occupational therapy intervention focused on improving the work function to usual care. The intervention over a period of six months, included individualized work assessments and interventions such as education about arthritis, ergonomics and pacing, stress management, activities of daily living and meetings with employers regarding accommodations. The results indicated that the group receiving occupational therapy work focused intervention improves significantly more than the usual care group.

Kjeken, I., Darre, S., Smedslund, G., Hagen, K. B., & Nossum, R. (2011). Effect of assistive technology in hand osteoarthritis: a randomised controlled trial. Annals of the rheumatic diseases, 70(8), 1447-1452.

Macedo, A. M., Oakley, S. P., Panayi, G. S., & Kirkham, B. W. (2009). Functional and work outcomes improve in patients with rheumatoid arthritis who receive targeted, comprehensive occupational therapy. Arthritis Care & Research, 61(11), 1522-1530.

van der Linden, M. L., Kumaran, B. R., Wade, F. A., & Nutton, R. W. (2012). The Canadian Occupational Performance Measure Before and After Total Knee Arthroplasty, Which Activities do Patients Rate as Important?. Journal of Bone & Joint Surgery, British Volume, 94(SUPP XXIX), 24-24.

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