It is a question that has been asked more than once, especially in the years since the first major case of the condition was diagnosed in a hospital in the UK, in May 2015.
But a survey of more than 600 dementia sufferers has found that occupational and occupational-related therapies for people with dementia are not the most effective way of helping people who have the condition, but the best option, the Journal of Occupational and Environmental Medicine (JOE) has found.
The authors argue that while they believe there are good reasons to use a combination of physical therapy and cognitive rehabilitation in people with mild cognitive impairment, it is not clear that either treatment is the best way to treat the condition.
A combination of occupational and cognitive rehab The JOE report, titled The Evidence of Benefit and Disadvantage of Occupation Therapy in Mild Cognitive Impairment (MCHI), suggests that there is evidence to suggest that occupational therapy is an effective therapy for some people with MCHI, while the evidence of a negative impact on the overall quality of life for people without MCHIs is not yet clear.
The JOSE team conducted a review of the literature on occupational therapy and occupational rehabilitation.
They analysed data from more than 20 studies and compared outcomes across various occupational therapy modalities, such as occupational therapy versus cognitive rehabilitation, occupational therapy plus physical therapy, and occupational therapy alone.
The report also looked at evidence on whether a combination or combination of these therapies can be more effective than physical therapy alone in people who do not have MCHDs.
“This was a cross-sectional study of people with severe mental illness who were in an acute care hospital,” said Dr Anne Parnell, senior research fellow at JOE.
“We were looking at people with a diagnosis of MCH or mild cognitive dysfunction who were given occupational therapy.
There was no evidence that they would benefit from physical therapy.”
The study found that the effectiveness of occupational therapy compared to physical therapy was “significant and clinically significant”, although it did not take into account the individual’s specific needs.
The results suggest that the most important thing to consider when choosing a combination therapy for people who are not currently taking any other treatments is whether the therapy is going to be more beneficial than the alternative treatment.
The paper concluded that while occupational therapy may be an effective treatment for some patients with MCDIs, there is no evidence to support the use of physical therapists as a primary treatment for people in a nursing home setting.
“The evidence to date suggests that occupational therapists should be used as a last resort in those with mild-to-moderate cognitive impairment and as a part of the primary intervention for people at risk of relapse if they do not respond to physical rehabilitation,” the report said.
The main findings of the report are: There was “limited evidence” for the effectiveness and safety of occupational therapists for people diagnosed with MCSI.
There is “no clear evidence that occupational therapist use is superior to physical therapist use” in people diagnosed in an outpatient setting.
The “evidence of benefit” for occupational therapy was not clear.
There are also “substantial gaps” in the evidence for the efficacy of occupational therapist interventions.
There were “substantially fewer studies” of occupational therapies in people receiving cognitive rehabilitation than there were for physical therapists.
The researchers suggest that further research on the effectiveness, safety, and cost effectiveness of different types of occupational rehabilitation is needed.
“In general, we found limited evidence that physical therapy is superior in patients with mild to moderate cognitive impairment compared to occupational therapy,” the paper concluded.
“However, there are some limitations to this evidence.
Some studies found that physical therapists are not better at reducing relapse rates than occupational therapists.”
The authors also recommend further studies to “evaluate the effectiveness” of physical therapist and occupational therapist treatments for people experiencing a relapse.
“More research is needed to clarify whether occupational therapy improves outcomes for patients with moderate to severe cognitive impairment who have not responded to physical therapies,” the researchers said.
“Future research on this topic is warranted.”
This research was funded by the National Institute for Health Research (NIHR) through the Australian Research Council (ARC) grant 4-0514.
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