Kayla Ninnis’s research while affiliated with Flinders University and other places

Introduction Home assessments conducted by occupational therapists can identify hazards and prevent falls. However, they may not be conducted because of limited time or long distances between the therapist’s workplace and the person’s home. Developments in technologies may overcome such barriers and could improve the quality of the home assessment process. Method This scoping review synthesises the findings of studies evaluating information and communication technology use within occupational therapy home assessments. Results Fourteen studies were included and revealed the two main approaches to technology use: the development of new applications and the use of existing and readily available technologies. Facilitators and barriers to use were also identified. Facilitators included usefulness, ease of use and the potential for cost-effectiveness. Barriers to use included poor usability, unsuitability for some populations and perceived threat to the role of occupational therapy. The synthesis revealed that traditional in-home assessments conducted by therapists are more sensitive in identifying hazards. Conclusion The availability of new technologies offers potential to improve service delivery; however these technologies are underutilised in clinical practice. Technologies may offer advantages in the conduct of home assessments, especially regarding efficiency, but have not yet been shown to be superior in terms of patient outcome.

Purpose: To examine in people with neurological disorders, which method/s of providing external cues to improve task performance are most effective. Methods: Medline, EMBASE, and PsycINFO were systematically searched. Two reviewers independently screened, extracted data, and assessed the quality of the evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE). Results: Twenty six studies were included. Studies examined a wide-range of cues including visual, tactile, auditory, verbal, and multi-component cues. Cueing (any type) improved walking speed when comparing cues to no cues (mean difference (95% confidence interval): 0.08 m/s (0.06–0.10), I² = 68%, low quality of evidence). Remaining evidence was analysed narratively; evidence that cueing improves activity-related outcomes was inconsistent and rated as very low quality. It was not possible to determine which form of cueing may be more effective than others. Conclusion: Providing cues to encourage successful task performance is a core component of rehabilitation, however there is limited evidence on the type of cueing or which tasks benefit most from external cueing. Low-quality evidence suggests there may be a beneficial effect of cueing (any type) on walking speed. Sufficiently powered randomised controlled trials are needed to inform therapists of the most effective cueing strategies to improve activity performance in populations with a neurological disorder. • Implications for rehabilitation • Providing cues is a core component of rehabilitation and may improve successful task performance and activities in people with neurological conditions including stroke, Parkinson’s disease, Alzheimer’s disease, traumatic brain injury, and multiple sclerosis, but evidence is limited for most neurological conditions with much research focusing on stroke and Parkinson’s disease. • Therapists should consider using a range of different types of cues depending on the aims of treatment and the neurological condition. There is currently insufficient evidence to suggest one form of cueing is superior to other forms. • Therapists should appreciate that responding optimally to cues may take many sessions to have an effect on activities such as walking. • Further studies should be conducted over a longer timeframe to examine the effects of different types of cues towards task performance and activities in people with neurological conditions.