![]() ![]() ![]() As executive functioning refers to a variety of processes, it is difficult or impossible to assess with a single measure, but it is crucial given the impact impairment can have on a person’s ability to work. 11 To plan cognitive interventions, OTs often perform standardised assessments to determine which areas of executive functioning that are affected. 10 With a plethora of screening tools and outcome measures how do we ensure that the outcome measures chosen by an OT are applicable and have strong validity and reliability to help us manage return to work outcomes?Ĭognitive interventions used by OTs may involve implementing coping and compensation strategies to assist people to participate in work activities. 9Ĭlaims for cognitive impairment such as this are often referred to an OT to assess cognition and plan treatment rehabilitation needs of cancer survivors, so it is essential that OTs can assess cognition to evaluate the outcomes of any interventions. The evidence suggest that the over-recruitment of brain regions is due to reduced neural integrity and connections after chemotherapy. 8įurthermore, the excess active areas are seen after chemotherapy, meaning that the brain is compensating to maintain adequate performance levels. 7 fMRI studies of 60‑year-old identical twins measuring structural brain changes demonstrate that heightened activity occurs in more regions, indicating that the brain is working harder to complete tasks. ![]() These cognitive changes impact activities of daily living (ADL), family and occupational roles. 4,5Ĭancer related cognitive impairment, also called “chemo brain”, is recognised as a side-effect of cancer treatment that impacts 30% to 70% of breast cancer survivors. Cognitive function is the ability of the brain to acquire, process, store and retrieve information. 3Ĭognition is defined as a process comprising eight domains: attention, concentration, information-processing speed, memory, language, executive function, visuospatial ability, and psychomotor ability. 2 Similarly, we are seeing early trends in the COVID‑19 pandemic where an acute disease can persist in the long term and affect brain and cognitive function. 1 This is most prevalent in the breast cancer population, with a 91% survival rate. People who have undergone chemotherapy frequently complain of mild cognitive impairments such as memory loss and an inability to focus which impact participation in valued occupations and roles. Such assessment can help guide functional upgrade and measurable work capacity. Cognitive assessment by an occupational therapist (OT) is sometimes used in individual disability income insurance (IDII) claims and managing return to work where the primary diagnosis is cancer and there are subjective reports of ongoing fatigue and mental impairment. ![]()
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