Review Article

Mapping Effectiveness Studies of Occupational Therapy in Africa: A Scoping Review

Table 4

Effectiveness studies from Africa by field of practice and level of evidence.

Area of practice
AuthorsStudy aimLevel of evidenceSample sizeName of interventionOutcome measuresEffectiveSize of effect

Community development
González-Bernal et al. [46]The aim of this research was to verify the effectiveness of a community-based OT intervention in the volition, quality of life, and perceived self-stigma of people with disabilities in the Moroccan city of Azrou.III-394Community occupational therapyVolitional questionnaire, WHOQOL-BREF, the stigma consciousness questionnaire, attribution questionnaire, ad hoc interview (Likert scale)YesNot reported

Hands
Naudé and de Klerk [76]To explore aspects of feasibility related to the recruitment, consent, and retention rates in consideration of a future definitive randomised control trial. In addition, preliminary results of an early active therapy protocol compared to an early passive therapy protocol were reported on, together with patient satisfaction and demographics.II31Early active mobilisationTotal active motion, Jamar hand dynamometer, Michigan Hand Questionnaire, Smith Hand Function EvaluationYesNot reported
Spark, et al. [59]To determine the range of movement (ROM), power, and pinch grip strength post-FTR and to establish factors that may affect theseIII-3126Passive motion, controlled active motion, or early active motion protocolsBilateral hand ROM, bilateral grip strength, and pinch strengthNoNot reported
Young et al. [60]To report on the rehabilitation and functional outcomes of a patient who had his hand replanted at the distal forearm in a private practice setting in Umhlanga, South AfricaIV1Early active mobilisationROM—goniometer; sensation—monofilaments and disk criminator; muscle strength—hydraulic dynamometer, B&L pinch gauge, and manual muscle testing; hand function—nine hole peg test, Jebsen-Taylor Hand Function Test, and DASHYesNot applicable
Devan [57]To describes a technique that utilizes a combination of an orthosis and Kinesio tape, thereby creating a treatment protocol that shortens the immobilisation phase for these patientsIV16Early active mobilisationGoniometerYesNot reported

Mental health
Gandawa [45]To determine whether participation in an eight-week volunteer program for learners was more effective than an eight-session life skill training program in improving alcohol use behaviour and perceptionsII34Volunteer program vs. life skill groupAlcohol expectancy questionnaire—adolescents, alcohol timeline follow-backNoNone
Strauss et al. [40]To determine the effect of the tempo of music on the activity participation of the inhibited and agitated mental healthcare users with acute psychosisII160Music tempoResearcher developed their own assessment of participation because “there are no assessments to measure participation”; included attention, following of instructions, directedness towards activity, and willingness to participateYesNot reported
Van Rensburg et al. [42]To determine the short-term effect of a group drumming intervention program on aggression among adolescent girls at a school for girls diagnosed with conduct disorder in Bloemfontein in the Free StateII26Drumming programDemographic questionnaire, aggression scaleYesNot reported
De Villiers [41]To determine the effect of a 90-minute online intervention, to improve knowledge of individualized sensory processing preferences and associated modulation strategies on the occupational performance of adults with major affective disordersII27Education on individualized sensory processing styles and associated modulation strategiesCanadian Occupational Performance Measure, WHODAS 2.0, PHQ-9, and GAD-7YesNot reported
Crouch [44]To make an effective stress management program available to the impoverished rural community of the Acornhoek area of the Limpopo provinceII120Stress management programQuestionnaire 1, questionnaire 2—both developed from literature and contextualizedYesNot reported
Engelbrecht et al. [36]To determine whether attendance at an occupational therapy-led day treatment centre for mental healthcare users affects the use of inpatient services in South AfricaIII-244Occupational therapy-led day treatment centreNumber of admissions, days in hospitalYesMedium to large
Ramano and de Beer [39]To compare the outcomes of the proposed new occupational therapy (SCO) group program, with the existing occupational therapy (SCN) group programIII-2100New occupational therapy (SCO) group programBay Area Functional Performance Evaluation-Revised (BaFPE-R)YesVery small to medium
Grobler [37]To compare an activity program with an outcome-based program for optimal functioning and reintegration of mental healthcare users into the communityIII-3102Activity-based occupational therapy vs. outcome-based occupational therapyInternational Classification of Functioning, Disability and HealthYesNot reported
Plastow et al. [38]To examine the effects of an occupational therapist-led African drumming group on mental well-being among adult psychiatric inpatients with mood disordersIV13Occupational therapy-led African drummingStellenbosch Mood Scale (STEMS), Enjoyment of Interaction Scale, Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7)YesLarge
Silaule and Casteleijn [43]To evaluate the change in activity participation of mental healthcare users attending an occupational therapy programIV64Occupational therapy programActivity Participation Outcome Measure (APOM)YesNot reported

Paediatrics
Vlok et al. [25]To investigate the effect of ocular motor exercises, in combination with a visual perceptual program, on the visual perception of seven-year-old learners with visual perceptual problemsII32Visual perceptual intervention programThe Developmental Test of Visual Perception, 2nd edition, by Hammil, Pearson, and Voress 15 (DTVP-2) was used as the pre- and postprogram measurementNoSmall
Ramugondo et al. [26]To describe the playfulness in children with HIV and PHE on HAART living in challenging socioeconomic areas in South Africa, and to evaluate the feasibility and preliminary effectiveness of a play-informed, caregiver-implemented, home-based intervention (PICIHBI) for improving playII24Play-informed, caregiver-implemented, home-based intervention (PICIHBI)Test of playfulness, background information questionnaireNoSmall
Hughes et al. [22]To determine the effect of a soft neoprene thumb abductor splint on upper limb function in children with CP with a thumb-in-palm deformityII28Neoprene thumb abduction splints and home programQuality of Upper Extremity Skills TestNoVery small to large
Buckle et al. [27]To determine whether learners with attention deficit hyperactivity disorder (ADHD) and definite difference in sensory processing would be able to improve their in-seat behaviour, task completion speed, and attention-to-task as a result of a weighted vestII30Weighted vestsTime seated per 20 minutes (in-seat behaviour), time in seconds (task completion), Conners’ Continuous Performance Test II (CPT II) (attention to task)YesNot reported
Hewson [61]To design and evaluate a postural control program for infants, in which defined stimulatory activities are embedded into the everyday activities of the parentsII50Infant postural control program (IPCP)Screening Questionnaire, Baby’s Day Diary©, Peabody Developmental Motor Scales–2nd Edition (PDMS-2)YesNot reported
Lecuona et al. [30]To investigate the effect of Ayres Sensory Integration (ASI) on the development of premature infants in the first 12 months of lifeII24Ayers Sensory Integration (ASI)the Infant/Toddler Sensory Profile (ITSP), the Test of Sensory Function in Infants (TSFI), and Bayley III Scales of Infant and Toddler Development (BIII)YesNot reported
Van Heerden et al. [34]To establish whether a life skill program would have a short-term effect on the emotional intelligence of children in Grade RII88Life skillsCilliers Emotional Intelligence TestYesNot reported
Russell et al. [64]To assess the effectiveness of the Developmental Resource Stimulation Programme for children with DS younger than 42 monthsIII-230Developmental Resource Stimulation ProgrammeThe Bayley Scales of Infant and Toddler Development, 3rd edition (Bayley Scales III)NoNot reported
Levin [29]To identify whether Stetro pencil grips, inclined surfaces, and splints are effective in enhancing writing speed and legibility in grade two children with learning disabilitiesIII-222Assistive devices for pencil graspAuthor-developed handwriting assessment including speed and legibility (letter formation, spacing between words, letter spacing between lines, accuracy, and general appearance)NoNot reported
Chedzey [31]To determine the level of efficacy of the CTP on the development of three-to-four-year-old children in the rural Mahikeng areasIII-249The cross-trainer program (CTP)ECDC (Early Childhood Development Criteria) consisting of Section A: Cognitive SRRA (School Readiness Risk Areas), Section B: Fine Motor Coordination, and Section C: Gross Motor CoordinationYesNot reported
Salzwedel [33]To determine the effect of the SEMOSTI sensory-motor program, on the gross motor proficiency of four-to-six-year-old childrenIII-273SEMOSTI (sensory motor stimulation program)Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOT-2), questionnaires: physical activity (frequency, duration, type in domains of vigorous, low to moderate, and sedentary)YesNot reported
Smit [35]To determine the effect of a classroom-based program on handwriting for children with pencil grasp problemsIII-245Pencil grip providedLyytinen-Lund (1998) observation schedule, pinch meter, Minnesota Handwriting AssessmentYesLarge
Hamer-Rohrer et al. [21]To establish whether a CIMT (constraint-induced movement therapy) course in the home environment will result in improved hand function and performance in functional skills (activities of daily living) in a young child with asymmetrical cerebral palsyIII-31Constraint-induced movement therapyPediatric Evaluation of Disability InventoryYesNot reported
Du Plessis et al. [23]To determine the effect of 12 hippotherapy sessions on physiological effort and walking speed over 60 mIII-310HippotherapyPhysiological cost index (PCI) and walking speedYesNot reported
Russell et al. [24]To establish the effect of combined therapy approaches (CTA) on the intervention of four children aged 48.1 months to 60 months with cerebral palsy (CP)IV4CTA (combined therapy approaches)PEDI-CAT, gross motor function measure, and goal attainment scaleNoNone
Demopoulos [28]To investigate the relationship between a sensory diet and in-seat behaviour of a learner in the classroomIV12Sensory dietDaily behaviour assessment scaleNoNone
Bastable et al. [20]To determine the effect of a nonpowered, self-initiated mobility program on the engagement of young children with severe mobility limitationsIV4Self-initiated mobility programThe Individual Child Engagement Record—Revised (ICER–R)2, Gross Motor Functioning Classification Level (baseline only)YesMedium to large (Per participant)
Jorge et al. [63]To explore whether 7-to-24-month-old infants with fussy behaviour would respond to an intervention program consisting of a two-week sensory diet and parent educationIV12Parent education and sensory dietDemographic questionnaire, survey questions about the parents’ knowledge of RSPD, parent self-report Infant-Toddler Symptom ChecklistYesLarge
Delgado [56]To investigate the effect a supination splint on the upper limb function of children with cerebral palsy for six months after they were injected with botulinum toxin AIII-310Supination splintModified Ashworth scores; goniometry measurements of the elbow, forearm, wrist, and thumb; the Quality of Upper Extremity Skills Test (QUEST) and a subjective hand assessmentYesNot reported

Physical rehabilitation
Jansen and Casteleijn [52]To investigate whether occupational therapy, tailored to the level of motivation for patients with diabetic foot complications, has more positive treatment outcomes than occupational therapy that is notIII-110Occupational therapy program using Vona du Toit Model of Creative AbilityReintegration to normal living index, wound tracing, creative participation assessmentYesNot reported
Kamwesiga et al. [48]To evaluate the feasibility of (i) a mobile phone supported family-centred ADL intervention F@ce™ and (ii) the study design for evaluating the effects of the intervention on the perceived impact of stroke, perceived participation in everyday life, and self-efficacy in everyday activities among persons with stroke and their families in UgandaIII-230F@ceCOPM, Self-Efficacy, Stroke Impact Scale 3.0 Uganda version, Barthel Index, Occupational Gaps Questionnaire Ugandan versionYesVaries, but favours F@ce
Msengana et al. [51]To establish the profile of the dysfunction with which stroke survivors present as well as the recovery their upper limb movement and independence in personal management on referral, at discharge and for two months postdischargeIII-359Occupational therapyThe Fugl-Meyer Assessment Upper Extremity (FMA UE) and the South African Data Functional Medicine (SADFM) Beta Scale®YesNot reported
Mamabolo et al. [50]The aim of this study was to establish the degree of functional independence of patients with stroke at discharge and more than six weeks postdischargeIV68Stroke group and home-based interventionBarthel IndexYesNot reported
Haffejee et al. [53]To determine the functional mobility outcome and the factors that influence it post-TBI at discharge from hospitalIV60Occupational therapyFunctional Mobility Outcomes from the Rivermead Mobility Index ScoreYesNot reported
Cawood and Visagie [47]To describe the functional outcomes achieved by stroke survivors in an urban Western Cape provinceIV53Occupational therapyStroke Impact Scale (SIS) Version 3.0, Modified Barthel Index (MBI)YesNot reported
Graham [62]To determine the value of CBR training, undertaken by the Department of Occupational TherapyIV20Child care courseQuestionnaire on knowledge gained from each workshop, retention of knowledge over one month, and skills learned used in daily handling of childrenYesNot reported
Kloppers [49]To describe the outcomes achieved by clients after participating in rehabilitation at the Bishop Lavis Rehabilitation Centre (BLRC) over a three-month periodIV78Rehabilitation (occupational therapy, physiotherapy, and limited speech and language therapy)Adapted Zambian Activity and Participation questionnaire, Barthel Index, Oswestry Back Pain questionnaire, AIMS2-SF Arthritis Impact Scale, DASH (Disability of the Arm, Shoulder, and Hand), clinical mobility scale, carer stress scale, and CRALMYesNot reported

Work practice
Van der Linde [54]To determine the impact of a staff development program to increase knowledge, skills, and attitudes to work with PIMD on their perceived job satisfaction over timeIV12Staff trainingJob satisfaction questionnaireNoNot reported
Soeker [55]To determine whether MOOSE is an effective model to enhance the cognitive skills of individuals with brain injuryIV10MOOSE (Model of Occupational Self Efficacy) programMontreal Cognitive AssessmentYesNot reported