Occupational therapy interventions for instrumental activities of daily living for adultswith parkinson's disease: A systematic review

Erin R. Foster, Lisa G. Carson, Jamie Archer, Elizabeth G. Hunter

Research output: Contribution to journalReview articlepeer-review

9 Scopus citations


Importance: Instrumental activities of daily living (IADLs) are important for independence, safety, and productivity, and people with Parkinson's disease (PD) can experience IADL limitations. Occupational therapy practitioners should address IADLs with their clients with PD. Objective: To systematically review the evidence for the effectiveness of occupational therapy interventions to improve or maintain IADL function in adults with PD. Data Sources: MEDLINE, CINAHL, PsycINFO, OTseeker, and Cochrane databases from January 2011 to December 2018. Study Selection and Data Collection: Primary inclusion criteria were peer-reviewed journal articles describing Level 1-3 studies that tested the effect of an intervention within the scope of occupational therapy on an IADL outcome in people with PD. Three reviewers assessed records for inclusion, quality, and validity following Cochrane Collaboration and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Findings: Twenty-two studies met the inclusion criteria and were categorized into four themes on the basis of primary focus or type of intervention: Physical activity, specific IADL-focused, cognitive rehabilitation, and individualized occupational therapy interventions. There were 9 Level 1b, 9 Level 2b, and 4 Level 3b studies. Strong strength of evidence was found for the beneficial effect of occupational therapy-related interventions for physical activity levels and handwriting, moderate strength of evidence for IADL participation and medication adherence, and low strength of evidence for cognitive rehabilitation. Conclusions and Relevance: Occupational therapy interventions can improve health management and maintenance (i.e., physical activity levels, medication management), handwriting, and IADL participation for people with PD. Further research is needed on cognitive rehabilitation. This review is limited by the small number of studies that specifically addressed IADL function in treatment and as an outcome.

Original languageEnglish
Article number7503190030
JournalAmerican Journal of Occupational Therapy
Issue number3
StatePublished - May 2021

Bibliographical note

Funding Information:
This systematic review was supported and funded by the AOTA Evidence-Based Practice Program. It was conducted following an a priori review protocol and Cochrane Collaboration methodology (Higgins et al., 2019) and is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (Moher et al., 2010). AOTA staff, a research methodologist (Elizabeth G. Hunter), a medical librarian, and external experts developed the research question and search terms.

Funding Information:
AOTA provided support for this work. Erin R. Foster is funded by the National Institutes of Health (National Institute on Aging [NIA] Grant R21AG063974, NIA Grant R01AG065214, and National Institute of Diabetes and Digestive and Kidney Diseases Grant R01DK064832) and the Advanced Research Center of the Greater St. Louis chapter of the American Parkinson Disease Association.

Publisher Copyright:
© 2021 American Occupational Therapy Association, Inc. All rights reserved.

ASJC Scopus subject areas

  • Occupational Therapy


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