Author ORCID Identifier
https://orcid.org/0000-0002-0532-603X
Date Available
7-26-2026
Year of Publication
2024
Document Type
Doctoral Dissertation
Degree Name
Doctor of Philosophy (PhD)
College
Health Sciences
Department/School/Program
Rehabilitation Sciences
Advisor
Dr. Dana Howell
Co-Director of Graduate Studies
Dr. Patrick Kitzman
Abstract
The aim of this dissertation is to increase the body of research of how occupational therapists can address multiple sclerosis rehabilitation through occupational therapy services. Multiple sclerosis is a neurodegenerative disease that creates challenges for individuals to engage in meaningful occupations and significantly affects many areas of their lives. Occupational therapists play a role in the rehabilitation process for people with multiple sclerosis by providing occupation-focused interventions that may improve the health and well-being of clients living with the disease. As a result of the unpredictability of symptoms experienced by this population, individualized approaches to addressing participation and occupational performance are essential. Occupational therapists may obtain additional training for this population by completing the multiple sclerosis certification specialization. While some evidence explores occupational therapy interventions for adults living with multiple sclerosis, limited evidence explores and describes how occupational therapists are addressing multiple sclerosis rehabilitation and how a multiple sclerosis certification impacts occupational therapists’ practice and leads to specialized knowledge and skills for addressing the unique needs of this population.
This dissertation is a combination of research projects centered around occupational therapists’ practices addressing multiple sclerosis rehabilitation. This dissertation includes a systematic review, a qualitative study, and a mixed method study focusing on multiple sclerosis and occupational therapists working with this population. The systematic review was conducted to better understand the effectiveness of occupational therapy interventions that improve fatigue and cognition outcomes for people with multiple sclerosis. There was strong strength of evidence supporting occupational therapy telehealth interventions and moderate strength of evidence supporting community or clinic-based occupational therapy interventions to improve fatigue. There was a low strength of evidence to support occupational therapy specific interventions to improve cognition outcomes for people with multiple sclerosis. The systematic review results helped shape the qualitative exploration of occupational therapists’ providing multiple sclerosis rehabilitation in various practice settings. The qualitative study explored five occupational therapists’ experiences with multiple sclerosis rehabilitation, including the assessments and interventions used for symptom management in their clinical practices. Three themes emerged: client-centered and occupation-based care, occupational therapy interventions and treatment approaches to multiple sclerosis care, and knowledge development and multiple sclerosis. The results emphasized that occupational therapists working with people with multiple sclerosis are driven to provide individualized and occupation-based care to address the various dimensions of physical, mental, and emotional changes their clients face. However, practice settings can impact occupational therapist’s ability to focus on their client’s needs and occupation-based interventions.
Finally, a mixed methods sequential explanatory design was used to explore occupational therapists’ practices for clients living with multiple sclerosis through surveys and qualitative interviews. This study explored two samples of occupational therapists who have worked with clients with multiple sclerosis and do not have their multiple sclerosis certification and occupational therapists who have their multiple sclerosis certification. Twenty-six occupational therapists completed the surveys: eighteen occupational therapists without multiple sclerosis certification, and eight occupational therapists with multiple sclerosis certification. The survey results demonstrated practitioners’ confidence in treating clients with multiple sclerosis, treatment delivery methods, treatment and intervention approaches, and the common multiple sclerosis
symptoms addressed in occupational therapy practice. Both occupational therapists described how they participated in multidisciplinary teams and empowered and advocated for this population. The qualitative interviews only explored occupational therapists that have their multiple sclerosis certification to further examine their motivations for becoming multiple sclerosis certified specialists and their multiple sclerosis occupational therapy practices. Five occupational therapists with multiple sclerosis certifications participated in virtual interviews. Three overarching themes emerged: occupational therapists' deepening their understanding of multiple sclerosis, multidisciplinary collaboration and occupational therapy for multiple sclerosis care, and empowerment and advocacy for clients with multiple sclerosis through occupational therapy.
Both phases of our mixed methods study demonstrated the importance of occupational therapists addressing this population, including how multiple sclerosis certification influences occupational therapists, helping clients navigate their multiple sclerosis symptoms, and occupational participation challenges. Occupational therapists are motivated to become experts and undergo training and specializations through certifications to enhance their delivery services and establish credibility with their clients. The multiple sclerosis certification demonstrates the important role of multidisciplinary management for multiple sclerosis, including occupational therapy. Furthermore, client empowerment and advocacy through occupational therapy is integral. These studies reveal the need for more research to be conducted in the area of occupational therapy for people living with multiple sclerosis. Furthermore, improving knowledge and expertise in multiple sclerosis management, staying current with evidence specific to multiple sclerosis, and utilizing effective occupational therapy interventions are crucial for this population. The final chapter (chapter 6) of this dissertation provides further implications for occupational therapists working with clients living with multiple sclerosis and discusses future occupational therapy practice and research.
Digital Object Identifier (DOI)
https://doi.org/10.13023/etd.2024.365
Recommended Citation
AlGhadban, Dana, "A MIXED METHODS EXPLORATION OF OCCUPATIONAL THERAPY PRATICE AND MULTIPLE SCLEROSIS SPECIALIZATION" (2024). Theses and Dissertations--Rehabilitation Sciences. 107.
https://uknowledge.uky.edu/rehabsci_etds/107
