Data sets from research in clinical practice professions often do not meet assumptions necessary for appropriate use of parametric statistics (Lezak and Gray, 1984). When assumptions underlying the use of the parametric tests are violated or cannot be documented, the power of the parametric test may be invalidated and consequently, the significance levels inaccurate (Gibbons, 1976). Much research has investigated the relative merits of parametric versus nonparametric procedures using simulation studies, but little has been done using actual data sets from a particular discipline. This study compared the application of parametric and nonparametric statistics using a body of literature in clinical occupational therapy. The most common parametric procedures in occupational therapy research literature from 1980 - 1984 were identified using methodology adapted from Goodwin and Goodwin (1985). Five small sample size data sets from published occupational therapy research articles typifying the most commonly used univariate parametric procedures were obtained, and subjected to exploratory data analyses (Tukey, 1977) in order to evaluate whether or not assumptions underlying appropriate use of the respective parametric procedures had been met. Subsequently, the nonparametric analogue test was identified and computed. Results revealed that in three of the five cases (paired t-test, one factor ANOVA and Pearson Correlation Coefficient) assumptions underlying the use of the parametric test were not met. In one case (independent t-test) the assumptions were met with a minor qualification. In only one case (simple linear regression) were assumptions clearly met. It was also found that in each of the two cases where parametric assumptions were met, no significant differences in p values between the parametric and the nonparametric tests were found. And conversely, in each of the three cases where parametric assumptions were not met, significant differences between the parametric and nonparametric results were found. These findings indicate that if cases were considered as a whole, there was a one hundred percent agreement between whether or not parametric assumptions were violated and whether or not differences were discovered regarding parametric versus nonparametric results. Other findings regarding (a) non-normality, (b) outliers, (c) multiple violation of assumptions for a given procedure, and (d) research designs employed are discussed and implications identified. Suggestions for future research are put forth. / Ph. D.

Clinical research has been identified with key occupational therapy issues such as professionalization and establishing the efficacy of practice within the competitive health care marketplace. The natural clinical practice setting provides the optimum environment for conducting research pertaining to practice, and a small but growing number of practitioners have managed to integrate research and practice in such an environment. While there has been a significant amount of literature advocating research involvement for practitioners primarily involved in clinical practice, no formal studies existed of the complex factors affecting a therapist's ability to integrate research with practice. This exploratory, descriptive study investigated an emerging role in occupational therapy: therapists who combine practitioner and researcher roles in their daily work with patients in clinical settings. Four major research questions were posed: (a) How does an occupational therapy practitioner adopt the practitioner /researcher role? (b) What activities constitute research in clinical settings? (c) How does the clinical environment affect research activities? and (d) What educational experiences do practitioner /researchers describe as important for accomplishing research in clinical settings? Goals were to develop an understanding of the emerging role by identifying personal, environmental, and educational factors, and determining their importance for current practitioners while obtaining recommendations for others. A custom-designed questionnaire was sent to the practitioner /researcher population (N = 116); the response rate was 89% (103). Quantitative analyses included measures of central tendency and variability. The Number Cruncher Statistical System computer program assisted with quantitative analyses and the Ethnograph computer program assisted written questionnaire analyses. Demographic information was collected to enhance data interpretation. Major findings include: (a) learning circumstances focusing on performance and application of clinical research were important for adopting a dual practice/research role; (b) research activities reflected the evolving character of the role; (c) support from facility administration and a personal commitment to research were critical for success; (d) formal courses were important for current research, but so were informal discussions regarding application and problem solving. A lack of opportunities for continuing education in research was reported. Implications for university curricula, continuing education, and clinical environments are discussed. Recommendations for future research are presented. / Ed. D.

Indiana University-Purdue University Indianapolis (IUPUI) / Stroke is the main cause of disability in the United States. Individuals with stroke commonly report sensory impairment affects their recovery. Motor recovery and sensory impairment are related and impact individuals’ ability to perform valued occupations. Despite the prevalence of sensation impairment after stroke, many occupational therapists fail to include sensation assessment and intervention in treatment planning. The exclusion of sensation in occupational therapy interventions during stroke rehabilitation may be due to the lack of literature supporting the association between sensation and occupational performance. The current study aimed to determine the relationship between touch sensation of the affected hand and occupational performance and satisfaction in individuals with chronic stroke. Using a cross-sectional study design, this study associated factors related to hand sensation and function in individuals with chronic stroke. Fifty individuals with chronic stroke participated in a one-time testing session in which assessments related to sensation, movement of the hand and engagement in daily activities were administered. Correlation analyses were utilized to determine relationships between touch sensation of the affected hand with individuals’ abilities to engage in valued daily activities, arm and hand disability, and manual abilities. The main finding of the study was that individuals with intact sensation reported greater ability to perform valued occupations and satisfaction with their performance, as compared with individuals with touch sensation impairment. For individuals with impaired touch sensation of the affected hand, impairment of touch sensation of the hand did not correlate with individuals’ performance or satisfaction with valued occupations, arm or hand movement, or manual abilities. Collectively, the results of this study reflect the complex interaction between touch sensation, occupational performance, motor functioning, and manual abilities of the affected hand for individuals’ who have experienced a stroke. This study informs therapists, rehabilitation scientists, and other healthcare professionals that client-centered, individualized approaches, including a wide array of clinical assessments and intervention, including assessment of occupational performance and sensation, remain important components in stroke rehabilitation.