Intensity of meaning upon the efficiency of a reach movement in healthy adults using negatively associated objects

The objective of this study was to determine whether reaching for negatively preferred objects elicited a different quality of reach movement compared to neutrally preferred objects. Forty healthy adults were asked to reach for seven different types of candy while wearing sensors on bony landmarks of their dominant upper extremities including the ulnar styloid process and metacarpophalangeal joint of the third digit. Motion analysis technology was used to capture kinetic and kinematic data from these sensors, in particular, movement time, movement units, peak velocity, displacement, and percentage of movement time to peak velocity were measured. After reaching for each candy, participants filled out a corresponding 26 item preference survey designed to gather information about their preference for that particular candy. The candies ranged from Hershey’s ® Milk Chocolate to Hotlix ® Insect Candy in order to represent a variety of preferences. Items were rated on a 5 point Likert scale that ranged from “Strongly Agree” to “Strongly Disagree. ” The results indicated that the quality of participants’ reach movements were less efficient when reaching for their least preferred compared to their neutrally preferred candies on the variables of movement time, movement units, and peak velocity, but not for displacement and percentage of movement time to peak velocity. These findings are congruent with previous studies that have investigated occupational performance during situations involving relative risk, and contribute to the growing body of knowledge that exists regarding occupational performance during negatively associated occupational forms. Therapists can use this knowledge to synthesize occupational forms where a less efficient quality of reach may be desirable for example during safety interventions, in order to help clients develop situationally appropriate skills. INTENSITY OF MEANING 3 Intensity of Meaning upon the Efficiency of a Reach Movement in Healthy Adults using Negatively Associated Objects Meaning is a multidimensional concept of great importance to the profession of occupational therapy. When a person ascribes meaning to an occupation, it can lead to enhanced occupational performance. This is a fundamental assumption within the profession of occupational therapy and has been corroborated by numerous research findings (Kircher, 1984; Henry, Nelson, & Duncombe, 1984; Sietsma, Nelson, Mulder, Scheidel, & White, 1993; Wu, Trombly, & Lin, 1994; Murphy, Trombly, Tickle-Degnen, & Jacobs, 1999; Hartman, Kopp Miller, & Nelson, 2000; Holubar & Rice, 2006; Rice, Davies, & Maitra, 2009; Rice & Renock 2006). The findings of these studies have direct implications for occupational therapy practice, where it is the desire of the therapist and the client, for the client to be successful at a variety of occupations. But what is meaning? And how does one ascribe it? How intense does the level of meaning have to be to in order to elicit a greater occupational performance? In their Conceptual Framework for Therapeutic Occupation (CFTO), Nelson and Thomas (2003) describe meaning as the interpretation one makes out of the occupational form, (or context). Meaning is a subjective experience which cannot be directly accessed or manipulated by others. The occupational form on the other hand, is external to the person and may be altered by outsiders. How a client ascribes meaning is dependent on the interaction between his or her developmental structure, (or unique qualities), and the physical and sociocultural aspects of the occupational form. Due to these variations, individuals may ascribe different meanings to the same occupational form (Nelson & Thomas, 2003). Although one can never fully predict what kind of meaning a person will assign to an occupational form, it is the objective of the occupational therapist to synthesize the occupational INTENSITY OF MEANING 4 form based on his or her knowledge of the client’s developmental structure. This is done in the hope that meaning will occur, and the client will experience what Nelson and Thomas (2003) describe as purpose, or a desire to act. This desire usually results in active doing by the client, also called occupational performance (Nelson & Thomas, 2003). Even though meaning is a subjective experience, the resulting occupational performance (in a particular occupational form) may be similar among groups of individuals who share something in common (e.g. college students, healthy adults, persons with CVA or TBI). This has made it possible for various occupational forms to be systematically studied in order to distinguish which ones lead to greater occupational performance. Occupational forms that have been examined under this premise include occupationally embedded exercise (also known as purposeful or materials-based activity) versus rote exercise, preference, choice versus no choice, hands-on learning versus demonstration, keeping versus not keeping, immediate versus prolonged exposure, and contextual relevance and ownership. Kircher (1984) studied the effect of purposeful versus non-purposeful occupation amongst twenty-six healthy adult females using a counterbalanced design. Purposeful occupation was operationalized as jumping with a rope, and non-purposeful occupation as jumping in place. Each participant was attached to an EKG during the experiment. Using The Borg Scale of the Rate of Perceived Exertion (RPE), participants were asked to stop jumping once they felt they were working very hard (a level 17 on the scale). Results indicated that participants’ heart rates at a predetermined RPE were significantly higher when jumping with a rope than jumping without one. In other words, when engaged in purposeful occupation compared to non-purposeful occupation, a higher heart rate was able to be obtained before the INTENSITY OF MEANING 5 participants felt like they were working very hard. This study was the first to measure the benefits of purposeful occupation (or occupationally embedded exercise) in this way. Henry et al. (1984) examined the effect of choice versus no choice during an individual or group origami activity with forty female college students. Choice was operationalized as the participants being able to choose which origami designs they used. Results showed that participants who had no choice, and were in a group situation viewed themselves as less powerful compared to participants in a group situation who had a choice. Sietsma et al. (1993) investigated the effects of occupationally embedded exercise versus rote exercise on the range of motion of twenty adult men and woman with traumatic brain injury. Participants in the occupationally embedded condition were asked to lean forward and reach in order to play a game, whereas those in the rote condition were only asked to lean forward and reach. The results revealed that range of motion was greater in the occupationally embedded condition. These findings are useful because they suggest that populations with disabilities can benefit from added meaning to the occupational form. Wu et al. (1994) explored the effects of materials based occupation versus imagery based and rote occupation from a kinematic perspective amongst thirty-seven female college students. Participants in the materials based condition we asked to pick up a pencil from a pencil holder and prepare to write their name, participants in the imagery based condition were asked to imagine picking up a pencil, and those in the rote condition were asked to reach forward. The results indicated that materials based occupation leads to faster, smoother movement than imagery based or rote occupation. Murphy et al. (1999) studied the effect of keeping versus not keeping an end-product, on intrinsic motivation. Fifty female college students chose between painting a ceramic vase, INTENSITY OF MEANING 6 decorating cookies, stringing beads to make a necklace, or creating stationary. Participants were told in advance whether they would be keeping or not-keeping the end products. Results showed that participants engaged in their occupation of choice longer when they knew they could keep the end product. Hartman et al. (2000) investigated the effects of hands-on occupation versus demonstration on recall memory in children. Seventy three third grade boys and girls either watched a model volcano being made (demonstration condition) or participated in making a model volcano (hands-on learning condition). Following each condition the participants were asked to recall the steps required to make the volcano. The researchers found that participants in the hands-on condition recalled more steps than those in the demonstration condition. Holubar and Rice (2006) studied the effects of context (familiar or unfamiliar) and ownership (object owned by the participant or owned by the researcher) on quality of movement during a reaching and placing task involving thirty-two adult women. The familiar context was the participant’s home and the unfamiliar context was the research laboratory. The object was a mug that was either owned by the participant or the researcher. The results indicated that participants’ movements were more efficient (indicated by less movement time) when reaching for their own mug regardless of the context. Movement units were also fewer when participants reached for their own mug in the lab setting compared to at home. No significant differences were found on the factor of context. Rice et al. (2009) explored the effects of exposure (prolonged or immediate) and object relevancy (a cup or a mass of clay) on quality of movement during a reaching and placing task involving fifty-nine adult female volunteers. The results indicated that prolonged exposure to the INTENSITY OF MEANING 7 cup or clay led to more efficient movement than immediate exposure, as indicated by less movement time and fewer movement units. No difference in performance was found between re