Occupational therapists (OTs) have been in the spotlight this month after the National Disability Insurance Agency (NDIA) froze NDIS payments for these services at $193.99 per hour for the sixth year.

The NDIA also cut travel payments for OTs who visit people in their home and community by 50%.

Health Minister Mark Bulter says it’s important people on the NDIS aren’t paying more for therapy and support than they would pay in the health or aged care system.

But OTs are concerned this could affect therapists’ viability, including their ability to support people with disability in their homes and communities.

But what can OTs actually do? And why is it often better to do this in a person’s home and community?

Who might see an OT?

Imagine trying to get back to your daily life after a major health setback, such as a car accident or stroke, or an episode of a long-term condition or disability, such as depression or arthritis. The things you used to do with ease can become difficult and exhausting.

After such a setback, your home or community can also feel like an obstacle course. Maybe you can’t carry the laundry basket out to the line anymore, or you’re struggling to keep up with your children.

This is where occupational therapy can make a real difference. OTs are health professionals that enable people to do the things they need, want and love to do in daily life, from getting dressed to cooking dinner, gardening to driving.

Occupational therapists work with people of all ages. They overcome barriers by changing the environments and objects we use, teaching new skills, rehabilitating old ones and tweaking the way we tackle tasks.

What can OTs do in the home and community?

Seeing people in their own homes and communities allows the therapist to get a more accurate picture of a person’s strengths and abilities, which can be difficult to understand in a clinic.

OTs use their skills and creativity to provide personalised care, tailored to individual needs and circumstances.

An older person with dementia might, for example, cause alarm by putting a plastic kettle on the stove of a hospital kitchen. But they could make their cup of tea perfectly safely at home with their stove top kettle.

OTs can support home and community mobility, such as checking a wheelchair passes smoothly through doorways and can manoeuvre in tight spaces such as bathrooms.

But they can also advise on kitchen aids and seating to save energy for people with conditions such as multiple sclerosis, to support them continuing to cook family meals.

In their work with neurodivergent people of different ages, an OT might help an autistic teen develop sensory strategies to deal with their busy and noisy school day.

For other people, OT support might help them navigate their local public transport system. Learning and practising skills where they’re used makes it easier to carry them over into everyday life.

What does the research say?

Research shows home and community OT can lead to better activity and participation than clinic-based therapy. It’s also cost-effective.

For stroke survivors, OT makes everyday tasks like showering or getting dressed easier.

OT at home eases burden and stress for the parents of children with cerebral palsy and carers of people with dementia.

OT at home helps older people with ongoing health issues to be more actively involved in their communities.

Community OT is also effective in supporting recovery for people with mental health problems, enabling them to enjoy community and leisure activities, seek and maintain employment and enhance physical activity.

OT focuses on helping you do the things that keep you well and independent, which means fewer trips back to the hospital. OTs can spot and solve trip hazards within homes, for example, before a frail person has a fall.

People who get OT at home soon after leaving hospital are less likely to be readmitted. Emerging research also suggests OT can work jointly with paramedics when someone falls at home by visiting and offering immediate treatment that prevent avoidable hospital stays.

There are some downsides, such as limited access in disadvantaged communities. While telehealth can address some barriers, it is not suitable in every case.

How do Australians access OTs?

There are many pathways to access OT services, but the complexity of the health-care system means the process is challenging to navigate.

OT services can also be costly, due to severely limited funding, equipment and transport costs.

OT is available as part of Home Care Packages and the Commonwealth Home Support Programme for older people.

OT has also played a key role in supporting NDIS participants since the scheme’s inception. However, waiting lists often stretch for many months and not everyone knows about what OT can offer.

You can also access community OT through Medicare Chronic Disease Management plans, local community health centres and councils and through private health insurance rebates.

Thanks to Lana O’Neil (Occupational Therapist at Western Health in Victoria) and Sarah McCann (Senior Occupational Therapist at Western Health) for sharing their clinical expertise for this article.

Danielle Hitch, Senior Lecturer in Occupational Therapy, Deakin University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Whether you enjoy chocolate milk regularly, as a weekend treat, or as an occasional dose of childhood nostalgia, it probably wouldn’t be the first option you think of for post-workout recovery.

Unless you’re on TikTok, perhaps. According to many people on the social media platform, chocolate milk is not only delicious, but it offers benefits comparable to sports drinks after a workout.

So is there any evidence to support this? Let’s take a look.

Rehydrating after a workout is important

Water accounts for somewhere between 50% and 60% of our body weight. Water has many important functions in the body, including helping to keep our body at the right temperature through sweating.

We lose water naturally from our bodies when we sweat, as well as through our breathing and when we go to the toilet. So it’s important to stay hydrated to replenish the water we lose.

When we don’t, we become dehydrated, which can put a strain on our bodies. Signs and symptoms of dehydration can range from thirst and dizziness to low blood pressure and confusion.

Athletes, because of their higher levels of exertion, lose more water through sweating and from respiration (when their breathing rate gets faster). If they’re training or competing in hot or humid environments they will sweat even more.

Dehydration impacts athletes’ performance and like for all of us, can affect their health.

So finding ways to ensure athletes rehydrate quickly during and after they train or compete is important. Fortunately, sports scientists and dietitians have done research looking at the composition of different fluids to understand which ones rehydrate athletes most effectively.

The beverage hydration index

The best hydrating drinks are those the body retains the most of once they’ve been consumed. By doing studies where they give people different drinks in standardised conditions, scientists have been able to determine how various options stack up.

To this end, they’ve developed something called the beverage hydration index, which measures to what degree different fluids hydrate a person compared to still water.

According to this index beverages with similar fluid retention to still water include sparkling water, sports drinks, cola, diet cola, tea, coffee, and beer below 4% alcohol. That said, alcohol is probably best avoided when recovering from exercise.

Beverages with superior fluid retention to still water include milk (both full-fat and skim), soy milk, orange juice and oral rehydration solutions.

This body of research indicates that when it comes to rehydration after exercise, unflavoured milk (full fat, skim or soy) is better than sports drinks.

But what about chocolate milk?

A small study looked at the effects of chocolate milk compared to plain milk on rehydration and exercise performance in futsal players (futsal is similar to soccer but played on a court indoors). The researchers found no difference in rehydration between the two. There’s no other published research to my knowledge looking at how chocolate milk compares to regular milk for rehydration during or after exercise.

But rehydration isn’t the only thing athletes look for in sports drinks. In the same study, drinking chocolate milk after play (referred to as the recovery period) increased the time it took for the futsal players to become exhausted in further exercise (a shuttle run test) four hours later.

This was also shown in a review of several clinical trials. The analysis found that, compared to different placebos (such as water) or other drinks containing fat, protein and carbohydrates, chocolate milk lengthened the time to exhaustion during exercise.

What’s in chocolate milk?

Milk contains protein, carbohydrates and electrolytes, each of which can affect hydration, performance, or both.

Protein is important for building muscle, which is beneficial for performance. The electrolytes in milk (including sodium and potassium) help to replace electrolytes lost through sweating, so can also be good for performance, and aid hydration.

Compared to regular milk, chocolate milk contains added sugar. This provides extra carbohydrates, which are likewise beneficial for performance. Carbohydrates provide an immediate source of energy for athletes’ working muscles, where they’re stored as glycogen. This might contribute to the edge chocolate milk appears to have over plain milk in terms of athletic endurance.

Coffee-flavoured milk has an additional advantage. It contains caffeine, which can improve athletic performance by reducing the perceived effort that goes into exercise.

One study showed that a frappe-type drink prepared with filtered coffee, skim milk and sugar led to better muscle glycogen levels after exercise compared to plain milk with an equivalent amount of sugar added.

So what’s the verdict?

Evidence shows chocolate milk can rehydrate better than water or sports drinks after exercise. But there isn’t evidence to suggest it can rehydrate better than plain milk. Chocolate milk does appear to improve athletic endurance compared to plain milk though.

Ultimately, the best drink for athletes to consume to rehydrate is the one they’re most likely to drink.

While many TikTok trends are not based on evidence, it seems chocolate milk could actually be a good option for recovery from exercise. And it will be cheaper than specialised sports nutrition products. You can buy different brands from the supermarket or make your own at home with a drinking chocolate powder.

This doesn’t mean everyone should look to chocolate milk when they’re feeling thirsty. Chocolate milk does have more calories than plain milk and many other drinks because of the added sugar. For most of us, chocolate milk may be best enjoyed as an occasional treat.

Evangeline Mantzioris, Program Director of Nutrition and Food Sciences, Accredited Practising Dietitian, University of South Australia

This article is republished from The Conversation under a Creative Commons license. Read the original article.