1. Introduction

Occupational therapy (OT) is a medical rehabilitation discipline that enables individuals to perform daily activities and improve their quality of life [1]. OT helps individuals of all ages overcome diseases and disabilities, including neurological conditions (e.g., stroke, multiple sclerosis, and traumatic brain injury [TBI]), orthopedic conditions (e.g., fractures, rheumatoid arthritis, and osteoarthritis), mental health disorders (e.g., depression, anxiety disorders, and schizophrenia), developmental disorders (e.g., autism, Down syndrome, and cerebral palsy), and geriatric disorders (e.g., Parkinson’s disease, Alzheimer, and dementia) [2, 3].

The overall goal of OT is to maximize functioning and independency in occupational performance [4]. According to the World Federation of Occupational Therapists (WFOT), OT is a client-centered health profession concerned with promoting health and well-being through occupation [5]. Across the different physical and mental disability cases, OT is aimed at improving the functioning of individuals at home [6] and within their communities [7, 8]. OT plays a vital role in improving occupational performance, where occupations cover three main domains of self-care (dressing, grooming, eating, etc.), productivity (studying, working, volunteering, etc.), and leisure (swimming, gardening, reading, etc.) [4].

Day-to-day activities, deemed meaningful and worthwhile by individuals, fall under the purview of OT. According to the American Occupational Therapy Association (AOTA), domains defining the focus of OT should incorporate all services that allow clients to engage in daily activities in selected contexts, roles, and circumstances at the person, group, or population levels. In addition to these domains, the AOTA outlines the service delivery process, including valid and reliable assessments, evidence-based interventions, and occupation-based individualized outcomes [1]. Within this scope, OT services may include but are not limited to hand, cognitive, mental, sensory, work, driving, and burn management.

OT interventions vary in their approaches. As outlined by the AOTA, approaches to OT intervention include remediation (improving impaired functions), compensation (adapting tasks or environment), rehabilitation (restoring lost skills), and health promotion/prevention (preventing the onset of occupational performance issues by promoting healthy habits and routines) [1]. These approaches are used based on the nature of the condition and the individual’s goals. Across physical and mental health conditions, OT supports individuals at home, in educational and vocational settings, and in community participation.

Similar to other medical rehabilitation disciplines, OT is based on scientific evidence. These services are effective for diverse neurological, musculoskeletal, and psychosocial conditions covering all age groups [9]. Based on an extensive literature review, several researchers have reported distinct treatment strategies for various conditions. More specifically, while some researchers agreed on employing a specific method for a certain condition, others suggested different methods for similar conditions [3, 10–15].

Among the treatment strategies for neurological conditions such as stroke, the use of assistive technologies—including ramps and electrical hoists for transportation—has been found to be effective [3, 10, 11]. Another widely used intervention is constraint-induced movement therapy (CIMT), which involves restricting the use of the unaffected (i.e., unimpaired) limb to encourage use of the more affected (i.e., weaker) limb during functional activities [10].

For orthopedic conditions such as trigger finger—identified as the second most commonly addressed condition in the literature—the application of splints is a frequently recommended intervention [11, 12]. In addition, other treatment modalities such as orthoses, laser therapy, fluidotherapy, and specific therapeutic exercises have also been suggested [13, 14].

In the management of pediatric conditions such as Down syndrome and autism spectrum disorder, sensory integration therapy is commonly emphasized to enhance participation in daily occupations [15, 16]. One study compared the effectiveness of sensory integration alone to a combined approach involving sensory integration, vestibular stimulation, and neurodevelopmental therapy. Results indicated that the combined approach yielded better outcomes than sensory integration alone [16]. In contrast, another study reported that compensatory techniques and contextual modifications were the most frequently used interventions for individuals with Down syndrome [17].

Cerebral palsy is another condition commonly addressed in OT, as reported by Rassafiani et al. [18]. Recommended interventions often include active vestibular activities, such as the use of a bolster swing, therapy ball, ramps, or trampoline, to improve balance and coordination [18, 19]. Additionally, hippotherapy has demonstrated effectiveness in enhancing postural control and balance in children with cerebral palsy [20].

In the domain of mental health, OT plays a vital role in promoting functional independence, emotional regulation, and engagement in meaningful daily activities. OT interventions for individuals with mental health conditions, such as depression, and anxiety disorders, often focus on enhancing coping strategies, building social skills, and improving participation in self-care, work, and leisure activities [21].

One common approach involves the use of cognitive behavioral strategies to address distorted thought patterns and support behavior modification, particularly for individuals experiencing anxiety or mood disorders [22]. Group-based interventions, including life skill training and psychoeducation, are also frequently employed to improve interpersonal functioning and promote community integration [23].

It should be noted that OT practice is influenced by socioeconomic conditions, values, and cultures [24]. Previous research indicated that creating a culture with diverse meanings and occupation-focused practices requires consideration of various worldviews [25, 26]. Rehabilitation and disability services in Saudi Arabia have undergone significant transformation in recent years, emphasizing the inclusivity of individuals with disability. Within this evolving landscape, OT has emerged as a vital component of the rehabilitation sector. OTs are formally certified by the Saudi Commission for Health Specialties (SCFHS) and contribute to patient care through assessment, treatment planning, and therapeutic interventions. OT services in Saudi Arabia are primarily delivered within secondary and tertiary healthcare settings, focusing on patients with physical, neurological, and developmental conditions. According to recent Ministry of Health statistics, over 91,000 patients received OT services from ministry sectors in 2022 alone, with an additional 59,000 served by other government bodies, such as military and educational hospitals [27]. A recent study on the scope of OT practice in Saudi Arabia revealed that services extend beyond hospital-based rehabilitation to include autism centers, facilities for children with disabilities, and home healthcare programs. However, OT services remain largely absent in primary care, school settings, and community-based programs, indicating a critical area for future development. Moreover, OT services in Saudi Arabia typically require a referral from a physician, which reflects the current medical model of care [28]. While this model ensures collaboration, it also highlights the limited autonomy of OTs in clinical decision-making and underscores the need for stronger interdisciplinary coordination.

Although OT services can be accessed at major rehabilitation hospitals, their availability in academic settings in Saudi Arabia has only been established within the past 13 years [29]. OT is being taught at only five universities in Saudi Arabia. The programs are united in several aspects, where students are enrolled in a 4-year course-based education followed by 1 year of internship. Most programs offer OT at an undergraduate level, where a bachelor’s degree is awarded upon the completion of the program. The majority of the programs start with courses of basic medical sciences of anatomy, physiology, and biomechanics, followed by more OT core courses for assessing and treating different pediatrics, geriatrics, neurologic, musculoskeletal, and psychiatric conditions [29].

In addition to the novelty of the OT profession in Saudi Arabia, there is a lack of awareness among health professionals and community members in Saudi Arabia regarding the most frequent conditions and effective treatment procedures provided by occupational therapists [30–34], which can hinder the identification of patients needing OT. Moreover, the limited knowledge of the role of OT among health professionals may confine treatment approaches that could maximize patients’ quality of life within a multidisciplinary rehabilitation approach. An in-depth understanding of common disorders encountered at OT clinics and corresponding treatment approaches will aid in improving the OT services provided. Moreover, closing this gap in knowledge will contribute to the awareness of the OT field in the Kingdom of Saudi Arabia and help enhance and develop this profession at both academic and clinical levels.

Given the abovementioned context, it is essential to identify the most prevalent conditions managed by occupational therapists in Saudi Arabia, as well as the therapeutic strategies commonly employed in their treatment. Such an investigation holds the potential to enhance both public and professional awareness, promote the expansion of OT services, and support the advancement of the profession at academic and clinical levels. Although international literature has extensively documented common OT interventions across a range of conditions [3–20], there remains a paucity of local data specific to the Saudi context.

Accordingly, the present study is aimed at determining the most frequently utilized interventional techniques and the conditions for which OT is most commonly sought in Saudi Arabia. The findings are anticipated to raise awareness among community members and healthcare professionals regarding the scope of OT, including the common disorders addressed and the treatment approaches implemented. Furthermore, the study seeks to contribute to the existing body of knowledge by providing context-specific insights that may inform the practices of occupational therapists across the country.

2. Materials and Methods

3. Results

Overall, 131 occupational therapists participated in the survey with a response rate of 57%, comprising 80 (61.1%) females and 51 (38.9%) males. Table 1 summarizes the sociodemographic and educational characteristics of the participants. Most participants (88.5%) held a bachelor’s degree, and 9.2% also held a master’s degree. Table 1 presents the remaining analysis of participants’ qualifications.

As presented in Table 1, the majority of participants (n = 86, 64.9%) had 1–3 years of experience, whereas only 12 (9.2%) participants had more than 10 years of experience as certified occupational therapists. Most participants were from Riyadh, Jeddah, and the Eastern Region.

In addition, the questionnaire revealed that the participating occupational therapists were from different clinical settings, such as rehabilitation hospitals, outpatient clinics, and acute care settings. Table 2 lists the distribution of settings in descending order. In these settings, 54.2% of participating occupational therapists reported working with individuals aged 6–12 years. Only 42% of the participants had worked with patients aged 13–18 years (Table 2).

Furthermore, the results revealed a pattern of frequently observed medical conditions and therapeutic interventions. Participating occupational therapists reported that neurological conditions (64.3% of the responses) were the most frequently observed. Conversely, respiratory diseases were the least frequently reported condition, comprising approximately 4.7% of responses (Table 3). It should be noted that respondents did not identify mental health conditions as an area of their clinical practice.

Furthermore, the survey identified therapeutic interventions employed to address common conditions. As shown in Table 4, therapeutic exercise was the most frequently reported interventional method used by participating occupational therapists, with approximately 77% of responses. Functional electrical stimulation, with only 19.8% of the responses, was the least common interventional method reported.

Regarding the mapping of interventions to the PEO model, the results were as follows: (1) for therapeutic exercises in association with the PEO model, the intervention targeted the person to improve muscle strength, functional performance, and physical ability; (2) the educational interventions focused on the three aspects of the PEO model, that is, the person to optimize problem-solving abilities, occupation at school or workplace, and the environment to modify the surrounding environment. (3) Splinting as an intervention was related to maintaining the joint range of motion, preventing contractures, correcting deformity, and different occupations such as work and school.

Considering the OT framework and processes [36], participating occupational therapists suggested that different types of rehabilitation interventions, such as occupations and activities, education and training, and advocacy, should be applied in OT. When mapping the interventions selected by the sample (Table 5), four aspects of the intervention were covered; however, two aspects were not applied by the therapists including group and virtual intervention. Moreover, respondents covered all five approaches recommended by the OT framework and processes.

4. Discussion

In the current study, we aimed to identify the most common disorders managed by occupational therapists currently practicing in Saudi Arabia, as well as the methods used to treat these disorders. This study explored the current practices employed by occupational therapists to address common disorders in rehabilitation clinics in Saudi Arabia. Based on data collected from 131 occupational therapists in Saudi Arabia, neurological conditions were the most common condition encountered in clinical settings, followed by developmental disorders. Therapeutic exercise was the most commonly used intervention, followed by educational intervention.

Herein, our findings revealed several relationships between the reported conditions and therapeutic interventions. According to participating therapists, neurological disorders, including stroke, cerebral palsy, and TBI, were the most frequently observed conditions (~64.3% of respondents). Among interventional strategies reported in the survey, therapeutic exercise, CIMT, proprioceptive neuromuscular facilitation, neurodevelopment treatment, and mirror therapy were the most commonly reported interventional methods for patients with stroke. However, CIMT and neurodevelopment treatment are frequently employed in patients with cerebral palsy. Analyzing the survey results, CIMT and splints were employed in patients with TBI.

Furthermore, 49.6% of occupational therapists ranked developmental disorders second among the most frequently encountered conditions. Specifically, the most common conditions documented by participating therapists were autism, attention deficit hyperactivity disorder, and cerebral palsy, all considered neurological and developmental disorders. Additionally, our analysis revealed that sensory integration interventions were the most commonly used therapeutic interventions for developmental disorders. Children with developmental disorders might be hyper- or hyporesponsive to sensory stimuli. Therefore, challenging children in a joyful, entertaining context would be an ideal approach to ensure that they learn to respond correctly and function normally in their environment. According to the participating therapists, interventions such as educational and counseling sessions for parents and caregivers were also implemented, in addition to environmental and lifestyle changes.

In OT clinics, physical disability was the third most common condition encountered, with spinal cord injury accounting for 44.7% of all cases. Notably, therapeutic exercises were the most frequently used interventional strategies to regain muscle strength and endurance, whereas the use of splints was secondary to preventing deformities. Another treatment approach in patients with spinal cord injury is the use of assistive devices, typically warranting lifetime usage to ease accessibility and participation. The survey also recorded educational interventions, such as counseling and informative sessions for the patient and his family, as an interventional strategy.

In addition to physical disabilities, orthopedic disorders account for 31% of cases observed in OT clinics, with hand injuries being the most frequently documented condition. As examples of orthopedic disorders, participants reported fractures, carpal tunnel syndrome, De Quervain’s syndrome, trigger finger, and hip replacement. The most common interventional methods for these conditions include the use of splints, assistive devices, environmental and lifestyle modifications, therapeutic modalities, and exercise.

The relationship between educational qualifications and frequently observed conditions was also examined. A considerable percentage of respondents (88.5%) with bachelor’s degrees reported that neurological and developmental conditions were the most frequently encountered in clinical settings. Conversely, therapists with a master’s degree, comprising 9.2% of the survey population, predominantly encountered neurological conditions. Orthopedic disorders were the second most common condition reported by participants holding a master’s degree.

In addition, data analysis revealed a relationship between the most reported interventions and reported workplaces. Therapeutic exercises were the most commonly reported interventional methods used by therapists in rehabilitation settings, followed by splinting, educational interventions, and therapeutic modalities. Therapeutic exercises are most commonly applied in outpatient clinics, followed by educational interventions and sensory integration therapy. Accordingly, based on survey data analysis, therapeutic exercises were the most therapeutic strategy applied by occupational therapists in Saudi Arabia across different settings. In OT, therapeutic exercise, as the main means of intervention, is used as a preparatory method for occupational performance. Therefore, it is essential to redirect OT services to activities of daily living and use occupation as the main treatment modality. Several challenges, including time constraints, case overload, and therapeutic equipment, impede the proper implementation of novel OT services in Saudi Arabia. Moreover, the biomechanical working paradigm in several health institutions in Saudi Arabia hinders the application of biopsychsocial approaches, such as the therapeutic use of the self or cognitive behavioral therapy [37, 38].

The results of the present study are consistent with those reported previously, revealing that the most common conditions encountered by occupational therapists include stroke, cerebral palsy, and autism [3, 9, 17–20, 25]. TBI was also reported as one of the most common conditions treated by occupational therapists. It should be noted that no previous report has documented TBI as a common condition encountered by occupational therapists.

Compared with the findings of previous reports, our results highlight the application of similar interventional strategies in patients with stroke and autism. Unlike previous results that included the use of bolster swing, ball, ramps, and trampoline in patients with cerebral palsy [18], as reported by Rassafiani et al., our results revealed that neurodevelopmental treatment was the most common intervention for patients with cerebral palsy. Moreover, hippotherapy is a prescribed intervention for individuals with cerebral palsy, as reported by Zadnikar and Kastrin [20]; however, this approach was not reported in our sample.

Gandhi et al. have demonstrated that mirror therapy is a useful and feasible strategy for patients with stroke during the acute, subacute, and chronic disease phases. Additionally, mirror therapy can influence not only motor deficits but also other aspects, such as sensation, visuospatial neglect, and pain [39]. Hence, the results of the current study provide preliminary data supporting the use of mirror therapy in patients with stroke, given that this approach is the most commonly utilized interventional method, as reported by participating occupational therapists.

A large proportion of the participating occupational therapists who had worked with patients with autism reported the efficacy of the sensory integration approach. This finding is consistent with that reported by Schaaf et al. [40]. Reportedly, changes in behavior and participation can be associated with alterations in the ability to process and integrate sensory information for better praxis, providing preliminary evidence supporting the sensory integration approach.

A similar study was conducted in Kuwait by Alenezi and Alsairafi in 2022, though focusing only on the profiling of the pediatric OT practice in Kuwait [41]. Their study indicated that the most commonly seen conditions were developmental delay, learning disability, and neurological disorders. And the most frequently applied intervention techniques were family education, assistive and adaptive equipment prescription, activities of daily living training, and environmental modification [41]. Their finding is in line with the findings of our study, highlighting the similar OT service development and expansion in the region.

As recommended by the AOTA, OT activities should address one of the following domains: occupation and activities, intervention to support occupations, education and training, and advocacy, as highlighted in our research. However, group and virtual interventions were not mentioned in our research sample, although these interventions have been deemed effective in reducing psychological symptoms such as anxiety, increasing positive mood states, and inducing relaxation [3]. Moreover, barriers to establishing and integrating these domains need to be considered, owing to a lack of awareness among occupational therapists regarding their importance and effectiveness within different patient groups. The results of this study illustrate that the approaches used by participating occupational therapists align with the AOTA-recommended interventional approaches, namely, health promotion, restoration (remediation and restoration), maintenance, modification (compensation and adaptation), and prevention. These approaches reflect the comprehensive role of OT rehabilitation implemented by occupational therapists in Saudi Arabia.

The scope of OT practice across Arab countries varies significantly due to differences in healthcare infrastructure, professional regulation, educational standards, and public awareness. In many Arab nations, OT is still an emerging profession, with limited integration into healthcare systems and a narrow focus primarily on physical rehabilitation within hospital settings. Countries such as Egypt and Lebanon have established OT programs yet often face challenges related to professional recognition and standardized licensure, as the program is not established at the academic level [42, 43]. In contrast, Saudi Arabia along with other countries such as Kuwait, Jordan, and Oman had made notable strides in advancing OT practice, supported academic development [29, 44–46]. The country hosts multiple accredited OT educational programs and mandates licensure through the SCFHS, ensuring a regulated professional framework. Therefore, OT is increasingly involved in diverse clinical areas, including pediatrics, neurology, and rehabilitation, although continued efforts are needed to expand services into community and mental health domains [47, 48].

When it comes to the development of new OT services in Saudi Arabia, a culturally sensitive approach is essential. This is specifically true for services relating to the management of mental health and psychological conditions. Cultural knowledge and competency were found to be very important for Middle East OT service development [48]. This is particularly important due to the increased prevalence of mental health disorders in Saudi Arabia [49]. Nearly one in four adults in Saudi Arabia has a lifetime risk of acquiring a diagnosable mental disease, with high rates of social anxiety, obsessive–compulsive disorder, and separation anxiety disorder, particularly in adults [49]. Unfortunately, less than one-third of Saudi Arabians with lifelong psychiatric conditions receive any kind of therapy, indicating a significant treatment gap in the country [49]. Hence, OT services for mental health disorders are also lacking. In an effort to overcome this limitation, more educational campaigns and services should tackle the management of mental health disorders [47]. Awareness about mental health–related OT practice is essential to enhance the profession’s presence within this overlooked field.

Moreover, more efforts at the educational level should be implemented to address the gaps in the holistic implementation of OT intervention in Saudi Arabia. Al-Heizan suggested implementing organizational learning within Saudi universities in general and within OT programs in particular [50]. Organizational learning as described by Senge focuses on establishing “organizations where people continually expand their capacity to create the results they truly desire, where new and expansive patterns of thinking are nurtured, where collective aspiration is set free, and where people are continually learning to see the whole together” [51]. Within the OT education, this could be translated into providing educational environments that allow innovations of therapeutic applications and promoting reflection and inquiry where gathering, sharing, embracing, and applying knowledge is enhanced in a dynamic educational environment [50].

5. Conclusions

In the current study, we aimed to identify the most common diseases and treatment methods used by occupational therapists in Saudi Arabia. Based on our results, neurological diseases such as stroke, cerebral palsy, and TBI are the most commonly treated by occupational therapists. Developmental disorders in children, such as autism and cerebral palsy, fall under both neurological and developmental umbrellas. The most common therapeutic interventions for neurological diseases include mirror therapy and CIMT for stroke. CIMT is also used to address TBI and neurodevelopmental treatment of cerebral palsy. Regarding developmental disorders, sensory integration of children and educational services for parents were reported as the most common therapeutic procedures employed by occupational therapists in Saudi Arabia for autism and cerebral palsy. Thus, OTs play a vital role within rehabilitation teams, particularly in managing complex cases of neurological disorders. They are also involved in specialized centers including autism centers, rehabilitation facilities, and day care centers for individuals with disabilities.

Conflicts of Interest

The authors declare no conflicts of interest.

Funding

No funding was received for this manuscript.