Neurology and Cognitive Occupational Therapy Practice Across the Middle East and North Africa: An Exploratory Multicountry Cross-Sectional Survey.

The 118 respondents are a convenience and snowball sample recruited through professional networks and social media, so they are not a regional average. Kuwait, Saudi Arabia and Jordan supplied 68.6% of responses and seven countries supplied fewer than five each. Because the survey link circulated openly, the number of therapists who saw it is unknown and no response rate can be calculated. People already engaged with professional networks were more likely to take part (77.1% had attended a conference), so the barriers reported here are those of the more engaged, and less engaged therapists are likely missing. Everything reflects self-report about what therapists say they use, not observation of what they do. Reported use of a model or frame of reference may reflect training history or professional identity rather than day-to-day practice. The post hoc subgroup comparisons were not adjusted for multiple comparisons and several groups were very small, including 26 postgraduate-qualified respondents, 8 from Morocco and 5 from Iran and Turkey. The subregional and qualification patterns are exploratory signals, not established differences. The barrier questionnaire was written for this study, and its six items did not behave as a single scale (Cronbach alpha 0.40 to 0.48), so summing them into a total barrier score would be misleading. Translation and language equivalence across Arabic, English, French, Turkish and Farsi settings was not formally checked with a forward and back translation. The monthly income question also had inconsistently ordered response labels, so income was reported but not analysed further.

Funded by Kuwait University (grant ZN06/22). The author declares no competing interests. The paper does not state that the funder had any role in designing the study, analysing the data or writing it up.

Do not read the 71.2% NDT figure as the share of treatment time these therapists spend on Bobath. The survey recorded what therapists report using, most of them also reported motor-learning approaches, and the authors say the number reflects widespread reported affiliation with NDT rather than observed practice.