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Occupational Therapy and Physical Disabilities: Scope, theory, and approaches to practice
Terms in this set (39)
OT's domain of concern
*In particular engagement in occupation to support participation in context.
*Occupation includes functional life activities like grooming, working, caring for children.
*The main purpose of OT is to address performance issues that interfere with successful participation in occupation.
*are the building blocks of performance in occupation.
*These skills apply flexibility and with many minute levels of precision to the entire range of human activity, from caring to children to operating a forklift to designing web pages.
1. Motor skills
2. Process skills
3. Communication/Interaction skills
*Patterns help to make performance more automatic and thus less demanding of conscious attention.
Performance Skills: Motor
Performance skills: Process
Performance skills: communication/interaction
*A context is the background into which something is interwoven
*context gives meaning
*The context supplies the background and often the meaning of the activity-how and why its is performed.
*Contexts provide cues about what kind of occupational performance is expected and effective.
*they take into account all of the parameters of a specific activity.
1. Objects used and their properties
2. Space demands
3. Social demands
4. Sequencing and timing
5. Required actions
6. Required body functions
7. Required body structures
Occupational Therapy Practice Framework
1. Body Functions
2. Body structures
Model of Human Occupations (MOHO)
*gives a broad perspective for organizing the OT process.
*The core idea of the model of human occupation is that humans have an inborn drive to explore and master their surroundings.
*MOHO is a systems model- it is a holistic model (one that looks at the whole) rather than a a reductionist model (one that looks intensely at one part, such as muscular function)
3 practice approached
2. Motor learning-Sensorimotor
Frame of Reference
*Is based on a theory and contains specific elements, asking or answering specific questions about the patient.
*A FOR is theoretical not necessarily practical.
*has a practical focus
*Its purpose is to guide the OT process to help us identify problems and technical solutions.
Is the activity of exploring and attempting to control the environment
According to the MOHO model the individual and the environment are seen as interacting and affecting one another.
MOHO: 3 interrelated components of human occupation
3. Performance capacity
3 key elements of volition:
1. causation- personal causation, values, and beliefs
2. values-are internalized images of what is important and meaningful to do. Values motivate behavior in many ways.
3. interests- are what one finds enjoyable or satisfying to do. Interests are things that attract people.
*Together and separately, personal causation, values, and interests supply motivation or volition to engage in occupation.
*refers to activities that have been performed enough times to become routine and customary.
*2 elements of habituation are habits and internalized roles.
-Habits are automatic routines or patterns of activity that a
seems to perform almost by reflex, without much conscious
Internalized roles (part of habituation)
*are personalized occupational roles that consist of many different habits, routines, and skills. (occupational roles are homemaker, student, and retiree.
Role change/role transition (part of habituation)
*Occurs as life moves forward and the person grows. Roles contract, expand, are modified, and sometimes are abandoned or replaced.
*is the ability for doing things
*Doing things depends on the body of structures and functions and on the subjective experience of them.
*Performance capacity and performance skills are in many cases the primary focus of occupational therapy intervention for person with physical disabilities.
*Performance skills depend on performance capacity.
*The act of doing work, play, activities of daily living, and other activities within the context of human life.
Human and nonhuman object world in which the human occupation is carried out.
Individual's sense of own competence and effectiveness.
Patterns for organizing productive activity, usually according to the product or service produced (grade school student, homemaker, basketball player)
Practice Approaches: Biomechanical Approach
*the treatment of physical dysfunction considers the human body as a living machine.
*Techniques in this approach derive from kinetics.
*Tx methods employ principles of physics, related to forces, levers, and torque.
*Typical evaluation and treatment techniques used in this approach are measurement of joint ROM, muscle strength, therapeutic exs., and orthotics as well as therapeutic activity for kinetic purposes, or the application of movement principles in the performance of activities.
The science of the motions of objects and the forces acting on them.
The study of the forces acting on the objects at rest.
GOALS of the Biomechanical Approach
1. Evaluate specific physical limitations in ROM, strength, and endurance.
2. Restore these functions
3. Prevent or reduce deformity
*is most appropriate for patients whose central nervous system is intact but who have lower motor neuron or orthopedic disorders. These patients can control isolated movements and specific movement patterns but may have weakness, low endurance, or joint limitation.
*disabilities typically treated with this approach:
1. orthopedic conditions (RA, osteoarthritis, fractures, amputations, hand trauma),
3. Lower motor neurons (peripheral nerve injuries)
4. Guillain-barre syndrome
5. Spinal cord injuries
6. Pimary muscle diseases (Muscular dystrophy)
7. Also applied in ergonomics and work hardening w/ an emphasis on proper positioning and the optimum fit between the biomechanics of the individual and the work environment.
Sensorimotor and Motor Learning Approaches
*developed for tx of patients who have CNS dysfunction
*All sensorimotor approaches to treatment use neurophysiological mechanisms to normalize muscle tone and elicit more normal motor responses. They provide controlled input to the nervous system which in turn is meant to stimulate specific responses.
* Therapy is incorporating these reflexes into purposeful activity and at integrating them so that their power is reduced and movement becomes more controlled and voluntary.
*This approach does not include purposeful ax.
*AOTA advices that the techniques of an approach not associated with purposeful ax. may be used to prepare the client or patient for better performance and prevention of disability through self participation in occupation.
*Should only be used to stimulate or condition the nervous system so that purposeful ax. can be attempted, ideally during the same tx session.
*Motor learning is a more recent approach that is associated with the sensorimotor approach and focuses on the acquisition of motor skills through practice and feedback.
*the context or practice environment for movement activities is a major focus.
*The motor learning approach is based in learning theory.
*Rehabilitation means a restoration to a former state or to a proper state.
*In medicine it means the return to the fullest physical, mental, social, vocational, and economic usefulness that is possible for the individual.
*It refers to the ability to live and work with remaining capabilities.
*Focus is on capabilities rather than disabilities
*Rehabilitation is concerned with the intrinsic worth and dignity of the individual and with the restoration of a satisfying and purposeful life.
*This approach uses measures that enable a person to live as independently as possible despite residual disability.
*Its goal is to help the patient learn to work around or compensate for physical limitations.
*In relation to occupation, the rehabilitation approach focuses on the occupations themselves and on the performance skills rather than on body structures and functions.
Rehabilitation Approach treatment methods
*Self care evaluation and training
*Acquisition and training in assistive devices
*Acquisition and training in use of adaptive clothing
*Homemaking and child care
*Work simplification and EC
*Work related activities
*Home evaluation and adaptation
*Acquisition and training in the use of communication aids and environmental control systems
*Continuum is a continous series of elements passing into each other.
*A treatment continuum begins with the onset of injury or disability and ends with the restoration of the patient to maximal independence.
*prepares the patient to engage in activity. (ie. facilitation, exs., inhibition,positioning,sensory stim, physical agent modalities, braces and splints.
*Stage 1: the therapist is mainly concerned with maintaining or remedying the functions of the body.
*meets 2 of the 3 characteristics of purposeful activity.
1. The patient participates actively
2. The activity requires and elicits coordination of sensory,
motor, psychosocial, and cognitive systems.
*Has been the core of OT since its inception.
*Purposeful activity has an inherent or autonomous goal and is relevant and meaningful to the patient.
*feeding, hygeine, dressing, mobility, communication, arts, crafts, games, sports, work, and educational ax.
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