Occupations, Purposeful Activities and Preparatory Activities – Flashcards
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What is the basic tool of occupational therapy practice ?
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Active Occupation
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What is Active Occupation ?
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those activities in which people engage as part of their life's roles.
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What separates OT from other disciplines ?
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OT helps patients regain their skills with active occupations as therapy
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What are three major aspects of OT knowledge base?
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egocentric realm(mind&body) exocentric realm(time&space) consensual realm(society&culture)
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What is egocentric realm ?
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the patient's mind and body
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What OT knowledge based is used when considering a patient's time and space ?
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exocentric realm
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When the OT is considering a patient's society and cultural background or roles; what knowledge base is in use?
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consensual realm
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What adjunctive therapy is not considered an entry level skill, that some OTs and OTAs has become increasingly skilled in ?
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Physical Agent Modalities
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What is purposeful activity?
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"goal directed" behaviors or tasks that comprise occupations
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In order for an activity to be considered purposeful it must meet these certain criteria.
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Individual must be an active, voluntary participant. must be directed toward a goal that the individual consider meaningful. has both inherent and therapeutic goals.
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What are 7 reasons OT use purposeful activities? Purposeful activities are used or adapted for use to meet one or more of the following therapeutic objectives, be able to name at least 4.
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1.develop or maintain strength,endurance, work tolerance, ROM, and coordination. 2.practice and use voluntary and automatic movements in goal directed tasks. 3.provide for purposeful use of and general exercise to affected parts. 4.explore vocational potential or training in work skills. 5.improve sensation, perception, and cognition. 6.improve socialization skills and enhance emotional growth and development. 7.increase independence in occupational role performance.
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Why is activity valuable?
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It maintains health in a healthy person and restores health after illness or disability
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What happens when a person engage in relevant, meaningful, and purposeful activity?
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change is possible and dysfunction is reversible
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What concept was OT founded upon?
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that human beings have an occupational nature and humans naturally engage in activity
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True or False Everything we do is an occupation.
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True
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What does an OT assessment establish?
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the patient's occupational goals and needs
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True or False ? OT treats every patient with a one size fits all approach when considering therapy.
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False Therapy must be individualized for each patient with evaluative tools
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What are some evaluative tools OT may use to learn patients interests and/or needs ?
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interest checklist, activity configuration, occupational history, interview, activity analysis
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Activities selected for therapeutic purposes should be:
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goal directed, meaningful to the patient, matched to individual needs in relation to social roles, capable of eliciting the mental or physical participation of the patient, designed to prevent or reverse dysfunction and develop skills to enhance performance in life roles, related to patient's interests, adaptable, gradable, and age appropriate, selected through knowledge and professional judgment, selected in cooperation with the patient.
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What must the patient be able to do in order for adaptations to be effective ?
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In order for adaptations to be effective a patient must be comfortable
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What does an activities usefulness often rely on ?
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adaptation to the special needs of the patient or the environment
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Pacing and modifying the activity to obtain the patients maximal performance would be considered?
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grading
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Changing the position or environment of the patient would be considered?
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adapting
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What are some reasons activities are graded?
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to increase strength, ROM, endurance, tolerance, coordination, and perceptional, cognitive, and social skills.
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True or False ? Not every activity can be graded but every activity can be adapted.
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False. Every activity should be gradable and adaptable.
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Considering activities that are used for physical restoration, what 3 characteristics must they meet?
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1. Activities should provide action rather than merely the position of involved joints and muscles. 2. Activities should provide repetition of motion. 3. Activities should allow for one or more kinds of grading such as resistance, range, coordination, endurance, or complexity.
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What type of exercises are most used for purposeful activity?
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active and resistive exercises
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What are activities that are considered non-purposeful and generally do not have an inherent goal but may engage the patient mentally and physically?
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simulated or enabling activity
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Why do OTs use simulated or enabling activities?
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to practice specific motor skills. to train in perceptual and cognitive skills. to practice motor and process skills necessary for function in the home and community.
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What are some examples of simulated or enabling activities ?
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stacking cones, standing boards, and fastener boards
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What can be used as a preliminary step toward preparing the patient for purposeful and occupational performance?
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adjunctive modalities
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what is the most effective use of therapeutic exercise
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orthopedic disorders and lower motor neuron disorders that produce weakness and flaccidity.
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What are two Therapeutic Approaches
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Biomechanical Approach, and Sensorimotor Approach
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The approach that is most frequently used in OT, Likely to be used in the treatment of lower motor neuron disorders (i.e. GB, muscular dystrophy) and orthopedic dysfunctions.
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Biomechanical Approach
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What are the goals of the Biomechanical Approach ?
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improvements in strength, range of motion, and muscle endurance
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Likely to be used for upper motor neuron disorders
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Sensorimotor Approach
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What are the goals of the Sensorimotor Approach?
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improvements in balance, posture, muscle tone, and the facilitation or inhibition of abnormal reflexes and movement
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What is the general purpose for using therapeutic exercise with therapeutic activity?
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to develop awareness of normal movement patterns and improve voluntary automatic movement responses, to develop strength and endurance in patterns of movement that are acceptable and necessary and don't produce deformity, to improve coordination, regardless of strength, increase the power of specific isolated muscles or muscle groups, aid in overcoming ROM deficits, increase in strength of muscles that will power hand splints, mobile arm support, and other devices, increase work tolerance and physical endurance through increased strength, prevent or eliminate contractures from developing.
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What is most effective for orthopedic disorders and lower motor neuron disorders that produce weakness and flaccidity?
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Therapeutic Exercise
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What are some contraindications of therapeutic exercise?
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patients with poor general health, patients with inflamed joints, and who have had recent surgeries
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What are some signs of fatigue
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slowed performance, distraction, perspiration, increase in rate of respiration, performance of exercise pattern through a decreased ROM, and inability to complete the prescribed number of repetitions.
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Name some exercises that are used to increase strength.
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active-assisted, active, resistive isotonic, and isometric exercises.
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What are strengthening programs generally based on ?
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contracting the muscle against a large resistance for a few repetitions.
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What is the clinical name for muscle endurance ?
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activity tolerance
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What is the muscle's ability to work for prolonged periods and resist fatigue?
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Muscle endurance
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To increase strength patients are given
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high-load, low repetition
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To increase endurance patients are given
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low-load, high repetition
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Requires use of large muscle groups in sustained rhythmic aerobic exercise or activity often used in cardiac rehab programs
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Physical conditioning and cardiovascular fitness
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What exercises are used to maintain joint motion and flexibility
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AROM and PROM
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What is combined activity of many muscles into smooth patterns and sequences of motion ?
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Coordination
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What involves conscious attention to guidance of an activity?
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Control
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What is the difference between motor control an coordination?
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Coordination is a sequence of motion while Motor Control is the working of nerves and muscles together.
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What are the three type of muscle contractions?
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Isometric/ static contraction, Isotonic/concentric contraction, Isotonic/eccentric contraction
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What muscle contraction involves no joint motion and the muscle length remains the same?
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Isometric/ static contraction
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What type of muscle contraction involves joint motion and muscle shortening?
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Isotonic/concentric contraction
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What type of muscle contraction involves joint motion and the muscle remains lengthened ?
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Isotonic/eccentric contraction
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What are the 5 muscle roles ? Define each.
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Agonist -prime movers ex. biceps brachii, Synergist - helper ex. brachioradialis performs at task, Antagonist - oppose ex. triceps brachii, Stabilizer - balancer; assists the agonist to balance the force of contracting muscles, Neutralizer - prevents unwanted movements; allows muscle to perform more than one movement; ex: flex/ext while also sup/pron
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Name 5 exercise and activity classifications.
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Isotonic Resistive Exercise, Progressive Resistive Exercise, Isotonic Active Exercise, Active- Assisted Exercise, Passive Exercise,
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Which exercise activity classification uses muscle contraction against a specific amount of weight to move the load through a certain ROM ?
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Isotonic Resistive Exercise
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Which exercise activity is based on the overload principle; where muscles perform more efficiently if given a warm-up period and must be taxed beyond usual daily activity to improve in performance and strength ?
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(PRE) Progressive Resistive Exercise
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Which exercise activity involves the use of muscle contractions and is an active exercise that is performed when the patient moves the joint through its available ROM against no outside resistance?
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Isotonic Active Exercise
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Which exercise activity involves the patient moving their joint through partial ROM and the therapist or mechanical device completes the range.
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Active- Assisted Exercise
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Which exercise involves no muscle contraction, this exercise is not used to increase strength, it's purpose is to maintain ROM, thereby preventing contractures, adhesion and deformity.
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Passive Exercise
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Name 4 other exercise activity classifications.
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Passive Stretch, Active Stretch, Isometric Exercise without Resistance, and Isometric Exercise with Resistance.
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Described when the therapist moves the joint through the available ROM and hold momentarily, applying gentle but firm force or stretch at the end of the ROM
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Passive Stretch
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Described by increasing joint ROM; patient uses force of the agonist muscle to increase the length of the antagonist muscle.
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Active Stretch
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Used when a muscle or group of muscles is actively contracted and relaxed without producing motion of the joint that it ordinarily mobilizes. Purpose is to maintain muscle strength when active motion is not possible or is contraindicated.
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Isometric Exercise without Resistance
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What exercise would be used when muscle strength is graded 3+to 5
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Isometric Exercise with Resistance
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ANESTHTHESIA COMPLETE
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LOSS OF SENSATION
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PARETHESIA
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ABNOMRAL SENSATION SUCHA AS TINGLING
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HYPOTHESIA
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DECREASED DULL OR SENSATION (ANOTHER NAME IS HYPOSENSITIVITY
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HYPERTHESIA
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INCREASED TACTILE SENSITIVITY (ANOTHER NAME IS HYPRSENSITIVITY
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ANALGESIA
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COMPLETE LOSS OF PAIN SENSTATION
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HYPALGESIA AKA HYPOALGESIA
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DIMINSISHED PAIN SENSATION
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REMEDIAL TREATMENT
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AIMS TO CHANGE THE SENSORY RESPOSNE ITSELF AND RESTORE MORE NORMAL SENSORY FUNCTION
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COMPENSATORY TREATMENT
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INVOLVES USING STRATEGIES FOR ADJUSTING AND ADAPTING TO SENSORY CHANGE OR LOSS
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remedial treatment
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purpose is to promote recovery of dulled or absent sensation via appropriate sensory input.
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examples of remedial treatment
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light touch deep pressure vibration proprioceptors and weight - bearing
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compensatory treatment
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helps maximize safe performance in occupation by working around problems associated with sensory deficits
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examples of compensatory treatment
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skin inspection, using uninvolved or less involved, visual compensation
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what can cause PNS
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diabetes, carpal tunnel syndrome, spinal stenosis, thoracic outlet syndrome, lyme disease, HIV, Guillain-Barre
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Client education
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ota has a more direct role he or she explains the benefits of using the affected part as one way to help reduce hypersensitivity
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Safety is the first and major forces of compensatory training for clients who lack protective sensation.
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compensatory treatment
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introduced after desensitization treatment ins completed. the program begins with teaching the client how to use sensation.
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remedial treatment
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reduce edema
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way to reduce edema would include: elevation, contrast baths, massage compression, AROM
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IMPROVE ROM
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ways to increase include: improve tissue elasticity, improve soft tissue mobility
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normalize sensation
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includes sensory re-education, sensory desensitization
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increasing strength
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includes, BTE weight well, theraband, grade resistance hand grips or theraputty
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improving functioning in the areas of occupation
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includes crafts games dexterity activities, BADL tasks, IADL tasks, work samples
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What are some causes of acute hand injuries?
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Work-related farm injuries Industrial injuries Disease (example arthritis, congenital anomalies)
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What does the loss of a hand effect?
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Mechanical tasks that the hand performs Family finances All areas of occupation
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There are two phases of recovering from a hand injury.
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Healing - cellular level repair of wound Restoration - remediation of the lost function (strength, dexterity, sensation, etc)
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In regards to hand injury the primary role of the OT is
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To instruct the patient in self management of condition
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Demographic info
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Includes: Age hand dominance, general media conditions, occupations, living situation, a vocational interests, patients goals for therapy
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The initial assessment of an OT consists of
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Information gathering And Observation
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In the observation phase of OT
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The patient is observed entering the clinic or office
