Intervention Flashcards
Fall prevention techniques
Securing gait belt snugly around the client’s waist prior to functional t/f or mobility
Facilitating and providing assistance to support the pt in an upright posture
Ensuring proper footwear and placement of feet
Testing for adequate LE strength and motor control prior to mobilization
Monitoring vital signs
Assessing the ned for patient-lift equipment
First-then board
A visual support shared with a client that offers a preferred activity after a nonpreferred or challenging task to increase engagement
Compression garment
A custom-fit garment used in burn rehab programs to prevent and reduce hypertrophic scars by providing pressure over the affected area
Also used to manage lymphedema or other types of swelling
Tendon gliding exercises
Series of hand exercises intended to prevent tendon adhesion and preserve tendon excursion, includes the following:
- straight fist
- hook fist
- intrinsic plus
- straight IPs
- full fist
Neural gliding exercises
Series of structured UP exercises intended to prevent nerve adhesion and preserve neural mobility often used as an adjunct for compression neuropathies or nerve entrapment syndromes
Codman’s pendulum exercises
Therapeutic ex for the shoulder joint in which the client bends forward at the waist with the arm perpendicular to the floor, then rocks the body side-to-side allowing the relaxed arm to freely move in a clockwise and counterclockwise direction
Isometric exercise
Type of exercise in which a muscle or muscle group and the joint angle do not move when the muscle(s) acting on the joint are contracted
Principles for joint protection
Using the largest joint possible for the task
Sliding items and performing tasks bilaterally
Modifying the environment
Considering adaptive equipment
Work hardening
Structured rehab program aimed at maximizing a client’s physical ability to return to a specific job function after an injury, may include:
- job simulation activities
- work conditioning exercises
Work conditioning
Program focusing on returning a client to work, may:
- include restoring ability and capacity associated with work related tasks
- precede work hardening program
Mental practice/motor imagery
Intervention approach used in rehab where the client creates a mental image of a desired movement and imagines performing the motion without actually moving the body part
Constraint-induced movement therapy
Evidence-based intervention approach in stroke rehab where the unaffected limb is restrained to facilitate functional use of the affected limb
Principles of body mechanics
Plan movements
Load close to body and bend knees when lifting
Ensure solid base of support and use inertia when appropriate
Steps of diaphragmatic breathing
Place hand on abdomen
Inhale to fill the lungs with a slow, deep breath
Pay attention to chest moving slightly and abdomen rising
Exhale while abdomen relaxes
Tummy time facilitates…
development of oral, fine, and gross motor skills
Edema management may include…
Limb elevation
Cryotherapy
Compression
Retrograde massage
Manual edema mobilization
Purposeful activity/movement
Reality orientation
Intervention method used for persons with cognitive impairment that includes routine and consistent reminder of:
- time, date, and weather
- current location
- familiar names
- roles of people in their support network
Automaticity
Ability to perform activities using an automatic response or habit, involves less attention to details of the procedural steps
Intervention strategies may include:
- linking a new activity with an existing one
- ensuring consistency in instruction, steps, and environment
Explicit instruction
Most direct level of graded cueing that includes instruction in the next step required for a given activity
Ex: Now that you finished bathing, it’s time to dry your feet.
Cognitive compensatory strategy
Internal or external method to maximize cognitive performance where strategy training may be a 3 phase process:
- acquisition
- application
- adaptation
Scanning training
Intervention for visual field deficits to structure a visual search and increase awareness of blind spots, may include:
- progression of clinic activities to contextual task performance
- visual anchoring
- change in head and body position
Metacognitive strategy
Self-management method that includes the ability to identify cognitive challenges during day to day activities and to create strategies that can be duplicated over time
Internal memory strategy
Group of techniques to aid in mentally organizing cognitive information for retrieval at a later time
Therapeutically used in conjunction with external strategies:
- visual imagery
- grouping similar information mnemonically
Egocentric cooperative group
A type of group in which members focus on completing a project or activity over several sessions
Group members choose level of interaction with each other, which is often based on the need to complete various aspects of the project
Group maintenance roles
A type of role in the group process where members contribute to the overall performance of the group
Types include:
- harmonizer
- compromiser
- follower
Social autopsy
An intervention technique in which the client is asked to reflect on a social event to consider behaviors and motivations associated with the situation
Power card
An intervention technique that addresses social skills used with individuals who have ASD by listing the steps of a desired behavior on a card with a picture that shows the client’s special interest or hero
Video detective
An intervention technique that addresses social skills used with individuals who have ASD by presenting a mute video clip to the client, who must identify and interpret the emotions expressed through nonverbal behaviors
Anchoring technique
Strategy used in visual scanning training where a visual cue is placed in the impaired field of view and the client is encouraged to scan to the visual cue
Gesture training
Compensatory intervention for neurobehavioral deficits that includes providing graded levels of task demands in 2 phases:
- transitive gesture training (client demonstrates use of common objects)
- intransitive gesture training (client performs pantomime gestures based on cues)
Progressive part learning
A technique for teaching skills in which the therapist breaks down a task into several steps and teaches each step individually to the client
Whole learning
A technique for teaching skills in which the client learns the entire sequence of steps within the task
Random practice
A method of learning that involves learning skills associated with a task in a varied order
Blocked practice
A method of learning that involves practicing the same skill or task over and over
Handling
Therapeutic technique that involves providing physical support and cueing to manually guide the torso or limbs into functional movement patterns
Support is graded based on the amount of assistance the client needs
Errorless learning
Cognitive intervention method in which the task or activity is set up so that the client does not make an error, may be useful for clients with severe memory impairment and during skill training
Spaced retrieval
Cognitive intervention method in which the client is asked to recall information at expanding intervals
Scar management
Mobilization orthoses
Massage
Compression
Densensitization
ROM
Thermal modalities
Top down approach
Big picture
Occupations –> performance skills
Or just adapting and remediating occupations
Bottom up approach
Performance skills –> occupations
Developmental
Treating the subacute stage of RA
Begin to introduce heat in moderation
- contrast bath
- continuous US
- hot pack
- fluidotherapy/whirpool
- paraffin
Goal is to restore ROM through pain free P/AROM or use of dynamic orthotic (LMB).
- functional activities based on occupations and function.
Prevent flare ups.
Adapt and modify equipment
Treating inactive stage of RA
Paraffin
Joint protection
Orthotics
- maintain or prevent decline
Preparatory tasks
Theraband or weight lifting to increase strength
Often called:
- therapeutic exercise
- therapeutic activity
Preparatory methods
PROM to wam a patient up
Hot pack
Something you do to a patient
Purpose of therapeutic exercise and activity in OT
Develop or restore normal movement patterns and improve voluntary or automatic responses
Develop or restore strength and endurance to allow for functional tasks
Develop, improve, or restore coordination
Increase muscle power
Remediate ROM deficits
Increase work or task tolerance
Prevent or eliminate contracture or deformity
Procedural reasoning
Based on what needs to happen next
Rules, policy, protocol
Closely related to client factors and body functions
- diagnosis, prognosis
What typically happens
- gives birth to critical pathways, clinical tracts, protocols
Interactive reasoning
Focus is on what makes the patient tick
Therapeutic use of self is big
Not everyone tracts the same
- what motivates this client?
- how do you communicate with them?
Conditional reasoning
The “what if” game
Constant reassessment of function
Context is huge
“Ok, you can bathe in the rehab bathtub, but what if you go to Disney or home?”
Narrative reasoning
Storytelling
Lets the patient tell their story
Therapist uses therapeutic use of self to connect and look for themes
Used more in psych, with noncompliant patients, and children with autism
Pragmatic reasoning
Realistic/sensible
Considering community supports, environment, and therapist skill level
Facilitation techniques
Increase tone
Heavy joint compression
Manual resistance
Quick stretch
Tapping
Vibration
Fast brushing
Vestibular stim (fast motion)
Inhibitory techniques
Decrease tone
Neutral warmth
Slow stroking
Light joint compression (consistent)
Slow vestibular stim
Prolonged stretch
Backward chaining
when the OTP begins the task and then asks the client to complete the task; allows sense of accomplishment when the task is finished
Forward chaining
when the client begins the task and once unable to complete the task the OTP steps in
Narrative reasoning
The process used to help the therapist understand what the client is experiencing and how it is affecting their daily life.
This process helps clients express who they are and make sense of what is happening to them.
Pragmatic reasoning
Consists of the practical, mundane, real-world decisions involved in arranging for and delivering therapy to clients, such as scheduling therapy sessions and deciding on the best way to use the tools available in a particular treatment setting to meet clients’ needs.
These decisions represent the creativity, compromises, and adjustments the therapist makes throughout the workday to juggle busy schedules.
Ethical reasoning
Take into account the context of treatment and the types of ethical decisions that may emerge.
Some of the ethical decisions that come up in practice include issues related to confidentiality, autonomy, justice, veracity, and fidelity. These terms are all defined in the AOTA OT Code of Ethics.
Interactive reasoning
At its core, it reflects the choices the therapist makes with regard to initiating, fostering, and supporting an ongoing therapeutic relationship with each individual client.
Realization that every client will need different things from the client-therapist relationship.
Important components: active listening, trust building, affirmation and validation, genuineness, confrontation, and empathy.
Conditional reasoning
Therapists must flexibly modify interventions in response to changing conditions. We refer to this as “thinking on your feet.”
The therapist’s ability to design interventions to meet multiple goals is also an important aspect of conditional reasoning.
Consider motor performance skills…when using a neuromuscular or ortho rehab approach, the therapist needs to select and combine individual actions with process skills such as initiating, sequencing, and terminating tasks. By doing so, the therapist enables the client to develop effective performance patterns and move towards their desired occupational performance goals.
Clinical reasoning
The big idea is that you understand the differences among the various methods and combine them thoughtfully.
Using more than one type of reasoning can be a practical and realistic way to select the interventions and approaches that are best suited to help your client.
