L26: OT and MDT management Lumbar and Pelvic Pain

Question 1

What is the occupational therapy role in pain?

Answer 1

Occupational therapists utilize interventions that focus on optimizing occupational performance and engagement, developing self-efficacy and pain self‐management skills, acquiring pain health literacy, and the prevention of chronic, enduring pain

Question 2

What are the 5 levels of occupational therapy theory?

Answer 2

Question 3

What are the 3 principles basic to Occupational Therapy practice?

Answer 3

1. Occupation
2. Purposeful Activity
3. Function

Question 4

What is Occupation?

Answer 4

In occupational therapy, occupations refer to the everyday activities that people do as individuals, in families and with communities to occupy time and bring meaning and purpose to life. Occupations include things people need to, want to and are expected to do.

Question 5

In occupational therapy, occupations refer to the ______ activities that people do as _____, in ____ and with _____ to occupy time and bring meaning and purpose to life. Occupations include things people need to, want to and are expected to do.

Answer 5

everyday; individuals; families; communities

Question 6

Why is it important to inform practice and process in practice models in OT?

Answer 6

Inform practice and process. They helps us to consider and explain the relationship between the the person, the environment and occupational performance.

Question 7

What are 3 models that work well in a pain setting on OT?

Answer 7

1. Person-Environment-Occupation Model of Occupational Performance
2. Model of Human Occupation (MOHO)
3. Kawa Model

Question 8

What is the P-E-O Model in OT?

Answer 8

Person environment and occupation factors

Question 9

What is the Kawa Model?

Answer 9

Rocks = barriers (eg. LBP)

Logs = personal attributes (eg. determination, perfectionist = keep going uni even though back pain or might do exercises perfectly (compliant))

Question 10

What are 5 features in the model of human occupation (MOHO)?

Answer 10

1. Physical and Social Environment:
   
   • ‘the environment: it’s opportunities, demands and constraints impact on what people do and how they do it.’
2. Volition:
   
   • ‘is reflected in the wide range of thoughts and feelings people have about things they have done are doing or might do.’
   • These include the things we value, are interested in and our beliefs about our abilities and ourselves.’
3. Roles:
   
   • ‘ The roles we carry out in life gives us our identify. There is a substantial cost to personal identity when persons, are no longer recognised as the fathers, mothers, partners, students, workers… friends.’
4. Habits:
   
   • Habits enable us to unconsciously organise our actions to carry out the tasks we need to do efficiently.’
   • Although the habitual ways of doing almost everything we do go largely unnoticed getting through the day without them would be unbearably cumbersome.’ Performance
5. Capacity:
   
   • Our mental and physical capacity interacts with all these other factors to determine our ability to do the things we want and need to do.

Question 11

What is the physical and social environment in MOHO model?

Answer 11

‘the environment: it’s opportunities, demands and constraints impact on what people do and how they do it.’

Question 12

What is the vollition in MOHO model?

Answer 12

‘is reflected in the wide range of thoughts and feelings people have about things they have done are doing or might do.’ These include the things we value, are interested in and our beliefs about our abilities and ourselves.’

Question 13

What are the roles in MOHO model?

Answer 13

‘ The roles we carry out in life gives us our identify. There is a substantial cost to personal identity when persons, are no longer recognised as the fathers, mothers, partners, students, workers… friends.’

Question 14

What are the habits in MOHO model?

Answer 14

Habits enable us to unconsciously organise our actions to carry out the tasks we need to do efficiently.’ Although the habitual ways of doing almost everything we do go largely unnoticed getting through the day without them would be unbearably cumbersome.’ Eg. showering

Question 15

What is the performance capacity in MOHO model?

Answer 15

Our mental and physical capacity interacts with all these other factors to determine our ability to do the things we want and need to do.

Question 16

Specific theoretical frameworks that help guide how deficits, problems, client circumstances are approached and dealt with. For example: The Biopsychosocial frame of reference is commonly used in _____ pain.

Answer 16

persistent

Question 17

What are the 9 features of pain?

Answer 17

Question 18

What is the OT approach to pain?

Answer 18

“An approach is a set of ideas and actions that leads to the selection of specific treatment techniques. An approach enables therapists to apply theoretical constructs in a practical way by transforming theory into intervention procedures” Approaches are informed by one or more frame of reference. For example Biopsychosocial + Biomechanical

Question 19

In OT, “Many tools are not exclusive to occupational therapy, but can be aligned with an approach, frame of reference and theoretical model that are congruent with occupational therapy theory. They are what therapists use to enable client _____ and achieve occupational ____”

Answer 19

performance ; goals

Question 20

What are 4 example techniques for OT?

Answer 20

1. Motivational Interviewing
2. Shared Decision Making
3. Canadian Occupational Performance Measure (COPM)
4. Mindfulness

Question 21

What are 5 OT information gathering techniques?

Answer 21

1. Medical records/ referrals
2. Interview (unstructured, semi structured, structured)
3. Observations
4. Activity analysis
5. Specific Assessments ○ OT specifics (such as Canadian Occupational Performance Measure) ○ Generic (Valued Living Questionnaire)

Question 22

What is the Canadian Occupational Performance Measure?

Answer 22

Listen and rate how well and happy with areas they are having difficulty

• Rate importance, satisfaction

Question 23

What are 10 Multidisciplinary Pain Centre Occupational Therapy Assessment?

Answer 23

1. Background Information
2. Pain Description
3. Pain rating
4. Pain beliefs
5. Activity patterns (boom bust or avoidant)
6. Identified aggravating factors
7. Identified coping strategies
8. Psychosocial impact
9. Social and Environmental (including home environment)
10. Activities of Living (Occupational Engagement): sleep, self- care, mobility, transport, eating and food preparation, financial, leisure, work

Question 24

Occupational Therapist can use a motivational interviewing (technique) for a resume building intervention (approach), informed by their _____ lens (frame of reference) with a focus of addressing occupational performance (practice model) because the therapist sees ____ as vital to health and wellbeing (paradigm)

Answer 24

biopsychosocial; occupation

Question 25

What are 8 OT interventions in pain?

Answer 25

1. Sleep Management / Education about Sleep Hygiene
2. Stress / Relaxation
3. Activity Pacing
4. Problem Solving
5. Energy Conservation
6. Task Simplification / Modification
7. Advising someone how and when to decrease or increase activity levels (activity modulation)
8. Sensory desensitisation

Question 26

What are 6 Sleep Management / Education on Sleep Hygiene in OT?

Answer 26

1. Educating clients and caregivers on sleep misconceptions and expectations
2. Encouraging health management behaviors such as smoking cessation, reduced caffeine intake, a balanced diet, and adequate exercise.
3. Establishing predictable routines, including regular times for waking and sleeping
4. Establishing individualized sleep hygiene routines (e.g., habits and patterns to facilitate restorative sleep)
5. Teaching cognitive-behavioral and cognitive restructuring techniques, such as leaving the bedroom if awake and returning only when sleepy, or exploring self-talk statements regarding sleep patterns
6. Modifying the environment, including noise, light, temperature, bedding (Eg. provide comfortable pillow), and technology use while in bed

Question 27

How does sleep affect energy?

Answer 27

Amount of sleep = dictates energy (eg. less sleep = less energy) –> while can use caffeine

Question 28

What is a way that OTs help a person to relax?

Answer 28

to attain a state of calmness and reduce level of pain, anxiety, stress or anger.

Deep breathing relaxation technique, imagery relaxation technique, progressive muscle relaxation technique.

Question 29

What is the purpose of activity pacing?

Answer 29

To optimize participation in daily occupation by altering lifestyle habits and routine. Address activity avoidance and boom busting.

Question 30

How to activity pace ?

Answer 30

Spacing out activities, prioritising what needs to be done, planning ahead, sharing the load.

Question 31

What is the aim of Simplification Techniques in Energy Conservation and Work in OT?

Answer 31

to reduce the amount of energy consumption in performing daily activities throughout the day.

• Example: prioritization, planning, pacing and posture, using assistive equipment.

Question 32

What are 5 other OT interventions?

Answer 32

1. Connecting people to community resources/social group – craft group, men’s shed, local pool, meet up
2. Assisting people to navigate the health system and community supports – mental health care plans, NDIS, Red Cross transport, Centrelink
3. Identifying /challenging thoughts and beliefs about pain
4. Music therapy
5. Occupied in an engaged activity –> brain “forgets” pain Home modification

Question 33

What are 4 characteristics of working in a MDT?

Answer 33

1. Ultimately working towards enabling patients to manage pain better.
2. Being aware of services provided by each discipline.
3. Acknowledging some overlap in services that could be provided and understanding the organisation’s decision on whose role it is to provide a particular intervention
4. Conducting joint sessions such as home visits etc.