week 5 Flashcards
OT Interventions for ALS
▪ Adaptive equipment and assistive technology
▪ Safety
▪ Positioning
▪ Functional mobility
▪ Client and family education
▪ Focus on function
and comfort
OT Interventions for MS
▪ Adaptive equipment and assistive technology
▪ Safety
▪ Positioning
▪ Functional mobility
▪ Client and family education
OT Interventions for HD
Early
▪ Safety
▪ Management of a daily routine
▪ Compensatory Training and use of ECT
▪ Exercises
OT Interventions for HD
middle
▪ Caregiver Training
▪ AE and fatigue management
OT Interventions for HD
Late
▪ Avoid skin breakdown
▪ Contracture management
OT Interventions for PD
mild
▪ Exercise
▪ Adaptive Equipment
OT Interventions for PD
moderate
Adaptive equipment and adaptive techniques
OT Interventions for PD
severe
▪ Positioning
▪ Caregiver Training and Education
OT Interventions for Dementia
▪ Adaptive equipment and assistive technology
▪ Safety
▪ Positioning
▪ Functional mobility
▪ Client and family education
Neurological Classification of SCI/D
▪ ASIA scale
▪ Based on a test of strength and somatosensation
▪ Motor
Sensory
Medical Intervention for SCI/D
▪ ABCDE algorithm of advanced trauma life
support
▪ Ensuring stability of airway, breathing, and circulation
and minimizing disability and exposure.
▪ Cervical collars, backboards, and orthotics
▪ Surgery to stabilize the spine
▪ Regulate their blood pressure and heart rate
▪ Avoidance of hypotension
▪ Tracheostomy
▪ Cough Assist
▪ Early mobilization
What kinds of pain are commonly seen with
SCI/D?
▪ Mechanical
▪ Central
▪ Radicular
How can OT address pain prevention/reduction?
▪ Energy conservation and work simplification
strategies
▪ Wheelchair/seating and positioning techniques
▪ Mental health maintenance
How does SCI/D affect muscle tone?
▪ How can spasticity both impede and facilitate the performance
of certain ADLs?
▪ How is spasticity treated by physicians? By OT practitioners?
Work capacity evaluation (WCE)
▪ Evaluates musculoskeletal abilities but also includes
the ability to perform work-related functions
▪ Looks not only at the injured area, but also identifies
abilities and problems that prohibit the client from
wholly engaging in a full RTW program Work Conditioning
Developing the Client’s Work
Conditioning Program
▪ The occupational therapist and the OTA will
develop a problem list.
▪ In conjunction with the client, goals are developed.
▪ The occupational therapist and the OTA will plan
exercises and stretches to address the goals
Documenting the Client’s Work
Conditioning Program
▪ Unlike other settings, the weekly progress notes
and reevaluation notes are directed to the referring physician.
▪ These notes, in a letter format, are completed every
Friday and cover the previous week’s sessions
Work Hardening
8 hours per day, 5 days per week for up to 6
weeks
Initial Evaluation in Work Hardening
Understanding the description of the job to
which the injured worker is going to be returning
is more important at this stage than when the
client was in the work conditioning phase
Work Hardening Goals
Resolve or ameliorate the problems identified
▪Simulate real work activities
Developing the Client’s Work Hardening Program
Client has to understand the reason behind the
revision and simulation
Resolving the client’s pain was a realistic goal
Documentation in Work Hardening Program
Cover same information as a Work
Conditioning Program
▪Notes are to be completed every Friday and
cover the previous week’s sessions.
▪Reevaluations are to be completed every 2
weeks (10 sessions)
Discharge criteria are met when:
- The client has demonstrated that he or she is able to
RTW without restrictions.
▪ The client has demonstrated that he or she is able to
RTW with restrictions as identified by the potential
employer as reasonable.
▪ The client has plateaued in his or her progress
Functional Capacity Evaluation (FCE)
An objective and comprehensive assessment
of a person’s demonstrated ability to sustain
work in a competitive job market
Minimal required components of an FCE
▪ Initial interview
▪ Job analysis, where applicable
▪ Extensive, full body musculoskeletal assessment
▪ Education regarding anatomy and physiology
▪ Job-specific or client-specific dynamic lifting assessment
▪ Realistic simulated work activities
▪ 8 hours/day for multiple days in succession
▪ Distraction testing
Repeatability
An FCE is not a record of the maximum a person is
able to perform in all these areas of concern but,
rather, is documented evidence in the FCR of the
client’s demonstrated ability to sustain and repeat,
day after day, within their pain tolerance.
Cross checks for validity of effort
▪ Pain can not be measured objectively
▪ Monitor’s client’s vital signs and the way the client
moves when the individual does not know that he or
she is being observed
Distraction testing
Uses non-traditional methods (not standardized tests)
to determine abilities
Symptom Magnifier
Individuals who magnify their pain behaviors, either
consciously or unconsciously, for secondary gain
Functional Capacity Report (FCR)
▪ The FCR is the concluding report of the FCE
▪ If a clearly written physical job description exists,
the FCR will state conclusively whether or not
the individual has demonstrated the ability to
RTW.
