week 6 Flashcards
Athritis
inflammatory, infectious,
metabolic, or autoimmune. It can be progressive,
static, or have periods of remission and
exacerbation
Interventions for arthritis
Pain management, orthotics, adaptation, client education, adaptive equipment, exercise
Osteoarthritis
Joint pain, which often increases after activity or as the day
goes on.
Joint stiffnes
decresed ROM
OA treatment
Reduce pain, improve overall function, reduce the potential for long-term disability
▪Education
-lifestyle changes
Rheumatoid Arthritis
immune system’s cells do not function correctly and begin to
attack healthy tissues.
▪ The resulting inflammation produces chemicals that target
and cause a thickening of the synovium
Rheumatoid Arthritis Treatment
During periods of remission, OT intervention may include gently
progressive exercise.
▪ During an exacerbation of RA, the joints must rest, so therapeutic
exercise is limited. Instead, the treatment focuses on client education
and reducing pain and inflammation.
▪ Orthotics
education
adaptive equipment
Fibromyalgia
widespread musculoskeletal
pain instead of joint pain or destruction.
▪ Sleep deprivation, fatigue, memory
impairment, and psychosocial issues
Fibromyalgia Treatment
▪ Generally directed at relieving pain and addressing
other symptoms
▪ Graded Exercise
▪ Adaptive Equipment
▪ ECT, WS, and Ergonomic Training
Lupus
Both an autoimmune condition and systemic, affecting many
body systems and organs as well as the joints
▪ Painful, swollen joints
▪ Extreme fatigue and unexplained fever
▪ Butterfly-shaped rash over the nose and cheeks
▪ Photosensitivity
Lupus Treatment
▪ Lifestyle modifications are very
important, especially protection from
the sun and avoiding overexertion.
▪ If arthritic changes are pronounced, use
of orthotics may be necessary
▪ Graded Exercises
▪ Training in ECT, WS, and Ergonotics
Gout
▪ Metabolic condition caused when the bodily waste
product uric acid deposits tiny needlelike crystals
into the joints and soft tissues
▪Intense pain
▪Swelling
▪Redness
▪Heat/warm joint
▪Joint stiffness
▪Joint deformity
▪Tophi
Gout Treatment
▪Medical treatment of gout involves use of
medication, lifestyle changes, and client
education
OT Interventions
▪ Decreasing pain
▪ Improving function
▪ Environmental and lifestyle modifications
▪ Decreasing risk of deformity or disability
Client Education
▪ Decreasing pain
▪ Improving function
▪ Environmental and lifestyle modifications
▪ Decreasing risk of deformity or disability
Adaptive Equipment
▪ Decreasing pain
▪ Improving function
▪ Environmental and lifestyle modifications
▪ Decreasing risk of deformity or disability
Edema Management and Modalities
▪ Decreasing pain
▪ Improving function
▪ Environmental and lifestyle modifications
▪ Decreasing risk of deformity or disability
Edema Management and Modalities
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Controlling swelling can lead to a decrease in pain and a subsequent increase
in function
Therapeutic Exercises and Activities
used to maintain or
increase range of motion and strength, leading to improved
function.
▪ Graded and progressive exercises
▪ Home exercise and home activity programs
▪ Land-based and aquatic exercises
▪ Engagement in real or virtual leisure activities
What Affects Adult Drivers?
functional impairments
associated with aging
Treatment of the adult driver may be focused on
returning to driving or determining that it is time
to stop driving
Team Members and Organizations
Regarding driver evaluation and rehabilitation:
DRSs may include individuals with an educational
background that did not address medical conditions.
Screening/Evaluation for Driving and
Community Mobility: Operational Factors
minimum capacities to
be able to safely operate a motor vehicle (e.g.,
significant visual deficit, moderate or severe
dementia), there is no justification for a specialist’s
referral.
▪ Assessment of fitness to drive
necessary mental or physical requirements
Strategic level:
Decision-making process, affecting all levels of driving
▪Determining trip goals and mode of transport (e.g., bike, drive, walk)
▪Navigating as well as being able to modify or change “plans,” both in
anticipation of trip and while on the road
Tactical level
Decisions/maneuvers made during driving maneuvers
▪Slowing down due to weather
▪Knowing if it is safe to make a left turn
▪Deciding whether to pass a slower vehicle
Operational level
Human-machine interaction used to control the vehicle
▪Steering, pushing brake pedal, using turn signal
▪Having the physical skills to carry out the tactical maneuvers
▪Possessing the overlearned skills developed through driving
experience
Interventions to Facilitate Return to Driving
not any different from other ADL or IADL tasks
- Interactive driving simulator
-Adaptive Equipment
STRENGTH OF THE HAND
Formal Testing
▪ Test is performed x3 alternating between left and right. The score is then
averaged.
▪ 5% to 10% difference in strength usually exists between the client’s dominant and
nondominant hand for these test
Pinch Gauge
Dynamometer
SENSATION OF THE HAND
- Stereognosis
- Choose a handful of common objects such as a nail, a key, paper clip, coin, pen, ect.
- Have the client ID the objects with eyes occluded
Semmes Weinstein monofilament test
Two-point Discrimination tests
COORDINATION
Nine Hole Peg Test
Minnesota Manual Dexterity Kit
Self-Management
“individual’s ability to manage the symptoms,
treatment, physical and psychosocial consequences
and lifestyle changes inherent in living with a
chronic condition.”
Self management goals
Empower individuals with knowledge of their
chronic condition, develop problem-solving skills to
recognize and navigate lifestyle changes, and
emphasize the collaborative partnership developed
between clients and healthcare providers
OT Role in Self-Management
supportive partnership self-management:
Transform habits, roles, rituals, and routines
▪ Physical, personal, temporal, social, virtual, and cultural
Health Maintenance Management (IADL)
OT Intervention
▪1) Teaching health management strategies an self-monitoring skills
▪2) Incorporating energy conservation and
activity modification techniques
▪3) Developing coping strategies
▪4) Adapting behaviors
Precontemplation
Provide appropriate information as to why change may
be helpful, presented in a nonauthoritarian manner by way of simple information
Contemplation
analyze the arguments for and against change Reflect on different options for change and the likely effect of each
Preparation
plan change carefully rather than make a rushed decision.
Break plan down into achievable goals. Write down commitment to change.
Think about where the client can get support for following his or her plans
Action
-follow his or her plan, -Reward and
congratulate self on successes .
-Remind self of the benefits
-Pace self at a level where he or she
will be able to sustain motivation and recognize there is a life outside of the plan.
-Learn from things that do not turn out as expected.
-Make use of
appropriate support.
Maintenance
Recognize that development is an ongoing process. Maintain and review plans until absolutely sure they are no longer required
Motivational Interviewing
include resisting the righting reflex (e.g., the urge to correct clients), understanding the client’s motivations, listening with empathy, and empowering the client utilizing hope and encouragement
Self-Monitoring and Lifestyle Modifications
Developing self-monitoring strategies increases self-
awareness of the disease’s impact on daily life and
empowers individuals to make informed choices.
