Theories and FOR (Intro)-Exam 3

Define Theories

A set of phenomena and the relationships among the concepts in those phenomena.

Define Phenomena

General results that have been observed reliably in systematic empirical research. (an established answer to a research question)

Define Frame of Reference

Guidelines for practice that provides direction for evaluation and treatment of particular deficits in the OT domain of concern.

List two terms that go along with Frame of Reference

•Guidelines for practice

•Model of practice

What does a Frame of Reference provide?

A framework for the clinician to make clinical decisions based on scientific theoretical foundations.

Where do theoretical foundations of OT come from?

Biological, science, psychology, sociology, and medicine.

What are assumptions based on in a Rehabilitative Frame of Reference?

Systems and learning theories.

Who does a rehabilitative frame of reference work with?

People who cannot be cured medically or surgically to help them achieve maximum level of function.

What does indicators of function/dysfunction revolve around in a Rehabilitative Frame of Reference?

If a person can perform ADLs/IADLs safely and if the person is able to participate in meaningful leisure activities.

What's the main goal of the rehabilitative FOR?

Is to maximize independence despite the presence of persistent impairments.

What does the rehabilitative FOR consider?

Rehabilitation as the process of facilitating patients in fulfilling meaningful occupations and social roles with competence.

What does the rehabilitative FOR utilize?

Adaptive devices, orthotics, environmental modifications, wheelchair modifications, ambulatory aids, and adaptive procedures.

What can increase the patient's independence in ADL's, home management, work, and leisure? (Rehabilitative FOR)

Safety education

List some highlights of the rehabilitative FOR

Adaptive devices, work simplification and energy conservation, Work related activities, orthotics and prosthetic training, Environmental modification, Wheelchair modification and management, Adapted procedure and safety education

What does the theoretical base of the biomechanical FOR come from?

Anatomy, physiology, and kinesiology.

Who does the biomechanical FOR treat?

Those with impairments in biomechanical body structures and functions.

What can occupational performance be regained by? (Behavioral FOR)

Treating the underlying impairments that limit function using a remedial approach.

Where're indicators of function and dysfunction embedded? (Biomechanical FOR)

ROM, strength, endurance, structural stability, and peripheral edema.

List interventions using the biomechanical FOR

PROM, Active Assisted ROM, work hardening and nerve gliding

List some things involved in physical function

Muscular performance, stability, mobility and flexibility, cardio-respiratory/endurance, coordination, balance and posture.

Who was the neurodevelopmental FOR developed by?

Karl and Berta Bobath for people with cerebral palsy

What is the theoretical base of the neurodevelopmental FOR dervied from?

Developmental, neurological, and dynamic systems theories.

What was the neurodevelopmental FOR developed to inhibit?

Abnormal muscle tone and reflexes and facilitate normal movement through positioning.

What does the patient learn in the neurodevelopmental FOR?

Normal muscle movement by experiencing what normal movement feels like.

What is the NDT used to do?

Analyze and treat posture and movement impairments based on kinesiology and biomechanics.

What does the NDT consider?

Planes of movement, alignment, ROM, base of support, muscle strength, postural control, weight shifts, and mobility.

What are the movement's incorporated in NDT?

Reaching, grasping, releasing of objects, righting reactions, weight bearing, and in-hand manipulation.

What can reaching, grasping, releasing of objects, righting reactions, weight bearing, and in-hand manipulation easily be incorporated in? (Neurodevelopmental FOR)

Functional task such as self-care or play.

Define NDT

Neurodevelopmental Therapy is a hands-on treatment approach for individuals with central nervous system pathophysiology such as hypotonia or ataxia. Direct handling, positioning and guidance of the child's movements are used to optimize function.

Who was the sensory integration FOR developed by?

Jean Ayers

Define information processing (Sensory integration FOR)

The brains ability to receive, organize, and respond to sensory input in a consistent and meaningful way.

What does the theoretical base assume in the sensory integration FOR?

That sensory integration is based on neuroscience and developmental theories.

What is critical for brain function and an important foundation for learning and behavior? (Sensory Integration FOR)

Sensory Input

What's the function of sensory modulation? (sensory integration FOR)

Typical responses to sensory stimuli.

What's the dysfunction of sensory modulation? (sensory integration FOR)

Exaggerated or excessive response to sensory stimuli.

What does sensory stimuli include? (sensory integration FOR)

Touch, auditory, visual, vestibular, smell, taste, proprioceptive.

What's the function of developmental dyspraxia? (sensory integration FOR)

The ability to create new complex motor task.

What's the dysfunction of developmental dyspraxia? (sensory integration FOR)

The inability to create new complex motor task.

Define Bilateral Integration

Using both sides of the body in a coordinated way.

Define Sensory Discrimination

The ability to develop and use motor memory to guide planned movement.

What does the developmental FOR suggest?

Development is sequential, and behaviors are primarily influenced by the mastery and integration of skills in previous stages.

How does the developmental FOR view people?

As dynamic, developing, and transitioning through periods of growth and decline.

List some intervention techniques with the developmental FOR

Activities, relationships, and environment to facilitate the development of skills.

How many adaptive skills are included in the developmental FOR?

6

What's the sensory integration skill included in the developmental FOR?

Information processing

What're the cognitive skills included in the developmental FOR?

Perceive, represent and organize, sensory integration for thinking and problem solving

What's the dyadic integration skill included in the developmental FOR?

Engage in a variety of primary groups

What's the group interaction skill included in the developmental FOR?

Participate in a variety of groups

What're the self-identity skills included in the developmental FOR?

Ability to perceive self as an autonomous, holistic, acceptable person who has permanence and continuity over time

What're the sexual identity skills included in the developmental FOR?

Ability to perceive sexual nature as good and to participate in long term relationships.

Who was the cognitive disability FOR (CDM) developed by?

Claudia Allen

What was the cognitive disabilty FOR based on?

Observation of adult patients with persistent mental disorders.

What does the cognitive disability FOR focus on?

Understanding functional cognition

What are task. analysis and activity analysis mainly used for?

Analyzing each task to match the demands to the cognitive level to each client during intervention.

What do short-term goals aim to match in the cognitive disability FOR?

The current level of performance

What are long-term goals based on in the cognitive disability FOR?

Prediction of change in performance levels.

What's the ultimate goal of the cognitive disability FOR?

To maintain the client's existing skills, and to develop new coping strategies.

List some approaches to the cognitive disability FOR

•Modifying activities

•Modifying environments

•Establishing and restoring performance skills and activity patterns, e.g., routines

•Maintenance and prevention of the client's best ability to function

Why must cognitive ability be determined in the cognitive disability FOR?

To grasp information before treatment can be established.

How many cognitive levels are in the cognitive disability FOR?

6

What's level 1? (CDM)

Automatic actions - total care

What's level 2? (CDM)

Postural actions - may do basic ADL's and ambulate still needs total care

What's level 3? (CDM)

Manual actions - care on site, uses familiar objects, needs help and cues, has poor safety

What's level 4? (CDM)

Goal directed/oriented actions - daily on-site supervision, learns with repetition

What's level 5? (CDM)

Exploratory - needs daily/ weekly supervision

What's level 6? (CDM)

Planned actions - lives independently

What does 0 on the scale of CDM mean?

Generalized reflexive actions, comatose

What does 6 on the scale of CDM mean?

Normal functioning

What level must clients operate to be considered safe for independent living?

At level 5/6

What does the test require in the cognitive level screen?

The patient to follow directions, use fine motor skills, and learning to complete short leather lacing task with string and needle.

Who was the proprioceptive neuromuscular facilitation (PNF) developed by?

•Herman Kabat

What's the proprioceptive neuromuscular facilitation (PNF) heavily influenced by?

Neurophysiology, anatomy, and kinesiology.

What're the main goals of using PNF after injury or surgery is to improve?

•range of motion (ROM)

•flexibility

•strength

•Coordination

•increasing joint stability

•neuromuscular control.

What does the PNF FOR believe?

That the body recognizes total movement patterns before specific muscle actions and that these patterns occur in either a spiral or diagonal pattern.

What does the occupational therapist analyze and treat?

These movements and posture deficits with therapeutic handling techniques.

What're PNF patterns initiated from?

Distal to proximal during sequences.

What's early motor behavior dominated by?

Reflex activity, vs. mature motor behavior is reinforced by postural reflexes.

What does the PNF FOR guide?

An occupational therapist in identifying postural and movement abnormalities.

What does the therapist use after identification? (PNF)

Handling techniques to address these deficits by introducing normal movement patterns and/or sequences to tasks and activities.

What does the PNF use stimuli to proprioceptors to do?

Hasten responses and recovery.

List some theoretical assumptions include of the PNF

•Normal movement and posture requires balanced interaction of antagonist.

•Early motor behavior is dominated by reflexes

•Mature motor behavior is reinforced or supported by postural reflex mechanisms.

•Normal motor development proceeds in a cephalocaudal and proximal distal direction.

•Improvement on motor ability is dependent on motor learning

•Normal motor behavior has an orderly quality some overlapping can occur.

How are indicators of function and dysfunction evaluated?

Smooth, controlled functional movement patterns of the head, neck, trunk, and extremities.

What may interventions of the PNF focus on?

Movement patterns in diagonal, forward, backward, and circular directions. Movement in and through different planes.

What does the Brunnstrom FOR use? For what?

Primitive synergistic patterns; improve motor control

What does the Brunnstrom FOR theory state?

Damage to the central nervous system causes a patient to regress to a less mature movement pattern.

What do different muscle groups work tother to create? (Brunnstrom FOR)

Normal muscle movements this results in the collaboration between muscles know as synergies

How many stages does recovery (Brunnstrom FOR)?

7 stages

List the 7 stages of recovery for Brunnstrom FOR

•1: Flaccidity

•2: Spasticity

•3: Gained voluntary control through synergies (increased spasticity)

•4: Patterns outside of synergy develop (decreased spasticity)

•5: Complex movement combinations form (further decreased spasticity)

•6: Disappearance of spasticity

•7: Normal function is restored

Who developed the model of human occupation? When?

Gary Keilhofner and Janice Burke based on theories of Mary Reilly. 1980's

What was the MOHO theory created to guide?

Clients and the therapy process. It is now the most widely used occupation-based model in the world.

What's special about MOHO?

Was the first theory to consider the barriers and difficulties of engagement in everyday activities.

What does MOHO address?

The motivation, routine, nature of performance, and the influence of the environment on occupation.

How does MOHO view man?

As an open system

Define input (MOHO)

Information enters the human system

Define throughput (MOHO)

Information processed utilizing volition, habituation, and performance capacity.

Define output (MOHO)

(Results) this is seen as information and action which provides feedback to the system.

How does MOHO view occupation?

Behavior that is internally gratifying and used to fulfill a variety of culturally and socially accepted roles.

Where do occupations receive their feedback from? (MOHO)

The environment and has a integral role in self-development.

What's the focus of treatment for MOHO?

Accomplishing change in volition, habituation, and performance capacity

How is the focus of treatment of MOHO achieved?

Through occupational engagement.