#1 Occupational Therapy

What physical setting can occupational therapy be in?

Can be done in various settings, more commonly given at an occupational medicine facility, including:

- MD

- PT

- X-ray

- Specialty doctors (ortho)

Can be delivered in an outpatient facility, hospital, rehab, or subacute facility, workplace

What comprises patient care for OT?

1. Medical review

2. Thorough evaluation

3. Job requirements

4. Risk factors (environment/noise/physical requirements)

5. Tailored rehab to assist quick return to occupation

6. Assess readiness to RTW (return to work) -- ther ex, braces, adaptations, retraining

What are different aspects of assessment for OT?

Consider all the same factors you would in an o/p ortho clinic:

1. Strength

2. ROM

3. Sensation

4. Dexterity

5. Reflexes

6. Compensations

7. Body parts, core strength, cardiovascular

8. Stretching and flexibility

9. Balance and proprioception

What are different treatments/plan of care?

1. Ortho techniques -- STM, jt. mob

2. Ther ex -- start general then work towards specificity to job

3. Modalities as needed

What are different modifications/adaptations that can be done?

1. Taping/bracing

2. Work station modification (stools, chair, flooring, machinery, devices)

Historically, what were terms used for return to work (RTW)?

Work conditioning, work hardening

What is the current term for RTW?

Work rehabilitation: a multidisciplinary approach that incorporates physical function, behavioral and vocational needs

- Communication is vital with all medical and workplace stakeholders

What does work rehabilitation include?

1. All the activities performing in the conditioning plus activities of work stimulation -- specific lifting/carrying/steps/stairs/prolonged positioning/cart/hand truck/repetitive activities

2. If appropriate a work conditioning aerobic component may be added

3. Can include increasing the amount of time activities completed

4. Body mechanic education/back school: make sure they're educated in safe posture/positioning/safe back positioning and lifting mechanics

What are the responsibilities of the provider?

1. Know the job requirements/responsibilities of the patient's job

2. Document progress

3. Appropriate equipment to provide similar activities

4. Good communication