Therapeutic Occupations and Modalities 1

Therapeutic Occupations and Modalities

Chapter Outline

• Active Occupation

• Philosophic Foundations

• Realms of Occupational Therapy

  • Egocentric Realm

  • Exocentric Realm

  • Consensual Realm

• Relationships Among Realms

• Evolving Practice

• Purposeful Occupation and Activity

• Occupation and Health

• Assessment of Occupational Role Performance

• Activity Analysis

  • Principles of Activity Analysis

• Therapeutic Approaches

  • Biomechanical Approach

  • Sensorimotor Approach

• Adapting and Grading Activity

  • Adaptation of Activity

  • Grading of Activity

  • Selection of Activity

  • Simulated or Enabling Activity

• Adjunctive Modalities

• Therapeutic Exercise and Activity

• Physical Agent Modalities

• Summary

• Key Terms

Learning Objectives

After studying this chapter, practitioners will be able to:

1. Understand organizing concepts of occupational genesis related to active occupation.

2. Discuss the role of activity analysis in therapeutic activity selection.

3. Recognize differences between therapeutic activity and therapeutic exercise.

4. Identify the role of physical agent modalities in occupational therapy.

5. Explain how grading activity improves functional performance.

6. Differentiate between various therapeutic exercises.

7. Describe the use of simulated and enabling activities.

8. Facilitate understanding of adjunctive modalities in occupational therapy.

9. Identify requirements for adjunctive modalities set by AOTA.

10. Conduct an activity analysis suitable for physical dysfunction.

Active Occupation

• Definition: Foundation of OT; includes personal care, crafting, technology use, games, and vocational skills.

• Function: Promotes growth and health; enables therapists to help clients regain skills through meaningful activities.

• Relevance: Engagement in activities enhances performance and builds transferable skills.

Philosophic Foundations

• OTs integrate knowledge of the mind (egocentric realm), material world (exocentric realm), and social influences (consensual realm).

• Principles from Dewey emphasize learning through doing, reflecting the origins of OT influenced by pragmatism and mental hygiene movements.

Realms of Occupational Therapy

• Egocentric Realm: Focus on client factors affecting occupational performance (motor, cognitively-perceptual skills).

• Exocentric Realm: Understanding the material world; adapting environments and objects to enhance performance.

• Consensual Realm: Recognizing the impact of social contexts on occupational performance and participation.

Evolving Practice

• OT continues to evolve with societal changes. New modalities (like technology) are incorporated into practice.

• OTs use crafts, modern therapies, and various modalities to enhance competency.

Purposeful Occupation and Activity

• Definition: Activity must have a meaningful goal to be effective in treatment; distinguishes OT from non-purposeful activities.

• Engaging in purposeful activity encourages natural movement and enhances overall performance.

Occupation and Health

• Occupation is essential for health; clients engage in meaningful activities for rehabilitation and well-being.

Assessment of Occupational Role Performance

• Utilize client-centered, top-down approaches for identifying occupational goals and needs.

Activity Analysis

• Essential for selecting appropriate therapies; includes understanding individual contributions, physical and social environments.

• Activities must be goal-directed, meaningful, and appropriately challenging.

Therapeutic Approaches

• Biomechanical Approach: Targets improvements in strength, ROM, and motor function for physical disabilities.

• Sensorimotor Approach: Focuses on sensory perception and motor patterns for upper motor neuron dysfunctions.

Adapting and Grading Activity

Adaptation of Activity

• Activities may require modifications for clients’ needs or environmental factors.

Grading of Activity

• Pacing and adjusting activities to enhance client performance sustainably.

Selection of Activity

• Choose activities based on their potential to restore function and keep clients motivated; must be relevant to the client’s interests.

Simulated or Enabling Activity

• Used when actual activities cannot be performed; includes adaptations that maintain client interest and engagement.

Adjunctive Modalities

• Techniques coax the body into therapeutic activity, traditionally used by physical therapists but now included in OT practice to assist function.

Therapeutic Exercise and Activity

• Both essential and supportive forms of intervention, aimed at enhancing function through goal-directed exercises.