Week 1 Flashcards
(14 cards)
Top down approach
Looks at the person holistically, emphasizing overall participation in meaningful occupations. How the person engages in occupations within their environment
Bottom up
Focuses on specific client factors (e.g., strength, range of motion, cognition). Examines isolated impairments or skills without initially considering the broader context
Occupational analysis
- Write out the steps of washing dishes
- Skills Required (fine motor skills, grip strength, mental fatigue, processing skills)
- Client Factors:
(physical symptoms, Goals) - Environmental & Contextual Considerations- Physical, Social
- Barriers to Occupational Performance
(Pain and swelling in hands/wrists/finger
Decreased grip strength)
Biomechanical model
- focused on the PHYSICAL CAPACITY of our body and measures when limit (impairments) occur
- Physical capacity refers to a persons musculoskeletal capacity (including strength, endurance, range of motion).
- Musculoskeletal capacity determines functional motion.
- Functional motion influences occupational performance
- provides information about the capacity of bones, joints and muscles of our bodies,
Biomechanical model strength and weakness
Benefit: Focus on Physical Function
Limitation: Lack of Holistic Perspective
Clinical features of Rheumatoid Arthritis (RA)
Chronic inflammatory disease, immune system attacks own tissue
Inflammation of synovial joint
Abnormal tissue clings to cartilage
Immobilized joint
Upper body
- Small joints of the hands and wrists most commonly affected first
- morning stiffness for 30-60 mins
Lower limb
- Metatarsophalangeal (MTP) joints in the feet → painful walking, Mild ankle discomfort may begin
- swelling, pain
Flare up of RA
Timeframe: Episodic, can occur at any stage
Increased joint inflammation and pain
Marked swelling, redness, warmth
Severe stiffness, especially in the morning or after rest
Possible tendon sheath inflammation (tenosynovitis)
Decreased range of motion, increased fatigue during hand use
Long term upper limb RA
- Ulnar deviation (fingers drift toward the little finger side)
- Swan-neck deformity (hyperextension of PIP, flexion of DIP)
- Boutonniere deformity (flexion of PIP, extension of DIP)
Long term lower limb RA
Foot deformities:
- Hammer toes, claw toes
- Flattened arches or valgus deformity of the foot
“the systemic nature” of RA
- can cause inflammation beyond the musculoskeletal system, due to widespread immune system activation. It can impact multiple organs and systems throughout the body.
Assessment for RA
ROM: Goniometry provides objective, measurable data on joint limitations that affect function.
Grip strength, pinch test
Worker Role Interview (WRI)
- semi-structured interview, with an accompanying 16 item rating scale
16 items are each assessed on a 4 point scale – SS = Strongly support – S = Supports – I = Interferes – SI = Significantly interferes – NA= not applicable with returning to work - For: Adults experiencing work injuries and physical and mental health conditions,
- Aim: To assess the impacts of personal causation, values, interests, roles, habits, and perception of the environment on potential for obtaining or returning to work
- Has 6 areas: personal causation, values, interests, roles, habits, perception of environment
- applied: explore daily routines, work history, goals, environment etc
Work Environment Impact Scale (WEIS)
- semi-structured interview and rating scale designed to gather information on how individuals with physical or psychosocial disabilities experience their work environments
- For: people who are currently employed, individuals who are not currently working, but are anticipating return
- Used to identify needed workplace accommodations
- Questions organised around 17 topics covering features of work environments, including: physical space, social contacts, coworkers, supervisors, job role, task demands, time demands, work schedule,
job rewards - Each item is scored on a 4-point scale to indicate how the environmental factor impacts the worker’s performance, satisfaction, well-being (physical, social, emotional)
SS = strongly support
S = supports
I = interferes
SI = significantly interferes
NA= not applicable - 3 areas - motor skills, space and objects, communication and interaction skills
- applied: obsreve or intervew the client about their abilitu to perform 10 daily tasks, score each item, use total score to determine level of dependency and inform goal setting
CPPF
- enter/initiate
- set the stage
- assess/evaluate
- Agree on Objectives and Plan
- Implement the Plan
- Monitor/Modify
- Evaluate Outcome
- Conclude/Exit
