Feature Article Occupational Therapy

Role of the Occupational Therapist

Contributed by Margarita Makoutonina and Ashwini Rao, Ed.D., OTR

For most patients with Movement Disorders, motor, cognitive and behavioral impairments lead to a loss of functional ability and independence in activities of daily living (ADL), which in turn diminishes their quality of life (QOL).
Occupational therapy (OT) involves therapeutic use of contextually appropriate functional activities to enhance participation in roles at home, school, workplace and community.

OT uses three approaches:

1. Working directly with the patient (individually or in a group);
2. Modifying the task and/or environment to accommodate the patient's limitations at the same time presenting a therapeutic challenge;
3. Working with the patients' caregivers to ensure appropriate follow-up of the therapeutic program and promote mechanisms to cope with disability.

OT practitioners administer standardized assessments of motor skills (posture and balance, transfers, mobility, hand function), daily living skills (feeding, toileting, dressing, bathing), process skills (initiation, sequencing, organization, adjustment etc.)1, instrumental ADL skills (driving, cooking, cleaning, shopping etc.) and QOL.

OT promotes health and wellness in patients through functional training of motor skills (bed mobility and transfers, balance and mobility, reducing fall risk, and improving hand function), process skills (organization and task adaptation), and psychosocial adaptation. To maximize function, OT performs task modifications (use of adapted utensils, built-up handles, adaptive clothing), environmental modifications (rearranging furniture, organizing ramps and walk-in shower, grab bars) and prescription of assistive devices (raised toilet seats, walking aids, splints and braces).

In addition, OT teaches people the techniques and strategies to learn new and adaptive ways of performing the basic daily activities and to achieve independence in all facets of their lives, giving individuals the “skills for the job of living” necessary for independent and satisfying lives 2.

References
1. Occupational therapy practice framework: domain and process. Am J Occup
Ther 2002; 56(6):609-639.
2. (Rao, A.K. Role of occupational therapy movement disorders of the basal
ganglia. Physical Disabilities Special Interest Section Quarterly. 2008,
31(3), 1-4.)
3. Website: www.parkinsons.northwestern.edu
Sports and Life magazines. Sports, Fitness, Recreation, and Leisure magazines.
Physical Disabilities Special Interest Section Quarterly
American Occupational Therapy Association articles. September 2008.

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