Tuesday, February 26, 2013

MODEL AND FRAME OF REFERENCE OCCUPATIONAL THERAPY


MODEL


Model of Human Occupation (MOHO)
Is perhaps the best-researched model of practice in occupational therapy. Model of practice that views occupation in terms of volition, habituation, performance, and environment.




Canadian Model of Occupational Therapy (CMOP)
Has also generated a wealth of research to support its design. The core of this model is spirituality, which is defined broadly as anything that motivates or inspires a person.The person, environment (which includes institutions), and occupations are the other parts of the model.





Person-Environment-Occupation-Performance (PEOP)
A model of practice developed by Christiansen and Baum provides definitions and describes the interactive nature of human beings. This model provides generic, broad terms for each area (e.g., person, environment, occupation, performance).

Person includes the physical, psychological aspects of the individual. Environment includes the physical and social supports, and those things that interfere with the individual's performance. Occupation refers to the everyday things people do and in which they find meaning. Peformance refers to the actions of occupations.





Canadian Occupational Performance Measure
Is a semistructured interview based on this model and provides practitioners with the tool to organize their thoughts.
This interview tool helps identify the family's priorities for their child with special needs and assists in developing therapy goals with the child's primary caregivers. Distributed by the AOTA.


FRAME OF REFERENCES



Neurodevelopment frame of reference
Requires that the practitioner touch the client throughout the movement and facilitate a normal movement pattern.




Behavioral frame of reference
To reward positive behaviors and ignore negative ones.



Cognitive disability frame of reference
Proposed by Claudia Allen this frame of reference Is based on the premise that cognitive disorders in those with mental health disabilities are caused by neurobiologic defects or deficits related to the biologic functioning of the brain. derived from research in neuroscience, cognitive psychology, information processing, and biologic psychiatry.



Biomechanical frame of reference
A frame of reference derived from theories in kinetics and kinematics; used with individuals who have deficitis in the peripheral nervous, musculoskeletal, integumentary, or cardiopulmonary system



Developmental frame of reference
Identifies the highest level motor, social, cognitive skills in which a client can engage, and facilitate improvements in function from the staring point. Grade activities so that the client cane achieve them, but is slightly challenged. Help "close the gap" in the areas in which the client is unable to perform.



Motor control frame of reference
Work with the client impaired motor skills through activities in the natural environment. Allow the client to make mistakes and learn from them. This FOR suggests that the practitioner provide verbal and physical cues as necessary. Practice should take place in short sessions with frequent breaks.



Perceptual motor training FOR
Work with the client on improving his memory, cognitive skills, safety awareness, and visual perception through a variety of table top activities. May include many computer-type games and strategies.



Sensorimotor frame of reference
Work on improving the client motor skills through practice of occupations. The OT practitioner sets up activities in which the client practices his coordination.



Psycho-dynamic
FOR

Sensory Integration
 FOR 
Rehabilitation
FOR
KAWA Model
http://quizlet.com/_3k2i1

Saturday, February 23, 2013

TRANSFER TECHNIQUE

Body Mechanic

Stand closely to the client.
Bend knees: use legs not the back.
Keep a neutral spine (not bent or arched back).




Keep a wide base of support.
Open up legs and parallel to the shoulder.
 
Keep heels down.
For hemiplegia client, put legs between
client's affected leg to secure that side
.

* Don't tackle more than you can handle ; ask for help.
* Don't combine movements. Avoid rotating at the same time as bending forward / backward.

Body Position


Instruct client to be in slightly
ant. pelvic tilt position and midline
trunk position.
Move weight forward,
removing weight from buttock.

Client's feet be placed firmly on the floor with ankles stabilized and with
knees aligned at 90 degrees of flexion over the feet.

Client heels should be slightly pointed
 towards the place to be transferred.
Client should either wear shoes or be barefoot.
Keep client arms in safe position and
not in the way  of the transfer.


POSITIONING THE WHEELCHAIR

Wheelchair position at approximately a
30 degrees angle to the surface to which
the client is tran
The break on the wheelchair 
and the bed are locked.

The client's feet place firmly on the
floor, hip width apart and with knees
over the feet.

Remove the armrest and clear the footrest.
Remove the pelvic seatbelt, chest
and trunk / lateral supports.

* Place the wheelchair next to the unaffected side.


BED MOBILITY


Place hand under client's scapula on the affected side.

Put another hand under
 client's leg while the unaffected
 side with knee flexed.
Client clasping the strong hand around the weak
arm and lift upper extremities towards the ceiling.

Adjusting client body on the bed ;
 move upper body first.
Therapist assist the affected side
and gently mobilize it forward.
Client use hand on the unaffected
side to mobilize his/her body
Continue with lower body. Therapist hold on
patient affected leg and assist it while client
mobilize his/her lower body by using bridging technique.



Bring client's feet off the edge or the bed.
Stabilize the lower extremities.
Sit up ; shift client's body to an upright sitting position.
Assist affected side by holding client's scapula.

Place client's hand on the bed at the sides
of his/her body to help maintain balance.
Gently assist client's leg down to the floor.










Thursday, February 21, 2013

ACCESS FOR DISABLE PERSON TO PUBLIC BUILDINGS

Diagnose : Lower Limbs Amputation, patient using manual wheelchair.

 During this activity, patient need to access the public building from

  • Car park into the building
  • Going to the library
  • From the library to the cafeteria
  • Then going to the wash room

From car park going into the building


Car park size  454cm x 253cm, which is not according to the standards set

The client cannot transfer from the car to wheelchair because of the spacing remaining between two cars is too small. The entrance also too far from the parking provided. Client doesn't have trouble entering the building as the ramp provided and followed the standards set.


Entering the Library at 2nd floor

Client using elevator to access to the 2nd floor.

Small Ramp provided to wheelchair
 user  access to the elevator

Elevator door size 111cm which is
 suitable for wheelchair accessibility
Button height also according the
standards set
Signal for door to open enable client
to move on time



Inside button still followed
the standards set
Measure space in elevator = 198 x 179














 Entering the Library


No wheelchair user can pass any Rotator
 bars entrances or exits
At the library one entrance / exit provided
 for wheelchair user with 85" width.

Obstacles present in the library:

Spaces between two bookcase is too narrow.
The wheelchair can through the spaces but
cannot make any turn inside the gap.
Highest level of the bookcase  can be
 reached but need extra effort by the user.


Unilateral door ( to the computer room)
not suitable for the wheelchair user.











However....

The photocopy machine still can still be
 used by the wheelchair user although
no knee space on the machine.
The computer table wheelchair user friendly.




At the Cafeteria


Not enough knee space underneath
the hand washing sink.
Extra effort needed to reach the tissue
paper as the sink knee space not
following the standards set.



Washroom

As the OKU (disable person) wash room provided inside the building at every level, the wash rooms meet the measurement standards set.