Self-care strategies for Specific

Disorders

Mrs. Ruiz

Dupuytren’s Contracture Complex Regional Pain Syndrome (CRPS) Fractures Cumulative Trauma Disorders (CTD)

DeQuervains Medial/Lateral epicondylitis Trigger finger

Peripheral Nerve Compressions Median Ulnar Radial

Musculoskeletal

Rotator cuff tendonitis Adhesive capsulitis Shoulder dislocation Arthritis Osteogenisis Imperfecta Total hip replacement Total hip arthroplasty Amputations Burns Pain

Musculoskeletal

Cerebral Vascular Accident (CVA) Traumatic brain injury (TBI) Spinal cord injury (SCI) Cerebral palsy (CP) Movement Disorders

Parkinson's Spina Bifida Muscular Distrophies

Duchenne Arthrogryposis multiplex congenita Spinal muscular dystrophy Congenital Myasthenia gravis Charcot-Marie-Tooth disease

Neurological

Huntington’s Chorea Cerebellar/Spinocerebellar disorder Peripheral Nervous system/neuromuscular

diseases ALS Brachial plexus Peripheral neuropathies Guillan-Barre Syndrome Myasthenia Gravis

Demyelinating Diseases MS

Neurological

Role of OTA Assist in collaboration of date for the

evaluation once service competency has been established.

OTA cannot independently evaluate or interpret evaluation results.

Occupational Therapy Evaluation and Intervention for Neurological

System Disorders

Evaluation Sensory and motor dysfunction

Extent of paralysis/weakness Severity and distribution of spasticity Gross and fine motor coordination loss Evaluation of sensory modalities: Light touch,

Pain, Pressure, Proprioception, Kinesthesia, Temperature, Gustatory, Olfactory, Auditory.

Postural control evaluation Manual muscle testing Skin integrity

Occupational Therapy Evaluation and Intervention for Neurological

System Disorders

Cognitive/perceptual dysfunction Evaluation of foundation visual skills: acuity,

visual fields, accommodation, pursuits, saccades. Evaluation of pervasive impairments:

decreased arousal, decreased alertness, loss of selective sustained attention, concrete thinking, decreased insight, impaired judgment, confusion.

Evaluation of the impact on ADL: apraxia, spatial neglect, body neglect, perseveration, organization and sequencing dysfunction, and memory loss.

Occupational Therapy Evaluation and Intervention for Neurological

System Disorders

Psychosocial Dysfunction Evaluation of emotional disturbances: apathy,

depression, aggression, irritability, frustration tolerance.

Coping mechanisms Adaptation to change in occupational role

functioning or difficulty in assuming occupational roles.

Occupational Therapy Evaluation and Intervention for Neurological System Disorders

Areas of Occupation Evaluation Basic ADL Instrumental ADL Dural medical equipment evaluation School/work and return to school/work issues. Play/leisure Mobility needs Social participation interest

Occupational Therapy Evaluation and Intervention for Neurological System

Disorders

Performance Context Evaluation Cultural barriers Architectural barriers Societal barriers Financial barriers Stigma Home evaluation School/work site evaluation

Occupational Therapy Evaluation and Intervention for Neurological System

Disorders

General Intervention/Treatment Guidelines Positioning

Seating and wheeled mobility Bed positioning Pressure reduction and pressure relief techniques

Postural control training for seated and standing activities.

Motor learning approaches Motor control retraining/relearning for functional

integration of affected limbs Specific ADL retraining Prescription for assistive devices and technology Family/caregiver education

Occupational Therapy Evaluation and Intervention for Neurological System

Disorders

General Intervention/Treatment Guidelines Cognitive-perceptual retraining Visual skills retraining or adaptation Intervention for sexual dysfunction Bowel and bladder training with adaptive

techniques Skin care education Durable medical equipment Sensory re-education Community re-integration Work hardening programs

Occupational Therapy Evaluation and Intervention for Neurological System Disorders

COPD CAD Cystic Fibrosis Assessment

Pain/angina (note location, severity) Dyspnea (severity and position) Fatigue/perceived exertion (severity and time of

occurrence) Palpitations Dizziness (note if associated with postural changes) Edema (especially in LE)

Note location and measurement

Cardiovascular and Pulmonary Disorders

Cancer Scleroderma AIDS Rehabilitation for Immunological

system Disorders Goals and approaches can be preventive,

restorative, supportive, and or palliative depending on treatment setting, diagnosis, stage of illness, and expected outcome.

Immunological Conditions

Self-care: Adaptation and training to do self-care tasks

with grater ease while conserving energy: Ex. an individual with scleroderma

Alter grasp and pinch patterns and level of demand and UE demand.

Alter size of feeding utensils and tooth brushes to accommodate decreased ability to open mouth.

Prevent shearing forces on skin during specific personal ADl.

Immunological System Disorders Interventions

Work Modifications to work site to allow participation

in component tasks and activities. Counseling for transitioning

Leisure Modify tasks Determine interests and skills

Rest Monitor sleep habits and patterns to relax and

unwind. Maximize positioning during sleep.

Immunological System Disorders Interventions

Acute hospitalization phase Early mobilization Preservation of function Positioning Psychological/emotional support Prevention of long term disability

Inpatient rehabilitation Restoration of functional abilities

Self care-ADL IADL Energy conservation and work simplifications

Restoration of activity/exercise tolerance Role adjustment intervention Planning to return to community

Access to environment

Immunological System Disorders Interventions

Home care Restoration of functional ability Community mobility

Inner and outer boundaries of home environment Into the street/block Venture into the community

Use of transportation, medical appointments, leisure access

Community based care School related

Transition from home to schooling Work related

Immunological System Disorders Interventions

Diabetes Type I Type II

Rehabilitation Preventive exercise Education concerning compliance and need

for medical management of condition. Lifestyle readjustment to complications when

and if they occur. Low vision

Endocrine System and Metabolic System

Protective issues regarding peripheral neuropathy Safety assessment Education concerning risk associated with

sensory loss Skin care Pain management Adaptive equipment/techniques to facilitate

participation in lifestyle Instrumental activities supporting compliance

of self management

Endocrine System and Metabolic System