Occupational Therapy Conceptual Model

Biomechanics Test Positioning

   It is important to use bony landmarks and proper positioning for measuring range of motion because the normative values that we use to determine if there is any deficit within the range of motion in a joint is based on specific bony landmarks and proper positioning. By following these reference points we will be able to get a more accurate assessment of the clients range of motion and the implications of the values we get in our measurement. Using landmarks and positioning can also help improve both inter-rater and intra-rater reliability. Inter-rater reliability is important because once again we want to know that the values we get are consistent with others' measurements since we use normative values to determine deficits. Intra-rater reliability is important because we tend to re-measure range of motion to determine if there has been improvement and to see if treatment is effective and following these measurement protocols, we are better able to reduce the risk of measuring differently, skewing results from measurement to measurement. The purpose of the "test position" is important because different positioning can effect the movement of a joint since there can be anatomical limitations or advantages to a joint in different positions. The effect of gravity is also important to consider and can change from position to position which is why it is important to always initially test in an against gravity position, when applicable, and only then if the gravity proves to be too great of a resistance to then use a gravity eliminated position. A gravity eliminated position is useful to test range of motion when a person lacks the strength to overcome gravity, because it is still important to note if there are other limitations to range of motion aside from a lack of strength.

Biomechanics Activity Analysis

   Everyday I fill up my water cup with a pitcher of water. My starting position is having my arms relaxed at my side with my right elbow bent around 90°, my wrist is extended and my MCP, PIP, and DIP joints are all flexed around the handle of the pitcher. The final position would have my right shoulder abducted and internally rotated, my wrist flexed and my MCP, PIP, and DIP joints still flexed. The wrist flexion and shoulder flexion occur in the sagittal plane about the frontal axis. The internal rotation of the humerus occurs in the horizontal plane about the vertical axis. The osteokinematic action at the wrist joint is flexion; it is an angular open kinematic chain motion. For the arthrokinematics, the carpal bone which is convex glides and rolls in opposite directions on the radius which is a concave surface. The prime movers are extensor carpi radialis longus, extensor carpi radialis brevis, and extensor carpi ulnaris which would be an eccentric activation acting as decelerators, since the action of pouring the water would happen in the direction of gravity.

Making Healthcare More Client Friendly

    It is easy for healthcare professionals to use medical terminology when explaining a diagnosis, since it is the most accurate description of what is happening with a client or patient, but it is important to remember who the audience is and what their "health literacy" is.  "Health literacy" is an individuals ability to comprehend medical and health related information. In Professor Flick's lecture, she explained the importance of discovering the best delivery method of the information for the client, whether that be through audio, something visual, or through something they can read. It is important to communicate with the client about what they need so they do not feel embarrassed and withhold the fact they cannot understand what is being told to them. As we saw in a video that was presented during this lecture, it is vital that clients and patients understand paperwork and other things that are designed to inform them of their diagnosis and recommendations, because without that understanding they may be signing things away without the intention to or simply the knowledge that it had been done.

   From this Professor Flick's lecture I also learned about the institute for healthcare improvement triple aim, which looks at improving the patients experience of care, improving the health of populations as a whole, and reducing the per capita cost of health care. These are important for occupational therapists because it is important to individualize care to each patient since we have a client-centered approach and by doing this which should aim to maximize the experience as a positive experience. Occupational therapists also address the health of populations by doing community based health where we go out into the community to do screenings. I can see how occupational therapists are already working to improve the healthcare they provide to their clients to improve not only the client's health but also their experience of healthcare.

OTs in the Community

   After listening to the "Glass Half Full occupational therapy" podcast, titled "Au-some swimmers", I realized how big of a need there is for occupational therapy in the community setting, especially since  often there is a lack of funding. This podcast discussed a program that was started by OTs to help train lifeguards at a local swim lesson program to work with children with autism and other sensory processing disorders. To be honest, before listening to this podcast I overlooked many of the barriers present for a child who is on the spectrum may face when learning to swim. For example, it was brought up that even the time of day and day of the week can make a huge difference based on the number of people who may also be using the pool. The program that is discussed in the podcast helps lifeguards address these issues and helps train them to handle some of the behavioral differences in children with autism so that they can do their job effectively and teach the child to swim.
   It is easy to look at a child who is miserable and uncomfortable trying to learn to swim and figure why put them through that? However the reality is that if a child does not have basic swimming skills they are at a high risk of drowning if they ever fall in the water. This is why it is important for occupational therapists to go out into the community and help where they can. This podcast helped show me that there are so many essential programs out there that are not currently adapted for people who have a disability and we need OTs to be active in the community to help these programs interact in the necessary ways with people who have a disability for the safety and comfort of everyone involved.

SKRRT! (OT misconceptions)

"Blissful Ordinariness"

   Many people who are considered "able bodied" and "able minded" often take for granted the ease with which they go about their everyday tasks, such as, brushing their teeth, taking a shower, driving to work, etc.. For other people who may have a disability, these often considered "mindless" tasks can be a huge challenge that interrupts the flow of their daily routine. This brings us to the idea of "blissful ordinariness". This involves moving through one's day with little to no barriers and really not giving much thought into the tasks that make up one's everyday routine; in a sense someone's everyday life is rather ordinary. Not everyone experiences  "blissful ordinariness" in their everyday life due to an array of reasons and this is where occupational therapists can help.
   Occupational therapists emphasize the importance of the therapeutic relationship between themselves and the client. This means that the occupational therapist works on developing a relationship with the client that allows the OT to better understand the client as a whole rather than just for their disability, which is considered a holistic approach. Having this relationship helps build trust and understanding with the client which can help build "blissful ordinariness", because by understanding the client and their life you can better decipher what things are important for a client to be able to help them achieve a more cohesive routine to their day. No two people's daily demands are the same nor are their values; by taking a holistic approach occupational therapists are able to individualize treatment to help each individual client find and achieve their version of "blissful ordinariness".