BOOK
Pedretti's Occupational Therapy - E-Book
Heidi McHugh Pendleton | Winifred Schultz-Krohn
(2017)
Additional Information
Book Details
Abstract
Pedretti’s Occupational Therapy: Practice Skills for Physical Dysfunction, 8th Edition prepares you for occupational therapy practice with adults who have physical disabilities. This cornerstone text provides a foundation for the development of clinical reasoning skills in a comprehensive, case-based learning approach to physical dysfunction. New full color photos and helpful pedagogy, including threaded case studies, OT Practice Notes, ethical considerations, and end-of-chapter review questions, reinforce learning, enhance retention, and prompt you to apply principles in a clinical setting.
- UNIQUE! Threaded case studies , woven throughout each chapter, help you apply concepts to real-life clinical practice.
- UNIQUE! Ethical Considerations boxes highlight the key ethical concerns of treatment options so you can practice ethically.
- UNIQUE! OT Practice Notes convey important considerations for professional practice.
- Focuses on the occupational therapist’s role in health and wellness, which the OTA has identified as a key practice area in the 21st century.
- Information on prevention, rather than simply intervention or treatment, shows how OTs can take a proactive role in patient care.
- Evidence-based content included throughout, especially in regards to evaluation and intervention.
- Content on occupational therapy’s commitment to considering cultural and ethnic diversity in every chapter.
- Key terms, chapter outlines, chapter objectives lay out the information you can expect to learn from each chapter.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | cover | ||
| Inside Front Cover | ifc1 | ||
| Pedretti's Occupational Therapy | i | ||
| Copyright Page | iv | ||
| Contributors | v | ||
| Dedication | ix | ||
| Foreword | x | ||
| Preface | xi | ||
| Acknowledgments | xii | ||
| Table Of Contents | xiii | ||
| Second half title page | xv | ||
| I Overview: Occupational Therapy Foundations for Physical Dysfunction | 1 | ||
| 1 The Occupational Therapy Practice Framework and the Practice of Occupational Therapy for People With Physical Disabilities | 1 | ||
| Chapter Outline | 1 | ||
| Learning Objectives | 1 | ||
| Key Terms | 1 | ||
| The Occupational Therapy Practice Framework: Domain and Process, Third Edition (OTPF-3)—Overview | 2 | ||
| Evolution of the Occupational Therapy Practice Framework | 3 | ||
| Need for the Occupational Therapy Practice Framework | 3 | ||
| Fit Between the OTPF-3 and the International Classification of Functioning, Disability, and Health (ICF) | 3 | ||
| The OTPF-3: Description | 4 | ||
| The Occupational Therapy Domain | 4 | ||
| Occupations | 4 | ||
| Performance Skills and Performance Patterns | 5 | ||
| Contexts and Environments | 7 | ||
| Client Factors | 8 | ||
| The Occupational Therapy Process | 8 | ||
| Skills That Inform and Guide the Occupational Therapy Process | 9 | ||
| Types of Occupational Therapy Intervention | 10 | ||
| Occupations and Activities | 10 | ||
| Preparatory Methods and Preparatory Tasks | 11 | ||
| Education and Training | 12 | ||
| Advocacy | 12 | ||
| Group Intervention | 12 | ||
| Strategies for Learning the OTPF-3 | 12 | ||
| The OTPF-3: Its Use in This Book | 14 | ||
| Summary | 14 | ||
| Review Questions | 14 | ||
| References | 14 | ||
| Suggested Readings | 15 | ||
| 2 History and Practice Trends in Physical Dysfunction Intervention | 16 | ||
| Chapter Outline | 16 | ||
| Learning Objectives | 16 | ||
| Key Terms | 16 | ||
| Roots of Occupational Therapy | 16 | ||
| Moral Treatment Movement | 17 | ||
| Arts and Crafts Movement | 17 | ||
| Scientific Management | 17 | ||
| Expansion and Specialization | 18 | ||
| The Rehabilitation Model | 18 | ||
| Physical Dysfunction as a Specialty | 18 | ||
| A New Paradigm of Disability: the Disability Rights and Independent Living Movements | 18 | ||
| Providing Humanistic and Scientific Care: an Ongoing Discussion Within the Profession | 19 | ||
| Moral Treatment and the Medical Model | 19 | ||
| The Rehabilitation Model and the Social Model | 20 | ||
| Contemporary Practice: Addressing the Unintended Consequences of the Rehabilitation Model | 21 | ||
| Using History to Understand Today’s Practice | 21 | ||
| Review Questions | 22 | ||
| References | 22 | ||
| Suggested Reading | 23 | ||
| II Occupational Therapy Process and Practice | 24 | ||
| 3 Application of the Occupational Therapy Practice Framework to Physical Dysfunction | 24 | ||
| Chapter Outline | 24 | ||
| Learning Objectives | 24 | ||
| Key Terms | 25 | ||
| Section 1 The Occupational Therapy Process | 25 | ||
| The Steps of the Occupational Therapy Process | 25 | ||
| Referral | 25 | ||
| Screening | 26 | ||
| Evaluation | 26 | ||
| Intervention Planning | 27 | ||
| Intervention Implementation | 28 | ||
| Intervention Review | 29 | ||
| Outcomes | 30 | ||
| Clinical Reasoning in the Intervention Process | 30 | ||
| Clinical Reasoning in Context | 31 | ||
| Client-Centered Practice | 32 | ||
| Theories, Models of Practice, and Frames of Reference | 32 | ||
| Theory | 32 | ||
| Model of Practice | 33 | ||
| Model of Human Occupation | 33 | ||
| Ecology of Human Performance | 33 | ||
| Person-Environment-Occupation Model | 34 | ||
| Frame of Reference | 34 | ||
| Biomechanical Frame of Reference | 34 | ||
| Rehabilitation Frame of Reference | 34 | ||
| Sensorimotor Frame of Reference | 34 | ||
| Meeting the Client’s Needs | 34 | ||
| Teamwork Within the Occupational Therapy Profession | 35 | ||
| OT-OTA Relationship | 35 | ||
| Occupational Therapy Aides | 35 | ||
| Teamwork With Other Professionals | 35 | ||
| Ethics | 36 | ||
| Summary: Section 1 | 37 | ||
| Section 2 ractice Settings FOR Physical Disabilities | 37 | ||
| Continuum of Healthcare | 37 | ||
| Inpatient Settings | 38 | ||
| Acute Care Inpatient Setting | 38 | ||
| Inpatient Rehabilitation Setting | 39 | ||
| Acute Rehabilitation | 40 | ||
| Subacute Rehabilitation | 40 | ||
| Skilled Nursing Facilities | 40 | ||
| Community-Based Settings | 41 | ||
| Home- and Community-Based Settings | 41 | ||
| Intermediate Care Facilities (Residential Care) | 41 | ||
| Assisted Living Unit or Residence | 41 | ||
| Home Health | 42 | ||
| Outpatient Settings | 43 | ||
| Day Treatment | 43 | ||
| Work Site Therapy Settings | 43 | ||
| Emerging Practice: Telemedicine | 44 | ||
| Summary: Section 2 | 44 | ||
| Review Questions | 44 | ||
| References | 45 | ||
| Suggested Readings | 46 | ||
| 4 Evidence-Based Practice for Occupational Therapy | 47 | ||
| Chapter Outline | 47 | ||
| Learning Objectives | 47 | ||
| Key Terms | 47 | ||
| Models of Evidence-Based Practice | 47 | ||
| The Systematic Occupational Therapy Practice Model—SOTP | 48 | ||
| Theoretical and Logical Foundations of SOTP | 50 | ||
| Complementarity With Contemporary Practice Models | 50 | ||
| Sequence of SOTP | 50 | ||
| Statement of the Problem | 50 | ||
| Ascertaining Need | 52 | ||
| Goals and Objectives | 53 | ||
| Goal: Jane will improve her promptness so as to be able to get to work on time (performance), to her satisfaction. | 54 | ||
| Reflexive Intervention | 54 | ||
| Outcome Assessment | 55 | ||
| Summary | 56 | ||
| Review Questions | 56 | ||
| References | 56 | ||
| Suggested Readings | 57 | ||
| 5 Health Promotion and Well-Being for People With Physical Disabilities | 58 | ||
| Chapter Outline | 58 | ||
| Learning Objectives | 58 | ||
| Key Terms | 58 | ||
| Historical Influences and Considerations | 59 | ||
| Early History and Symbolism | 59 | ||
| Development of a Profession | 59 | ||
| Milestones in Occupational Therapy Health Promotion Interventions | 60 | ||
| Lifestyle Redesign Programs | 60 | ||
| International Trends | 60 | ||
| Health Promotion Principles and Practice | 61 | ||
| Models of Health Promotion Practice | 62 | ||
| Transtheoretical Model | 62 | ||
| PRECEDE-PROCEED Model | 63 | ||
| Occupational Therapy Involvement in Health Promotion and Disease Prevention | 63 | ||
| Health Promotion and Occupational Participation | 64 | ||
| Secondary Conditions and People With Disabilities | 65 | ||
| Evaluation: Emphasizing the Promotion of Health and Well-Being | 65 | ||
| Intervention | 66 | ||
| Summary | 67 | ||
| Review Questions | 68 | ||
| References | 68 | ||
| 6 Personal and Social Contexts of Disability | 71 | ||
| Chapter Outline | 71 | ||
| Learning Objectives | 71 | ||
| Key Terms | 71 | ||
| Client-Centered Self-Report | 73 | ||
| Personal Context | 74 | ||
| Disability Experience | 74 | ||
| Individual Differences | 74 | ||
| Stage Models of Adjustment to Disability | 75 | ||
| Social Model of Disability | 76 | ||
| Stages of Life and Self-Concept | 76 | ||
| Understanding Individual Experience | 77 | ||
| Social Context | 78 | ||
| Social Status and Disability | 78 | ||
| Disability as a Collective Experience | 79 | ||
| Occupational Therapy Practice and the Independent Living Philosophy | 80 | ||
| Person-First Language | 81 | ||
| Culture of Disability | 82 | ||
| Design and Disability | 84 | ||
| Interactional Process: the Person With a Disability and the Environment | 84 | ||
| International Classification of Functioning, Disability, and Health | 84 | ||
| Relationship Between the OT and the Person With a Disability | 86 | ||
| The Therapist as an Environmental Factor | 86 | ||
| Therapeutic Use of Self | 87 | ||
| Client-Centered Practice: A Shift From the Medical to the Social Model | 88 | ||
| Life Satisfaction and Quality of Life | 88 | ||
| Summary | 88 | ||
| Review Questions | 89 | ||
| References | 89 | ||
| 7 Teaching Activities in Occupational Therapy | 92 | ||
| Chapter Outline | 92 | ||
| Learning Objectives | 92 | ||
| Key Terms | 93 | ||
| Key Phrases | 93 | ||
| Section 1 Teaching Strategies in Occupational Therapy | 93 | ||
| Why Occupational Therapists Teach | 93 | ||
| Phases of Learning | 94 | ||
| Learning Capacities | 94 | ||
| Procedural and Declarative Learning | 94 | ||
| Principles of Teaching and Learning in Occupational Therapy | 95 | ||
| Identify a Meaningful Occupation, Activity, or Task | 95 | ||
| Choose Instructional Mode Compatible With Client’s Cognition | 95 | ||
| Structure the Learning Environment | 96 | ||
| Provide Reinforcement and Grading of Activities | 96 | ||
| Structure Feedback and Practice | 96 | ||
| Contextual Interference | 97 | ||
| Blocked and Random Practice Schedules | 97 | ||
| Whole Versus Part Practice | 97 | ||
| Cognitive Strategies | 98 | ||
| Practice Contexts | 98 | ||
| Help Client Develop Self-Awareness and Self-Monitoring Skills | 98 | ||
| Factors That Influence the Learning Process | 98 | ||
| Section 1 Summary | 99 | ||
| Section 2 the Therapeutic Use of Self: Embodying Mindfulness in Occupational Therapy | 99 | ||
| The Therapeutic Use of Self | 100 | ||
| Environmental Effects on the Development of the Therapeutic Use of Self | 102 | ||
| Mindfulness and the Enhancement of the Therapeutic Use of Self | 103 | ||
| Mindfulness in Western Medicine, Healthcare, and Society | 106 | ||
| Employing Mindfulness in Occupational Therapy Practice | 110 | ||
| Integrating Occupational Therapy and Mindfulness | 111 | ||
| Mindfulness-Based Occupational Therapy (MBOT) Competencies | 111 | ||
| Apply It Now: Practice Descriptions | 112 | ||
| Practice 1: Body Awareness Practice in Sitting or Lying Down | 112 | ||
| Practice 2: Opening to and Expanding Awareness Practice | 114 | ||
| Practice 3: Mindful Movement Practice During ADLs | 115 | ||
| Section 2 Summary | 116 | ||
| Acknowledgments | 116 | ||
| Review Questions | 116 | ||
| References | 117 | ||
| Additional Resources | 119 | ||
| Mindfulness Recording Resources | 119 | ||
| Professional Training in MBSR | 119 | ||
| 8 Documentation of Occupational Therapy Services | 120 | ||
| Chapter Outline | 120 | ||
| Learning Objectives | 120 | ||
| Key Terms | 120 | ||
| Purposes of Documentation | 121 | ||
| Best Practices | 121 | ||
| Clinical/Professional Reasoning Skills | 123 | ||
| Clinical Reasoning in Documentation | 124 | ||
| Legal Liability | 124 | ||
| Initial Evaluation | 124 | ||
| Screening Report | 125 | ||
| Evaluation Report | 125 | ||
| Intervention Plan | 125 | ||
| Intervention Goals | 126 | ||
| RUMBA | 126 | ||
| SMART | 127 | ||
| Progress Reports | 127 | ||
| SOAP Progress Note | 128 | ||
| Narrative Notes | 129 | ||
| Descriptive Notes | 130 | ||
| Progress Checklists or Flow Sheets | 130 | ||
| Discharge Reports | 130 | ||
| Electronic and Paper-Based Documentation | 131 | ||
| Confidentiality and Documentation | 133 | ||
| Summary | 140 | ||
| References | 140 | ||
| 9 Infection Control and Safety Issues in the Clinic | 141 | ||
| Chapter Outline | 141 | ||
| Learning Objectives | 141 | ||
| Key Terms | 141 | ||
| Safety Recommendations for the Clinic | 142 | ||
| Precautions With Special Equipment | 142 | ||
| Hospital Beds | 143 | ||
| Ventilators | 143 | ||
| Monitors | 143 | ||
| Feeding Devices | 144 | ||
| Catheters | 144 | ||
| Infection Control | 144 | ||
| Isolation Systems | 147 | ||
| Incidents and Emergencies | 149 | ||
| Falls | 150 | ||
| Burns | 150 | ||
| Bleeding | 150 | ||
| Shock | 150 | ||
| Seizures | 150 | ||
| Insulin-Related Illnesses | 151 | ||
| Respiratory Distress | 151 | ||
| Choking and Cardiac Arrest | 151 | ||
| Summary | 153 | ||
| Review Questions | 153 | ||
| References | 154 | ||
| III Occupational Performance and the Performance Areas: Evaluation and Intervention | 155 | ||
| 10 Activities of Daily Living | 155 | ||
| Chapter Outline | 155 | ||
| Learning Objectives | 155 | ||
| Key Terms | 156 | ||
| Definitions of Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs) | 157 | ||
| Considerations in ADL and IADL Occupational Analysis and Training | 157 | ||
| Definition of “Client” | 157 | ||
| Client Factors | 157 | ||
| Sleep and Rest | 158 | ||
| Performance Skills | 158 | ||
| Performance Patterns | 158 | ||
| Environment and Context | 159 | ||
| Cultural, Personal, Temporal, and Virtual Contexts | 159 | ||
| Finances | 159 | ||
| Occupational Justice | 160 | ||
| Evaluation of ADLs and IADLs | 160 | ||
| General Procedure | 160 | ||
| Performance of ADLs and IADLs | 161 | ||
| Recording the Results of the ADL Assessment | 161 | ||
| Instrumental Activities of Daily Living | 162 | ||
| Home Management Assessment | 162 | ||
| Home Assessment | 162 | ||
| Financial Management | 191 | ||
| Community Mobility | 191 | ||
| Health Management and Maintenance | 192 | ||
| ADL and IADL Training | 193 | ||
| Methods of Teaching ADLs | 193 | ||
| Recording Progress in ADL Performance | 194 | ||
| Assistive Technology and Adaptive Equipment | 194 | ||
| Specific ADL and IADL Techniques | 195 | ||
| ADLs for the Person With Limited Range of Motion or Strength | 195 | ||
| Lower Extremity Dressing Activities | 195 | ||
| Upper Extremity Dressing Activities | 195 | ||
| Feeding Activities | 197 | ||
| Personal Hygiene and Grooming Activities | 198 | ||
| Communication Management and Environmental Adaptations | 199 | ||
| Functional Mobility | 199 | ||
| Home Management, Meal Preparation, and Cleanup Activities | 200 | ||
| ADLs for the Person With Incoordination | 201 | ||
| Dressing Activities | 201 | ||
| Feeding Activities | 202 | ||
| Personal Hygiene and Grooming Activities | 202 | ||
| Communication Management and Environmental Adaptations | 203 | ||
| Functional Mobility | 203 | ||
| Home Management, Meal Preparation, and Cleanup Activities | 204 | ||
| ADLs for the Person With Hemiplegia or Use of Only One Upper Extremity | 205 | ||
| Dressing Activities | 205 | ||
| General setup. | 205 | ||
| Shirts. | 205 | ||
| Method 1. | 205 | ||
| Donning a shirt | 205 | ||
| Removing a shirt | 206 | ||
| Method 2 | 206 | ||
| Donning a shirt | 206 | ||
| Removing a shirt (one sleeve off at a time) | 206 | ||
| Method 3 | 207 | ||
| Donning a shirt | 207 | ||
| Removing a shirt. | 207 | ||
| Variation—donning a pullover shirt | 207 | ||
| Variation—removing a pullover shirt | 207 | ||
| Trousers. | 207 | ||
| Method 1 | 207 | ||
| Donning trousers | 207 | ||
| Removing trousers | 207 | ||
| Method 2 | 207 | ||
| Donning trousers. | 207 | ||
| IV Performance Skills and Client Factors: Evaluation and Intervention | 435 | ||
| 18 Performance Skills | 435 | ||
| Chapter Outline | 435 | ||
| Learning Objectives | 435 | ||
| Key Terms | 435 | ||
| Current Occupational Therapy Practice Framework (OTPF-3) | 435 | ||
| Role of Performance Skills and Client Factors in Occupational Performance | 435 | ||
| Occupation-Based Approaches and Neuroscientific Evidence | 436 | ||
| Performance Skills and Client Factors | 437 | ||
| Motor Control Theory | 438 | ||
| Neuroscience Research Related to Practice | 440 | ||
| Best Practice Occupational Therapy Service | 442 | ||
| Summary | 443 | ||
| Review Questions | 443 | ||
| References | 443 | ||
| Suggested Readings | 443 | ||
| 19 Evaluation of Motor Control | 444 | ||
| Chapter Outline | 444 | ||
| Learning Objectives | 444 | ||
| Key Terms | 445 | ||
| The Upper Motor Neuron and Lower Motor Neuron Systems | 448 | ||
| Client-Centered Performance Interviews to Detect Problem Areas in Motor Control | 448 | ||
| Standardized Activities of Daily Living Assessments for Motor Control | 449 | ||
| Muscle Tone | 449 | ||
| Abnormal Muscle Tone | 451 | ||
| Flaccidity | 451 | ||
| Hypotonus | 451 | ||
| Hypertonus | 451 | ||
| Cerebral Hypertonia | 452 | ||
| Spinal Hypertonia | 452 | ||
| Spasticity | 452 | ||
| Clonus. | 453 | ||
| Rigidity | 453 | ||
| Seizures and Todd’s Paralysis | 453 | ||
| Muscle Tone Assessment | 453 | ||
| Guidelines for Muscle Tone Assessment | 453 | ||
| Manual Rating Scales for Spasticity and Hypertonicity | 454 | ||
| Ashworth Scale | 454 | ||
| Tardieu Scale | 454 | ||
| Mild/Moderate/Severe Spasticity Scale | 454 | ||
| Mechanical and Computer Rating Systems for Spasticity and Hypertonicity | 455 | ||
| Range-of-Motion Assessment in Evaluation of Tone | 455 | ||
| Other Considerations in Tone Assessment | 455 | ||
| Assessing Movement and Control | 455 | ||
| Sensation | 455 | ||
| Medical Assessment of Muscle Tone | 455 | ||
| Normal Postural Mechanism | 455 | ||
| Righting Reactions | 456 | ||
| Equilibrium Reactions | 456 | ||
| Protective Reactions | 456 | ||
| Assessment of Righting, Equilibrium, and Protective Reactions and Balance | 456 | ||
| Primitive Reflexes | 456 | ||
| Brainstem-Level Reflexes | 456 | ||
| Asymmetric tonic neck reflex. | 456 | ||
| Symmetric tonic neck reflex. | 456 | ||
| Tonic labyrinthine reflex. | 456 | ||
| Positive supporting reaction. | 456 | ||
| Spinal-Level Reflexes | 458 | ||
| Crossed extension reflex. | 458 | ||
| Flexor withdrawal reflex. | 458 | ||
| Grasp reflex. | 458 | ||
| Trunk Control Assessment | 458 | ||
| Trunk Flexors | 458 | ||
| Trunk Extensors | 458 | ||
| Test 1. | 458 | ||
| Test 2. | 458 | ||
| Test 3. | 459 | ||
| Lateral Flexors | 459 | ||
| Trunk Rotation | 459 | ||
| Coordination | 459 | ||
| Incoordination | 459 | ||
| Cerebellar Disorders | 459 | ||
| Ataxia | 459 | ||
| Dysdiadochokinesis | 460 | ||
| Dysmetria | 460 | ||
| Dyssynergia or Asynergia | 460 | ||
| Nystagmus | 460 | ||
| Dysarthria | 460 | ||
| Extrapyramidal Disorders | 460 | ||
| Chorea | 460 | ||
| Athetoid Movements | 460 | ||
| Dystonia | 460 | ||
| Ballism | 460 | ||
| Tremor | 461 | ||
| Assessment of Coordination | 461 | ||
| Medical Assessment of Coordination | 461 | ||
| Occupational Therapy Assessment of Coordination | 461 | ||
| Occupational Therapy Intervention | 461 | ||
| Intervention for Hypertonicity and Spasticity | 461 | ||
| Conservative Treatment Approaches | 462 | ||
| Weight bearing. | 462 | ||
| Traditional Sensorimotor Approaches | 462 | ||
| Casting. | 462 | ||
| Physical Agent Modalities | 462 | ||
| Distal-to-Proximal Approach | 462 | ||
| Surgical Methods | 463 | ||
| Pharmacological Agents | 464 | ||
| Treatment of Rigidity | 464 | ||
| Treatment of Flaccidity | 464 | ||
| Treatment of Incoordination | 464 | ||
| Surgical Intervention for Movement Disorders | 465 | ||
| Rehabilitation Robotics | 465 | ||
| Summary | 466 | ||
| Review Questions | 466 | ||
| References | 467 | ||
| Suggested Readings | 469 | ||
| 20 Occupation-Based Functional Motion Assessment | 470 | ||
| Chapter Outline | 470 | ||
| Learning Objectives | 470 | ||
| Key Terms | 470 | ||
| Clinical Observation | 471 | ||
| Occupation-Based Functional Motion Assessment | 473 | ||
| Lower Extremity | 473 | ||
| Hip Complex | 473 | ||
| Flexion and extension. | 473 | ||
| Abduction and adduction. | 473 | ||
| Internal and external rotation. | 473 | ||
| Knee | 473 | ||
| Ankle and Foot | 473 | ||
| Plantar flexion. | 473 | ||
| Dorsiflexion. | 473 | ||
| Inversion and eversion. | 473 | ||
| Upper Extremity | 473 | ||
| Shoulder Complex | 474 | ||
| Shoulder flexion and abduction with scapula upward rotation (overhead movements). | 474 | ||
| Shoulder extension and adduction with scapula downward rotation. | 474 | ||
| Horizontal adduction and abduction. | 474 | ||
| Internal and external rotation. | 475 | ||
| Extension and adduction. | 475 | ||
| Flexion and adduction. | 475 | ||
| Elbow and Forearm | 475 | ||
| Wrist and Hand | 475 | ||
| Summary | 475 | ||
| Review Questions | 476 | ||
| References | 476 | ||
| 21 Joint Range of Motion* | 477 | ||
| Chapter Outline | 477 | ||
| Learning Objectives | 477 | ||
| Key Terms | 477 | ||
| Joint Measurement | 478 | ||
| Planes and Axes of Movement | 479 | ||
| Principles and Procedures in Joint Measurement | 479 | ||
| Visual Observation | 480 | ||
| Palpation | 480 | ||
| Positioning of Therapist and Support of Limbs | 480 | ||
| Precautions and Contraindications | 481 | ||
| End-Feel | 481 | ||
| Two-Joint Muscles | 481 | ||
| Methods of Joint Measurement | 481 | ||
| 180-Degree System | 481 | ||
| 360-Degree System | 482 | ||
| Goniometers | 482 | ||
| Recording Measurements | 483 | ||
| 180-Degree System | 483 | ||
| Results of Assessment as the Basis for Planning Intervention | 484 | ||
| Procedure for Measuring Passive Range of Motion | 485 | ||
| General Procedure: 180-Degree Method of Measurement | 486 | ||
| Motion Screen/Motion Screening Test | 486 | ||
| Specific Directions for Joint Measurement Using the 180-Degree System | 489 | ||
| Spine | 489 | ||
| Cervical Spine | 489 | ||
| Thoracic and Lumbar Spine | 491 | ||
| Upper Extremity | 493 | ||
| Shoulder | 493 | ||
| Glenohumeral (GH) joint movement versus total shoulder movement. | 493 | ||
| Isolating glenohumeral joint movement. | 493 | ||
| Elbow | 497 | ||
| Forearm | 498 | ||
| Wrist | 500 | ||
| Fingers | 502 | ||
| Thumb | 506 | ||
| Lower Extremity | 509 | ||
| Hip | 509 | ||
| Knee | 509 | ||
| Summary | 510 | ||
| Review Questions | 510 | ||
| Exercises | 510 | ||
| References | 510 | ||
| 22 Evaluation of Muscle Strength* | 512 | ||
| Chapter Outline | 512 | ||
| Learning Objectives | 512 | ||
| Key Terms | 513 | ||
| Muscle Strength | 513 | ||
| Causes of Muscle Weakness | 514 | ||
| Methods to Evaluate Muscle Strength | 514 | ||
| Purposes of Manual Muscle Testing | 515 | ||
| Individual Differences in Manual Muscle Testing | 515 | ||
| Limitations of the Manual Muscle Test | 515 | ||
| Contraindications and Precautions | 515 | ||
| Role of Joint Range of Motion When Performing Manual Muscle Testing | 515 | ||
| Role of Gravity When Performing Manual Muscle Testing | 516 | ||
| Application of Pressure During Manual Muscle Testing | 516 | ||
| Palpation of Muscle Contraction | 517 | ||
| Substitutions | 517 | ||
| Knowledge and Skill of the Occupational Therapist | 517 | ||
| Principles of Manual Muscle Testing | 520 | ||
| Preparation for Testing | 520 | ||
| Specific Procedure for Testing | 520 | ||
| Grading of Muscle Strength | 520 | ||
| Manual Muscle Testing of the Upper Extremity | 521 | ||
| Shoulder Flexion (Fig. 22.5) | 522 | ||
| Shoulder Extension (Figs. 22.6 to 22.11) | 524 | ||
| Shoulder Abduction (Figs. 22.12 to 22.14) | 526 | ||
| Shoulder External Rotation (Figs. 22.15 to 22.19) | 527 | ||
| Shoulder Internal Rotation (Figs. 22.20 to 22.22) | 530 | ||
| Shoulder Horizontal Abduction (Figs. 22.23 to 22.26) | 531 | ||
| Shoulder Horizontal Adduction (Figs. 22.27 to 22.29B) | 533 | ||
| Elbow Flexion (Figs. 22.30 to 22.32) | 535 | ||
| Elbow Extension (Figs. 22.33 to 22.38) | 537 | ||
| Forearm Supination (Figs. 22.39 to 22.42) | 539 | ||
| Forearm Pronation (Figs. 22.43 to 22.46) | 541 | ||
| Wrist Extension (Figs. 22.47 to 22.49) | 542 | ||
| Wrist Flexion (Figs. 22.50 to 22.52) | 544 | ||
| Wrist Radial Deviation (Figs. 22.53 to 22.55) | 545 | ||
| Wrist Ulnar Deviation (Figs. 22.56A to 22.57) | 546 | ||
| Metacarpophalangeal Flexion (Figs. 22.58 to 22.63) | 547 | ||
| Metacarpophalangeal Extension (Figs. 22.64 to 22.67) | 550 | ||
| Proximal Interphalangeal Flexion, Second Through Fifth Fingers (Figs. 22.68 to 22.70) | 551 | ||
| Distal Interphalangeal Flexion, Second Through Fifth Fingers (Figs. 22.71 to 22.74) | 553 | ||
| Finger Abduction (Figs. 22.75 to 22.77) | 554 | ||
| Finger Adduction (Figs. 22.78 to 22.81) | 556 | ||
| Interphalangeal Extension (Figs. 22.82 to 22.85) | 558 | ||
| Thumb Metacarpophalangeal Extension (Figs. 22.86 to 22.88) | 559 | ||
| Thumb Interphalangeal Extension (Figs. 22.89 to 22.92) | 561 | ||
| Thumb Metacarpophalangeal Flexion (Figs. 22.93 to 22.95) | 563 | ||
| Thumb Interphalangeal Flexion (Figs. 22.96 to 22.98) | 564 | ||
| Thumb Palmar Abduction (Also Referred to as Abduction of the Carpal-Metacarpal Joint) (Figs. 22.99 to 22.100B) | 565 | ||
| Thumb Radial Abduction (Also Referred to as Extension of the Carpal-Metacarpal Joint) (Figs. 22.101 to 22.103) | 566 | ||
| Thumb Adduction (Figs. 22.104 to 22.106) | 568 | ||
| Opposition of the Thumb to the Fifth Finger (Figs. 22.107 to 22.109) | 569 | ||
| Manual Muscle Testing of the Lower Extremity | 570 | ||
| Hip Extension (Figs. 22.110 to 22.111) | 570 | ||
| Hip Abduction (Figs. 22.112 to 22.113) | 571 | ||
| Hip External Rotation (Figs. 22.114 to 22.115) | 572 | ||
| Knee Extension (Figs. 22.116 to 22.117) | 574 | ||
| Ankle Dorsiflexion (Figs. 22.118 to 22.119) | 575 | ||
| Foot Eversion (Figs. 22.120 to 22.121) | 576 | ||
| Results of Assessment as a Basis for Intervention Planning | 577 | ||
| Summary | 578 | ||
| Review Questions | 579 | ||
| References | 579 | ||
| 23 Evaluation of Sensation and Intervention for Sensory Dysfunction* | 580 | ||
| Chapter Outline | 580 | ||
| Learning Objectives | 580 | ||
| Key Terms | 580 | ||
| Somatotopic Arrangement | 582 | ||
| Neuroplasticity | 582 | ||
| Somatosensory System | 582 | ||
| Superficial Sensation | 583 | ||
| Pain Sensation | 584 | ||
| Test for pain (protective sensation) | 585 | ||
| Procedure | 585 | ||
| Response | 585 | ||
| Scoring | 585 | ||
| Temperature Awareness | 585 | ||
| Test for temperature awareness (protective sensation) | 586 | ||
| V The Occupational Therapy Process: Implementation of Intervention | 710 | ||
| 29 Therapeutic Occupations and Modalities | 710 | ||
| Chapter Outline | 710 | ||
| Learning Objectives | 710 | ||
| Key Terms | 710 | ||
| Occupational Therapy Intervention | 711 | ||
| OTPF-3 as the Foundation for Intervention Planning and Implementation | 711 | ||
| Occupation | 711 | ||
| Relationships Among Person, Environment, and Occupation as They Relate to Intervention Choices | 712 | ||
| Types of Occupational Therapy Intervention | 712 | ||
| Occupational Analysis and Activity Analysis | 713 | ||
| Activity Analysis | 713 | ||
| Grading and Adapting Occupations and Activities | 713 | ||
| Adapting (Compensating) | 713 | ||
| Grading (Remediating) | 714 | ||
| Grading Down | 714 | ||
| Grading Up | 714 | ||
| Examples of Grading | 715 | ||
| Strength | 715 | ||
| Range of Motion | 715 | ||
| Endurance and Tolerance | 715 | ||
| Coordination | 715 | ||
| Perceptual, Cognitive, and Social Skills | 716 | ||
| Preparatory Tasks and Preparatory Methods | 717 | ||
| Preparatory Tasks: Therapeutic Exercise and Therapeutic Activity | 717 | ||
| Purposes | 717 | ||
| Indications for Use | 717 | ||
| Contraindications | 718 | ||
| Exercise Programs | 718 | ||
| Progression of Exercise Programs | 718 | ||
| Range of Motion and Joint Flexibility | 718 | ||
| Active and Passive Stretch | 719 | ||
| Muscle Strengthening | 719 | ||
| Implementing Therapeutic Exercises and Therapeutic Activities | 721 | ||
| Improving Muscle Strength | 721 | ||
| Improving Muscle Endurance | 721 | ||
| Physical Conditioning and Cardiovascular Fitness | 721 | ||
| General Exercise and Activity Precautions | 721 | ||
| Neuromuscular Control and Coordination | 722 | ||
| Neuromuscular Control | 722 | ||
| Coordination Training | 722 | ||
| Physical Agent Modalities | 723 | ||
| Thermal Agents | 723 | ||
| Superficial Thermal Agents | 723 | ||
| Convection | 723 | ||
| Conduction | 724 | ||
| Deep Thermal Agents | 724 | ||
| Electrotherapeutic Agents | 725 | ||
| Transcutaneous Electrical Nerve Stimulation | 725 | ||
| Neuromuscular Electrical Stimulation | 726 | ||
| Mechanical Devices | 726 | ||
| Summary | 726 | ||
| Review Questions | 726 | ||
| References | 726 | ||
| Suggested Readings | 727 | ||
| 30 Orthotics | 728 | ||
| Chapter Outline | 728 | ||
| Learning Objectives | 728 | ||
| Key Terms | 729 | ||
| Section 1 Hand Orthotic Fabrication: Principles, Practice, and Decision Making | 729 | ||
| Role of the Occupational Therapist | 730 | ||
| Anatomic Structures of the Hand | 731 | ||
| Wrist | 731 | ||
| Wrist Tenodesis | 731 | ||
| Metacarpal Joints | 732 | ||
| Metacarpophalangeal Joints | 732 | ||
| Thumb | 732 | ||
| Interphalangeal Joints | 732 | ||
| Forearm Rotation | 732 | ||
| Ligaments of the Wrist and Hand | 733 | ||
| Metacarpophalangeal Joints | 734 | ||
| Proximal Interphalangeal Joints | 734 | ||
| Distal Interphalangeal Joints | 734 | ||
| Muscles and Tendons of the Forearm, Wrist, and Hand | 734 | ||
| Nerve Supply | 735 | ||
| Blood Supply | 736 | ||
| Skin | 736 | ||
| Superficial Anatomy and Landmarks | 736 | ||
| Prehension and Grasp Patterns | 736 | ||
| Lateral Prehension | 737 | ||
| Palmar Prehension | 737 | ||
| Tip Prehension | 737 | ||
| Cylindrical Grasp | 738 | ||
| Spherical Grasp | 738 | ||
| Hook Grasp | 738 | ||
| Intrinsic Plus Grasp | 738 | ||
| Mechanics of the Hand and Principles of Orthotic Fabrication | 739 | ||
| Axis of Motion | 739 | ||
| Force | 739 | ||
| Definitions | 739 | ||
| Translational Forces | 740 | ||
| Orthosis Classifications | 741 | ||
| Orthoses Classified by Type | 741 | ||
| Orthoses Classified by Purpose | 742 | ||
| Restriction Orthoses | 742 | ||
| Immobilization Orthoses | 742 | ||
| Mobilization Orthoses | 742 | ||
| Orthoses Classified by Design | 743 | ||
| Single-Surface or Circumferential Design | 743 | ||
| Indications for Single-Surface Orthosis Fabrication | 744 | ||
| Indications for Circumferential Orthosis Fabrication | 744 | ||
| When to Use and When Not to Use Orthotics | 744 | ||
| Compliance Issues | 744 | ||
| Ability to Don and Doff an Orthosis | 744 | ||
| Skin Tolerance and Hypersensitivity | 744 | ||
| Wearing Schedule | 744 | ||
| Orthosis Fabrication Process | 744 | ||
| Step One: Creating a Pattern | 744 | ||
| Step Two: Choosing Appropriate Material | 747 | ||
| Characteristics of Orthotic Materials | 747 | ||
| Resistance to stretch. | 747 | ||
| Conformability or drape. | 747 | ||
| Memory. | 747 | ||
| Rigidity versus flexibility. | 747 | ||
| Bonding. | 747 | ||
| Self-sealing edges. | 747 | ||
| Soft orthotic materials. | 747 | ||
| Choosing the Best Category of Material for the Orthosis | 748 | ||
| Forearm-based and hand-based orthoses. | 748 | ||
| Large upper and lower extremity orthoses. | 748 | ||
| Circumferential orthoses. | 748 | ||
| Serial orthoses. | 748 | ||
| Step Three: Choosing the Type of Traction | 748 | ||
| Dynamic Traction | 748 | ||
| Static Traction | 749 | ||
| Serial Static Traction | 749 | ||
| Static Progressive Traction | 749 | ||
| Implications of application of force. | 749 | ||
| Amount of force to apply. | 749 | ||
| Duration of traction. | 749 | ||
| Step Four: Choosing an Orthosis Design for a Given Purpose | 750 | ||
| Mobilizing Orthoses to Remodel Scar Tissue and Reduce Contractures | 750 | ||
| Immobilizing and Restrictive Orthoses for Pain Reduction | 750 | ||
| Immobilizing Orthoses for Positioning | 751 | ||
| Step Five: Fabrication | 751 | ||
| Fabrication Techniques for Single-Surface Orthoses | 751 | ||
| Fabrication Techniques for Circumferential Orthoses | 752 | ||
| Fabrication and Fitting of Semiflexible Orthoses and Prefabricated Orthoses | 753 | ||
| Section 2 rm Supports | 754 | ||
| Introduction and Clinical Reasoning | 754 | ||
| Static Arm Supports | 755 | ||
| Dynamic Arm Supports | 756 | ||
| Suspension Arm Devices | 756 | ||
| Suspension Arm Slings | 756 | ||
| Suspension Arm Supports | 756 | ||
| Adjustment of Suspension Arm Devices | 756 | ||
| Mobile Arm Supports | 757 | ||
| How Mobile Arm Supports Work | 757 | ||
| Criteria for Use | 757 | ||
| Goals, occupational performance, and client motivation. | 757 | ||
| Adequate motor control. | 758 | ||
| Adequate source of power. | 758 | ||
| Sufficient passive range of motion. | 758 | ||
| Stable trunk positioning. | 758 | ||
| Freedom from interfering pain. | 758 | ||
| Adequate cognition. | 758 | ||
| Mobile Arm Support Parts and Their Function: The JAECO/Rancho MultiLink Mobile Arm Support | 758 | ||
| Adjustment capabilities of individual parts. | 758 | ||
| MultiLink mount. | 758 | ||
| Forearm support and offset swivel. | 758 | ||
| MultiLink arms. | 758 | ||
| Mobile arm support mount relocators. | 760 | ||
| Arm height adjustor. | 760 | ||
| Other mobile arm supports. | 760 | ||
| Training | 760 | ||
| Freestanding Dynamic Arm Supports | 761 | ||
| Dynamic Arm Supports for the Ambulatory Client | 762 | ||
| Robot-Assisted Therapy | 762 | ||
| Cost | 763 | ||
| Summary | 764 | ||
| Acknowledgments for Section 2 | 765 | ||
| Review Questions | 764 | ||
| References | 764 | ||
| 31 Traditional Sensorimotor Approaches to Intervention* | 766 | ||
| Chapter Outline | 766 | ||
| Learning Objectives | 766 | ||
| Key Terms | 767 | ||
| Overview* | 767 | ||
| Central Nervous System Control of Movement | 767 | ||
| Sensorimotor Cortex | 768 | ||
| Relation to Sensorimotor Intervention Approaches | 771 | ||
| Reflex and Hierarchical Models of Motor Control | 771 | ||
| Section 1 Traditional Sensorimotor Intervention Approaches* | 771 | ||
| Rood Approach | 771 | ||
| Brunnstrom (Movement Therapy) Approach | 772 | ||
| Proprioceptive Neuromuscular Facilitation Approach | 772 | ||
| Neurodevelopmental Treatment Approach | 773 | ||
| Section 1 Summary | 773 | ||
| Section 2 Proprioceptive Neuromuscular Facilitation Approach | 773 | ||
| History | 774 | ||
| Principles of Intervention | 774 | ||
| Motor Learning | 776 | ||
| Auditory System | 776 | ||
| Visual System | 776 | ||
| Tactile System | 776 | ||
| Assessment | 777 | ||
| Intervention Implementation | 777 | ||
| Diagonal Patterns | 778 | ||
| Unilateral Patterns | 778 | ||
| Bilateral Patterns | 779 | ||
| Combined Movements of Upper and Lower Extremities | 780 | ||
| Total Patterns | 780 | ||
| Procedures | 781 | ||
| Techniques | 782 | ||
| Techniques Directed to the Agonist | 783 | ||
| Reversal of Antagonist Techniques | 786 | ||
| Relaxation Techniques | 787 | ||
| Section 2 Summary | 787 | ||
| Section 3 eurodevelopmental Treatment Approach* | 789 | ||
| Historical Context of the Neurodevelopmental Treatment Approach | 789 | ||
| Berta Bobath’s Developing Theory: Original Concepts and Changes Over Time | 790 | ||
| Philosophy of Neurodevelopmental Treatment | 790 | ||
| Key Principles of Neurodevelopmental Treatment | 790 | ||
| Using Neurodevelopmental Treatment to Restore Participation in Occupation | 790 | ||
| Evaluation | 791 | ||
| Intervention | 791 | ||
| Neurodevelopmental Treatment and Evidence-Based Practice | 793 | ||
| Review Questions | 794 | ||
| References | 795 | ||
| Suggested Readings | 796 | ||
| 32 Motor Learning | 798 | ||
| Chapter Outline | 798 | ||
| Learning Objectives | 798 | ||
| Key Terms | 798 | ||
| Theoretical Foundations of Motor Learning | 799 | ||
| Dynamic Systems Theory | 799 | ||
| Task-Oriented Approach | 799 | ||
| Constraint-Induced Movement Therapy | 800 | ||
| Robotics | 805 | ||
| Virtual Reality Technology | 805 | ||
| Bilateral Training Techniques | 805 | ||
| Summary | 805 | ||
| Review Questions | 806 | ||
| References | 806 | ||
| Suggested Readings | 808 | ||
| VI Intervention Applications | 809 | ||
| 33 Cerebrovascular Accident (Stroke) | 809 | ||
| Chapter Outline | 809 | ||
| Learning Objectives | 809 | ||
| Key Terms | 810 | ||
| Definition of Stroke | 810 | ||
| Causes of Stroke | 811 | ||
| Ischemia | 811 | ||
| Hemorrhage | 811 | ||
| Related Syndromes | 811 | ||
| Transient Ischemic Attacks | 811 | ||
| Effects of Stroke | 811 | ||
| Internal Carotid Artery | 811 | ||
| Middle Cerebral Artery | 811 | ||
| Anterior Cerebral Artery | 812 | ||
| Posterior Cerebral Artery | 812 | ||
| Cerebellar Artery System | 812 | ||
| Vertebrobasilar Artery System | 812 | ||
| Medical Management | 812 | ||
| Evaluation and Intervention Procedures for Clients Who Sustained a Stroke | 815 | ||
| Client-Centered Assessments | 816 | ||
| Top-Down Approach to Assessment | 816 | ||
| Effects of Neurological Deficits on Performance in Areas of Occupation | 817 | ||
| Standardized Tools | 817 | ||
| Adopting a Framework for Intervention | 817 | ||
| Functional Limitations Commonly Observed After Stroke | 821 | ||
| Inability to Perform Chosen Occupations While Seated | 821 | ||
| Inability to Engage in Chosen Occupations While Standing | 822 | ||
| Inability to Communicate Secondary to Language Dysfunction | 826 | ||
| Aphasia | 827 | ||
| Global aphasia. | 827 | ||
| Broca’s aphasia. | 827 | ||
| Wernicke’s aphasia. | 827 | ||
| Anomic aphasia. | 827 | ||
| Dysarthria | 827 | ||
| Communication With Clients Who Have Aphasia | 827 | ||
| Inability to Perform Chosen Occupations Secondary to Neurobehavioral/ Cognitive-Perceptual Impairments | 827 | ||
| Inability to Perform Chosen Tasks Secondary to Upper Extremity Dysfunction | 830 | ||
| Integration Into Function | 830 | ||
| Upper Extremity Complications After Stroke | 832 | ||
| Subluxation. | 832 | ||
| Abnormal skeletal muscle activity. | 832 | ||
| Prevention of pain syndromes and contracture | 833 | ||
| Protection of unstable joints. | 833 | ||
| Maintaining soft tissue length. | 833 | ||
| Positioning programs. | 833 | ||
| Soft tissue elongation. | 833 | ||
| Orthotics. | 834 | ||
| Client management. | 834 | ||
| Nonfunctional Upper Extremity | 834 | ||
| Inability to Perform Chosen Tasks Secondary to Visual Impairment | 834 | ||
| Psychosocial Adjustment | 834 | ||
| Summary | 836 | ||
| Review Questions | 838 | ||
| References | 838 | ||
| 34 Traumatic Brain Injury | 841 | ||
| Chapter Outline | 841 | ||
| Learning Objectives | 841 | ||
| Key Terms | 842 | ||
| Epidemiology | 842 | ||
| Concussions | 842 | ||
| Chronic Traumatic Encephalopathy | 843 | ||
| Pathophysiology | 843 | ||
| Focal Brain Injury | 843 | ||
| Multifocal and Diffuse Brain Injury | 844 | ||
| Prevention of Secondary Brain Injuries | 844 | ||
| Coma and Levels of Consciousness | 845 | ||
| Clinical Picture | 846 | ||
| Physical Status | 846 | ||
| Decorticate, Decerebrate, and Motor Rigidity | 848 | ||
| Abnormal Muscle Tone and Spasticity | 848 | ||
| Primitive Reflexes | 849 | ||
| Muscle Weakness | 850 | ||
| Decreased Functional Endurance | 850 | ||
| Ataxia | 850 | ||
| Postural Deficits | 850 | ||
| Limitations of Joint Motion | 850 | ||
| Sensation | 850 | ||
| Integration of Total Body Movements | 850 | ||
| Dysphagia | 851 | ||
| Self-Feeding | 851 | ||
| Cognitive Status | 851 | ||
| Attention and Concentration | 851 | ||
| Memory | 851 | ||
| Initiation and Termination of Activities | 851 | ||
| Safety Awareness and Judgment | 851 | ||
| Processing of Information | 852 | ||
| Executive Functions and Abstract Thought | 852 | ||
| Generalization | 852 | ||
| Visual Status | 852 | ||
| Perceptual Skills | 852 | ||
| Psychosocial Factors | 853 | ||
| Self-Concept | 853 | ||
| Social Roles | 853 | ||
| Independent Living Status | 853 | ||
| Dealing With Loss | 854 | ||
| Affective Changes | 854 | ||
| Behavioral Status | 854 | ||
| Evaluation of the Individual at a Lower RLA Level | 855 | ||
| Intervention for the Individual at a Lower RLA Level | 855 | ||
| Sensory Stimulation | 856 | ||
| Wheelchair Positioning | 856 | ||
| Pelvis | 856 | ||
| Trunk | 857 | ||
| Lower Extremities | 857 | ||
| Upper Extremities | 857 | ||
| Head | 857 | ||
| Bed Positioning | 857 | ||
| Splinting and Casting | 858 | ||
| Dysphagia | 859 | ||
| Behavior and Cognition | 859 | ||
| Family and Caregiver Education | 859 | ||
| Evaluation of the Individual at an Intermediate or Higher RLA Level | 859 | ||
| Physical Status | 859 | ||
| Dysphagia | 860 | ||
| Cognition | 860 | ||
| Vision | 860 | ||
| Perceptual Function | 860 | ||
| Activities of Daily Living | 861 | ||
| Driving | 861 | ||
| Vocational Rehabilitation | 861 | ||
| Psychosocial Skills | 861 | ||
| Intervention for the Individual at an Intermediate or Higher RLA Level | 862 | ||
| Neuromuscular Impairments | 862 | ||
| Ataxia | 863 | ||
| Cognition | 863 | ||
| Vision | 863 | ||
| Perception | 864 | ||
| Behavioral Management | 864 | ||
| Dysphagia and Self-Feeding | 865 | ||
| Functional Mobility | 865 | ||
| Bed Mobility | 865 | ||
| Wheelchair Management | 865 | ||
| Functional Ambulation | 865 | ||
| Community Travel | 865 | ||
| Transfers | 866 | ||
| Home Management | 866 | ||
| Community Reintegration | 866 | ||
| Psychosocial Skills | 867 | ||
| Substance Use | 867 | ||
| Discharge Planning | 867 | ||
| Home Safety | 867 | ||
| Equipment Evaluation and Ordering | 867 | ||
| Family and Caregiver Education | 868 | ||
| Recommendations for Driver’s Training | 868 | ||
| Recommendations for Vocational Training and Work Skills | 868 | ||
| Summary | 868 | ||
| Review Questions | 868 | ||
| References | 868 | ||
| Suggested Readings | 870 | ||
| 35 Degenerative Diseases of the Central Nervous System | 871 | ||
| Chapter Outline | 871 | ||
| Learning Objectives | 871 | ||
| Key Terms | 872 | ||
| Introduction | 872 | ||
| Section 1: Amyotrophic Lateral Sclerosis | 873 | ||
| Pathophysiology | 875 | ||
| Clinical Picture | 875 | ||
| Medical Management | 876 | ||
| Occupational Therapy Evaluation and Intervention | 876 | ||
| Role of the Occupational Therapist | 876 | ||
| Section 1 Summary | 878 | ||
| Section 2: Alzheimer’s Disease | 878 | ||
| Incidence | 879 | ||
| Pathophysiology | 879 | ||
| Clinical Picture | 880 | ||
| Medical Management | 880 | ||
| Role of the Occupational Therapist | 883 | ||
| Evaluation | 883 | ||
| Intervention Methods | 884 | ||
| Section 2 Summary | 885 | ||
| Section 3: Huntington’s Disease | 885 | ||
| Incidence | 885 | ||
| Pathophysiology | 885 | ||
| Clinical Picture | 885 | ||
| Medical Management | 886 | ||
| Role of the Occupational Therapist | 887 | ||
| Section 3 Summary | 889 | ||
| Section 4: Multiple Sclerosis | 889 | ||
| Incidence | 889 | ||
| Etiology | 889 | ||
| Clinical Picture | 889 | ||
| Medical Management | 890 | ||
| Role of the Occupational Therapist | 891 | ||
| Goal Setting and Intervention | 892 | ||
| Section 4 Summary | 893 | ||
| Section 5: Parkinson’s Disease | 893 | ||
| Incidence | 893 | ||
| Pathophysiology | 894 | ||
| Clinical Picture | 894 | ||
| Medical Management | 895 | ||
| Role of the Occupational Therapist | 896 | ||
| Section 5 Summary | 898 | ||
| Review Questions | 898 | ||
| References | 899 | ||
| Suggested Readings | 903 | ||
| Resources | 903 | ||
| 36 Spinal Cord Injury | 904 | ||
| Chapter Outline | 904 | ||
| Learning Objectives | 904 | ||
| Key Terms | 904 | ||
| Acknowledgment | 905 | ||
| Results of A Spinal Cord Injury | 905 | ||
| Complete Versus Incomplete Neurological Classification | 905 | ||
| Clinical Syndromes | 907 | ||
| Central Cord Syndrome | 907 | ||
| Brown-Séquard Syndrome (Lateral Damage) | 907 | ||
| Anterior Spinal Cord Syndrome | 907 | ||
| Conus Medullaris Syndrome | 907 | ||
| Cauda Equina Syndrome | 907 | ||
| Prognosis for Recovery | 907 | ||
| Medical and Surgical Management of the Person With A Spinal Cord Injury | 908 | ||
| Complications After A Spinal Cord Injury | 909 | ||
| Neurogenic Bladder and Bowel | 909 | ||
| Pressure Injuries | 909 | ||
| Orthostatic Hypotension | 909 | ||
| Autonomic Dysreflexia | 910 | ||
| Decreased Vital Capacity | 910 | ||
| Spasticity | 910 | ||
| Heterotopic Ossification | 910 | ||
| Pain | 910 | ||
| Spinal Cord Injury Rehabilitation | 911 | ||
| Rehabilitation Team | 911 | ||
| Goal of Rehabilitation | 911 | ||
| Occupational Therapy Evaluation | 911 | ||
| Occupational Profile | 911 | ||
| Psychosocial Status | 911 | ||
| Clinical Picture | 912 | ||
| Body Functions and Structures | 912 | ||
| Functional Status | 913 | ||
| Establishing Intervention Objectives | 913 | ||
| Occupational Therapy Intervention | 913 | ||
| Phases of Recovery | 913 | ||
| Acute Phase | 913 | ||
| Post-Acute Phase: Inpatient Rehabilitation | 915 | ||
| High tetraplegia/quadriplegia (C1-C4). | 915 | ||
| Tetraplegia (quadriplegia)/high paraplegia (C5-T1). | 919 | ||
| Paraplegia (T2-T12, L1-L5). | 922 | ||
| Incomplete SCI/clinical syndromes. | 923 | ||
| Equipment | 923 | ||
| Outpatient Rehabilitation | 924 | ||
| Sexual Function | 924 | ||
| Sleep and Rest | 925 | ||
| Children and Adolescents With A Spinal Cord Injury | 925 | ||
| Aging With A Spinal Cord Injury | 926 | ||
| Research | 926 | ||
| Summary | 927 | ||
| Review Questions | 927 | ||
| References | 927 | ||
| Resources | 928 | ||
| 37 Disorders of the Motor Unit* | 929 | ||
| Chapter Outline | 929 | ||
| Learning Objectives | 929 | ||
| Key Terms | 929 | ||
| Neurogenic Disorders | 931 | ||
| Peripheral Neuropathies | 931 | ||
| Guillain-Barré Syndrome | 931 | ||
| Role of the Occupational Therapist | 932 | ||
| Poliomyelitis and Postpolio Syndrome | 934 | ||
| Role of the Occupational Therapist | 934 | ||
| Peripheral Nerve Injuries | 936 | ||
| Axillary Nerve Injury | 937 | ||
| Brachial Plexus Injuries | 937 | ||
| Long Thoracic Nerve Injury | 939 | ||
| Psychosocial Interventions for Peripheral Nerve Injuries | 939 | ||
| Neuromuscular Disorders | 939 | ||
| Neuromuscular Junction: Myasthenia Gravis | 939 | ||
| Role of the Occupational Therapist | 940 | ||
| Myopathic Disorders | 940 | ||
| Muscular Dystrophies | 940 | ||
| Role of the Occupational Therapist | 941 | ||
| Summary | 942 | ||
| Review Questions | 943 | ||
| References | 943 | ||
| Suggested Readings | 944 | ||
| 38 Arthritis | 945 | ||
| Chapter Outline | 945 | ||
| Learning Objectives | 945 | ||
| Key Terms | 945 | ||
| Overview of Rheumatic Diseases | 946 | ||
| Osteoarthritis | 946 | ||
| Clinical Features | 947 | ||
| Diagnostic Criteria | 947 | ||
| Medical Management | 948 | ||
| Surgical Management | 948 | ||
| Rheumatoid Arthritis | 949 | ||
| Clinical Features | 949 | ||
| Diagnostic Criteria | 950 | ||
| Medical Management | 950 | ||
| Surgical Management | 951 | ||
| Occupational Therapy Evaluation | 951 | ||
| Client History | 951 | ||
| Occupational Profile | 951 | ||
| Occupational Performance Status | 951 | ||
| Cognitive, Psychological, and Social Status | 952 | ||
| Clinical Status | 952 | ||
| Goal Setting | 957 | ||
| Intervention Objectives and Planning | 958 | ||
| Occupational Therapy Intervention | 958 | ||
| Sleep and Rest | 959 | ||
| Physical Agent Modalities | 959 | ||
| Therapeutic Exercise | 959 | ||
| Therapeutic Activity | 960 | ||
| Splinting | 961 | ||
| Indications | 961 | ||
| Considerations | 961 | ||
| Options | 961 | ||
| Commonly Used Splints for Arthritis | 961 | ||
| Occupational Performance Training | 964 | ||
| Assistive Devices | 965 | ||
| Client and Family Education | 965 | ||
| Disease Process | 966 | ||
| Symptom Management | 966 | ||
| Joint Protection and Fatigue Management | 966 | ||
| Community Resources | 968 | ||
| Summary | 968 | ||
| Review Questions | 969 | ||
| References | 969 | ||
| Suggested Readings | 971 | ||
| Resources | 971 | ||
| 39 Hand and Upper Extremity Injuries* | 972 | ||
| Chapter Outline | 972 | ||
| Learning Objectives | 972 | ||
| Key Terms | 972 | ||
| Examination and Evaluation | 974 | ||
| Observation and Topographic Assessment | 974 | ||
| Assessment of Performance Skills and Client Factors | 975 | ||
| Screening the Cervical Neck and Shoulder | 975 | ||
| Assessment of Movement | 975 | ||
| Limited movement in the shoulder. | 975 | ||
| Impingement tests. | 975 | ||
| Drop arm test. | 975 | ||
| Soft tissue tightness. | 975 | ||
| Assessment of Peripheral Nerve Status | 976 | ||
| Categories of tests. | 976 | ||
| Adson maneuver. | 977 | ||
| Roos test. | 977 | ||
| Upper limb tension test (brachial plexus tension test). | 977 | ||
| Tinel’s sign. | 977 | ||
| Phalen’s test and reverse Phalen’s test. | 977 | ||
| Carpal compression test. | 977 | ||
| Elbow flexion test. | 977 | ||
| Quick tests for motor function in the peripheral nerves. | 977 | ||
| Sensory mapping. | 977 | ||
| Sympathetic function. | 977 | ||
| Nerve compression and nerve regeneration. | 978 | ||
| Vibration. | 978 | ||
| Touch pressure. | 978 | ||
| Two-point and moving two-point discrimination. | 978 | ||
| Modified Moberg pick-up test. | 979 | ||
| Edema assessment. | 979 | ||
| Grip and Pinch Strength | 980 | ||
| Functional Assessment | 980 | ||
| Intervention | 981 | ||
| Fractures | 981 | ||
| Nerve Injuries | 982 | ||
| Radial Nerve | 982 | ||
| Median Nerve | 982 | ||
| Ulnar Nerve | 984 | ||
| Postoperative Management of Nerve Repair | 984 | ||
| Sensory reeducation. | 985 | ||
| Tendon transfers. | 985 | ||
| Tendon Injuries | 986 | ||
| Flexor Tendons | 986 | ||
| Immobilization. | 986 | ||
| Early passive mobilization. | 986 | ||
| Early active mobilization. | 987 | ||
| Post-acute flexor tendon rehabilitation. | 987 | ||
| Flexor tendon reconstruction. | 989 | ||
| Extensor Tendons | 989 | ||
| Total active motion and total passive motion. | 990 | ||
| Complex Injuries | 991 | ||
| Edema | 991 | ||
| Elevation | 991 | ||
| Manual Edema Mobilization | 991 | ||
| Active Range of Motion | 992 | ||
| Compression | 992 | ||
| Wound Healing and Scar Remodeling | 992 | ||
| Wound Care and Dressings | 993 | ||
| Pressure | 993 | ||
| Massage | 993 | ||
| Active Range of Motion and Electrical Stimulation | 993 | ||
| Pain Syndromes | 993 | ||
| Desensitization | 993 | ||
| Neuromas | 994 | ||
| Complex Regional Pain Syndrome | 994 | ||
| Transcutaneous Electrical Nerve Stimulation | 994 | ||
| Joint Stiffness | 995 | ||
| Cumulative Trauma Disorders | 995 | ||
| Elastic Therapeutic Taping | 996 | ||
| Strengthening Activities | 997 | ||
| Computerized Evaluation and Exercise Equipment | 997 | ||
| Weight Well | 997 | ||
| TheraBand | 998 | ||
| Hand-Strengthening Equipment | 998 | ||
| Purposeful and Occupation-Based Activity | 998 | ||
| Functional Capacity Evaluation | 998 | ||
| Work Hardening | 999 | ||
| Consultation With Industry | 999 | ||
| Psychosocial Effects of Hand Injuries | 1000 | ||
| Summary | 1000 | ||
| Review Questions | 1001 | ||
| References | 1001 | ||
| Resources | 1003 | ||
| 40 Orthopedic Conditions | 1004 | ||
| Chapter Outline | 1004 | ||
| Learning Objectives | 1004 | ||
| Key Terms | 1005 | ||
| Introduction to Orthopedic Conditions | 1005 | ||
| Emotional and Social Factors for the Orthopedic Patient | 1005 | ||
| Rehabilitation Team | 1006 | ||
| Section 1: Hip Fractures and Replacement | 1007 | ||
| General Medical Management of Fractures | 1007 | ||
| Etiology of Fractures | 1007 | ||
| Medical and Surgical Management | 1007 | ||
| Types of Hip Fractures and Medical Management | 1008 | ||
| Femoral Neck Fractures | 1008 | ||
| Intertrochanteric Fractures | 1009 | ||
| Subtrochanteric Fractures | 1009 | ||
| Fall Prevention | 1009 | ||
| Hip Joint Replacement | 1010 | ||
| Etiology and Medical Management | 1010 | ||
| Special Considerations for Hip Replacements | 1011 | ||
| Medical Equipment | 1011 | ||
| Role of Occupational Therapy for Clients With Hip Fracture or Hip Replacement | 1012 | ||
| Evaluation and Intervention | 1012 | ||
| Client Education | 1012 | ||
| Specific Training Techniques for Participation in Occupations | 1013 | ||
| Bed Mobility | 1013 | ||
| Transfers | 1013 | ||
| Chair. | 1014 | ||
| Commode chair. | 1014 | ||
| Shower stall. | 1014 | ||
| Tub shower (without shower doors). | 1014 | ||
| Car. | 1014 | ||
| Lower-Body Dressing | 1015 | ||
| Lower-Body Bathing | 1015 | ||
| Hair Shampoo | 1015 | ||
| Homemaking | 1015 | ||
| Sexual Activity | 1015 | ||
| Caregiver Training | 1015 | ||
| Evidence Regarding Occupational Therapy Intervention | 1016 | ||
| Section 2: Knee Joint Replacements | 1017 | ||
| Etiology and Medical Management | 1017 | ||
| Special Considerations for Knee Replacements | 1018 | ||
| Medical Equipment | 1019 | ||
| Role of Occupational Therapy for Clients With Knee Joint Replacement | 1019 | ||
| Evaluation and Intervention | 1019 | ||
| Specific Training Techniques for Participation in Occupations | 1019 | ||
| Bed Mobility | 1020 | ||
| Transfers | 1020 | ||
| Chair or commode chair. | 1020 | ||
| Shower stall. | 1020 | ||
| Tub shower (without shower doors). | 1020 | ||
| Car. | 1020 | ||
| Lower-Body Dressing and Bathing | 1020 | ||
| Homemaking | 1021 | ||
| Sexual Activity | 1021 | ||
| Evidence Regarding Occupational Therapy Intervention | 1021 | ||
| Section 3: Shoulder Joint Replacements | 1021 | ||
| Etiology and Medical Management | 1022 | ||
| Special Considerations for Shoulder Joint Replacements | 1023 | ||
| Role of Occupational Therapy for Clients With Shoulder Joint Replacement | 1024 | ||
| Evaluation and Intervention | 1024 | ||
| Therapeutic Exercise Considerations | 1024 | ||
| Total Shoulder Replacement | 1024 | ||
| Reverse Total Shoulder Replacement | 1025 | ||
| Specific Training Techniques for Participation in Occupations | 1026 | ||
| Sleeping Positions and Bed Mobility | 1026 | ||
| Functional Mobility | 1026 | ||
| Upper-Body Dressing and Bathing | 1026 | ||
| Lower-Body Dressing and Bathing | 1026 | ||
| Homemaking | 1026 | ||
| Evidence Regarding Occupational Therapy Intervention | 1026 | ||
| Summary | 1027 | ||
| Review Questions | 1027 | ||
| References | 1028 | ||
| 41 Low Back Pain* | 1030 | ||
| Chapter Outline | 1030 | ||
| Learning Objectives | 1030 | ||
| Key Terms | 1030 | ||
| Introduction | 1031 | ||
| Common Causes of Low Back Pain | 1031 | ||
| Vertebral Column and Musculature Review | 1031 | ||
| Common Low Back Pain Diagnoses | 1033 | ||
| Occupational Therapy Evaluation | 1033 | ||
| Postoperative Occupational Therapy Evaluation | 1033 | ||
| Occupational Therapy Interventions | 1034 | ||
| Client Education | 1034 | ||
| Body Mechanics | 1034 | ||
| Ergonomics at Work | 1035 | ||
| Energy Conservation | 1036 | ||
| Activity Pacing | 1036 | ||
| Occupational Strength and Endurance Building | 1037 | ||
| Self-Regulation Training and Coping Skills | 1037 | ||
| Stress and Anxiety | 1037 | ||
| Depression | 1038 | ||
| Behavioral Health Interventions | 1038 | ||
| Lifestyle Modifications | 1038 | ||
| Eating | 1038 | ||
| Sleep | 1038 | ||
| Exercise | 1038 | ||
| Medication Management and Cognition | 1039 | ||
| Adaptive Equipment | 1039 | ||
| Postoperative Interventions | 1039 | ||
| Client-Centered Occupational Therapy Analysis | 1039 | ||
| Evaluation | 1039 | ||
| Intervention | 1039 | ||
| Reassessment | 1039 | ||
| Intervention Strategies for Frequently Impacted Occupations | 1040 | ||
| Showering | 1040 | ||
| Dressing | 1040 | ||
| Functional Mobility | 1040 | ||
| Personal Hygiene | 1040 | ||
| Sexual Activity | 1042 | ||
| Sleep | 1043 | ||
| Toileting | 1043 | ||
| Child Care | 1043 | ||
| Pet Care | 1043 | ||
| Computer Use | 1043 | ||
| Driving | 1044 | ||
| Home Management | 1044 | ||
| Organization | 1044 | ||
| Laundry | 1044 | ||
| Dishes | 1044 | ||
| Cleaning | 1045 | ||
| Yard Work | 1045 | ||
| Shopping | 1045 | ||
| Work | 1045 | ||
| Leisure | 1046 | ||
| Other Multidisciplinary Pain Team Members | 1046 | ||
| Physician | 1046 | ||
| Physical Therapist | 1046 | ||
| Pain Psychologist | 1047 | ||
| Summary | 1047 | ||
| Review Questions | 1047 | ||
| References | 1047 | ||
| 42 Burns and Burn Rehabilitation*,****It is important for the reader to recognize that although the American Occupational Therapy Association, to date, does not have an official burn specialization, the American Burn Association (for the burn center verification-type of accreditation) has indicated recommendations for occupational therapists to have the following experiences in order to work with burn patients: extensive experience in (1) intensive care unit and acute care, (2) hand therapy, (3) pediatrics, and (4) upper and lower extremity splinting. | 1048 | ||
| Chapter Outline | 1048 | ||
| Learning Objectives | 1048 | ||
| Key Terms | 1049 | ||
| Incidence of Burn Injuries and Burn-Related Deaths | 1050 | ||
| Skin Anatomy | 1050 | ||
| Skin Function | 1051 | ||
| Mechanism of Injury and Burn Depth | 1051 | ||
| Percentage of Total Body Surface Area Involved | 1053 | ||
| Severity of Injury | 1053 | ||
| Phases of Wound Healing | 1055 | ||
| Inflammatory Phase | 1055 | ||
| Proliferation Phase | 1055 | ||
| Maturation Phase | 1055 | ||
| Scar Formation | 1055 | ||
| Initial Medical Management | 1056 | ||
| Fluid Resuscitation and Edema | 1056 | ||
| Respiratory Management | 1056 | ||
| Wound Care and Infection Control | 1057 | ||
| Topical Antimicrobial Agents | 1057 | ||
| Biological Dressings | 1058 | ||
| Biosynthetic Products | 1058 | ||
| Hydrotherapy | 1058 | ||
| Sepsis | 1059 | ||
| Surgical Intervention | 1059 | ||
| Vacuum-Assisted Closure | 1059 | ||
| Nutrition | 1059 | ||
| Associated Problems and Complications | 1060 | ||
| Stress | 1060 | ||
| Pain | 1060 | ||
| Pain Assessment | 1060 | ||
| Pain Management | 1060 | ||
| Psychosocial Factors | 1061 | ||
| Burn Rehabilitation | 1062 | ||
| The Team | 1062 | ||
| Goals of Rehabilitation | 1062 | ||
| Phases of Recovery | 1062 | ||
| Acute Care Phase | 1062 | ||
| Surgical and Postoperative Phase | 1062 | ||
| Rehabilitation Phase | 1063 | ||
| Reconstructive Phase | 1063 | ||
| Occupational Therapy Evaluation | 1063 | ||
| Occupational Therapy Intervention | 1065 | ||
| Acute Care Phase | 1065 | ||
| Preventive Positioning | 1065 | ||
| Splinting | 1066 | ||
| Activities of Daily Living | 1067 | ||
| Therapeutic Exercise and Activity Tolerance | 1067 | ||
| Client Education | 1067 | ||
| Surgical and Postoperative Phase | 1067 | ||
| Positioning and Postoperative Splinting | 1067 | ||
| Therapeutic Exercise and Activity | 1068 | ||
| Activities of Daily Living and Client Education | 1068 | ||
| Rehabilitation Phase: Inpatient | 1068 | ||
| Reassessment and Intervention Goals | 1069 | ||
| Skin Conditioning and Scar Massage | 1069 | ||
| Compression Therapy | 1069 | ||
| Therapeutic Exercise and Activity | 1069 | ||
| Edema Management | 1070 | ||
| Activities of Daily Living | 1070 | ||
| Splinting | 1071 | ||
| Client Education | 1072 | ||
| Rehabilitation Phase: Outpatient | 1072 | ||
| Reassessment | 1072 | ||
| Therapeutic Exercise and Activity | 1072 | ||
| Scar Management | 1073 | ||
| Activities of Daily Living | 1074 | ||
| Community Reentry | 1074 | ||
| Psychological Adjustment | 1075 | ||
| Discharge From Treatment | 1075 | ||
| Burn-Related Complications | 1075 | ||
| Heterotopic Ossification | 1075 | ||
| Neuromuscular Complications | 1076 | ||
| Facial Disfigurement | 1076 | ||
| Summary | 1080 | ||
| Review Questions | 1080 | ||
| References | 1080 | ||
| Resources | 1082 | ||
| 43 Amputations and Prosthetics | 1083 | ||
| Chapter Outline | 1083 | ||
| Learning Objectives | 1083 | ||
| Key Terms | 1084 | ||
| Section 1: General Considerations in Upper Limb Amputationsa | 1084 | ||
| Causes and Incidence of Amputation | 1084 | ||
| Classification of Amputation Levels | 1084 | ||
| Rehabilitation as a Team Approach | 1085 | ||
| Surgical Management | 1085 | ||
| Section 2: Upper Limb Amputations | 1085 | ||
| Preprosthetic Training | 1086 | ||
| Evaluation | 1086 | ||
| Activities of Daily Living | 1086 | ||
| Wound Healing and Limb Shaping | 1086 | ||
| Pain Management | 1086 | ||
| Desensitization | 1086 | ||
| Phantom Limb Pain | 1087 | ||
| Phantom Limb Sensation | 1087 | ||
| Neuroma | 1088 | ||
| Upper Extremity Range of Motion, Strength, and Endurance | 1088 | ||
| Myosite Testing and Training | 1088 | ||
| Psychological Support | 1089 | ||
| Choosing the Prosthesis | 1090 | ||
| Types of Prosthetic Systems | 1090 | ||
| Body-Powered Prosthesis | 1090 | ||
| Electrically Powered Prosthesis | 1090 | ||
| Hybrid Prostheses | 1091 | ||
| Passive Prosthesis | 1091 | ||
| Activity-Specific Prosthesis | 1091 | ||
| Upper Limb Prosthetic Componentry | 1092 | ||
| Body-Powered Components | 1092 | ||
| Prosthetic sock. | 1092 | ||
| Socket. | 1092 | ||
| Harness and control system. | 1093 | ||
| Terminal device. | 1093 | ||
| Wrist unit. | 1094 | ||
| Transradial hinges. | 1094 | ||
| Elbow units. | 1094 | ||
| Shoulder units. | 1094 | ||
| Electrically Powered Components | 1095 | ||
| Terminal devices. | 1095 | ||
| Wrist units. | 1096 | ||
| Elbow units. | 1096 | ||
| Shoulder units. | 1096 | ||
| Prosthetic Training | 1096 | ||
| Evaluation of the Prosthesis | 1096 | ||
| Donning and Doffing the Prosthesis | 1096 | ||
| Wearing Schedule | 1097 | ||
| Residual Limb Hygiene | 1098 | ||
| Operational Prosthetic Knowledge | 1098 | ||
| Care of the Prosthesis | 1098 | ||
| Intermediate Prosthetic Training | 1098 | ||
| Controls Training | 1098 | ||
| Body-Powered Prosthesis | 1098 | ||
| Electrically Powered Prosthesis | 1098 | ||
| Use Training | 1099 | ||
| Advanced Prosthetic Training | 1101 | ||
| Functional Training | 1101 | ||
| Adaptive Sports and Recreation | 1101 | ||
| Driver Training | 1102 | ||
| Considerations for Bilateral Amputations | 1102 | ||
| Outcome Measures | 1102 | ||
| Current Research and Emerging Technologies | 1105 | ||
| Section 2 Summary | 1106 | ||
| Section 3: Lower Limb Amputations | 1107 | ||
| Levels of Lower Limb Amputation | 1107 | ||
| Causes of Lower Limb Amputation | 1108 | ||
| Postsurgical Residual Limb Care | 1108 | ||
| Lower Limb Equipment and Prostheses | 1108 | ||
| Participation in Occupations | 1110 | ||
| Client Factors | 1110 | ||
| Performance Skills | 1111 | ||
| Performance Patterns | 1111 | ||
| Psychosocial Repercussions | 1111 | ||
| Context, Environment, and Activity Demands | 1112 | ||
| Additional Considerations With Elderly Clients | 1112 | ||
| Review Questions | 1113 | ||
| References | 1113 | ||
| Resources | 1116 | ||
| 44 Cardiac and Pulmonary Disease | 1117 | ||
| Chapter Outline | 1117 | ||
| Learning Objectives | 1117 | ||
| Key Terms | 1118 | ||
| Anatomy and Circulation | 1118 | ||
| What Causes the Heart to Contract? | 1118 | ||
| Cardiac Cycle | 1119 | ||
| Ischemic Heart Disease | 1119 | ||
| Valvular Disease | 1121 | ||
| Cardiac Risk Factors | 1122 | ||
| Medical Management | 1122 | ||
| Cardiac Medications | 1123 | ||
| Psychosocial Considerations | 1123 | ||
| Cardiac Rehabilitation | 1124 | ||
| Sternal Precautions | 1125 | ||
| Monitoring Response to Activity | 1125 | ||
| Heart Rate | 1125 | ||
| Blood Pressure | 1125 | ||
| Anatomy and Physiology of Respiration | 1126 | ||
| Innervation of the Respiratory System | 1126 | ||
| Chronic Lung Disease | 1127 | ||
| Pulmonary Risk Factors | 1128 | ||
| Medical Management | 1128 | ||
| Signs and Symptoms of Respiratory Distress | 1128 | ||
| Psychosocial Considerations | 1128 | ||
| Pulmonary Rehabilitation | 1128 | ||
| Intervention Techniques | 1129 | ||
| Dyspnea control postures. | 1129 | ||
| Pursed-lip breathing. | 1129 | ||
| Diaphragmatic breathing. | 1129 | ||
| Relaxation. | 1129 | ||
| Other treatments and considerations. | 1129 | ||
| Evaluation | 1129 | ||
| Review of the Medical Record | 1129 | ||
| Patient Interview | 1129 | ||
| Clinical Evaluation | 1129 | ||
| Intervention | 1130 | ||
| Progression and Energy Costs | 1130 | ||
| Energy Conservation | 1131 | ||
| Lifestyle Modification | 1131 | ||
| Patient and Family Education | 1131 | ||
| Summary | 1131 | ||
| Review Questions | 1132 | ||
| References | 1132 | ||
| 45 Cancer and Oncology Rehabilitation | 1134 | ||
| Chapter Outline | 1134 | ||
| Learning Objectives | 1134 | ||
| Key Terms | 1134 | ||
| Introduction to Cancer and Oncology Rehabilitation | 1135 | ||
| Treatment Options | 1135 | ||
| Precautions, Contraindications, and Medical Complexity | 1135 | ||
| Radiology and Imaging | 1136 | ||
| Occupational Therapy and Cancer: Domain and Process | 1136 | ||
| Common Assessments Used in Oncology Rehabilitation by Occupational Therapists | 1136 | ||
| Significant Secondary Conditions Related to Cancer and Cancer Treatment | 1137 | ||
| Cancer-Related Fatigue | 1137 | ||
| Cancer-Related Cognitive Dysfunction | 1138 | ||
| Chemotherapy-Induced Peripheral Neuropathy | 1138 | ||
| Cancer-Related Pain | 1139 | ||
| Deconditioning in Oncology | 1139 | ||
| Cardiovascular and Pulmonary Considerations | 1139 | ||
| Psychosocial Issues (Body Image, Depression, Anxiety) | 1139 | ||
| Lymphedema | 1140 | ||
| Palliative Care and Hospice | 1140 | ||
| Summary | 1140 | ||
| Review Questions | 1141 | ||
| References | 1141 | ||
| Suggested Readings | 1141 | ||
| 46 Special Needs of the Older Adult* | 1142 | ||
| Chapter Outline | 1142 | ||
| Learning Objectives | 1142 | ||
| Key Terms | 1142 | ||
| Introduction | 1143 | ||
| Wellness and Productive Aging | 1143 | ||
| Aging in Place | 1144 | ||
| Occupations | 1145 | ||
| Activities of Daily Living | 1145 | ||
| Instrumental Activities of Daily Living | 1146 | ||
| Rest and Sleep | 1148 | ||
| Education | 1149 | ||
| Work | 1149 | ||
| Leisure | 1149 | ||
| Social Participation | 1150 | ||
| Policy Affecting Older Adults | 1150 | ||
| Assessment and Intervention | 1151 | ||
| The Aging Process | 1153 | ||
| Changes in Mental Structures and Functions | 1154 | ||
| Depression | 1156 | ||
| Anxiety | 1156 | ||
| Substance Abuse | 1156 | ||
| Changes in Sensory Structures and Functions | 1157 | ||
| Vision | 1157 | ||
| Hearing | 1158 | ||
| Dual Sensory Loss | 1158 | ||
| Smell and Taste | 1158 | ||
| Changes in Neuromusculoskeletal and Movement-Related Structures and Functions | 1158 | ||
| Changes in Cardiovascular, Hematologic, Immunologic, and Respiratory System Structures and Functions | 1159 | ||
| Changes in Voice and Speech Functions; Digestive, Metabolic, and Endocrine Functions; and Genitourinary and Reproductive Functions | 1160 | ||
| Changes in Skin and Related Structure Functions | 1161 | ||
| Summary | 1162 | ||
| Review Questions | 1163 | ||
| References | 1163 | ||
| 47 HIV Infection and AIDS | 1167 | ||
| Chapter Outline | 1167 | ||
| Learning Objectives | 1167 | ||
| Key Terms | 1167 | ||
| Origins and Current Status of HIV Infection | 1168 | ||
| Infection Process | 1170 | ||
| Transmission | 1170 | ||
| Diagnosis | 1170 | ||
| Pharmacology | 1171 | ||
| Aging and HIV Infection | 1172 | ||
| Neurologic Sequelae of HIV/AIDS | 1173 | ||
| Neuropathies | 1173 | ||
| Dementia | 1174 | ||
| Early Stages of AIDS-Dementia Complex | 1175 | ||
| Later Stages of AIDS-Dementia Complex | 1175 | ||
| HIV/AIDS Pathologies: Client Factors | 1176 | ||
| Positive Prevention | 1176 | ||
| Assessment | 1176 | ||
| Intervention | 1180 | ||
| Prevention of Disability | 1180 | ||
| Education and Health Promotion | 1181 | ||
| Maintaining and Restoring Performance | 1181 | ||
| Modifications, Adaptations, and Compensatory Approaches to Intervention | 1181 | ||
| Advocacy and Psychosocial Considerations | 1181 | ||
| Summary | 1182 | ||
| Review Questions | 1182 | ||
| References | 1182 | ||
| Suggested Readings | 1183 | ||
| 48 Polytrauma and Occupational Therapy* | 1184 | ||
| Chapter Outline | 1184 | ||
| Learning Objectives | 1184 | ||
| Key Terms | 1184 | ||
| Polytrauma | 1185 | ||
| Types of Blast Injuries | 1185 | ||
| Polytrauma Rehabilitation Centers | 1186 | ||
| Polytrauma Transitional Rehabilitation Program | 1190 | ||
| Polytrauma Network Sites | 1191 | ||
| Long-Term Management/Polytrauma Support Clinic Teams | 1193 | ||
| Summary | 1193 | ||
| Review Questions | 1193 | ||
| References | 1193 | ||
| 49 Occupational Therapy in Hospice and Palliative Care | 1195 | ||
| Chapter Outline | 1195 | ||
| Learning Objectives | 1195 | ||
| Key Terms | 1195 | ||
| Hospice and Palliative Care | 1196 | ||
| Evidence Base for Occupational Therapy Services | 1197 | ||
| Role of Occupational Therapy | 1197 | ||
| The Grieving Process | 1197 | ||
| Dying Trajectories | 1198 | ||
| The Terminal Phase | 1199 | ||
| OTPF-3—Domain | 1199 | ||
| Occupation | 1199 | ||
| Client Factors | 1199 | ||
| Values, beliefs, and spirituality. | 1200 | ||
| Body structures and body functions. | 1200 | ||
| Performance Skills and Patterns | 1200 | ||
| Environments and Contexts | 1201 | ||
| Physical environment. | 1201 | ||
| Social environment. | 1201 | ||
| OTPF-3—Process | 1202 | ||
| Evaluation | 1202 | ||
| Kay’s evaluation. | 1204 | ||
| Intervention | 1205 | ||
| Targeting Intervention Outcomes | 1209 | ||
| Clinician Self-Care | 1209 | ||
| Summary | 1210 | ||
| Epilogue | 1210 | ||
| Review Questions | 1210 | ||
| References | 1210 | ||
| Index | 1215 | ||
| A | 1215 | ||
| B | 1217 | ||
| C | 1218 | ||
| D | 1220 | ||
| E | 1221 | ||
| F | 1222 | ||
| G | 1223 | ||
| H | 1224 | ||
| I | 1225 | ||
| J | 1226 | ||
| K | 1226 | ||
| L | 1227 | ||
| M | 1227 | ||
| N | 1229 | ||
| O | 1230 | ||
| P | 1231 | ||
| Q | 1234 | ||
| R | 1234 | ||
| S | 1235 | ||
| T | 1238 | ||
| U | 1239 | ||
| V | 1240 | ||
| W | 1240 | ||
| X | 1241 | ||
| Y | 1241 | ||
| Z | 1241 |