The following interventions are provided to give an idea of the role of occupational therapy within an acute care setting, which tends to be busy, fast-paced, and may have limited resources of time, equipment, and therapists.
In rehabilitation settings, more in-depth focus may occur, such as completing a wheelchair application for long-term use, or engaging individuals in longer sessions with an opportunity for physical training and practicing daily activities.
In rehabilitation settings, more in-depth focus may occur, such as completing a wheelchair application for long-term use, or engaging individuals in longer sessions with an opportunity for physical training and practicing daily activities.
Seating
Key Measurements (inches):
Cushioning
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Upper Extremity Intervention
Often, we neglect to notice how important the various functions of our upper limbs are to us. Upper extremity function greatly impacts performance in daily life activities (i.e., self-care activities such as eating, bathing, dressing, teeth brushing). Preserving upper limb function is very important to help restore independence and ensure safety upon discharge from your facility.
Note: Please refer to "Sternal Precautions" page, and exert caution as necessary
You may encounter individuals who would benefit from an upper extremity exercise program after events such as:
Upper Extremity Exercise Programs can help or improve:
Upper Extremity Assessment
Due to time restrictions related to large caseloads, and informal upper extremity assessment should be performed prior to providing a patient an exercise program. Institutional formal assessment forms may vary, but will measure the following elements outlined below.
of the...
Shoulder
Elbow and Forearm
Wrist
Hand
As noted, due to time constraints in acute care settings, it is unlikely that an OT will be able to conduct a through upper extremity assessment. A brief examination of the above components should be assessed before providing equipment and a program.
In a rehabilitation setting, therapists may incorporate the following standardized tests into their assessments:
Equipment Suggestions and Intended Focus
Other Ideas
Note: Please refer to "Sternal Precautions" page, and exert caution as necessary
You may encounter individuals who would benefit from an upper extremity exercise program after events such as:
- Heart attack/ cardiac arrest (depending on the amount of time the brain was deprived oxygen)
- Stroke during or after a procedure
- Long recovery period to reach a stable state, and thus became severely deconditioned
- Lack of upper extremity function prior to admittance that should be addressed
Upper Extremity Exercise Programs can help or improve:
- Range of Motion (ROM)
- Strength
- Endurance
- Fine motor/ dexterity
- Function
- Independence
Upper Extremity Assessment
Due to time restrictions related to large caseloads, and informal upper extremity assessment should be performed prior to providing a patient an exercise program. Institutional formal assessment forms may vary, but will measure the following elements outlined below.
- Range of Motion (Active, Passive)
- Strength (Manual Muscle Testing)
of the...
Shoulder
- Flexion/ Extension
- Adduction/ Abduction
- Internal/ External Rotation
Elbow and Forearm
- Elbow Flexion/ Extension/
- Forearm Pronation/ Supination
Wrist
- Flexion/ Extension
- Radial/ Ulnar Deviation
Hand
- Finger Flexion/ Extension
- Finger Adduction/ Abduction
- Finger Opposition
- Dominance (Right or Left)
- Grasp/ Grip Strength
- Pinch (Lateral, Tip-to-Tip, 3-Point)
- Sensation
As noted, due to time constraints in acute care settings, it is unlikely that an OT will be able to conduct a through upper extremity assessment. A brief examination of the above components should be assessed before providing equipment and a program.
In a rehabilitation setting, therapists may incorporate the following standardized tests into their assessments:
- Purdue Pegboard Test
- Mathiowetz Box & Block Test of Manual Dexterity
- 9 Hole Peg Test
- Use a dynamometer to test grip strength (3 trials)
- Use a calibrated pinch guage to test pinch strength (3 trials)
Equipment Suggestions and Intended Focus
- Pegboard and peg (fine motor/ dexterity)
- Stacking cones (targeting, reaching)
- Putty (pinch, grip, endurance, pulling, rolling, simulate cutting with a knife)
- Stress ball (grip strength, endurance
Other Ideas
- Be creative! Adapt programs as the patient improves, making sure to offer a challenge and keep it interesting
- Try to work in or relate exercises to meaningful activities (e.g. knitting, writing)