OTA II
Types of Activities
Class Outline
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Course outline and expectations
Purposeful Activities
Activity Analysis
Adapting and Grading Activity
Therapeutic Exercise
Physical Agent Modalities
In-class Activity Analysis
Assessment
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Attendance & Participation: 10%
Assignment: 15%
Presentation: 15%
Practical Laboratories: 40%
Final Examination: 20%
**Mark the Dates!
Evaluation
Date
Assignment Paper
August 14, 2012
Assignment Presentation
September 4, 2012
Practical Laboratories
Weekly
Final Examination
September 11, 2012
Online Resources
http://occupationaltherapyassistant.edublogs.org
Learning Objectives
Source: CAOT, 2009.
Roles of the OTA
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Expert in enabling occupation
Professional
Communicator
Scholarly Practitioner
Collaborator
Change Agent
Practice Manager
(optional) Focused Skill-Specialist
Introduction
OT’s use purposeful activities in addition to skillful
applications of therapeutic exercise, physical agent
modalities, as well as facilitation and inhibitation
techniques associated with the sensorimotor
approaches to treatment.
OT’s use these strategies to promote the development
of the individual’s ability to engage in Occupational
Performance.
Purposeful Activity
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What makes an activity purposeful?
Why is purposeful activity important?
List examples of purposeful activity
Purposeful Activity:
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Goal directed behaviours or tasks that comprise of
occupations. An activity is purposeful if the individual is
an active, voluntary participant and if the activity is
directed toward a goal that the individual considers
meaningful.
Primary treatment modality of OT
Activity must have an intrinsic or inherent goal beyond
the motor function required to perform the activity
Brings focus for the individual to the goal as opposed to
focusing on the processes required for the activity.
Objectives of use of Purposeful
Activities:
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To maintain strength/ROM/endurance/work tolerance/
coordination
To practice and use voluntary/authentic movement in
activities
To provide purposeful use and general exercise to the
affected parts
To explore vocational potential
To improve sensation/perception/cognition
To improve socialization skills and enhance emotional
growth
To increase independence of occupational performance
Activity Analysis
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A breakdown of an activity where the activity
characteristics match with the performance
components needed in treatment.
Ex. In order to stir ingredients in a bowl during
cooking the person requires two-handed skills,
grasp, grip strength, coordination, and sensation
Can be done from varying approaches, for
example a biomechanical approach (muscles, joints,
motor patterns), vs. a sensorimotor approach
(movement patters and perceptual skills).
Principles of Activity Analysis
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To be goal directed
Have some significance/meaning to the client to meet
individual needs in relation to social roles
Require client’s mental or physical participation
Be designated to prevent or reverse dysfunction
To develop skills to enhance performance in life roles
Relate to client’s interest
Be adaptable/gradable/age appropriate
Be selected through knowledge and professional
judgment of the OT practitioner with the client’s input
Let’s Try!
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Pair up!
Choose an activity that you do in your day to day
life, and ANALYZE!
Share your results with the group
How do I analyze an activity?
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Break the activity down
Determine skills required for each step
Determine where the challenge is present
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Let’s do it together
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Adapting and Grading Activities:
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Adapting Activities: change activities in order to
accommodate for the client’s residual abilities
 Examples?
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Grading Activities: gradual increase in demands to
increase levels of performance as patient’s
capabilities increase
 Examples?
Activity Selection
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Activity selected should relate to desired outcome
Activities should provide repetition
Activities should allow for more than one type of
grading
Activities should remain as close as possible to the
end goal. i.e. Active resistance are most often used
in purposeful activities (ex. Lifting a grocery bag)
Enabling Activities
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Purpose is to engage the patient’s mental and
physical participation, to practice specific motor
patterns, train in perceptual and cognitive skills and
practice sensorimotor skills that will be necessary for
functioning in the home and community
When are they appropriate?
Therapeutic Exercise:
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Exercise (preparation) and activity (application) are
complementary to one another. Both can be part of the
treatment plan if the exercise is applied to a purposeful
activity.
Is used to prepare the patient for occupational performance
Used to decrease or eliminate substitution patterns. (ex.
Holding on to a glass in neutral wrist position vs. too much
pronation (palms down) or too much supination (palms up).
Purpose is to remediate sensorimotor dysfunction, augment
purposeful activity and prepare the patient for doing tasks
in performance areas.
Indications and Contraindications for
use of therapeutic exercise:
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Indications:
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Effective in treatment of orthopedic problems, weakness and flaccidity
Must be able to medically participate in an exercise regimen
Able to understand direction
Be interested and motivated
Potential for recovery or improvement in strength, ROM, coordination, or
movement patterns.
Direct correlation of movements with purposeful activities
Sensation at least partially intact so the patient can perceive motion and
position of exercise part and have some sense of superficial and deep pain
Muscles and tendons must be intact
Have an effective ROM
Relatively free of pain during movements
Client uses proper breathing
No substitute movements are occuring
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Contraindicated for:
 Patients
with poor general health, or inflamed joints or
who have had recent surgery.
 Severely limited ROM caused by well-established
permanent contractures
 Spasticity
 Lack of voluntary control of isolated motion or those
with involuntary movements
Types of Activities
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To increase muscle strength
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Active assisted – OT/OTA helps movement
Active – independently move
Resistive isotonic – contraction of muscle and joint with gravity or weight
Isometric exercises – static without joint movement and only muscle
contraction
To increase muscle endurance
Exercise for physical conditioning and cardiovascular fitness
Exercise to improve coordination
Exercises for ROM and joint flexibility
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Active
passive
Physical Agent Modalities:
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Thermal Modalities
Cooling Modalities
Electrical Modalities
Thermal Modalities
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Types:
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Purpose:
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Paraffin wax use
Hot packs
Whirlpool
ultrasound
Increase ROM
Decrease joint stiffness
Decrease muscle spasms
Decrease edema
Increase blood flow
Assist with treatment strategies (ex. Splinting, stretching)
Contraindications:
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Acute conditions
Clients with sensory loss
Clients with vascular structures
Very young or old clients
Cooling Modalities
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Types:
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Purpose:
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Cold packs
Cooling devices
Ice massage
Decrease edema
Decrease pain
Decrease inflammation
Decrease muscle spasms
Contraindications:
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Clients with cold intolerance
Vascular repairs
Contrast Baths (hot and cold) are sometimes used to increase circulation, which
decreases edema and pain
Electrical Modalities
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Transcutaneous electrical nerve stimulation (TENS)
 Provides
constant electrical stimulation with a
modulated current to reduce pain (ex. Acute/chronic
injuries, after surgery)
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Functional Electrical Stimulation (FES)
 Provides
continuous interrupted current and applied to
motor point of the muscle (ex. Use after nerve injury
Selecting appropriate modalities:
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Occupational performance stage = purposeful
activities
Practice stage = use of enabling activities
Preparation = use of adjunctive modalities
Activity Analysis Exercise
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In groups of 2 (switch partners)
We’re going to try again
Choose a more complex activity to analyze
We will come back and share when you are done