NAJMA ADAM
LECTURER OCCUPATIONAL THERAPY
DOW UNIVERSITY OF HEALTH SCIENCES/
PINE GROOVE REHABILITATION CENTER
HILAL-E-AHMER
Occupational Therapy
Help for people with
Parkinson’s
Take a moment to think of some of
the things (occupations) you have
done today to attend this lecture….
• Have you had a shower,
• Had breakfast with family,
• Driven a car?
HOW WOULD YOU…
HAVE A SHOWER IF…
• You have rigidity in your muscles?
• You had poor balance?
• You couldn’t reach your arms up
to your hair?
HOW WOULD YOU…
HAVE BREAKFAST WITH FAMILY
IF…
• You couldn’t hold a spoon/fork?
• You take a long time to finish
your meal?
• You just couldn’t cope with
getting out of bed?
HOW WOULD YOU…
DRIVE A CAR IF…
• You were paralyzed from
the waist down?
• You were fearful leaving
the garage?
• You lost the use of your
right hand?
HOW WOULD YOU…
HAVE COME TO ATTEND THIS LECTURE
IF…
• You had pain in your back?
• You heard voices in your
head?
• You had tremors in your
hands?
OCCUPATIONAL THERAPISTS
…have the knowledge and
the skills to help people
overcome these and other
barriers they may face in
doing their everyday
occupations!
What is an
Occupational Therapist?
Health Care
Professionals who
enable people to lead a
more productive,
satisfying, and
independent life.
Who do Occupational Therapists work
with?
Children
Adolescents
Seniors
Adults
Where do Occupational Therapists
work?
•
•
•
•
•
•
Hospitals
Schools/Special schools
Mental Health Facilities
Armed forces
Old Homes
Private Clinics
• Rehabilitation Centers
• Community Health
Centers
• Insurance Companies
• Client Homes
• Client Work Places
THE ROLE OF OCCUPATIONAL THERAPIST FOR
PEOPLE WITH PARKINSON’S
• INCREASE AND MAINTAIN INDEPENDENCE
IN ACTIVITIES OF DAILY LIVING (ADL’s)
• INCREASE MOBILITY & CO-ORDINATION
Activities of Daily Living(ADL’s)
Basic ADL’s
Self care
• Feeding
• Grooming
• Dressing
• Bathing
• Personal hygiene
• Toileting
Instrumental ADL’s
Interaction with physical environment
• Putting things away & getting things
out of the closet
• Telephoning
• Written communication
• Using paper money, checks or coins
• Using books, newspapers &
entertainment equipments
• Using public/private transportation
• Leisure activities
Dressing:
• Warm & light room.
•Firm seat with both feet on the
floor with back supported.
Clothing:
•Easy to handle.
•Light weight
•warm /stretchy fabrics
•Easily laundered
•Cotton – or cotton – polyester
•Wide openings
Aids:
•Elastic laces
•Shoe horn
•Slipper – socks
Eating :
• Begin meal slightly ahead
of the rest of his family
• Eat little and often
• One course of main meal at
midday
• 2nd course on the evening
• Half filled mug(tremor)
Aids:
• Padded /light weight cutlery
• Plate guards
• Non slip mats
• Weighted bracelets (not too heavy)
• Mugs & cups with two enlarged handles
Correct positioning.
It may be useful to reduce
the distance between the
hands and mouth e.g.
raising the table or plate,
or by positioning the
patient so that his elbows
can be used as a pivot in
order to assist hand
movement
Home Safety and Management
•Even floor.
•Non-slip polishes
•Grab rails e.g. bath, toilet, steps.
•Plan but flexible routine will help
to conserve energy.
•Non-iron and dip-dry fabrics.
Carrying aids:
•Net bag clipped to the walking
frame.
•Trolley or an apron with large
pockets all reduce the danger of
tripping
•Alarm system
•Telephone
Bathing:
•Shower chair
•Non-slip bath mat
Beds:
•Firm mattress
•Grab rail by the bed
•Night light luminous
•Alarm clock
•Light left on in the
hallway
Mobility & Co-ordination
Aim
(1) Gait
(2) Balance
(3) Transfers
1. Gait:
Rx Aim:
•
To improve size & rhythm
of the walking pattern
•
Large; rhythmical bilateral
non-resisted movements
Walking
•
Practice using foot outlines
lines marked on the floor
at paced intervals are all
suitable.
•
Activities which encourage
walking should be under
supervision.
2. Balance:Initially
•Work at a balance table.
•Mirror
Later
•Encourage side flexion and
rotation.
•Encouraged to bend and
stoop, such as gardening and
skittles.
•Wedged shoes
•Leather soled shoes
•Weighted clothing.
•Raised chairs /beds.
•Inclined seats reduces the
risk of over balancing when
rising.
Initiating Movement
•Rocking motion with verbal
stimulus
•“one, two, three go!”
•Counting,
•Marching,
•Music, or rhythmic encouragement
•‘step and step and ….’
•One step backward before
attempting to walk forward.
Auditory & visual stimuli (received
when climbing up stairs often makes
this activity easier than walking on
level ground).
3.Transfers:
•Stable & firm surface.
•A firm wedged cushion or rocking
motion for rising from sitting.
•Raise the back legs of a chair
slightly.
•Steady high chair with arm rest.
Co-ordination:
•large bilateral and
rhythmic activities with
little resistance.
•As co-ordination
improves the time spent
on each activity can be
increased and the size of
movement decreased.
•Regular practice of
writing patterns.
Writing:
Initially:
•Blackboard
•large poster-sized sheets
of paper
Later :
•Rhythmical writing
patterns using widely
spaced lines.
•Progressions to writing
letters and words.
Writing aids:
• Padded pens
• Writing board
• Roller ball pen (easier
than fountain or ball
point pen).
Support for the patient and his family
•Reassure
•Therapist should help
the family to be realistic
in their expectations.
•The family should not
expect the patient to
perform activities
beyond his capacity, but
emphasize those he can
do.
Social Activities
Work in small groups (to avoid
isolation and to assist
communication).
•Positive and purposeful.
•Familiar and interesting activities
•A wide variety of stimuli in the form
of colour, sound and touch.
•The therapist should work within the
concentration span of the patient.
•Maintain social contact through
•Hobbies
•Pastimes.
•Visits.
•Outings.
work
•Part-time work.
•less responsibility at work may be
considered.
•It is unwise for the patient to persist
with work to the point where he
becomes exhausted and possibly
unsafe.
REFERENCES
• THE PRACTICE OF OCCUPATIONAL THERAPY
An introduction to the treatment of Physical
Dysfunction (II EDITION-ANN TURNER)
• QUICK REFERENCE TO OCCUPATIONAL
THERAPY ( KATHLYN L.REED)
• WILLARD AND SPACKMAN’S OCCUPATIONAL
THERAPY (XI EDITION)
Take Home Message
ADD LIFE TO YEARS
NOT
YEARS TO LIFE