Re: why is no one writing?

[Quinn McCoy]

Okay, I'm new, and working in pediatrics, but here are some of the frames we learned in school: (get ready for textbook definitions.....) So read over them and choose the ones that mostly fit with your approach to treatment?   1. Biomechanical - body, muscles, how things should work.  PROM, AROM, endurance, joint measurement, muscle strength testing, kinetic activity, therapeutic exercise, orthotics.   2.  Sensory Integration- includes spinning, brushing, proprioception, vestibular stimulation, tactile things, defensiveness, etc.   3.  NDT (neurodevelopmental theory) believed to be effective with any person with abnormal movement due to a central nervous system deficit.  Usually focus is to inhibit abnormal movement patterns and replace them with the normal movement patterns that will provide appropriate sensory information for motor learning.   4.  PNF (proprioceptive neuromuscular facilitation) a method of promoting or hastening the response of the neuromuscular mechanism through stimulation of the proprioceptor.  Remember " UE diagonal patterns of movement"? Includes appropriate positioning, the use of manual contact for positioning or stimulation, and verbal commands and instructions for movement.  Also stretching muscles and providing resistance to movement.  Goal directed movements combined with facilitation techniques are said to be best.   5.  Cognitive-Perceptual Model - built upon an understanding of the brain's information processing ability and its impairment in cases of brain injury.  THis model is concerned with how impaired cognitive and perceptual processes restrict occupational performance.   6.  Claudia Allen's Cognitive Disabilities Frame:  ACL levels, cognitive only, does not take into account physical limitations.   7.  Developmental Model:  applying knowledge of human development to therapeutic intervention.  It is an orderly progression of the patient through developmental levels and stages.  Therapist looks at the person, their motivation, their behaviors, their adaptation abilities, their environment, their limits.  Therapist provides a "growth facilitating environment" and helps the patient move through developmental levels as far as possible.   8. MOHO (model of human occupation)  Human being is made of up 3 subsystems:  Volition, habituation, and mind-brain-body performance.  Humans self-organize through their occupations. Therapeutic occupations should relate to the life circumstances of the individual and the individual's desires and needs for future occupational behavior.  Therapy is very individualized.  (and when is occupational therapy NOT individualized????)   Okay, I'm sure there are plenty more, but I"m starting to get "test anxiety flashbacks" so I think I'll go spin for a while. :) Quinn , OTR/L ----- Original Message ----- From: mr silva To: [EMAIL PROTECTED] Sent: Saturday, August 04, 2001 8:38 PM Subject: why is no one writing? I wonder if maybe people aren't writing because the topics tend to be very deep, and may not be a reflection of what practitioners want to discuss.  For example, when I joined, what I hoped I would find, and what I unfortunately haven't found, is an exchange of treatment ideas for a variety of disabilities/conditions our patients have, and ways to improve our technical skills.  As I'm saying this, however, I do have to ask the group a "deeper" question.  So, I'd like to start dialogues in 2 different directions.  The first is something I really need, asap, as I've got a student coming soon and a form to fill out.  The second dialogue, however, is of far more interest to me.  Here goes:   1.  I've got a Level 1 student coming sooooon, and the school wants to know what Frames of Reference I am using.  Now, I really hesitate to ask this question of you all, as I really, really do no want to get into philosophical discussions.  I'm leaving these issues to the theorists.  I presume Ron is rolling is eyes right now - I'm really not picking on you Ron - but I don't want to get into a discussion about this - I just need some fast, quick help.  I work in home health with a variety of paitents with a variety of conditions.  Can anyone tell me what Frames of Reference they use in this type of setting?   2.  How about we talk about an area that is one of my favorite directions for OT to go into - pulmonary rehab.  For the longest time, I really didn't have a good handle on how to treat these patients, beyond energy conservation.  But a couple of years ago, I found this fabulous website (see attachment above) and which has specific treatment ideas for various conditions - one of the best OT websites around, I believe.  I used this site as a springboard for doing further reading and research into this condition, and it has totally changed the way I work with patients, and has really made me a much more effective practitioner.  Now, whenever I work with a patient with a pulmonary (and often cardiac) diagnosis, I give them an information packet, rich with information, and especially teach them to really listen to what their bodies are telling them (by way of symptoms) and to act accordingly.  For example, if they are cognitively intact, we discuss SOB - what makes them SOB, what makes it worse, better, etc, so they can really start thinking about it.  Very often, they have been SOB for so long, they don't think about it, and only notice it when it is really bad.  However, they can make real changes in their lives if they recognize the early stages of SOB, and learn to "nip it in the bud" right away before it gets worse, by performing proper breathing techniques.  We then discuss the Levels of SOB (I've whittled the levels down to 3 is it is much more user friendly for the elderly) and teach how to apply them.  We actually practice many different ADLs and leisure activities, teaching the patient self-monitoring skills, until they can control their breathing, without my intervening.  I can't tell you what a powerful difference this has made in patients lives, and it was all through this website, jumpstarting ideas and getting me excited about possibilities.    This is what I hope this forum will produce - a real dialogue ideas.  What do you all think?  In exchange for sharing this wonderful website with you, please, please, please, help me with #1 - Frames of Reference - please, please, please!!! Donna