Hey Joe,
Thanks for the neologism for good handwriting!  I'll have to use that
sometime to see the surprised look on people's faces. :) 

-----Original Message-----
From: Joe Wells [mailto:[EMAIL PROTECTED] 
Sent: Thursday, July 31, 2003 9:39 PM
To: [EMAIL PROTECTED]
Subject: Re: [OTlist] what is OT?

Hi Ron/ Jimmie:

Just my views:

Ron stated "The  PT  has  evaluated  her and began treating with the
> following  modalities:  hot/cold,  cervical  traction,  TENS,  isometric
> stretches  and  massage.  All  of these are functional activities in the
> sense  that  each modality has a function. "

These are defined as strictly modalities/ procedures both by payor sources
(modalities/ procedures to facilitate function). However, as an Occupational
therapist, I also view it as a "function/ occupation" that the physical
therapist is involved in to "meaningfully" carry out his vocational role. So
its application becomes a functional activity for the PT and its result,
outcome, fruit perpetuates 'function' of some kind (in this case physically)
for the person receiving it. Functional activities as normally described,
are activities that the person is engaged in doing- walking, feeding,
dressing, etc..

I agree all these modalities have a function but a telephone, camera, desk
all though having some kind of function,( e.g, to enable communication, to
help visual memories, or to help writing/ reading) are not 'functional
activities', these may be seen as 'means' ( if they were adapted/ medically
prescribed they would then become  'modalities' ;-)) to facilitate
functional activities such as to communicate adequately  with a son living
in Japan, photoshoot for a living, or perform homework with 'eugraphia'
(just made a word from 'euphoria'- to make it mean 'good handwriting':-))

However, to me these modalities may facilitate functional improvement-
increase in spinal movements, decrease in pain/ stiffness, etc.. If the
restriction in movement,pain and stiffness had caused difficulty either
physically, mentally or emotionally to allow routine or not routine
activities that a person should or wishes to indulge in, then it had caused
an 'occupational dysfunction/ limitation'. Hence, I believe a loss of human
functioning in its truest sense from perspectives of physical, mental and
emotional functioning does cause a 'meaningful' loss to the person, and gain
of function with the same perspectives facilitates his/her occupation in
activities that he must or wants to engage in. The degrees of functional
gains is directly related to 'occupational' gains. E.g: a) No voluntary
control R upper extremity (R-UE)/ L UE-AE amputee (so that we do not talk
about one handed tech.)= Zero UE "function"="dependent self feeding"  b)
Late stage 4 Brunstorm: 90 degrees elbow flexion/ mid-prone forearm/ fair
vol. control (function)= "moderate assist feeding" c) Stage 6 Brunstorm: 130
degrees elbow flexion/ normal vol control (function)= "independent feeding"

To me "function" already means it's good, normal, physiological; hence
meaningful and relevant; if not I would term it as "dysfunction"- abnormal,
subnormal, pathological, and obviously detrimental to the 'meaningful' and
'relevant' engagement in human life.

I agree, that only the client judges the true 'meaning' of a function, what
does lifting her hand really mean- waving, combing her hair, or able to say
"cheers"- and that function thus, transcribes into her 'occupation' to
comminicate, care for self, or socialize respectively.

Ron- excerpts from your site:

"Function:

The action for which a person or thing is particularly fitted or employed.
Source: Dictionary.com


The definition on function for a 'person' indicates 'action' for one is
fitted (suited?  Per age, sex, or culturally); and employed (vocationally/
occupied in). So function and occupation are really too, close. They are
mainly differentiated in the academia/ linguistics.

To me whether we are PT, OT, SLP, MD, DC or what not, based upon what our
practice acts state, we are all, in parts or wholly, involved to facilitate
human 'functioning' (physical, mental, social/ emotional) via modalities/
procedures such as exercises, augmentative devices, surgeries, medication,
counseling, etc....and all these ofcourse, improves or at least are intended
to improve the client's ability to engage in 'occupations' that he/ she
should normally or wishes to engage in!

Just my thoughts.

Joe

P.S:

Ron, your wife is right- Male OTs do have a lot to say. Hope she is feeling
better.








----- Original Message -----
From: "Ron Carson" <[EMAIL PROTECTED]>
To: "Jimmie Arcenaux" <[EMAIL PROTECTED]>
Sent: Thursday, July 31, 2003 8:38 PM
Subject: Re: [OTlist] what is OT?


> Hello Jimmie:
>
> I  tend  to disagree with your statement that: "A functional activity by
> its definition has meaning and relevance to the individual's life" Well,
> maybe  I  don't  disagree 100% with the statement but from a therapeutic
> perspective, I will disagree. Here's an example.
>
> My  wife recently began seeing PT for what was diagnosed as degenerative
> disk  disease.  However, these activities may
> have  little  meaning  and relevance to my wife's life. Yes, they may be
> improving her spinal function but are the activities full of meaning and
> relevance. Probably not, but in truth only she can answer that question.
>
> And  I  think  that  points  to  one  of the biggest differences between
> function  and  meaning.  Something's  function  is  what  you see on the
> outside,  however,  something's  meaning  is what one experiences on the
> inside.  There is almost no way that you can look someone engaging in an
> activity,  regardless  of  its  function,  and understand the activities
> meaning  and  relevance  to  the client. Only the client experiences the
> meaning  so  only  the  client  can  fully  express  the meaning.
>
> Almost  everything  in  which  a  person  engages  or  experiences has a
> function.  But of that in which we engage, how much has true meaning and
> relevance?
>
> I  guess  the  debate  begs the question, what is the difference between
> function  and  occupation. For my opinion on this question , I point you
> to the following link: www.otnow.com/newsletter/current_newsletter.htm
>
> Thanks for the interesting debate,
>
> Ron
>
> P.S. My wife says that male OT's always have a lot to say!!! :-)
>
> =============================================
>
> On 7/30/2003,[EMAIL PROTECTED] wrote:
>
> JA> Biraj,
>
> JA> Are you implying that "activities which an individual needs to do or
is
> JA> expected to do" are not functional? I agree that occupation is a
broader
> JA> concept, but I believe what is occupational is also functional.
Occupation
> JA> to me is the work of living as a human being.  A functional activity
by its
> JA> definition has meaning and relevance to the individual's life.
>
> JA> Thanks Brian for the reference to the roots of OT.  I could not agree
with
> JA> you more.
>
> JA> Jimmie
>
> JA> -----Original Message-----
> JA> From: Incandescent [mailto:[EMAIL PROTECTED]
> JA> Sent: Wednesday, July 30, 2003 9:04 AM
> JA> To: [EMAIL PROTECTED]
> JA> Subject: Re: [OTlist] what is OT?
>
> JA> Hi Jimmie:
>
> JA> Not to put too fine a point on this but my sense is that when viewed
from
> JA> the
> JA> perspective of activities "Occupational" is a distinct and larger
concept
> JA> than
> JA> "functional". The former also includes within it what is meaningful to
the
> JA> individual, whereas "functional" as the word implies refers to those
aspects
> JA> of
> JA> activities which an individual needs to do or is expected to do - thus
> JA> functional.
>
> JA> What do others think?
>
> JA> Biraj
>
> JA> Jimmie Arcenaux wrote:
>
> >> I believe also that the use of occupational or "functional" (I hate
using
> >> that term because it is coined well too often by OTs) activities as the
> >> primary treatment modality is a hallmark of occupational therapy.  It
is
> >> what the professions history is based upon.
> >> Jimmie
>
>
>
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