Hello,

OK, has anyone else read the article titled, "it's A Matter of Strength:  
Optimizing Functional Independence" in the June 27 edition of Advance for OTs?  
I cannot for the life of me understand why OTs pigeon hole themselves into the 
upper extremity thing all the time.  The article mentions that OTs do upper 
extremity strengthening or exercise close to 10 times by my reckoning.  This is 
along with many other unfathomable comments.

One quote, "For the geriatric population, upper extremity strength plays a key 
role in maintaining independence."  I suppose strength in the rest of the body 
has no bearing on independence.  Why make a statement like that? 

Another quote, "In addition, the age-related decline in muscle mass that leads 
to decreasing upper body strength and endurance often creates difficulties for 
older people.  Without the strength required to perform basic activities of 
daily living (ADL), many older people become frustrated, eat less, lose self 
esteem, reduce their socialization, and limit or stop participation in other 
formerly enjoyable activities."  It seems like a chicken before the egg 
scenario!  I feel that the decline in strength is secondary to the occupational 
dysfunction and that progressing limitation in occupational capabilities and 
participation in daily occupations leads to many secondary issues including 
decreased strength/endurance.  Although, I can see where their coming from, it 
would be a clearer example of OT to use a differnet approach (i.e. one focusing 
on the occupational task and using engagement in purposeful activtiy as a 
primary means for intervention).

They go on to mention regarding observation of inability to transfer, push up 
from a chair, mobilize around the facility, support their weight and maneuver 
with a walker and relate this to identify a patient in need of upper extremity 
strengthening.  Did I miss something?  Wouldn't the above items more denote an 
individual in need of lower extremity strengthening?  Regardless, why don't 
they explore the occupational limitations associated with all of the above 
limitations and focus their interventions appropriately.  If a patient is 
having difficulty as noted above, they would probably have difficulty with self 
care, productivity and leisure interests.  Will upper extremity strengthening 
ameliorate the occupational issues?  If you were to take a biomechanical 
approach, why wouldn't you prescribe lower extremity strengthening for this 
type of patient?

The most blatant statement reads, "..what sets occupational therapy apart from 
other therapy disciplines is the focus on tasks and goals that relate to 
functional activities."  It would come as a surprise to most PTs that they 
don't focus on tasks and goals that relate to function.  I really don't believe 
this is what makes OT a distinct profession.

They finish with a statement about getting out the "message" about signs of 
declining strength and endurance.  I would rather they not get that message 
out...Thank you very much.


Jimmie Arceneaux, LOTR
Metro Preferred Home Care
3501 N. Causeway Blvd., Ste 200
Metairie, LA 70002
504-838-7080
Fax 504-833-9309

*** NOTICE--The attached communication contains privileged and confidential 
information.  If you are not the intended recipient, DO NOT read, copy, or 
disseminate this communication.  Non-intended recipients are hereby placed on 
notice that any unauthorized disclosure, duplication, distribution, or taking 
of any action in reliance on the contents of these materials is expressly 
prohibited.  If you have received this communication in error, please delete 
this information in its entirety and contact the Amedisys Privacy Hotline at 
1-866-518-6684.  Also, please immediately notify the sender via e-mail that you 
have received this communication in error. ***

--
Unsubscribe?
  [EMAIL PROTECTED]

Change options?
  www.otnow.com/mailman/options/otlist_otnow.com

Archive?
  www.mail-archive.com/[email protected]

Help?
  [EMAIL PROTECTED]

Reply via email to