I was going to ask you for a link to that article, Jimmie, but
then I found it - here:
http://occupational-therapy.advanceweb.com/common/EditorialSearch/AViewer.aspx?AN=OT_05jun27_otp40.html&AD=06-27-2005
Yes - I find it sad also - and not just from on OT point of view - but
also - what happened to "preventive thinking"? (Not quite sure
how to say this in English). All these people mentioned, from my point
of view, could have been "caught" much earlier? And also - motivation
and options for "residents" to keep up their activities is never once
mentioned.....
Susanne, denmark
----- Original Message -----
From: "Jimmie Arceneaux" <[EMAIL PROTECTED]>
To: <[email protected]>
Sent: Friday, July 01, 2005 11:08 PM
Subject: [OTlist] "It's A Matter of Strength"
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
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