Jimmie Arceneaux: "If you were to take a biomechanical approach,
why wouldn't you prescribe lower extremity strengthening for this type
of patient?"
I do believe the above statement from Jimmie has a lot of depth. We have
done and will continue to do ourselves a disservice, if we get stuck on
dividing the body/ systems and not practice our profession holistically as
it should be/ was meant to be ( no matter whatever approach we take-
biomechanical, occupational, motor-behavioral, sensori-integral or whatever,
whether the approaches are taken in isolation or adjunctive with each
other).
Joe
----- Original Message -----
From: "susanne" <[EMAIL PROTECTED]>
To: <[email protected]>
Sent: Friday, July 01, 2005 9:52 PM
Subject: Re: [OTlist] "It's A Matter of Strength"
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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