To me, the entire concept of UE strength as the *primary* cause of dependence and UE strengthening as the *primary* method of "optimizing functional independence" is wrong. Experience tells me that most people's loss of independence is related to loss of mobility. Truly, I believe that IF OT's are the functional experts, then we SHOULD be the experts in mobility, not UE function. This is not to say that UE is not important in independence - it's just not what is often MOST important.
Ron ----- Original Message ----- From: Jimmie Arceneaux <[EMAIL PROTECTED]> Sent: Friday, July 01, 2005 To: [email protected] <[email protected]> Subj: [OTlist] "It's A Matter of Strength" JA> Hello, JA> OK, has anyone else read the article titled, "it's A Matter of JA> Strength: Optimizing Functional Independence" in the June 27 JA> edition of Advance for OTs? I cannot for the life of me understand JA> why OTs pigeon hole themselves into the upper extremity thing all JA> the time. The article mentions that OTs do upper extremity JA> strengthening or exercise close to 10 times by my reckoning. This JA> is along with many other unfathomable comments. JA> One quote, "For the geriatric population, upper extremity JA> strength plays a key role in maintaining independence." I suppose JA> strength in the rest of the body has no bearing on independence. JA> Why make a statement like that? JA> Another quote, "In addition, the age-related decline in muscle JA> mass that leads to decreasing upper body strength and endurance JA> often creates difficulties for older people. Without the strength JA> required to perform basic activities of daily living (ADL), many JA> older people become frustrated, eat less, lose self esteem, reduce JA> their socialization, and limit or stop participation in other JA> formerly enjoyable activities." It seems like a chicken before the JA> egg scenario! I feel that the decline in strength is secondary to JA> the occupational dysfunction and that progressing limitation in JA> occupational capabilities and participation in daily occupations JA> leads to many secondary issues including decreased JA> strength/endurance. Although, I can see where their coming from, it JA> would be a clearer example of OT to use a differnet approach (i.e. JA> one focusing on the occupational task and using engagement in JA> purposeful activtiy as a primary means for intervention). JA> They go on to mention regarding observation of inability to JA> transfer, push up from a chair, mobilize around the facility, JA> support their weight and maneuver with a walker and relate this to JA> identify a patient in need of upper extremity strengthening. Did I JA> miss something? Wouldn't the above items more denote an individual JA> in need of lower extremity strengthening? Regardless, why don't JA> they explore the occupational limitations associated with all of the JA> above limitations and focus their interventions appropriately. If a JA> patient is having difficulty as noted above, they would probably JA> have difficulty with self care, productivity and leisure interests. JA> Will upper extremity strengthening ameliorate the occupational JA> issues? If you were to take a biomechanical approach, why wouldn't JA> you prescribe lower extremity strengthening for this type of patient? JA> The most blatant statement reads, "..what sets occupational JA> therapy apart from other therapy disciplines is the focus on tasks JA> and goals that relate to functional activities." It would come as a JA> surprise to most PTs that they don't focus on tasks and goals that JA> relate to function. I really don't believe this is what makes OT a JA> distinct profession. JA> They finish with a statement about getting out the "message" JA> about signs of declining strength and endurance. I would rather JA> they not get that message out...Thank you very much. JA> Jimmie Arceneaux, LOTR JA> Metro Preferred Home Care JA> 3501 N. Causeway Blvd., Ste 200 JA> Metairie, LA 70002 JA> 504-838-7080 JA> Fax 504-833-9309 JA> *** NOTICE--The attached communication contains privileged and JA> confidential information. If you are not the intended recipient, DO JA> NOT read, copy, or disseminate this communication. Non-intended JA> recipients are hereby placed on notice that any unauthorized JA> disclosure, duplication, distribution, or taking of any action in JA> reliance on the contents of these materials is expressly prohibited. JA> If you have received this communication in error, please delete this JA> information in its entirety and contact the Amedisys Privacy Hotline JA> at 1-866-518-6684. Also, please immediately notify the sender via JA> e-mail that you have received this communication in error. *** JA> -- JA> Unsubscribe? JA> [EMAIL PROTECTED] JA> Change options? JA> www.otnow.com/mailman/options/otlist_otnow.com JA> Archive? JA> www.mail-archive.com/[email protected] JA> Help? JA> [EMAIL PROTECTED] -- Unsubscribe? [EMAIL PROTECTED] Change options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/[email protected] Help? [EMAIL PROTECTED]
