Kari, I think it's a good thing for OT students to learn ROM, MMT,
joint gliding, etc. All that biomechanical stuff certainly has a role
in the OT practice arena. But, I am opposed to two things:
1. OT's learning and applying those bio skills ONLY to the UE
2. OT's making those bio measurements their goals
There is clearly a need to take ROM measurements for such things as
splints, w/c seating, etc. And, I do MMT to help establish medical
necessity for power w/c.
So, I'm not against OT's learning these skills at all. In fact, I
think we should learn more of them. But it's HOW and WHY we apply
these skills that separate us from PT. And, there MUST be a clear line
between OT and PT, otherwise we are going to get gobbled up.
I am not now nor have I ever been anti-PT. But, there is "writing on
the wall" that OT is moving in the wrong direction, and has been for
many years. In my opinion, we are trying to compete with PT in the
phys-dys realm and frankly we can't.
At our fingertips is one thing that separates us from ALL other
professions, and yet we seem so blind.
Man, I love these questions and discussions. My brain is on fire and I
am ever thankful to those who are posting questions and challenging my
statements.
Ron
--
Ron Carson MHS, OT
----- Original Message -----
From: Kari Rogozinski <[EMAIL PROTECTED]>
Sent: Sunday, August 31, 2008
To: [email protected] <[email protected]>
Subj: [OTlist] Elbow Break, Referral...
KR> Measuring ROM and MMS is still very much a part of the curriculum
KR> in OT school. My colleague teaches the phys/dys course at the
KR> local university and they spend ample time making sure the
KR> students can take these measurements, not sure why they would
KR> spend so much time on it if we weren't supposed to be doing them?
KR> I have been practicing for almost 8 years now and i too take
KR> measurements at eval and find they have everything to do with function.
KR>
KR> Ron, it really seems to bother u that other OT's use these
KR> measurements or include what they were trained to do , why is
KR> that? Do you feel that PT's are the only onces that should be taking
measurements?
KR>
KR> IMO, I don't find that there is a clear cut example of specific
KR> OT patient or specific PT patient. PT and OT can and will overlap
KR> in many instances but can work in conjunction with one another to
KR> make the clients as functional and safe as possible. I've never
KR> really seen a patient and thought to myself only a PT can help
KR> them, rather the opposite. I have found that most clients that
KR> are being treated by a physical therapist have functional
KR> limitations that can be addressed by OT.
KR>
KR> Just my thoughts,
KR>
KR> Kari, OTR/L
KR>
KR>
KR>
KR> --- On Sun, 8/31/08, L Sloan <[EMAIL PROTECTED]> wrote:
KR> From: L Sloan <[EMAIL PROTECTED]>
KR> Subject: Re: [OTlist] Elbow Break, Referral..
KR> To: [email protected]
KR> Date: Sunday, August 31, 2008, 9:09 AM
KR> Sorry Ron...I totally disagree...in my 20 years I have always included ROM,
pain
KR> with function....that is how I was trained...maybe school has changed since
KR> then........to me the ROM and pain has everything to do with the
function...I
KR> have always assessed it when doing an evaluation...that is part of my
assessment
KR> as sensation is, coordination, cognition etc. I do not consider that PT....
KR> Lisa
KR> ----- Original Message ----
KR> From: Ron Carson <[EMAIL PROTECTED]>
KR> To: L Sloan <[email protected]>
KR> Sent: Sunday, August 31, 2008 7:09:48 AM
KR> Subject: Re: [OTlist] Elbow Break, Referral...
KR> If the goal is increased ROM or decreased pain, why include the
KR> "functional" component? It seems obvious to me that if ROM/pain
KR> are
KR> the ONLY things preventing the patient from doing self-care, then
KR> positively impacting these area will directly improve self-care. So,
KR> why even include the the "function".
KR> If the goal is occupation, then I see no reason for the ROM/pain
KR> component. As and OT, I strongly believe that occupation should be the
KR> goal, but occupation is not always the goal of the patient or MD. And
KR> it's these situations where OT is out on a limb, because we are truly
KR> practicing OT, but PT.
KR> Ron
KR> --
KR> Ron Carson MHS, OT
KR> ----- Original Message -----
KR> From: L Sloan <[EMAIL PROTECTED]>
KR> Sent: Saturday, August 30, 2008
KR> To: [email protected] <[email protected]>
KR> Subj: [OTlist] Elbow Break, Referral...
LS>> How About....
LS>> Patient will demonstrate increased active range of motion to ____
LS>> during upper and lower body dressing activities.....or...
LS>> Patient will demonstrate increased AROM to ___ to allow patient
LS>> to complete upper and lower body selfcare activities safely...
LS>> Patient will demonstrate a decrease in pain from ___ to ___ to
LS>> enable her to complete her dressing activities.
LS>> ??? Lisa
LS>> ----- Original Message ----
LS>> From: Ron Carson <[EMAIL PROTECTED]>
LS>> To: OTlist <[email protected]>
LS>> Sent: Saturday, August 30, 2008 3:48:47 PM
LS>> Subject: [OTlist] Elbow Break, Referral...
LS>> Received a new referral for a elbow fracture. I shouldn't have
KR> taken
LS>> it but I did.
LS>> And here is the dilemma facing our profession. The patient is
KR> 95,
LS>> previously living independently. Fractured elbow in a fall. Now living
LS>> with daughter. She is in a large amount of pain. Obviously, she
KR> is
LS>> dependent for most of her occupations. She currently uses a cane but
LS>> is not safe.
LS>> The patient's immediate concerns are her elbow. When pressed,
KR> she of
LS>> course wants to go back home, but that is not an immediate goal.
LS>> So what do I write for goals? For example should I write:
LS>> Patient will self-report pain as 3 out of 10
LS>> Patient's will increase active elbow extension to -20
KR> degrees
LS>> These goals seem to direct the patients and doctor's concerns but
KR> are
LS>> not occupationally oriented. So, should I write:
LS>> Patient will safely and independently dress lower body
LS>> Patient will safely and independently ambulate to the
KR> bathroom
LS>> using the least restrictive mobility aid
LS>> I like these goals but they don't address the immediate concerns.
LS>> Ron
LS>> --
LS>> Ron Carson MHS, OT
LS>> --
LS>> Options?
LS>> www..otnow.com/mailman/options/otlist_otnow.com
LS>> Archive?
LS>> www.mail-archive.com/[email protected]
LS>>
KR> --
KR> Options?
KR> www.otnow.com/mailman/options/otlist_otnow.com
KR> Archive?
KR> www.mail-archive.com/[email protected]
KR>
KR> --
KR> Options?
KR> www.otnow.com/mailman/options/otlist_otnow.com
KR> Archive?
KR> www.mail-archive.com/[email protected]
KR>
--
Options?
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