Arley 
I could not agree more!  You are making some of the same points that I believe 
Dr. Sorenesen has made recently with regard to EI (quite a broohaha).  We 
simply don't know how/when to D/C I believe in part because we have not 
established plans of care based on sound clinical reasoning.  We confuse 
altruism with therapeutic intervention (give a man a fish vs. teach a man to 
fish).  This results in treating everyone and everything and if done so long 
enough even the smallest changes/improvements are claimed to be as result of 
treatment.  My two cents.


Neal C. Luther,OTR/L
Rehab Program Coordinator
Advanced Home Care
1-336-878-8824 xt 3205
[EMAIL PROTECTED]

Home Care is our Business...Caring is our Specialty



The information contained in this electronic document from Advanced Home Care 
is privileged and confidential information intended for the sole use of [EMAIL 
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this communication in error, please immediately notify the person listed above 
and discard the original.-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Johnson, Arley
Sent: Friday, September 05, 2008 9:19 AM
To: [email protected]
Subject: Re: [OTlist] Advance for OT Article: Point #3

I would like to start by asking this question: If an OT is treating a stroke 
patient and uses neurofacilitation strategies in their treatment or a peds 
therapist performs prepping techniques prior to her play activities, is there a 
difference when an OT uses PAMs and strengthening exercises with the ortho 
population en route to addressing occupation based deficits?
I think we need to address the root of the problem by appropriate means and 
then bring it home to the patient during and after every session to a 
functional, meaningful implication/connection. 

The thought pattern posed in the original query should prohibit us from being 
on burn units. There is a lot of biomechanical activity going on in this field 
prior to addressing the functional deficits directly. But the therapists are 
aware that without proper splinting, constant ROM and strengthening, the 
ability to regain any true function in any capacity would be limited by skin 
contractures.

I admit, when I did ortho rehab, my supervisors thought I pulled the discharge 
trigger too early, but I wasn't comfortable treating them when they didn't have 
any functional deficits. If pain was present, but didn't limit their engagement 
in their roles successfully, then I recommended the physician to address the 
issue, not therapy.

Just my humble opinion...

Arley Johnson MS, OTR/L

 

-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Ron Carson
Sent: Friday, September 05, 2008 8:28 AM
To: OTlist
Subject: [OTlist] Advance for OT Article: Point #3

=========================================================
SOURCE:

   Advance for OT, Sep 1, 2008, P. 46

Article Title:

   "Injuries  to  the  Wrist: Beneath the Surface of Ulnar
   Wrist Pain."
============================================================

"[OT] treatment generally involved  rest by splinting and activity
modification; reduction of pain and inflammation by cryotherapy and
.. ROM and strengthening..."

Again, recognizing that this article is about treating an injury, is
the above description accurate for OT?  What is different about the
above compared to what PT might do?

IF OT's expertise is occupation, where's the occupation in the above
description?

Thanks,

Ron
-- 
Ron Carson MHS, OT


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