I first have to agree with Chris....but, my question is did you ask the patient, "Why do you want the range of motion to improve, and why do you want the pain to go away?" I emphasis a movement-strategy-impairment approach to examination. I first observe the patient perform functional tasks, decide if the strategy is faulty, and then hypothesize why (i.e. what impairments cause the faulty strategy in fu8nctional movements). If the patient demonstrates for you particular functional activites and the limitations of the strategy are evident, then you can correlate for her how the range and pain affect function.
Secondly, I don't get it, Ron. Why did the PT say he/she could not do anything for this patient? David A. Lehman, PhD, PT Associate Professor Tennessee State University Department of Physical Therapy 3500 John A. Merritt Blvd. Nashville, TN 37209 615-963-5946 [EMAIL PROTECTED] Visit my website: http://www.tnstate.edu/interior.asp?mid=2410&ptid=1 This email and any files transmitted with it may contain confidential information and is intended solely for use by the individual to whom it is addressed. If you receive this correspondence in error, please notify the sender and delete the email from your system. Do not disclose its contents with others. -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of [EMAIL PROTECTED] Sent: Tuesday, October 21, 2008 11:30 AM To: [email protected] Subject: Re: [OTlist] UE Evauation Yesterday... Ron said: "For sure,?? improving?? her?? elbow? function? will? improve? occupational performance, but the patient's concern is NOT occupation." If the patient is not concerned about her occupations why does she want her elbow to improve in function? And the record player continues! Chris Nahrwold MS, OTR -----Original Message----- From: Ron Carson <[EMAIL PROTECTED]> To: [email protected] Sent: Tue, 21 Oct 2008 9:19 am Subject: [OTlist] UE Evauation Yesterday... Hello Everyone: Yesterday, I received a home health referral for a humeral fracture/tricpes tendon reattachement. By now, I'm sure most regular readers are aware of my stance on OT's NOT being UE experts. Interestingly, PT had already evaled the patient and said they couldn't do anything. So, as I'm sitting there talking with the patient, I'm encouraging her to use her affected UE for daily activity such as eating, dressing, toileting. During this time, I'm thinking there just isn't much role for OT. The patient's concern is ROM and pain, not occupation. For sure, improving her elbow function will improve occupational performance, but the patient's concern is NOT occupation. As I'm sitting there pondering doing ROM, exercises and strengthening the patient tells me that her doctor ordered outpatient PT. Since patients can not be on home health while going to outpatient therapy, I discharged the patient. It was an awkward situation. The family and I discussed the differences between OT and PT and how some OT's treat UE injuries. Ron -- Ron Carson MHS, OT -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/[email protected] -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/[email protected] -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/[email protected]
