I'm going to try and answer the questions posed by Ron as an OT student in Canada...
1. Why do OT's treat arms and not legs? My understanding is that we do. Ambulating can be a significant facilitator to engaging in occupations. In this mindset, L/E therapy most definitely falls under the OT realm. I think a common way to split up rehab caseloads is U/E to OT and L/E to PT shoulders and elbows and hands are more immediate to engagement than legs, but really the division seems pretty arbitrary, and maybe just a convenient way to split up a caseload. 2. Aren't MOST PT's better trained to treat physical dysfunction? I don't know. I thought this would be clearer to both us students and the physios after we took and interdisciplinary class, but it just got more blurry. My conclusion is that as long as the client is getting the best and most complete care, from whomever that is, then that theoretically is the right professional. If an OT doesn't feel competent in an intervention, then yes, refer. OR...boost your education and skills in that area. OR...devise a plan where you learn from the PT or vice versa. I don't think it has to be a one or the other thing, even though it often works out that way. Also, if we refer based on the notion that most PT's are more competent in phys med, implying that not all are, then we miss the client-centered premise of OT, by not locating the best care. CM> 3. Where is the line between focused treatment on an UE and focused CM> treatment on occupation? Can both co-exist with the same CM> patient/therapist? Yes, I think so. Occupation for many clients is dependent on physically interacting with the environment, often with hands, which are placed in that environment with shoulders and elbows. I think U/E focused therapy and occupation focussed therapy MUST co-exist. What's the point of having a working limb if you don't have anything to do with it? And what's the point of having something to do if you don't have the physical capabilities to do it? One way it was explained to me: During shoulder rehab, PTs will have their clients do those shoulder circles. BORING. Say the client had a love of painting, then the OT therapy would involve putting a canvas at various planes and angles. The client gets shoulder rehab, based on the clinical expertise of the OT in U/E rehab (the planes and angles and duration part of it) and the client engages in their occupation of painting. And yes, we have been told several times that using the cones is not really OT... _________________________________________________________________ Create a cool, new character for your Windows Live™ Messenger. http://go.microsoft.com/?linkid=9656621 -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/[email protected]
