Occupational Therapy: Ue Aromatherapy For Wellbeing

Active range of motion (AROM) is when a joint is moved by the muscles that act on it. AROM promotes fluid movement and decreased edema, as well as preserving movement. Therapists have clients perform AROM to determine whether they are performing within normal limits (WNL) and have the muscle strength to complete a full range of motion (ROM). AROM can be performed within a pain-free range for certain injuries to the arm. However, in cases of a repaired or broken extremity, AROM can cause damage, and Passive Range of Motion (PROM) is recommended instead to promote joint and tissue integrity.

Understanding the underlying problem and the potential damage of AROM

Understanding the underlying problem is a crucial step in addressing any issue, and this is no different when it comes to AROM (active range of motion) and its potential damage. By definition, AROM refers to the movement of a joint through its range of motion, with the individual's muscles acting as the driving force. While this can be beneficial in rehabilitation, it is important to recognise the potential risks involved.

Firstly, let's consider the nature of the problem. In the context of AROM, the issue at hand is typically related to joint injuries or conditions that require rehabilitation. Understanding the specific problem is essential, as it helps determine whether AROM is an appropriate course of action or if alternative approaches, such as PROM (passive range of motion), should be considered.

The potential damage associated with AROM is an important factor to consider. If performed incorrectly or in certain conditions, AROM can cause further injury or complications. For instance, in cases of tendon repairs, AROM can lead to scarring over tendons, hindering their recovery. Additionally, in individuals with a repaired or broken extremity, AROM can cause damage, while PROM can be a safer option for promoting joint and tissue integrity. It is crucial to assess whether performing AROM could result in adverse effects on the patient's condition.

To illustrate this point, consider an example: an individual with a repaired or broken extremity. In such cases, AROM may put excessive strain on the affected area, leading to further damage. On the other hand, PROM can be safely utilised to promote joint and tissue integrity without risking additional harm. This highlights the importance of understanding the underlying problem and the potential consequences of AROM.

Moreover, it is worth noting that the decision between AROM and PROM should be made on a case-by-case basis, as there are instances where AROM is preferable. For instance, with certain arm injuries, AROM within a pain-free range may be recommended. By understanding the underlying problem and potential risks, healthcare professionals can make informed decisions about the most suitable treatment approach.

Assessing the client's ability to perform within normal limits

Assessing a client's ability to perform within normal limits is a key part of the initial assessment by an occupational therapist. The therapist will first identify the major areas of occupation that have been affected by the client's condition and the contributing factors that are impacting the client's occupational performance. This involves understanding the client's diagnosis and the specific factors that are limiting their functional ability.

To assess a client's ability to perform within normal limits, the therapist will have the client perform active range of motion (AROM) exercises. AROM refers to the movement of a joint by the muscles that act on it. The therapist will determine whether the client can perform AROM within normal limits (WNL) and has the muscle strength to complete a full range of motion (ROM). If the client is unable to achieve full AROM, the therapist will assess passive range of motion (PROM). This involves moving the joint to its full range of motion without the client's muscles doing the work.

During the AROM assessment, the therapist will use a goniometer to measure the degrees of motion achieved by the client and record any deviations from the normal range. They will also identify any factors that may be contributing to the client's inability to complete active ROM, such as muscle weakness, pain, or limited flexibility. The therapist will then work with the client to set priorities and goals for rehabilitation, focusing on the areas of occupation that are most important to the client.

It is important to note that the assessment of AROM should be performed within a pain-free range to avoid causing further injury. In some cases, such as with a repaired or broken extremity, AROM can cause damage, while PROM can be safer while still promoting joint and tissue integrity. The therapist must understand the underlying problem and the potential risks of each type of movement to determine the most appropriate treatment approach.

Identifying the contributing factors and addressing them through occupational therapy

Active range of motion (AROM) is when a joint is moved by the muscles that act on it. A therapist may ask a client to perform AROM to determine whether they are performing within normal limits and have the muscle strength to complete the full range of motion. If a client is unable to perform a full AROM, a therapist may assess their passive range of motion (PROM).

As part of the initial assessment, an occupational therapist will develop a "problem list" to identify the major areas of occupation that have been affected by the client's condition. The contributing factors that affect the client's occupational performance are also identified. These contributing factors are the result of the client's diagnosis but are distinct from it. The therapist must identify the specific factors that contribute to the functional limitation.

For example, a client may state that their goal is to "walk again". However, ambulation is a physical therapy goal. The therapist can probe deeper by asking what activities the client wishes to walk for, such as meal preparation or carrying items. The client can then take an active role in goal setting, which has been shown to improve functional outcomes and increase satisfaction with the rehabilitation process.

The functional problem statement has two parts: the area of occupation that is a concern and the contributing factors that are interfering with the client's engagement in that area. The contributing factors that limit engagement in the desired occupation can be identified using the OTPF-III (American Occupational Therapy Association).

Once the contributing factors have been identified, they can be addressed through occupational therapy interventions. These interventions focus on the client's ability to engage in occupation, which distinguishes occupational therapy from other healthcare disciplines.

Educating the client about the purpose and benefits of occupational therapy

Occupational therapy (OT) is a treatment that helps people improve their ability to perform daily tasks and live as independently as possible. It is often used in workplace applications, like returning to work after an injury, but it can also be used to help with other daily activities such as self-care, gardening, cooking, shopping, and dancing. OT can be beneficial for people of all ages who are experiencing limitations in their daily activities due to injury, illness, developmental delays, or emotional or physical problems.

The goal of OT is to help clients regain or maintain their independence and participate in the activities they enjoy. OT can help clients improve their range of motion and strength safely, decrease pain while building strength, and improve visual skills. It can also provide adaptive strategies and equipment, such as jar openers and shower chairs, to help clients perform daily activities more easily and comfortably.

One important aspect of OT is educating clients about the purpose and benefits of the therapy. During the first session, the therapist will talk to the client about their goals and limitations and assess which tasks are most important to them. The therapist will also explain how OT can help the client improve their ability to perform these tasks independently. This may involve therapeutic exercises and activities geared toward the client's specific goals. For example, if a client is having difficulty grasping objects, the therapist might challenge them to a game of chess, knowing that re-learning to grasp the chess pieces will also help them with other daily activities.

In addition to improving physical function, OT can also address emotional and mental health issues. OT can be part of a treatment plan that improves overall physical and mental health, and therapists can connect clients to emotional and social resources to help them feel supported during their daily routine. This may include caregiver training to help caregivers understand the cognitive changes that can occur with certain conditions, such as visual hallucinations and decreased memory in people with Parkinson's disease. By educating clients about the purpose and benefits of OT, therapists can empower them to take an active role in their recovery and improve their quality of life.

Developing an occupational profile and conducting an analysis of the client's performance

Developing an occupational profile and conducting a client performance analysis are crucial steps in understanding a client's needs and creating effective intervention plans. This process is essential when working on occupation-based AROM of UE (upper extremity) and can be guided by the following steps:

Developing an Occupational Profile:

• Identification of the Occupation: Begin by clearly defining the occupation that is the focus of the intervention. This includes understanding the specific job duties, tasks, and responsibilities associated with the occupation.
• Stakeholder Identification and Training: Identify the key stakeholders, including employers, employees, and industry experts. Ensure they are trained and involved in the process of developing occupational standards.
• Task Analysis: Identify the key groups of tasks, functions, and skills relevant to the occupation. Break down the occupation into its core components to understand the specific demands and requirements.
• Learning Outcomes Analysis: Analyze the learning outcomes or competencies required for each group of tasks. This includes identifying the knowledge, skills, and attitudes necessary for successful job performance.
• Occupational Standard Development: Collaborate with stakeholders to draft a comprehensive occupational standard (OS) that outlines the occupation's definition, required competencies, occupational hazards, work environment, career pathways, and any relevant legal provisions.
• Verification and Publication: Verify the OS with sector experts and make improvements as suggested. Once consensus is reached, publish the OS to serve as a reference for curriculum development and training programs.

Conducting a Client Performance Analysis:

• Understanding Client Needs: Assess the client's current level of performance and identify areas where they may be experiencing difficulties or limitations. Understand the underlying problems and goals to tailor the intervention plan accordingly.
• Analysis of Performance Criteria: Evaluate the client's performance against the established performance criteria and standards for the occupation. This includes assessing their knowledge, skills, and attitudes in relation to the required competencies.
• Identifying Gaps: By comparing the client's performance to the occupational standards, identify specific gaps or deficiencies that need to be addressed through intervention.
• Consideration of Client Factors: Take into account individual client factors, such as physical limitations, motivation, and learning style. This ensures that the intervention plan is customized to their unique needs and capabilities.
• Setting Measurable Goals: Based on the analysis, set specific and measurable goals for the client's performance improvement. These goals should be realistic and achievable, with a clear timeframe for progress.

By following these steps, occupational therapists can develop a comprehensive occupational profile and conduct an in-depth client performance analysis, leading to effective and tailored intervention strategies for improving the client's upper extremity function and overall job performance.

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