navigation buttonnavigation buttonnavigation buttonnavigation button
heading

NEONATAL STIMULATION AND OCCUPATIONAL THERAPY

An expanding body of research has documented the short-term advantages of gentle touch and massage for healthy term infants and some growing and medically stable preterm infants. These sensations are among the earliest to develop during gestation, and ultimately provide stimulation, organization, communication, and emotional exchange. In response to the recognition that small, fragile preterm infants are reported to significantly react to tactile stimulation, several researchers have implemented a "gentle human touch" model of providing tactile interaction with infants. The occupational therapist can provide a suitable ward program for massage and stimulation. A specialized program with tactile modalities and movement is also incorporated in treating the baby.

 

RECOVERY AND REHABILITATION

After reconstructive hand surgery, patients undergo a supervised program of hand therapy and rehabilitation. Occupational therapy can assist traumatic Injuries such as:

•    Amputations of the fingers and hand
•    Flexor and extensor tendon injuries
•    Fractures and dislocations of the hand and wrist
•    Microsurgical replantation and revascularization
•    Peripheral nerve injuries of the upper extremity

To enhance your recovery and give you the fullest possible use of your hand, your surgeon may recommend a course of rehabilitation (occupational therapy) under the direction of a trained hand therapist. Your therapy may include hand exercises, heat and massage therapy, electrical nerve stimulation, splinting, traction, and special wrappings to control swelling. Keep in mind that surgery is just the foundation for recovery. It's crucial that you follow the therapist's instructions and complete the entire course of therapy if you want to regain the maximum use of your hand.

 

OCCUPATIONAL THERAPY WEEK 3-7 OCTOBER 2016

 What is Occupational Therapy?

  • The assesment and treatment of people, with any injury , illness or disability.
  • The therapy is for all ages from newborn until old age.
  • The therapies forcuses on improving use of the limbs and body for all areas of ones life including self care, household chores, school, work, leisure and sports.
  • is functional therapy and helps an individual become more independent in their daily life activities.
  • The purpose is to help individuals improve their quality of life.

The following services are provided:

  • Hand rehabilitation of adults and children such brachial plexus injury, peripheral nerve injury, tendon injury, fractures, burns, amputations of UL and LL, joint replacement, arthritis.
  • Paediatric conditions:cerebral palsy,birth abnormalities, neonatal & premature birth developmental delays.
  • constraction of pressure garments.
  • splinting for injuries and sport injuries.
  • Plastic and scar management.
  • ordering of assistive devices and other aids for bathing, toileting, etc.
  • caregiver training for family and patients.
  • cognitive rehabilitation following brain trauma.
  • Vocational & functional assesments & work reintegration.

Follow this link for more info on Occupational Therapy week:

http:/otasa.org.za/national-occupational-therapy-week-3-7-oct-2016/

 

BURNS

A burn is a partial or complete destruction of the skin caused by some form of energy usually thermal energy.Burn energy is a complicated injury as it invovled multiple tissue systems including bone, tendon, ligament ,vessel, nerve and skin.Thus the treatments are typically multifaceted.

Rehabilitation plays a critical role in optimising outcomes.Most important is patient education, especially as therapy and home programmes are intensive and time consuming.

The Occupational Therapist assist with wound care, monitoring dressings, and superficial scar management once the wound has healed.This involves the use of pressure garment and other compression devices.

Splints are widely used for reducing swelling and pain and helping with correcting deformities where possible.Addtionally specific excerises are done to mobilise the affected limb and especially in the hand to retrain functionally use, such as gripping.

 

COGNITIVE REHABILITATION

Occupational therapy deals with patients that suffer with a host cognitive problems such as confusion, anxiety,forgetfulness, memory loss, poor concentration and problems following instructions.These problems can occur with dementia, strokes,tumors, brain trauma,the normal ageing process, psychiatric conditions or psychosis with ageing.

Occupational Therapy provides beacon of hope to individuals with these problems by stimulating the brain's ability to execute these functions.This is done by analysing the specific areas and providing individuals with "ëxcerises" for the mind and helping to stimulate these functions using activities that one does in ones own daily life (in lifes task and roles).The aim is to improve cognitive skills as much as possible using various activities such as educational games and an individuals's daily activities.

 


WHAT IS SCAR MASSAGE?

What is Scar Management?

Massaging a scar invovles rubbing and moving the skin underlying tissue in a firm manner.When massaging , it is recommended that you use non purfumed moisturising agent, such as creams (sorblene or vitamin E).This will help moisturise the scar.

Why massage?

Scar tissue becomes hard and raised. Massage can help to soften and flatten the scar tissue.Scar tissue may stick to the underlying muscles, tendons, blood vessels , nerves and bones. Massage can prevent this from happening and help keep the scar tissue flexible. Scars may feel sentitive , tingle or hurt when touched.

Precautions:

Note that you must massage open wounds.if the scar becomes sore, blisters, reopens or the skin develops a rash, stop massaging until the tissue normalises. 

 

OCCUPATIONAL THERAPY IN THE MANAGEMENT OF CEREBRAL PALSY

Cerebral palsy is a medical condition where children have disabilities of movement, speech, cognition, or combination of these problems. These largely develop due to difficulty with pregnancy or birth. 

A family centered approach is used with children who have CP. The Occupational therapist has to work closely with families in order to address their concerns and priorities for their child. The focus is to get the children to be stimulated and involved in the daily routines and families activities.  Parent counseling is also an important aspect of occupational therapy treatment with regard to optimizing the parent's skills in caring for and playing with their child to support improvement of their child's abilities to do things.

Occupational therapists may address issues relating to sensory, cognitive, or motor impairments resulting from CP that affect the child's participation in self-care, productivity, or leisure. Occupational therapy enables individuals with cerebral play to participate in activities of daily living that are meaningful to them.  This involves getting children of all ages to engage in movement, play, learning and scholastic ability.

 

Occupational Therapist may also recommend changes to the play are, changes to the structure of the room or building and seating positioning techniques to allow the child to play effectively.  The occupational therapist typically assesses the child's abilities and difficulties. They assist with adapting the immediate environment and incorporate participation in daily activities.

 

PAIN

There are many causes of pain in the body and this can be quite debilitating as this restricts movement and subsequently function. When pain is chronic, there is limitation of daily activities at home, work and leisure tasks.

Commonly, pain can be soft tissue, muscular, nerve related or boney. Based on the medical cause, occupational therapy can assist to reduce pain with lifestyle modifications, adaptations to the environment and use of assistive devices. Furthermore, occupational therapy has at its disposal many modalities to help reduce pain. This includes soft tissue therapy, use of rigid thermoplastic and/ or soft splints, stretch and strengthening muscle exercises and densensitisation techniques.

The occupational therapist is particularly trained to help people cope with pain by improving their ergonomics when executing their daily activities, especially when pain is chronic in nature. A close relationship with the multidisciplinary team is also undertaken for chronic pain management.

 

RHEUMATOID ARTHRITIS

  • Rheumatoid Arthritis (RA) is a chronic systemic disease characterised by synovial inflammation. It is triggered by the immune system. Early clinical signs of RA are joint swelling and inflammation of the proximal interphalangeal joints (PIPJ), the metacarpal joints and the joints of the wrists.
  • Occuptional therapy is crucial is helping people to live as independently as possible with the condition by trying to retain function in all areas of life.
  • Prevent joint pain and deformity, which includes making appropriate splints
  • Maintain joint mobility (ROM), including hand rehabilitation and post-operative treatment if required
  • Maintain or increase physical endurance
  • Maintain or increase functional ability, which includes providing suitable adaptive equipment and devices
  • Together with the patient, problem solve how to modify daily activities at home or work to protect joints and conserve energy
  • Promote psychological adjustment to chronic disability

 

 

OEDEMA

Oedema refers to fluid retention or swelling. Oedema can occur as an injury response, as when there are fractures and soft tissue injury. The swelling is usually related to the venous (veins) system or the lymphatic system. This injury response can also become exaggerated and cause secondary stiffness of joints, thus retarding movement and use of the limb, especially in the hand. The occupational therapist has many therapeutic modalities and interventions that can help reduce the oedema and so prevent stiffness of the affected area. These include:

  • Compression bandages and pressure garments.
  • Massage techniques, including light and/or deep massage
  • Splints- Thermoplastic braces or casts that support limbs to reduce oedema, or to help stretch contractures and regains lost movement.
  • Types: thermoplastic resting splints,  soft splints and on occasion dynamic splints
  • Use of Elevation as the force of gravity causes oedema to flow proximally.
  • Temperature- use of hand and ice for specific time frames
  • Oedema drill exercises and mobilisation to help move the affected aspect.
  • Modalities such as Infrared, vibration, Stimulators ( TENS and FES) and CPM unit is also incorporated in therapy.

                                                  

SPORTS INJURY MANAGEMENT

Occupational therapy can be beneficial in the treatment of sports injuries especially in the upper extremity, for fractures, dislocations, tendon injuries,  soft tissue injuries and nerve damage. Largely the occupational therapist is involved in rehabilitation after acute medical management has been done, or after surgery has taken place. The management is as follows:

  1. acute care - assessment of the injury, considering surgical or non surgical intervention.

  2. treatment - application of thermoplastic or soft splints, oedema and scar management to reduce pain,  desensitization therapy and advice to encourage healing;
  3. Rehabilitation- progressive management for full return to sport using Range of motion exercises, isolated muscle strengthening and functional use of the hand. Note Conditioning exercises as per sport is not done.

occupational therapy is an important adjunct to the entire team in any sports injury, despite the sport being played as a leisure pursuit, for schools or professionally.

 

OCCUPATIONAL THERAPY AND VOCATION/WORK REHABILITATION

There is a wide range of problems that account for occupational injuries such as  Injury (head, falls or to the limbs), back pain, poor ergonomics, Sprains and muscle strains, Computer neck and Carpal tunnel amongst a few.

The occupational therapist is involved with workplace assessments which includes:

  • examination of the injury status
  • Assisting the injured the client to return to pre-injury level of functioning where possible
  • biomechanical requirements for tasks at work
  • determining availability of alternative/light tasks
  • Communicating with key stakeholders (supervisors, Employers, General Practitioner, Health Professionals) to help the client achieve return to work

 The occupational therapist assists with gradual return to work by focusing on:

  • determining a graded return to work programme
  • supervision and advice regarding work practices such as ergonomics
  • assist the injured client to maintain a safe level of work activity whilst recovering from an injury
  • address barriers to return to work

 

OCCUPATIONAL THERAPY AND NEWBORNS

Research has documented the short-term advantages of gentle touch and massage for healthy term infants and some growing and medically stable preterm infants.

Massage involves touch and handling, and can elicit cutaneous, proprioceptive, vestibular and/or sensory perceptions. These sensations are among the earliest to develop during gestation, and ultimately provide stimulation, organization, communication, and emotional development.

The occupational therapist can provide a suitable program for massage, stimulation and exercises. A specialised program with tactile modalities and movement is also incorporated in treating the baby. Furthermore the program includes a progression of touch, stroking, holding and movement of the infant, and this also helps develop the parent-infant relationships in the NICU phase.

Given that some babies have abnormalities of the limbs, splints are fabricated by the occupational therapist to help correct deformities. This is typically for postural deformities. Strict splinting regimes must be followed, with soft splints rather than thermoplastic being favored.

 

 

SPINAL CORD INJURY

SPINAL CORD INJURY CAN BE ONE OF THE MOST DEVASTATING INJURIES THAT ONE CAN ENCOUNTER GIVEN THE MULTITUDE OF SYSTEMS IN THE BODY THAT ARE INVOLVED, INCLUDING INTERALIA MOTOR, SENSORY, UROGENITAL, PARASYMPATHETICS AND FUNCTIONAL.

REHABILITATION HAS TO BE OF LONG TERM DURATION AND THE FOCUS IS PREVENTATIVE TO AVOID STRUCTURES FROM WEAKENING AND CONTRACTING, REHABILITATIVE TO HELP WITH COMPENSATION AND ADAPTATING TO MOTOR LOSS AND MAINTENANCE IN NATURE TO ENSURE THAT THERE IS NO FURTHER REGRESSION IN MUSCLE STRENGTH.

REHABILITATION CAN BE FRUSTRATING AS OUTCOMES ARE NOT ACHIEVED INSTANTLY AND RATHER OUTCOMES OF SOME GOALS AND MUSCLE RECOVERY CAN TAKE MONTHS TO YEARS. IT IS IMPORTANT TO PERSERVERE AND TO KEEP IN MIND SHORT TERM GOALS WITH YOUR THERAPIST.... AND BY DOING SO THERE WILL BE BENEFITS OF IMPROVED FUNCTIONAL CAPACITY.

FOLLOW THE SUCCESS OF MARK CHARLESWORTH, A VERY DETERMINED AND STRONG WILLED MAN, WHO SUSTAINED A CERVICAL NECK INJURY AND HAD NO MOVEMENT OF THE ENTIRE BODY AND LIMBS. WITHIN 7 YEARS HE HAS SUCCEEDED IN MAKING TREMENDOUS RECOVERY AS HE IS WALKING WITH A WALKING FRAME AND REGAINED ALMOST FULL RETURN OF HAND FUNCTION.HE LITERALLY DEDICATED 4 HOURS OF REHABILITATION PER DAY POST IMMOBILISATION PHASE TO DATE TO IMPROVE HIS CONDITION. HE HAS BEEN GENEROUS ENOUGH TO START A CHARITY FUND (55O STEPS) AND TO RAISE FUNDS HE HAS WALKED UP KZN'S MOSES MABIDHA STADIUM ARCH OF 550 STEPS ON 13TH MAY 2012!!!! SUPPORT HIS CAUSE ON www.550steps.co.za


ARTHRITIS

In the care of arthritis, occupational therapy aims at:

  • Preventing joint pain and deformities, which includes making appropriate splints
  • Maintaining joint mobility (ROM), including hand rehabilitation and post-operative treatment if required
  • Improving overall physical endurance
  • Helping with functional ability, which includes providing suitable adaptive equipment and devices.
  • Assisting to problem solve how to modify daily activities at home or work to protect joints and conserve energy

 

Here are some tips to help you cope with Arthritis:

  • respect pain and thus stop doing an activity if it causes pain
  • balance activity and rest ( work rest work rest principle)
  • use correct pattrens of motion when moving
  • exercise in the range of motion where you dont have pain
  • use adaptive equipment if necessary
  • avoid mantaining one position (eg standing) for prolonged periods of time.
  • try not to do a task that cannot be stopped if it proves to be painful

 

photo

photo

Home   |   Services   |   News   |   Contact

© 2011- 2012 Niki Singh, Durban Occupational Therapist, South Africa.

Website designed by Personalised Promotions in association with SA Medical Specialists.