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Medical Disability Advisor  >  Occupational Therapy

Occupational Therapy


Specialists


  • Cardiologist
  • Internal Medicine Internist
  • Neurologist
  • Occupational Therapist
  • Physiatrist
  • Physical Therapist
  • Psychiatrist
  • Pulmonologist
  • Rheumatologist

Comorbid Conditions


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Factors Influencing Duration


Length of disability depends on the individual's underlying condition, extent of therapy needed, level of individual’s motivation, and individual response to therapy.

Medical Codes


ICD-9-CM:
93.8 - Rehabilitation Therapy
93.83 - Occupational Therapy; Daily Living Activities Therapy
V57 - Care Involving Use of Rehabilitation Procedures
V57.2 - Care Involving Use of Rehabilitation Procedures; Occupational Therapy and Vocational Rehabilitation
V57.21 - Care Involving Use of Rehabilitation Procedures; Encounter for Occupational Therapy

Definition


Occupational therapy is a rehabilitation process that helps individuals perform their daily activities despite the presence of any illness, disability, or injury. The goal of occupational therapy is to help individuals with compromised physical functioning adapt to their impairment(s) to regain optimal function. Three categories of activities are addressed by occupational therapy: activities of daily living, work and productive activities, and recreational or leisure activities.

Activities of daily living are tasks such as grooming, personal health care needs, dressing, bathing, mobility, eating, and communication. Relearning these essential skills decreases dependence on others. Tasks focus on the use of orthotic or prosthetic devices and the adaptation of the individual's physical environment.

Work and productivity activities include home management tasks such as domestic tasks, money/budget management, and job-related activities such as pursuing a career and performing well on the job. Productivity and employability training focus on skills the individual needs to be successful at a job. Work performance skills, safety, grooming, appropriate attire and appearance, psychosocial aspects of the workplace, punctuality, following instructions, use of proper body mechanics, and work habits also may be taught.

Since occupational therapy focuses on the whole person, attention must be given to activities the individual pursues for recreation/pleasure. Individuals are taught about and engage in specific leisure activities and also learn how participation in leisure activities contributes to their overall health and well being.

Occupational therapy interventions focus on the individual within the context of his or her environment, addressing activities that are meaningful to the individual. This may involve modifying the individual’s environment so that participation in desired activities can be resumed. For example, after surgery such as total hip replacement, individuals receive occupational therapy to learn how to dress while protecting the new hip. Individuals may receive occupational therapy following heart attacks (myocardial infarction) or in chronic illness such as pulmonary disease to learn how to perform their daily activities in a manner to conserve energy and oxygen needs. Individuals may receive occupational therapy after injury or surgery to the hand (e.g., carpal tunnel syndrome or carpal tunnel release) to maximize function in the injured hand by regaining dexterity and strength. A further benefit of occupational therapy is education on proper ergonomics for prevention or further injury.

Source: Medical Disability Advisor



Reason for Procedure


Individuals receive occupational therapy if they are unable to fulfill their desired social roles, perform activities of daily living and personal health care needs, perform essential functions at work, or participate in recreational activities, due to physical or mental impairments. Occupational therapy addresses the timely return to both personal tasks such as household management and professional tasks that are found within the individual's job. Conditions such as carpal tunnel syndrome, surgery such as total hip replacement, diseases such as multiple sclerosis, recovery from acute illness such as (cerebral vascular accident-CVA) or myocardial infarction, and mental impairments such as those due to a traumatic brain injury are examples of conditions in which there is a need for occupational therapy intervention.

Some Individuals who engage in occupational therapy do so to maintain functional ability or to adjust to a progressive illness. For example, the individual with multiple sclerosis will be encouraged to use tools such as writing implements with thicker shafts to compensate for impaired hand movement. Individuals also may undergo occupational therapy to help strengthen the arms and hands due to fractures, nerve injuries, or disease processes such as osteoarthritis or rheumatoid arthritis. Individuals learn appropriate ergonomics and exercises to increase dexterity and grip strength and to increase range of motion in the extremities.

Source: Medical Disability Advisor



How Procedure is Performed


Occupational therapists evaluate physical and mental function and an individual's ability to perform daily, necessary tasks. They evaluate range of motion, strength, sensation, balance, fine motor coordination, and cognition to determine where deficits may lie. In addition, occupational therapists evaluate home and work environment to enable accessibility and safety in these areas. The specific therapeutic measures employed take into account the individual's needs and interests. Following interviews, observation-specific tests, and physical measurements to establish a baseline, a program of specific goal-oriented activities and instruction is designed for the individual. Therapy is conducted either on an individual basis or as part of group therapy.

Occupational therapists may provide education on and general exercises for strengthening and stretching the musculoskeletal system. Occupational therapists may have individuals perform exercises to improve fine motor coordination. Individuals who have altered sensation in an area of the body may undergo desensitization techniques. Individuals may engage in practice of activities of daily living. They may learn strategies for home management such as planning household tasks to decrease the amount of energy that is expended. Individuals may learn adaptive strategies for work such as using an ergonomic keyboard to prevent carpal tunnel syndrome. Individuals may learn community mobility such as maneuvering a wheelchair in a store. They may learn to compensate for thinking process (cognitive) deficits by writing down any instructions they need to remember.

Source: Medical Disability Advisor



Prognosis


Therapeutic outcomes vary depending upon the individual's severity of the diagnosis, pre-existing and co-existing conditions, access to health care, financial coverage for health care, the individual's motivation, and availability of social support. Therapeutic outcomes are generally good for individuals with acute impairments (e.g., rotator cuff injury). Those persons with severe, chronic, or multiple deficits may see delayed and or marginal improvement during therapy. In some cases, recovery gains may continue to occur well after the formal therapy program has been completed.

In general, those individuals who receive occupational therapy achieve faster recovery than those individuals who do not participate in rehabilitation programs. For individuals with neurological diagnoses such as stroke or spinal cord injury, rehabilitation is crucial for recovery of function. Most individuals can expect to engage to their maximum functional ability in the activities that they participated in prior to disability either independently or by using adaptive equipment.

Source: Medical Disability Advisor



Complications


Individuals may experience muscle pain due to exertion. Individuals may also experience pain due to over-exertion from being progressed too quickly.

Source: Medical Disability Advisor



Return to Work (Restrictions / Accommodations)


Many persons treated with occupational therapy continue to work. If the occupational therapy requires the use of hand splints, an individual whose job requires extensive hand use may require temporary reassignment to other duties. Work restrictions and accommodations will need to be tailored to the individual's disability. The occupational therapist may need to visit the work site to observe/assess the essential functions of the job before making recommendations for accommodations or alternate job placement.

Source: Medical Disability Advisor



General References


Redford, John B. "Assistive Devices." Practice of Geriatrics. Eds. Edmund H. Duthie and Paul R. Katz. 3rd ed. Philadelphia: W.B. Saunders, 1998. 173-186. MD Consult. Elsevier, Inc. 22 May 2005 <http://home.mdconsult.com/das/book/body/0/852/1.html>.

Source: Medical Disability Advisor






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