Seated Mobility and and AROM Group | Occupational Therapy Intervention

Seated AROM and Mobility – Group

Occupational Therapy Intervention : Group Intervention

Documentation and Activity Rationale

The patient engaged in AAROM of RUE working proximally to distally (shoulder flexion, shoulder abduction, adduction) within 2 planes (15 repetitions each movement) as well as trunk flexion in order to decrease tone, increase strength and mobility, and re-establish correct movement patterns for ongoing independence with ADLs and IADLs important to his quality of life. The patient is noted to have ongoing hemiplegia in RUE and demonstrates elicitation of AROM to approximately 40% of WNL due to continued mm. weakness.

Grading Strategies

Grading Up:

complete standing
add weighted long-bar to exercise sequence

Grading Down:

decrease repetitions
add rest breaks in between sets

Appropriate Diagnoses / Deficits

generalized weakness
balance deficits (when completed standing)
CVA
TBI

Visual Perceptual Retrieval Task | Occupational Therapy Interventions

OT Practitioners

Visual Perceptual Retrieval Task

Occupational Therapy Intervention : Visual Perceptual

Documentation and Activity Rationale

The patient engaged in a visual-perceptual retrieval task in which he was challenged with navigating the environment, motor planning, floor level reaching, dynamic balance, gait clearance, and LE strengthening for scaling the aerobic stepper. The patient was asked to pick up 3 beanbags with specified colored and displayed poor auditory processing and trunk flexion in order to successfully complete the task. The patient was noted to pull the bean bag up his leg in order to efficiently grasp it.

Grading Strategies

Grading Up:

longer obstacle course
more hurdles/activity
integrate dual-tasking

Grading Down:

place items on elevated surfaces
decrease stepper height
“pick up as many as you can”

Appropriate Diagnoses / Deficits

balance deficits
memory Changes
CVA
TBI

Intrinsic Hand Strength | Occupational Therapy Interventions

OT Practitioners

Intrinsic Hand Strengthening

Occupational Therapy Intervention : Hand Strengthening

Documentation and Activity Rationale

The patient engaged in intrinsic hand musculature strengthening in which she was tasked with isometric holds of the following pinch grasps: 3-jaw chuck, tip-to-tip, and lateral pinch. 5 second holds were completed of each x10 repetitions with rest breaks in between each set d/t fine motor fatigue.

Grading Strategies

Grading Up:

consistently use max resistance eggs
increase isometric holds
hold the egg at end range and complete “pulse” repetitions

Grading Down:

light resistance eggs

Appropriate Diagnoses / Deficits

generalized weakness
atrophy s/p hand and/or wrist weakness
CVA
TBI

Getting Up from Ground Level | Occupational Therapy Intervention

OT Practitioners

Getting up from Ground Level

Occupational Therapy Intervention : Functional Intervention

Documentation and Activity Rationale

The patient engaged in a transfer from ground level in quadruped position to standing independently using furniture for assistance. The patient was tasked with motor planning, weight shifting through all extremities. Therapist provided education in safety awareness and proper body mechanics throughout the floor to stand transfer in order to increased patient ability to achieve independent functional mobility without assistance.

Grading Strategies

Grading Down:

supply a pillow for the patient’s knees
use a sturdy chair or ottoman to help the patient boost self

Appropriate Diagnoses / Deficits

older adults
balance deficits
CVA
TBI

Memory Obstacle Course | Occupational Therapy Interventions

OT Practitioners

Memory Obstacle Course

Occupational Therapy Intervention : Dual Tasking

Documentation and Activity Rationale

The patient engaged in a dual-tasking obstacle course designed with alternating (3) hurdles with 6″ rise 2″ run and (3) aerobic steps 8″ rise by 13″ run to simulate various obstacles required during continuous community mobility. The patient was given 2-4 instructions varying between the difficulty of single-step and multi-step commands in order to assess and enhance working memory, topographical orientation, selective attention, sustained attention, and emotional regulation under pressure.

Grading Strategies

Grading Up:

more complex image
more hurdles/activity
less cues

Grading Down:

remove the hurdles
less busy environment

Appropriate Diagnoses / Deficits

Alzheimer’s
Dementias
Memory Changes
Attention deficits [alternating/divided]
CVA
TBI