Narrow BOS to Wide BOS | Occupational Therapy Interventions

Narrow BOS to Wide BOS

Occupational Therapy Intervention : Balance

Documentation and Activity Rationale

Patient participated in agility-centered activity using a high contrast agility ladder to invoke the vestibular, neuromuscular, muscular, and visual perceptual body systems in order to increase balance, gross coordination, visual perception, agility, invoke involuntary postural correction, attention to task, motor planning, movement intention, and neuromuscular communication. The patient demonstrated difficulty in performing a forward linear pattern which required him to alternate between a narrow BOS and wide BOS x6 step sequence. CGA with x4 errors requiring verbal and visual cues.

Grading Strategies

Grading Up:

add dual task component
more metronome beat
increase speed of task

Grading Down:

stand in one square and complete step pattern
complete at a slow pace

Appropriate Diagnoses / Deficits

Alzheimer’s
Dementias
Memory Changes
Parkinson’s Disease
CVA
TBI

Opening a Jar Activity | Occupational Therapy Interventions

OT Practitioners

Functional Hand Strength – Jar Opening

Occupational Therapy Intervention : Functional Hand Strength

Documentation and Activity Rationale

The patient engaged functional hand strengthening activity in which she was tasked with maintaining a spherical grasp against ‘power web’ resistance. The patient completed x2 repetitions of x3 different sized lids in order to increase intrinsic and extrinsic hand musculature and increase participation in patient-specified meaningful activities like opening jars, pop bottles, medicine bottles, containers, and more.

Grading Strategies

Grading Up:

increase repetitions
increase variability in lid/functional grasp items

Grading Down:

begin with AROM before adding resistance
decrease repetitions
incorporate rest breaks in between each set

Appropriate Diagnoses / Deficits

generalized weakness
atrophy s/p hand and/or wrist surgery

Reaching in Cupboard | Occupational Therapy Interventions

OT Practitioners

Functional Reaching Intervetion

Occupational Therapy Intervention : Functional Reaching

Documentation and Activity Rationale

The patient engaged in an activity requiring him to stand on balance pad [uneven surface] with BLE to evoke balance and right reaction while reaching upward and crossing midline to retrieve yellow theraband. Once yellow theraband secured in grasp, the patient was required to shift his gaze posteriorly, return to forward, and complete cross-midline resistance training. 10 reps each side. This task is used to improve the patient’s ability to maintain balance while reaching up into cupboards which he identified to be a challenge for him.

Grading Strategies

Grading Up:

have pt stand on bosu ball
increase frequency of directional changes
incorporate into an obstacle course

Grading Down:

eliminate dynamic foam pad
complete seated

Appropriate Diagnoses / Deficits

balance deficits
CVA
TBI

Context Based Functional Ambulation Training | Occupational Therapy Intervention

OT Practitioners

Functional Ambulation Training

Occupational Therapy Intervention : Functional Ambulation Training

Documentation and Activity Rationale

Patient engaged in ambulation across multiple terrains for 15 minutes in indoor and outdoor environments in order to improve functional and community mobility. Patient required CGA to navigate elevations and depressions in terrain, but was otherwise independent with ambulation.

Grading Strategies

Grading Up:

increase the difficulty of the terrain
increase time/milage

Grading Down:

start in clinic with busy environment (e.g. chairs, hurdles…)

Appropriate Diagnoses / Deficits

CVA
TBI

Functional Grasp [Reach. Grasp, Place] | Occupational Therapy Interventions

OT Practitioners

Functional Grasp Training

Occupational Therapy Intervention : Functional Grasp

Documentation and Activity Rationale

The patient engaged in reach, grasp, and release activity in which he was challenged with midline crossing, movement intention, grasp release, gross grasp, and modulation of movement. x20 cones were completed within 7m 37s with moderate difficulty and x5 tactile cueing for proper form.

Grading Strategies

Grading Up:

use larger cylindrical objects
use a combination of objects
complete while standing
set up to facilitate trunk rotation
complete seated
decrease amount of cones

Grading Down:

complete seated
decrease amount of cones

Appropriate Diagnoses / Deficits

s/p hand and/or wrist surgery
muscle weakness
CVA
TBI