Lower Body in Occupational Therapy
General:
Occupational therapy practitioner CAN treat the lower body! In fact, in many ways, an occupational therapy practitioner is the BEST practitioner to take lead on lower body rehabilitation and restorative therapy. Despite what you may have learned…or maybe never learned in school…an occupational therapy practitioner should know just as much, if not more about the lower body as they do about the upper body! Occupational therapy practitioners treat the entire body! If your patient wants to do any of the activities found within the 8 domains of occupational therapy, they will need their occupational therapy practitioner to address mobility including restoring function, restoring structures, enhancing performance skills, and maximizing independence. This is a continuum!
So what are some things an occupational therapy practitioner can do for the lower body?
Assign & Train
Assigning and training an Adaptive Equipment and Duable Medical Equipment
Increase safety and efficiency of gain or standing
Prevent deformity or impairment
Determine wheelchair and seating needs
Determine walker, care, mobility aid
ASSESS
Assessing gait, posture, and body mechanics to restore musculoskeletal and neuromuscular function
Gait– manner a person walks
Ambulation – process of moving from place to place
[Necessary] for interdisciplinary or multidisciplinary apprach to rehabilitation
REMEDIATION [Balance]
Remediation of balance and integration of effective weight shifting bilaterally
Achieving equilibrium without acceleration
Increasing standing tolerance in varying degrees of COG displacement
Stability during dynamic weight shift required BUE AROM
Stability during any activity meaningful to your patient
REMEDIATION [Transitional]
Remediation/Restoring Transitional Movements
Moving from one position to another with varying degrees of extraneous cognitive load and contextual factors
Examples:
- Sit to stand
- Stand to sit
- supine to sit to stand
- stand to sit to supine
- sit to stand – pivot [parallel or perpendicular- stand to sit
Assessments to use in Evaluation and Progress Notes:
- BERG Balance Assessment
- Timed Up and Go
- 5 Times Sit to Stand
- 10ft Tandem Line
- Modified Falls Efficacy Scale
- Lower Extremity Functional Scale (LEFS)
- Brief Pain Inventory
- ABC Balance Scale
- Tinnetti Gait and Balance
- Gait analysis Checklist
Membership Perks
Two Membership Options!
Your investment gives you resources to save you stress, self-doubt, and burnout as you become a confident and competent practitioner who can stand up for your professional point of view and scope of practice.
Lower Body for Occupational Therapy
Take this course for a broader, generalized understanding of the lower extremities, gait abnormalities, and gait analysis. Learn why this knowledge is important for both OTs and OTAs! Don’t worry, we don’t get stuck in the weeds. This course will give you just enough information to help you incorporate the lower body into your interventions…and give you some great printables!e
What you’ll get:
- Confidence that lower body rehabilitation is in the OT Scope of Practice (never question it again)!
- 20 Handouts from the BOT Resource Portal
- Improved generalized understanding of the lower body (if you didn’t get much of this in school!)
Common Problems in Lower Body
Foot Drop
- Difficulty or inability for dorsiflexion
- Reduced knee function, hip flexion, and ankle dorsiflexion all may affect clearing during foot swing
- If untreated, client can develop a nonfunctional gait pattern, be at risk for falls. And further functional decline.
- Can cause hip circumduction
- What muscle is affected?
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- Common peroneal nerve, common fibular nerve
- Branches off the sciatic nerve, lumbosacral plexus, and the L5 nerve root proximally
- Innervates anterior tibialis muscle
- What can cause this diagnosis?
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- Neurological damage in CNS / PNS
- Diabetes mellitus
- Tumors
- Motor neuron disease
- MS
- Adverse reactions to drugs and alcohol
- Treatment
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- Surgical Intervention
- Modalities
- Strengthening and movement therapy
- Motor re-learning strategies
- AFO management
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Circumduction
- During hip swing the pelvis hikes while the hip abducts on the unsupported side
- The leg advances in a circular motion out to the side
- Decreases safety, increases energy expenditure, decreases movement options for the development of more functional gait patterns
Hemiplegic Gait
**New Research suggests that reciprocal arm swing has very little effect on gait efficiency**
- Foot drop
- Synergy pattern: hip adduction, hip extension, hip medial rotation, knee extension, ankle plantar flexion, and ankle inversion
- Slow speed, short stance phase, poorly coordinated movements, and decreased weight bearing on the affected extremity
- The trunk muscles may by hypertonic restricting normal pelvic forward rotation during gait
Browse the Resource Store!
Don’t want to pay for each PDF individually? No problem! The BOT Portal Membership comes with all printable resources and more!
