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Biomechanical Model in OT
Transcript of Biomechanical Model in OT
Occupational Therapy Biomechanical Approach The By Jessica Szklut,
Kristen Scheuer and Samantha Martemucci What is the Biomechanical Model? "the model explains how the body is designed for and is used to accomplish motion" (66) "emphasizes the goal of restoring abilities for motion" (66) kinetics-the study of how forces produce motion in body parts kinematics- the study of motion of body parts in time Theory stems from: Who uses this approach? people with limitations in moving freely, with adequate strength, in a sustained fashion
usually issue stems from disease/injury
musculoskeletal system, peripheral nervous system, integumentary system, cardiopulmonary system explains how the body is made for motion and how it accomplishes that motion
reciprocal relationship between one's ability for movement and the influence of movement on activities
focus on remediation and compensation strong focus on client factors takes environments and occupation into consideration focus on compensation or modification "whether for manipulation of objects, gesturing in communication, or standing in a line while waiting a turn, all occupations involve persons stabilizing and moving their bodies" (66) Basic Concepts of Motion Joint Range of Motion Strength the extent of muscle strength determines what kind of functional movement one's body can perform The biomechanical model explains how the body produces the stability and movement required to perform occupations using three broad concepts: joint range of motion, strength, endurance held in place by ligaments and muscles Range of Motion active range of motion- range of movement that a person can produce using voluntary muscle contraction passive range of motion- range of movement that is possible when an outside force moves a joint Endurance depends on musculoskeletal system but also entails the functions of other body systems "what makes the biomechanical model a unique model of practice in occupational therapy is the way biomechanical principles are applied to understanding and enhancing occupational performance and the use of occupations to influence changes in range of motion, strength, and endurance" (77) Strengths of
the Model preventative Weaknesses of
the Model focuses on motion - less on personal factors What about
OT? primarily concerned with motion during occupation was not originally compiled by OT's allows for a more holistic approach facilitate adaptation How do OTs assess a client with this approach? functional evaluation of active range of motion Measuring ROM goniometer- measures degrees in movement about the axis of a joint
instrument with protractor, axis, and 2 arms that is placed over joint and aligned over bones Measuring Strength without instrument - break test with instrument - dynamometer helps measure grip strength client exerting maximum force on something that measures the amount of force the client produces Measuring Endurance statistically- looks at how long a client can maintain a contraction dynamically- duration or number of times client can preform task before showing fatigue Biomechanical Intervention
Plans interventions are aimed to restore function of targeted limitation as well as their underlying causes (73) stretching- increase limited range of motion (due to tightness of soft tissue around a specific joint) strength and endurance interventions: increasing stress on muscle through resistance
rate of an exercise session
frequency of sessions
duration of resistance required Range of Motion Intervention Physical Agent Modalities used to maintain or restore capacity EMS (electrical muscle stimulation Work Hardening work hardening- an individualized biomechanical approach to treatment aimed at returning an individual to work, usually to a specific job (76) combines exercise and biomechanical equipment while simulating the physical environment of a specific job incorporates meaning and purpose into treatment Progression from Kinetics Focuses of Model produces movement and stability helps determine extent to which a person is able to execute necessary tasks (ADL/IADL) joints are connections between two or more bones elasticity- ability to stretch and to return to original shape and size after movement type and structure of joints determine amount of movement most important with activities that require repeated motion or sustained effort over time determines extent to which people can do the tasks that make up occupational life cardiorespiratory endurance- more broadly to the ability to sustain activity over time muscle endurance- refers to the ability of muscles to contract repeatedly to do work clear, direct, practical guidelines see results and measure progress research based- widely used lens of the medical model easy to use with other practitioners OT's vs PT's - less justification medical model based less focus on activity and occupation orientation intervention less therapeutic relationship in order to put it into OT perspective: make sure movement or exercise is not the main focus Treatment Focus: allow for occupational goals to be set and evaluated provide documentation of clinically significant functional progress improve motivation remember: prepare for daily life (movement to function) need to create a client-centered relationship OT Overview therapist assisted passive range of motion (to evaluate existing range of motion) Initial Evaluation ultrasound heat or cold packs paraffin baths Multiple Choice: Of the following 4 cases, who would not benefit from this model A. someone with limitations in moving freely B. Someone with an impairment in the cognition-motor system C. Someone suffering from arthritis D. Someone with a prosthetic leg Case Study A 25 year old college baseball player was receiving occupational therapy after having surgery on his shoulder. The therapist was testing his ability for the muscles surrounding his shoulder to contract repeatedly while lifting light weight. Is the OT measuring ROM, strength or endurance? can you give us an example of how an Occupational Therapist would create an activity for limited range of motion from this model? Application: Multiple Choice What type of instrument is used to measure degrees of movement in the axis of a joint? A. geriometer
D. CT Scan Multiple Choice Which of the following is NOT an example of a physical agent modality? A. Massage
C. Hot pack
D. Electrical Muscle Stimulation Manual Muscle Testing Work Oriented Evaluation: Ability to do a particular movement against the criteria for how much is required for a particular kind of task