Occupational technology and therapy

This article will attempt an explanation of occupational research and its' value for the Occupational Remedy profession in enjoying occupational experiences, taking a look at the main skill of activity/occupation analyses in professional practice, and how this applies to the process of occupational research with a chosen personal occupational performance to go over the 'form, function and interpretation' of an individual experience and will conclude with an analysis of how a knowledge of activity research will inform the development of professional practice.

Occupational research is the analysis of profession and the influences that shape job. Occupational science experts seek to develop knowledge on; humans as occupational beings, the proper execution, function and interpretation of human job, the partnership between human profession and health insurance and the contextual influences on profession. Although occupational technology is an interdisciplinary field of enquiry, its central concentrate on occupation means it can advise the practice of Occupational Therapy (Clark et al 1991). Just over 10 years ago, occupational technology announced its entrance on the plan for occupational therapy in the 21st century (Yerxa et al 1989). The first ten years has highlighted the obstacles to the perspective. These include the lay understanding of the value of activities and participation, which masks the complexity of occupation. Occupational science seeks to increase the knowledge of occupational remedy and offer a base.

Occupation can be an incredibly common yet also highly complex phenomenon. It really is ever-present, it pertains to everything individuals do. Defining, studying and understanding occupation is incredibly difficult, hence the role of occupational knowledge in opening up opportunities for methodical research and research. Occupation has largely been educated in subjects applied to the medical model or have been of the purely practical dynamics. While subjects of that kind are essential, they give more opinion to knowledge exterior to occupational remedy. The simplest classification of occupational research, then, is that it is the rigorous study of humans as occupational beings (Yerxa et al 1989).

The founders of the world's first Occupational Remedy Society accepted that the job needed such a science; that it was one of the secrets to the continuing development of the career. Occupational scientists examine people's occupational natures across a broad spectrum of matter, that is, they explore other point of view, philosophy or idea from the idea of view of the human need for profession (Wilcock 1991). So, for example, they reconsider, research and recommend on politics, spirituality, education, sociable structures, science and technology, the mass media, work, expansion, development and imagination, and health from an occupational point of view. If they are thorough, that will encompass reductionist as well as holistic perspectives and exploratory methods. Profession crosses so many boundaries that there are hardly any areas of study which could not contribute to what is essentially a fresh way of looking at the world and its peoples. It is a new perspective which has much to provide in the next century.

Occupation is the dynamic relationship between the occupational form and occupational performance. (Nelson 1996). Many people start to see the term profession as employment one will. However, this is of occupation sometimes appears in a much wider framework by an Occupational Therapist. A individual can be employed in a variety of occupations: leisure, self-care or educational activities are just a few types of job. (Richards 2003). Wu and Lin (2010) explained that the occupational form was the

". . . objective pre-existing framework or environmental framework that elicits or tutorials subsequent human being performance".

The occupational form involves objective features. These may include materials, human framework and socio-cultural dimensions. Occupational performance is the effective voluntary real human doing of the occupational form. (Kramer et al 2003). Townsend et al (2007) says that occupation impacts health and well-being. Job creates framework and organizes time. Job brings meaning alive, culturally and individually. Occupations are specific. People value different occupations.

Occupational therapy has, as you of its root base or foundations, the necessity and use of activities to achieve the goals set. The foundation of this activity orientation can be followed back to one of the founding fathers, Dr Adolph Meyer, who kept that healing activity

. . . "was a pleasure in success, a genuine pleasure in the utilization and activity of one's hands and muscles, and a happy gratitude of their time" (Lamorot, Coffey & Hersch 2001)

In trying to find the appropriate task for a customer in order to achieve the most effective treatment, several factors is highly recommended. Activities should be goal directed and should have always a particular reason or goal for his or her use. They aren't chosen to complete idle time. Typically, therapists validate their options of activity by relating that activity to handle a deficit in a performance area or performance aspect in line with the framework. Activities also needs to have some level of interest or relevance to your client. This may be in the form of as an important part of assisting your client to reach a larger goal in the foreseeable future or to have a romance with their required life assignments. (Finlay 2004)

Many activities require mental and/or physical involvement, meaning that the client can participate the selection process; the client may determine a chosen process or activity before actually carrying out the task chosen. When choosing an activity age and developmental appropriateness must be looked at. There also be the potential to break the experience into various levels of complexity or competence in order to grade participants of different age groups and capabilities.

Identify the experience to demonstrate activity consciousness

Out of the activities of daily living and under the word self care, the experience I chose to focus on was cleaning my pearly whites. Looking at my ability to acquire and use cleaning materials for good oral hygiene which could include toothpaste, mouthwash, or dental floss.

Task analysis comprising at least 15 steps

Have accurate tools for task

Usually performed in the bathroom

Pick up teeth brush

Turn cold touch on

Rinse brush

Turn cold touch off

Pick up toothpaste

Undo lid

Squeeze paste onto teeth brush

Close lid

Clean teeth

Spit and wash mouth with cool water (no 4 & 6)

Dry face

Place toothbrush back rack

Place paste back in rack

Squeeze toothpaste onto brush

Slight shoulder flexion, horizontal abduction, elbow flexion, wrist neutral, fingers flexed

Raise toothbrush to mouth

Elbow flexion, forearm neutral, wrist flexed, fingers flexed

Brush teeth up and down

Elbow flexion, forearm neutral, wrist flexion and expansion, fingers flexed

Rinse toothbrush

Shoulder flexion, elbow expansion, forearm pronated, wrist ulnar and radial deviation, finger flexion

Demand Analysis: Modified from Hersch, Lamport & Coffey's (2005) Activity Examination for Expected Performance

Part 1

PERFORMANCE SKILLS

Component

Description

How required?

A. Electric motor SKILLS

1.

Posture

Stabilises, aligns, positions

To maintain an upright position when the body's equilibrium and balance is challenged. Stabilising the trunk and keeping the position in a safe and managed manner when completing the activity

2

Mobility

Walks, gets to, bends

To move your body to enable me to complete the duty, without stumbling or scuffing my feet and also to be able to successfully reach for an object with my arm, and bending my body to orient myself to the task

3

Coordination

Coordinates, manipulates, flows

I can utilize several body part in relationship to the task object or activity

4

Strength & effort

Moves, transports, lifts, calibrates, grips

The amount of muscle power utilised to withstand movement or the power to move items, including the capacity to go against gravity. Also using the correct grip or pinch techniques to grasp items and consider the drive placed on an object through the task

5

Energy

Endures, paces

To be able to perform task without tiring

B. PROCESS SKILLS

1

Energy

Endures, paces

To have the ability to perform process without tiring

2

Knowledge

Chooses, uses, holders, heeds, inquires

My ability to choose, utilise and protect appropriate tools and materials related to the task

3

Temporal organisation

Initiates, remains, sequences, terminates

My ability to plan, organise and perform the steps involved with a task in the proper sequential order and discontinue at the proper time

4

Organising space & Objects

Searches/locates, gathers, organises, restores, navigates

To gather necessary equipment, and organise the duty space and items, the placement of the various tools in a rational and organised manner for successful conclusion, then have the ability to clean and gain tools to appropriate places. Also contains the motion of my own body around any environmental object.

5

Adaptation

Notices/responds, accommodates, adjusts, benefits

I be capable of recognise a difficulty and accommodate or improve the task in response i. e. jogging out of toothpaste

C. Communication/Discussion Skills

1

Physicality

Contacts, gazes, gestures, manoeuvres, orients, postures

To use my body and move my body into the correct position

2

Information exchange

Articulates, asserts, asks, engages, expresses, modulates, stocks, speaks, sustains)

To take part in meaningful conversation, to give and obtain information i. e. showing another person the steps necessary to clean their teeth

3

Relations

Collaborates, conforms, focuses, relates, respects

Having the ability to connect to others, and to bond, or form links, or maintain appropriate relationships

PART 2

CLIENT FACTORS

Component

Description

How required?

A

Body Function Categories

1

Mental Functions - Affective, cognitive & perceptual

a

Global

Consciousness, orientation, sleeping, temperament & personality, energy & drive

I was alert and in a position to respond to environmental stimuli, in a position to identify person, place and time (orientated x3), possessed previously experienced quality sleep that will affect my capability to take part in daily occupation, I had formed emotional stableness and determination to do job.

b

Specific

Attention, storage area, perceptual thought, more impressive range cognition, language, calculation, motor unit planning, psychomotor, emotional, experience of self & time

I could focus on the task for a period, and recall the info related to the duty, was able to recognise sensory suggestions, got clear thought, use personal judgement and manage time.

2

Sensory Functions & Pain

a

Seeing

I could see and utilise all visual fields

b

Hearing / Vestibular

I could react to does sound i. e. water running

c

Other

Taste, smell, proprioception, touch, discrimination

Taste the toothpaste, touch sensitivity when squeezing toothpaste or cleaning teeth, responding to temp i. e. water when rinsing my oral cavity.

d

Pain

To know if something is wrong - sore gums and distinguish between pointed or flat pain

3

Neuromusculoskeletal & motion related functions

a

Joints & bones

Mobility, stability

To maintain an upright position, anatomically forecasted joint motions.

b

Muscle

Power, firmness endurance

When using hands to perform cleaning action and maintaining strength

c

Movement

Motor reflex, reactions, voluntary, involuntary, gait

My specific walking pattern

d

Cardiovascular

Haematological, immunological, respiratory

Blood pressure

e

Voice

& Speech

f

Digestive

Metabolic, endocrine

g

Genitourinary

Reproductive

h

Skin

Hair, nails

B

Body framework Categories

1

Nervous system

2

Eye

Ear & related structures

3

Voice

And speech

4

Cardiovascular

Immunological, respiratory

5

Digestive

6

Genitourinary

Reproductive

7

Movement

8

Skin

& Related structures

Section 4: Analysing Performance Patterns and Contexts

Part 1 Performance Patterns

A

Habits

Useful - positive and support completion of daily activity.

Impoverished - Not regular, need to work on

Dominating - Compulsive and overpowering practices i. e. abnormal hand washing

B

Routines

Daily activities that happen regularly in my daily performance

C

Roles

Tasks or behaviours that meet communal requirements of accepted normal behavior - fresh breath

Part 2 : Performance Contexts

A

Cultural

Refers to the expectations of a contemporary society, considering customs and behavioural habits, regardless of ethnical setting, condition and nationwide legislation will impact financing of basic programs including education, career, and transportation. Subsequently these will impact after the availability of services to those in need. Every effort should be produced to protect the non-public rights of the average person.

B

Physical

Can include factors that may influence the individual's capacity to function within a specific environment including the outdoor physical surfaces; the indoor area including furniture, rugs, and household pets; and the need for specific tools to cope with each setting.

C

Social

considers the evaluation of the sociable support system, in each circumstance noting the availableness and anticipations of a number of caregivers, spouses, other members of the family, friends, community health aides and organizations.

D

Personal

looks at specific traits or factors that are not related to an individual's current physical health. These range from factors such as a person's age, scope of education and public or economic status.

E

Spiritual

A component of an individual's life that motivates or sustains each individual through life's items, issues, problems and alternatives.

F

Temporal

Refers to the time aspect of occupational performance, like the time of day or stage in an individual's life.

G

Virtual

Considers a person's use of technology and tools such as computer systems or radios for communication.

There are specific skills and attributes that are usually integrated to complete a functional skill, Performance skills include motor unit skills - the skills that are utilised to connect to the surroundings and the duties or objects within the surroundings; which include pose, mobility, coordination, power and effort and energy, process skills - that are being used to keep up the actions necessary to complete daily living skills; and consist of energy, knowledge, temporal organisation, organising space and things and version, and communication/discussion skills - which is the competency to clarify and describe individual needs and ideas to others in a socially accepted manner and include; physicality, information exchange and relations.

Performance habits or patterns are behaviours engaged when completing day-to-day tasks. These habits can vary from simple daily routines to complicated patterns used to operate within an individual's daily occupations and include; useful, impoverished, dominating, daily habit and roles. Other outside factors that can impact or impact upon an individual's working are also considered and occupational Therapists must keep these contexts in mind when choosing the correct intervention programme and healing activities, these take consideration of; Cultural, Physical, Community, Personal, Spiritual, Temporal and Virtual.

Activity demands are specific components of an activity that are essential for completion of an activity or task. Contained in the category are the things used and their properties, physical space needs, sociable requirements, sequencing, and timing of a task. Also included are specific body requirements or underlying body functions necessary to complete the duty successfully.

Individual customer factors which may impact on a person's performance in regions of job are also considered. In considering client factors it is necessary to be aware of body functions - the physiological and psychological function - and structures and web page link this knowledge to the functions and buildings clearly recognized as had a need to complete an profession or activity, specifically mental functions, sensory functions and pain, tone of voice and conversation functions, functions of the cardiovascular, haematological, immunological and respiratory system systems, functions of the intestinal, metabolic and endocrine system, genitourinary and reproductive functions, neuromusculoskeletal and activity related functions, the functions of the skin and related structures and finally body buildings.

Molineux (2007) shows that an individual's performing is represented at two levels; at the level of body structures and functions, with an occupational level of what the person is with the capacity of doing (activities) and what they actually do in their current environment (involvement). There is not automatically a progression from impairment of body functions and structures to limits or problems in involvement in activity. Sick health or impairment are realized to have an impact on body set ups and functions but might not exactly always lead to activity restrictions or affect involvement.

Occupational form is explained by Christiansen and Baum (1997) as the objective context of job which it is essential to comprehend in the analysis of the effect of a changeover. This evaluation includes environment, time, who's involved and functions of meaning. The word function in this context can be involved with effective occupational performance in both observable and non-observable components. Meanings are personal and intrapersonal dynamics are portrayed in symbolic doing, with a deep effect upon the sense of home. The amount to which the concentration of interest has switched from how occupation may be used to regain health to how profession can be understood as a way to promote well being is found within the work of Wilcock (1998).

Conclusion

Occupational therapists must really know what is inherent within an activity itself before putting it on as a healing tool. One of many ways to do this is to be familiar with the experience itself. That is activity analysis. Simply the activity in question is viewed in detail and divided into its component parts in order to look for the individual skills necessary for the task. One effective way is to judge the task based on the framework. In doing this, each part of the task is evaluated and analysed to establish the fact that a performance component is utilised. Each step is cared for similarly. Once a detailed examination is completed of all steps, the therapist can decide how to adapt this task for a particular customer, aiming at the individual's recovery and go back to functioning of their individual occupational roles.

Analysing the duty by performance components can provide the specialist with specific information about a task, and exactly how this related to a clients specific region of weakness. In taking a look at activity analysis the Therapist can see the range of movements (ROM) that is involved with every part of the task. Among the core values of occupational therapy is the worthiness and use of purposeful and important activity, therefore activities are analysed to understand their meaning and exactly how each element or collection can be utilized therapeutically to keep up or improve occupational performance and preferably quality of life.

Movement Analysis Schema

A person in a wheelchair sits to stands, steps towards a couch, rests down on the couch, twists body and increases legs to lay on the sofa with the back raised (Video tutorial on moodle)

Summary of: 'Sit-to-Stand'

Joint

Starting position

Finishing position

Movement

Muscles

Type of m/work

Hip

Flexion

90o

Neutral

Extension

Hip extensors

Glut maximum, hamstrings

Concentric

Knee

Flexion 90o

Neutral

(expansion)

Extension

Knee extensors (Quads)

Concentric

Ankle

Neutral

(Planti-

grade)

Neutral

Dorsiflexion

"

"

Plantarflexion

Plantarflexors

(Gastroc, soleus)

Plantar flexors

(gastroc, soleus)

Eccentric

Concentric

Shoulder

Rotracted & elevated

Neutral

Extension

Levator Scapulae, Pectoralis trivial, Trapezius, Rhomboideus major,

Concentric

elbow

Flexion

Neutral

Extension

Pectoralis major, Latissmus dorsi, Deltoid, Teres major

Concentric

wrist

Flexion

Neutral

Extension

Brachialis, Brachoradialis, Triceps brachii, pronator teres, pronator quadratus

Concentric

Stepping

When we take a step, the weight has to be moved onto the accommodating leg. To do this the body has got the hip abductor muscles of the encouraging leg to deal isometrically. This retains the pelvis steady before stepping leg makes connection with the floor. At this time the assignments of the calf change, the stepping lower leg has now end up being the supporting leg (thus allowing the other calf to become the stepping leg). Therefore the new supporting calf requires the hip abductors to written agreement isometrically to repair the pelvis, and allows the new stepping calf to move.

Joint

Starting position

Finishing position

Movement

Muscle Group

Type of m/work

L Hip

Neutral

Stabilising

Neutral

Adduction

& Medial rotation

Hip extensors

Glut maximum, hamstrings

Isometric

"

Concentric

R Hip

Neutral

Neutral

Abduction

& medial rotation & Flexion

Hip extensors

Glut max, hamstrings

Isometric

"

Concentric

L Knee

Neutral

Neutral

Flexion

Knee extensors (Quads)

Isometric

R Knee

Flexion

Neutral

Flexion

Knee extensors (Quads)

Isometric

L Ankle

Neutral

Neutral

Plantar-flexion

"

Dorsiflexion

Plantarflexors

(Gastroc, soleus)

Plantar flexors

(gastroc, soleus)

Concentric

R Ankle

Neutral

Neutral

Plantar-flexion

"

Dorsiflexion

Plantarflexors

(Gastroc, soleus)

Plantar flexors

(gastroc, soleus)

Concentric

Sitting again on the couch

Joint

Starting position

Finishing position

Movement

Muscles

Type of m/work

Hip

Neutral

Flexion

90o

Flexion

Hip extensors

Glut max, hamstrings

Eccentric

Knee

Neutral

(Extension)

Flexion

90o

Flexion

Knee extensors (Quads)

Eccentric

Ankle

Neutral

Neutral

Dorsiflexion

"

"

Plantarflexion

Plantarflexors

(Gastroc, soleus)

Plantar flexors

(gastroc, soleus)

Eccentric

Concentric

Shoulder

Neutral

Rotracted & elevated

Flexion

Levator Scapulae, Pectoralis minor, Trapezius, Rhomboideus major

Eccentric

Elbow

Neutral

Flexion

Flexion

Pectoralis major, Latissmus dorsi, Deltoid, Teres major

Eccentric

Wrist

Neutral

Extension

Extension

Brachialis, Brachoradialis, Triceps brachii, pronator teres, pronator quadratus

Eccentric

Lying back onto the sofa - lifting lower limbs up onto couch

Joint

Starting position

Finishing position

Movement

Muscle Group

Type of m/work

L Hip

Flexion

Flexion

Adduction & Extension

Hip extensors

Glut utmost, hamstrings

Concentric

R Hip

Flexion

Flexion

Abduction & Extension

Hip extensors

Glut potential, hamstrings

Concentric

L Knee

Flexion

Neutral

Extension

Knee

extensors (Quads)

Concentric

R Knee

Flexion

Neutral

Extension

Knee

extensors (Quads)

Concentric

L Ankle

Flexion

Neutral

Dorsiflexion

"

"

Plantarflexion

Plantarflexors

(Gastroc, soleus)

Plantar flexors

(gastroc, soleus)

Isometric

R Ankle

Flexion

Neutral

Dorsiflexion

"

"

Plantarflexion

Plantarflexors

(Gastroc, soleus)

Plantar flexors

(gastroc, soleus)

Isometric

shoulder

Rotracted & Elevated

Neutral

Flexion?

Levator Scapulae, Pectoralis slight, Trapezius, Rhomboideus major,

Eccentric

elbow

Flexion

Neutral

Flexion

Pectoralis major, Latissmus dorsi, Deltoid, Teres major

Eccentric

wrist

Flexion

Neutral

Flexion

Brachialis, Brachoradialis, Triceps brachii, pronator teres, pronator quadratus

Eccentric

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