Occupational Therapy for Physical Dysfunction Seventh Edition

1455 Pages·2013·39.44 MB·English

Occupational Therapy
for Physical Dysfunction
Seventh Edition
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Occupational Therapy
for Physical Dysfunction
Seventh Edition
EDITORS
Mary Vining Radomski,
PhD, OTR/ L, FAOTA
Clinical Scientist, Occupational Therapist
Courage Kenny Research Center
Occupational Therapist
Courage Kenny Rehabilitation Institute
Minneapolis, Minnesota
Catherine A. Trombly Latham,
ScD, OTR/L, FAOTA
Professor Emerita
Department of Occupational Therapy
College of Health and Rehabilitation Sciences: Sargent College
Boston University
Boston, Massachusetts
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Senior Editor: Michael Noble
Product Manager: John Larkin, Heather Rybacki
Development Editor : Kelly Horvath
Marketing Manager : Shauna Kelley
Designer: Teresa Mallon
Compositor: Absolute Service, Inc.
Seventh Edition
Copyright © 2014 Lippincott Williams & Wilkins, a Wolters Kluwer business
351 West Camden Street Two Commerce Square
Baltimore, MD 21201 2001 Market Street
Philadelphia, PA 19103
Printed in China
Sixth Edition, 2008; Fifth Edition, 2002
NOTICE TO READER: This publication contains information relating to general principles of medical care that
should not be construed as specifi c instructions for individual patients. Manufacturers’ product information and
package inserts should be reviewed for current information, including contraindications, dosages, and precautions. It
remains the responsibility of the practitioner to evaluate the appropriateness of a particular opinion or therapy in the
context of the actual clinical situation and with due consideration of any new developments in the fi eld and current
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9 8 7 6 5 4 3 2 1
Library of Congress Cataloging-in-Publication Data
Occupational therapy for physical dysfunction / editors, Mary Vining Radomski, Catherine A. Trombly Latham. --
Seventh edition.
p.; cm.
Includes bibliographical references and index.
ISBN 978-1-4511-2746-1 (hardback : alk. paper)
I. Radomski, Mary Vining, editor of compilation. II. Latham, Catherine A. Trombly editor of compilation.
[DNLM: 1. Occupational Therapy. 2. Disabled Persons--rehabilitation. WB 555]
RM735
615.8’515--dc23
2013029668
DISCLAIMER
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quences from application of the information in this book and make no warranty, expressed or implied, with respect
to the currency, completeness, or accuracy of the contents of the publication. Application of this information in a
particular situation remains the professional responsibility of the practitioner; the clinical treatments described and
recommended may not be considered absolute and universal recommendations.
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this text are in accordance with the current recommendations and practice at the time of publication. However, in view
of ongoing research, changes in government regulations, and the constant fl ow of information relating to drug therapy
and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and
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or infrequently employed drug.
Some drugs and medical devices presented in this publication have Food and Drug Administration (FDA) clear-
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Dedication
To the profession’s authors—past, present, and future.
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Preface
The seventh edition of O ccupational Therapy for Physical Section V elucidates intervention principles and prac-
Dysfunction emphasizes four key themes that are essential tices for persons with physical dysfunction. As in earlier
to the best possible occupational therapy for adults with editions, this section does not provide recipes for the
physical disabilities and to the future of the profession: treatment of people with particular diagnoses but rather
descriptions of best practice. The professional occupa-
● Reliance on evidence/research to inform occupational
tional therapist can choose from these for a particular
therapy assessment and intervention
patient who has his or her own particular goals and mani-
● Occupation as the central intervention and outcome of
festation of a diagnosis.
occupational therapy services
Section VI includes discussions of the practice of
● Importance of expert activity analysis that synthesizes
occupational therapy for particular major diagnostic
theoretical knowledge, clinical skills, and awareness of
categories, each written by a specialist in that area. These
person and contextual factors to occupational therapy
experts alert therapists who are beginning to practice
practice
with one of these populations to various commonly
● Appreciation for the individuality, unique circum-
encountered impairments that affect occupational func-
stances, and priorities of each patient/client.
tioning and to the specialized assessments and treat-
These themes are evident in the book’s organization, ments that have been developed for persons carrying the
features, ancillaries, terminology, and authorship. diagnosis.
In addition to the textbook, the following three chap-
ters from the sixth edition are now available to readers
ORGANIZATION on thePoint, the book’s website (thepoint.lww.com):
Optimizing Motor Behavior Using the Bobath Approach,
Similar to the previous edition, the seventh edition is
Optimizing Motor Behavior Using the Brunnstrom
composed of six sections with 45 chapters.
Movement Therapy Approach, and Managing Defi cit of
Section I lays the foundation for the rest of the text-
First-Level Motor Control Capacities Using Rood and
book. Chapter 1 addresses theoretical foundations (with
Proprioceptive Neuromuscular Facilitation Techniques.
emphasis on the Model of Occupational Functioning),
The intervention techniques described in these chapters
and Chapter 2 addresses practical foundations of occupa-
are not adequately supported by current evidence, and to
tional therapy for adults with physical dysfunction.
remain consistent with the key themes described above,
Section II presents the areas of assessment in which
we did not include them in the book. However, because
an occupational therapist working in acute medical, in-
many practitioners continue to refer to these approaches
patient/outpatient rehabilitation, and community-based
and related concepts, these chapters are preserved to serve
rehabilitation settings should be competent. The chapter
as important resources.
sequence generally represents the order in which occupa-
tional therapists might conduct assessment, beginning
with appraisal of the specifi c context and evaluating the FEATURES
person’s occupational roles and competence, followed
by assessment of the person’s abilities and capacities This edition also has a number of features that emphasize
that support role performance and fi nally assessment of the scientifi c and refl ective foundations of clinical practice.
the relevant environmental constraints and enablers of The chapters in Section II (Assessment of Occupational
performance. Function) include Assessment Tables that summarize
Section III presents three mechanisms of therapeutic the psychometric properties, strengths, and weaknesses of
change: occupation and occupation as therapy, learning, the assessment methods described in the chapter.
and therapeutic rapport. Evidence Tables (where evidence exists) are included
Section IV presents therapeutic technologies that in chapters in Section III (Therapeutic Mechanisms), Sec-
enable and support occupational functioning: splinting, tion IV (Therapeutic Technologies), Section V (Interven-
wheelchairs, adapted or assistive devices, and physical tion for Occupational Function), and Section VI (Reha-
agent modalities. bilitation to Promote Occupational Function for Selected
vi
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Preface vii
Diagnostic Categories). These tables summarize research of research, including that from other disciplines, to
studies that address the interventions mentioned in the practice), Safety Notes (precautions to be observed), and
chapters and/or Case Examples. They are not exhaustive Resources (where to fi nd information and equipment)
compendia of all research but represent the current best are included throughout the chapters to showcase and
evidence for the effectiveness of the interventions and emphasize key concepts.
serve as examples of culling critical information from
research articles. Readers will fi nd information pertain- ANCILLARIES
ing to these tables and other features in this volume’s
User’s Guide . As indicated above, a website is available at thepoint.lww
The Case Examples in this edition continue to high- .com. Students can go to the site to see how an expert
light the “whys” of the assessment and intervention would answer the questions posed in Clinical Reasoning
process. In general, Case Examples are designed to help Boxes throughout the text. Clinical Reasoning Boxes
students appreciate how various topics described in the (questions and answers) from the sixth edition are also
chapter relate to and inform occupational therapy prac- available on the site. Instructors’ Resources have been
tice. Readers will fi nd that the Case Example format in this posted, including PowerPoint slides that provide lecture
edition describes the actions of therapy (“ Occupational outlines for each chapter and an image bank containing
Therapy Process”) along with the therapist’s internal all images and tables from the book.
dialogue to explain why he or she approached occupa- Also at thePoint, students can access audiovisual con-
tional therapy assessment and/or intervention as he or she tent in which core techniques are demonstrated. Brief
did (“Clinical Reasoning Process”). video clips help learners visualize and review key aspects of
New to this edition are three A ctivity Analysis Case practice, including the measurement of upper extremity
Examples, the goal of which is to explicate the clinical range of motion and hand strength, upper and lower
reasoning that occupational therapists use in selecting extremity dressing techniques for individuals with hemi-
and modifying activities to meet patients’ therapeutic plegia and paraplegia (new to this edition), how to fabri-
goals. Three types of activity analyses are introduced in cate a splint, and how to assist clients as they transfer into
Chapter 12 by Catherine Verrier Piersol, PhD, OTR/L, and out of a wheelchair.
and modeled in later chapters by other authors. In
Chapter 27 ( Restoring Competence for Homemaker TERMINOLOGY
and Parent Roles), Susan Fasoli, ScD, OTR/L, developed
an Activity-Focused Analysis Case Example . This Throughout this book, readers will note an amalgam
is a deconstruction of the activity itself outside of the of occupational therapy terminology, derived from
client-specifi c application or context. This type of activity the Occupational Therapy Practice Framework: Domain &
analysis is intended to provide a schema that readers may Process, Second Edition (American Occupational Therapy
use to build a repertoire of therapeutic occupations and Association, 2008), I nternational Classifi cation of Func-
emphasizes occupation-as-means. In Chapter 37 (Hand tioning (World Health Organization, 2001), O ccupational
Impairments), Cynthia Cooper, MFA, MA, OTR/L, CHT, Functioning Model , and generic “OT speak.” This supports
developed a C lient-Focused Activity Analysis Case our aim to develop multilingual practitioners. The use
Example . This is a description of the reasoning involved of various terms and frameworks in the textbook refl ects
in the therapeutic use of occupation-as-means for a partic- the different ways in which practicing occupational ther-
ular therapeutic goal for a specifi c person. In Chapter 25 apists and occupational therapy scholars talk about the
(Restoring the Role of Independent Person), Anne Birge work we do each day. If you fi nd yourself needing to think
James, PhD, OTR/L, developed an Environment-Client twice to do some translation, get used to it. In practice,
Focused Activity Analysis Case Example . This is a de- we must be profi cient at adapting our language based
construction of the specifi c activity-environment- person on the needs of those with whom we communicate, un-
fi t to determine and/or optimize the likelihood of suc- derstanding that most of us spend our day with people
cessful performance of occupation-as-end. Activity Analy- who have never heard of occupational therapy, much
sis Case Example templates are also available on thePoint less our professional vocabulary. Similarly, some authors
( thepoint.lww.com) should readers choose to use them to elected to refer to recipients of occupational therapy ser-
develop activity analyses on their own. vices as clients, others as patients. This too refl ects ways
As in the previous edition, a Glossary and boxes in which appropriate terminology varies based on the
highlighting C linical Reasoning (opportunities to de- context of the situation. In general, the term “patient”
velop clinical reasoning skills that go beyond the material is most often used in acute medical and inpatient reha-
that can be looked up in the chapter), Procedures for bilitation settings; it refl ects a more passive role of the
Practice (how to do a particular assessment or treatment), person receiving care and is the term used by other pro-
Defi nitions, R esearch Notes (examples of application fessionals on the health care team. The term “client” is
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viii Preface
used in reference to a person living in the community sharing their knowledge and skills with occupational
who is receiving outpatient, home-based, or community- therapists preparing to enter the fi eld.
based services. It refl ects the assumption that the person
Mary Vining Radomski
receiving services is ready to assume a more directive role
Catherine A. Trombly Latham
in organizing his or her care.
REFERENCES
AUTHORS
American Occupational Therapy Association. (2008). Occupational
Sixty-eight outstanding clinical and academic occupa- therapy practice framework: Domain & process (2nd ed.). A merican
Journal of Occupational Therapy, 62, 625–683.
tional therapists and experienced lay persons contrib-
World Health Organization. (2001). I nternational Classifi cation of Function-
uted to this edition. They each did so with the desire to
ing, Disability and Health–Short version. Geneva, Switzerland: World
contribute to the profession of occupational therapy by Health Organization.
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Acknowledgments
We gratefully acknowledge the many individuals who ing space for our photography and videography sessions
have helped us with the seventh edition of O ccupational and to Cheryl Smith and Matthew White, OTR/L of the
Therapy for Physical Dysfunction . As always, we relied on Courage Kenny Research Center. We are especially grate-
the accommodation, practical assistance, and occasional ful to Elizabeth Plummer, who allowed us to use her beau-
indulgence of our friends and loved ones, most notably tiful photograph on the cover of the book.
our husbands, Jim Radomski and John Latham; we thank As mentioned in the Preface, we recognize the con-
them for their help with this work. Heather Rybacki, Man- tribution, commitment, and hard work of this edition’s
aging Editor at Lippincott Williams & Wilkins, worked authors. In this edition, we are particularly grateful to
with us throughout the planning and editing of the the authors who are also members of the U.S. Army
seventh edition. John Larkin, Product Manager, and Russ Medical Specialists Corps including MAJ Charles Quick,
Hall (Absolute Service, Inc.) orchestrated and prepared the MAJ Priscillia Bejarano, LTC Andrew Fabrizio, MAJ Jose
production of the book. We appreciate their expertise, pro- Rafols, MAJ Sarah Mitsch, MAJ(P) Kathleen Yancosek,
fessionalism, and the continuity that they brought to this and those with recent military service (Valerie Rice, Lisa
project. Smurr Walters, and Lynsay Whelan). We recognize the
Many others were quick to agree to our requests for historically important ways that military clinicians have
assistance with photographs, videography, and ancil- infl uenced our profession and their service to our country.
laries. Emily Eastman, occupational therapy student at All of these authors stand on the shoulders of 51 previ-
St. Catherine University, was an exceptional model for the ous authors who have shaped the textbook’s content since
new range of motion and manual muscle testing photo- the fi rst edition was published in 1977 (see the list that
graphs. We appreciate Jennifer Theis, MS, OTR/L, who follows). Past and present authors have taken on this work
developed the storyboards for the new video on car trans- with a desire to advance the profession by sharing their
fers and dressing techniques, and Kelly Tollefson (and expertise with you and for that, we are most grateful.
her sister/driver, Amy) and Susan Hagel, MS CTRS, who
demonstrated these techniques in the videos. Thanks too Mary Vining Radomski
to the Courage Kenny Rehabilitation Institute for provid- Catherine Trombly Latham
ix
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