Re: [OTlist] New Member
Here's a link for joining the list: www.otnow.com/mailman/listinfo/otlist_otnow.com or just direct them to www.OTnow.com Thanks, Ron - Original Message - From: Mary Alice Cafiero [EMAIL PROTECTED] Sent: Monday, August 25, 2008 To: OTlist@OTnow.com OTlist@OTnow.com Subj: [OTlist] New Member MAC Where do I tell someone to go to join our lively discussions? I can't MAC even remember how I joined. MAC MA MAC Mary Alice Cafiero MAC [EMAIL PROTECTED] MAC 972-757-3733 MAC Fax 888-708-8683 MAC This message, including any attachments, may include confidential, MAC privileged and/or inside information. Any distribution or use of this MAC communication by anyone other than the intended recipient(s) is MAC strictly prohibited and may be unlawful. If you are not the recipient MAC of this message, please notify the sender and permanently delete the MAC message from your system. MAC On Aug 25, 2008, at 10:30 PM, Ron Carson wrote: DING, DING, DING, we have a winner Outstanding suggestions! - Original Message - From: Mary Alice Cafiero [EMAIL PROTECTED] Sent: Monday, August 25, 2008 To: OTlist@OTnow.com OTlist@OTnow.com Subj: [OTlist] Do You Agree with This Statement? MAC I think if a specialty area is going to be the focus of publicity MAC display, it should make sure to include that it is a specialty in MAC the much larger profession of OT where you can find information MAC about many areas in the professionblah, blah, blah. MAC DONT leave it at just the OTs prevent repetitive motion injuries. It MAC needs to include some context within the larger picture of OT. Define MAC its place in our world. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] OT/PT perspective
Mary, Your comments are well spoken. They actually lead me to ask you and any others willing to chime in a question. How would you suggest starting a program to train home health PT's or OT's to perform power mobility/seating assessments? Our company is a large, not-for-profit company with ~ 160 therapists across three states. We currently have an underdeveloped power w-c/specialty seating service line. They are however, distinctly separate from the home health side of our business. I want them to work together. Any thoughts. Neal C. Luther,OTR/L Rehab Program Coordinator Advanced Home Care 1-336-878-8824 xt 3205 [EMAIL PROTECTED] Home Care is our Business...Caring is our Specialty The information contained in this electronic document from Advanced Home Care is privileged and confidential information intended for the sole use of [EMAIL PROTECTED] If the reader of this communication is not the intended recipient, or the employee or agent responsible for delivering it to the intended recipient, you are hereby notified that any dissemination, distribution or copying of this communication is strictly prohibited. If you have received this communication in error, please immediately notify the person listed above and discard the original.-Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Mary Alice Cafiero Sent: Monday, August 25, 2008 11:19 PM To: OTlist@OTnow.com Subject: [OTlist] OT/PT perspective I first must start my comment by saying that many of my dear friends are Physical Therapists. I love them and learn from the constantly. I also continually learn the differences in our approaches to situations. The example coming to mind is when I am doing a wheelchair clinic at a teaching hospital with a PMR doctor, patient and patient family, and wheelchair supplier. My role was previously done by a PT who is now doing research full time. I have not met her directly but have heard wonderful things about her. I do know that her approach to a seating assessment and my approach to the same assessment are very different. For instance, she measured every joint angle upper and lower extremity with a goniometer. I want to know what is limited and what that limitation hinders. I also want to know the mechanism for why it is limited, and if it is fixed or flexible. I want a lot more information in question and answer format or in patient giving me a narrative format about how they use their chair, what they can and cannot do in their chair, and what needs to be different next time around. I think much of the most valuable information I get comes from that type of conversation. BUT I don't get a goniometer out of my briefcase. I'll tell the supplier that we need to have a specific type of footplate because their knees can't come to 90 degrees, but I'm not going to measure it. So, is that a huge difference? Not in and of itself. My focus is on getting the client the best equipment possible so that mobility is easy and they can go do what they want to do. I wish it was simple to do that. It's very complex and is what consumes my life these days. The above comments are not a knock on PT. I work with some amazing PTs who do wonderful seating and mobility evaluations. Conversely, I work with some OTs who totally miss the point and should not be doing a mobility evaluation. PTs and OTs alike need to be willing to admit that Seating and Mobility is another specialty area. Not every new graduate from every program has the skills to walk in and start doing evaluations for complex rehab equipment. Until our national organizations agree with this, we are fighting a seriously uphill battle! That was a little rantish. And a bit oddball and tangential because I am very tired. If it doesn't make sense, just ask me! Mary Alice Mary Alice Cafiero [EMAIL PROTECTED] 972-757-3733 Fax 888-708-8683 This message, including any attachments, may include confidential, privileged and/or inside information. Any distribution or use of this communication by anyone other than the intended recipient(s) is strictly prohibited and may be unlawful. If you are not the recipient of this message, please notify the sender and permanently delete the message from your system. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
[OTlist] Musician and DeQuervain's tendonitis
I have a question for all the hand therapists out there. My 12 year old daughter has been playing the clarinet for 1 year and has now switched to an alto clarinet (essentially the same hand holds). In the last year she had developed bilateral DeQuervain's twice. To give you a little history, I had bilateral DeQuervain's release shortly after she was born 12 years ago. Since I had been pregnant, there was essentially no treatment for it and the case was so severe, my thumbs were non-functional. Surgery was the only option. After the surgery, the surgeon said that I had an anatomical abnormality--2 sheaths instead of one. My sister and aunt both have severe DeQuervain's but won't get it fixed. This is clearly a family trait. When she flares up, I splint her with a thumb spica, start anti-inflammatories (ibuprofen) and she reduces (or stops) playing if possible. This seems to relieve the pain. I have already tried to change the way she holds the instrument, but in my limited knowledge of an alto clarinet, I can't see any way to accomplish this. The school year is only 3 weeks old and she's already had to start wearing the splint 3 or 4 times per week. She independently puts it on at night because it makes her thumbs feel better. She's just in 7th grade and we have years to go in band. What I'm wondering is if there is anything else I can do? Are there stretches or an exercise program that I can start her on. Any suggestions would be appreciated. Hands are just out of my realm of knowledge. Judy Hamby, MHS, OTR/L, BCPR . -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
[OTlist] Would You Treat For Refer to PT?
Received a new home health referral. Patient's diagnosis is right shoulder pain. Patient presents with bicep tendon pain during AROM, PROM and palpation. She lives alone and is independent with all her daily living tasks. I referred the patient to PT for the shoulder pain. Would you, as an OT, treat this patient? Thanks, Ron -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
[OTlist] refer for PT
I as an OT would not treat this patient in the sense that I do not have enough experience w/shoulders. It seems like she needs some type of modality help with the pain and such. If she was NOT independent w/her ADL's and fxal activities, I would definitely work with her as an OT for those types of things! Cindy **It's only a deal if it's where you want to go. Find your travel deal here. (http://information.travel.aol.com/deals?ncid=aoltrv000547) -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Would You Treat For Refer to PT?
Are you sure she can reach up into high cabinets in order to cook and clean with that right arm? Can she fasten her bra the way she used to with an internal rotation?approach in back or is?she resorting to compensation, but she would like to get back to her?prior method??I'm sure if you dig hard?enough you?will find some occupational dysfunction. If not I would defer to PT. ?As an OT it depends if you are comfortable and competent to treat shoulder dysfunction.? I have had two post professional OT courses on shoulder dysfunctiion, ?taught at a credited program of OT, so I have to answer yes to your question. -Original Message- From: Ron Carson [EMAIL PROTECTED] To: OTlist OTlist@OTnow.com Sent: Tue, 26 Aug 2008 3:15 pm Subject: [OTlist] Would You Treat For Refer to PT? Received a new home health referral. Patient's diagnosis is right shoulder pain. Patient presents with bicep tendon pain during AROM, PROM and palpation. She lives alone and is independent with all her daily living tasks. I referred the patient to PT for the shoulder pain. Would you, as an OT, treat this patient? Thanks, Ron -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Would You Treat Or Refer to PT?
When asked, the patient reported that she was able to do all her daily living. Now, this brings up an interesting point. Obviously, the patient *is* limited by her pain. She does not use her right arm in the same manner as if she didn't have pain. So, does this qualify her for OT? If we use this approach, why doesn't OT treat people who are limited by back, hip, leg or foot pain? On the other hand, the patient's concerns are ONLY related to her pain, nothing else is of great importance. Since she does not have perceived occupational deficits, does this disqualify her for OT? How hard should an OT dig to find occupational deficits? Isn't the OT's job to help **the patient** identify and prioritize their deficits? Obviously, this approach isn't effective with cognitively impaired patients, but for patients who are able, shouldn't THEY identify their occupational deficits, with the help of the OT? Ron - Original Message - From: [EMAIL PROTECTED] [EMAIL PROTECTED] Sent: Tuesday, August 26, 2008 To: OTlist@OTnow.com OTlist@OTnow.com Subj: [OTlist] Would You Treat For Refer to PT? cac Are you sure she can reach up into high cabinets in order to cac cook and clean with that right arm? Can she fasten her bra the cac way she used to with an internal rotation?approach in back or cac is?she resorting to compensation, but she would like to get back cac to her?prior method??I'm sure if you dig hard?enough you?will cac find some occupational dysfunction. If not I would defer to PT. cac ?As an OT it depends if you are comfortable and competent to cac treat shoulder dysfunction.? I have had two post professional OT cac courses on shoulder dysfunctiion, ?taught at a credited program cac of OT, so I have to answer yes to your question. cac -Original Message- cac From: Ron Carson [EMAIL PROTECTED] cac To: OTlist OTlist@OTnow.com cac Sent: Tue, 26 Aug 2008 3:15 pm cac Subject: [OTlist] Would You Treat For Refer to PT? cac Received a new home health referral. Patient's diagnosis is right cac shoulder pain. Patient presents with bicep tendon pain during AROM, cac PROM and palpation. She lives alone and is independent with all her cac daily living tasks. cac I referred the patient to PT for the shoulder pain. Would you, as an cac OT, treat this patient? cac Thanks, cac Ron cac -- cac Options? cac www.otnow.com/mailman/options/otlist_otnow.com cac Archive? cac www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
[OTlist] Qualitative research
Hi Could any body point me in the direction of qualitative primary study regarding (CAN GROUP EXERCISE/ACTIVITY IMPROVE MENTAL HEALTH IN PEOPLE WITH MENTAL ILLNESS) I am a mere student of mature years and have found it very difficult to find research on this subject especially from OT. I am needing the information For a critical review Essay at university which is of personal interest to myself and has wide relevance across health and social care professionals and education. Any help will me very appreciated. Regards Paul Middleton Chairman Sheffield Forum Badminton Club -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Qualitative research
Try: www.cochrane.org Ron - Original Message - From: Paul Middleton [EMAIL PROTECTED] Sent: Tuesday, August 26, 2008 To: OTlist OTlist@OTnow.com Subj: [OTlist] Qualitative research PM Hi Could any body point me in the direction of qualitative PM primary study regarding (CAN GROUP EXERCISE/ACTIVITY IMPROVE PM MENTAL HEALTH IN PEOPLE WITH MENTAL ILLNESS) PM I am a mere student of mature years and have found it very PM difficult to find research on this subject especially from OT. I PM am needing the information For a critical review Essay at PM university which is of personal interest to myself and has wide PM relevance across health and social care professionals and education. PM Any help will me very appreciated. PM Regards PM Paul Middleton PM Chairman PM Sheffield Forum Badminton Club PM -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Would You Treat For Refer to PT?
Ron, I personally would not treat her because I don't feel that I have the experience with modalities and therapeutic exercise that would benefit her the most. I think there are OTs out there that do have this experience, so I don't think it is necessarily an inappropriate OT referral. I think it is a case of a therapist needing to refer when something is outside the scope of their expertise or comfort level. Mary Alice Mary Alice Cafiero [EMAIL PROTECTED] 972-757-3733 Fax 888-708-8683 This message, including any attachments, may include confidential, privileged and/or inside information. Any distribution or use of this communication by anyone other than the intended recipient(s) is strictly prohibited and may be unlawful. If you are not the recipient of this message, please notify the sender and permanently delete the message from your system. On Aug 26, 2008, at 3:15 PM, Ron Carson wrote: Received a new home health referral. Patient's diagnosis is right shoulder pain. Patient presents with bicep tendon pain during AROM, PROM and palpation. She lives alone and is independent with all her daily living tasks. I referred the patient to PT for the shoulder pain. Would you, as an OT, treat this patient? Thanks, Ron -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Would You Treat For Refer to PT?
Ron, I noticed that you said you asked the patient. I find that usually when i have them perform specific tasks instead of asking, the findings don't match what is reported. Don't you think she is entitled to an evaluation at least and then decide which way to go. It is hard for me to believe that she is safe and Independent with all daily living tasks. If her dominant side is affected( I'm assuming she is right dominant), it makes me wonder how she is lifting things or carrying things with that side. Is she using proper compensatory techniques or is she going to cause damage elsewhere? --- On Tue, 8/26/08, Ron Carson [EMAIL PROTECTED] wrote: From: Ron Carson [EMAIL PROTECTED] Subject: [OTlist] Would You Treat For Refer to PT? To: OTlist OTlist@OTnow.com Date: Tuesday, August 26, 2008, 4:15 PM Received a new home health referral. Patient's diagnosis is right shoulder pain. Patient presents with bicep tendon pain during AROM, PROM and palpation. She lives alone and is independent with all her daily living tasks. I referred the patient to PT for the shoulder pain. Would you, as an OT, treat this patient? Thanks, Ron -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Would You Treat For Refer to PT?
Oops, I failed to mention that I my referral to PT was s/p my OT eval. Everything the patient stated matched my observation of her movement. Yes, it is her dominant side. She does not do much lifting with her right arm, because of the pain. She does close in work with her right arm, such as crocheting, eating, turning book pages, etc. But she does no lifting with her right shoulder. I also think that within the course of an evaluation, it's difficult to assess ALL daily living tasks, (i.e. driving, washing dishes, shampooing hair). What I do is extrapolate my observations and the patient's reports to form a basis of all daily living. However, it is best to not say all when I don't really know that to be a fact! Ron - Original Message - From: Kari Rogozinski [EMAIL PROTECTED] Sent: Tuesday, August 26, 2008 To: OTlist@OTnow.com OTlist@OTnow.com Subj: [OTlist] Would You Treat For Refer to PT? KR Ron, KR KR I noticed that you said you asked the patient. I find that KR usually when i have them perform specific tasks instead of asking, KR the findings don't match what is reported. Don't you think she is KR entitled to an evaluation at least and then decide which way to KR go. It is hard for me to believe that she is safe and Independent KR with all daily living tasks. If her dominant side is affected( KR I'm assuming she is right dominant), it makes me wonder how she is KR lifting things or carrying things with that side. Is she using KR proper compensatory techniques or is she going to cause damage elsewhere? KR --- On Tue, 8/26/08, Ron Carson [EMAIL PROTECTED] wrote: KR From: Ron Carson [EMAIL PROTECTED] KR Subject: [OTlist] Would You Treat For Refer to PT? KR To: OTlist OTlist@OTnow.com KR Date: Tuesday, August 26, 2008, 4:15 PM KR Received a new home health referral. Patient's diagnosis is right KR shoulder pain. Patient presents with bicep tendon pain during AROM, KR PROM and palpation. She lives alone and is independent with all her KR daily living tasks. KR I referred the patient to PT for the shoulder pain. Would you, as an KR OT, treat this patient? KR Thanks, KR Ron KR -- KR Options? KR www.otnow.com/mailman/options/otlist_otnow.com KR Archive? KR www.mail-archive.com/otlist@otnow.com KR -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Would You Treat For Refer to PT?
Does she?not lift?with her right shoulder because of the high pain level?? If she lives alone how will she take her trash out?? How will she load and unload her groceries from her car?? How will she carry her laundry basket to her room to put her clothes away?? Unless this lady has a fulltime maid, her life is a little difficult right now.? Perhaps prompting the lady's memory isn't such a bad idea, considering that her mind is probably focused on her high pain level, and she is probably thinking to herself Why does this guy have to know that information, I just want him to work on my arm, and she is giving you short answers, probably unaware that you were going to DC her. ?I would start on goal oriented compensation techniques to get her through her typical IADLs and a restorative program for her shoulder involving modalities, soft tissue mobilization around the coracoid process, relaxation facilitation techniques for?the shoulder,?and a graded therapeutic exercise program.? Based on AOTAs position papers over the years, this is certainly an appropriate?approach.? What is wrong with a bottom up approach starting with body functions and gradually improving to graded functional activities when the pain and the AROM improves significantly.? There is no way a patient like this would improve based on a top down approach.? She would learn to compensate, but from your evaluation it sounds like she wants her pain to improve, and for her shoulder to improve to her normal baseline.? Why in the world wouldn't a skilled OT with orthopedic shoulder?experience take this case? As OTs it is in our scope of practice to treat shoulders, knees, backs, hips, whatever, from a compensation and a restorative approach depending on the state in which you practice.? Now based on our level of education I would not suggest diving into restorative techniques for these areas unless you have had?extensive training, and if your PT partner on the other side of the clinic is working on the same thing.? Team work and communication is the key for those situations. -Original Message- From: Ron Carson [EMAIL PROTECTED] To: Kari Rogozinski OTlist@OTnow.com Sent: Tue, 26 Aug 2008 7:03 pm Subject: Re: [OTlist] Would You Treat For Refer to PT? Oops, I failed to mention that I my referral to PT was s/p my OT eval. Everything the patient stated matched my observation of her movement. Yes, it is her dominant side. She does not do much lifting with her right arm, because of the pain. She does close in work with her right arm, such as crocheting, eating, turning book pages, etc. But she does no lifting with her right shoulder. I also think that within the course of an evaluation, it's difficult to assess ALL daily living tasks, (i.e. driving, washing dishes, shampooing hair). What I do is extrapolate my observations and the patient's reports to form a basis of all daily living. However, it is best to not say all when I don't really know that to be a fact! Ron - Original Message - From: Kari Rogozinski [EMAIL PROTECTED] Sent: Tuesday, August 26, 2008 To: OTlist@OTnow.com OTlist@OTnow.com Subj: [OTlist] Would You Treat For Refer to PT? KR Ron, KR ? KR I noticed that you said you asked the patient.? I find that KR usually when i have them perform specific tasks instead of asking, KR the findings don't match what is reported.? Don't you think she is KR entitled to an evaluation at least and then decide which way to KR go.? It is hard for me to believe that she is safe and Independent KR with all daily living tasks.? If her dominant side is affected( KR I'm assuming she is right dominant), it makes me wonder how she is KR lifting things or carrying things with that side.? Is she using KR proper compensatory techniques or is she going to cause damage elsewhere?? KR --- On Tue, 8/26/08, Ron Carson [EMAIL PROTECTED] wrote: KR From: Ron Carson [EMAIL PROTECTED] KR Subject: [OTlist] Would You Treat For Refer to PT? KR To: OTlist OTlist@OTnow.com KR Date: Tuesday, August 26, 2008, 4:15 PM KR Received a new home health referral. Patient's diagnosis is right KR shoulder pain. Patient presents with bicep tendon pain during AROM, KR PROM and palpation. She lives alone and is independent with all her KR daily living tasks. KR I referred the patient to PT for the shoulder pain. Would you, as an KR OT, treat this patient? KR Thanks, KR Ron KR -- KR Options? KR www.otnow.com/mailman/options/otlist_otnow.com KR Archive? KR www.mail-archive.com/otlist@otnow.com KR -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Would You Treat For Refer to PT?
Ron, I find myself in a very similar situation currently with a gentleman who is s/p humeral fracture. He went to an urgent care clinic wear they x-rayed him, gave him a sling and told him to wear it for 4 weeks, then wrote an order for OT. I am seeing him under Medicare part B in his ALF facility. He is reporting minimal pain, and even though it is his right (dominant arm), he totally figured out how to compensate and was very functional during his recuperation when he had limitation on weightlifting, etc. I debated back and forth what to do--turf to PT or attempt to do what I hate to do (straight exercises for the entire visit). Logistics prevailed and it was easier early on for me to come to the man than for him to get to a PT, so I proceeded, setting him up on graded range of motion programs. I have progressed him now to the point where we are using occupation based interventions during our sessions. But I will confess that I felt a bit like a fraud during the early weeks when I was doing straight exercise with him, because I wanted him to have the benefit of a skilled PT versus me, a generalist who is not a fan of exercise as a main modality for OT. In fact, now his main complaint is continued decreased ROM. It has gotten better, and he is quite functional, but he wants 100% return. I am going to refer him to PT and D/C him as I think I have maxed out what I can offer. Had this man been status post surery, or a rotator cuff repair, I woud have turfed him immediatley to the PT's. I have enjoyed great realtionships with the PT's I've worked with over the years and I think its becasue I let them do what they are experts at, and I do that at which I am an expert (facilitating engagement in occupation). In fact, more than once I have been thanked for acknowledging my limitations, especially in the ortho category--I am very aware of the potential for trouble because I saw first hand a bad outcome due to negligence on the part of the OT . The OT thought she knew what she was doing in regard to shoulder rehab and repeatedly put a client with a rotator cuff injury on the arm bike and re-injured the man. Needless to say, that did not help our pofessional credibilty one bit. Terrianne --- On Tue, 8/26/08, [EMAIL PROTECTED] [EMAIL PROTECTED] wrote: From: [EMAIL PROTECTED] [EMAIL PROTECTED] Subject: Re: [OTlist] Would You Treat For Refer to PT? To: OTlist@OTnow.com Date: Tuesday, August 26, 2008, 9:36 PM Does she?not lift?with her right shoulder because of the high pain level?? If she lives alone how will she take her trash out?? How will she load and unload her groceries from her car?? How will she carry her laundry basket to her room to put her clothes away?? Unless this lady has a fulltime maid, her life is a little difficult right now.? Perhaps prompting the lady's memory isn't such a bad idea, considering that her mind is probably focused on her high pain level, and she is probably thinking to herself Why does this guy have to know that information, I just want him to work on my arm, and she is giving you short answers, probably unaware that you were going to DC her. ?I would start on goal oriented compensation techniques to get her through her typical IADLs and a restorative program for her shoulder involving modalities, soft tissue mobilization around the coracoid process, relaxation facilitation techniques for?the shoulder,?and a graded therapeutic exercise program.? Based on AOTAs position papers over the years, this is certainly an appropriate?approach.? What is wrong with a bottom up approach starting with body functions and gradually improving to graded functional activities when the pain and the AROM improves significantly.? There is no way a patient like this would improve based on a top down approach.? She would learn to compensate, but from your evaluation it sounds like she wants her pain to improve, and for her shoulder to improve to her normal baseline.? Why in the world wouldn't a skilled OT with orthopedic shoulder?experience take this case? As OTs it is in our scope of practice to treat shoulders, knees, backs, hips, whatever, from a compensation and a restorative approach depending on the state in which you practice.? Now based on our level of education I would not suggest diving into restorative techniques for these areas unless you have had?extensive training, and if your PT partner on the other side of the clinic is working on the same thing.? Team work and communication is the key for those situations. -Original Message- From: Ron Carson [EMAIL PROTECTED] To: Kari Rogozinski OTlist@OTnow.com Sent: Tue, 26 Aug 2008 7:03 pm Subject: Re: [OTlist] Would You Treat For Refer to PT? Oops, I failed to mention that I my referral to PT was s/p my OT eval. Everything the patient stated matched my observation of her movement. Yes, it is her dominant side. She does not do much lifting with her right arm, because of the pain. She
