I'm not a big fan of that breakdown in components either, but what I
did gather from that quote was the agitated person wouldn't do anything
but shoot baskets, so I think that both PT and OT had to stretch a bit
in order for the patient to get through the agitated stage from an
inurance point of view, if you know what I mean.
From a multidiciplinary approach I can see why both disciplines would
use that treatment choice. I'm sure working on a dynamic challenge
like that would assist with a PT's walking and stair climbing goals.
I'm sure working on a game like that in OT would help with their ADL
goals and the actual leisure goal of playing BB. Not sure if I would
feel comfortable with both disciplines working on it at the same time,
for every treatment session. That would be odd. but I guess the world
of traumatic brain injury is a unique animal in which treatment choices
are limited especially during the intitial stages of the game. And to
let the patient lie around and do nothing until they "come around" is
unlikely and tough on the body, mind, and soul.
I can see Ron's point about the perception of PTs using occupations as
a modality, but when it comes down to it, I think in this situation
they were doing all that was allowed by the patient. I would be more
concerned if they wrote goals that were directly occupationally based
versus pain, steps, balance, ROM, strenght, etc. Not trying to
minimize the problem, just trying to provide a rational explaination,
because it happens all of the time in acute rehab, when the patient
doesn't feel like getting up and moving.
Chris Nahrwold MS, OTR
-Original Message-
From: Ron Carson
To: OTlist
Sent: Tue, Aug 18, 2009 7:16 pm
Subject: [OTlist] Difference?
"If a patient does not respond to a specific treatment
intervention,
team members discuss what is working for them and incorporate
that
into the PT sessions. For example, we had a patient who
enjoyed
playing basketball but wasn't interested in much else due
to his
agitated state from his brain injury. The OT used this
task for
counting, visual perceptual training and attention. The PT used
this
task by having the patient stand and shoot baskets from
varying
distances to address balance and coordination. When treating
persons
with acquired brain injury, it is essential to identify what
will
motivate them to participate in therapy while
providing
interventions that will address their impairments and
functional
limitations" SOURCE: (Rehab Management. Vol. 22, No.7, Page 15.)
The above quote is taken from a brief physician written article
on an
interdisciplinary approach to stroke rehab. I should mention
that the
magazines article has a picture of an OT doing UE range of motion, what
else
right??? None the less, look at the quote. Notice that the MD
refers to
incorporating intervention into PT sessions? Oversight on his part, or
just
a fact that PT IS the team?
Also, please tell me what the heck is the difference between what the
PT and
the OT are doing? The whole concept of separating basketball into
specific
treatment spectrums is just plain silly. If a person is "playing"
basketball
isn't he working on ALL the processes needed to through the ball
into a
hoop? Why would OT segment out their treatment into cognitive "stuff"
while
the PT addresses the physical "stuff"?
In my opinion OT should be the ONLY discipline using basketball for
rehab.
PT should be in the gym working on ROM, strength, pain, etc.
For 10 YEARS, I've been preaching that occupation is our bread and
butter.
But, phys-dys OT's are so stupidly stuck on limiting themselves to UE
rehab
that OTHER disciplines are grabbing onto the VERY TERRITORY that we
should
be staking claim to.
I predict, that one day in the future, OT's will look back and say,
why did
we let PT take over using daily occupation as a treatment modality.
We are literally shooting ourselves in the foot just so we can lay
claim to
the stupid arm! Tragic really!!!
Ron
~~~
Ron Carson MHS, OT
www.OTnow.com
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