Essay on Occupational Therapy
Occupational Therapy Term Papers
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Joe is currently a client receiving treatment at a hand therapy clinic, due to a traumatic injury to his left hand. Carpentry work has been Joe's profession for many years. He suffered a debilitating injury to flexor tendons of the 2nd and 3rd metacarpals, fracturing the first metacarpal bone, severing the 4th finger and all innervation to the fingers. The flexor tendons are repaired, the first metacarpal bone has healed and the open wound in the palm of his hand has finally closed. Joe has severe disability to the left hand and is limited in function of all occupational areas. He has an extreme amount of stiffness, pain and weakness due to the tendon repair. This results in a limited active and passive range of motion in his wrist and fingers.
Goniometric assessment was chosen for Joe due to the weakness of the muscles and loss of innervation to the hand. A comprehensive evaluation of joint range of motion is appropriate to improve functional abilities of his hand. Due to the extreme amount of stiffness in the left hand, goniometric assessment will enable the therapist to assessment will enable the therapist to assess dysfunction and start a rehabilitative program. Measurements of Joe's wrist and proximal interphalangeal finger joints were taken to provide new information on how the appropriate intervention activities were progressing him to a more functional range of motion. This was an appropriate evaluation tool because it provided information on how progression was made at each joint to alleviate stiffness and pain in Joe's left hand. The passive range of motion measurements provided information on how much Joe has improved since the beginning of treatment.
Special tests and evaluation procedures that would be appropriate for this patient would be to test for a positive Tinel sign and testing opposition or pinching. The special test of Tinel sign would be performed to assess and determine the innervation that is returning back to the fingers. The therapist can tap over the volar surface of the wrist and proximal phalanges to show a positive sign of tingling over the fingers. The positive sign would show the return of innervation to the area. Joe had a positive Tinel sign over the proximal phalanges. Another evaluation procedure is testing opposition and pinching. Opposition of the thumb to the index finger is a recent range of motion returning to Joe's left hand. This shows the reduced amount of stiffness in the finger flexors and the return of some functional mobility of the joints.
The process of evaluating Joe began by reviewing records to get an idea of his current symptoms and functional abilities. Palpation was used to locate specific bony landmarks in his wrist. There was some deformity of his wrist due to the trauma but the specific landmarks were located with some effort. Joe was very cooperative and willing to allow me to perform goniometric measurements on his wrist and hand. There were no problems with communication or positioning. Through this clinical assignment I learned that there is no magic cookbook in the way if positioning the patient. All bony landmarks must be in alignment and the fulcrum must be in the proper position. As long as these standards are followed, the patient can be positioned in a way that is most comfortable and what works best for the therapist. As students this is a great experience due to the fact that we have a limited amount of time while learning how to perform the measurements and must stick to the textbook. There were not any required adaptations to standard procedures. While administering...
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