OT’s: Tips for Incorporating Function into a Plan of Care
By: Cristina Klymasz, MS, OTR/L, CBIS, RYT, CLT, MSCS
April marks many things: spring weather, April Fool’s Day, and OT month. Happy OT Month my fellow OT’s! In celebration of OT month, this blog will discuss the importance of keeping tasks functional and also provide some tips.
While implementing functional tasks is a specialty of an OT, it is a very meaningful intervention for all rehabilitation specialists, such as speech therapists and physical therapists. Current evidence based research is highlighting the importance of functional task training in all conditions/diagnoses and areas of rehabilitation. The research highlights the following with functional task training:
- Higher levels of client satisfaction
- Higher levels of home exercise program (HEP) compliance
- Larger gains in objective measurements and outcome measures
- Higher attendance compliance
- Larger cognitive improvements with incorporation of functional tasks, even if cognition is not being directly addressed. The beauty of what we call ‘neuroplasticity’. New and varied experiences lead to more cognitive stimulation- and more progress!
But how do we as rehabilitation specialists incorporate function? With increased productivity and documentation demands, how can we incorporate function without increased time in planning and designing activities? Here are some practical tips for all rehabilitation specialists:
Tips for Incorporating Function into a Plan of Care:
- If the client will be returning to a hands-on job, such as an electrician or plumber: Can he/she climb a ladder safely? Incorporate this, when safe and appropriate, into a treatment plan.
- If the client will be returning to healthcare or public service: Can the client perform CPR with their stamina? Can this be simulated with a Bosu board or a peanut? Can the client assume kneeling?
- If the client will be returning to functional mobility in the community: Can he/she ambulate on several types of surfaces safely? Maybe attempt when appropriate: ambulation on rocks, sand, and curb-cut-outs.
- If the client needs to react quickly in order return to driving or responding in an emergency: Time pressure the client during regular session tasks. If a typical task tasks takes 5 minutes to complete, can he/she complete it 30 seconds faster without overwhelm or task breakdown?
- If the client is retired and returning to enjoyed leisure activities: Can the client ambulate uneven surfaces and distances, such as on a golf course? Can the client perform co-contraction motions safely, such as when swinging a golf club or a baseball bat? Do you have a golf-club or a baseball bat to trial functional motion? Can you simulate bowling with a medicine ball and bolsters? Can the client quickly deal cards if there is an orthopedic or neurological condition affecting his/her hand(s)?
- If the client will be returning to managing their health and daily tasks: Can they make and follow important phone calls- such as negotiating a medical insurance issue? Does the person need education on taking notes when he/she attends a doctor’s visit?
- If the client is a child or teenager: Can he/she assume developmental positions allowing him/her to participate in their everyday activities? Can the client grasp and functionally use toys? Can the client sit or kneel for a duration of time to play sports or play with a friend?
This is not an exhaustive list but a start to guide us all in beginning to think about how to add more functional tasks into our treatment planning without a significant amount of extra work. It is quite amazing how addicting it can become when we reap the great results! For more ideas and information on the research, check-out the course: Evidence Based Cognitive Rehab Strategies for the Neurological Patient: A Toolkit to Improve ADL Independence, Ambulation Safety, Reading, and Communication here!