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Occupational Therapy Janet L. Poole, PhD, OTR/L Occupational Therapy Program University of New Mexico, Albuquerque, NM, USA [email protected]

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Page 1: Occupational Therapy - Sklerodermi · Occupational Therapy Goals for Persons with Systemic ... alternative techniques, ... curved bristle brushes, children’s

Occupational Therapy

Janet L. Poole, PhD, OTR/L

Occupational Therapy Program

University of New Mexico, Albuquerque, NM, USA

[email protected]

Page 2: Occupational Therapy - Sklerodermi · Occupational Therapy Goals for Persons with Systemic ... alternative techniques, ... curved bristle brushes, children’s

Occupational Therapy

Goals for Persons with Systemic

Sclerosis

• Increase participation in daily tasks

– Increase joint motion

– Increase hand function

– Increase independence in performing daily

activities

– Education regarding assistive devices,

alternative techniques, energy conservation

Page 3: Occupational Therapy - Sklerodermi · Occupational Therapy Goals for Persons with Systemic ... alternative techniques, ... curved bristle brushes, children’s

MCP Flexion

Thumb Abduction

PIP Extension

Thumb flexion

PIP

�����

�

MCP

Page 4: Occupational Therapy - Sklerodermi · Occupational Therapy Goals for Persons with Systemic ... alternative techniques, ... curved bristle brushes, children’s

How to monitor the motion in key

hand joints

Draw a hand out line to help monitor finger extension

Page 5: Occupational Therapy - Sklerodermi · Occupational Therapy Goals for Persons with Systemic ... alternative techniques, ... curved bristle brushes, children’s

How to monitor the motion in key

hand joints

Templates to monitor MCP flexion

MCP joint

Page 6: Occupational Therapy - Sklerodermi · Occupational Therapy Goals for Persons with Systemic ... alternative techniques, ... curved bristle brushes, children’s

Thumb abduction

Find the largest size object that will fit in the

web space with all sides of web space touching

object

Gap; object

too large

Page 7: Occupational Therapy - Sklerodermi · Occupational Therapy Goals for Persons with Systemic ... alternative techniques, ... curved bristle brushes, children’s

Oral Exercises(Naylor. JADA 1982; 105:814-817)

• Exaggerated facial movements such as smiling,pursing lips

← Augmentation withtongue depressors

← Manual stretching of mouthwith fingers

Page 8: Occupational Therapy - Sklerodermi · Occupational Therapy Goals for Persons with Systemic ... alternative techniques, ... curved bristle brushes, children’s

• Toothbrushes for

decreased hand

dexterity

Electric flosser

ORAL HYGIENE

Electric

toothbrush

•Electric tooth brushes, water jets,

curved bristle brushes, children’s

toothbrushes

Page 9: Occupational Therapy - Sklerodermi · Occupational Therapy Goals for Persons with Systemic ... alternative techniques, ... curved bristle brushes, children’s

Assistive/Adapted Devices

•Manipulation-large handles

•

Page 10: Occupational Therapy - Sklerodermi · Occupational Therapy Goals for Persons with Systemic ... alternative techniques, ... curved bristle brushes, children’s

Dressing devices

Button hooks

Zipper pulls & rings

Sock aid

Reacher

Long shoe horn

Page 11: Occupational Therapy - Sklerodermi · Occupational Therapy Goals for Persons with Systemic ... alternative techniques, ... curved bristle brushes, children’s

Good grips and Oxo

Key holders

Open It Medication Bottle OpenerFrom easycomfort.com

Page 12: Occupational Therapy - Sklerodermi · Occupational Therapy Goals for Persons with Systemic ... alternative techniques, ... curved bristle brushes, children’s

Jar and Can Openers

JarPop

3-in-1 opener

Page 13: Occupational Therapy - Sklerodermi · Occupational Therapy Goals for Persons with Systemic ... alternative techniques, ... curved bristle brushes, children’s

Websites

(Google “assistive devices”)

• www.disabilityproducts.com

• Easycomforts.com

• www.sammonspreston

• www.maddak.com

• www.oxo.com

Page 14: Occupational Therapy - Sklerodermi · Occupational Therapy Goals for Persons with Systemic ... alternative techniques, ... curved bristle brushes, children’s

Energy Conservation

the four P’s� Prioritze

� Make a list of priorities and the order by importance; delegate

� Plan ahead

� Pace yourself and avoid fatigue; slow down� Balance rest and activity: short frequent rests

� Posture� Sit when possible but alternate positions too

� Use good posture

� Use good body mechanics

Page 15: Occupational Therapy - Sklerodermi · Occupational Therapy Goals for Persons with Systemic ... alternative techniques, ... curved bristle brushes, children’s

Solutions used by working people

with scleroderma• Ask/accept help from co-workers

• Modify work hours – 4 day weeks or shorter

days (start later)

• Work from home

• Keep WARM

• Switch tasks and take breaks to cut fatigue or

stress

• At home – renegotiate tasks at home, sleep on

weekends, prepare for workweek

Page 16: Occupational Therapy - Sklerodermi · Occupational Therapy Goals for Persons with Systemic ... alternative techniques, ... curved bristle brushes, children’s

•Voice

activated

• Keyboarding aids

Ideas for the computer

www.coldhands.me

Page 17: Occupational Therapy - Sklerodermi · Occupational Therapy Goals for Persons with Systemic ... alternative techniques, ... curved bristle brushes, children’s

Chinese health balls or

qi gong balls (come in

smaller sizes)

Dexterity / coordination exercises

Touch thumb to

each finger quickly

Lift and lower

fingers one at a

time quickly

Fig. 2 Fig. 3

Jumping rubber band

magic trick

Page 18: Occupational Therapy - Sklerodermi · Occupational Therapy Goals for Persons with Systemic ... alternative techniques, ... curved bristle brushes, children’s

http://www.nimblefingers.com/b_stret.htm

Dexterity Exercises

Page 19: Occupational Therapy - Sklerodermi · Occupational Therapy Goals for Persons with Systemic ... alternative techniques, ... curved bristle brushes, children’s

Questions and AnswersQuestionsQuestions


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