Column: Learning about OT during Occupational Therapy Month

Frank Grispino MOT, OTR/L, CHT

Since every April is Occupational Therapy Month, and I’m an occupational therapist, I thought I would take this month’s column and give you an overview of the discipline.

Occupational therapy formally started in the early 1900s. It was originally used in the treatment of individuals with mental health issues. Physically and mentally wounded veterans from WWI and WWII increased the need for occupational therapy. Physical dysfunction now became another area addressed by practitioners in the field. This gave the discipline an identity, and propelled it toward what it is today.

The name occupational therapy, or OT, can be confusing to those in the field of health care and the lay public, too. Occupation in this sense refers to human occupation, not a job or career. Human occupation can be thought of as another word for activity. OTs use activity whenever possible as therapeutic interventions. Multiple strong studies have shown that use of an activity vs. plain exercise is a more effective way to rehabilitate.

The guiding goal of occupational therapy is to improve a person’s function in the life roles they participate in. Parent, student, artist, worker and musician are just a few examples of life roles. When the performance of these roles suffers because of mental or physical disability, the occupational therapist may be called in to help with the goal of maximizing independence.

There are several ways the OT may do this. We can try to fix the physical problem — again, using functional activity as a therapeutic medium when possible. Occupational therapists spend a lot of time learning to analyze tasks and break them down into base components or steps. From this information, an OT can identify where and how the dysfunction impacts the task performance. At this point, it’s easier to modify the task or the way the task is performed. If the physical problem can’t be fixed, this allows the use of modified techniques or adaptive equipment to maximize independence.

An example of fixing the physical problem would be rehabilitation after a carpal tunnel release. The muscles are strengthened that became weak when the nerve was compressed, and independence improves. Occupational therapists/hand therapists also custom-fabricate splints. Reasons for using custom splints can be for protection or mobilization. Complex hand injuries with tendon involvement is a common area custom splints are needed. The same splint can mobilize and protect different structures if necessary.

An example of a modified technique is teaching someone to put on a shirt by dressing the arm that had shoulder surgery first and undressing it last. This ensures the boldest movements are performed with the uninjured arm, and increases independence when dressing.

The last example is the use of adaptive equipment. Special equipment like long-handled shoehorns and sock aids can be used to maximize independence when dressing in cases where the injured person may not be able or allowed to bend over, like after a back surgery.

These are some of the most basic situations and examples. Imagine the possibilities for more complex diagnoses like spinal cord injury, traumatic brain injury, traumatic hand injury, blindness or autism spectrum disorders. There’s really no place an OT can’t operate with the proper experience and training.

I’m a hand therapist. My clinical practice is specialized to deal with dysfunction from the hand to shoulder. Other areas of specialty include pediatrics, low vision, mental health, neurological disorders and injuries and school-based. These are just a few. The field of OT is perfect for people who get bored and like variety, though most of the more complex specialties take years and mountains of continuing education to master.

Do you think you could be helped by Occupational Therapy or want to learn more? Give me a call at my Maryville clinic, ARC PT+. My phone number is 660-224-2077. I’m happy to help.