Ja's Weight Bearing Intervention Session Essay
JA’s Weight Bearing Intervention Session by Jeanese Murdock, OTAS
Care Team Home Health-Keely Peel, COTA
Overview of Patients Occupational Profile
JA is a 14 year old male with severe spastic Cerebral palsy and scoliosis. JA is on a trach and requires 24 hour assistance. He is seen two times a week by OT and the treatment sessions are mainly focused on range of motion and taylor sitting to decrease the contractures. When starting a session he is very tight, by the end on a thirty minute session you can usually have him relaxed and stretched out. One of the ways JA copes with this is chewing on his fingers so much so that the first digit of each hand is callused at the MCP joint. When working with JA one of the things you really have to watch is his trach, he is oxygen dependent via the …show more content…
trach.
POC Goals that were addressed
The goals addressed were patient will maintain normal tone throughout body by tolerating a variety of weight bearing positions to decrease the progression of contractures. Patient will demonstrate an appropriate level of arousal for 15 minutes for increased participation during grooming activities with max assist.
Frame of Reference used to address goals
The Frame of References I chose to address JA’s goals were biomechanical and neurodevelopmental in order to address motor movements and improve strength by having JA weight bear to bilateral upper extremities in order to participate in ADL skills.
Statement related to how I used EBP research
JA’s goals to normalize tone to decrease contractures is supported through weight bearing activities. In order to elicit a response from JA evidence shows that you can increase this response through weight bearing.
Intervention implementation and outcomes
I started my session by getting JA in quadruped with good body alignment on a makeshift bolster, within a few minutes of this position JA was raising his head into neck extension which is not a usual pattern for him. After several more minutes JA was extending his left elbow along with left hand finger extension which is normally in flexion at the elbow and the fingers. I applied the hand over hand technique in order for JA to tap the balloon and he smiled. This weight bearing activity elicited overall decreased tone which is what we were anticipating.
What would I change to make this a better
session?
The treatment session worked well with elicited responses which is not normal for JA with that being said and without a lot of experience I would not change it. It was working so I did not feel a need to change. However, in my next session with JA I will try another part of my originally planned session to see if I get similar responses.
Take away message
The take away message for me was the feeling of accomplishment to see the response from JA, not only him but the reaction on the COTA and nurses face when JA responded to the activity. Knowing that I facilitated a session that JA benefitted from gave me a feeling of satisfaction and confidence. I now have a greater understanding of how to utilize the information I research.
Care Team Home Health-Keely Peel, COTA
Overview of Patients Occupational Profile
JA is a 14 year old male with severe spastic Cerebral palsy and scoliosis. JA is on a trach and requires 24 hour assistance. He is seen two times a week by OT and the treatment sessions are mainly focused on range of motion and taylor sitting to decrease the contractures. When starting a session he is very tight, by the end on a thirty minute session you can usually have him relaxed and stretched out. One of the ways JA copes with this is chewing on his fingers so much so that the first digit of each hand is callused at the MCP joint. When working with JA one of the things you really have to watch is his trach, he is oxygen dependent via the …show more content…
trach.
POC Goals that were addressed
The goals addressed were patient will maintain normal tone throughout body by tolerating a variety of weight bearing positions to decrease the progression of contractures. Patient will demonstrate an appropriate level of arousal for 15 minutes for increased participation during grooming activities with max assist.
Frame of Reference used to address goals
The Frame of References I chose to address JA’s goals were biomechanical and neurodevelopmental in order to address motor movements and improve strength by having JA weight bear to bilateral upper extremities in order to participate in ADL skills.
Statement related to how I used EBP research
JA’s goals to normalize tone to decrease contractures is supported through weight bearing activities. In order to elicit a response from JA evidence shows that you can increase this response through weight bearing.
Intervention implementation and outcomes
I started my session by getting JA in quadruped with good body alignment on a makeshift bolster, within a few minutes of this position JA was raising his head into neck extension which is not a usual pattern for him. After several more minutes JA was extending his left elbow along with left hand finger extension which is normally in flexion at the elbow and the fingers. I applied the hand over hand technique in order for JA to tap the balloon and he smiled. This weight bearing activity elicited overall decreased tone which is what we were anticipating.
What would I change to make this a better
session?
The treatment session worked well with elicited responses which is not normal for JA with that being said and without a lot of experience I would not change it. It was working so I did not feel a need to change. However, in my next session with JA I will try another part of my originally planned session to see if I get similar responses.
Take away message
The take away message for me was the feeling of accomplishment to see the response from JA, not only him but the reaction on the COTA and nurses face when JA responded to the activity. Knowing that I facilitated a session that JA benefitted from gave me a feeling of satisfaction and confidence. I now have a greater understanding of how to utilize the information I research.