©German Occupational Therapy Association

 

 

   

Occupational therapy – second-class physiotherapy?

A classification of Kristina van Eyck

   

©German Occupational Therapy Association

Occupational therapy – second-class physiotherapy?

"Occupational therapy?! You dance Ringelrei with the children" - "Handicraft aunts!" - "That's second-rate physiotherapy"

There are always reactions like this when the topic of occupational therapy comes up. The most common question, however, is "What is occupational therapy and what exactly do you do?" This is a very good question, because occupational therapy cannot be described in one sentence. Well, it's going to be long, but it's worth reading.

Let's start with the question of what occupational therapy actually is and where it comes from.

The basic idea came about as early as the 1st century AD in Rome, when it was recognized that work, music and occupation for the mentally ill represent a sensible treatment method. At the beginning of the 20th century, work was used as a therapeutic measure for the mentally ill in the USA for the first time. During the First World War, the focus shifted to functional rehabilitation and reintegration into the world of work. In 1976 there was the first law on the profession of "occupational and occupational therapist" in the Federal Republic of Germany and in 1999 the profession was given the name "ergotherapy". The term "èrgon" comes from the Greek and means something like work, work, deed - healing through work and action.

Let's take a look at the definition of occupational therapy according to the German Association for Occupational Therapy: "Occupational therapy supports and accompanies people of all ages who are in their ability to act restricted or threatened with restriction are. The goal is to get them at the Carrying out activities that are meaningful to them in the areas of self-sufficiency, productivity and leisure in their personal environment to strengthen.
serve here specific activities, environmental adaptation and advice to the human Ability to act in everyday life, social participation and improving his quality of life to enable." (DVE08/2007)                                                                                                                                                                                                            

For a better understanding, let's transfer this definition to a neurological example:

Mr A. is 70 years old and suffers from Parkinson's disease. Symptoms are limited to incipient balance difficulties. He is an avid cyclist (meaningful activity) and makes regular with his family (personal environment) small bike trips. Now he feels increasingly unsafe with the bike and no longer dares to ride.

During the Therapy We would now consider, among other things, its environment, activities important to it and its resources and limitations. In this case, there would be different approaches: Depending on the risk of falling, balance could be trained and cycling could be analyzed and, if necessary, difficult situations could be practiced. Alternatively, advice on aids for a bicycle with three wheels would be something that should be tested. This would also be in agreement with Mr. A Participation allows.

This definition of the DVE reflects the core of the profession and is used across all professional fields. Occupational therapy is a very diverse profession and can be found in different areas. The six major fields are: neurology and orthopaedics, paediatrics, geriatrics, occupational therapy and psychiatry. Other fields include traumatology, rheumatology, hand therapy, community-oriented occupational therapy, job coaching, palliative care and school-based occupational therapy.

The following criteria form a basic orientation for occupational therapy treatment:

  • -Client centricity
  • - Importance of activity for humans
  • -Eligibility to participate
  • - Exchange between science and practice

 

If I transfer these points of orientation to the clinical picture of Parkinson's disease and consider three different people with three different courses of the disease and main symptoms, it becomes clear that there is no such thing as THE occupational therapy treatment plan.

Mr. B. has few motor impairments, but notices that he is increasingly forgetting things in everyday life and cannot integrate his exercises into everyday life.

  • With him, the focus would be on brain performance training and the transfer of memory strategies into everyday life. As well as adapting the environment to this forgetfulness or using aids, for example by having reminders in the apartment or using digital gadgets as reminders. For the integration of the exercises into everyday life, a joint structural aid could possibly be worked out/discussed/designed together with the relatives.

Ms. C. is in a wheelchair and has difficulty getting up, dressing and undressing, and her upper body is bent forward with a tendency to fall to the right, even when seated.

  • Ms. C. focuses on motor exercises. So it makes sense to do exercises for body awareness and erection and for postural control in order to counteract the tendency to fall. In addition, you can start directly in everyday life and practice getting up and changing in dressing training.

 

Ms. D. is mainly affected by this freezing and the starting difficulties that mean it cannot start regularly.

  • For Ms D., the focus would initially be on testing cueing strategies and considering how these can be integrated into everyday life.

In all three examples, communication with the patient is a prerequisite for filtering out what is of particular importance to him. In principle, however, it should be noted with this disease – move a lot and move a lot.

Well, it's becoming clear that there are also overlaps with physical therapy, that "tinkering" can represent a method of action to achieve a specific goal, and that even "circle dancing" can have a deeper meaning. However, one thing is clear - it is worth asking, because there is often more to it than meets the eye at first glance.

German Association of Occupational Therapists (2007): Definition. In: Definition – German Association for Occupational Therapy (DVE)

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