Patricia Siegel, Brandi L. Jones, Janet L. Poole; Occupational Therapy Interventions for Adults With Fibromyalgia. Am J Occup Ther 2018;72(5):7205395010p1-7205395010p4. doi: 10.5014/ajot.2018.725002.
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© 2018 American Occupational Therapy Association
Evidence Connection articles provide a clinical application of systematic reviews developed in conjunction with the American Occupational Therapy Association’s (AOTA’s) Evidence-Based Practice Project. In this Evidence Connection article, we describe a case report of a person recently diagnosed with fibromyalgia. The occupational therapy assessment and intervention process in the home setting is described. Findings from the systematic review (Poole & Siegel, 2017) on this topic were published in the January/February 2017 issue of the American Journal of Occupational Therapy and in AOTA’s Occupational Therapy Practice Guidelines for Adults With Arthritis and Other Rheumatic Conditions (Poole et al., 2017). Each article in this series summarizes the evidence from the published reviews on a given topic and presents an application of the evidence to a related clinical case. Evidence Connection articles illustrate how the research evidence from the reviews can be used to inform and guide clinical reasoning.
Plan tasks in advance. Terry instructed Jennifer to use a journal to establish a plan for cleaning, including vacuuming and changing bed sheets, each week.
Prioritize cleaning tasks, including vacuuming and changing bed sheets, for the week. After a task from the journal was completed, Jennifer would rate the task on a scale of 1–10 to indicate how much time and energy she had spent with the task as well as her fatigue after the task. This documentation allowed Jennifer to see where she was spending her energy and which tasks created more fatigue for her.
Plan and organize activities. Terry instructed Jennifer to group tasks that required less energy (e.g., grading student papers, paying bills) with those that were more taxing, such as vacuuming. She also suggested that Jennifer schedule and plan rest periods during which she could do mindfulness training. This type of schedule allowed Jennifer to schedule vacuuming and changing bed sheets into her other daily tasks without increasing pain and fatigue (Lera et al., 2009).
Use good posture and body mechanics during tasks. Terry instructed Jennifer to avoid staying in one position for extended periods and to change her position often. She also advised her to use good body mechanics during vacuuming, including using larger joints to move the vacuum and lifting with her legs when picking it up.
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