Susan E. Fasoli, Mary K. Ferraro, Susan H. Lin; Occupational Therapy Can Benefit From an Interprofessional Rehabilitation Treatment Specification System. Am J Occup Ther 2019;73(2):7302347010p1-7302347010p6. doi: 10.5014/ajot.2019.030189.
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© 2019 American Occupational Therapy Association
To advance evidence-based practice across rehabilitation professions, clinicians, and researchers could benefit from a structured way to clearly describe the treatment interventions used by their discipline. Development of the Rehabilitation Treatment Specification System is an interprofessional effort to use a theory-driven and systematic approach to define, specify, and quantify the complex nature of rehabilitation treatments. In this article, we introduce this novel approach and provide a case example that illustrates application to clinical practice. We invite occupational therapy practitioners to consider how clear specification of the content and process of their interventions could benefit practice, research, and education.
Bill is a 69-yr-old, left-handed man with left hemiparesis after a right middle cerebral artery stroke who has received inpatient rehabilitation for the past 2 wk. His occupational profile revealed that he is a state court clerk retiree who lives with his spouse and has two grown children in the area. Areas of high importance on the Canadian Occupational Performance Measure (Law et al., 2014) include home maintenance tasks and building wooden birdhouses with his four grandchildren.
Further standardized evaluations reveal limited functional use of Bill’s dominant left upper extremity. Proximal motion at the left shoulder and elbow is fair to fair minus, and he can position the hand on the table with weak but deliberate motions. Active finger flexion and extension are present, but extension is limited; fine motor coordination is very impaired (e.g., Bill can use the left hand to stabilize a jar but is unable to manipulate utensils or grooming tools during activities of daily living). Left neglect is evident during many functional tasks; Bill does not regularly scan to the left visual space. Bill’s spouse attends therapy regularly and comments on his decreased motivation and unawareness of his deficits.
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