Peer Review And Public Commentary
Following the formation of a final draft, the CPG draft was subjected to a 3-week peer review for additional input from external content experts and stakeholders. More than 250 comments from 12 societies were collected via an electronic structured review form. All peer reviewers were required to disclose any potential conflicts of interest, which were recorded and, as necessary, addressed.
After modifying the draft in response to peer review, the CPG was subjected to a 2-week public comment period. Commenters consisted of the APTA Board of Directors , the APTA Scientific and Practice Affairs Committee, all relevant APTA sections and academies, stakeholder organizations, and the physical therapy community at large. More than 47 public comments were received. Revisions to the draft were made in response to relevant comments.
Ot Encompasses Several Different Areas:
- Activities of Daily Living . These are the basic self care skills of eating, dressing, grooming, bathing, toileting and toilet hygiene and personal care devices .
- Instrumental Activities of Daily Living . These include the care of others, care of pets, financial management, driving and community mobility, health and medication management, meal prep and clean up, religious and spiritual activities, shopping, safety and emergency maintenance, etc.
- Functional Mobility. This includes getting around your home and environment to perform your daily activities, transfers to bed, toilet, bathtub/shower, couch, recliner chair, wheelchair and car, etc.
- Adaptive Equipment. This includes long handle utensils to reach your feet or back, tremor management eating utensils, non skid mats, button hook, lidded cup with straw, scoop dish, adaptive pen, etc.
- Work Activities. This includes work station set-up/ergonomics, adaptive devices to make it easier to perform work tasks .
- Cognition. This includes activities to stimulate cognitive function to maximize performance .
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How To Treat Parkinsons Disease Symptoms With Occupational Therapy
Parkinsons disease can introduce all types of challenges into your daily life, including those that interfere with simple activities that you used to take for granted such as eating, writing, and using a cell phone. Sometimes medication changes can help you move more easily, but sometimes that is not enough.
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How Can Occupational Therapy Help Me
As Parkinsons progresses you may find tasks or hobbies become more difficult or take more time and energy, for example turning in bed, eating and drinking, doing up buttons, using a computer and writing. Your occupational therapist will first assess your daily routines and often your home, work and leisure activities. He or she will then recommend different ways of doing difficult tasks, or advise on the use of appropriate gadgets or technical aids to assist you.
An occupational therapist can also advise how to adapt your home or workplace to improve easy movement or safety, for example by arranging the installation of extra hand rails by steps, stairs and perhaps in bathrooms. He or she may also advise on how to prevent some potential problems before they arise.
It is important to stress that the success of occupational therapy is dependent on your collaboration with your therapist. The advice and recommendations you are given should be a catalyst for you to develop your own routines that enhance quality of life and preserve independence. Occupational therapy cannot overcome daily challenges without your active engagement and cooperation!
Ideally, you should ask to be referred to, or contact directly, an occupational therapy service as soon as you start to find everyday tasks difficult. Because your symptoms will gradually change, you will probably need to contact an experienced therapist from time to time so that you can learn new strategies.
Tip: Enhancing Hand Coordination
We use our hands throughout the day in all activities. People with PD may notice changes in the ease in which they perform hand and finger motions. An occupational therapist can help evaluate and make recommendations to improve hand coordination:
- Exercise hands and fingers regularly
- Engage in enjoyable and stimulating hand exercises, such as gardening or knitting
- Use toothbrushes, hairbrushes, silverware and writing tools with larger handles
- Use both hands in tasks dont favor one hand over the other
- Schedule tasks that require greater hand control for times when you are well rested and medications are working well
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How Can Occupational Therapy Help Parkinson’s Disease
For Parkinson’s disease, occupational therapy generally provides assessment, treatment, and recommendations in the following areas:
- Arm and hand therapy
- Driver evaluation and vehicle modification information
- Cooking and homemaking adaptations
- Ways to make the most of your energy
- Computer modifications
- Workplace or work equipment modifications
- Leisure skill development
Voting On The Recommendations
GDG members agreed on the strength of every recommendation. Recommendations were approved and adopted when a majority of 60% of the GDG voted to approve. All recommendations received 100% agreement among the quorum of the voting GDG. No disagreements were recorded during recommendation voting. When changes were made to the strength of a recommendation based on the magnitude of benefit or potential risk, harm, or cost, the GDG voted and provided an explanation in the rationale.
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Enabling A Cell Phones Accessibility Settings
Smartphones have many accessibility settings. An iPhone, for example, has numerous features for people with vision, motor, hearing and learning challenges. Click on the Settings icon and select Accessibility to see all the options.
Experiment with all the different settings that can help make using your smartphone easier. For example, you can set up your smartphone so that it responds to voice commands. You can also use speech-to-text on many smartphones or take advantage of the word prediction software. You can set up your cell phone so that it will ignore multiple touches or respond only to the first or last place that you touch. You may have to try different settings to see which one or combination best helps you use your cell phone.
Always remember, slowing down and avoiding multitasking while trying to use your phone can help minimize mistakes.
The above is just a sampling of what an OT can help you with. OTs can also help you better navigate additional daily tasks like dressing, bathing, and more.
Which Works For Me
After your evaluation, let your therapist decide which exercise program is best for you. It is never too early or too late to start an exercise program for Parkinsons. Research has demonstrated functional improvements at all stages of the disease. Your therapist will determine with you which treatment protocol best suits your needs. Contact us to schedule your evaluation.
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Preparing Meals And Navigating The Kitchen
Consider where things are located in your kitchen. You might want to reorganize or rearrange things in your kitchen so that frequently needed items are the easiest to access. Plan ahead and break down the steps of your meal prep so that it is more manageable.
There are lots of tricks and tips that OTs have to help in the kitchen such as sliding heavy pots of water along the countertop instead of carrying them or sitting at the kitchen table to chop vegetables instead of standing. If you enjoy cooking, there are likely lots of suggestions an OT can make to help you be safer and more independent in the kitchen.
Tips And Tricks From An Occupational Therapist That Can Help Increase Independence During Daily Activities
Lisa Carson, OTD, OTR/L is an occupational therapist at Washington University in St. Louis, Missouri, who works closely with our APDA Greater St. Louis Chapter. She has a lot of expertise in treating people with PD, helping them to achieve increased independence. If you are interested in working with an OT, be sure to speak to your neurologist about it and ask for a recommendation. Your local APDA Chapter may also be able to refer you to an Occupational Therapist in your area.
Recently, I was able to ask Dr. Carson about tips and tricks for people with PD who are having difficulty with some basic activities such as eating, preparing meals, writing, using a keyboard, and using a cell phone. Here are her suggestions:
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How Ot Can Help Improve Your Quality Of Life Throughout The Stages Of Parkinsons:
In Stage I of Parkinsons, tremor and other movement symptoms are mild and typically affect one side of the body. OT during Stage I can address:
As Parkinsons progresses to Stage II, tremor, rigidity and other movement symptoms impact both sides of the body and posture and walking are also affected. OT during this stage can address:
- Stretch to warm up before dressing. Allow plenty of time to get ready before going out into your community. Use adaptive equipment to make dressing easier, such as a long handle shoe horn, elastic shoe laces, button hook, Velcro closures on shoes and clothes, etc.
- Toileting. Use a regular schedule to help prevent accidents. Use pads, briefs or panty liners to help with incontinence. Use plastic or washable pads for bed.
- Exercise Training. Continue large amplitude exercises as you are able.
In Stage III of Parkinsons, symptoms include loss of balance and slowness of movement, and falls are more common. Though the person living with Parkinsons is still fully independent, symptoms significantly impair activities of daily living such as dressing and eating. To help during this stage, OT can address:
In Stage IV of Parkinsons, symptoms are severe and very limiting. Tremor may be less, but rigidity and freezing can profoundly affect your quality of life. While its possible to stand without assistance, movement may require a walker. OT during Stage IV can address:
Add Aqua Therapy To Your Parkinsons Patients Treatment
HydroWorx offers a variety of products specifically designed to help facilities, just like yours, bring the benefits of aqua therapy to Parkinsons patients and many others. We can work with you to identify your patients needs to determine the ideal hydrotherapy solution from our versatile family of products.
Not only can we help you identify the best possible equipment for your facility needs, but also unique and creative ways to integrate aquatics into your Parkinsons patients current treatment routines. When you have the equipment onsite, it becomes simpler to make adjustments, especially when you take advantage of features enhancing the experience like adjustable-floor therapy pools and variable-speed underwater treadmills.
The use of aquatic therapy, underwater treadmills and resistance jet technology for Parkinsons patients can do the following and more:
- Help regain trunk balance
- Improve ambulation
- Encourage confidence
All of the above are critical when encouraging Parkinsons patients to exercise for their health and to reduce the severity of their symptoms.
Aquatics offers a full range of exercises patients can do without a fear of falling to hold them back. Whether youre working with Parkinsons patients, Alzheimers patients or patients with a host of other physical and neurological conditions, hydrotherapy can be an effective tool for promoting overall physical fitness and good health.
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Occupational Therapy For People With Parkinsons
Second edition
The last eight years have seen a rapid growth in the evidence base across a broad range of treatments for Parkinsons, including evaluation of the impact of occupational therapy.
This second edition of guidance for occupational therapists will help practitioners to deliver effective and evidence-based care when working with people living with Parkinsons.
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How Do I Find An Occupational Therapist
Referral procedures depend on where you live and treatment may or may not be accessible through your countrys national health system.
In some countries occupational therapy is prescribed by medical doctors but in others people with Parkinsons can contact an occupational therapist direct without going through their doctor.
Training and accreditation varies throughout Europe so it is best to check the experience of anyone you consult. It is helpful to be seen by someone who has experience of Parkinsons, and always ask for references and the likely costs before treatment commences.
Best Practice Guidelines are available online for occupational therapists working with people who have Parkinsons. ParkinsonNet also provides evidence based guidelines in English.
Your national Parkinsons organisation may be able to provide information based on members experiences. See also, Other Parkinsons organisations.
How Long Does The Lsvt Program Last
The LSVT BIG program is 16 sessions: four consecutive days per week for four weeks. Each session lasts one hour. There is daily homework practice as well. Once a person graduates from LSVT BIG with the skilled therapy sessions, the recommendation is to continue the exercises daily.
At our clinic, we have occupational therapy, physical therapy and speech-language pathology all under one roof. Occupational and physical therapy combine to provide the frequency of services each week, which allows us to address a vast number of a persons concerns in that four-week period.
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Who Is Lisa Warren
Lisa Warren graduated from the University of Texas Medical Branch with a B.S. in occupational therapy. She received a Masters of Health Science from the University of Florida. She has more than 30 years of experience as an occupational therapist. Lisa is the rehabilitation site manager for the UF Health Norman Fixel Institute for Neurological Diseases. She has been a member of this team since 2010. This rehab clinic provides occupational therapy, physical therapy and speech therapy evaluations and treatment for persons with neurological disorders. Lisa has lectured healthcare providers locally, nationally and internationally on therapy for Parkinsons Disease, Huntingtons Disease, dystonia, essential tremor and other neurological disorders. She frequently speaks to support groups, teaches therapy students and provides community workshops.
Lisa has lectured locally and nationally on therapy for Parkinsons Disease, Huntingtons Disease, dystonia, essential tremor and other neurological disorders. She frequently speaks to support groups and at community workshops. She has established a quarterly meeting of therapists across the US and Canada for information sharing on the treatment of patients with neurological disorders. She is considered a world expert on OT for Parkinsons disease.
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Differences Between Physical Therapy And Occupational Therapy
While physical therapy and occupational therapy may be seen as interchangeable, there are some differences between the 2 practices. PT focuses on the physical rehabilitation of people recovering from injuries or disease. The goal of PT is to restore mobility. Physical therapists also educate people on managing their condition to maintain long-term benefits.3
OT also deals with rehabilitation and motion. However, it is focused more on enabling the person to engage in daily activities as seamlessly as possible. Occupational therapists also suggest adaptations and modifications to the persons environment.3
Physical therapists focus primarily on anatomy and the persons strength, functional capacity, and motor development. Occupational therapists combine physical aspects with mental health. They design exercises that teach people coping and management skills within their limits.3
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Use Your Personal Strengths
How can you build on your strengths and minimize your limitations? For example, if you have the strength of helping children enjoy reading, you could exercise that strength by reading to your grandchildren, by listening to them as they read, or by playing a reading game that stimulates both your imagination and theirs.
One of your strengths may be thinking skills. One thinking skill is imagining doing the activity before doing it. For example, imagining writing big can actually help you write big. Another thinking skill is speaking the steps out loud. When combing your hair, try saying hold and comb, to avoid dropping the comb.
Make sure you are exercising. Improving strength, balance and endurance through exercise supports your participation in all sorts of activities. Whether it is dancing or walking to a neighbors house, find an enjoyable way to exercise.
Lastly, be positive. Think, I will do rather than Ill try to and you may be more successful.
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Big Things Learned About Treating Patients With Parkinsons Through Lsvt Big
As three of the faculty for the LSVT BIG Training and Certification Course, we have had the incredible opportunity to learn from each other over the years. Although each of us has unique backgrounds and paths that led us to become Occupational Therapists, we share a common passion for helping people with Parkinsons disease .
We have also realized there are common themes in the lessons we have each learned and in ways we have changed our approach to treating patients with PD since becoming LSVT BIG Certified.
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Occupational Therapy Practice Guidelines For Adults With Neurodegenerative Diseases
Using an evidence-based perspective and key concepts from the Occupational Therapy Practice Framework, this guideline provides an overview of the occupational therapy process for adults with neurodegenerative diseases, specifically multiple sclerosis, amyotrophic lateral sclerosis, and Parkinsons disease. It defines the occupational therapy domain and interventions that occur within the boundaries of acceptable practice. Topics include interventions focusing on activity and participation such as fatigue management, health promotion, and functional mobility interventions focusing on client factors and performance skills, such as cognitive or memory training and exercise or motor training self-management and cognitivebehavioral strategies to improve task and occupational performance and palliative care. These guidelines should be useful to the many entities involved in providing occupational therapy services to people with neurodegenerative diseases, such as occupational therapy practitioners, team members, educators, clients, families, caregivers, third-party payers, and policymakers.
Parkinsons Disease And Occupational Therapy: Helping People To Live Better With Their Pd Symptoms
If youre living with Parkinsons Disease an Occupational Therapist may be able to help you achieve your goals so you can perform better to live better.
Whether youre frustrated by your ability to perform everyday tasks, had a fall or perhaps youve experienced a decline in confidence to manage at home?
Whatever your situation, these are all very real and all too common experiences many people affected by PD, maybe much like you, have on a regular basis.
We would like to help.
No intervention can reverse or cure Parkinsons disease. This has been real frustration for many people, maybe much like you as well as David Norris our Senior OT who is passionate about providing Parkinsons Disease occupational therapy services.
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