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Occupational Therapy

A client-centered health profession focused on enabling people to participate in activities of daily living through therapeutic interventions.

Model of Human Occupation (MOHO)

Model of Human Occupation (MOHO) is a clinical topic covering pathophysiology, diagnosis, evidence-based treatment, and patient care.

Key points: Core principles, practical applications, and advanced concepts that build deep understanding.

Occupational Performance

Occupational Performance is a clinical topic covering pathophysiology, diagnosis, evidence-based treatment, and patient care.

Key points: Core principles, practical applications, and advanced concepts that build deep understanding.

Adaptive Equipment

Adaptive Equipment is a clinical topic covering pathophysiology, diagnosis, evidence-based treatment, and patient care.

Key points: Core principles, practical applications, and advanced concepts that build deep understanding.

Sensory Integration

Sensory Integration is a clinical topic covering pathophysiology, diagnosis, evidence-based treatment, and patient care.

Key points: Core principles, practical applications, and advanced concepts that build deep understanding.

Hand Therapy

Hand Therapy is a clinical topic covering pathophysiology, diagnosis, evidence-based treatment, and patient care.

Key points: Core principles, practical applications, and advanced concepts that build deep understanding.

Pediatric Occupational Therapy

Pediatric Occupational Therapy is a clinical topic covering pathophysiology, diagnosis, evidence-based treatment, and patient care.

Key points: Core principles, practical applications, and advanced concepts that build deep understanding.

Ergonomics

Ergonomics is a clinical topic covering pathophysiology, diagnosis, evidence-based treatment, and patient care.

Key points: Core principles, practical applications, and advanced concepts that build deep understanding.

Community Reintegration

Community Reintegration is a clinical topic covering pathophysiology, diagnosis, evidence-based treatment, and patient care.

Key points: Core principles, practical applications, and advanced concepts that build deep understanding.

Key Formulas & Equations

FIM Score (Functional Independence Measure): 1-7 scale per item (1 = total assist, 7 = complete independence)
Total FIM: Range 18-126 (18 = total dependence; 126 = complete independence)
Motor FIM: 13 items (eating, grooming, bathing, dressing, toileting, bladder, bowel, transfers, locomotion)
Cognitive FIM: 5 items (comprehension, expression, social interaction, problem solving, memory)
Barthel Index: 0-100 scale for ADLs
Feeding: 10 = Independent; 5 = Needs help; 0 = Dependent
Bathing: 5 = Independent; 0 = Dependent
Grooming: 5 = Independent; 0 = Dependent
Dressing: 10 = Independent; 5 = Needs help; 0 = Dependent
Bowels: 10 = Continent; 5 = Occasional accident; 0 = Incontinent
Bladder: 10 = Continent; 5 = Occasional accident; 0 = Incontinent/catheterized
Toilet use: 10 = Independent; 5 = Needs help; 0 = Dependent
Transfers: 15 = Independent; 10 = Minor help; 5 = Major help; 0 = Unable
Mobility: 15 = Independent; 10 = Wheelchair independent; 5 = Walks with help; 0 = Immobile
Stairs: 10 = Independent; 5 = Needs help; 0 = Unable
Canadian Occupational Performance Measure (COPM): 1-10 scale for performance and satisfaction
Activity of Daily Living (ADL) Categories:
Basic ADLs: Dressing, bathing, eating, grooming, toileting, transferring
Instrumental ADLs: Cooking, cleaning, shopping, managing money, using phone, transportation
Grip Strength (Dynamometer): Average of 3 trials per hand
Range of Motion (ROM): Measured with goniometer
Spasticity (Modified Ashworth Scale): 0 = No increase in tone; 1 = Slight increase; 1+ = Slight increase with catch; 2 = More marked increase; 3 = Considerable increase; 4 = Rigid

Core Concepts

Model of Human Occupation (MOHO)

A theoretical framework explaining how occupation is motivated, patterned, and performed. Includes volition, habituation, and performance capacity.

Occupational Performance

The ability to carry out activities of daily living, work, leisure, and social participation. Assessed and addressed through therapeutic intervention.

Adaptive Equipment

Devices that assist with daily activities: reachers, dressing aids, adapted utensils, grab bars, and environmental control units.

Sensory Integration

Theory explaining how the brain processes sensory information. Used in pediatric OT for children with sensory processing difficulties.

Hand Therapy

Specialized rehabilitation of the upper extremity. Includes splinting, exercise, scar management, and activity modification.

Pediatric Occupational Therapy

Treatment of children with developmental delays, sensory processing disorders, autism, and learning difficulties through play-based therapy.

Ergonomics

The science of fitting the job to the worker. Includes workstation assessment, body mechanics training, and injury prevention.

Community Reintegration

Helping clients return to community life after illness or injury. Includes vocational rehabilitation, driving assessment, and social skills training.

Worked Examples

Example 1: Barthel Index

Problem: Patient scores: Feeding 10, Bathing 5, Grooming 5, Dressing 10, Bowels 10, Bladder 5, Toilet 10, Transfers 15, Mobility 15, Stairs 5. Calculate total.

Solution:

Total = 10 + 5 + 5 + 10 + 10 + 5 + 10 + 15 + 15 + 5 = 90/100

Interpretation: Mild dependence (61-90 = mild dependence)

Example 2: FIM Interpretation

Problem: A patient has Motor FIM = 70 and Cognitive FIM = 30. Interpret the scores.

Solution:

Motor FIM 70/91 = Modified independence to minimal assistance

Cognitive FIM 30/35 = Modified independence to minimal assistance

Example 3: ROM Measurement

Problem: Shoulder flexion: start 30°, end 150°. Calculate ROM.

Solution:

ROM = 150° - 30° = 120° (normal shoulder flexion: 180°)

Practice Problems

Problem 1

Interpret Barthel Index score of 45.

Answer: Severe dependence (0-40 = severe dependence; 41-60 = moderate dependence)

Problem 2

Calculate ROM for elbow flexion: start 10°, end 140°.

Answer: ROM = 140° - 10° = 130°

Problem 3

Identify the difference between basic ADLs and instrumental ADLs.

Answer: Basic ADLs = self-care tasks (dressing, bathing); Instrumental ADLs = complex life skills (cooking, managing money)

Problem 4

Interpret Modified Ashworth Scale score of 2.

Answer: More marked increase in muscle tone through most of ROM, but affected part easily moved

Problem 5

Calculate total FIM if Motor = 85 and Cognitive = 32.

Answer: Total FIM = 85 + 32 = 117/126

Problem 6

What does a COPM performance score of 3 indicate?

Answer: Able to perform the activity but with difficulty or modifications (1-10 scale)

Problem 7

Calculate grip strength average if trials are: 20 kg, 22 kg, 24 kg.

Answer: Average = (20 + 22 + 24)/3 = 22 kg

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