INTERVENTION PLAN FOR COMMUNITY CLIENT WITH REFLECTION

Long-Term Goal: By d/c, client will independently complete grooming and hygiene as part of a morning routine.

Short-Term Goal: In 4 weeks, client will independently complete facial hair removal.

Describe one (and only one)

Describe client factors relevant to occupational List and provide rationale for the
performance problem in the goals you selected OPM and CPM you will be using in
this treatment relevant to this
client’s goals
Voluntary motor control  MOHO – Client is
experiencing low levels
R UE of motivation. He
 Shoulder – Client can actively flex his previously sang and
shoulder to approx. 90 degrees played the piano and
however his R arm goes into a flexed drums in a band and can
synergistic pattern. no longer due those
 Elbow – Client can actively flex his occupations. We can
elbow WFL – his elbow stays flexed address aspects of his
at rest. Client can actively extend routine in order to
elbow approx. 10 degrees – can increase his
extend it completely in a closed chain performance and
position with difficulty. volition. This will help
 Forearm – Client is unable to pronate the client improve
or supinate his forearm. – Uses occupational
unaffected arm to manually turn performance and
wrist or he moves his shoulder to try participation.
and achieve pronation/supination.
 Wrist – Client can actively  Motor control model –
flex/extend his wrist less than 10 Change will occur using
degrees. high repetition
Describe the skilled OT session you will way you can grade the activity
use to address the client factors in the in your treatment session up
first column. and down on one client factor
Client factor: Active elbow
extension of R arm.
Balloon shaving task Grade up:
 The client will be standing  Have the client sit
during the activity. The down to increase
client will be cued as/if the degrees of
needed to implement freedom to make
strategies to manage clonus active extension of
of his R LE such as bending his R arm more
his R knee. challenging.
 The client will apply shaving
cream to a balloon placed at
arm’s length in front of him. Grade down:
The therapist will hold the  Move the balloon
balloon in a static position. closer to the
The client will actively patient to decrease
extend the fingers of his R the amount of
(most affected) hand WFL. active extension
The therapist will facilitate required.
the rest of his finger
extension to allow him to
grasp the shaving cream can
with his index finger placed
  Fingers – Client can actively flex and
adduct his thumb approx. 10
degrees. He can actively flex his
index finger about 20 degrees at the
PIP and DIP joints. He can also
actively flex his pinky finger approx.
10 degrees at the PIP and DIP joints.
He has no other AROM in his fingers.
L UE
 Client can actively flex, extend,
pronate, and supinate L UE WFL.
 Client demonstrates deficits in FMC
and has clonus in his L hand due to
spasticity when he is performing
active movements.
L LE
 Client has voluntary motor control
WFL in his L LE.
R LE
 Client can stand for only 5-10
minutes before spasticity in his R LE
becomes more evident causing him
to be unsteady while standing.
 Client has minimal control of
voluntary movement in his R foot
and ankle.
 Client can actively flex and extend his
R hip and knee WFL.
Increased muscle tone
 Client’s R UE and R LE are hypertonic.
movements to give
multiple opportunities
to practice and improve
motor control. By
having the client
complete repetitive
movements, it will
strengthen the neural
pathways to the client’s
muscles which will
increase motor function
and improve
occupational
performance.
 Client will grasp a covered
on the trigger. Client will
extend his arm completely
to reach the balloon. Client
will actively flex his index
finger to apply shaving
cream onto the balloon.
Once the shaving cream is
on the balloon, the client
will extend his arm
completely to smear the
shaving cream over the
surface of the balloon using
the back surface of his
fingers. If the client is
unable to apply the shaving
cream and smear it on the
balloon with his arm
completely extended, the
therapist will facilitate the
movement.
plastic razor with his L (less
affected) hand and alter
motions of flexion,
extension, radial deviation,
ulnar deviation, supination,
and pronation as cued by
the therapist to completely
remove the shaving cream
off the balloon.