OCCUPATIONAL

THERAPY IN
ORTHOPEDICS
CASE PRESENTATION
BY: VIJAYA DHARSHINI.M
BOT 3RD YEAR
DEPARTMENT OF OCCUPATIONAL THERAPY
SRIHER
LOW BACK
PAIN
DEMOGRAPHIC
DATA
• NAME: Shanmuga Priyaa. S
• AGE: 44 years old
• SEX: Female
• DOB: 13/03/1978
• MARITAL STATUS: Married
• CHIEF COMPLAINTS: Pain in the back ,
cant able to sit for a long time in a
same place , pains heavily while driving
two wheeler and also while bending
and getting up straight.
 • BIRTH HISTORY:
full time normal delivery and also in 10 months of
pregnancy.
• FAMILY HISTORY:
she is the first child in the family and later
HISTORY one sister with three years of age difference.

COLLECTI except her.

no one else has this problem in her family

ON: • EDUCATIONAL HISTORY:

she has completed her UG in BSC.
Computer science and PG in masters.
There is no problems or issues in her
educational history.
 • OCCUPATIONAL HISTORY
Now she works in the IT sector for more than 20 years continuously.
She has to work five days per week and nearly 10 to 12 hours per day.
She also takes break from her work during the month of April or may for
atleast 15 to 20 days.
• MEDICAL HISTORY
She doesn’t have any medical complications except this back
pain and she isn’t undertaking any medications.
CONT.. • PAIN HISTORY
This pain is there for her more than a month so this is subacute
period of lowback pain
• SOCIAL HISTORY
She is socially very active person she used to take part in
marathons till 40 years of age and has a good friends and relations
circle.
She used to organize events in her work place on special days
especially.
ON OBSERVATION

BODY BUILT: MOBILITY: Walking SKIN: No

Adequate discoloration.
 • GENRAL INSPECTION OF THE LOWER
Mild Swelling was present
• GENERAL PALPATION OF THE LOWER BACK
PHYSICAL Mild warmth tone
EXAMINATI • GAIT
ON Her gait is fair but she says there is pain
while walking but there is no much difference
seen in her gait. she finds it difficult to do
some activities like bending down, getting up
from the floor .
 • ROLAND MORRIS DISABILITY QUESSTIONAIRE
score – 14/24
• WONG – BAKER FACES PAIN RATING SCALE
Hurts little more

TOOLS
USED :
 • ADL
She is independent in ADL activites but
she has pain while doing the activities.
Cont.
Assessment:
Functional independent measure.
 The aims of occupational therapy assessment are generally agreed to:

• decide whether occupational therapy is appropriate or necessary

• establish abilities, disabilities and the effects of the environment on an

individual’s occupations

• formulate a package of information (data collection) to plan future goals

JUST TO • formulate a baseline to compare progress and regress

KNOW: • assist decision-making regarding the modification of intervention plans

• involve, inform, educate and motivate the individual (client)

• establish the efficacy (and evidence base) of occupational therapy

intervention

• assist resource decision-making regarding demands on service provision

 ACTIVITIES OF DAILY LIVING
PROBLEMS PAINFUL RANGE OF MOTION
RELAVENT VOCATIONAL
GAIT
TO OT: POSTURAL ABNORMATILITES
 • SHORT TERM
To improve range of motion.
To reduce the postural abnormalities.
GOALS: To correct the gait pattern.
• LONG TERM
To improve ADL activities.
 BIOMECHANICAL FRAME OF REFERENCE

COGNITIVE BEHAVIOURAL THERAPY

TREATMENT REHABILITAITVE FRAME OF REFERENCE
APPROACHE
MODEL OF HUMAN OCCUPATION
S
FUNCTIONAL OPTIMIZATION APPROACH

SYMPTOMS MODULATION APPROACH

 RICE
BIOMECHANI  Rest
 Ice
CAL FRAME  Compression
OF  Elevation
REFERENCE Bed positioning
BED POSITIONING
 • She has the fear of pain before doing some
activities.
• Fear of pain resulting in decreased interest on
engagement of household activites
COGNITIVE
BEHAVIOUR Intervention:
To address fear avoidance issues
AL
THERAPY Goal:
Decreased fear avoidance behaviour exhibited by
the patient.
Increased activity in daily living
REHABILITATIVE FRAME OF REFERENCE

ADAPTIVE ENVIRONMENTAL ENERGY WORK ORTHOTIC

DEVICES MODIFICATION CONSERVATION SIMPLICATION DEVICES
Sit to stand way to use fridge
CONT

LS BELT SEAT RAISER NO WEIGHT NO TWO WHEELER BACK SUPPORT IN

LIFTHING DRIVING THE SEATS
Laundry
 VOLITION --- HABITUTATION ---
PERFORMANCE

MODEL OF
HUMAN To enhance Motivation

OCCUPATIO
N To make the techniques in routine

To improve performance skills

 Patient tend to avoid certain postures

Active range of movement is limited

and painful
SYMPTOMS
MODULATIO METHOD:
N
APPROACH EXERCISES

STRETCH
Exercises
and stretch
 https://link.springer.com/article/10.1023/A:1023008632131

ARTICLE: Incorporating cognitive-behavioral therapy with occupational t

herapy: a comparative study with patients with low back pain
THANK YOU