Date implemented:

Clients Initials and Age: D.F. 46 y.o. Time allotted for session: 30 mins.
09/20/17
Diagnosis and any Precautions: (1) General debility from cancer treatment.
Neph drains, catheter, obesity, low endurance/fatigue.
Goal/s being addressed: (1) 1. Pt will complete lower body dressing Mod I
2. Pt will complete IADL Mod I, utilizing least restrictive device
Results (link to activity
Activity Demands Modifications (provided
Specific Objectives for objectives; include
Intervention Activities (setting, materials, and during the activity and
this activity (list 2-3) objective measures of
(5) social requirements) planned for next
(5) performance when
(5) session) (5)
possible) (5)
Preparatory (10 minutes): -(Red) Therapy Gym

*Pt will be seated at a table -Table

and will work with pink
Thera putty
-Pt will sanitize hands
-Pt will dig out hidden
objects and reach across
table to drop them in the
empty container one at a
time
-Once all objects have been
removed from the putty (or
10 minutes have passed), pt
will re-bury the objects in
the putty
-Pt will return putty to
container and replace lid
-Dynamic sitting for lower
body dressing
-Hand strengthening for
grasping clothing and
operating assistive devices
(i.e. reacher)
-In-hand manipulation of
small objects for IADL
participation (*count how
many objects were
removed*
-Container of pink Thera
putty with hidden objects
GRADING UP:
-Pt will have to place the
removed objects into the
container and lid that are
-How many objects were This intervention was not
placed further away and on
removed? used because the patient
opposite sides of the table
had done this the day
to maximize reach in all
-Any loss of balance? before and I was seeing her
directions
on her second day of
-Did pt fatigue? therapy.
-Once objects have been
removed from the putty,
OT will disperse them on
the table top so pts
dynamic sitting balance is
challenged more

-Pt will sanitize hands GRADING DOWN:

-Pt will not dig out hidden
objects, but will instead
work on pulling Thera

Functional (20 minutes):
*Pt will stand at a table and
follow printed directions to
assemble a PVC clothes
rack from pieces in a box
-Pt will stand as long as he
can, but will be allowed
rest breaks as needed
-Pt will look at printed
directions and choose
appropriate PVC pieces
from box
-Pt will assemble clothing
rack as shown in the
picture
-If time allows, pt will
hang clothes on hangers
(managing fasteners as
appropriate) and then onto
the rack
-Pt will take the clothing
rack apart and put it back
into the box
putty apart and rolling it
into snakes on the table top
-Pt will dig out objects and
place them in the container
sitting next to him, rather
than across the table
-(Red) Therapy Gym
-Table
-PVC clothes rack kit (in
Red Gym) including
instructions and hangers
-Increase endurance for
-Clothing to hang
lower body dressing (*time
how long pt stands*)
GRADING UP:
-PVC pieces will be taken
-Dynamic standing for
from box and dispersed
ADL participation
around table top so pt must
reach further/move to
-Fine-motor manipulation
retrieve the needed pieces
for IADL (medication
management, etc.)
-Pt will hang clothing
participation and fastening
articles on hangers and
clothing for dressing
hang on the built rack
(manipulating buttons and
-Cognition (following
fasteners as appropriate)
instructions)
GRADING DOWN:
-Pt will sit at table and
build clothes rack from
printed instructions
-OT will lay PVC pieces in
proper position and pt will
assemble
-How long did pt stand?
~10 mins.
This activity went well.
-Number of rest breaks?
The pt finished it without
2
difficulty and much faster
than anticipated. During
-Any loss of balance?
the session, I moved the
No
placement of the box the pt
was taking pieces from to
-Any assistance needed
challenge dynamic reach
with fine-motor portion?
more. To challenge the pt
No
more, I would raise the
table higher so she would
-Was pt able to follow
have to reach higher and
printed directions?
farther to connect the
Yes
pieces. I would also
encourage the pt to try to
-Were verbal cues needed?
finish the last little bit
No
before taking a rest break
to challenge standing
-Self-correction (if
endurance.
applicable)?
Corrected self on order of
pipe pieces
 BACK-UP IDEAS:
I ended up playing a few
Stand and: rounds of standing Uno
-Fold laundry with the pt. We played
-play Uno Uno without any
-play cognitive Jenga modifications. To get
more effort from the client,
I could have placed the
draw deck in a different
position so it would have
been more challenging.

S/OT name: Ashley Whitacre

Find one peer-reviewed article that supports the intervention you planned/provided. At the bottom of your plan, paste the abstract and
citation and then in your own words describe how this supports your intervention plan. (5)

Total: 32 points

Quittan, M. (2016). Aspects of physical medicine and rehabilitation in the treatment of deconditioned patients in the acute care setting: the role of
skeletal muscle. Wiener Medizinische Wochenschrift, 166(1-2), 28-38. doi:10.1007/S10354-015-0418-X

Abstract Summary

Skeletal muscles are essential for movement as well as for survival. Knowledge about the organ skeletal muscle is underrepresented.
Ageing and multiple chronic diseases are accompanied by loss of muscle mass, termed muscle wasting. Nevertheless, muscles are one
of the target organs within the rehabilitation process. This review highlights the role of skeletal muscles from various aspects, diagnostic
procedures to quantify muscle mass and strength and, most importantly, lists countermeasures to muscle wasting. Although structured and
progressive strength training is the cornerstone in the treatment of muscle wasting, several other methods exist to slow down or reverse the
process of muscle wasting. Among them are neuromuscular electrical stimulation and alternative exercise modes, positioning, stretching
and, as an emerging field, drug therapy.
My Support:

This supports my intervention plan because it shows how important positioning and using muscles are for maintaining movement and
recovering. This specifically looked at patients who had become deconditioned during recovery, which aligned with my patients
diagnosis. By having my patient stand during the treatment, her leg muscles, which hadnt been used much lately, were being
strengthened just by becoming load-bearing again.