Rehabilitation

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Rehabilitation Medicine is a special branch of medical science which helps to raise the quality of living of persons with physical incapacities or mental or emotional problems by bringing them back to a life which is effective and fruitful.

Unlike other branches of medicine, rehabilitation is being implemented as a “team”. That means patients are treated together by many rehabilitation professionals.

A rehabilitation team may be led by a Psychiatrist, Physiatrist, Orthopaedician, Neurologist or a Pediatrician.

The following are the members of a Rehabilitation Team.
1.Occupational Therapist
2. Physiotherapist
3. Speech Therapist
4. Prosthetic & Orthotics Specialist
5. Psychiatrist
6. Social Work
7. Rehabilitation Nurse
8. Vocational Counsellor

Here Occupational therapist acts a key role in the decision making & implementation of “Individual specific” treatment program for a person with incapacities.

Occupational Therapy- Various Areas of function
      Occupational Therapy functions for people of all ages. For e.g. for the physical, emotional & psychological problems of newborn babies, children, students, adults, officials, workers and elderly. Short descriptions of role of OT in these areas are given below.

(i) Occupational Therapy in Pediatric Care

In India, 6.88% of the children in the age group 0-6 are estimated to be having physical, mental or intellectual problems. Furthermore, learning disabilities and hyper activity disorder which are often gone unnoticed by parents or medical experts aggravate this problem. The service of rehabilitation professionals like Occupational Therapists is inevitable in bringing upthese children to light from the darkness of disability.
Only 5% of the above mentioned children utilize any sort of rehabilitations facilities.

1. New born Baby Care

As far as a new born is concerned, his “occupation” is feeding on breast milk and exploring his surroundings. But babies who arepremature,those born with physical disabilities may be having incapability in these areas. In such cases Occupational Therapists help in making them maximum self-sufficient in his/her occupation,by oro-motorexercise (exercise for muscles in the mouth) and multisensory stimulation (stimulation of the sense organs).

2. Learning disability and Behavioral Disability in Children

Another major field of activity of Occupational Therapists is learning disability and behavioral disability in children. Hyper activity, autism and learning disability/dyslexia are some of the problems found commonly among children these days. Occupational Therapy plays a crucial role in this area.

For example, it has been scientifically proved that Occupational Therapy can bring these children to the mainstream of the society through sensory integration (a method of treatment introduced by Occupational therapists which helps in developing the right response and behavioral pattern in a child with altered ‘sensory integration’ induced disorders (Like Autism, Dyslexia, ADHD etc..) by stimulating and integrating the sense organs).

Such children will be often having better intellectual ability. Even though the exact causes of these problems areunknown, medical experts suggest that changes in modern life style may be the turning point for these problems.

Because of the lifetrends in nuclear families these days, parents are not getting sufficient opportunity to interact or spent time with their children. The above problems are seen mainly in children from such a background.Moreover, problems of children in such families will be noticed at a very late stage. Hence solution to these disabilities gets delayed.

Such children can be brought back to near normal life (fully or partly) through innovative methods in Occupational Therapy such as Play therapy (treatment through plays), sensory integration, behavioral therapy and group therapy.

The Headmaster had called the parents of Alvin of first standard saying that he will not be allowed to continue in the school. They have already sat in that hot seat many times because of his naughty behavior which often cross the limits. Not listening at all to what is being taught. Not correctly copying even what is written on the board, attacking classmates. There were no mistakes which Alvin didn’t commit.

The reply of parents to the doubt of the class teacher that the child may be having learning disability was like this: All of us in our family are in good positions. We have never made him want. Then how can he be intellectually poor? The teacher had to struggle a lot to clear their misunderstanding and convince them to take the child to a child psychiatrist & pediatric occupational therapist.

There is a sigh of relief on the face of the patents when they are informed that Alvin is concentrating on studies after the therapy.

3. Pediatric Neurology

An Occupational therapist can help Newborn babies or Children with neurological disorders to overcome their developmental delay, day-to-day activity limitation and thus make them as independent as possible with their condition. These children may be having problems with in dexterous activities like writing, buttoning etc… and in feeding activities. Here occupational therapist will give either remediating or compensatory or at times both way of treatmenttechniquesto overcome these issues.

In addition, these children will be having problem with free ambulation in the school & home environment. Here Occupational Therapist will suggest home modification, activity modification, or specialized assistive devices to overcome these issues

 Occupational Therapy in Neurological Rehabilitation 

The effect inflicted by stroke, brain injury and weakness of the nervous system upon a person and his family is very grave. Because of these diseases, the ability of a person to do his job gets reduced and his financial liabilities get escalated. The expenses for treatment and care will increase considerably.

Above all, the intellectual, mental and emotional problems created by these diseases on the person, seriously affect the family and relatives. All the treatments in Occupational Therapy is centered around a person’s “occupation”. This is the main factor that distinguishes thisprofession from other health care professions.

For example, a person who has got his brain injured in a road accident may loss his mobility, ability to speak, and to engage back in the profession he was previously in, ability to think either fully or partly. In such a situation the method of functioning of Occupational Therapy will be varied. Some of such treatment methods given below:

1. Cognitive Rehabilitation

Here, the Occupational Therapist retrains that person’s capacity to think, ability to plan, judge a situation and act accordingly, memory power and interest in work. This area differentiates OT – Neurorehabilitation from other allied health science.

Revathy who is an electric & electronics engineer approached OT seeking treatment for memory loss happened after a bike accident. As a result of this accident, Revathy became unable to return to her job, do her routine activities, rememberingeverything or talk effectively. These problems seriously affected the confidence of Revathy. In the OT evaluation it became clear that Revathy is not only having memory loss, but also having depression, indifferent attitude and escalated anger.

Following this, the Occupational Therapist started giving training to Revathy through activities like Memory Games and Cognitive Retraining. “Activity Schedule” was prepared and given to do the daily activities properly. Along with this, Revathy was made familiar through many books and videos how people like her were able to overcome similar situations. Gradually Revathy felt that her memory power is increasing. Along with that,Revathy’s self confidence in her profession also upgraded. Today Revathy is doing her job as efficiently as before.

2.Neuro-Motor Rehabilitation

Here the Occupational Therapist finds out the physical disabilities which stand as obstacles whichprevent a person from engaging in his profession, daily activities and entertainments. Then the therapist will endeavor to find solution through scientifically proven and innovative exercises.

Dr. Vighnesh was a famous nuero physician in the city. His right limbs got weak due to paralysis (Stroke). Even though there was nothing wrong with his intelligence, he was not able to write using his right hand or do his daily activities himself or even walk normally. At this circumstance, the Occupational Therapist gave him training to write with his left hand and suggested changes for using the toilets and bedroom in his home easily. Today Dr. Vighnesh is used to write and do daily activities himself using his left hand. Moreover, he is active in his profession as before.

 Occupational Therapy in Orthopedic Care

In musculoskeletal diseases (eg. fractures and frozen shoulder) and post-surgerical conditions, Occupational Therapy is inevitable in making a person maximum self-sufficient and thus raises the quality of life.

For example, for a person who got his hands seriously injured in an accident, it will become impossible for him use his hands effectively for his daily activities and other jobs. Here the Occupational Therapist will help him to attain the original ability through Gross Motor & Fine Motor hand function training.

Pain around shoulder (Frozen shoulder, periarthritis of shoulder etc…)Among Middle aged individuals – especially among ladies – are very common. This will cause severe pain in the shoulder during overhead reaching, day to day activities etc… Ultimately this will make the person less efficient in his/her occupation. Here the occupational therapist will formulate exercises incorporated with functional activities to overcome these issues.

In addition to all these, the occupational therapist plays a vital role in the “Hand rehabilitation” following plastic surgeries, tendon repair.This is one of the major functional area in occupational therapy.

Occupational Therapy in Mental Health Care

Mental Health Care is another area which differentiates Occupational Therapy from other rehabilitation professions. It was in this area that Occupational Therapy first started& gained worldwide attention.

As we know, clear reflection of mental health problems will first appear in a person’s “occupation” (profession, self-care and entertainment). Mental health problems considerably reduce the efficiency in engaging “occupation” in many persons.

The main reason for this is the changes in aperson’s interest, concentration and reasoning in the “occupation”. Here the Occupational Therapist will help persons to come back gradually to normal life by engaging them in “occupation” according to their ability and raising their concentration, interest and other skills to do the job.

Occupational Therapy in Ergonomics

Ergonomics is a branch of science which examines whether the relation between a person and his occupation is healthy, finds problems in it and suggests solution. The efficiency of a person in his work will be decreased significantly if a smooth relationship doesn’t exist between his profession and his physical and mental health.

Those who don’t experience difficulty sometimes in work and daily activities due to back pain or neck pain are very rare among us. Most of us don’t realize or notice the fact that 70% of this back pain is due to our wrong posture, way of walking or sitting. In other words, it is because we are engaging in our occupation in the wrong manner.

For example, when a software engineer works for about 8-10 hours continuously sitting, his sitting posture, height and size of the computer monitor, shape of the keyboard, size of the mouse, location and other working conditions are the major factors which determines the health and effective functioning of that person.

Here the Occupational Therapist finds out the areas and conditions of a person’s work which are problematic and suggests appropriate solutions for them. Thus condition for engaging smoothly and safely in the “occupation” is ensured for that person.

This is an area of Occupational Therapy which has got much popularity in foreign countries. Some foreign companies and international companies functioning in India are already seeking this service.

Occupational Therapy in Geriatric Care

Dementia is a problem commonly found in elderly people. Because of this,elderly are prone for various accidents. They also face difficulties in personal relationships. In such situations, the Occupational Therapist helps that person to be free from these accidents through cognitive retraining activities and environmental modification.

It has been scientifically proved that an Occupational Therapist can reduce falls in the elderly to a great extent through Physical conditioning exercise.

Other Functional Areas of Occupational Therapy

An Occupational Therapist functions in many areas apart from the areas mentioned above. Some of those areas are:

  1. Splinting (technique that helps in positioning the body part correctly after surgeries and in rheumatism and weakness of limbs) is another unique specialty in Occupational Therapy.
  1. It is the Occupational Therapist who scientifically prescribe wheel chair, walking stick and crutches for a person after finding out their physical ability and occupational needs.
  1. Hand rehabilitation
  1. In Special Schools
  1. Barrier free environment designing for disabled(Designing buildings and other things for the disabled in a manner in which they can use them without difficulty)
  1. Early Intervention (Determining diseases/problems that are possible to occur in new born babies)