Date of Award

2022

Document Type

Scholarly Project

Degree Name

Doctor of Occupational Therapy (OTD)

Department

Occupational Therapy

First Advisor

Anne Haskins

Abstract

Title: Upper Extremity Evaluation & Intervention Through the Utilization of Occupation-based Activities within the Model of Human Occupation Perspective.

Background: The importance of upper extremity rehabilitation is vital for clients to be able to reengage in their valued occupations that were affected due to a recent injury, illness, or surgery. Upper extremity fractures make up approximately 590,000 fractures annually in the USA (Napora et al., 2020). Clients with these types of conditions seek therapy to help improve their ability to gain back function within their body and daily lives. Through this process, clients are asked to perform various exercises that can assist with range of motion, strength, and endurance. However, upper extremity practitioners tend to rely on the use of rote exercises to help clients gain the skills they need to participate in daily activities (Hanson & Maudal, 2020; Robinson et al., 2016). Such reliance on biomechanical interventions is problematic as research has shown clients are more motivated when they perform activities that they find meaningful within their lives than when they perform exercises (Grice, 2015; Robinson et al., 2016; White, 2013). These exercises are often packaged in a program clients complete at home, called home exercise programs (HEPs). These programs are given to clients to perform at home so that they can work on their skills at home that are needed for safe engagement in daily activities. However, adherence to HEPs that supply rote exercises was found to be less compared to an occupationbased approach that allowed clients to engage in daily activities that also combined the targeted skill (White, 2013). The lack of time and resources can disrupt a client’s ability to practice on the skills they need, however, creating occupation-based HEPs can help assist with adherence while providing activities at home that the client can incorporate into their daily routines.

Purpose: The purpose of this scholarly project was created to provide clients with occupationbased HEPs that will allow them to engage in valued activities that will assist them in gaining skills that they need. The intended audience for this product is for students currently working in their fieldwork placements and new occupational therapists to provide clients with different HEPs, while also creating their own based on the client’s interests and roles within their lives.

Methodology: The product was developed following a review of literature that showed need for increased occupation-based approaches within the upper extremity rehabilitation setting. The product materials were organized based on the Model of Human Occupation (MOHO; O’Brien, 2017), biomechanical frame of reference (Grice, 2021), and the andragogical learning theory (Bastable et al., 2020).

Conclusion: The results of the literature review and direct interactions with clients who had varying upper extremity conditions guided the development of the product, the Occupationbased Home Exercise Programs. This product contains occupation-based HEPs that target a variety of skills while incorporating daily activities that the client can practice at home within their daily routines. Additionally, the product includes a background on MOHO and the biomechanical frame of reference that helps justify the occupation-based approach to better assist clients with reengagement in valued activities. Instructions are provided for future students and new practitioners to create occupation-based HEP. This product assists with solving the problem of reduced adherence to HEPs by incorporating activities within a client’s routine to work on skills that are functional and value

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