The use of occupational therapy in work rehabilitation has diminished over the last 20 years. Therapy resources have been diverted to the acute sector as a response to the pressure within National Health Service trusts to achieve early discharges. Occupational therapy in the United Kingdom has therefore suffered a loss of facilities and of therapists experienced in returning injured or ill employees to work. This contrasts with the development of occupational therapy in work rehabilitation abroad.

Occupational therapists, through their education and training, have the potential to develop the necessary skills to assess and treat injured employees to return them to work. There exists a significant number of employees at work and absent from work with musculoskeletal problems, who need the services of occupational therapists specialising in work rehabilitation.

The aim of this article is to provide an overview of the current status of work rehabilitation, to give an example of a therapist-led work rehabilitation intervention with a client and to demonstrate the unique role that occupational therapy played in assisting in the client's return to work.

In 1992, the Johns Hopkins Hospital and University initiated a program aimed at the early diagnosis and treatment of potential upper extremity work related musculoskeletal disorders (UEWMSDs), ergonomic assessment and abatement of work areas where individuals with UEWMSDs are employed, as well as the identification and correction of areas throughout the hospital and university where UEWMSDs could possibly occur. The program resulted in an initial increase in the number and cost for the treatment of UEWMSDs. Subsequently, there was a significant decrease in the number of UEWMSDs reported and virtual elimination of the need to use surgical procedures to correct these conditions. This article suggests that a coordinated program of medical care, ergonomic assessment, and intervention can be efficacious in the primary, secondary, and tertiary prevention of UEWMSD.

This study examined the use of aides in occupational therapy practice, the supervision and training of aides, and practitioners' attitudes toward the use of aides. On the basis of the data, it is suggested that occupational therapy practitioners would benefit from taking a proactive role in determining how aides can be used to maximize service delivery while maintaining quality services. There also appear to be ethical concerns related to appropriate delegation of tasks to aides and to their supervision and training.

The article aimed to gain a better understanding of how spirituality might inform practice, we interviewed eight occupational therapists who stated that they considered spirituality while working with patients. In the first, addressing religious concerns, therapists dealt with patients' religious questions and issues. In the second, addressing suffering, therapists assisted patients to deal with their feelings related to loss and pain, attempted to relieve patients' distress and helped patients move towards increased functioning. In the third, encouraging the self, therapists worked to assist patients to acknowledge their own worth and to use their unique gifts and interests. In the fourth, growing as a person, therapists themselves were transformed as a result of the therapeutic encounter. This study represents an early attempt to determine what occupational therapists who consider spirituality actually do in practice. Future research should go deeper into the experience of such therapists, to gain a richer understanding of the phenomenon.

What is the role of occupational therapists with regard to clients' spirituality? What activities address spirituality in occupational therapy? Whom do practitioners think should be responsible for helping clients with their spiritual needs? The objectives of this study were to address these and other related questions by validating a previously used questionnaire and establishing a baseline of occupational therapists' opinions and practices about spirituality and therapy on which future research can be built. In general, the respondents reported that spirituality is important and helpful in their personal lives and a very important dimension of the health and rehabilitation of their clients. However, less than 40% of the respondents indicated that addressing clients' spiritual needs was within the scope of their professional practice, and the majority (82%) reported that their academic training did not prepare them to address the spiritual needs of clients. The questionnaire, now validated with a national sample, may be used for follow-up studies to further investigate the role of spirituality in health and rehabilitation.

Nursing homes receive higher rates of reimbursement based on intensity of rehab services that are provided, so there is an incentive for facilities to provide as much 'high intensity' therapy as possible.
Typically, the students express ethical distress because they often believe that the recipients of these services are receiving marginal or no benefit from their participation.
As a population, OT students feel disempowered about expressing concerns in this area during their fieldwork experiences because
a) they perceive that they are 'just students' and don't want to make waves
b) they feel confused because their clinical preceptors are all engaging in the behavior
c) they have competing pragmatic concerns, like graduating on time, having to find a new fieldwork, etc.
Students report that many practitioners 'go along' with the push for more therapy because they become concerned with job security or that they simply accept these practices as 'being the way things are done.

The primary objective of occupational therapy in this setting is to provide a supportive environment where patients can practice and improve the execution of the work-related activities they need to perform their jobs while they are learning to live with or control their symptoms. Treatment may include the use of a balance monitor, a multiwork station, a pneumatic lifting-lowering device, a computerized upper extremity work simulator, and a truck-driving simulator.

Health care workers who have patient transfer duties are at risk for back injury. Transferring patients between beds and gurneys is a rigorous pulling task that requires back, leg, and arm strength. This study analyzed the efficiency of commercially available transfer devices, namely a patient roller, patient shifter, and draw sheet. The patient roller was the most efficient transfer device in moving participants compared with the draw sheet and patient shifter. Transfer forces can be estimated with the use of linear equations, with patient weight, direction of transfer and transfer device as the independent variables. These estimated forces can assist occupational therapists in the returning their injured health care coworkers to patient transfer duties. The results further indicated that high forces are required to transfer patients; therefore, patient-transfer personnel should obtain assistance when moving patients.

The use of occupation as a therapeutic method is the essence of the profession of occupational therapy. This core of therapeutic occupation is flexible across cultures, times, health care environments, and different philosophies of the nature of the human being. Given this adaptability, the profession espouses diverse models of practice-the multiple frames of reference that guide therapeutic occupation for different populations in different settings. Across the history of the profession, therapeutic occupation has been the common core of otherwise different approaches to intervention. Although each of the many past and current models of practice has a different viewpoint, the common factor is the synthesis of occupational forms designed to elicit meaningful and purposeful occupational performance. Occupational synthesis is the essential act of the occupational therapist. It is necessary that occupational therapists confirm the power of therapeutic occupation through research that examines the profession's central principles. Occupational therapists are also urged to use the term occupation consistently and proudly in their interactions with recipients of therapy, fellow health care professionals, and each other. The profession of occupational therapy will flourish because occupation, its core, is so basic to human health yet so flexible, depending on the needs of the individual human being.

This website gives examples and clarifications regarding ICD-10 codes and how to bill utilizing the cheat sheet for occupational, physical, and speech therapists.

The radial nerve is the most frequently injured major nerve of the upper extremity. This article establishes the most background information regarding the anatomy and the loss of function as well. The splinting of certain techniques will help re-establish a tendonesis pattern of the hand to help improve function.

The purpose of this study was to identify the characteristics of male occupational therapists so that better strategies for recruiting men into the profession can be developed and the problem of retaining men in the field can be addressed. The study showed that as a group, male occupational therapists today are younger, more likely to have advanced degrees, and less likely to be married than their 1969 counterparts. Additional data included employment data, educational data, and demographic information such as family position, education and occupation of parents, extracurricular activities in high school and college, factors influencing career choice, and goals for the future.

The occupational therapists at Indiana Hand to Shoulder Center jointly author a manual geared toward medical professionals who manage patients with hand and upper extremity medical conditions. Titled "Diagnosis and Treatment Manual for Physicians and Therapists," this publication contains over 300 pages describing the nonsurgical and postoperative rehabilitation for conditions relating to the hand, wrist, elbow, and shoulder. This is a great resource for protocols regarding various conditions of the upper extremity.

This handout provides the most widely used iontophoresis drugs used and the indications for the specific drugs. Working in a hand clinic, we have used various drugs and it has helped with the polarity of the drugs and the indications.

This website analyzes all the aspects of the FCE and how occupational therapists are incorporated to test individuals. FCEs typically require the evaluator to determine the worker's capability to perform various work-related tasks and whether there is a match between these abilities and the essential job performance components. This is a great resource for anyone wanting to attain a FCE certification.

This pilot study compared the effectiveness of 3 postoperative rehabilitation protocols for patients with Zones V and VI extensor tendon lacerations. Twenty-seven patients were recruited from 3 sites and randomly assigned to 1 of 3 established treatment protocols: immobilization, early passive motion (EPM), and early active motion (EAM). Outcome measures were collected at 3, 6, and 12 wk after treatment and included total active motion (TAM). Patients with Zones V and VI extensor tendon injuries treated with the EAM protocol recovered range of motion more rapidly.

The purpose of this study was to measure functional outcomes after outpatient occupational therapy for clients who had upper-extremity injury and surgery or both. The Canadian Occupational Performance Measure (COPM) was used to guide the occupational therapy sessions and to measure outcomes. The Disability of Arm, Shoulder, and Hand (DASH) questionnaire and the Short Form 36 (SF-36) were also administered to the clients pre and post 6 to 8 weeks of hand rehabilitation services. Clients with upper-extremity injury or surgery made strong, positive gains in functional measures following client-centered occupational therapy services. The COPM was the most sensitive to client change, followed by the DASH, and then the SF-36.

This article describes a case report of the occupational therapy management of a 53-year-old woman diagnosed with primary shoulder adhesive capsulitis. Compensatory occupation, preparatory methods, and purposeful activities are demonstrated as being critical to minimizing connective tissue deformation associated with this condition. Occupation-based treatment that was provided in a timely manner immediately decreased pain, improved range and quality of motion, and enhanced occupational performance.

This evidence-based review examined the evidence supporting the use of occupation-based interventions to improve areas of occupation and social participation poststroke. Only 6 studies addressed leisure, social participation, or rest and sleep, with sufficient evidence to support only leisure-based interventions. The implications of this review for research, education, and practice in occupational therapy are also discussed.

Work hardening, presented in this paper as a "new" service for the industrially injured, is actually well grounded in the traditional models and practices of occupational therapy. Recent developments that created the need for the specialized services that occupational therapists are uniquely qualified to provide include growth of private sector vocational rehabilitation, changes in workers' compensation laws, and increasing costs of vocational rehabilitation. This paper describes work hardening in its present form.