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My Level IIA fieldwork was with hand therapy.

Typically, in this particular setting,


occupation-based interventions are not seen as often as in other setting. There was one patient in
particular who was s/p reverse shoulder arthroplasty. Our therapeutic goals included increased
right shoulder flexion and abduction while inhibiting upper trapezius compensation. Her
intervention program included staking cones onto a metal pole and clipping clothespins.
Whenever we would get to these activates I could see her become less interested and she would
outwardly show signs of fatigue. After two sessions incorporating these activities she voiced her
dislike for it and essentially disengaged from therapy. The intervention designed was not
currently client centered or occupation based. Therefore, I challenged myself to find activities
that would have meaning to the client while also serving to reach her therapeutic goals.
Working with the client, we were able to find suitable activities that were challenging and
motivating. We decided that drinking from a cup and turning on and off a light switch were
meaningful tasks that client would like to resume performing. Allowing the client to actively
participate allowed the intervention to be more client-centered.
In another situation, a client who was a flight attendant, received therapy for a distal
radius fracture. In addition to the typical activities used with this population, we incorporated
pushing and pulling of a weighted sleigh to mimic the pushing and pulling of the drink cart while
on flights. In addition, part of the intervention consisted of moving a weighted crate from one
shelf to another to replicate her work duties.
Overall, despite the limitations presented in the hand therapy clinic, I was still able to
incorporate occupation-based practice into the clients intervention plans. Doing so increased the
clients motivation and endurance for therapy, while allowing the clients to reach their
therapeutic goals.

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