Documenting progress: hand therapy treatment shift from biomechanical to occupational adaptation

Area of Science:

• Occupational therapy
• Rehabilitation medicine
• Rheumatology

Background:

• Therapeutic relationships are crucial for client-centered care but challenging in time-limited healthcare.
• Traditional biomechanical approaches may not always meet client needs in complex orthopedic cases.

Observation:

• A case report details a client with lupus-related arthritis, 6 days post-surgery, initially treated with a biomechanical frame of reference.
• Limited progress was observed after 10 weeks, prompting a shift in therapeutic approach.

Findings:

• Transitioning to an occupational adaptation (OA) approach, utilizing the Canadian Occupational Performance Measure, resulted in significant functional improvements.
• The OA approach demonstrated clinical importance across all addressed functional tasks.

Implications:

• The occupational adaptation approach effectively bridges the gap between evidence-based practice, client-centered goals, and healthcare system constraints.
• This case highlights OA as a viable and effective strategy for improving outcomes in orthopedic outpatient settings.