The OT view of kinesiology is based on…
The Systems Oriented Approach
- looking at more than the disease or disorder
* International Classification of Functioning, Disability, and Healt (ICF)
* OT Framework
- relationship between person, environment, and occupation
How is occupational therapy occupation based?
- Occupations can act as a therapeutic change agent.
- Occupations facilitate transfer of performance skills to multiple contexts.
- Occupations are selected to enhance motivation for improving occupations.
- Occupations promote self exploration and identification of values and interests.
- Chosen therapeutic occupations start with the current capacity of the client.
- Occupations create the opportunities to practice performance skills.
- Occupations are selected to support the appropriate intervention goal.
- Engagement in occupation produces feedback to grade performance.
- Successful occupational experience is necessary for achieving goals.
List and describe the 5 domains of the OT Framework.
- Occupations
- ADLs, BADLs, IADLs
- sleep, work, play, leisure, social participation - Performance skills
- motor, process, and social skills
- building blocks of occupations - Client factors
- body function, structure, values, beliefs, and personality - Performance pattern
- habits, routines, and roles - Contexts and environment
- Physical, personal, social, temporal, and virtual
Describe the OT process.
Evaluation
- referral, assessment, based on OT profile
Intervention
- remediate, compensate, create, maintain, prevent
Outcomes
- functional outcome measures, reevaluation and adjustment of intervention
Biomechanical frame of reference
Looks at the body as a machine.
OT models based on biomechanics allow us to:
- outline and define musculoskeletal problem
- develop exercise and activities to restore and maintain function
- design and fabricate equipment to meet functional goals
- measure musculoskeletal progress
Kinesiology has 2 basic philosophies. What are they?
- Mechanistic
- mind, person is separate from the body
- similar to biomechanical - Transformative
- views the person as an open system that can adapt and change due to injury or conflict
* soft tissue responds to the stresses placed upon it
Types of fibrous joints
suture
gomphosis
syndesmosis
Types of cartilaginous joints
synchondrosis
symphysis
Synovial joints
- diarthrodial
- has a capsule
- synovial fluid
- freely movable
- highly innervated
Movement in joints
Sliding and gliding (nonaxial)
Uniaxial
Biaxial
Polyaxial
Sliding and gliding movement in joints
- Plane joint
- Carpals and metacarpals
- Often overloooked
- important for joint mobilization
- small motions add up
Uniaxial movement in joints
- Hinge (elbow)
- Pivot (radioulnar or atlantoaxial)
- flexion/extension or rotation
Biaxial movement in joints
- Ellipsoid (radial carpal, metatarsalphalange)
- Saddle (CMC)
- flexion/extension, abduction/adduction
- 2 degrees of freedom
Polyaxial movement in joints
- Multiaxial
- Ball and socket (hip, shoulder)
- three degrees of freedom
- abduction/adduction, flexion/extension, and rotation
Joint play
movement not under voluntary control (passive); can’t be achieved by active muscular contraction; movement that happens in the actual joint
Component movement
involuntary obligatory joint motion occurring outside the joint accompanies active motion, i.e. - scapulohumeral rhythm
Happens in a synergy, like scratching your head. You can override the need to scratch.
Roll
New points on one surface come into contact with new points on the other surface
Rolling only occurs when the two articulating surfaces are incongruent (concave on convex or vice versa)
Slide, glide, translate
Translatory motion in which one constant point on one surface is contacting new points or a series of points on the other surface.
Pure gliding can occur when two surfaces are congruent and flat, or incongruent and curved.
Example: carpal bones
Spin
Occurs with rotation
No forward motion.
Occurs with all joints in the transverse plane along a vertical axis.
Spins in the direction of motion.
Concave motion rule
Convex “ ( “ surface is stationary and the concave surface “ ) “ moves
Joint play will be in the same direction
Glide and roll are in the dame direction as the shaft.
Happens with flex/ext and abd/add.
Convex motion rule
Concave “ ) “ surface if stationary and convex “ ( “ surface moves.
Joint play is in the opposite direction.
Glide and roll are in the opposite direction of each other.
The roll is in the direction of the shaft, the glide is in the opposite direction.
Bone goes up, joint surface moves down.
Example: shoulder
Loose or open pack
Point of least stress on the joint surfaces.
Joint capsule and ligament are loose.
Held in place by surface tension and muscle tone.
Easy to dislocate
Can be manipulated easier.
Non-weight bearing position.
Sitting on the edge of the high table, your knee is flexed and open
2 joints come apart.
Generally found in the midrange.
Closed pack
The joint position in which articulating bones have their maximum area of contact and ligaments are the most taut.
Joint stability is greatest.
Joint is “locked.”
“Unlocking” occurs due to slides or rolls.
The close-packed position for the knee, wrist, and interphalangeal joints is at full extension and for the ankle joint at full dorsiflexion.
Easy to damage capsule or ligaments.
Contraction and weight bearing creates a closed pack.
2 joints come together.
Injury in this position is often catastrophic.
What makes a joint stable?
The shape
- ball and socket is most stable
The capsule and ligament
The more mobile a joint is, the less stable.
Muscles can be built up to help stabilize joints.
