Occupational Therapy

From the area of Occupational Therapy specific treatment programs are designed, attending the initial evaluation, injury level and individual characteristics of the person with Spinal Cord Injury. The common goal is to achieve maximum autonomy, independence and quality of life of people with Spinal Cord Injury.

To do this it works as a team with the rest of professional of the interdisciplinary team. The Department of Occupational Therapy addresses the following aspects:

Activities of Daily Living

Our main goal is to achieve maximum autonomy and independence of the user with spinal cord injury, working the different activities of daily living: 

Basic Activities of Daily Living Training (BADL)

  • Nutrition
  • Clothing
  • Bathing
  • Personal hygiene
  • Transfer
  • Mobility: wheelchair management, postural changes, balance and trunk control.

Instrumental Activities of Daily Living Training (IADL):

  • Personal care
  • Homecare
  • Cash management
  • Medication
  • Public transport use
  • Computer access
  • Leisure
  • Work and study (adaptation and accessibility)

They are trained in the department itself, in the facilities and around the residential center, in order to simulate the maximum household characteristics, and the real difficulties that the user faces.

Usuario realizando una actividad para trabajar el rango articular de hombro en las instalaciones de la Fundación del Lesionado Medular
 
Usuario realizando actividad de pinza

Hand and upper limb treatment program

Functional activities of the hand, elbow and shoulder: aimed to give a role to the muscles of the hand and upper limb, who works physiotherapy equipment. Mobility for functional use is trained, in the first place with activities that simulate the different movements of ADL's, to train after ADL's themselves.

Hand and upper limb specific treatment: Given the importance of the hand in AVDs, these require specific and individualized treatment. Depending on the assessment, treatment to improve, maintain or failing that compensate the different alterations of the hand are programmed. To do so a number of techniques are used depending on the type of hand, including: analytical work of the hand, paraffin, cryotherapy, functional electrostimulation, sensitivity work, draining bandage, mobilization etc.

Innovative devices to work hand and upper limb:

  • Reha-digit for mobilization and relaxation of the hand. Increasing sensory stimulation of the fingers through repetitive vibration passive movements, besides the realization of a massage favoring the reduction of spasticity and rigidity in hand.
  • Bi-manu-track to mobilize and strengthen muscles both passive, active or active assisted pronation and supination movements of the elbow, and wrist flexoextension.
 

Advice and manufacture of splints and support products

  • Advice on positioning systems: The positioning system suitable for each case is assessed, (electric or manual wheelchair wheels, cushion, backrest, rehabilitation wedges) in order to achieve an adequate seated in the wheelchair. It is of great importance because good positioning prevents deformities at the spinal level, appearance of pressure sores, pains and injuries at the level of shoulder and scapular girdle.

 

  • Family counseling about the care of patients with spinal cord injury: From the patient's postural alignment in bed, to the support in transfers and other activities of daily living. Advice and manufacture of support products: The patient with spinal cord injury is advised about supports products to promote his/her independence in those activities they are not able to perform independently because of the injury.

 

  • Advice with Pressure measurement mat: there is a mat-shaped device, that allows us to objectively assess whether the user is seated correctly. This provides us a map of the pressures exerted by the user on his/her positioning system, and thus gives us the opportunity to correct seated in an objective way, thus preventing the risk of sores and deformities due to inadequate sitting.

 

  • Advice for environment mofification and home or workplace adaptation: To make these recommendations, takes into account the level of injury, the patient's and his/her family needs as well as the conditions of the house.
 

Manufacture of splints and support products:

The Occupational Therapy Department has a space for making support products, carried out tailored to the individual and, in some cases is not readily obtainable in the market, such as straps of AVD or punches.

Among other products are made: different types of adapters, resting splints, gauntlets, multipurpose straps, punches, etc.

Una mano tiene puesta un adaptador para poder escribir al ordenador                una mano lleva un adaptador para poder coger un bol√≠grafo
 
Usuario realizando actividad de Terapia Ocupacional con dispositivo Wii

Virtual Reality in Occupational Therapy

In recent years there have successfully incorporated new technologies to achieve treatment goals.

As an innovation, provide a feedback on movement and improves user involvement and motivation in treatment.

Currently are being used Wii© and Kinect© as accessible consoles. Through different types of games different purposes of treatment are worked.

It has also become a leisure alternative because so many users did not know they could use the consoles, being able to become accessible with minor adaptations at a very low cost.