1. NAJMA ADAM DOW UNIVERSITY OF HEALTH SCIENCES/
LECTURER OCCUPATIONAL THERAPY
DOW UNIVERSITY OF HEALTH SCIENCES/
PINE GROOVE REHABILITATION CENTER
HILAL-E-AHMER

2. Help for people with Parkinson’s
Occupational Therapy
Help for people with Parkinson’s

3. Now imagine this... Have you had a shower, Had breakfast with family,
Take a moment to think of some of the things (occupations) you have done today to attend this lecture….
Have you had a shower,
Had breakfast with family,
Driven a car?
Before we start talking about Occupational Therapy I want to give you guys something to think about…
Now imagine this...

4. HOW WOULD YOU… HAVE A SHOWER IF… You have rigidity in your muscles?
You had poor balance?
You couldn’t reach your arms up to your hair?
Maybe an OT would…
Recommend a seat for you to sit on.
Work on activities to work on your balance.
Install grab bars etc. to ensure safety.
Standing vs. sitting
Imagine not being able to wash your hair. Maybe an OT would help you..
work on strengthening your arms
Look at other ways to wash your hair (resting arms on counter)

5. HOW WOULD YOU… HAVE BREAKFAST WITH FAMILY IF…
You couldn’t hold a spoon/fork?
You take a long time to finish your meal?
You just couldn’t cope with getting out of bed?
Maybe an OT would…
Help you to regain movement and strength
Recommend a special fork
One handed-how will you use a knife?
Memory strategies for events.
Practice trials in community.
Write out directions checklist to follow.
One to one or group to focus on coping skills

6. HOW WOULD YOU… DRIVE A CAR IF… You were paralyzed from the waist down?
You were fearful leaving the garage?
You lost the use of your right hand?
Maybe an OT would…
Hand controls
Work on transferring into car and then placing wheelchair in car
Work on breaking down tasks to accomplish smaller goals
Splint?
Improve function in that hand
Adapt steering wheel
Moving switches to where they can be moved
Some function? Built up key, adapted knobs

7. HOW WOULD YOU… HAVE COME TO ATTEND THIS LECTURE IF…
You had pain in your back?
You heard voices in your head?
You had tremors in your hands?
May do a GRTW
Modify duties
New ways to lift things
Ergonomic assessment
Can they return to work?
Strategies to overcome _____________
Pain management
Adapting to a bigger grasp
Modify the work area
Splint for pain relief

8. OCCUPATIONAL THERAPISTS
…have the knowledge and the skills to help people overcome these and other barriers they may face in doing their everyday occupations!

9. What is an Occupational Therapist?
Health Care Professionals who enable people to lead a more productive, satisfying, and independent life.

10. Who do Occupational Therapists work with?
Children
Adolescents
Seniors
Adults

11. Where do Occupational Therapists work?
Hospitals
Schools/Special schools
Mental Health Facilities
Armed forces
Old Homes
Private Clinics
Rehabilitation Centers
Community Health Centers
Insurance Companies
Client Homes
Client Work Places

12. THE ROLE OF OCCUPATIONAL THERAPIST FOR PEOPLE WITH PARKINSON’S
INCREASE AND MAINTAIN INDEPENDENCE IN ACTIVITIES OF DAILY LIVING (ADL’s)
INCREASE MOBILITY & CO-ORDINATION

13. Activities of Daily Living(ADL’s)
Basic ADL’s
Instrumental ADL’s
Self care
Feeding
Grooming
Dressing
Bathing
Personal hygiene
Toileting
Interaction with physical environment
Putting things away & getting things out of the closet
Telephoning
Written communication
Using paper money, checks or coins
Using books, newspapers & entertainment equipments
Using public/private transportation
Leisure activities

14. Firm seat with both feet on the floor with back supported. Clothing:
Dressing:
Warm & light room.
Firm seat with both feet on the floor with back supported.
Clothing:
Easy to handle.
Light weight
warm /stretchy fabrics
Easily laundered
Cotton – or cotton – polyester
Wide openings
Aids:
Elastic laces
Shoe horn
Slipper – socks

15. Eating :
Begin meal slightly ahead
of the rest of his family
Eat little and often
One course of main meal at
midday
2nd course on the evening
Half filled mug(tremor)
Aids:
Padded /light weight cutlery
Plate guards
Non slip mats
Weighted bracelets (not too heavy)
Mugs & cups with two enlarged handles

16. Correct positioning.
It may be useful to reduce the distance between the hands and mouth e.g. raising the table or plate, or by positioning the patient so that his elbows can be used as a pivot in order to assist hand movement

17. Home Safety and Management
Even floor.
Non-slip polishes
Grab rails e.g. bath, toilet, steps.
Plan but flexible routine will help to conserve energy.
Non-iron and dip-dry fabrics.
Carrying aids:
Net bag clipped to the walking frame.
Trolley or an apron with large pockets all reduce the danger of tripping
Alarm system
Telephone

18. Bathing:
Shower chair
Non-slip bath mat
Beds:
Firm mattress
Grab rail by the bed
Night light luminous
Alarm clock
Light left on in the hallway

19. Mobility & Co-ordination
Aim
Gait
Balance
Transfers

20. 1. Gait:
Rx Aim:
To improve size & rhythm of the walking pattern
Large; rhythmical bilateral non-resisted movements Walking
Practice using foot outlines lines marked on the floor at paced intervals are all suitable.
Activities which encourage walking should be under supervision.

21. 2. Balance:-
Initially
Work at a balance table.
Mirror
Later
Encourage side flexion and rotation.
Encouraged to bend and stoop, such as gardening and skittles.
Wedged shoes
Leather soled shoes
Weighted clothing.
Raised chairs /beds.
Inclined seats reduces the risk of over balancing when rising.

22. Initiating Movement
Rocking motion with verbal stimulus
“one, two, three go!”
Counting,
Marching,
Music, or rhythmic encouragement
‘step and step and ….’
One step backward before attempting to walk forward.
Auditory & visual stimuli (received when climbing up stairs often makes this activity easier than walking on level ground).

23. 3.Transfers:
Stable & firm surface.
A firm wedged cushion or rocking motion for rising from sitting.
Raise the back legs of a chair slightly.
Steady high chair with arm rest.

24. Co-ordination:
large bilateral and rhythmic activities with little resistance.
As co-ordination improves the time spent on each activity can be increased and the size of movement decreased.
Regular practice of writing patterns.

26. large poster-sized sheets of paper
Writing:
Initially:
Blackboard
large poster-sized sheets of paper
Later :
Rhythmical writing patterns using widely spaced lines.

27. Progressions to writing letters and words.
Writing aids:
Padded pens
Writing board
Roller ball pen (easier than fountain or ball point pen).

28. Support for the patient and his family
Reassure
Therapist should help the family to be realistic in their expectations.
The family should not expect the patient to perform activities beyond his capacity, but emphasize those he can do.

29. Social Activities
Work in small groups (to avoid isolation and to assist communication).
Positive and purposeful.
Familiar and interesting activities
A wide variety of stimuli in the form of colour, sound and touch.
The therapist should work within the concentration span of the patient.
Maintain social contact through
Hobbies
Pastimes.
Visits.
Outings.

30. work
Part-time work.
less responsibility at work may be considered.
It is unwise for the patient to persist with work to the point where he becomes exhausted and possibly unsafe.

31. REFERENCES THE PRACTICE OF OCCUPATIONAL THERAPY
An introduction to the treatment of Physical Dysfunction (II EDITION-ANN TURNER)
QUICK REFERENCE TO OCCUPATIONAL THERAPY ( KATHLYN L.REED)
WILLARD AND SPACKMAN’S OCCUPATIONAL THERAPY (XI EDITION)

32. Take Home Message
ADD LIFE TO YEARS NOT YEARS TO LIFE