April is Occupational Therapy Month! This is a time to recognize and thank our therapists for what they do. If you see or know an occupational therapist, take a moment to reach out to them.
What is an occupational therapist's role in seating and wheeled mobility? Like many areas of therapy, it can overlap and vary across practice settings and organizations. It often depends on what type of therapist (occupational or physical) takes on the vested interest. Ideally, assessments occur using a multidisciplinary approach, which includes rehab technology suppliers, technicians, and manufacturers, along with the health care providers and caregivers.
Sunrise Medical's very own Director of Clinical Education, Jessica Presperin Pedersen OTD, MBA, OTR/L, ATP/SMS helped create the fact sheet below with The American Occupational Therapy Association. This resource continues to be helpful to understand the role of occupational therapy.
This blog was originally published by The American Occupational Therapy Association.
More than 3.6 million people in the United States depend on a wheeled mobility device (wheelchair or scooter) to perform activities of daily living and instrumental activities of daily living (U.S. Census Bureau, 2010). Seating and wheeled mobility (SWM) services provided by occupational therapy practitioners include specific positioning equipment, mobility devices, durable medical equipment (DME), and complex rehabilitation technology (CRT), used to optimize clients' environmental access and their ability to safely perform daily occupations. Seating systems or equipment are are designed to meet individuals' needs for postural support and alignment, skin integrity, function, and safety. Research shows the positive impact of equipment, such as wheelchairs, on the quality of life for individuals with mobility issues (Rehabilitation Engineering & Assistive Technology Society of North America, 2011).
Occupational therapists can recommend general DME, as well as CRT and mobility systems. Occupational therapy practitioners recognize the value of engagement in meaningful occupations, including daily activities, which are facilitated by appropriately selected DME and CRT mobility systems to achieve health, well-being, and participation in life.
Seating and wheeled mobility devices include:
- DME, which is equipment that can withstand repeated use (i.e., an item that could normally be rented), and is primarily and customarily used to serve a medical purpose, and generally is not useful in the absence of an illness or injury.
- CRT, which includes medically necessary, individually configured devices that require evaluation, configuration, fitting, adjustment, or programming. For the purposes of this fact sheet, CRT refers to individually configured manual wheelchair systems, power wheelchair systems, adaptive seating systems, alternative positioning systems, and other mobility devices, along with the associated services.
The Role of Occupational Therapy in SWM
Occupational therapists are the only health care professionals who use a client/environment/occupation perspective that considers the interface between these three elements when assessing and recommending complex equipment. Practitioners bring in-depth knowledge of occupational performance and participation, and they provide expertise in human function; human development; and the impact of physical, behavioral, social, and cognitive changes throughout the lifespan. Occupational therapy practitioners bring a distinct perspective on the impact of habits, roles, and routines on the life of the individual to determine what equipment will be most beneficial in all the person's environments, using a client-centered, participatory approach to intervention. Occupational therapy practitioners working in SWM can be generalists or specialists; specialists have a deeper knowledge of complexities related to the range and application of more sophisticated equipment and how it can be used to improve physiological functioning and the ability to perform activities of daily living that are important to the individual.
The role of occupational therapists providing SWM services includes:
- Conducting individualized, holistic evaluations to determine clients' skills and patterns of daily living and mobility
- Identifying and addressing clients' needs, interests, goals, supports, and barriers to participation in meaningful activities, roles, and occupations
- Assessing and recommending equipment, technology, and environmental modifications to increase accessibility and align with clients' needs, goals, and abilities
- Providing justification for funding sources and procurement of medically necessary equipment and technology by completing required documentation
- Fitting and customizing equipment to meet clients' present and potential future needs and goals
- Assisting clients to develop habits, roles, routines, and coping strategies that support physical, psychological, and social health and well-being
- Training clients, caregivers, and family members on safe and efficient device and technology use
- Remaining abreast of current policy and reimbursement changes, documentation requirements, and technological advances to support clients
- Measuring outcomes of clients' health and wellness, quality of life, participation, and occupational performance relative to function and participation
Who Can Benefit From SWM Services?
Individuals throughout the life span who have diverse clinical conditions (temporary or permanent), functional abilities, and mobility goals can benefit from occupational therapy practitioners providing SWM services and equipment. Some examples of services and equipment provided include proper seating and positioning within a classroom, independent mobility to complete grocery shopping in the community, a customized control system for a power wheelchair user with limited hand function, or a system for pressure redistribution and wound prevention. Caregivers and family members also benefit from SWM devices, equipment, and training, to assist with caregiving and facilitate client independence and safety.
Where and How are Services Provided?
Occupational therapy practitioners provide SWM services across many practice settings, including home health, educational and rehabilitation facilities, private practice, and community-based settings. Referral and documentation requirements may vary with funding sources, organizations, and policies. Occupational therapy practitioners ideally work with a multidisciplinary team that includes rehabilitation suppliers, technicians, and manufacturers, as well as other health care providers and representatives from funding sources to ensure the provision of proper equipment.
Conclusion
The distinct value of occupational therapy practitioners as providers of SWM services is demonstrated through their use of intervention models that integrate the client, occupation, and environment. Occupational therapy education, application of current evidence to practice, and clinical competency along the continuum from generalist to specialist help practitioners achieve optimal outcomes for clients. These outcomes can include enhanced or improved participation in work, community, and school-based activities and maintenance of health and wellness.
References
- Rehabilitation Engineering & Assistive Technology Society of North America. (2011). RESNA wheelchair service provision guide. Retrieved from http://www.resna.org/sites/ default/files/legacy/resources/position-papers/RESNAWheelchairServiceProvisionGuide.pdf
- U.S. Census Bureau. (2010). Americans with disabilities: 2010. Retrieved from www.census.gov/prod/2012pubs/p70-131.pdf
By Jill Sparacio, OTR/L, ATP/SMS, ABDA; Chris Chovan, OTR/L. ATP, CAPS; Cynthia Petito, OTR/L, ATP, CAPS; Jacqueline Anne Hall, MS, OTR/L ATP; Jessica Presperin Pedersen, OTR/L, OTDs, MBA, ATP/SMS; Leslie A. Jackson, OTD, OTR/L, ATP, CEAS III; and Theresa lee Gregorio-Torres, OTR., MA, ATP. Copyright © 2017 by the American Occupational Therapy Association. This material may be copied and distributed for personal or educational uses without written consent. For all other uses, contact copyright@aota.org.