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| Welcome! | Welcome back to our free evidence-based Rehabilitation Reference Center Update. You are receiving this newsletter because you are a subscriber of CINAHL and/or Rehabilitation Reference Center. Please share this with your colleagues, students, practitioners and others who would appreciate awareness of this information.
Rehabilitation Reference Center™ (RRC) is an evidence-based clinical reference tool for use by rehabilitation clinicians at the point-of-care. RRC provides physical therapists, occupational therapists, speech therapists and rehabilitation students with the best available evidence to provide the highest quality care and improve patient outcomes.
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Rehabilitation Reference Center in Daily Practice
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Mrs T is a 76 year old patient with breast cancer being seen for foot pain in the outpatient physical therapy setting.
The physical therapist wants to find some information on treating patients with cancer-related fatigue. She consults Rehabilitation Reference Center, keying in cancer-related fatigue. She consults the clinical review "Cancer-related Fatigue and Exercise."
She reads about cancer-related fatigue, including contraindications and precautions. Then, she reviews the examination and treatment of a person with cancer-related fatigue. Prior to performing the examination, based on the information gleaned from the Clinical Review, the physical therapist assures that the patient has received medical clearance for exercise therapy. She confirms that the patient does not have any unstable cardiac disease, acute infection, or other acute medical condition that would contraindicate exercise. She documents fatigue with a visual analog scale (VAS) such as the VAS for energy (VAS-E). Following the examination, she calls the physician's office to obtain clearance, specific precautions, and safety instructions/parameters regarding exercise therapy from the patient's oncologist.
Note: The above referenced Clinical Review is freely accessible to all readers of the Rehabilitation Reference Center Update.
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| Quick Overview | |
Caring for Patients with Eating Disorders
An eating disorder is a condition that involves extreme emotions, attitudes, and behaviors regarding weight and food issues. A person with an eating disorder suffers serious emotional and physical problems that can have life-threatening consequences.
Occupational therapy evaluations for patients with eating disorders should utilize a client-centered approach to most effectively evaluate deficits and needs. Occupational therapists should follow physician's orders regarding the reintroduction of all food, nutrients, and calories into the diet of a patient with an eating disorder; nutritional support for severely malnourished patients must be supervised by a nutrition professional because of the risk of refeeding syndrome, in which a patient can rapidly develop fluid and electrolyte disorders, especially hypophosphatemia, along with neurologic, pulmonary, cardiac, neuromuscular, and hematologic complications, including death. Occupational therapists should be aware that the incidence of suicide attempts and suicide is much higher among patients with eating disorders than among the general population and should take any verbalization of suicidal ideation seriously and inform the patient's primary physician and/or psychiatrist.
The goal of occupational therapy when used as a component of a multidisciplinary treatment approach for patients with eating disorders is to maximize the patient's level of physical and psychosocial functioning. OTs often use an activity-oriented approach, selecting those activities that will best meet the individual patient's needs and assist with his or her personal recovery from an eating disorder. Activities used for occupational therapy intervention with patients with eating disorders include projective media, menu planning and cooking, crafts, stress management training, relaxation therapy, social skills training, clothes shopping, movement therapy, and assertiveness training.
You can read the Clinical Review on "Eating Disorders (Occupational Therapy)" by logging into your subscription of Rehabilitation Reference Center.
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| Evidence-based Content Update | Recently, the clinical review Rheumatoid Arthritis (Occupational Therapy) was revised following review under the systematic literature surveillance program. Information of value to physical therapy practice regarding rheumatoid arthritis were a set of guidelines.
According to the Scottish Intercollegiate Guidelines Network's (SIGN) national clinical guideline for the management of RA, the benefits of skilled occupational therapy for these patients with respect to improved quality of life is clear; however, there are limited studies from which efficacy conclusions can be drawn, and evidence from randomized controlled trials (RCTs) is absent. SIGN's guideline emphasizes that occupational therapy should focus on improving activities of daily living (ADLs), providing equipment and adaptations as necessary; maximizing function and level of independence of the patient; educating patients on joint protection strategies, including how to reduce strain, properly use assistive devices, utilize rest schedules and energy-conservation techniques, and use proper exercise and splinting techniques.
We invite you to login to the Rehabilitation Reference Center to read new and updated clinical reviews as they become available.
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