— Dr. Deepak B. Asia

Occupational Therapy, often abbreviated as “OT”, incorporates meaningful and purposeful occupation to enable people with limitations or impairments to participate in everyday life. Occupational Therapy (OT) is an applied science and health profession that provides skilled treatment to help individuals develop, regain or maintain the skills necessary to participate in all facets of their lives. Occupational Therapy is any activity physical or mental, medically prescribed and professionally guided to aid a patient in recovery from disease or injury. Occupational therapists help people with disabilities to fulfill their roles and responsibilities as parent, worker, and /or student. OT does this through the use of therapeutic methods and assistive technology, orthotics (splint) and environmental modifications. The patient is what is important to the therapist. The patients needs, wants, desire for recovery are what the therapist will address and the goals are set with the help of family.

    Occupational therapists work with individuals, families, groups and populations to facilitate health and well-being through engagement or re-engagement in occupation. Occupational therapists are becoming increasingly involved in addressing the impact of social and environmental factors that contribute to exclusion and occupational deprivation. Therapeutic use of selfcare, work and play activities to increase independent function, enhances development, and prevents disability. It may include adaptation of task or environment to achieve maximum   indepen-dence and to enhance quality of life. Occupational therapists focus on making independence a reality. While complete independence may not occur depending on the extent of the disability, occupational therapists will work with the patient or client to come up with strategies, techniques, or adaptations so that they can be as independent as possible. Occupational therapists use occupations to enable this. In the context of occupational therapy, occupation refers to meaningful activity.

Occupational Therapy gives people the“skills for the job of living” necessary for living meaningful and satisfying lives. Occupational Therapy is based on concept and models and services typically include:

• Customized treatment programs to improve one’s ability to perform daily activities
• Comprehensive home and job site evaluations with adaptation recommendations
• Performance skills assessments and treatment
• Adaptive equipment recommendations and usage training
• Guidance to family members and caregivers.

Benefit from Occupational Therapy  : A wide variety of people may benefit from Occupational Therapy, these may include people with:

• Work-related injuries including lower back problems or repetitive strain injuries
• Physical, cognitive or psychological limitations following a stroke, brain injury or heart attack
• Arthritis, multiple sclerosis, or other serious chronic conditions
• Birth injuries, learning difficulties, or developmental disabilities
• Mental health difficulties Alzheimer’s, schizophrenia, and post-traumatic stress
• Substance abuse problems or eating disorders
• Obsessive compulsions, or diagnosed obsessive compulsive disorder (OCD)
• Burns, spinal cord injuries, or amputations
• Fractures or other injuries from falls, sports injuries, or accidents
• Visual, perceptual or cognitive impairment
• Developmental disabilities such as autism or cerebral palsy
• Domestic abuse issues.

Areas of Occupational Therapy: Occupational therapists work in a vast array of settings, these include:
Physical Dysfunctions:       

• Orthopedics (fractures/falls), Osteoarthritis Rheumatoid Arthritis.
• Physical capacity evaluation.
• Hand rehabilitation.
• Burns, Nerve injuries, Amputations
• Road Traffic Accidents etc.
• Prosthetic and Orthosois training.
• ADL (Activities of Daily Living) & Assistive Device Training.

Pediatrics/Developmental Disorders:

• Cerebral Palsy, Congenital Deformities, Downs Syndrome
• Mental Retardation, Autism, Learning disorder, ADHD
• Sensory Integration Dysfunction
• School Based Occupational Therapy
• Other Developmental Disabilities etc.

Cardio- Pulmonary Disordes:

• Work simplification and energy conversation techniques Cardiac Patients
• Myocardial Infarction, COPD, etc.

Cumulative Trauma Disorders:

• Work simplification and energy conversation techniques.
• Carpal Tunnel Syndrome, Low Back Pain. Work related Disorder

Community: Community based practice involves working with people in their own environment rather than in a hospital setting. It can also involve working with atypical populations such as the homeless or at-risk populations. Examples of community-based practice settings:

• Health promotion and lifestyle change
• Intermediate care
• Access to work place, Home and community modification
• People’s own homes, carrying out therapy and providing equipment and adaptations
• Vocational rehabilitation
• Architectural adaptations.

Neurological Disorder:

• Stroke rehabilitation (Paralysis).
• Head  injuries & Brain Tumor rehabilitation
• Movement disorder (Parkinson disease)
• Spinal cord injury rehabilitation
• Neuropathies and Myopathies etc.
• Multiple Sclerosis.
• ADL (Activities of Daily Living) & Assistive Device Training
• Adaptive device training
• Wheel chair training.

Geriatric:

• Alzheimers disease, Dementia etc.
• ADL (Activities of Daily Living) Training to elderly
• Adaptive device training
• Wheel chair training.
• Hospices (Old age Home)

Mental Health:

• Child and adolescent mental health services (CAMHS)
• Schizophrenia, Phobias, Mood, Anxiety Neurosis, Psychosomatic and Personality disorder
• Alcoholism and Substance abuse
• Functional capacity evaluation
• Mental health clinics (day care centre, half way home and sheltered workshops)
• Psychiatric rehabilitation programs
• Mental Hospital
• ADL (Activities of Daily Living) Training to Mentally ill Patients
• Forensic psychiatry.

Occupational Therapy Approaches:Services typically include:

• Teaching new ways of approaching tasks
• How to break down activities into achievable components e.g. sequencing a complex task like cooking a complex meal.
• Comprehensive home and job site evaluations with adaptation recommendations.
• Performance skills assessments and treatment
• Adaptive equipment recommendations and usage training.
• Environmental adaptation including provision of equipment or designing adaptations to remove obstacles or make them manageable
• Guidance to family members and caregivers.

Purpose of Occupational Therapy: 

• The purpose of Occupational Therapy is functional restoration to help each patient, find him and function again as a complete man physically, socially, educationally and economically.
• To enable people with limitations or impairments to participate in everyday life.
• As specific treatment for restoration of physical functions, to increase joint motion, muscle strength and co-ordination
• To teach self-help activities, those of daily living such as eating, dressing, writing, the use of adapted equipment
• As a supportive measure to help the patient to utilize constructively a prolonged period of   hospitalization and convalescence
• To develop work tolerance and maintenance of special skills as required by the patient’s job
• To structure opportunities for the development of more satisfying relationships in psychiatric patients
• For re-direction of recreational and a vocational interests
• To provide pre-vocational exploration to determine the patients physical and mental capacities, social adjustment, interests, work habits, skills and potential employment
• To  convert functionally dependent patient  into functionally  independent
• To help the disabled homemaker readjust to home routines with advice and instructions as to the adaptation of household equipment and work simplification.

Aims of Occupational Therapy:

• Occupational therapists focus on making functional  independence a reality
• To identify and evaluate barriers that may challenge the competence of individuals
• To identify and evaluate supports that facilitates Occupational Functioning
• To develop strategies to eliminate or ameliorate barriers
• To foster supports.

Opportunity & Scope of Occupational Therapy:Occupational Therapy is a noble profession offering variety of exciting employment opportunities in following setup:

• Multispeciality Hospitals
• Rehabilitation Centers
• Foreign countries:
• Non Governmental Organization
• In Industry for rehabilitation of Injured worker
• Teaching to Under & Post Graduates
•  Private Practice/Private clinics
• Geriatric homes/Old age Homes
• Mental Hospitals
• Centers for Physically and Mentally Handicapped Children
• Community health centre
• Schools
• Occupational health centre.

Training & Courses: Thecourses include class room teaching and practical sessions in clinics, where students learn the fundamentals of Occupational Therapy, along with other medical subjects like Anatomy, Physiology , Bioche-mistry, Pathology Pharmacology, Microbiology, Psychology, Medicine Psychiatry, Orthopae-dics and Surgery. Application  of various therapeutic techniques , principle, concept, and how to implement that in various medical and surgical condition.
   
Occupational Therapy Educa-tion Programs In India are Recognized By: ALL INDIA OCCUPATIONAL THERAPIST’s ASSOCIATION (AIOTA) AND WORLD FEDERATION OF OCCUPATIONAL THERAPIST’s (WFOT).

    A total no. of 25 Institutions all over India offer undergraduate course and few of them  also offer Post Graduate courses in Occupational Therapy. To find out more details of institutes offering courses in Occupational Therapy one can visit AIOTA official website : www. aiota. org
   
    Graduation: Bachelor of Occupational Therapy (B.O. Th)/ BOT : 4 and ½ year (Including 6 months Internships)
Eligibility for Admission: After 12th   with PCB or Common Entrance Test.
   
    Post Graduation: Master of Occupational Therapy (M.O. Th)/ MOT : 2 / 3 year.
Eligibility for Admission : After Graduation PG Entrance.

    PG Speciality: OT in Musculosketel, Neurological , Psychiatric, Developmental (Paediatric) Conditions, Hand Therapy, Industrial rehabilitation.

Dr. Deepak B. Asia is  Consultant Neuro. Occupational Therapist and Ex. Asst. Prof., Occupational Therapy School and Centre, Government Medical College, Nagpur.   email Id: deepakasia2001@yahoo.com