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Tim's Case 33 y/o M (Task Analysis-Fishing (Tying bobber onto fishing…
Tim's Case 33 y/o M
Personal Interests & Values
Mountain bike riding, enjoys fishing, rock climbing, lifting weights, bike riding.
Dx & current status:
Left Distal Radius Fx. PMH: immobilized in cast for 6 weeks and presents to therapy to initiate AROM. Bone is stable. Wrist and fingers are still stiff.
Performance Patterns (routines, roles, etc.)
:
Construction manager, employee, outdoorsman, soon to be new father, & husband
Reason the Client is seeking OT
services and concerns related to engagement in occupations
Tim has just had his cast taken off that he had on for 6 months.
He is left hand dominant and is experiencing stiffness in his wrist and fingers that is inhibiting his occupational participation and full participation at work.
Occupations in which the client is successful
Leisure exploration and participation, rest and sleep, dressing, toileting, feeding, showering, functional mobility, care for others, financial management, health management and maintenance, job performance
Occupational History
Project manager at new construction site helping with manual labor when needed; lives with wife; diagnosed with distal radius fracture
Task Analysis-Fishing
Tying bobber onto fishing line
Justification
: This is a fine motor activity that will require Tim to utilize his finger dexterity and loosen his finger stiffness
Client factors:
joint mobility, joint stability, muscle power, muscle tone, muscle endurance, motor reflexes, control of voluntary movements
Grading:
Use a heavier test line because it is thicker and will be easier for him to practice with
Reeling
Justification:
This is a good activity to increase the range of motion in Tim's wrist.
Client factors:
joint mobility and stability, muscle power, muscle tone, muscle endurance, motor reflexes, control of voluntary movement
Grading:
Have him start at a slow pace to make it easier and have him increase speed. You could also add resistance to the bobber to make reeling harder.
Practice casting a fishing pole
Justification:
Practicing casting is a good way to initiate AROM with movements such as radial/ulnar deviation, flexion/extension
Grading:
A PVC pipe could be used to grade down the activity and imitate the shape of a fishing pole until enough strength is built up to use the actual pole. Repetitions, duration of activity, and weight can all be used to grade the activity up or down. When he is ready, we will move to a real fishing poll and bobber
Client factors:
Joint mobility and stability, power, muscle tone and endurance, motor reflexes, involuntary and voluntary movement reactions
Justification:
Tim's main concern is being able to go back to work fully but his wrist and fingers are very stiff. We will use fishing as a therapeutic activity to alleviate his stiffness and increase his work participation
Environment
Physical: Works on construction sites in Austin, TX
Social: Wife pregnant for first time
Context
Cultural
Support from wife
Personal
33 year old male; project manager
Temporal
Spring time; currently off work due to injury
Virtual
Has many hobbies requiring physical activitiy
Client's priorities & desired outcomes:
wants to be able to fully engage and participate in his job (go back to work full duty), be prepared to be a father
Assessments
Range of Motion
Manual Muscle Testing
Observation
COPM
Therapeutic use of self
Collaborating
: Have him tell us what activities he wants to engage in (fishing) and have him teach us about fishing
Encouraging
: We would find what is important to Tim and use that activity or goal of is to encourage him to participate in therapy as motivation to get back to work and his hobbies
Empathetic
: Understanding and explaining to him that we understand what he is going through and can help him get back to work if the proper steps are taken
Client Report