Activity Analysis: How to Determine OT Treatments

Activity analysis is the KEY to occupational therapy.

It helps us be holistic. It helps us be client centered. It helps us look at how we can help our patients return to the occupations that they need and want to do!

Sometimes when we are working with our patients as occupational therapy practitioners, we tend to get stuck in the rut of only working on the occupation that the patient is having trouble with. If they have difficulty with dressing, we only work on dressing. If they are having difficulty with toileting, we only work on toileting.

We cannot forget that using our occupational therapy activity analysis skills are unique to our profession and how we use this to break down the body functions, environment, etc to determine what exactly is limiting occupational performance!

When we do this, we can figure out what we exactly need to hone in on to help our patients reach their goals!

In this article, we will talk about:

• What activity analysis is
• How we use it to determine appropriate skilled OT interventions
• How do we document it and
• How do we as OT practitioners use this to progress the patient toward their goals vs one-off treatment interventions

I am sharing a micro-video and resources from the OT Flourish Membership today that explains exactly how to do this in your own practice.

Activity Analysis Definition

Activity analysis defined as the process used by OT practitioners which “addresses the typical demands of an activity, the range of skills involved in its performance, and the various cultural meanings that might be ascribed to it” (Crepeau, Cohn, & Boyt Schell, 2003, p.192).

So in order to get creative, client centered and occupation based, activity is the most important thing to breaking down what we need to be addressing with the patient from a holistic perspective.

Start with: 

• Complete an activity analysis and see what body functions of the activity they are ACTUALLY having trouble with.
  • Is it dynamic balance?
  • Is it fine motor?
  • Is it visual perception?

Example:

Long Term Goal: Patient will don lower body clothing independently within 6 weeks.

 

 

 Intervention

• Once you can pinpoint an area (or more!) that the patient is having difficulty with from your activity analysis, figure out what other type of occupations and body functions address this same area.
• Be client centered!
  • Integrate activities are occupation based or meaningful to them into your treatment sessions or directly address the underlying deficit.

Working on endurance because they cannot stand the 2 minutes it takes to pull up their pants?

• Interventions could include:
  • • • cornhole
      • facility scavenger hunts
      • folding laundry
      • light cooking task
      • standing at parallel bars

*NOTE: You must measure how long they participate in the task to document our skilled intervention and progress the patient at the next visit.

Grasping their pants giving them trouble because they have weakness?

• Interventions could include:
  • • • mixing cookie dough
      • squeezing spray bottles to clean windows
      • wringing out wet washcloths
      • theraputty exercises

*NOTE: You must document level/strength of putty, grip strength, X number of times participating in the exercise/activity, etc to show progression in this area vs a “one off” treatment technique.

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You can use an occupation based kit that you can make for your department, which is an easy way to be more occupation centered and is easy to grab and go when you need it or even get creative with activities that they may enjoy vs traditional exercise (which is also absolutely appropriate and can be integrated into their plan of care) like a scavenger hunt to address their deficits.

OT Flourish Membership Members also have exclusive access to 100s of resources to help you find interventions that will address these areas:

• Occupation Based Treatment Idea lists in the Clinical Resource Area
• Occupation Based Treatment Idea Micro-Video List

Documentation

• Document the specific body function/component that you are working on so you can directly link it to the occupation and goal that the patient is working on.

  • Example Documentation:

    • Therapist instructed in dynamic sitting balance activity, requiring the patient to pick up objects from floor level 10x with 1, 30 second rest break to progress toward lower body dressing.
      • You could have completed any activity to work on dynamic balance in this scenario:
        • picking up socks out of a laundry basket
        • playing Jenga with set up of the blocks on the floor
      • You do not have to document the specific activity (as in you do not have to document that the patient is playing Jena) unless it is directly related to the goal.