ACTIVITY ANALYSIS 1

The importance of activity analysis in Occupational Therapy Practice. Explain one of the activity analysis that can be taken.

Activity analysis is a process used to identify the properties inherent in a given occupation, task, or activity, as well as the skills, abilities, and capacities required to complete it. Fidler and Velde (1999) proved that in their book title as Activities: Reality and Symbol, there are a number of different perspectives that influence how activities are studied and assessed. In therapeutic recreation, activity analysis is taught and used as a prequisite for program planning. Activity analysis is viewed as a procedure for examining the inherent characteristics of activities to select those most appropriate to perform objectives. Analysis includes asessment of the cognitive, physical, interpersonal, social, affective and administrative factors. The outlines and ratings scales for such analyses are impressively thorough and are a valuable resource for the study of activity analysis.

Besides that, Claudia Kay Allen (1987) explain that a philosphical framework to explain the value of using activity as a treatment method is the challenge pursued for this lectureship. Primary resources came from Soviet psychology, the only social science discipline using the concept of activity as a focus of study. The focus of study selected for occupational therapy is disability, which is explained within the context of doing an activity. The patient’s purpose for doing an activity is described by the degree of sensorimotor thought processed during a functional state. A hierarchy of activity analysis is used to begin the development of typologies for feasible operations, satisfactory results, and desirable activities. The philosophical framework is applied to three types of patient populations that pose problems in stating treatment objectives, patients that have (a) a good prognosis but one that is associated with alternative explanations for change, (b) a poor prognosis associated with a lifelong disability, and (c) a grave prognosis associated with a progressive loss of functional abilities. A refined treatment hypothesis is suggested: Therapeutic activity compensates for disability by using remaining capabilities to accomplish desirable activities with satisfactory results. Hence, the desirable activities according to the patients need and preferable can be accomplished through well-planned of constructed activity analysis.

Activity analysis can help the therapist to look at a specific individual's functional deficits and choose an activity that has meaning or purposeful to the client and that will facilitate occupational performance. Trombly (1995) stated that the model of occupational functioning leads her to conceptualize occupation both as treatment end goal and as means to remediate impairments. In both dimensions, meaningfulness and purposefulness are key therapeutic qualities. Purposefulness is hypothesized to organize behavior and meaningfulness to motivate performance.

Furthermore, Steinback (1986) proved that individuals will be motivated to perform longer when the activity is purposeful. Fifteen male and fifteen female subjects performed activities designated as purposeful and non-purposeful that required the same muscle function. Subjects continued each activity to a predefined level of perceived exertion. The number of repetitions performed, the heart rate, and electromyogram (EMG) recordings were compared for the purposeful and non-purposeful activities. Results showed a significantly greater number of repetitions performed on the purposeful activities (p = .001) recorded at equal levels of exertion. The hypothesis that individuals will be motivated to perform longer when the activity is purposeful was supported empirically, thereby substantiating a basic premise of occupational therapy. Thus, activity analysis is used to select an activity to remediate deficient capacities and abilities or, knowing the person’s skills, abilities, and capacities, to ensure successful completion of the activity or to motivate engagement in activity.

When activity analysis is completed and the desired of a specific activity that the client wants and needs to do are understood, the client’s specific skills and abilities are then compared with the selected desired activity. Crepeau (2003) explained that occupation-based activity analysis places the person (client) in the foreground. It takes into account the particular person’s (client) interests, goals, abilities, and contexts, as well as the demands of the activity itself. These considerations shape the practitioner’s efforts to help the… person (client) reach his/her goals through carefully designated evaluation and intervention.

Nelson (1988) believe that purpose can be derived from the meaning one makes of a situation but according to Fisher (1994),  meaning can be derived from one’s purpose for engaging in the activity. Meaning and purpose, when considered in relation to occupation, are inextricably interrelated. Fisher (1998) proved that purposefulness is important, but it is not enough. Occupation is both purposeful and meaningful. If we can identify activities that have potential to be meaningful to the person, we can use them to increase motivation and a sense of purpose. In this process, we cannot confuse our purposes or meanings with those of our clients. Four global groups of activities that occupational therapy practitioners use in practice are described—exercise, contrived occupation, therapeutic occupation, and adaptive occupation. Therapeutic occupation and adaptive occupation are proposed as the legitimate activities of occupational therapy.

Activity analysis is used as part of the therapeutic intervention. The activity analysis suitable for the patient is designed to reach the goals of the patients in improving their impairments respectively. Sietsema et al. (1993) study the principle of occupational therapy and motor learning theory in the context of neurodevelopmental treatment techniques. Ten trials of occupationally embedded intervention (playing Simon,™ a computer-controlled game) were compared with 10 trials of rote arm-reach exercise. A counterbalanced design was structured so that each subject experienced each condition one week apart. Subjects were 17 men and 3 women with traumatic brain injury who exhibited mild to moderate spasticity in the upper extremity. Maximum distance from hip to wrist during active reach of the affected extremity was measured by digitization of videotape with the Motion Analysis™ EV-3D system. Results indicated that the use of the game elicited significantly more range of motion than the rote exercise (t (19) = 5.77, p < .001). These results support the use of an occupationally embedded intervention for persons with traumatic brain injury and add to the theoretical base of occupational therapy.

In addition to that, Neistadt et al. (1993) explained that  occupational therapists often use tabletop board games in treatment to help adult clients with physical disabilities improve the perceptual, cognitive, sensory, and fine motor skill components of occupational behavior. Detailed activity analyses of these types of activities, including performance norms, are not available in the occupational therapy literature. Such analyses would help therapists consider the multiple skill demands of tabletop games and allow more systematic grading of these treatment activities. This paper presents a model for analyzing therapeutic activities in relation to relevant motor learning and cognitive–perceptual literature. Included in this analysis are a description of the activity, examination of its component skills and of the qualitative features of activity performance, suggestions for grading and for treatment goals, and some preliminary performance standards derived from a pilot study of 18 adults without physical disabilities.

Moreover, Earley et al. (2010) addressed the use of therapeutic occupations and activities within a modified constraint-induced movement therapy (mCIMT) approach for a 52-year-old female violinist four year after ischemic stroke. Analysis of occupational performance was completed before and after intervention using a modified version of the Fugl-Meyer Sensorimotor Evaluation, the Motor Functioning Assessment, the Arm Improvement and Movement Checklist, and information obtained from a client journal maintained throughout treatment. The mCIMT protocol included use of constraint of the affected arm, with emphasis placed on participation in meaningful occupations and activities. Improved function in the affected extremity was noted at the conclusion of mCIMT. After completion of therapy, the client reported a return to playing violin. The findings from this case report suggest that use of meaningful occupations and activities integrated into a mCIMT protocol may be effective in addressing skills deficits for clients with upper-extremity chronic hemiparesis.

In conclusion, activity analysis is used to understand the demands that a specific desired activity takes places on a client. It is used as a part of therapeutic intervention, help the client reach his/her goals through carefully evaluation and intervention, help the therapist to select an activity to remediate deficient capacities to ensure successful completion of the activity or to motivate engagement in activity.

 

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