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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