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A stroke. A fall. A motorcycle accident. A combat-related injury. A degenerative disease. Post-traumatic stress disorder. All of these may require occupational therapy to regain full function and independence.
This April, Walter Reed National Military Medical Center’s 33 occupational therapists and OT assistants celebrated National Occupational Therapy month.
According to the U.S. Bureau of Labor Statistics, there are nearly 127,000 OTs across the country. At Walter Reed Bethesda, occupational therapists can be found on the inpatient units, and the following outpatient sub-clinics: neurological / TBI, behavioral health, orthopedic / hand and amputee/multi-trauma. The WRB OT clinic also supports recreational therapy and assistive technology.
“Occupational therapy is a very broad, allied health profession that is focused on helping people return to their normal and meaningful activities of daily life,” explained Army Maj. Michelle Luken, occupational therapy service chief at WRNMMC. “That can be anything from feeding themselves, or getting dressed independently to performing optimally on their M-4 range qualification.”
“OT Month helps raise awareness for what we do in Occupational Therapy,” explained Mark Marsico, WRNMMC occupational therapist. “We often get confused with other types of therapy, so it is good to advocate for what we do and how we are able to help patients that would normally not know what we do.”
Working alongside physical therapy, physical medicine, orthopedics, prosthetics and behavioral health, OT focuses on regaining independence and optimizing performance.
“We are able to view and treat the person in a very holistic way,” Luken continued. “Each of us are trained to identify and treat clients’ functional deficits, whether they are physical, cognitive, behavioral, and/or and interpersonal in nature.
Marsico explained his take on OT with a very specific analogy, “For those who have suffered a stroke, amputation or other ailment, physical therapy will get them to walk back down the hallway again. OT will work to ensure they have clothes on while they do it.”
“We all like to work with the patient’s personal interests,” continued the Air Force Reserve captain. “We have found that patients will work harder at their recovery if the treatments are interesting and fun for them! We can help our military members get back to being able to put on their uniform again or disassemble a firearm. We can help parents be able to change diapers or play games with their children. We work closely with recreational therapists to help our patients participate in sports and other hobbies. If it is of interest to a patient and they want to be able to do it again, we can set that as a goal and help them achieve it.”
Luken gave an example of how occupational therapy plays a key role in overall health and well-being. “I often have patients come in to the hand clinic for a repetitive strain injury, like lateral epicondylitis, or tennis elbow. And through my occupational profile, which is my interview portion of the evaluation, I sometimes find out that they’re having a really hard time getting quality sleep. They have poor nutrition, they’re stressed to their limit. All of those things interfere with the body’s ability to heal from soft-tissue injuries.”
With this information, she knows that she is addressing more than just elbow pain. She can address stress management, sleep, and basic nutrition needs, and refer to Behavioral Health and Nutrition Services, as needed.
Marsico provided some details about working with a Sailor who was involved in an accident while deployed. “His hand was completely severed when a trash compactor door malfunctioned. His hand was reattached after over nine hours of being separated. He had an amazing team of surgeons and other providers that were able to reattach his hand. We have been working with him since last summer and he has made great progress. He has returned to performing some of the tasks that he enjoys, such as fixing his car and playing video games. He still has a way to go, but has exceed everyone’s expectations!”
Luken, who came from the private sector, described the advantages of working at Walter Reed Bethesda as, “Being able to address the whole person, and having the time and the resources to do so.”
Referrals to the orthopedic / hand clinic are mostly done through a patient's primary care physician or an orthopedic provider, explained Luken. However, she has taken advantage of a unique opportunity available to military OTs. Through some rigorous training she has been designated as a ‘physician extender’ for upper extremity/neuromusculoskeletal conditions. This 7H Advanced Skill Identifier allows her provide direct-access care for patients with upper extremity injuries and conditions. The 7H also allows Luken to diagnose, order imaging, refer to other specialties, and prescribe certain medications. While Luken is currently the only OT in the department with the 7H identified, other OTs are currently undergoing the training.
| Date Taken: | 04.15.2019 |
| Date Posted: | 05.21.2019 10:05 |
| Story ID: | 323231 |
| Location: | BETHESDA, MD, US |
| Web Views: | 109 |
| Downloads: | 0 |
This work, National OT Month: - Celebrating providers who strive to maintain, restore daily life functions, by Mark Oswell, identified by DVIDS, must comply with the restrictions shown on https://www.dvidshub.net/about/copyright.
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