Ingrid Söderback

Horticultural therapy: the ‘healing garden’and gardening in rehabilitation measures at Danderyd hospital rehabilitation clinic, Sweden

Objectives: Objectives were to review the literature on horticultural therapy and describe the Danderyd Hospital Horticultural Therapy Garden and its associated horticultural therapy programme. Design: The literature review is based on the search words ‘gardening’, ‘healing garden’ and ‘horticultural therapy’. The description is based on the second authors personal knowledge and popular-scientific articles initiated by her. The material has been integrated with acknowledged occupational therapy literature. Setting: The setting was the Danderyd Hospital Rehabilitation Clinic, Sweden, Horticultural Therapy Garden. Participants: Forty-six patients with brain damage participated in group horticultural therapy. Results: Horticulture therapy included the following forms: imagining nature, viewing nature, visiting a hospital healing garden and, most important, actual gardening. It was expected to influence healing, alleviate stress, increase well-being and promote participation in social life and re-employment for people with mental or physical illness. The Horticultural Therapy Garden was described regarding the design of the outdoor environment, adaptations of garden tools, cultivation methods and plant material. This therapy programme for mediating mental healing, recreation, social interaction, sensory stimulation, cognitive re-organization and training of sensory motor function is outlined and pre-vocational skills and the teaching of ergonomical body positions are assessed. Conclusion: This study gives a broad historic survey and a systematic description of horticultural therapy with emphasis on its use in rehabilitation following brain damage. Horticulture therapy mediates emotional, cognitive and/or sensory motor functional improvement, increased social participation, health, well-being and life satisfaction. However, the effectiveness, especially of the interacting and acting forms, needs investigation.

The actual state of the effects, treatment and incidence of disabling pain in a gender perspective - a Swedish study

Purpose : The purpose of the study was to elicit the actual state of self-perceived experience of long-term and/or recurrent pain and its effects as reported by women and men with disabilities due to pain, in order to determine criteria for assessing the need for measures in rehabilitation/occupational therapy. Methods : The study used a comparative design with a sample randomized from the Swedish population aged 18-58 years (n = 10000). The inclusion criterion was that the respondents had or had had pain causing activity limitation or restricting participation in daily life. A special questionnaire including items concerning demography, pain, coping, occupations in daily life, work, treatments, care institutions and hospital/care staff visited, was posted to 1849 persons and was answered by 1448 respondents (study group n = 1305, control group n = 117). Results : Gender differences were found in the overall prevalence of pain, women reporting more frequent episodes of pain than men did. Differences were also found in pain variables, in daily occupations, days of sick-leave and work variables. Women completed more varied treatment than men. The incidence rate of long-term/recurrent pain in the population studied was 0.07. Conclusions : As a conclusion from this study, three essential components are suggested for use when assessing the need for rehabilitation/occupational therapy: (1) shoulder/arm or lower back pain of aching, tensed and/or searing character, particularly among women; (2) emotional/affective pain effects causing restlessness and depression, particularly among women; and (3) limitations in daily occupations assessed by FSQ and the demand/control/support model with results falling within the warning zones plus long sick-leave periods.PURPOSE The purpose of the study was to elicit the actual state of self-perceived experience of long-term and/or recurrent pain and its effects as reported by women and men with disabilities due to pain, in order to determine criteria for assessing the need for measures in rehabilitation/occupational therapy. METHODS The study used a comparative design with a sample randomized from the Swedish population aged 18-58 years (n = 10,000). The inclusion criterion was that the respondents had or had had pain causing activity limitation or restricting participation in daily life. A special questionnaire including items concerning demography, pain, coping, occupations in daily life, work, treatments, care institutions and hospital/care staff visited, was posted to 1,849 persons and was answered by 1,448 respondents (study group n = 1,305, control group n= 117). RESULTS Gender differences were found in the overall prevalence of pain, women reporting more frequent episodes of pain than men did. Differences were also found in pain variables, in daily occupations, days of sick-leave and work variables. Women completed more varied treatment than men. The incidence rate of long-term/recurrent pain in the population studied was 0.07. CONCLUSIONS As a conclusion from this study, three essential components are suggested for use when assessing the need for rehabilitation/occupational therapy: (1) shoulder/arm or lower back pain of aching, tensed and/or searing character, particularly among women; (2) emotional/affective pain effects causing restlessness and depression, particularly among women; and (3) limitations in daily occupations assessed by FSQ and the demand/control/support model with results falling within the warning zones plus long sick-leave periods.

Impairment/function and disability/activity 3 years after cerebrovascular incident or brain trauma: A rehabilitation and occupational therapy view

A consecutive series of 195 individuals who had had a stroke or brain trauma in 1986 responded in 1989 to a questionnaire about the consequences of the incident for occupational performance. The questionnaire contained 86 questions organized to correspond to the WHO International Classification of Impairments, Disabilities and Handicaps (ICIDH). The questions were distributed over 11 areas of occupational performance: work, leisure activities/social role, life satisfaction, sensori-motor, perceptual, intellectual, emotional function, sleep, personal care, domestic/housework/gardening, and temporal adaptation. None of the individuals considered they had attained the same level of occupational performance in all 11 areas as before the incident. Eight patterns of occupational performance were identified: 35% considered that they performed personal care at the same level and had the same temporal adaptation as before the incident, and that they had minimal impairment/disability in the other areas of occupational performance; 27% thought that they had a considerable degree of disability in all areas of occupational performance except for temporal adaptation; 8% thought that they had imbalance in temporal adaptation and severe performance difficulties in all 11 areas of occupational performance; 4% were dissatisfied with their life situation, and had a changed family role, did not practise the leisure activities they wanted, and had severe sleep problems; and for 9% the levels of performance varied a great deal and depended on the particular area of performance. The consequences of stroke or brain trauma for function and activity 3 years afterwards are considerable.

Work technique training for patients with chronic pain in neck, shoulder and arm. A questionnaire pilot study after a comprehensive exercise-oriented rehabilitation program

Syftet med denna studie var att följa upp hur patienter såg på sin arbetsmiljö och arbetsteknik samt hur föreslagna arbetsplatsanpassningar hade genomförts efter deltagande i ett multimodalt intensivträningsinriktat rehabiliteringsprogram. Programmet inkluderade en väsentlig del av individuell ergonomisk analys, individuell ergonomisk rådgivning och specifik arbeetsteknikträning på arbetsterapiavdelningen. Patienterna hade kronisk muskuloskelettal smärta i armen. Efter rehabiliteringsprogrammet skickades ett frågeformulär till 181 patienter, varav 135 patienter (109 kvinnor och 26 män) (75%) svarade. Mer än halften av patienterna rapporterade att de oftere än en gång i veckan tänkte tillbaka på den individuella ergonomiska rådgivningen som gavs i samband med att videofilmen tagen på deras arbetsplats presenterades. Deras skattningar visade på en hög medvetandegrad när det gällde att la mikropauser under arbetet (dvs atl räta upp ryggen kombinerat med muskelavslappning), att arbeta med armarna nära kroppen och att lyfta bördor nära kroppen. Hälften av patienterna hade använt sig av möjligheten att ändra arbetsställning mer än en gång per timme. Resultatet indikerar att patienterna var medvetna om sin arbetsteknik efter deltagandet i rehabiliteringsprogrammet.

An activity analysis of hand grips used in housework by female rheumatoid arthritics.

In this nonexperimental study, videofilmed, self-selected housework activities of rheumatic women were analyzed. The women gripped and manipulated objects in their homes. The activities were analyzed under the headings Activity, Actions, Objects, and Grip. The films were viewed frame by frame, and the data was computerized for statistical analysis. The women performed five self-selected housework activities and eight groups of actions (n = 340). During the actions the women handled 12 groups of objects using the eight grip classes of Sollermans grip classification. The diagonal volar grip was the most common grip (20%), and the tripoid pinch was the least common (0.29%); 34% of the actions were right-handed, 19% left-handed, and 47% bimanual. No clear grip pattern was revealed by the activity analysis.

Occupational Therapy Work Training Programs For Brain-Damaged Individuals

Work is mans chief occupation (Yerxa and Baum, 1986; Jacobs, 1990). Adults devote the majority of their time to work (Kemp and Kleinplatz, 1985; Bing, 1989). Individuals in a modern society such as Sweden have the right to a meaningful and productive life (The Association, 1980; Viktorin, 1988; Krafft, Rigner, and Wilhelmson, 1988). Work is an important, necessary activity that is assumed to fulfill and satisfy fundamental human needs (Reed, 1983; Karlsson, 1986; Jacobs, 1990). The concept of work cannot be reduced to a single, simple definition (Karlsson, 1986; Kielhofner, 1985; Bing, 1989; Kemp and Kleinplatz, 1983; Holmes, 1985). In existing definitions, two extremes can be discerned. In one, work is activity that gives the performer some form of reward (Karlsson, 1986). In the other, work is all forms of productive occupation, rewarded or not (Kielhofner, 1985). Productive occupation means the production of goods or services needed by others or that afford the individual and society new abilities, ideas, knowledge, and experience. Work gives the individual life roles. Work thus consists of activities that are of value for the individual, for others, and for society. Work is considered by many a precondition of physical, mehtal, and social health. Illness or injury that alters an individuals work ability has serious consequences (Kemp and Kleinplatz, 1985; Holmes, 1985) for that individuals work role, habits, and tolerance (Yerxa and Baum, 1986). Traditionally, occupational therapists work as team members in rehabilitation (Marshall, 1985; Smith and Bohmfalk, 1985/86), with the goal that the individual will retain or return to work. The occupational therapists role is to guide and support individuals in their endeavors to regain the necessary skills, control, and work endurance (Le Vesconte, 1970). The therapist needs to know how the individual handles tools and materials, the demands work tasks make on the individual, and how functional impairment affects work habits and work skill. The therapist

Interventions: The Occupational Therapist Manages for Adaptations

This part of the handbook surveys the occupational therapy interventions (OTIs) in which the occupational therapist (OT) manages adaptations. These interventions aims are that the client modify (i.e., internal adaptations; coping ability) him/herself to present circumstances, and thus is able to perform activities of daily life (ADL) in the most independent way. The adaptive interventions include environmental adaptations (housing adaptations, accessibility, accommodations, electric prosthesis, orthotics, splints, assistive devices), universal design, occupational adaptations, temporal adaptations, and intrinsic adaptations. Each of these adaptive interventions (apart from occupational adaptations) are represented by one to four chapters in this part of the handbook. The case of John, a man suffering from paraplegia, illustrates some of these adaptive interventions.

Adaptive Interventions: Overview

This chapter surveys the intrinsic, occupational, temporal, and environmental adaptive interventions used in occupational therapy. Therapeutic media are outlined, and the occupational therapist’s role is clarified. The chapters of this part of the handbook exemplify how OTs manage the clients’ various adaptations aimed at facilitate his or her (Fig. 3.1) occupational performance. The clinical applications of the four major factors of adaptations are illustrated through the case of John, a man suffering from paraplegia. Open image in new window Fig. 3.1 The figure shows the OT’s role in managing the occupational therapy interventions aimed at adaptation of the client’s internal and external environment. The figure is a stylized Ankh-sign.

Basic Elements for Conducting Evidence-Based Occupational Therapy

This chapter reports on methodology for evaluating the effectiveness of the interventions discussed in this handbook. The content and the four steps that compose evidence-based interventions are described as well as the various methods for conducting quality assurance. Assessment instruments represent the prerequisites for conducting evaluations of intervention effectiveness. Therefore, their possible aims, psychometric functions, and the process of collecting data and interpreting the results are reported in broad terms. An overview of the various available methods, such as the Goal Attainment Scale for evaluating a single client’s progress when participating in therapeutic sessions, is presented. The terminology of outcome statements is discussed. Finally, recommendations for future advances in occupational therapy are suggested.

The transfer of knowledge in occupational therapy: the case of work ability assessment

Kunskapsöverföringen inom arbetsterapi diskuteras i marknadsföringstermer. Dessa exemplifieras med strategier som författarna föreslår för att lärare, kliniskt verksamma arbetsterapeuter och annan rehabiliteringspersonal skulle kunna förbättra sina kunskaper om arbetsförmågebedömningar och om arbetsrelsterade rehabiliteringsprogram.