OT 537: Media Project

     My client is a 36-year-old married male who suffered a C7 spinal cord injury (SCI) as a result of falling off of a ladder while working on his music retail store.  He opened his music store 18 months ago and typically spends around 70 hours a week there selling CD’s, DVD’s, and tapes. My client wears a halo vest, has flaccid paralysis in his upper and lower extremities, has lost all sensation distal to the C7 location, and currently requires assistance for all activities of daily living (ADLs), transfers and mobility. He is currently in the acute care setting, and his goal in OT is to do activities that will allow him to go the rehabilitation hospital. Because his injury was so recent, he tends to become frustrated, but overall is a very optimistic guy who believes that success comes from hard work and persistence. My client’s music retail store and his wife are two important, meaningful aspects of his life, so in consideration of cultural context, he wishes to stay true to his Korean culture, he would like to get back to running his store independently, and to continue his obligations of being a good, supportive husband in hopes that his wife can stop working once they have children. 

     I was assigned a random household item, a Parmesan cheese container, to use as an intervention for my client. I was stumped at first because at this point in my client’s recovery, he can do very little, but one thing that he can do with a halo vest and without getting fatigued too quickly is stretching. Stretching can help reduce pain and the chances of spasticity and contractures. My suggestion is to roll the container back and forth to stretch my client’s wrist flexors and extensors. At the C7 level, there may be limited finger and fine motor movement, but there should be available wrist movement and elbow extension. In addition, it may be beneficial to add rubber bands or something similar to the container that he can slide his hands into, as he may have a difficult time keeping a grip on the container while rolling it. It will be important for my client to maintain ROM and strength in his upper extremities so that he can eventually get back to independently doing meaningful occupations, such as running his store effectively. In addition, Tenodesis grasp becomes available at C6, so he can also use the Parmesan cheese container to practice picking objects up and releasing them into the container. Tenodesis is when your fingers passively flex when the wrist is extended, and they extend when the wrist is flexed. This can allow even those with C6 or C7 SCI to pick up and release objects. This is significant for my client in order for him to organize, pick up, and manipulate the CD’s, tapes, and DVD’s in his store.

 

     This assignment was incredibly eye opening for me in the fact that you can use the simplest of material for an intervention. There is always some positive way to use it, and not in the way in which it was created. In addition, I learned that it is always essential to consider the client’s goals and what meaningful occupations he/ she wants to get back to. I have always thought of myself of not being creative, but this assignment forced me to use my “OT think” to create something purposeful and useful for my client. I now feel more confident in exploring out-of-the-box ideas and materials in order to best meet my client’s needs.