Introduction to Occupational Therapy

Physiology is the study of how the body parts and living organisms work and physical and chemical factor responsible for the origin, progression and development of life. Physiology is a foundation for further studies in the health science. Occupational therapy is a health profession that helps patients improve their nervous system functions including motor, social, personal, academic and vocational pursuits. Occupational therapy is professional trained in the biological, physical, and medical and behavior science. Through physiology, occupational therapists have insight into and be able to explain peripheral, the central and the autonomous nervous system’s functions and structure. From knowing the normal state of nervous system, occupational therapists can address the dysfunctions and improve their nervous system. Occupational Therapist incorporates the study of nervous system as it relates to participation in daily life. Therefore, occupational therapists are able to convert basic physiology concept to patient care. Occupational therapy used the knowledge of nervous system to treat conditions which related to nervous system such as multiple sclerosis, Parkinson’s disease, and cerebral palsy.

Multiple sclerosis is an immune-mediated process in which an abnormal response of the immune system produces inflammation in the central nervous system which is brain, spinal cord and optic nerves (National Multiple Sclerosis Society, 2014). The damaged myelin where the protective membrane of nerve fibers is multiple sclerosis in various central nervous system (Lammert & Zeeb, 2014). The T and B lymphatic cells and autoantibodies cause myelin damage, neuroinflammtion and neurodegeneration which make multiple sclerosis be a part of the group of autoimmune disease (Lammert & Zeeb, 2014). The damaged myelin forms scar tissue (National Multiple Sclerosis Society, 2014). Since the myelin is damaged, the nerve impulses travelling to and from the brain and spinal cord are distorted and producing many of symptoms (National Multiple Sclerosis Society, 2014).

Occupational therapist will offer strengthening and stretching exercise for the upper body to improve coordination (Wilson,n.d.). Normally, people who have multiple sclerosis have spasticity, especially lower body parts because the nerve impulse become smaller as going through the nerve (Wilson,n.d.). If they do not do stretching exercises regularly, their legs can be stiffen (Wilson,n.d.). Strengthening exercises are improve weakened muscle in moving and walking (Wilson,n.d.).

Parkinson’s is a lacking of dopamine because some nerve cells in brain have died (Parkinson’s UK, n.d.). Parkinson’s is a progressive deteriorate in nervous system and their movement become slower (Parkinson’s UK, n.d.). The main symptoms of Parkinson’s are tremor, slowness of movement and rigidity which cause them involuntary shaking in their part of body, walk slowly, take longer to do their activities of daily life, stiff muscles, pain and muscle cramps (Parkinson’s UK, n.d.). Due to the message from brain to every part of body may not go through properly, it interrupts their activity of daily life such as bladder and bowel problems, eye problems, falls and dizziness, fatigue, freezing, pain, restless legs syndrome, skin and sweating problem, sleep problems, speech and communication problems and swallowing problem (Parkinson’s UK, n.d.). People with Parkinson’s can experience mental health such as anxiety, dementia, depression, hallucination and delusion and memory problems because they worry about living with the condition or because of possible changes in brain (Parkinson’s UK, n.d.).

There is no way to improve the brain condition, so occupational therapists will help in finding easier ways to do their activity of daily life by recommending some equipment and changes their home safer (Parkinson’s UK, n.d.). The development of glial scar after central nervous system injuries is prohibit axon regeneration (University of Cambride, n.d.). The major molecules in glial scar are chondroitin sulpahate proteoglycans, semaphorins, ephrins and sulfated glycosaminoglycan (University of Cambride, n.d.). If the sulfated glycosaminoglycan, chondroitinase and proteoglycans are lost, this can promote axon regeneration in central nervous system (University of Cambride, n.d.). Axons that have high regenerative potential have large amount of ribosomes and other protein synthesis machinery in axon (University of Cambride, n.d.). However, central nervous system do not transport ribosomes which decrease the capability of nerve cells to regenerate (University of Cambride, n.d.). Besides that, axons in central nervous system need to have right integrin and surface integrin to interact with matrix glycoprotein in order to perform regeneration (University of Cambride, n.d.). However, various inhibitory molecules inactivate the Alpha9 intergrin and tenascin which allow them to regenerate (University of Cambride, n.d.).

Cerebral palsy is a disorder that which caused by brain damage (Bachrach, 2012). This disorder can be occurred before or during a child’ birth or during the first 3 to 5 years child (Bachrach, 2012). There is no cure for this disease, but treatments include physical and occupational therapy, speech therapy, drugs to control seizures, relax muscle spasms and alleviate pain to overcome developmental disabilities and learn new ways to adopt this disabilities (National Institute of Neurological Disorder and Stroke, 2014). Their condition can be improved by doing surgery to correct anatomical abnormalities (National Institute of Neurological Disorder and Stroke, 2014). To smoother their activity of daily life, equipment like wheelchairs, walker and communication aids also help to improve their lives (National Institute of Neurological Disorder and Stroke, 2014). There are three types of cerebral palsy which are spastic cerebral palsy, athetoid cerebral palsy and ataxic cerebral palsy (Bachrach, 2012). Spastic cerebral palsy can cause stiffness in muscle which cause them have walking difficulties (Bachrach, 2012). Athetoid cerebral palsy can lead to involuntary and uncontrolled movement. Ataxic cerebral palsy can cause them imbalance and depth perception (Bachrach, 2012). For them, they have difficult in doing activities of daily life such as bathing, dressing, feeding, mobility, grooming and bowel (Bachrach, 2012).

For children, occupational therapists normally will focus on playing and learning to achieve the goals that settled by multiple disciplinary team. Occupational therapy can address social, psychological and environmental factors involved with the children. Occupational therapist address working on fine motor by grasping and releasing toys, playing puzzle, sorting out the shape and number and others in order to exercise their hand’s muscle for developing handwriting skills. Occupational therapy for cerebral palsy can meet their needs by addressing hand-eye coordination to improve play skills such as hitting a target, batting a ball, bowling, coping from whiteboard and others. Occupational therapist helps children with developmental learning delay in activity of daily life such as bathing, dressing, grooming, feeding and movement. Normally, these children are more impulsive, aggressive, behavior disorder and low confidence due to their disorder. Occupational therapists also have to teach them how to vent out their stress and manage their anger. Occupational therapists will recommend them to write down their feeling in dairy or participating in physical activity likes sport. Due to their weak muscle tone, muscle and motor skills, occupational therapists have to teach them to use specialized equipment such as wheelchair, splint and dressing devices. Normally, their eating utensils are modified to bigger and heavier handles than normal one in order they can feed themselves. Their cups with special handles and plates with higher lips to keep and drink from slipping off. The clients with physical limitation can operate computer with touch screen and voice recognition to make their works easier. Special computers have the capability to help them perform taks that would normally be impossible for them.

As nerve cells do not have centrioles to perform cell division, once the nerve cells are damaged, it is hard to recover. Dealing with disease or disorder associated with nervous system, there is no cure or hundred percent to recover back to normal life. However, as a occupational therapist, they will try their best in finding easier way to perform their activity of daily life. Not only occupational therapists ask them to do some exercises or play, but occupational therapists also have to go their home to have an assessment to modify their home to make their life easier. Normally, for those who have disorder or disease, their parents or caregivers may experience some mental health, so the occupational therapists have to improve their family members to decrease assistances on other for help with self-care, increase physical mobility and give consultation to the family member. From the knowledge of nervous system, occupational therapists know how to treat them to improve their lives and prevent any accident which can make it worse.

References

Bachrach, S. J. (2012). Cerebral Palsy. Retrieved from http://kidshealth.org/parent/medical/brain/cerebral_palsy.html#

Lammert, E., & Zeeb, M. (2014). Metabolism of Human Disease. Retrieved from http://books.google.com.my/books?hl=en&lr=&id=75_IAwAAQBAJ&oi=fnd&pg=PA47&dq=introduction+of+multiple+sclerosis+&ots=x4gUh7V244&sig=DvW5sK0mKakeMR9sRSgPslIdRwU#v=onepage&q=introduction of multiple sclerosis&f=false

National Institute of Neurological Disorder and Stroke (2014).NINDS Cerebral Palsy Information Page. Retrieved from http://www.ninds.nih.gov/disorders/cerebral_palsy/cerebral_palsy.htm

University of Cambridge. (n.d.). John van Geest Centre for Brain Repair. Retrieved from http://www.brc.cam.ac.uk/principal-investigators/james-fawcett/axon-regeneration-in-the-central-nervous-system/

National Multiple Sclerosis Society (2014). Definition of Multiple Sclerosis. Retrieved from http://www.nationalmssociety.org/What-is-MS/Definition-of-MS

Parkinson’s UK (n.d.). Occupational Therapy and Parkinson’s. Retrieved from http://www.parkinsons.org.uk/content/occupational-therapy-and-parkinsons

Wilson,M. A. (n.d.). Multiple Sclerosis and Exercise. Retrieved from http://www.sitandbefit.org/multiple_sclerosis