Neurological disorder

The theoretical base of biomechanical frame of reference (FOR) is considered as a remedial approach focusing on impairments that limit occupational performance. This FOR assumes clients are able to acquire the voluntary motor skills necessary to perform the desired human occupation, meaning that the underlying impairment is amenable to remediation. It also assumes that engaging in occupation and therapeutic activities has the potential to remediate the underlying impairment, and results in improvement in occupational performance.

The Neuro-Developmental Treatment (NDT) frame of reference is used to analyze and treat posture and movement impairments based on kinesiology and biomechanics. To identify difficulties and plan for intervention, the following concepts are to be considered in NDT, including planes of movement, alignment, range of motion, base of support, muscle strength, postural control, weight shifts, and mobility. NDT assumes that posture and movement impairments are changeable. Thus, it utilizes movement analysis to identify missing or atypical elements.

The Model of Occupational Self Efficacy describes a process in accepting the consequences and occupational limitations for the individuals that suffer from traumatic brain injury. It consists of four stages. At stage 1 (a strong personal belief in functional abilities), clients usually develop feelings of frustration, demotivation, and anger due to the loss of daily life function after brain injury. Therapists will provide encouragement for the clients by creating a specific environment that can improve and develop the feeling of acceptance.

The three-phase framework helps to view the life resuming process of people who suffer from long-term disabilities such as stroke, traumatic brain injury, and whiplash, and to provide the right intervention at the right time. In this framework, the reestablishment of previous role(s) of the clients and/or the development of a new role are the most important. The role achievement is believed to be the primary goal of therapy intervention for people with long-term disabilities. The three phases are included as named for this framework.

The Hand Function Evaluation Model (HFEM) aims to guide assessment of the impairment and disabilities for preschool-age children presenting hand dysfunction. In the HFEM, hand function is evaluated at three levels: 1) sensorimotor performance, 2) developmental progress, and 3) hand function performance. At the first level, assessment of sensorimotor performance includes grip strength, dexterity, and stereognosis of the child. In particular, the evaluation of the grip strength includes four subtypes: power, tip pinch, three point chuck, and lateral pinch grip.

The Framework of Occupational Gradation (FOG) focuses on one’s active movements with the more involved upper extremity. There are two versions of FOG, one for young children (C-FOG) and one for older children and adults (A-FOG). Both aim to provide occupational ideas in preventing learned non-use of the more involved upper extremity for clients with neurological impairment. These ideas can be incorporated into daily lives to increase use of the extremity. Appropriateness of task for each client is determined by hand dominance and perceived meaningfulness.