Rheumatoid Arthritis: Occupational Therapy Implication For Promotion Of Mobility 1

As an occupational therapist, whatever I do, I supplement and complement whatever the physiotherapist/physical therapist does, that there be no repetition of clinical care, or clash in ideas in treatment. This is done for all aspects of rehabilitation, but here we will discuss first in the area of mobility. The prescription of a walking aid, be it a walking stick, quadstick or walking frame may be given to a patient for reasons of safety and function.

All therapists must take note that the correct height is of upmost importance - too high or too low and it will create an imbalance of the muscles and joint structures involved, causing unnecessary compensatory movements that will tax the involved muscles and tissues. To get the correct length or height, we need to get the patient to be wearing their normal attire and shoes, stand straight as how they would normally stand, and then measure the length from the ground to the patient's greater trochanter. This would be the most accurate data.

An alternative to the measurement, the walking stick can be placed on the ground and the its height should be at the wrist crease for the length to be of an appropriate length. Any additional length should be collapsed upon (they are collapsible now, but they used to saw the additional lengths off). The rubber at the bottom should be changed regularly, as they can wear out relatively fast. The walking stick is used at the opposite hand of the affected leg, so as to transfer the weight of the body through the arm and stick. We do not encourage the use of double sided walking stick, as they are more unstable that way. If necessary, we can encourage the use of walking frames or crutches.

If crutches are deemed necessary, the physiotherapist will assess the patients for the use of the crutches and teach them how to use it, but the occupational therapist's role would then to monitor their correct and adequate use of the walking aid when carrying out their roles in the rehabilitation program. Axillary crutches (the kind that rests under the arm pits) are not often recommended, as they have a risk or a contra indication of use - the tisk is the danger of damage to the gleno humeral joint and axillary region in the case of a fall or a near fall that can dislocate the joint.