Occupational therapy (OT) focuses on improving the ability to carry out daily work, school, self-care and leisure activities. Occupational therapy often targets small muscles and fine motor coordination, such as movements of the arms and hands.

A registered occupational therapist (OTR) will complete an evaluation to assess the patient's strength, mobility and execution of everyday tasks. This may include identifying particular activities or behaviors to help determine the appropriate therapy plan. Determining how motivated a patient is to recover from painful injuries or conditions can help the patient and therapist set realistic short- and long-term treatment and recovery goals.

An occupational therapy evaluation will be completed to assess the patient’s strength, mobility and execution of everyday tasks. This may include identifying particular activities or behaviors to help determine the appropriate therapy plan. Determining how motivated a patient is to recover from painful injuries or conditions can help the patient and therapist set realistic short- and long-term treatment and recovery goals.

The scope of the evaluation depends in part on the setting and the patient’s goals. For example, a head injury patient hoping to be discharged home may be assessed initially for safety in showering and dressing and later in cooking and driving. The evaluation of a nursing home resident with declining upper-body mobility may focus on wheelchair positioning and arm range of motion and coordination.

In instances where occupational therapy is necessary for a work-related injury or disability, a functional capacity evaluation (FCE) may be performed by an occupational therapist, sometimes in conjunction with a physical therapist. An FCE assesses a patient’s physical and functional abilities and establishes the physical degree of work a patient is capable of doing. There are two types of FCE:

• Baseline FCE. An evaluation of a patient’s physical ability to work.
  
  
• Job-specific FCE. An assessment of a patient’s physical abilities to perform a specific job. Simulated work activities are often part of a job-specific FCE.

A FCE typically emphasizes job-related goals rather than individual aptitudes, interest and personality. It may last as long as several hours in some cases. An FCE is most often performed in a controlled environment where direct observations and measurements of specific work activities can be made (e.g., job site, hospital rehabilitation department). An FCE is often useful in determining various types of information, including:

• Flexibility, strength, balance, coordination, cardiovascular condition and body mechanics.
  
  
• Work restrictions, modifications, or accommodations necessary to prevent further pain or injury (e.g., environmental factors).
  
  
• The extent of painful impairments or disabilities.
  
  
• The patient’s ability to manage pain while working either full time or on modified duty.
  
  
• Predicting a patient’s ability to work after a rehabilitation program is completed.

After the patient is assessed, a treatment plan is tailored to the needs of the patient. Some individuals may require only advice or information to limit pain or handle their disability. Others may require specific treatment or equipment as part of occupational therapy. To reduce pain and improve daily functioning, occupational therapy may include:

• Pain-reducing activities or exercises
  
  
• Instruction in new methods to carry out tasks
  
  
• Assessments of home and job safety
  
  
• Improving posture and ergonomics
  
  
• Splints or orthotics
  
  
• Thermotherapy or cryotherapy (hot or cold packs)
  
  
• Other modalities, such as hydrotherapy, ultrasound therapy or electrical therapy (e.g., transcutaneous electrical nerve stimulation)
  
  
• Assistive devices (e.g., reachers, dressing aids, jar openers, rocker knives)
  
  
• Installation of helpful devices (e.g., bathroom grab bars)
  
  
• Adaptive equipment (e.g., commode chair, shower bench).