Occupational Therapy Intervention for Thumb CMC OA: A Case Report

This report details an occupational therapy intervention for a 78-year-old retired art teacher, Martha Washington, diagnosed with CMC osteoarthritis in her thumbs. The assignment focuses on addressing Martha's limitations in performing activities of daily living, such as playing with her dog, due to pain and stiffness. The intervention involves applied technology, specifically finger spread and object pickups, to improve thumb range of motion and reduce stiffness. The report explains the implementation of these activities, their benefits, and how they can help Martha adapt to her limitations and continue participating in her occupations. The report also references the Occupational Therapy Practice Framework and discusses grading the activities for progression. The goal is to improve Martha's ability to perform functional tasks and enhance her quality of life.

Running head: OCCUPATIONAL THERAPY 1
Occupational Therapy
Name
Institution

OCCUPATIONAL THERAPY 2
Assignment 2
Identification
The interventions were successfully implemented but the patient still had some notable
difficulties and limitations. Some of this include difficulty holding items using her thumb,
difficulty in playing with her dog, difficulty massaging and washing her dog, and potential risk
of complications because the healing process is slow. It is, therefore, important to create an
environment that allows Martha to continue with her activities of daily living and occupation.
Applied Technology
Several ways can help in ensuring that Martha can continue participating in activities even with
her present limitations without the risk of aggravating her thumb. One of these ways is by
practicing finger spread. This activity helps in improving the range of motion of the thumb and
other fingers. It is a way of creating an environment that can allow Martha to adapt to her daily
progress while also letting her participate in activities of daily living. Finger press begins with
pinching the tips of the thumb and the fingers. It had been stated that Martha feels pain when she
attempts to pinch anything. Therefore, this activity is important in ensuring the problem does not
reoccur. An elastic band is then placed around the fingers and the fingers moved away from the
thumb until the band is very tight. The thumb and the fingers are moved away and close to each
other for at least 10 times (Hoggan et al., 2013). This activity helps in strengthening the thumb
joint and increasing the range of motion. The thumb and the fingers are then moved towards the
palm and the band placed in the middle. The fingers are then straightened and bent in succession
around 10 times. For best results, this activity is repeated at least 3 times every day.

OCCUPATIONAL THERAPY 3
Another activity that can be used to modify Martha’s environment and allow her to continue with
occupations is objects pickups. This activity also helps in improving the range of motion of the
thumb while at the same time training the thumb to move freely without any limitations. Object
pickups reduce the stiffness of the thumb joint thus reducing pain when one attempts to move
their thumb (Healthline, 2020). This activity is done by placing several coins or buttons on a
table and picking one object at a time and place it on a nearby table or at the far end of the same
table. The patient must use the affected thumb while picking the object. The patient must
additionally repeat this process for all the objects on the table for around 5 minutes. For the best
results, this activity should be done twice a day.
Summary
The applied technology will benefit Martha in several ways because it will allow her to keep
engaging in her activities despite her limitations without the risk of the problems reoccurring.
The range of motion of her thumb will be improved with these two activities of applied
technology thus allowing her to perform all the functions that may require thumb movement. It is
important to note that these activities help in reducing the stiffness of the thumb joint thus
elimination the pain experienced when pinching or gripping something. As a result, the
performance of her occupation like playing with her dog is improved because limitations are
eliminated. She can, therefore, be able to hold the chain appropriately while walking her dog thus
improving the quality of time she spends with the dog.

OCCUPATIONAL THERAPY 4
References
11 Trigger Finger Exercises for Pain, Stiffness, and More. (2020). Retrieved 27 March 2020,
from https://www.healthline.com/health/fitness-exercise/trigger-finger-exercises#object-
pickups
Hoggan, E., Nacenta, M., Kristensson, P. O., Williamson, J., Oulasvirta, A., & Lehtiö, A. (2013,
October). Multi-touch pinch gestures: Performance and ergonomics. In Proceedings of
the 2013 ACM international conference on Interactive tabletops and surfaces (pp. 219-
222).