Occupational therapy for patients with chronic diseases: CVA, rheumatoid arthritis and progressive diseases of the central nervous system.

A substantial proportion of the patients treated by occupational therapists have a chronic disease. The aim of this study was to describe the outlines of occupational therapy treatment for three specific groups of chronic diseases: progressive neurological diseases, cerebrovascular accident and rheumatoid arthritis. A total of 143 therapists, working in 49 occupational therapy departments in The Netherlands, were asked to complete a standard registration from based on the ICIDH. This form consisted of three sections: (a) patient characteristics, (b) occupational therapy diagnosis and treatment goals in terms of ICIDH and (c) treatment characteristics. The present study concerns 507 patients: 102 had progressive neurological diseases (PND), 338 had a CVA and 67 had rheumatoid arthritis (RA). Our results showed that each patient group was characterized by a specific treatment approach. Especially at the level of treatment programmes substantial differences between groups were observed. Besides the clear differences, similarities in approaches were found between the PND and RA group, e.g. total time spent on therapy differed largely between the PND and RA patients (both averages 6 h) and the CVA patients (average 14 h).

Factors Affecting the Choice of Treatment in Occupational Therapy Practice in Hospital-based Care.

The aim of this article was twofold: to describe the occurrence of treatment goals, health-care programmes and type of interventions chosen by occupational therapists; and to investigate relationships between treatment goals, health-care programmes and interventions. A survey on occupational therapy practice was carried out in The Netherlands. A registration form based on the International Classification of Impairments, Disabilities and Handicapts (ICIDH) was filled out for 944 patients. This registration form consisted of three sections: (i) patient characteristics, (ii) occupational therapy diagnosis and treatment goals in terms of ICIDH, and (iii) treatment characteristics. The patients were treated by occupational therapists working in nursing homes, rehabilitation centres or general hospitals. A total of 143 therapists, working in 49 departments of occupational therapy, participated in this study. Relationships existed between treatment goals and health-care programmes on the one hand and interventions on the other. Treatment goals and health-care programmes independently determined the choice of interventions in occupational therapy practice; the choice of interventions was not dependent on specific combinations of goals and programmes. Bases on these results, several profiles of occupational therapy treatment were identified.

Fractures of the intercondylar eminence of the tibia in childhood.

Fracture of the intercondylar eminence of the tibia occurs more frequently in children than in adults. This fracture may occur as an isolated injury without damage to the other structures of the knee joint. X-ray examination of the painful swollen knee of the child is necessary to determine the exact diagnosis. Type I and type II fractures of the intercondylar eminence of the tibia require only immobilisation in a plaster cast after anatomical reposition. Open reduction is often necessary following type III fractures and almost invariably following type IV fractures. Following anatomical reposition of the avulsed fragment the prognosis for complete recovery is excellent.