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Biomechanical
In this model, identify Bethany's dysfunctional aspects of her body (one arm) and then “Fixing” those aspects (increasing range of motion and strength) will allow her to regain function.
Why this Approach?
Surfing demands high levels of physical control
It emphasizes repetition and motor learning, which are key to mastering new movement patterns with one arm
The outcomes directly relate to her ability to perform meaningful occupations
Motivation: People maintain strength, ROM, and endurance to stay engaged in meaningful and motivating activities
For Bethany, she has all the desire to build back what she can to continue participation in important roles
Interventions
Stregthening
Static exercise: Planks to target core and shoulder stability ot maintain balance
Resistance exercise: Push-ups, Pull-ups, Sit-ups to increase strength in the good arm
Training aids: Using balance boards and resistance bands to practice pop-ups and balance on land before hitting the water
Endurance
Running: With and without weight to keep up the stamina when she hits the water
Paddle training: Go out in the water and keep paddling and pushing till failure, useful for prolonged surf sessions
Remediation/correction
Surfboard Progression: Starting on a long surfboard and working her way down to a small surfboard to increase the balance and control
Motor Re-education: Relearn movement sequences for paddling, popping up, and turning using visual cues and repetition (video feedback)
Goal: Bethany can return to the occupation she loves through strength training, ROM training, and endurance training
After these, Bethany...
Retrained her movement patterns and built core stability
Learned how to paddle, balance, and pop up on the surfboard effectively
Taught herself proper body mechanics and protection strategies to endure out on the water
References
References
Drette, D.P. & Gutman, S. A. (2021). Occupational therapy for physical dysfunction (8th ed.). Philadelphia, PA: Wolters Kluwer
Rybski, M.F. (2019). Kinesiology for Occupational Therapy (3rd ed.) Thorofar, NJ: Slack, Inc.
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