Students continue the study of additional adult disabilities to learn how effects of dysfunction on occupational habits and occupational roles, apply the Occupational Therapy (OT) process, problem-solve ideas, become introduced to rehabilitation assessment, treatment techniques, and community resources.
Prereq: Complete all first-semester courses
Coreq: OTA 1250
Semester: Spring
Identify the etiology, prevalence, process, and OT areas of evaluation and treatment regarding various physically disabling conditions experienced by adults.
Implement intervention strategies to remediate and/or compensate for cognitive deficits that affect occupational performance.
Articulate training methods and resources for patients and caregivers in techniques to enhance community mobility, including public transportation, community access, and issues related to driver rehabilitation.
Demonstrate the use of superficial thermal and mechanical modalities as a preparatory measure to improve occupational performance.
Research and present an innovative treatment technique pertaining to a physical disability to peers.
Use measures and quantitative standards such as number of repetitions, variation of size, time measurements, etc, with all documentation.
Accurately calculate the resting HR (heart rate) and target HR of a sample patient.
Demonstrate proficiency in utilizing presented information to clinically reason and implement treatment.
Explain how lifelong learning is crucial to maintaining competence in health professions.
Students will demonstrate therapeutic use of self and knowledge of teaching-learning methodology to effectively complete projects.
Students will effectively use appropriate and evidence-based information technology to complete written and oral communication.
EBP Paper
EBP Summary
Students will choose one topic or diagnosis from the Physical Dysfunction course sequence (1140, 1150, 1240, and 1250). Each student will develop a clinical question regarding occupational therapy assessment or diagnosis and then apply the evidence-based practice process to develop an answer. Students are expected to find and use at least 5 primary references. Students can re-use one article from this project for their Fieldwork Evidence-Based Practice Project (OTA 1270). Students will be asked to submit 1 paragraph reviews of articles throughout the semester, building towards their EBP project. Students will submit a written summary (5-6 pages) of their findings with clinical recommendations and references. Students are expected to incorporate feedback on their summaries from the writing center prior to submitting them for grading. Students will be expected to submit evidence of working with the writing center. Students will then present a summary of their findings and clinical recommendations.
Occupational Therapy’s Role and Effective Interventions in Muscular Dystrophy
Occupational Therapy Assistant Program, Salt Lake Community College
OTA 1240: Physical Dysfunction
Professor Gabe Byars
April 27th, 2025
Muscular dystrophy (MD) encompasses a group of genetic disorders characterized by progressive muscle weakness and degeneration, affecting approximately 1in 5,000 individuals worldwide. Among its various forms, Duchenne muscular dystrophy (DMD) is notably severe, often leading to loss of mobility, diminished upper body function, pain, fatigue, and compromised cardiac and respiratory health, which can impede daily activities and reduce independence. Individuals with MD frequently experience emotional challenges, including depression, anxiety, and social withdrawal, which can adversely affect cognitive functions. Behavioral and emotional difficulties are also prevalent, and these challenges extend to social participation; children with MD often engage less in physical and social activities compared to their peers, leading to a diminished quality of life (Bendixen et al., 2012). My question is what is occupational therapy’s (OT’s) role in MD, and what is the most effective intervention for this disease?
Given the wide-ranging physical, emotional, and social challenges associated with muscular dystrophy (MD), understanding the role of occupational therapy (OT) in supporting these individuals is crucial. A recent study by Graf et al. (2020) explored the perspectives of rehabilitation professionals on current practices for MD and revealed a lack of consensus regarding the use of exercise, with some clinicians advocating for strengthening and cardiovascular activities while others feared these could worsen muscle deterioration. This uncertainty highlights the broader issue of limited rehabilitation guidelines and inconsistent referral pathways, contributing to variable care outcomes. The study emphasizes that OTs, though frequently underutilized, play a vital role in preserving muscle function, promoting independence, and improving quality of life through client-centered interventions tailored to individual needs. Effective strategies include energy conservation techniques, adaptive equipment training, environmental modifications, and psychosocial support. A central theme is the importance of "muscle protection" strategies to help maintain muscle mass, which is critical for maximizing the benefits of emerging gene therapies. The authors call for standardized rehabilitation protocols and further research to establish evidence-based occupational therapy interventions for this population (Graf et al, 2020).
Management is key in slowing progression and maintaining function for individuals with neuromuscular diseases. Although medications can aid in the management process, a study by Öksüz et al. (2011) underscores the pivotal role of OT in managing neuromuscular diseases, including MD. In this randomized controlled trial involving 60 adult patients, the intervention group received client-centered activity adaptation education, while the control group was provided only with a physiotherapy home exercise program. The findings revealed that the intervention group exhibited statistically significant improvements in fatigue levels, functional independence (particularly in self-care and locomotion), upper limb function, and overall occupational performance and satisfaction. These results highlight the effectiveness of OT interventions in enhancing activity levels and occupational performance among patients with neuromuscular diseases. Consequently, the study advocates for the integration of comprehensive rehabilitation programs that include occupational therapy to address the multifaceted challenges faced by individuals with MD (Öksüz et al., 2011).
Further compounding the issue is the lack of standardized protocols. One article emphasized how the absence of rehabilitation guidelines and the underuse of OTs in care plans lead to variable and often inadequate treatment outcomes for those with adult-onset MDs. It also reinforced the necessity for muscle preservation strategies, especially in light of the potential of gene therapies. Protective strategies that preserve muscle integrity can help maintain function and prepare patients for more advanced treatments, placing OTs in a unique position to contribute meaningfully to long-term care plans (Lombardo, 2021).
Adding to these concerns is the broader issue of limited, research-backed occupational therapy interventions for adults with neuromuscular diseases, which leaves clinicians with little guidance on effective practices. A systematic review by Cup et al. (2008) assessed the efficacy of occupational therapy interventions for this population and identified a significant lack of high-quality evidence. Out of more than 3,500 studies reviewed, only two met rigorous methodological standards. Both focused specifically on hand training programs for individuals with myotonic dystrophy and Welander distal myopathy, reporting modest improvements in fine motor coordination and occupational performance as measured by the Canadian Occupational Performance Measure (COPM). However, neither study showed significant changes in grip force or pinch strength.
Expanding on the implications of these findings, Cup et al. (2008) also examined how tailored occupational therapy interventions might directly impact activities of daily living (ADLs) for patients with neuromuscular conditions. In one study included in the review, an intervention group receiving client-centered activity adaptation education demonstrated greater improvements in ADLs compared to a control group receiving only physiotherapy. Key challenges for participants included tasks such as climbing stairs and gardening—activities requiring strength, coordination, and endurance. Standardized instruments like the Functional Independence Measure (FIM), Disabilities of the Arm, Shoulder and Hand (DASH), and COPM were used to measure outcomes. These results highlight the importance of including occupational therapy in comprehensive rehabilitation programs for adults with neuromuscular diseases, while also emphasizing the ongoing need for well-designed, evidence-based research to identify the most effective interventions.
Similarly, a qualitative study by Lindsay et al. (2019) emphasizes that OTs play a crucial role in identifying what young adults with muscular dystrophy find meaningful and helping them engage in those occupations. OTs work to uncover each individual's values and priorities, then connect them with supports, accommodations, adaptive strategies, and resources needed to participate in daily life activities. This highlights OT’s client-centered approach — promoting independence, mental well-being, and social participation while navigating the physical, emotional, and environmental challenges of MD. While the study doesn’t pinpoint one singular “most effective” intervention (as MD presents with varying symptoms and progresses differently among individuals), it identifies key enablers that function as effective OT strategies: external supports and accommodations (like assistive technology and environmental modifications), self-care skills training, coping strategies for fatigue and mental health, and fostering opportunities for meaningful social and recreational engagement. These personalized, client-centered interventions, rather than a one-size-fits-all method, are shown to improve quality of life and occupational participation in individuals with MD.
Expanding on the need to clarify occupational therapy’s role and identify effective interventions for muscular dystrophy, a study by de Valle et al. (2017) sheds light on current care practices and highlights critical service gaps. In their article “Physical activity and the use of standard and complementary therapies in Duchenne and Becker muscular dystrophies,” the authors investigated the use and perceived benefits of allied health services, complementary therapies, nutritional supplements, and structured physical activity among boys with dystrophinopathies. Through a survey of 125 families within a neuromuscular clinic in Melbourne, Australia, with a 41% response rate, the study revealed that while 47% of families utilized occupational therapy services, access remained inconsistent and did not align with published international care guidelines.
This inconsistency emphasizes the underutilized yet essential role of occupational therapists in managing muscular dystrophy. OTs have a unique opportunity to support individuals with MD by promoting participation in meaningful daily occupations, preserving functional abilities through adaptive strategies, and addressing psychosocial challenges related to disease progression. The study highlighted that families frequently turned to physical activities like swimming and organized sports, which were valued for their physical and emotional benefits — areas where OTs could play a pivotal role in adapting and maintaining engagement as mobility declines (Valle et al., 2016).
Importantly, while families often sought complementary therapies like massage and nutritional supplements despite a lack of proven efficacy, this underscores a broader issue: the absence of clearly identified, evidence-based interventions for MD. The study calls for further research into the effectiveness of these approaches and suggests that clinicians, including OTs, should actively guide families toward safe, supportive, and meaningful activities tailored to individual needs. In summary, this article reinforces that occupational therapy should be a core component of multidisciplinary care for MD, advocating for client-centered, adaptive interventions that promote long-term quality of life, even as definitive, “most effective” interventions remain to be firmly established (Valle et al., 2016).
In summary, occupational therapists have the potential to play a pivotal role in the management of MD by helping individuals maintain function, adapt to limitations, and prepare for advanced medical treatments. Client-centered interventions, muscle preservation strategies, and ADL-focused therapy can improve quality of life and occupational performance. However, significant gaps in research and standardized care protocols hinder the consistent application of effective interventions. Expanding the evidence base and integrating OTs more fully into multidisciplinary care teams will be essential in improving outcomes for individuals with MD.
References
Bendixen, R. M., Senesac, C., Lott, D. J., & Vandenborne, K. (2012). Participation and quality of life in children with Duchenne muscular dystrophy using the International Classification of Functioning, Disability, and Health. Health and Quality of Life Outcomes, 10(1), 43. https://doi.org/10.1186/1477-7525-10-43
Cup, E. H. C., Sturkenboom, I. H. W. M., Pieterse, A. J., Hendricks, H. T., van Engelen, B. G. M., Oostendorp, R. A. B., & van der Wilt, G. J. (2008). The Evidence for Occupational Therapy for Adults with Neuromuscular Diseases: A Systematic Review. OTJR: Occupation, Participation and Health, 28(1), 12–18. https://doi.org/10.3928/15394492-20080101-02
Graf, K., Roche, J., & Roche, R. (2020). A Qualitative Study of Current Rehab Practices for Muscular Dystrophies: Views & Experiences of Rehab Professionals. American Journal of Occupational Therapy, 74(4_Supplement_1), 7411510306p1. https://doi.org/10.5014/ajot.2020.74s1-po8732
Lindsay, S., Cagliostro, E., & McAdam, L. (2019). Meaningful occupations of young adults with muscular dystrophy and other neuromuscular disorders. Canadian Journal of Occupational Therapy, 86(4), 277–288. https://doi.org/10.1177/0008417419832466
Lombardo M.E. (2021). Management of motor rehabilitation in individuals with muscular dystrophies. 1st Consensus Conference report from UILDM – Italian Muscular Dystrophy Association (Rome, January 25-26, 2019). Testata Della Rivista, 40, 72–87. https://old.actamyologica.it/article/management-of-motor-rehabilitation-in-individuals-with-muscular-dystrophies-1st-consensus-conference-report-from-uildm-italian-muscular-dystrophy-association-rome-january-25-26-2019/
Öksüz, Ç., Akel, B. S., & Bumin, G. (2011). Effect of occupational therapy on activity level and occupational performance in patients with neuromuscular disease. Fizyoterapi Rehabilitasyon, 22(03), 231-239.
Valle, K. L. de, Davidson, Z. E., Kennedy, R. A., Ryan, M. M., & Carroll, K. M. (2016). Physical activity and the use of standard and complementary therapies in Duchenne and Becker muscular dystrophies. Journal of Pediatric Rehabilitation Medicine, 9(1), 55–63. https://doi.org/10.3233/PRM-160364