Running head: OCCUPATIONAL ANALYSIS & INTERVENTION PLAN

Occupational Analysis & Intervention Plan

Touro University
Kristen Kincaid

OCCUPATIONAL ANALYSIS & INTERVENTION PLAN

Occupational Profile
1.

Client name: Kristen Kincaid

2. Age: 30
3. Sex:F
Briefly discuss each of the following:
4. Who is the client?
Kristen is a graduate student studying occupational therapy at Touro University. She is has been
obese for the past 5 years, and the weight is beginning to cause her bodily discomfort. She reports that
she frequently feels tired and out of shape. She days mainly consist of going to school and doing
homework. She is sedentary most of the time, but wishes to be more active. The client sees herself as
above average intelligence and as a leader. In the past, she has led several teams and operated a
personal business. The client states that she feels most comfortable when she is either leading a team or
working independently. The client reports that she feels overwhelmed by too much structure but does
need deadlines in order to work efficiently.
5. Why is the client seeking services and/or what are the clients concerns relative to engaging in
occupations and in daily life activities?
The client is concerned that her inability to rise from a seated or lying position and walk without
pain is affecting her overall physical activity level and her general outlook on life. The pain in her left
foot upon rising is impacting her ability to perform certain IALS such as home establishment and
management, health management and maintenance, and meal preparation and cleanup. She reports

OCCUPATIONAL ANALYSIS & INTERVENTION PLAN

that the pain she feels upon standing and walking discourages her from engaging in many activates. She
reports that while at home she mostly sits to avoid the pain in her foot. In addition, she avoids simple,
quick tasks, like grabbing a tissue, and instead asks someone to do it for her. She does this to avoid the
pain in her left foot. She wants to be able to perform these tasks for herself so she is not a burden to her
friends or roommates. In addition, the pain she feels upon standing is affecting her self-identity as an
independent, healthy adult. She is seeking services to find out if there is a way to limit or remove the
pain she feels upon standing so that she can engage in more activities than currently involved in.
6. What areas of occupation are successful and what areas are causing problems or risks?
Despite successful engagement in most areas of occupation, the client believes that she is spending
a disproportionate amount of time focused on education and not enough time engaging in occupations
of leisure, play and rest. The client has difficulty with her functional mobility after prolonged periods of
sitting and sleep.
This difficulty with functional mobility is impacting her ability to perform certain IADLS like home
establishment and management, health management and maintenance, and meal preparation and
cleanup. The client has plantar fasciitis in her left foot that causes intense pain in the sole of her foot
upon taking the first few steps after sitting or lying down for more than ten minutes. In addition, after
the sharp pain recedes, a dull pain takes place in her left foot that makes walking or standing
uncomfortable. The discomfort the client feels limits her engagement in typical exercise and does not
support an active lifestyle. Furthermore, the client believes that the chronic pain affects her mood. She
attributes her increased irritability to the chronic pain.
The client has a history of difficulty engaging in the occupation of sleep. Sometimes she is unable to
quite her mind enough to fall asleep and other time repeatedly wakes up during the night. Often she is
unable to secure the 8 hours or more of sleep she says she needs to perform at optimal level. The client

OCCUPATIONAL ANALYSIS & INTERVENTION PLAN

sites her sensitivity to sounds as a contributing factor to her inability to remain asleep. She has
implemented wearing earplugs nightly and says they help reduce the effect of noises, like the air
conditioner and bathroom fan that periodically come on during the night, on her ability to remain
asleep. In addition, the client has nerve issues in her neck and shoulder than cause pain when she sits
for too long or engages in repetitive upper body movements. She can handle the pain adequately during
wakeful hours, but the pain often interferes with her ability to fall and remain asleep. The client notes
that sometimes the pain is so intense that despite taking over the counter inflammation reducing
medication, she is unable to secure more than one to two hours a night. She maintains that nights like
this are not the norm, but come about after engaging in fine motor repetitive motions with her hands or
sitting for extended periods of time. Finally, the client says that sometimes she gets fixated on an idea
or an event and cannot fall asleep. She reports trying to relax or think of something else, but inevitably
the thought comes back to her and prevents her mind from relaxing enough to fall asleep.
7. What contexts and environments support or inhibit participation and engagement in desired
occupations?
The clients current geographical environment does not support her desire to spend time outdoors.
Many of the days in Las Vegas are sunny and warm, whereas the client prefers overcast and cool
weather. Since moving to this new environment almost 4 years ago, the client reports that she does not
engage in many activities outside. In addition, for the 3-4 months of summer, the client says that she
does not go out of the house unless necessary. The client thinks the new environment does not support
her overall goal to lead an active lifestyle.
The client reports that her currently living situation does not support her role as a single woman and
student. She lives in a 3 bedroom 2 bath house that she feels responsible for. She is the person primarily
responsible for the house maintenance, yard maintenance, and cleaning of the house. Often, the time

OCCUPATIONAL ANALYSIS & INTERVENTION PLAN

these responsibilities take limits the time she can spend on work or education. In addition, she currently
lives with her ex-boyfriend. The relationship ended 3 years ago; however he still lives in on the property.
The client reports that his constant presence limits her desire to go out and meet new people or spend
time at the gym. The client says these are occupations she usually feels compelled to do when she is
single, but that she does not do currently because her ex-boyfriend resides in the same home.
8. What is the clients occupational history?
The client is currently a student and part-time worker at Touro University. The client owes and
maintains a home in Las Vegas, Nevada. The client has worked since the age of 12 in numerous
positions. Some of the more jobs she has had are as an animal husbandry technician, substitute teacher,
bank teller, small business owner and an adult education instructor. The client has been a student for
the majority of her life. The client used to engage in outdoor activities like hiking on a regular basis. The
clients current and past roles are that of a daughter, friend, girl-friend, student, home owner, pet
owner, physically fit individual and traveler. The client uses technology daily in the form of a smart
phone or laptop connected to the internet.
9. What are the clients priorities and desired outcomes?
The clients highest priority is minimizing the amount of pain experienced daily in order to help
facilitate engagement in daily occupations. The client would like to know what procedures she can
implement that will reduce the pain upon standing, thereby increasing her activity level and decreasing
her chronic pain.

OCCUPATIONAL ANALYSIS & INTERVENTION PLAN

Occupational Analysis

1. Occupation: Rising from a bed in morning and walking to the bathroom.

2. Area(s) of occupation for the client:
Subcategory:
1. Activities of daily living
Functional Mobility
2. Instrumental activities of daily living
3. Education
4. Work
5. Play
6. Leisure
7. Social participation
3. Values, beliefs, spirituality associated with participation:
Client values independence, an active lifestyle and living pain-free.
Client believes that being an independent adult includes the ability to move around ones house,
school and community without assistance.
Client believes that walking about her house and yard are necessary to completing many
occupations of daily living.
Client believes that she is too young to have the amount of daily chronic pain that currently exists in
her life.
Client believes that her pain in her left foot affects her mood and overall sense of well-being.
Client believes her weight increases the amount of pain she feels in her left foot, but that the pain
limits her ability to move her body more often.
Client believes that if she were pain free she would be better equipped to handle daily stress.
Client believes that if she can find the best intervention, her pain level will decrease in her left foot.
Client does not think that spirituality is associated with this particular occupation.

OCCUPATIONAL ANALYSIS & INTERVENTION PLAN

4. Contexts:
Context
Physical/space demands

Social
Cultural

Personal

Supports
The distance between the bed
and the bathroom is less than 15
feet which makes the transfer
easier.
n/a
North American and western
culture emphasizes
independence.
The client is a young adult
should have few problems
completing the transfer.

Temporal

Virtual

Inhibits
The hardwood floor in the clients
bedroom does not provide
cushioning for the sole of the
foot.
n/a

The transfer takes place in the

morning after the client has been
in bed for 7 -8 hours. Weight
bearing on the left foot after that
amount of time is painful. The
pain makes the transfer difficult.
n/a

5. Objects and their properties used:

No tools or materials are needed for this activity. The only equipment needed is bed which is used to
move from a seated to standing position.

6. Social demands:
Society commonly believes that a young adult should be able to rise from a seated position and
walk without pain. Therefore, it is expected they will be able to complete this movement
quickly.
7. Sequence and timing:
1. Move pelvis into anterior pelvic tilt
2. Position feet flat on floor slightly behind knees
3. Place hands on lap
4. Use legs to push off from bed into standing position
5. Stand with weight primarily supported by right leg and foot
6. Limp to bathroom using upper limbs for balance
8. Body functions required:
Function

How It Is Used

None

Minimally

Greatly

OCCUPATIONAL ANALYSIS & INTERVENTION PLAN

Challenged

Judgment

Concept formation

Metacognition

Cognitive flexibility

Insight/awareness

Sustained attention

Selective attention

Used to determine if
awake enough or if
there is enough light
to sit up and walk to
the bathroom safely.
Used to determine,
once standing, if
individual can handle
the pain involved in
putting pressure on
the left foot. Decide
if the floor is clear of
clutter in order to
allow a safe passage
to the bathroom.
Knowing which order
to perform the steps
needed in order to
sit up in bed and
walk to the
bathroom.
If there is too much
clutter on the floor
to safely walk,
thinking about ways
to prevent that
problem next time.
Realizing the pain
involved in standing
and thinking of how
to avoid the pain in
the future.
If unable to put
pressure on the left
foot in order to limp,
then need to think of
using a crutch or
helper to get to the
bathroom.
Knowing that walking
upon waking causes
great pain and to
prepare for it
mentally. Know that
the floor is hard and
not carpeted and this
will increase the
pain.
Keeping attention
focused on the walk
from the bed to the
bathroom because
there is a good deal
of focus needed to
maintain balance
when limping.
Deciding to pay
attention to the
activity of walking
from the bed to bath
and not to other
things like school
assignments due
later that day.

Challenged

OCCUPATIONAL ANALYSIS & INTERVENTION PLAN

Divided attention

Short-term memory

Working memory

Long-term memory

Discrimination of senses: Auditory

Discrimination of senses: Tactile

Discrimination of senses: Visual

Used when attending

to the proper
location of arms and
feet when swinging
into an upright
position. Also used
when a part of the
attention is focused
on balance while
another part is
scanning the
environment for
items that may cause
tripping.
Knowing the very
next task you need to
complete in the
activity. For instance,
knowing that you are
in a seated position
at the edge of the
bed, and the next
movement will be to
prepare the body for
push off.
Knowing that you
already scanned the
environment for
obstacles before
starting to walk
toward bathroom.
Remembering all the
steps needed to
stand up from bed
and walk to the
bathroom.
Remembering that
there is pain when
standing and walking
and to prepare
mentally for it.
Remembering that it
is easy to trip so
clearing the
environment for
obstacles is
necessary.

x
Feeling the hard
ground beneath the
feet before rising and
discriminating
between the ground
and an obstacle
underfoot that may
cause tripping.
Discriminating
between a few and
many obstacles on
the floor.
Discriminating
between darkness
and enough light to
perform activity
safety.

OCCUPATIONAL ANALYSIS & INTERVENTION PLAN

Discrimination of senses: Olfactory

Discrimination of senses: Vestibularproprioception
Multisensory processing

Sensory Memory

Spatial relationships

Temporal relationships

Recognition

Categorization

Generalization

10

x
Knowing where the
body is in space and
correcting the bodys
balance using upper
body.
Looking under the
feet and feeling the
floors surface to
make sure there are
not objects present
that you will step on.
Knowing what an
obstacle free floor
should look like.
Knowing the amount
of light needed to
walk safely to the
bathroom. Knowing
that the ground
under the bed is hard
and dry.
Knowing that the bed
is roughly 12-15 feet
from the bathroom.
Knowing that the
soles of the feet
should touch the
floor when sitting up
at the edge of bed.
Knowing that the
dresser is nearby to
grasp for support if
necessary.
Knowing that in the
morning is usually
the time that client
needs to go to the
restroom. Knowing
how long sitting up
and getting to the
bathroom takes as to
not be late for
school.
Recognizing the need
to urinate upon
waking. Recognizing
that pain occurs
when putting weight
on the left foot.
Recognize that the
light through the
window means that
it is time to get up.
Categorize the light
through the window
and the light from
the table lamp both
help to guide the
way and can be used
to make the transfer
safer.
Having sat up after
lying down on a
couch or bed is the

OCCUPATIONAL ANALYSIS & INTERVENTION PLAN

Awareness of reality

Logical/coherent thought

Appropriate thought content

Execution of learned movements

Coping

Behavioral regulation

past and using the

same technique to
get up from bed.
Client has risen from
a seated position on
various surfaces and
can generalize that
this activity will be
performed in a
similar manner. The
client has walked
almost daily for her
entire life and can us
the walking pattern
that she has used in
the past in order to
perform this activity.
Being fully awake
and not dreaming
that it is time to get
up out of bed.
If there are objects
on the floor that can
cause the client to
trip, she can logically
conclude that she
needs to maneuver
around them. If the
client gets wakes up
but does not see
light through the
window or feel the
urge to urinate, then
she can logically
conclude that she
doesnt need to
transfer to the
bathroom.
If the client decides
that she must
transfer to the
bathroom then her
thought content
must be focused on
that activity and not
wishing she could go
back to sleep.
Standing from a
seated position and
walking with intent.
The client has
executed both of the
previous movements
daily for the past 25
years.
Coping with the pain
after weight bearing
on the left foot after
7-8 hours of rest.
The client must
control outbursts of
swearing, yelling or
whining when first
weight bearing on
the left foot in the

11

OCCUPATIONAL ANALYSIS & INTERVENTION PLAN

Body image

Self-concept

Self-esteem

Arousal

Consciousness

Orientation to self

Orientation,to place

morning. There are

other people nearby
sleeping who would
be woken if this
behavior was not
regulated.
When the client cant
rise from bed and
walk to the
bathroom without
pain she begins to
feel disgruntled with
her body in general.
She feels as
something always
wrong with her body
and that her body is
out of shape and
unhealthy.
Client is aware that
she is a young adult
and that feeling pain
when completing this
activity is
uncommon. She also
understands herself
to be an obese
person and
attributes much of
the pain to her
weight.
When client
performs activity she
begins to feel
unhappy with herself
and her current
situation. Her selfesteem is lowered
because she believes
that if she could lose
weight that the pain
would lessen. She
feels like a stronger
person would be able
to lose the weight.
Client needs to be
alert enough to walk
safely to the
bathroom and to
identify possible
tripping hazards on
the floor.
Client must be
consciousness and
awake to perform
activity.
Client is aware of her
identity as a recently
awoken individual
who must get up and
walk to the
bathroom.
Client knows that she
is in her own
bedroom and

12

OCCUPATIONAL ANALYSIS & INTERVENTION PLAN

Orientation to time

Orientation to others

Emotional stability

Motivation

Impulse control

walking to her own

bathroom. She is not
at a friends house or
a hotel.
Client knows that she
must perform this
activity around 6 am.
She also knows that
it should take no
longer than 3
minutes.
Client is aware that
there are others
sleeping in the rooms
next to hers and that
she must do the
activity quietly.
The client must
remain calm and
breath through the
pain when first
weight bearing on
the left foot.
Generally the client
is motivated to rise
from bed and walk to
the bathroom
because she needs to
either use the toilet
or shower to prepare
for the day.
Client must resist the
urge to roll back
toward the center of
the bed and fall back
asleep.

How It Is Used

Detection/registration

Detecting that there

is a need to rise from
bed and transfer to
the bathroom.

Tolerance of ambient sounds

Location and distance of sounds

Function

Awareness at distances

Appetite
Sleep

Visual modulation
Integration of senses

13

None

Minimally Challenged
x

x
The client sees that
she is ready to walk
as she feels the
ground beneath her.
The client moves her
body in space as she
focuses her eyes on
the door to the
bathroom.
The client knows the
distance between
the bed and the
bathroom.

x
x

Greatly Challenged

OCCUPATIONAL ANALYSIS & INTERVENTION PLAN

Moving against gravity

Taste
Smell
Body in space

Comfort with touch

Localizing pain

Thermal awareness
Joint range of motion

Joint stability/alignment

Strength

Muscle tone

14

She must move

through gravity when
rising from a seated
to standing position
and once again when
walking.

x
x
Client must know
that her body is
sitting on the edge of
her bed before rising
to a standing
position. She must
also know where her
arms and legs are in
space to properly
walk to the
bathroom.
Client must be
comfortable with the
fabric of the sheets,
her night clothes and
the ground under her
feet.
Client must be able
to tell the pain she
feels is from her left
foot and not from
another location.

x
Clients ROM needs
to be sufficient to
complete the
transfer. The
acetabulofemoral,
knee, foot joints
need to be mobile
enough to enable the
transfer. In addition
the shoulder joint
needs functional
ROM to aid in the
transfer.
Joints need to be
properly aligned and
stable to support the
weight of the clients
body while walking
to the bathroom.
Strength of the core
body muscles are
needed to maintain
posture and to stay
upright when
standing. Stretch of
the lower limbs must
be adequate to
support the clients
body weight and to
move against gravity.
Normal muscle tone
is needed for smooth
movement when the

OCCUPATIONAL ANALYSIS & INTERVENTION PLAN

Muscle endurance

Stretch reflex
ATNR
STNR
Righting and supporting reflex

Eye-hand coordination

Bilateral coordination
Crossing midline
Fine motor control
Oculomotor control

Gait patterns

Blood pressure
Heart rate
Respiratory rate
Respiratory rhythm

15

client stands from

edge of bed. Normal
tone is also needed
in the lower limbs to
allow smooth
movements of the
muscles.
Client uses thigh, leg,
and postural muscle
endurance while
standing and
walking. Client also
requires endurance
to remain upright
while on edge of
bed.

x
x
x
Clients gait is
abnormal when
performing transfer
from bed to
bathroom. The
clients balance I
often challenged and
they need to right
themselves before
falling.
The client combines
the visual stimuli of
the bathroom door
with their movement
of walking.

x
x
x
Client scans the floor
for possible
obstacles. Also used
when the client
switches from
looking at the
entrance to the
bathroom and
directly underfoot to
make sure there is
nothing on the floor.
Client uses abnormal
gait pattern to from
edge of bed to the
bathroom.
Will rise as client
wakes, sits on edge
of bed, and stands
Will rise as client
wakes, sits on edge
of bed, and stands
Will rise as client
wakes, sits on edge
of bed, and stands
Rhythm will continue

OCCUPATIONAL ANALYSIS & INTERVENTION PLAN

Respiratory depth

Physical endurance, aerobic capacity

to remain constant.
The depth will
increase as client sits
and walks compared
to when the client
was lying down
asleep.
Clients aerobic
capacity will be
minimally challenged
as the client stands
and walks.
x
x
Within normal rest
limits
Metabolism will
increase as client
stands and walks
because the body
will need more
energy.
Within normal rest
limits
Resisting the urge to
urinate until transfer
to the bathroom is
completed.

Metabolic system

Endocrine system
Urinary functions

Genital and reproductive function

Protective functions of the skin

x
x

x
x

x
The skin protects the
client from rough
fabrics in the bed. It
also provides a
barrier on the sole of
the foot when
standing.
The skin must repair
itself from exposure
to dry air and
abrasions, especially
on the sole of the
clients foot.

9. Muscular analysis of movements required:

Muscle
Shoulder flexion
Shoulder extension
Shoulder abduction
Shoulder adduction
Shoulder internal rotation
Shoulder external rotation
Elbow flexion
Elbow extension
Wrist supination

Voice functions
Voice rhythm and fluency
Alternative vocalization
Digestive system

Repair functions of the skin

16

Required?
Yes
Yes
No
Yes
No
No
Yes
Yes
No

OCCUPATIONAL ANALYSIS & INTERVENTION PLAN

Wrist pronation
Wrist flexion
Wrist extension
Thumb flexion
Thumb abduction
Finger flexion
Finger extension
Trunk flexion
Trunk extension
Trunk rotation
Lower extremities

17

Yes
Yes
Yes
No
No
Yes
No
Yes
Yes
Yes
Yes

10. Body structures required:

Category

Body Structure

Nervous system

Frontal lobe
Temporal lobe
Parietal lobe
Occipital lobe
Midbrain
Diencephalon
Basal ganglia
Cerebellum
Brain stem
Cranial nerves
Spinal cord
Spinal nerves
Meninges
Sympathetic nervous system
Parasympathetic nervous system
Eyeball: Conjunctiva, cornea, iris, retina, lens, vitreous body
Structures around eye: Lachrimal gland, eyelid, eyebrow,
external ocular muscles
Structure of external ear
Structure of middle ear: Tympanic membrane, Eustachian
canal, ossicles
Structures of inner ear: Cochlea, vestibular labyrinth,
semicircular canals, internal auditory meatus
Structures of the nose: External nose, nasal septum, nasal
fossae
Structure of the mouth: Teeth, gums, hard palate, soft
palate, tongue, lips
Structure of pharynx: Nasal pharynx and oral pharynx

Eyes, ears, and related

Structures

Voice and speech

structures

Required?
Check If
Yes
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
x

OCCUPATIONAL ANALYSIS & INTERVENTION PLAN

Cardiovascular system

Immune system

Respiratory system

Respiratory system
(continued)
Digestive, metabolic,
and endocrine systems

Genitourinary and
reproductive systems

Structures related to
Movement

Structure of larynx: Vocal folds

Heart: Atria, ventricles
Arteries
Veins
Capillaries
Lymphatic vessels
Lymphatic nodes
Thymus
Spleen
Bone marrow
Trachea
Lungs: Bronchial tree, alveoli
Thoracic cage
Muscles of respiration: Intercostal muscles, diaphragm
Salivary glands
Esophagus
Stomach
Intestines: Small and large
Pancreas
Liver
Gall bladder and ducts
Endocrine glands: Pituitary, thyroid, parathyroid, adrenal
Urinary system: Kidneys, ureters, bladder, urethra
Structure of pelvic floor
Structure of reproductive system Ovaries, uterus, breast and
nipple, vagina and external genitalia, testes, penis, prostate
Bones of cranium
Bones of face
Bones of neck region
Joints of head and neck
Bones of shoulder region
Joints of shoulder region
Muscles of shoulder region
Bones of upper arm
Ligaments and fascia of upper arm
Bones of forearm
Wrist joint
Muscles of forearm
Ligaments and fascia of forearm
Bones of hand
Joints of hand and fingers
Muscles of hand
Ligaments and fascia of hand
Bones of pelvis region
Joints of pelvic region

18

X
X
X
X
X
X
X
X
X
X
X
X
X

X
X

X
X
X
X
X
X
X
X
X
X
x
X
X
X
X
X

OCCUPATIONAL ANALYSIS & INTERVENTION PLAN

Structures related to
movement (continued)

Skin and related

structures

Muscles of pelvic region

Ligaments and fascia of pelvic region
Bones of thigh
Hip joint
Muscles of thigh
Ligaments and fascia of thigh
Bones of lower leg
Knee joint
Muscles of lower leg
Ligaments and fascia of lower leg
Bones of ankle and foot
Ankle, foot, and toe joints
Muscle of ankle and foot
Ligaments of fascia of ankle and foot
Cervical vertebral column
Lumbar vertebral column
Sacral vertebral column
Coccyx
Muscles of trunk
Ligaments and fascia of trunk
Areas of skin: Head, neck, shoulder, upper extremity, pelvic
region, lower extremities, trunk, and back
Structure of skin glands: Sweat and sebaceous
Structure of nails: Fingernails and toenails
Structure of hair

19

X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X

11. Performance skills required:

Skill

Required?

How the Skill Is Used

Motor/praxis

Yes

Needed to carry out the sequential movements of sitting to

standing and the skilled, purposeful movements of walking

Sensory (perceptual)

Yes
Yes

Emotion regulation

Cognitive
Communication/social

Yes

No

Taking in the visual information and identifying whether

there is a fall risk from clutter on the floor.
Client must deal with her pain appropriately in order to
avoid the pain triggering a cascade of negative emotions
that can follow her throughout the day.
Client must be scan the environment for obstacles that she
could trip over and think about how to avoid them.

OCCUPATIONAL ANALYSIS & INTERVENTION PLAN

12. Performance patterns:

Parts of this occupation has elements of which of the following: (check all that apply)

Pattern
Useful habit

Describe
Rising from bed every morning and walking to the bathroom is a very useful
habit as the bathroom is where the client can urinate after sleeping,
shower, and brush her teeth.

Dominating habit
x

Routine

The routine of rolling to the edge of the bed, then pushing off while
swinging her legs off the bed allows the client to sit up. Then the routine of
standing and walking to the bathroom allow her to prepare for her day.

Ritual
x

Role

Client identifies her role as that of a young, independent adult. Performing

a transfer from bed to bathroom is an occupation that the client feels she
should be able to perform.

Intervention Plan
1. Identify 1 objective and measurable goal of the intervention:
The objective of the intervention plan is to reduce the amount of pain the client feels in her
left foot when completing the functional transfer from bed to bathroom. The client will lower
her perceived pain from an 8 (on a scale of 0-10) to a 4 or lower within one month.
a. According to OTPF what type of outcome is this?
The outcome can be categorized as quality of life.

2. Intervention approach:

Approach

Describe

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Create/promote
x

Establish/restore

The intervention will focus on preparatory activities the client can perform

Maintain
Modify
Prevent

3. Activity selection
a. Activity selection: Identify 1 example of each for the intervention plan

Activity
Occupation-based
intervention

Describe
Practice the functional transfer after the interventions and modifications
have been put in place and see if the pain level decreases

Purposeful activity

Client will engage in a beginners yoga class at least once a week to stretch
her gastrocnemius, soleus, hamstrings and gluteus muscles that may be
contributing to the plantar fasciitis.

Preparatory method

Client will complete 25 foot pumps using left foot prior to getting out of bed
to increase blood flow to sole of foot.
Client will perform calf and hamstring stretches for a minimum of 30
seconds prior to getting out of bed.

Environment
Modifications

Client will modify environment by placing indoor shoes with heel support
within reaching distance from her bed. Client will wear shoes whenever
standing or walking.

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b. Discuss how activity selection relates back to occupational profile and occupational
analysis
The client expressed that she does not like the sedentary lifestyle she currently
has and would like to be more active. Using yoga as a purposeful activity will provide an
opportunity to gradually increase her physical activity level. In addition, the
occupational analysis indicated that core and lower body muscles are used to perform
the transfer and yoga can aid in increasing the endurance of these muscles.
c. Discuss how activity selection will support achievement of client identified goals and
goal of the intervention plan

Yoga will help to stretch the muscles that may be linked to plantar fasciitis. Also
the breathing techniques used in yoga may increase the clients ability to cope with her
chronic pain. In addition, a portion of the intervention plan focuses on preparatory
methods documented to decrease pain associated with plantar fasciitis. These have
been included because the clients main concern is the pain she feels in her left heel
that is making her functional transfer difficult. Furthermore, since the goal of the
intervention is to decrease pain while walking, the client will practice the preparatory
methods and then complete the walk from the bed to bathroom.

4. Describe how intervention can be graded or adapted and why

The preparatory methods used in the intervention can be graded up by having the client
perform more foot pumps, to increase endurance and blood flow to the foot, and can be
graded down by performing fewer foot pumps if the client doesnt have adequate endurance. In
addition, to grade the stretch up the client can hold the stretch for a longer period of time to
help lengthen the tissues and to grade it down the stretch can be held for a shorter duration
until the client builds a tolerance. In addition, the meaningful activity of yoga can be graded
down by shortening the duration of the class if the client does not have adequate endurance or
strength. It can be graded up by lengthening the class or attending an advanced class to increase
the endurance and strength requirements. The intervention call for the environment to be
modified by placing shoes with heel support near the bed so the client can avoid walking
barefoot on hardwood floors.

5. Safety concerns and/or precautions

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Objects on the floor are a tripping hazard for the client. In addition, because the client
has an abnormal gait pattern, there is a safety concern for her ability to maintain balance while
performing the transfer.
6. Discuss the role of the occupational therapy practitioner during the intervention

The occupational therapy practitioners role during the intervention is that of a

consultant. The OT used her knowledge to collaborate with the client on identifying the main
problem and tried to come up with solutions. In the future the client will try the solutions and
see if they work. Then the OT and the client can collaborate on ways to make them more
effective. In this situation, the practitioner is not directly responsible for the outcome of the
intervention, instead the OT gave the client interventions that may help decrease the amount of
pain. However, carrying out the interventions is up to the client.

7. Discuss what is expected of the client during the intervention

The client is expected to perform the interventions outlined. The client needs to
perform the preparatory methods every morning before getting out of bed in order to increase
the blood flow to her foot and to help release tension in her plantar aponeurosis. In addition,
the client is expected to modify her environment nightly by placing her shoes next to the bed.
Furthermore, client needs to assess her pain level on a scale of 0-10 every morning to determine
if the interventions are effective.

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