Madeline Dunlap

Fieldwork Assignment
Tx Ideas for 211
Problem Area 1: L hemi

Intervention: Pt will practice donning shirt using 1 handed dressing technique

with Min VC of the steps to complete UB dressing with Min A to increase L UE
use seated EOB
o Grade up: Pt will practice donning and doffing shirt using 1 handed
dressing technique with no VC of the steps to complete UB dressing
and no physical assistance to increase L UE use seated EOB
o Grade down: Pt will practice donning shirt using 1 handed dressing
technique with Mod VC of the steps to complete UB dressing with Mod
A to increase L UE use seated in w/c
Intervention: Pt will be sitting in w/c for support. OT will teach pt how to
don/doff socks using sock aid and dressing stick to increase independence in
dressing
o Grade up: Pt will perform doning of socks by placing both socks on
sock aid and completing the task. Pt will also doff both socks using
dressing stick.
o Grade down: Pt will perform doning of socks after OT places socks on
sock aid to complete the task. Pt will doff both socks using dressing
stick with help of OT when needed.
Intervention: Pt will stand at table with L hand on wash cloth and R hand
placed on top of L hand for WB. Pt will move wash cloth on table back and
forth (forward and back)
o Grade up: Pt will stand at table with L hand on wash cloth and R hand
placed on top of L hand for WB. Pt will move wash cloth on table
(forward, back, left, and right)
o Grade down: Pt will stand at table with L hand on wash cloth and R
hand placed on top of L hand for WB without moving wash cloth.

Problem Area 2: Activity tolerance

Intervention: Pt will practice 5 sit <-> stand with hemi walker seated in
wheelchair pushing off w/c with R UE to stand and place R UE on hemi walker
then reaching back with R UE to lower self on to w/c to work on fxnl transfers
o Grade up: Pt will practice 8 sit <-> stand with hemi walker seated in
wheelchair pushing off w/c with R UE to stand and place R UE on hemi
walker then reaching back with R UE to lower self on to w/c to work on
fxnl transfers
o Grade down: Pt will practice 3 sit <-> stand with hemi walker seated in
wheelchair pushing off w/c with R UE to stand and place R UE on hemi
walker then reaching back with R UE to lower self on to w/c to work on
fxnl transfers
Intervention: Pt will be sitting EOB with stabilization from OT if needed. Pt will
work on bed to w/c transfers with Mod A using hemi walker with OT 2 times to
increase activity tolerance

Madeline Dunlap
Fieldwork Assignment
Grade up: Pt will assist the OT when standing from the bed with use of
hemi walker, and moving body towards w/c with Mod A. Repeat 3 times
to increase activity tolerance, and to have the pt help with transfers.
o Grade down: Pt will assist the OT when standing from the bed with use
of hemi walker, and moving body towards w/c with Mod A. Repeat 1
time to increase activity tolerance, and to have the pt help with
transfers.
Intervention: Pt will be sitting in w/c to provide support. OT will teach pt how
to perform LB dressing using reacher to assist to improve independence in
ADLs
o Grade up: OT will ask the pt to doff his pants with physical assistance
to help him stand up to pull them down. The pt will don new pants with
reacher. OT will assist pt in standing to help pull them up.
o Grade down: Same as above, but OT will help pt thread B LE if
necessary. OT will assist the pt with don/doffing pants as necessary. Pt
can also practice with the reacher by picking up small items from
ground.
o

Problem Area 3: Standing balance

Intervention: Pt will stand at table shifting weight in LE towards left side,
back to midline, then towards right side while weight bearing through B UE
o Grade up: Pt will stand at table and shift weight in L LE while reaching
with R UE for an item and weight bearing in L UE. Pt will then shift
weight into R LE while reaching with R UE for an item and weight
bearing in L UE.
o Grade down: Pt will static stand at table while weight bearing through
B UE
Intervention: Pt standing in parallel bars practicing reaching outside BOS for
cones with R UE and stacking them on R side to increase dynamic standing
balance
o Grade up: Reaching further outside BOS anteriorly or laterally or
standing for a longer amount of time while stacking more cones. Pt can
also cross midline with R UE toward L side while stepping forward on
small block to increase dynamic standing balance and WB in L LE.
o Grade down: Practicing just standing in parallel bars without holding on
to bars and stack cones in front of pt instead of reaching outside BOS
Intervention: Pt will stand next to table to reach for bean bags with R UE on R
side to throw into bucket to work on dynamic standing balance
o Grade up: Pt will stand next to table to reach for bean bags with R UE
on L side to throw into bucket further away to work on dynamic
standing balance
o Grade down: Pt will stand in front of table to reach for bean bags with R
UE in front of pt and throw it into bucket closer distance