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Visual, perceptual, and motor dysfunction in occupational therapy

Visual, perceptual, and motor dysfunction
            Occupational therapy is integral to rehabilitation of patients with visual, perceptual, motor and any other dysfunctions. The therapy entails assessment and treatment of the defects resulting from injuries and or following brain damage by conditions such as stroke. To choose the appropriate intervention, the occupational therapist has to identify the state and nature of the impairment. This greatly facilitates the determination of the approaches of assessment and the limitations associated with each approach. The tools used by the therapists in assessment and remediation of the various problems vary in reliability, accuracy and the ability to cover all the required areas in the screening process. The major areas of interest in rehabilitation of patients with visual perceptual and motor dysfunction include impairments of visuospatial skills, constructional skills, agnosia, acalculia and apraxia (Rowland, Cooke, Gustafson, 2008). This paper will provide a literature review on interventions for visual, perceptual, and motor dysfunction used in occupational therapy for adults in physical disabilities settings such as an inpatient acute-care facility.
Visual perception is the ability to understand and interpret images as perceived by the eyes. The brain is the single most important part in this process. The brain functions to coordinate perceptions and the related response. Patients with difficulties in this coordination require the help of a therapist to offer alternative or compensatory models for them to cope. The intervention employed by the therapist, should consider the physical and the sociocultural environment of the patient. The intervention can be looked at as a process or sequence of activities which involves initial data collection, data interpretation and the eventual planning and implementation. Screening and evaluation is the most commonly used first step in intervention and may entail carrying out an interview and observations prior to initiating the intervention program (Cooke, McKenna, Fleming & Darnell, 2006).
The visual-perception therapy intervention involves the use of techniques that correct, modify or improve the binocular, visual processing and related perceptual disorders as well as oculomotor. These techniques include orthotics which cures disorders such as diplopia and strabismus. These disorders negatively affect the ability to control eye movement, sustaining eye focus at far or near, the ability to align vision simultaneously at far and near, visual acuity and depth awareness. The intervention methods used include computerized orientation programs that are important in improving vergence. The use of near point of convergence exercises in patients with convergence challenges. Such patients usually experience discomfort and are always straining at work or while reading resulting in discomfort and visual fatigue (Sanghavi, Kelkar, 2006).
In most acute-care facilities, behavioral visual therapy is applied mainly to tackle challenges of visual data processing. This results from difficulties in attention and concentration resulting from the inability to sustain focus or the inconsistent and rapid shift of focus from one object to another. The occupational therapists employ the use of numerous exercise models such as directional sequencers, Marsden balls, saccadic fixators, syntonics and rotation trainers. According to the American academy of Optometry, these modes of therapy are very effective in addressing the root causes of visual problems that in turn affect the visual abilities. The use of behavioral visual therapy has however been surrounded by controversy with some experts arguing that it is not entirely effective. According to a literature review of 2008, there is no concrete evidence that behavioral visual therapy has solved visual dysfunction problems and as such can not be advocated. A consensus among orthoptists and ophthalmologists is that the exercise can however improve vision control (Rowland, Cooke, Gustafson, 2008).
Motor dysfunction in adults may result from accidents that cause brain damage. This makes it difficult for one to coordinate motor functions since the link between the controlling part of the brain and the motor elements is lacking or ineffective. Simple tasks such as movement of fingers, writing and holding become impaired. Occupational therapists in therapy facilities mostly use various intervention techniques which fall under two major categories. These are the modular and the generalized approaches. The modular approach focuses on improving the identified difficulty. The technique succeeds through practice that involves mastering the skills in a step wise model for one to go back to the normal functioning they enjoyed prior to experiencing the challenge. The most used therapy in the modular approach is the cognitive motor intervention therapy, which puts emphasis on the emotional and cognitive aspects such as motivation of the patient. This is vital in reclaiming self-confidence which is an important part of the healing process (Bendixen & Kreider, 2011).
The generalized model focuses on the underlying problem based on the idea that the motor skill problem is a result of an underlying problem such as sensory challenges and kinesthetic coordination problem. The therapist therefore applies sensory integration or kinesthetic therapies that address regulatory, processor and coordination difficulties to achieve effective and integrated sensory input. The kinesthetic training results in improved motor skills through continued training (Bendixen & Kreider, 2011).
            Interventions for visual, perceptual, and motor dysfunction used in occupational therapy for adults in physical disabilities settings such as in inpatient acute-care facilities are evolving with emergence in technologies and new studies. The core aim is however to achieve normalcy in the patients’ lifestyle status.

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