The human body is simply awe-inspiring. Its capacity to do the things that people need to do, love to do, and are expected to do is nothing short of astounding. The limits to absolute human performance have yet to be discovered. The limits to our personal performance are often never fully actualized but can be revealed for different reasons and at different times throughout our life course. Our bodies are the manifestation of the interaction between our biological architecture, our personally-determined potential, the environment (social, natural, and constructed), and the actions and inactions that we take throughout our lifetime. There are few greater intellectual or philosophical pursuits than to explore the human body and all that it is capable of doing.
To gain a deeper appreciation of the phenomenal human body, we combine the study of internal body structures (anatomy); the study of the functions of all living body organisms (physiology); and the study of the determinants, learning, and control mechanisms involved with human movement (neuroscience and kinesiology); during the performance of life activities. This Course Manual was designed to facilitate a meaningful learning experience for occupational therapy students and practitioners who seek a deeper appreciation for and practical understanding of the human capacity for occupation. This Course Manual critically analyzes how body structures support body systems and their functions and respond to internal and external forces and other life stressors to produce meaningful movement. It provides readers with practical strategies for identifying and understanding movement-based occupational performance problems and for planning, implementing, and reviewing the effectiveness of movement-based interventions.
APPROACH
The authors of this text follow an eclectic approach to teaching and learning about the human capacity for participation and performance and its impacts on health and well-being. Our approach combines multiple facets of scientific and philosophical inquiry into the human body and its capacity to do.
There are several appropriate ways to describe this approach. First, it can be considered an applied neuro-biomechanical systems approach in that we explore how all the systems in the body work together to respond to internal and external forces. Special attention is paid to the nervous system and its role in receiving information, processing and interpreting information, and executing action in response to both internal and external information. In addition, we explore the practical application of this knowledge and leverage our understanding of it to maximize the effectiveness and efficiency of our clinical processes.
Second, our approach incorporates an occupation-based perspective, in that we are primarily interested in why and how people do what they do and the impact that movement has on health and well-being. We combine these approaches so that students and healthcare professionals have a comprehensive understanding of and appreciation for the complexities of the human capacity to participate in and perform occupations.
ORGANIZATION
Education about the body structures and functions in occupational therapy curricula has traditionally taken a biological, reductionistic approach. The vast majority of medical education anatomy texts are organized according to anatomical region, body systems, and clinical pathology. Often taught by anatomists and neuroscientists, educational content had little application to occupational therapy practice and understanding of occupations. Students frequently attempt to memorize content and are left trying to make their own connections from anatomy and neuroscience to occupational performance and participation.
This course manual is non-traditionally organized in that it does not strictly adhere to a bottom-up systems- or structures-based approach. In other words, it does not follow a reductionistic, decontextualized perspective. Instead, the authors have adopted a top-down approach that focuses first on understanding movement and its importance in promoting and supporting health, well-being, and occupational performance and participation. Once provided with the context of movement and occupational performance, students are presented with the underlying body structures and functions that make movement happen. It has been our experience that students learn more efficiently with this occupationally contextualized approach.
Movement patterns that are universal to human development throughout the life course and the performance of daily activities are introduced from a developmental, kinesiological perspective, beginning with breathing and progressing to transitional up-righting patterns, and bipedal upright patterns. Each pattern’s anatomy, physiology, biomechanics, and relevance to participation and performance of everyday activities are explored. In addition, evaluation and intervention principles of each movement pattern are discussed. The patterns discussed herein are categorized as:
- developmental patterns that develop and refine in early life.
- fundamental patterns that are the universal prerequisites for performing basic daily life activities, but that are introduced in a decontextualized manner.
- common performance patterns that are used in the context of performing any number of basic daily life activities.
Although there are far more movement patterns than those included in this Course Manual, they have been intentionally omitted due to their complexity, specificity, and non-universal nature.
It is the authors’ sincere hope that the organization of this text better facilitates students’ understanding of the integral relationship between human occupation, movement, and underlying body structures and functions.
HOW TO USE THIS COURSE MANUAL
This Course Manual presents students with multiple modes of learning so that they may:
- recognize common movement patterns and their underlying structures
- familiarize themselves with conducting an interdisciplinary chart review
- learn palpation techniques often used in clinical practice
- apply key concepts related to common health conditions seen in occupational therapy practice
- critically examine assessment strategies in the evaluation process
The modes of learning utilize case studies, multidisciplinary electronic health records software (EHR Go), interactive digital images (BioDigital Human), digital dissection software (4D Interactive Anatomy), human cadaver videos (Acland’s Video Atlas of Human Anatomy), and clinical assessment strategies to guide students through the learning process.
It is expected that students complete the required reading in advance of the class meeting. In-class discussions and labs are intended to reinforce the information presented here. Students will gain the greatest benefit by reviewing the case study, reading the Course Manual (students should familiarize themselves with the terminology in bolded italics), completing the Activity for Critical Thinking, and completing the Knowledge Check quizzes (when available in Moodle) prior to arriving to class. When directed to review the case studies’ electronic health records (EHR), students should familiarize themselves with the Occupational Profile, Occupational Therapy Evaluation, and other relevant documents. In the classroom, we will hold in-depth discussions about the content; interrogate the case studies, electronic health records, and assessment strategies using medical terminology; and formulate various assessment strategies used in clinical practice.
The authors have made every effort to provide clinical information that is up-to-date, accurate at the time of publication, and relevant to occupational therapy practice. Diagnostic and therapeutic approaches continue to evolve with new research and clinical experiences. Because standards of care are constantly changing, and because of the possibility of human error, the authors do not warrant that the information contained in this Course Manual is in every aspect accurate and comprehensive. Furthermore, we do not claim responsibility for harm, loss, or injury done to recipients of occupational therapy services, based on the information contained herein. Readers are strongly encouraged to consult multiple sources of information when making clinical decisions, particularly in regard to designing evaluations, prescribing interventions, understanding medications, and applying individual precautions and contraindications, all of which are subject to frequent changes. As always, we recommend that practitioners utilize their best clinical judgment when applying the concepts contained herein to clients.