Occupational Therapy Activity Game, Essay Example

Snakes and Ladders

Occupational Therapists are challenged with creating activities the not only are safe, but beneficial to the patient. Snakes and Ladders is a game that was redesigned with the intention to aid elderly patients with their balance, activity endurance, cognitive and self care activity. The life size board (150cm x 150cm) has been cut in half to easily facilitate the use of a walker. Each player will be given one cone. The cone is to be placed on the number one square. Each player will roll the single die and move their cone forward the amount of spaces they just rolled. Each player has to follow the same route, passing each consecutively numbered square. There are obstacles to consider. If a player lands on the lower number end of the ladder, they can shoot up that ladder to the number at the top. However, if they land on the higher number of a ladder or a snake, they have to go back to the bottom of that object. Rolling the number six will automatically allow that player to take an additional turn. The player that gets to the end first wins.

In Occupational therapy, it is essential to create ways to increase the patient’s mobility and their overall aptitude to function on their own. This game was reshaped with elderly patients in mind to improve weight-shifting, activity tolerance, hand-eye coordination, and cognitive components. “Healthy pleasures are daily or otherwise frequent occupations that go unnoticed but provide a sense of commitment.” (Ornstein & Sobel 1989) Utilizing a game takes away the “work” that goes along with therapy. This game may still prove to be difficult for some patients, but the atmosphere of it being enjoyable will hopefully obtain better results and greater commitment from the patients.

After an elderly individual has back surgery, they are often given many precautions they have to follow. These limitations consist of no bending, lifting, twisting, along with many other patient specific restrictions. For an Occupational Therapist, this can limit the activities used for aiding an elderly patient. Snakes and ladders was redesigned to a full-size board in order to actively involve patients with many different limitations. This game requires stretching and movement. Because of the walker accessibility, the patient can move throughout the game with no obstacles. Depending on the stage of their surgical recovery, the patient may need to use a long handle reacher to place their cone. As they progress in their healing, they will be able to bend over to place the cone and pick up the die, which will strengthen their mobility and range of motion. Patients will be able to interact with others, which will build their cognitive skills. Their participation will aid in core strengthening and activity tolerance. This game will provide not only the physical benefits, but because it is a cognitive activity, it will keep the patient’s minds active and involved.

Another commonly addressed area that Occupational Therapist see with elderly patients is total hip replacement. Post-op instructions are no bending 90 degrees and no turning toes inward or outward. Recovery from this and any type of surgery is a process, especially for the elderly. Core strengthening is a vital part of recovery after hip replacement. Using their walker, they will be able to move into the game, and work on their activity tolerance and as well as balance. Walking will have require them to use weight-shifting. Even if the participant favors a side, they will have to utilize the entire body and strengthen as they go. The patient has to maneuvering through the game, rolling the dice, and placing their cone. They have to move away from the board when its other players turn.  It requires mobility.  This also stimulates hand-eye coordination.  Similar to the back patients, to play this game they will have to initially use some type of device to place their cones due to the no 90 degrees bending restrictions; however, they do strengthen hand-eye coordination by rolling, counting, and placing their cone.

Total knee replacement will not benefit from the game during the initial stage when they are dependent a wheel chair. This game board is wheel chair accessible, but it would not be much of a strengthening tool for the patient outside of it being a cognitive activity. Once the patient is able to function using a walker, the game will help build balance, weight-shifting, stabilization, and activity tolerance. Weight-shifting will be on of the hardest tasks, inevitably the patient is going to favor the good the leg and use the healing leg as little as possible. But being interactive and life-size, they have to get into the game, literally, to participate. Their first attempt, they may only make it through four or five rolls before they reach their limit. But they will be able to come back and play another game, building up their strength in vital areas that will allow them to function how they did preoperatively. This is a game, it will become more enjoyable and less like work as they build up their tolerance and activity level.

And lastly, an Occupational Therapist could implement Snakes and Ladders as a therapeutic tool with cardiac patients. These individuals typically tire easy so whatever therapy is used, it has to be effective in a short amount of time initially. The cognitive factor is imperative for cardiac patients. It will take them some time to build their self care and activity endurance. Regardless of the type of cardiac patient, this game can be beneficial. “Many stroke survivors are physically reconditioned and have a high prevalence of cardio risk factors and problems that are potentially modifiable with exercise.” (Duncan, Richards, Wallace, Stokers-Yate, Pohl, Luchie, Ogle, Studenski 1998) Participation requires the cardiac patient to be mobile and stay involved. Keeping them active and involved is a way for an Occupational Therapist to incorporate necessary exercise.

The game of Snakes and Ladders has proven to be therapeutic. It addresses balance, activity endurance, and cognitive activity, along with strengthening self-care abilities. Requiring the patient to participate, they are thinking, moving, playing, they are involved in a physical activity. “Study suggests that engaging in regular physical

activity, among other health benefits, may delay or prevent the onset of cognitive impairment and dementia in the elderly, especially in women.” (Lauren, Verreault, Lindsay, MacPherson, & Rockwood 2001) Recovery is hard, for any patient, but elderly individuals are not nearly as resilient. Interacting with others provides a cognitive therapy that can give them more support to try harder and to remain positive.

Creating a game that Occupational Therapist can use to stimulate their clients, and strengthen skills that they once had is the purpose of Snakes and Ladders. “Research has shown that remaining active and productive is a key component of successful aging.” (Clark, Azen, Zemke, Jackson, Carlson, Mandel, Hay, Josephson, Cherry, Hessel, Pamler, & Lipson1997) Allotting for variable levels of involvement makes this therapeutic game useable by patients with many different ailments. The game like atmosphere will be more enjoyable for the patients, potentially yielding faster results. Snakes and Ladders provides balance, activity endurance, cognitive, and self-care activities for elder patients. It is a therapeutic tool that could aid an Occupational Therapist in getting their patients functioning in a way that they once did.

References

Lauren, Danielle; MSc; Rene´ Verreault, MD, PhD; Joan Lindsay, PhD; Kathleen MacPherson, MD; Kenneth Rockwood, MD.  (2001) Physical Activity and the Risk of Cognitive Impairment and Dimentia in Elderly Persons. Arch neurol/vol 58,  mar 2001.

Clark, Florence PhD, OTR; Stanley P. Azen PhD; Ruth Zemke, PhD, OTR; Jeanne Jackson, PhD, OTR; Mike Carlson, PhD; Deborah Mandel, MS, OTR; Joel Hay, Ph; Karen Josephson, MD; Barbara Cherry, PhD; Colin Hessel, MS; Joycelynne Pamler, MS; & Loren Lipson, MD.  (1997)  Occupational Therapy for Independent-Living Older Adults. A Randomized Controlled Trial. The Journal of the American Medical Association. October 1997, Volume 278.

Duncan, Pamela, PhD, PT; Lorie Richards, PhD, OT; Dennis Wallace, PhD; Joni Stokers-Yate, PT; Patricia Pohl, PhD, PT; Carl Luchie, PhD; Abna Ogle, MD; Stephanie Studenski, MD, MPH. (1998) A Randomized, Controlled Pilot Study of a Home-Based Exercise Program for Individuals with Mild and Moderate Stroke. American Stroke Association, 1998.

Ornstein, R. & D. Sobel. (1989) Healthy Pleasures.  New York: Addison-Wesley.