ACTIVITY ANALYSIS

                    ACTIVITY ANALYSIS

1.      INTRODUCTION: 

·         Activity analysis, or task analysis, is a fundamental skill of occupational therapists.

·         Occupational therapists analyze an activity because they want to know

Ø  whether the patient, given certain abilities, can be expected to do the activity

Ø  Whether the activity can challenge latent abilities or capacities and thereby improve these.

·         Activity analysis developed from industrial time-and motion study methods. Military occupational therapists applied these methods to rehabilitation of injured soldiers during World War I (Creighton, 1992)

·         Other methods of occupational analyses that focus on the performance of the patient are Performance Analysis (Fisher, 1998), Ecological Task Analysis (Burton & Davis, 1996; Davis & Burton, 1991), and Dynamic Performance Analysis (Polatajko, Mandich, & Martini, 2000).

·         This belief is stated in a position paper of the American Occupational Therapy Association (1995): “Whether physical or mental in nature, the behaviors necessary for completion of tasks in daily occupations can be analyzed according to specific components related to moving, perceiving, thinking, and feeling” .

·         Although tasks and activities require particular performance skills, abilities, and capacities, identification of these (activity analysis) is a high-level skill that requires practice under supervision. 

·         Activity analysis is ‘a process of dissecting an activity into its component parts and task sequence in order to identify its inherent properties and the skills required for its performance, thus allowing the therapist to evaluate its therapeutic potential

·         Analysing an activity enables the therapist to:

Ø  Understand the demands the activity will make on the service user, i.e. the range of skills required for its performance

Ø  Assess what needs the activity might satisfy

Ø  Determine the extent to which the activity might inhibit undesirable behaviour  or develop skill

Ø  Determine whether or not the activity is within the service user’s capacity

Ø  Discover the skills that the activity can develop in the service user; these may be specific skills, such as threading a needle, or more general transferable skills, such as reading

Ø  Provide a basis for adapting and grading activities to achieve particular outcomes.

·         TASK ANALYSIS All activities are made up of steps or tasks that are performed in sequence. Discovering the task sequence of an activity is called ‘task analysis’.

·         Task analysis may be carried out in order to:

Ø  Select an appropriate teaching method for an activity, for example, backward chaining (teaching the last stage of the task first, so that the therapist carries out most of the activity and the service user completes it)

Ø  Select an appropriate activity to meet a therapeutic aim

Ø  Adapt an activity to meet service user needs by changing or eliminating a step

Ø  Identify the precise part of an activity a service user is having difficulty performing

2.       ACTIVITY-FOCUSED ANALYSIS : FORMAT

1.      Name the activity goal.

2.      Describe the task demands:

Ø  Task constraints: How are the person and materials positioned, especially in relation to one another?

Ø  Task constraints: What utensils/tools/materials are normally used to do this activity?

Ø   Environmental constraints: Where is this activity usually carried out?

Ø  Contextual constraints: Does this activity or the way it is carried out hold particular meaning for certain cultures or social roles? Is there a time factor involved in carrying out the activity?

3.      What capacities and abilities are prerequisite to successful accomplishment of this activity

4.      List the steps of the activity.

5.      Describe the biomechanical internal constraints for the most therapeutic or repetitive step.

Ø  Motions

Ø  ROM Primary Muscles

Ø  Gravity Assists Resists, No Effect

Ø   Minimal Strength Required

Ø  Type of Contraction

6.      What must be stabilized to enable doing this activity, and how will that stabilization be provided

7.      For which ages is this activity appropriate

8.      What is the estimated MET level of this activity

9.      What precautions must be considered when using this activity in therapy

10.  For which short-term goal or goals is this activity appropriate 

11.  How can this activity be graded to improve the following:

Ø  Strength

Ø  Active ROM

Ø   Passive ROM

Ø  Endurance

Ø   Coordination and dexterity 

Ø  Edema

Ø  Perceptual abilities

Ø  Cognitive skills

3.  AN EXAMPLE OF AN ACTIVITY-FOCUSED ANALYSIS:

1.      Name the goal: Vacuuming the hallway carpet using a lightweight vacuum with a 25-foot cord.

2.      Describe the task demands:

·         Task constraints: How are the person and materials positioned, especially in relation to one another?

Ø  The vacuum cleaner is in a closet next to the area to be cleaned.

Ø  The electrical plug is halfway between the two ends of the hallway, 5 inches from the floor.

Ø  When vacuuming, the person will be directly behind the machine.

·         Task constraints: What utensils, tools, and materials are normally used to do this activity?

Ø  A lightweight vacuum cleaner

·         Environmental constraints: Where is this activity usually carried out?

Ø  The hallway is 30 feet long and 3 feet wide.

Ø  No furniture is in the way.

Ø  The carpet is a flat pile.

·         Contextual constraints: Does this activity or how it is carried out hold particular meaning for certain cultures or social roles? Is there a time factor involved in carrying out the activity?

Ø  The person takes pride in a clean, well-vacuumed home.

Ø  The person is not willing to switch to a lighter, nonmotorized carpet sweeper because of the feeling that it doesn’t do a proper job.

Ø   There is no limiting time factor involved in the activity under normal circumstances.

3.      What capacities and abilities are prerequisite to successful accomplishment of this activity?      

·         Standing balance

·         Ability to bend over and straighten up

·         Ability to grasp

·         Ability to walk forward and backward on carpeting

·         Ability to move dominant arm against gravity and moderate resistance

·         Vision1 4.

4.      List the steps.

1.      Get the vacuum cleaner from the closet.

2.      Unwind the cord.

3.      Plug cord into wall socket and turn vacuum cleaneron.

4.      Push the vacuum cleaner back and forth.

5.      Unplug it and wind the cord.

6.      Return the vacuum cleaner to the closet.

5.      Describe the biomechanical internal constraints for pushing the vacuum back and forth

6.      What must be stabilized to enable doing this activity, and how will that stabilization be provided?

Ø  Nothing

7.      For which ages is this activity appropriate?

Ø  18 years primarily

Ø  10–17 years secondarily

8.      What is the estimated MET level of this activity?

Ø  2–3 METs

9.      What precautions must be considered when using this activity in therapy?

Ø  If standing balance and bending over are not well developed, the patient must be guarded. 

Ø  A patient who is apt to lose balance walking on carpet must be guarded.

Ø  A patient who has low back pain must be taught to do the activity without bending forward.

Ø  A patient with low endurance needs to rest periodically.

10.  For which short-term goal or goals is this activity appropriate?

Ø  Strengthening of upper extremity musculature

Ø  Developing dynamic standing balance

Ø  Improving grip strength

Ø   Improving central and peripheral endurance

Ø  Learning proper back mechanics

11.  How can this activity be graded to improve the following?

·         Strength

Ø  Heavier vacuum cleaner

Ø  Thicker carpet

·         Active ROM

Ø  At limit

·         Passive ROM

Ø  Not applicable

·         Endurance

Ø  Increase amount of carpeting vacuumed before resting

Ø  Coordination, dexterity

Ø   Place furniture in the area so patient has to change directions of the vacuum to go around the obstacles

·         Edema

Ø  Not applicable

·         Improve perceptual abilities (examples)

Ø  Change the color of the “dirt” on the carpet, e.g., spread bits to be vacuumed either in contrasting colors or closer to the color of the carpet (figure–ground)

Ø   Put objects in the way for the person to figure out how to move around them (spatial relations)

·          Improve cognitive skills

Ø  Not applicable