Occupational Therapy for a Patient with Chronic Low Back Pain

職能治療於慢性下背痛的個案

楊尚育(Shang-Yu Yang) ； 林宗瑩(Chung-Ying Lin) ； 傅士豪(Shih-Hau Fu) ； 黃月珠(Yueh-Chu Huang)

《臺灣職能治療研究與實務雜誌》 11卷2期 (2015/12) Pp. 120-129

https://doi.org/10.6534/jtotrp.2015.11(2).120

摘要

在現代社會下背痛是一種常見的疾病，它影響患者的身體功能、情緒、社交活動與經常性工作。一般而言，下背痛患者通常接受跨專業治療，其中包含職能治療。然而，職能治療師主要專注於個案在活動的表現，並教導個案使用適當的身體力學和替代技術，在家裡或工作時保護他們免於下背痛。本文主要是應用加拿大職能表現測量為評估工具於慢性下背痛患者的個案報告。文中職能治療師依據加拿大職能表現測量的結果設計一個別化的治療方案，幫助個案解決她的問題，並實現個案的目標。治療師主要採用下背痛教育與疼痛管理兩種方式來介入解決個案的主要問題，此介入涵蓋了個案的生理與心理方面。本文的主要限制在於治療介入的時間似乎不足（僅維持兩個月），與未使用標準化評估工具來評估介入結果。因此，建議在未來的研究可提供較長的介入。本文提供職能治療師在應用加拿大職能表現測量於慢性下背痛個案臨床介入的參考。

關鍵字

職能治療 ； 下背痛 ； 加拿大職能表現測量

並列摘要

Low back pain (LBP), which affects patient physical function, emotions, social activities, and regular work, is a common disease in modern society. LBP patients typically receive multidisciplinary treatment, including occupational therapy. Occupational therapists focus on patient performance of activities, and teach them appropriate body mechanics and alternative techniques at home or work, to prevent LBP. We examined an intervention for a chronic LBP patient proposed by an occupational therapist, and adopted outcome measures from the Canadian Occupational Performance Measure (COPM). Based on the COPM findings, the occupational therapist designed an individualized treatment program to help the patient solve her problems, and achieve her goals. Two specific interventions (namely, education and pain management) were used in relation to the patient’s primary problems, including physical and psychosocial aspects. The main limitation of the case report was an insufficient duration of the intervention (2 months), and the absence of using standardized instruments to evaluate the intervention effects. Thus, a longer intervention is suggested in future studies. This paper provides occupational therapists with a clinical reference for using COPM on a patient with LBP.

並列關鍵字

Occupational therapy ； Low back pain ； Canadian Occupational Performance Measure (COPM)