Occupational Therapy in Physical Health

The goal of occupational therapy is to help you regain your independence and the necessary abilities to perform your activities, primarily using activity as a therapeutic medium. In its approach, the occupational therapist considers and can intervene on the person's abilities, environment, and occupations, and can evaluate and treat people with musculoskeletal, neurological, cognitive, or psychological injuries.

Following an injury or accident, it can be difficult to maintain balance and succeed in performing activities, although this is essential for physical and psychological well-being. This is where an occupational therapist can help.

Why and When to Consult in Occupational Therapy?

When pain and your difficulties interfere or are likely to interfere with performing your daily activities, work, or leisure.

Examples of conditions that can be managed in occupational therapy:

• Arthritis, osteoarthritis, tendinopathy, fibromyalgia, or any other musculoskeletal disorder
• Surgery following trauma
• Trauma to the cervical, dorsal, or lumbar regions
• Neurological problems (stroke, head trauma, multiple sclerosis, Parkinson's, etc.)
• Chronic or neuropathic pain
• Migraine, chronic headaches
• Chronic or neuropathic pain

Concretely, the occupational therapist can:

• Adapt and grade therapeutic activities based on a person's abilities to develop their tolerance and strength in daily life
• Develop physical and/or cognitive abilities to promote a safe and sustainable return to activities or work
• Provide education on posture hygiene and modify risky postures
• Develop safe working techniques
• Equip the client to develop pain management, energy conservation, and joint protection strategies
• Equip the client to develop stress management, organization, and communication strategies
• Evaluate and ergonomically adapt a workstation
• Evaluate the need for a walking aid

Sessions are conducted individually and are tailored to the client's needs (in the clinic or at home).

CNESST Occupational Therapy

Following a work accident (CNESST), your doctor may prescribe occupational therapy. The treatments are fully covered by CNESST. An initial evaluation will be conducted during the first appointment to assess your current abilities, work demands, and personal activities. An intervention plan will be developed based on the objectives to be achieved. This intervention plan is flexible according to rehabilitation progress and the modification of established goals.

Steps to Start Treatment

• Step 1: Following a work accident, you must fill out the Worker’s Claim (RTR) either online in your file on the CNESST website, by downloading and printing the document, or in the clinic during your first appointment. Here is the link to the form cnesst.gouv.qc.ca. If you already have your file number, please have it at your first appointment.
• Step 2: Consult a doctor to obtain a medical prescription for the injured area(s) and the necessary treatment(s) (occupational therapy).
• Step 3: Once you have these documents, contact us to schedule an evaluation appointment to start your rehabilitation. ** Treatments can begin 6 weeks after the date of the accident unless the doctor's diagnosis involves the hand.** The frequency of treatments can vary from 1 to 3 times a week.

What You May Be Entitled to as an Employee During Your Recovery

1. Income Replacement Benefit
   • CNESST provides an income replacement benefit to workers who are unable to perform their job due to a work-related injury.
   • It corresponds to 90% of the worker's net income.
   • It is paid every 2 weeks.
2. Reimbursement for Damaged Clothing
   • CNESST reimburses workers for costs paid for clothing damaged as a result of a work accident or by an orthosis or prosthesis required due to a work-related injury, up to the maximum amounts provided. The reimbursement includes costs for:
     • Cleaning
     • Repair
     • Replacement of damaged clothing
3. Reimbursement for Damaged Orthoses or Prostheses
   • CNESST reimburses workers for costs paid for the repair or replacement of their orthosis or prosthesis involuntarily damaged by an unexpected and sudden event occurring due to work.
4. Reimbursement for Medical Assistance
   • Medical assistance covers:
     • Services of healthcare professionals (such as doctors, specialized nurse practitioners, pharmacists, optometrists, and dentists)
     • Care or treatments provided by a public health facility (such as hospitals, CLSCs, CHSLDs, and rehabilitation centers)
     • Medications and other pharmaceutical products
     • Orthoses and prostheses
     • Care, treatments, technical aids, and expenses determined by CNESST regulation
5. Release for Treatment

   Your employer is obliged to release you so that you can access your treatments. Typically, a three-hour period is allowed without penalty.

6. Reimbursement of Travel and Stay Expenses
   • CNESST reimburses workers who have suffered a work-related injury for travel, meal, and accommodation expenses incurred for:
     • Receiving care
     • Undergoing medical examinations
     • Participating in an activity as part of a rehabilitation measure or individualized rehabilitation plan
7. Reimbursement of Home Maintenance Work Expenses
   • Reimbursement of home maintenance work expenses can be granted to a worker before consolidation if:
     • CNESST is certain that the worker has or will have a serious permanent impairment to their physical integrity
     • The needs for which the worker is requesting reimbursement will be permanent (e.g., reimbursement request following an amputation)
     • The worker is unable to perform the usual home maintenance tasks they would normally do themselves if not for their injury, based on available information about their health condition

     Examples of maintenance work: lawn mowing, painting, thorough cleaning, snow removal

8. Allowance for Personal Assistance at Home

   Examples of personal assistance at home: personal hygiene, meal preparation, light housekeeping, laundry

For reimbursement requests, visit your file on the CNESST website (cnesst.gouv.qc.ca) or consult your case officer!

Worker's Rights

Act respecting industrial accidents and occupational diseases

a-3.001 - Act respecting industrial accidents and occupational diseases (gouv.qc.ca)

Article 61: When a worker who has suffered a work-related injury returns to work, their employer pays their net salary for each day or part of a day the worker must be absent from work to receive care or undergo medical examinations related to their injury or to engage in an activity as part of their individualized rehabilitation plan. The Commission reimburses the employer, upon request, for the salary paid under the first paragraph, except when the worker has been absent from work to undergo a medical examination required by their employer.

SAAQ

Following a road accident (SAAQ), your doctor may refer you to occupational therapy. The treatments are fully covered by the SAAQ. An initial evaluation will be conducted during the first appointment to assess your current abilities, work demands, and personal activities. An intervention plan will be developed based on the objectives to be achieved. This intervention plan is flexible according to rehabilitation progress and the modification of established goals. The frequency of SAAQ occupational therapy treatments can vary from 1 to 3 times a week.

Here are the steps to start your physiotherapy treatments covered by the SAAQ without incurring any costs:

• Step 1: Following a road accident, you must report the accident online at the following address SAAQ: accident route or contact the SAAQ at 1-888-810-2525. After this declaration, you will receive a claim number that you must keep for all treatments and communications with the SAAQ regarding your file.
• Step 2: Consult a doctor to obtain a medical prescription for physiotherapy treatments. The injured area(s) must be noted on this prescription, as these are the only areas that can be treated.
• Step 3: A treatment authorization request must be made to the SAAQ with your prescription and claim number. Come to the clinic so we can help you complete the necessary documents for the SAAQ request. Once authorized, we will contact you to schedule the evaluation appointment. The request can take several days/weeks before the SAAQ agents make a decision regarding your file.

If you do not want to wait, you can pay for the treatments and start immediately, then get partially reimbursed by the SAAQ. You can also choose to extend the treatments in terms of session length by paying the difference. You can make a claim with your private insurance or your car insurance if you have the FAQ34 clause.

What You May Be Entitled to During Your Recovery

For more information, visit the SAAQ Benefits Table or contact them at 1-888-810-2525.

Types of Expenses

For more information, consult the SAAQ Benefits Table or contact your agent at 1-888-810-2525.

Public Automobile Insurance Plan

Three-year deadline to apply for benefits.

ELIGIBILITY

If you have been involved in a road accident that left you with a permanent physical disability – and you can no longer get in or out of a vehicle or drive it safely – you may be able to adapt a vehicle to your situation and get reimbursement for certain expenses.

Conditions for Vehicle Adaptation

• You can no longer get in, out, or drive a vehicle safely.
• The vehicle adaptation is recommended by an occupational therapist who is a member of the Quebec Order of Occupational Therapists.

Driving Ability Assessment

Driving is an activity that allows us to maintain our participation in certain activities independently. Despite all your good habits, your health condition may one day force you to stop driving. Accidents, health issues, or age can impair driving ability. When there is an impairment of physical or cognitive abilities, the Société de l'assurance automobile du Québec (SAAQ) may require a driving ability assessment to ensure the safety of the driver and other road users. If you doubt your driving abilities, you can also request the evaluation on a voluntary basis.

The Role of the Occupational Therapist

The occupational therapist evaluates the physical, perceptual, and cognitive abilities necessary to drive safely. They can propose solutions to improve driving abilities. If the abilities are not sufficient, the occupational therapist can assist the client in finding solutions to facilitate community mobility and engagement in meaningful activities.

Our Expertise

We specialize in the assessment of cognitive abilities. Please note that we do not perform evaluations for major vehicle adaptations (e.g., wheelchair accessibility).

Procedure

Here is the necessary information for making an appointment:

• 1 - Have the diagnosis in hand
• 2 - Have the condition G on the driver's license (if not, contact the SAAQ)
• 3 - Make an appointment with one of our occupational therapists. The first session takes place in the office. Physical and cognitive tests will be conducted.
• 4 - A road appointment with a driving instructor will be scheduled in the second phase.

Workstation Evaluation

The occupational therapist begins by evaluating the specific needs of the worker and their personal condition. A detailed analysis of work tasks, adopted postures, available equipment and its usage is conducted. The physical work environment and physical and mental demands will be evaluated. Finally, the lifestyle habits surrounding work will be analyzed. Taking measurements, photos, or videos may be necessary to guide the analysis and make appropriate recommendations.

Following the analysis of all data, recommendations will be made regarding the work environment and habits. Follow-up meetings may be scheduled to adjust the action plan. For simpler cases, the occupational therapist can provide education on workstation ergonomics in the clinic, including lifestyle habits and basic advice on the proper posture to adopt.

Evaluation for Adapted Transport

Several factors can limit an individual's ability to move independently. Most large municipalities provide adapted transport services to their residents to enable them to travel, even in the case of a limitation. To be eligible for this service, an individual must receive an evaluation from a healthcare professional to confirm that their condition limits their ability to move independently.

The occupational therapist can complete the documents for adapted transport if it is a physical issue (e.g., osteoarthritis, difficulty walking) or a cognitive limitation (e.g., neurocognitive disorder) that makes it impossible to use regular public transportation. To properly complete the required documentation, the occupational therapist will ask questions about your current limitations in various activities. Depending on the stated difficulties, a physical or cognitive test will be conducted to thoroughly document the physical and/or mental barriers that may affect your safe mobility. The evaluation takes place in an individual meeting at the clinic.

Evaluation for Parking Permits

The occupational therapist can evaluate the physical and/or mental barriers that may affect your safe mobility to complete the necessary documentation for obtaining a parking permit. You need to bring the form available on the SAAQ website. We will fill it out, and you can then send it to the SAAQ.

Pediatric Occupational Therapy

Your child may benefit from occupational therapy if they:

• Have difficulty staying in place at the table or school, constantly get up, move on their chair
• Have difficulty concentrating at school and it affects their grades
• Refuse to do their homework
• Have difficulty tying their shoelaces and fastening buttons
• Have difficulties with writing, drawing, or cutting
• Cry or have tantrums when they encounter difficulties, refuse to go to school, avoid facing their challenges
• Seem clumsy, have difficulty dressing, playing on playgrounds, or doing gym activities

The occupational therapist helps children who have daily difficulties at school or home. To do this, they consider the different areas of their development (motor, perceptual, cognitive, emotional, and sensory). They collaborate with parents and teachers to understand the children's difficulties and set goals. The aim is to help them improve their autonomy, promote their development, and facilitate their learning.

With their knowledge of child development and activity analysis, the occupational therapist conducts interventions through various games and activities carefully chosen and adapted to the goals. Regardless of the child's difficulties, at PhysioMédic, we aim to ensure maximum participation in all activities. Each small step is a great achievement, and we will support your little ones as they improve with joy!

Different Reasons for Consulting in Occupational Therapy

• Writing difficulties, difficulties with school prerequisites (cutting, etc.)
• Global developmental delay
• Motor agitation
• Attention deficit disorder with or without hyperactivity (ADHD)
• Coordination acquisition disorders (CAD), dyspraxia, or other motor challenges
• Behavioral disorders, oppositional defiant disorder
• Learning difficulties
• Sensory modulation difficulties
• Anxiety, depression
• Any other difficulty impacting the child's activities

Functional Capacity Development Program

The Functional Capacity Development Program is an intensive rehabilitation program where the worker is followed by an interdisciplinary team, addressing both physical and mental health according to each case. The program is personalized and takes into account the worker's bio-psychosocial factors. The duration of the program varies according to needs and can be done in conjunction with a gradual return-to-work plan. The program aims to progressively resume personal and professional activities intensively (half-day in the clinic, 5 days a week). A plan and specific objectives are established by an interdisciplinary team and the participant.

The sessions include various exercises (cardiovascular, overall strengthening, task simulation, etc.) and individual mental health sessions to quickly address any obstacles that may hinder rehabilitation. The program also includes education on chronic pain management, stress, and the gradual resumption of pre-injury activities within a balanced occupational schedule context.

Pain Management Program

Occupational therapists focus on optimizing occupational performance and participation, developing skills in self-efficacy and pain self-management, acquiring knowledge about pain, and preventing chronic and persistent pain (©The Canadian Association of Occupational Therapists, Ottawa. CAOT Position Statement - Pain Management in Occupational Therapy (2012)).

In the clinic, an evaluation meeting is scheduled to assess the physical and/or mental barriers that limit participation in personal and professional activities. Subsequently, meetings will be proposed to address several topics according to needs. For example:

• What is chronic pain? How to manage it?
• What is the impact of stress on pain and how to manage it daily?
• What tools can help improve my sleep?
• What activities can I engage in, or how can I adapt my activities to my current abilities?

Meetings are scheduled at your own pace.

Mental Health Occupational Therapy

The mental health occupational therapist evaluates how a person's social engagement is affected by their emotional, cognitive, or physical abilities. In the evaluation and intervention, they consider routine, occupational balance, and the obstacles that hinder functioning.

The occupational therapist can therefore assist the person in gradually resuming activities and adopting healthy lifestyle habits to improve their quality of life. They can also provide strategies to help the person overcome difficulties, which will benefit both their well-being and functioning. The resumption of healthy lifestyle habits and return to a good level of functioning will both reduce the symptoms of the illness and improve quality of life.

Examples of possible reasons for consultation:

• Depression
• Adjustment disorder, burnout
• Anxiety
• Bipolar disorders
• Personality disorders
• Post-traumatic stress
• Organizational difficulties

A medical diagnosis is not necessary to use the services of an occupational therapist. Sometimes, life circumstances lead to a change in our life balance, and it may be beneficial to develop tools to counteract the negative effects of occupational imbalance.

Occupational therapy interventions aim to:

• Improve energy levels
• Improve anxiety management
• Improve motivation and interest in resuming activities
• Improve sleep quality
• Increase functional abilities
• Facilitate a return to personal and professional activities
• Improve self-efficacy
• Restore a functional life balance
• Equip the client to develop stress management, organization, and communication strategies

Sessions are conducted individually and are tailored to the client's needs (in the clinic or at home).