Yoga is a complete system of occupational regulation, based on complex theories that address occupational risk factors while relating occupation directly to health and wellbeing. Although aspects of yoga have been used in Western occupational therapy settings, some of its underlying theories may have been overlooked. If validated by research, these theories may enrich occupational therapy philosophy. Yogic techniques of potential clinical use include pulse diagnosis, meditation and breath control. These are not described in detail in this opinion piece, but should be the subject of thorough literature reviews and, perhaps, further research.
A 71-year-old woman who had been taking ibandronate for 10 years presented to an Endocrinology Department with persistent mid-thigh pain. Pelvic X-ray showed bilateral femoral cortical expansion, indicating impending atypical femoral fractures (AFFs). AFFs have been linked to long-term bisphosphonate therapy and have morbidity and mortality similar to that of hip fractures. Such fractures can be averted by regular reviews of bisphosphonate therapy and vigilance for prodromal symptoms. This patient’s bisphosphonate therapy was stopped, and fractures were avoided by treatment with vitamin D and parathyroid hormone.
The occupational therapy profession was founded in 1917 on the notion that occupations contribute to psychological well being and physical adaptation. The credibility of occupational therapy has been threatened because the scientific basis of this notion is not always evident. The focus of occupational therapy in many physical settings has therefore shifted away from its original ethos towards one of physical problem solving and discharge facilitation. Psychoneuroimmunology (PNI) is a developing branch of science that provides a theoretical framework to support the profession’s return to its original ethos of using occupations to promote health. This paper is an analysis of psychoneuroimmunological evidence to support occupational therapy for inflammatory disorders. A broad literature search revealed mind-body inflammatory pathways including anatomical links, nerve growth factor, adrenocorticotrophin, cortisol, somatostatin and substance-P.
Reiki is a Tibetan healing energy technique used by health-care professionals in Japan and the United States of America to treat various pathologies. Reiki remains unproven by western science. The Royal College of Nursing has accredited a Reiki course, but further scientific research is needed to determine its clinical effectiveness.
Ayurveda is an Eastern system of medicine that has been practised for over 5000 years. The relationship between occupations and health is a fundamental aspect of the ayurvedic health model. It could contribute a strong spiritual element to modern occupational therapy practice and may be more culturally appropriate for people with strong Hindu/Buddhist beliefs than modern occupational therapy models. The aim of this paper is therefore to introduce the ayurvedic model to occupational therapists that are unfamiliar with it. It describes assumptions underlying the ayurvedic model and related frames of reference that are relevant to occupational therapy. Yoga is the main occupational therapy intervention advocated by the model. The branches of yoga are described. Other traditional interventions are summarised but not described in detail. Sanskrit terminology has mostly been removed and concepts have been simplified for the ease of a general readership.
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