A COTA in an outpatient clinic is working with a client with bilateral primary adhesive capsulitis. The OTR's assessment revealed interrupted sleep patterns and decreased ability to perform ADLs because of pain. ROM is close to functional but painful throughout the arc. What is the PRIMARY functional focus of occupational therapy intervention?

• A. ADL modifications and adaptive equipment education for grooming, bathing, and dressing
• B. Electrotherapeutic modalities followed by stretching exercises to facilitate increased ROM
• C. Rest, ice, elevation, and compression (RICE) to facilitate functional return
• D. Intra-articular corticosteroid injections to allow for better tolerance to stretch

Answer: (A)

The main issue being addressed is enabling the client to perform daily activities despite shoulder pain and limited movement. When ROM is near functional but painful and sleep is disrupted, the most effective OT approach is to help the person participate in daily tasks by modifying how those tasks are done and by using adaptive equipment. This reduces pain during grooming, bathing, and dressing, promotes independence, and supports safer, more efficient performance of ADLs in the presence of adhesive capsulitis.

In this scenario, the focus is on practical adaptations—built-up handles for easier grip, long-handled tools, sock aids, dressing sticks, and similar devices, plus strategies like task sequencing, pacing, and energy conservation. These interventions directly address the client’s functional needs and help maintain quality of life while pain management and ROM goals are addressed in other parts of care if appropriate.

Modalities, stretching, or injections are valuable components of broader care but fall outside the primary functional domain for OT here. RICE is more relevant to acute injuries and is not the OT-focused path to enabling daily functioning in this context.