“Occupational Therapy heals the body, mind, and spirit,” and “We may not have it all together, but together, we have it all,” are messages on two well-crafted wooden signs that hang in Walter Reed’s Occupational Therapy (OT) Outpatient Clinic in the America Zone (Bldg. 19).

Below the signs, Walter Reed OT team members take patients through various exercises and therapies to help them recover and improve their functional abilities to perform daily tasks and activities, or “occupations.” Many of the patients are service members with a goal of returning to their military units for duty.

Walter Reed’s OT is one of the largest in the nation, according to U.S. Army Col. Enrique Smith-Forbes, chief of OT in the Department of Rehabilitation. He explained sections of the service include the OT/Military Advanced Training Center, OT/Orthopedic Hands and Upper Extremity, OT/Inpatient, Ergonomics, Assistive Technology, Low Vision, OT/Traumatic Brain Injury and Behavioral Health, Sexual Intimacy, Adaptive Sports, Recreational Therapy, Firearms Training Simulator, and the Occupational Therapy Doctorate (OTD) Internship.

According to the Defense Centers for Public Health at Aberdeen Proving Ground, Maryland, service members experience 25 million limited duty days annually because of injuries, most of which are musculoskeletal injuries (or MSKI) requiring OT intervention. “When on limited duty status, a service member may not be able to maintain required training activities and may not be deployable. As a result, the combat readiness of the U.S. military forces is substantially reduced by MSKI,” explained Veronique Hauschild, a senior researcher at the Defense Centers for Public Health.

Hauschild added that for many MSKI, especially those affecting the upper extremities, “unique recovery treatments are most effective when tailored to the individual’s injury as well as their specific work and personal activities.” Those treatments are provided by trained OTs, such as those at Walter Reed.

Smith-Forbes said Walter Reed’s OT sections treat a variety of injuries including those caused by repetitive motions and impacting or preventing range of motion. OTs work with patients impacted by arthritis, post-traumatic stress, depression, Parkinson’s disease, muscular dystrophy, multiple sclerosis, cerebral palsy, neuropathy, complex regional pain syndrome, ALS and a number of other injuries and conditions. OTs also work with patients who have had strokes, traumatic brain injuries, spinal cord injuries, need in-home therapies, and help with low-vision challenges.

“In OT MATC, we evaluate and develop treatment plans for active-duty service members and Department of Defense beneficiaries with severe limb trauma [and] amputations,” Smith-Forbes explained.

“We see a variety of upper extremity soft-tissue injuries, such as tendonitis and carpal tunnel, and post-surgical cases [including] fracture fixations, tendon repairs [and] replantation surgery in the OT/Orthopedic Hands and Upper Extremity section,” he added.

OT/Inpatient provides therapy at the patient’s bedside or in the inpatient OT clinic, where “gym-based OT interventions for post-operative and critically ill patients focus on safety, early mobilization, and self-care and activities of daily living (ADL) to prevent complications and accelerate recovery,” Smith-Forbes continued.

“We [also] provide ergonomic assessments, posture and body mechanics training, workplace modifications, pain management, stretching and strengthening exercises, education, and training,” he added.

Assistive Technology OT provides assessments, evaluations, and assistance to patients for the use of devices of daily living, including utensils for eating, and those for hygiene such as toothbrushes, in addition to items used for smart home systems or mobility aids, Smith-Forbes shared.

Low Vision OT provides functional vision assessments and assistive technology training, such as the use of vision tools, including magnifiers and screen readers.

The OT TBI and Behavioral Health section assists patients with cognitive rehabilitation, motor skills coordination, activities of daily living, and more, while sexual intimacy OT evaluates and treats patients for neurological diagnoses, behavioral health diagnoses, sexual activity impairments and assistive technology needs.

Smith-Forbes explained Walter Reed’s OTs use adaptive sports and recreational therapy “to ensure a holistic approach to patient recovery, using structured activities to promote and enhance physical, emotional and social recovery.”

The Firearms Training Simulator, or FATS, is integrated into service members’ care plans to assess weapons shooting skills, helping many to return to duty, Smith-Forbes added.

“OT has been an extremely rewarding career,” shared Cynthia Lambert, supervisor of the OT Inpatient Section. “It’s very diverse and has allowed me to work in various settings. I believe the best way that I can say thank you [to service members] is helping them and their family members maximize their functional independence while they are recovering from various injuries or health concerns.”

“We make a difference in getting people back to those things that they believe are important to them,” added Navy Lt. Sophia Jurado, assistant service chief in OT. She added that she was introduced to OT while working as a physical therapy (PT) technician. She now works in Walter Reed’s Outpatient OT Hand Clinic, evaluating and treating various levels of upper extremity diagnosis. While PT focuses on restoring and improving a patient's ability to move their body following an injury or illness, OT focuses on improving the patient's ability to perform the activities of daily living.

Joan Margulies has been a licensed OT for 35 years and also specializes in upper extremity injuries. “I enjoy watching patients progress through the rehabilitation process. The transformation of my patients is inspiring for me,” she added.

Josef Butkus, OT supervisor for Outpatient Polytrauma and Amputee Care in the MATC, agrees, adding, “Seeing people learn to take on immense challenges, slowly find the keys to success, and being a resource to assist them on that path is very rewarding.”

“Frequently, we first meet patients after the worst trauma of their lives, and they slowly find steps to return to a full and active lives,” Butkus shared.

“We have the best patients and staff anywhere,” Butkus added. “I feel like the patients we work with have great resilience and are great problem solvers. Seeing patients return to being active and competitive is incredible. The entire medical team is outstanding and are excellent communicators to manage incredibly complex medical challenges,” he said.