Energy conservation techniques (ECTs) are also referred to as work simplification techniques, and both terms are very much within the realm of occupational therapy practice.
In order to clear up a common misconception, let’s state right off the bat that promoting ECTs is not synonymous with promoting the “art of laziness.” Rather, energy conservation techniques allow for users to redistribute efforts to complete tasks that are most important to them.
Duke University’s Department of Physical Therapy sums up energy conservation perfectly:
[Energy conservation] is the way activities are done to minimize muscle fatigue, joint stress, and pain. By using your body efficiently and doing things in a sequential way, you can save your energy, remain independent, and be less frustrated by your illness when the energy you have lasts throughout the day (2017).
What we gather from this is that energy conservation techniques – if taught correctly – promote independence.
This is exactly what occupational therapy is all about.
Educating on Energy Conservation Techniques
There are many energy conservation techniques that you can teach your patient to maximize their energy reserves.
Here is a general list of ideas you can work on with your patient:
- Educate your patient on pacing during the task and taking rest breaks throughout the day when they feel fatigued.
- Discuss planning and prioritizing the day around completing the most important tasks first, as well as the importance of not over-planning the day.
- Work with your patient to modify or simplify difficult tasks.
- Discuss delegating tasks as needed to family members, friends, or hired caregivers.
- Educate patients on the use of adaptive equipment during ADLs.
- Discuss completing ADLs and IADLs in the seated position. (It is useful to have chairs in every living area to take breaks.)
- Provide education and visual handouts on pursed lip breathing to complete as needed.
In addition to the previously mentioned strategies, there are seven common medical conditions (not all inclusive) which may require energy conservation techniques:
1. Multiple Sclerosis
Multiple Sclerosis (M.S.) is probably the most common discussion piece when referring to ECTs in school – and rightfully so. Depending on the type of M.S., even the most subtle movements cause infinite fatigue and/or pain. The Multiple Sclerosis Society of Canada sums up ECTs very well in their document titled “Some Guidelines on Saving Energy.”
OTs can offer great insight for patients using these types of educational handouts in order to assist them in redesigning their entire lifestyle as the disease progresses (or as it remits depending on the type).
2. Acute/Chronic Respiratory Failure
Energy conservation with respiratory patients often boils down to conserving oxygen for the brain. Frequently, these patients are on an oxygen supplement either daily or as needed. Over-expenditure of physical movement can result in oxygen desaturation (unsafe numbers dropping below 90% saturation).
Sometimes oxygen desaturation can be asymptomatic. Other times, it will result in increased fatigue, discoloration of the skin, nausea, and dizziness. When this happens, it is essential for the person to sit with their back supported or lay down with their head slightly elevated. In combination with ECT education, OTs can also promote the consistent use of a pulse oximeter so that the patient can track when they are doing too much and need to cut back.
3. Congestive Heart Failure and Other Cardiac Conditions
Patients with a history of cardiac dysfunction or congestive heart failure will come with a set of precautions as ordered by their primary physicians. Lifting precautions are the most common (i.e. not lifting anything above the head, lifting less than 5-10 lbs).
OT comes into play to assist in redesigning the individual’s lifestyle. If the patient is accustomed to household and yard chores that call for heavy lifting (moving boxes, carrying groceries, shoveling dirt, mowing the lawn, etc.), then the patient and the OT work together to simplify those chores or eliminate tasks that are unnecessary.
4. Amyotrophic Lateral Sclerosis (ALS)
Often referred to as “Lou Gehrig’s disease”, ALS is a progressively crippling disease that eventually takes the individual’s life. Unfortunately, it mercilessly takes away their quality of life for up to several years before death occurs. OT has a vital role throughout those years as the symptoms change for the patient.
At first, it may be simply educating the patient about ECTs and fall prevention which includes simplifying or eliminating physical activities that fatigue the body and compromise standing balance. As the disease reaches the end stages, it may be about preserving physical energy in order for the patient to breathe efficiently and stay awake for visitors or activities in sitting.
5. Hospice/Palliative Care Patients
Generally, hospice patients are given about 6 months or less to live. Common diseases include a decline in function due to age, malignant cancers, ALS, dementia, etc.
In summary, the patient and their caregivers have the understanding that the patient has an expectedly short time to live and do not generally expect functional progress. OTs working in hospice care would design treatment plans to aid patients in using ECTs to engage in only tasks that are most meaningful to them to promote a higher quality of life.
6. Repetitive Use Injuries
With repetitive use injuries, the goal of energy conservation is to minimize pain and movement to promote the healing of tissue and/or bone. Health care providers such as nursing staff are often subject to repetitive use injuries because of the physical strain of transferring patients.
OTs who work in the same facilities can provide transfer training and body mechanics education to prevent unnecessary injury. However, pain and injury can still occur despite the training. When that happens, ECTs and work simplification are the next best approaches (using mechanical lifts, 2-person transfers, scheduling transfers with patients ahead of time, etc.).
7. Complex Regional Pain Syndrome
Similar to repetitive use injuries, ECTs for complex regional pain syndrome would be to eliminate unnecessary pain. In this case, the pain is due to the chronic pain condition (lasting greater than six months) that most often affects one limb (arm, leg, hand, or foot) usually after an injury (Complex Regional Pain Syndrome Fact Sheet).
Because the condition is so vast in what portions of the body are affected and when it is a complex situation fitting for OTs to apply ECTs. The OT usually works with the patient in order to prevent unnecessary exacerbation of pain by identifying tasks and physical intensities that could set the pain off.
Energy conservation techniques are an important part of OT for patients with these conditions in these settings. I hope this post helped you get a good grasp on how and when you can provide your patients with the appropriate ECTs.
For more information and for some great educational content that you can give to your patients, be sure to visit the following sites: