Historically occupational therapists have planned treatment programs requiring activity involving different and diverse amounts of energy use by patients. Also, many energy saving methods and devices, now commonly applied by therapists, were developed empirically to make activities possible for paralyzed patients. For the energy deficient patient physiological concepts of energy may not apply because both psychological and sociological factors may influence how individuals convert food to energy for maintenance of homeostasis and musculoskeletal activity. Energy conservation measures identified with occupational therapy may be supplemented with Brief, Isometric, Maximal Exercise (BRIME) to enhancec energy reserves, and reflex mechanisms may also be used to facilitate movement for the energy deficient person. The older person with low energy but without serious medical problems may need thorough investigation of life style and environment in order to plan appropriate occupational therapy intervention.