Posture and Body Mechanics

    There are several reasons why it is important to teach proper posture and body mechanics to a client with faulty posture and poor body mechanics. Posture refers to the relationship between different body parts. Poor posture can place extra stress on the spine causing back and leg pain. Impaired posture can also affect someone’s functionality. With proper posture and body mechanics, a client can reduce the risk of injury. Poor posture can also lead to an increase in energy expenditure, so it is important to correct improper posture in order to reduce the amount of energy used. As an OT, I think it would be very beneficial to teach a client the proper body mechanics in lifting an object during an interventions. I would teach the client to plan their movement before they execute the job. I would instruct them to lower their center of gravity, lift with the legs, keep a straight back, and keep abdominal muscles strong. Proper lifting is important for everyone to learn because of how frequently objects need to be in day-to-day life.  

Nervous System Response to Google's "Loretta" Commercial

link: https://www.youtube.com/watch?v=6xSxXiHwMrg

 

The “Loretta” Google commercial that was shown during the Super Bowl this year has stuck with me since I first saw it. No matter how many times I watch it, I always end up with a huge emotional response. Google did a great job creating an advertisement that integrated several parts of the viewers’ human nervous system to invoke a response. For my family, this commercial reminded us of my Papaw. Papaw had dementia and was given an Alexa device to help him navigate his reality. He frequently asked Alexa what day it was, what time it was, and even scores for certain sporting teams that he loved; this device also allowed him to call family members when he could no longer operate his cell phone. This device was even more utilized after my “Mia”, his wife, passed away a few weeks before he did. So, this commercial really impacts my nervous system by reminding me of the final weeks that he was with us. The amygdala is a structure in the brain that processes emotions and connects them with memories. As I watched this advertisement, I was processing an emotional exchange between the user of the device and what the device was showing him. The amygdala also allowed me to feel empathetic towards the man that was missing his wife. The hippocampus was also utilized while watching this commercial because it reminded me of my grandfather’s situation a little over a year ago and also brings up memories of my grandparents in general. The memories of my grandfather using his Alexa are tied heavily to emotions as it was hard to watch him grieve Mia while struggling with dementia. The thalamus also plays a role in processing the sensory aspects of viewing the advertisement. The sounds and sights of the commercial are processed by the thalamus and then sent to other parts of the brain for processing. Finally, the mirror neurons in my brain fired during this commercial as the pictures and memories of the couple are shown. Some of his memories make you chuckle and others make you cry. I have a huge emotional response each time I view this commercial due to its affect on my nervous system.  

The Man Down South

In the story that we read for class, a soldier makes a bet with an older man at a pool. The older man bets that the young man cannot light his cigar ten times in a row with his lighter. If the young man wins the bet, he gets to take the older man's car, and if he loses, the older man gets to cut his little finger off. In the end, the old man's wife stops them from completing the bet. 

If the soldier in the story had lost the bet, he would have lost his little finger on the left hand. The loss of his pinky finger would have a major impact on his grip strength as the little finger contributes a huge percentage on grip strength. He would see a decrease in his ability to strongly grip an object. One occupation that the man may lose function in is exercising. The young man is a solider, therefore, his physical fitness may be very important for his job. The soldier would need to go to therapy and receive services to increase grip strength in the rest of his hand to compensate for the loss of the little finger.

                                                                                                                                                   Although the soldier’s life would be more difficult without a little finger, the wife of the man in the white suit also probably has a hard time completing activities of daily living as she only has one thumb and a finger. Her ability to drive the Cadillac from the story could be greatly impaired without use of her fingers. It would be difficult for her to grip and guide the steering wheel, however, there is a modification that could help her driving. A steering wheel spinner could be introduced in order to allow the woman to continue driving her Cadillac despite the amputations of her fingers. With the assistance in driving, the woman would be able to run errands as needed.

Neurotransmitter: Epinephrine

Implicit Bias in OT

Implicit bias is the unconscious biases or attitudes towards particular groups of individuals. These biases can be stereotypes or beliefs of races, ethnicities, genders, sexual orientation, and so many more. It is important for OTs and OT students to understand implicit bias, because OTs work with people of all backgrounds. If an OT can identify and address their personal biases, his or her interactions with clients will improve. These biases towards clients could greatly interfere with giving exceptional therapy.

There are several steps that I can take in order to address my own implicit biases. People often do not want to admit that they may have biases towards groups, however, growth and change come from identifying your personal, unconscious beliefs. The first step I can take towards addressing my biases is by taking tests that identify them. I can then take my results and educate myself on groups that I may have biases towards or against in order to identify how to improve my understanding of these groups. Education is the best way to improve relations with other groups that I may not understand. Finally, I should strive to befriend people of all backgrounds. Having diversity in my friendships teaches me more about other groups that I do not personally identify with and can eliminate biases that I may have.

My biggest takeaway from this lesson comes from the COTAD podcast from Dr. Varlesha Gibbs. Dr. Gibbs discusses the importance of diversity in the field of OT. Diversity can be improved by showing OTs of all groups represented in leadership, in our educational programs, and even on our websites. It should be a common goal of all OTs to promote diversity within the field because it can greatly benefit our services to others. Diverse practitioners can relate better to certain clients and understand their daily occupations better! As a future practitioner, I value learning about different cultures, experiences, and lifestyles of groups that I do not identify with through collaboration with individuals of different backgrounds. I also learned from the podcast with Debbie Hall, the importance of being present with others. If I see a client or colleague of a different background struggling, it may be best just to be present with them even if I do not think that I can help them. When dealing with diversity, there can often be pain that I will never understand due to my racial or religious identification, so instead of prying, I can just offer my friendship and presence to listen to them voice their feelings. Being present could end up being the best therapy for someone.

The Relevance of Scapulohumeral Rhythm and How it Affects Range of Motion

The scapulohumeral rhythm is very important in movement. The scapula must move in order to maintain contact with the humerus. As the scapula rotates, the glenoid fossa also rotates to maintain contact with the head of the humerus to allow full abduction of the shoulder. As the scapula rotates upward, the optimal length-tension relationship develops from the abductor muscles. The scapulohumeral rhythm maintains the subacromial space in the shoulder and prevents impingement of the structures that pass beneath it. Scapulohumeral rhythm allows for the scapula and humerus to move together and can greatly affect the range of motion (ROM) measurements of the shoulder. This rhythm influences how these structures interact to produce movement at the shoulder. The collaborative movement between the scapula and humerus allows the movement of the shoulder to be distributed between two joints. The ratio for movement between the scapula and humerus is 2:1; for every 3 degrees of movement in the shoulder, 1 degree comes from the scapulothoracic (ST) joint and 3 degrees come from the glenohumeral (GH) joint. In order for the shoulder to move the full 180 degrees, 60 degrees of movement comes from the ST joint and 120 degrees comes from the GH joint. Without adequate scapulohumeral rhythm, ROM can be impaired and impingement of the subacromial space can occur.

Conceptual Model of Occupational Therapy

References

Lancaster, S. (2020). OT 425: Foundations of Occupation-Centered Practice, session 30 lecture [PowerPoint 

     slides]. Retrieved from https://blackboard.uthsc.edu/webapps/blackboard/content/listContent.jsp?

      course_id=_14521_1&content_id=_752345_1

O’Brien, J.C. & Hussey, S.M. (2018). Introduction to occupational therapy (5^th ed). Elsevier.

Biomechanics: Test Positioning

When testing range of motion (ROM), it is very important that a therapist palpate for bony landmarks. Palpating for bony landmarks allows the therapist to find the locations to place the goniometer; without finding these landmarks, the test results would most likely be inaccurate and unreliable. Another important reason to palpate for bony land marks is to increase inter-rater reliability in testing ROM. Finally, when palpating for bony landmarks, a therapist may find abnormalities in soft tissue or bones that could identify an issue affecting one’s ROM. It is also imperative to properly position a client when assessing ROM. The client should be in a position that allows full ROM and gives reliable results. Test positioning also plays a key role in manual muscle testing (MMT). Following protocol, one should screen all clients against gravity initially, however, the client may benefit from a gravity-eliminated plane. Correctly positioning a patient allows the therapist to grade the test accurately and allows the client to remain comfortable and safe. It is imperative for a therapist to place a patient’s joint in a midrange position for accurate results. Finally, gravity-eliminated (GE) positioning is relevant in MMT because it allows testing on a client who may not be able to tolerate the force of gravity. By placing a client in a GE position, the therapist can evaluate even small muscle contractions.

Biomechanics Blog 1: Reaching for Food

Each day, I reach into the refrigerator to grab food. I start with my arm in a relaxed position by the side of my body. This position is similar to anatomical position, but my hand faces towards my thigh instead of being in a supine position. In the final position, I flex my shoulder joint, extend my elbow and wrist joints, and flex my MTP, PIP, and DIP joints to grasp the item. These actions occur in the sagittal plane and about the coronal/frontal axis. The osteokinematic movement of the shoulder joint is flexion of an open kinetic chain from a relaxed, more extended position, and it comes from the concentric (isotonic) movement of the prime movers. These prime movers are the deltoid, coracobrachialis, and pectoralis major muscles. The arthrokinematics movement at the shoulder joint occurs between the glenoid fossa (concave) and the head of the humerus (convex). The head of the humerus rolls superiorly and glides inferiorly on the glenoid fossa.

Health Literacy in Occupational Therapy

Health literacy is a vital part of the outcome of a client's overall health. It may seem obvious that one's ability to access, understand, and implement intervention into their lives will affect their health, but the not-so-obvious part of health literacy is accurately gauging an individual's ability to understand the information surrounding their health. It is important that practitioners and clinicians take several steps to ensure that their patients and clients understand exactly what is necessary to improve their health. Professor Flick shared that what is performed in a hospital or treatment facility only contributes a very small impact on one's overall health, and a huge impact comes from the client's determinants of health such as genetics, behavior, socio-economic status, education, and health services. It is important as practitioners to try to understand a client's situation as best as you can. In the podcast with Dr. Will Ross, he emphasizes the importance of empathy when working with individuals in a healthcare setting. You need to understand that there may be many factors as to why your client is not taking their medicine correctly or performing at-home exercises to support their intervention. The client may not be non-compliant but instead not properly informed on their health and how to improve it. 

When prescribing intervention methods, it is important to put yourself on your client's level. This means presenting the information in a way that best suits the client. Determining the client's ability to understand this information can be difficult for a practitioner, so it is best to be sensitive when making this judgement. Many clients may be insecure about their education on their health and may not openly voice their misunderstandings. Professor Flick shared a video that mentioned the importance of searching for clues in clients. If the client seems forgetful about their health, has a hard time filling out paper, or regularly misses appointments, they may not have proper access to resources imperative to their health or situation. As a practitioner, I will take this understanding into consideration and make accommodations to ensure that my clients are educated. I will make it a priority to make sure that my clients understand their health status as best as I can and find resources to educate them if I am unable to do so with my knowledge and experience. I will use several methods for educating my clients on their health interventions such as providing demonstrations with exercises and activities and have them "teach me" to show that they understand. I will find ways to provide pictures or videos of exercises to my clients and also use simple terms when educating them. It is vital that healthcare providers promote health and health literacy in effective ways for each individual client.

OT and ADHD

When people think about clients that occupational therapy (OT), their minds may go to people with autism, people that have suffered strokes, or people who have had surgery. Many people overlook the importance of occupational therapy with children with attention deficit hyperactivity disorder (ADHD). I listened to a podcast by Jennie Friedman, a coach for dealing with ADHD, with Dr. Lancaster as her guest about the impact of OT on those with ADHD. In the podcast, Friedman admits that she was once unaware of how significant OT intervention can be with this population!

Dr. Lancaster talked about a specific client of hers that received OT intervention to best manage her ADHD symptoms. The client was a kindergartener that often got ridiculed for her inability to sit still. Her teacher often took the girl's constant self-stimulating activities as the girl purposely acting out. Once referred to an OT evaluation, the client was put on a "sensory diet". Previous to listening to this podcast, I had never heard about a sensory diet and could not imagine what exactly this term meant. A sensory diet is a schedule of time (usually a few minutes) that a child is able to move, exercise, or stimulate their sensory needs in a  meaningful way. This sensory diet aides in a child's ability to control impulses to self-stimulate and contributes to better concentration in class. I chose this podcast because I have not seen an OT work with a child with ADHD and wanted to learn more about how intervention can help this population. I am very interested in learning more about this area of OT and have even considered purchasing the book Dr. Lancaster mentions as the "sensory bible for OTs".

Friedman, J. (Producer). (2016, November 16). Can occupational therapy help with ADHD [Audio podcast]. Retrieved from http://www.seeinadhd.com/occupational-therapy-help/