September 11, 2012

Upcoming OT Events

..And I'm back! 

Sincere apologies folks for not having updated the blog in a long while. There are a few great topics I have been working on to post, however before we get to that I just want to give everyone an update on what's happening in the world of Occupational Therapy. Below are some very important events taking place in the near future. Please get involved and help spread our profession of OT!


Join AOTA in helping others Live Life To Its Fullest by avoiding the pain and injury that can come from heavy backpacks and bags. Learn safety tips to stay protected from back pain throughout life and teach others how to properly choose, pack, lift, and carry various types of bags.

Falls Prevention Awareness Day - September 22, 2012 
According to AOTA, falls are a leading cause of decreased independence, disability, and even accidental death among older adults. Occupational therapy practitioners can play an essential role in reducing falls by addressing the multiple physical, environmental, and cognitive factors that can lead to a fall (www.aota.org).  Visit AOTA.org to learn ways you can increase the general public's knowledge about the role of OT in Fall Prevention.

AOTA Capitol Hill Day - September 24, 2012
Make the Voice of Occupational Therapy Heard on Capitol Hill.  Register Today! 

World Occupational Therapy Day - October 27, 2012
Promoted by the World Federation of Occupational Therapists (WFOT), World Occupational Therapy Day is an opportunity to increase the visibility of the profession and promote the activities of WFOT nationally and internationally. 

2012 AOTA/NBCOT National Student Conclave - November 9-10, 2012, Columbus, OH
As an occupational therapy student and soon-to-be new practitioner, you have already started setting up the field goals for your career. The 2012 AOTA/NBCOT National Student Conclave is a terrific opportunity for you to know how to score those points and be an OT pro! Get Involved! 

AOTA 93rd Annual Conference & Expo  - April 25-28, 2013, San Diego, CA
Connect to over 5,000 ocupational therapy professionals and over 350 exhibitors at AOTA's 93rd Annual Conference & Expo in San Diego, California! Click for more information.

brOT Movement was created by students from Thomas Jefferson University following the AOTA Conference in 2011, as a unique way to reference themselves as males in the pre-dominantly female Occupational Therapy profession. Their mission is "to ensure the realization of the American Occupational Therapy Association's (AOTA) centennial vision, by creating a widely recognized, diverse and powerful profession." brOT accepted the challenge by AOTA President Florence Clark to create and support movements seeking to fulfill the centennial vision. So, get involved! Join the Movement! 

April 01, 2012

Toolkit of All Toolkits

OCCUPATIONAL THERAPY FIELDWORK TOOLKIT

A list of important items for all your fieldwork and professional needs. 

1. Range of Motion and Degrees (MUST HAVE!)



 2.  Range of Motion (Angles)




3. Manual Muscle Testing Grading


5
Normal
subject completes ROM against gravity with maximal resistance
4+
Good Plus
completes ROM against gravity with moderate-maximal resistance
4
Good
completes ROM against gravity with moderate resistance
4-
Good Minus
completes ROM against gravity with minimal-moderate resistance
3+
Fair Plus
completes ROM against gravity with only minimal resistance
3
Fair
completes ROM against gravity without manual resistance
3-
Fair Minus
does not complete the range of motion against gravity, but does complete more than half of the range
2+
Poor Plus
is able to initiate movement against gravity
2
Poor
completes range of motion with gravity eliminated
2-
Poor Minus
does not complete ROM in a gravity eliminated position
1
Trace
muscle contraction can be palpated, but there is no joint movement
               0
Zero
patient demonstrates no palpable muscle contraction


4. Levels of Principal Dermatomes


5. Brachial Plexus

6. Spinal Segments


7. Spinal and Autonomic Nerves


8. Peripheral Nervous System


9. Developmental Milestones


10. Understanding EKG


11. Possible Nerve Involvement Weakness with Manual Resistive Test


12. Joints, Associated Motions, Plane of Motion, Axis of Rotation, and Average Range of Motion


13. Arrhythmias 


What are the different types of arrhythmias?
An atrial arrhythmia is an arrhythmia caused by abnormal function of the sinus node, or by the development of another atrial pacemaker within the heart tissue that takes over the function of the sinus node.

A ventricular arrhythmia is an arrhythmia caused by abnormal function of the sinus node, an interruption in the electrical conduction pathways, or the development of another area within the heart tissue that takes over the function of the sinus node.

Arrhythmias can also be classified as slow (bradyarrhythmia) or fast (tachyarrhythmia). "Brady-" means slow, while "tachy-" means fast.

Listed below are some of the more common arrhythmias:
Atrial Arrhythmias
Ventricular Arrhythmias
sinus arrhythmia - a condition in which the heart rate varies with breathing. Sinus arrhythmia is commonly found in children; adults may often have it as well. This is usually a benign condition - there may be no symptoms or problems associated with sinus arrhythmias.
premature ventricular contractions (PVCs) - a condition in which an electrical signal originates in the ventricles and causes the ventricles to contract before receiving the electrical signal from the atria. PVCs are not uncommon and often do not cause symptoms or problems. However, if the frequency of the PVCs increases to several per minute, symptoms such as weakness, fatigue, dizziness, fainting, or palpitations may be experienced.
sinus tachycardia - a condition in which the heart rate is faster than normal for the child's age because the sinus node is sending out electrical impulses at a rate faster than usual. This condition may cause symptoms such as weakness, fatigue, dizziness, or palpitations if the heart rate becomes too fast to pump an adequate supply of blood to the body. Sinus tachycardia is often temporary, occurring when the body is under stress from exercise, strong emotions, fever, or dehydration, to name a few causes. Once the stress is removed, the heart rate will usually return to its usual rate.
ventricular tachycardia (VT) - a condition in which an electrical signal is sent from the ventricles at a very fast but even rate. If the heart rate is sustained at a high rate, symptoms such as weakness, fatigue, dizziness, fainting, or palpitations may be experienced.
sick sinus syndrome - a condition in which the sinus node sends out electrical signals either too slowly or too fast. There may be alternation between too-fast and too-slow rates. This condition may cause symptoms if the rate becomes too slow or too fast for the body to tolerate.
ventricular fibrillation (VF) - a condition in which an electrical signal is sent from the ventricles at a very fast and erratic rate. As a result, the ventricles are unable to fill with blood and pump it out, thus causing a very low blood pressure and symptoms such as weakness, dizziness, fainting, or loss of consciousness.
premature supraventricular contractions or premature atrial contractions (PAC) - a condition in which the sinus node or another pacemaker site above the ventricles sends out an electrical signal early. The ventricles are unable to respond to this signal because they are still in the contraction phase.

supraventricular tachycardia (SVT), paroxysmal atrial tachycardia (PAT) - a condition in which the heart rate speeds up due to a series of early beats from the sinus node or another pacemaker site above the ventricles. PAT usually begins and ends rapidly, occurring in repeated periods. This condition can cause symptoms such as weakness, fatigue, dizziness, fainting, or palpitations if the heart rate becomes too fast.
atrial flutter - a condition in which the electrical signals come from the atria at a fast but even rate, thus causing the ventricles to contract faster and increase the heart rate. The heart rate maintains an even rate as it beats faster. When the signals from the atria are coming at a faster rate than the ventricles can respond to, the EKG pattern develops a signature "sawtooth" pattern, showing two or more P waves between each QRS complex. The number of P waves between each QRS complex is usually a constant number and is expressed as a ratio (i.e., a two-to one atrial flutter means that two P waves are occurring between each QRS).
atrial fibrillation - a condition in which the electrical signals come from the atria at a very fast and erratic rate. The ventricles contract in an erratic manner because of the


*References:
1. Visual Odyssey, 2001
2. Advance OT Practictioners
3. Netters, 2010
4. Pedretti, 2010

February 26, 2012

Occupational Therapy Explained...Bollywood Style!


You Said It! - Occupational Therapy! This is a Mini Movie created by vaithirehab1 (YouTube handle) with an intention to make the general public aware about Occupational Therapy and promote Occupational Therapy profession in India.


February 09, 2012

Occupational Therapy Terminology

Or as I'd like to call it, "OT Jargon". 

The first time many OT's open their first client chart, they become cross-eyed. I've come across at least 3 different ways to abbreviate the word "independent" and have written progress notes and discharge summaries ad nauseum. 

There are all sorts of abbreviations and symbols never seen before. It takes a lot of time to get used to but at the end you too can became familiar with "c/o, CBR, CXR, EOM, LOS..." and many more commonly used acronyms. 

Some time ago, I figured I should start making a list of all the symbols, abbreviations, and acronyms that I have come across and others that I might see in the future. Over the course of a few months and with the help of the Quick Reference Dictionary for Occupational Therapists by Karen Jacobs, EdD, OTR/L, CDE, FAOTA, I have compiled a list of useful terminology that might be beneficial to OT students, OTAs, OTRs, 
and even PTs.












(Credit for the above data goes toJacobs, K. (1998). Quick Reference Dictionary for Occupational Therapists. Slack Inc.

February 08, 2012

Falls and Fall Prevention


One of the very first lectures I attended when I started graduate school was on falls and fall prevention. Since then, we have had numerous lectures on the topic. I’m starting to think the topic might just be something to make note of as OTs.  So, here’s a little synopsis on what I’ve managed to retain from those lectures, followed by a list of appropriate Assessments (click on the name to direct you to the website).

Definition of fall: “A subject’s unintentionally coming to rest on the ground or on some other lower level, not as a result of major intrinsic event, for example, stroke or syncope or over whelming hazard that would result in a fall by most young, healthy persons” (Tinetti, et. Al., 1988). 33% of community dwelling elders, age 65 or older, fall at least 1 or more times a year, and the frequency increases with age. Falling leads to loss of mobility and independence; it affects all body systems.

As occupational therapists, some things to take into consideration when working with someone at risk of falls are height of fall, impact surface (concrete, rug, linonieum), shock absorbers (loss of subcutaneous fat, decreased muscle bulk), decreased protective reflexes (slow righting reflexes), and psychological injury.

There are other risk factors such as: age related changes (decreased visual acuity), balance (increased postural sway), musculoskeletal (forward shift in center of gravity), cognitive (changes in attention load for gait), chronic diseases or extrinsic factors such as slippery surface, obstacles in pathways, and poor illumination.

After the risk factors have been considered, a fall risk assessment including the patient’s physical, mental, and environmental aspect needs to be administered, as all three result in poor quality of life.

Here is a list of most of the falls assessments I am familiar with (Please suggest any other ones I might have missed):

- refers to the degree of confidence a person has in performing common activities of daily living without falling (Tinetti, Richman, & Powell, 1990). Also, refer to the following website:

-  assess the role of fear of falling in activity restriction (Lachman, M. E., 1998).

- evaluate day-to-day behaviors related to falls in older people. Also, refer to the following website:

4. The Safety Assessment of Function and the Environment for Rehabilitation (SAFER)


*need to purchase

*need to be certified to administer

8. Community Participation Indicators Version V 4.0





13. Get Up & Go (Tinetti)

- Tinetti Gait and Balance Assessments
- Foam and Dome Test



A few other great resources I’ve come across:
* Geriatric Examination Tool Kit provided by Missouri.edu. The kit includes assessment of gait, balance, fatigue, vision, manual muscle test, pain, reaction time, vestibular and transfers.


Sources:
-Clemson, Cumming & Heard, 2003

-Lachman, M. E., Howland, J., Tennstedt, S., Jette, A., Assman, S., & Peterson, E. (1998). Fear of Falling and Activity Restriction:  The Survey of Activities and Fear of Falling in the Elderly. Journal of Gerontology:  Psychological Sciences, 53B, P43-P50.

-Podsiadlo, D., Richardson, S. (1991). The timed ‘Up and Go’ Test: a Test of Basic Functional Mobility for Frail Elderly Persons. Journal of American Geriatric Society 39:142-14

-Rosemary Bakker, MS, ASID. Weill Medical College of Cornell University. Division of Geriatrics and Gerontology