neuro post 1

For this assignment, I chose to watch a movie called The Upside. This movie is about Philip Lacasse, a man with quadriplegia, who hires Dell Scott, a homeless man, to be his life auxiliary. Dell is a successful billionaire who unfortunately suffered a terrible accident while paragliding. The accident left him paralyzed from the neck down, requiring 24/7 care. I was very impressed by the movie because it displayed so many honest emotions from Philip about how he copes with his new life. He requires assistance with every aspect of his life. For example, he needs someone to help him with feeding, dressing, eating and showering. However, he does have a little independence when he is in his wheelchair because he is able to control it with his chin. Dell and Phillips relationship inspired me because they both had to let each other into their lives for the well-being of both. Dell relied on Phillip for his pay check and Phillip relied on Dell to be his care-taker. Towards the end of the movie, Phillip goes on a date but ends up getting put in the friend zone because of his disability. This completely devastated him and ultimately led to Phillip firing Dell and pushing everyone he cared about away. However, Dell does not give up on Phillip and they remained friends for life. I was empathic for Phillip throughout the movie because I put myself in his shoes and I could not imagine dealing with that amount of life change.

              The reason I chose to watch this movie for my first neuro note is because I wanted to further my knowledge on spinal cord injuries. As an occupational therapist, I am going to be working with people with a variety of spinal cord injuries. Over the past couple of weeks, I have learned how different every injury is. Spinal cord injuries not only change a person’s life physically but mentally as well. I recommend people watch this movie because it gives an in-depth idea of what people struggle with everyday when they are paralyzed. Depression is extremely common because of how different their life changes and how reliant they must be on other people. In the movie, Phillip struggles with depression and eventually tries to push every one that is close to him away. I think that part of the movie was important because of how severe his depression became. However, his friends knew they needed him then more than he ever had before. This is where an occupational therapist would come into play. As OT’s it is our job to help clients be as successful as possible in their daily life occupations. As for Phillip, an OT could have helped him find a reason that made his life worth living again. Overall, this movie was fantastic and I recommend everyone to watch it!

Burger, N. (Director). (2017). The Upside [Video file]. United States: Escape Artist. Retrieved July    22, 2019.

hierachy of mobility skills

The order for restoring confidence in mobility is somewhat complicated to understand but after careful review it makes sense the order. The order goes as follows: bed mobility, mat transfer, wheelchair transfer, bed transfer, functional ambulation for ADL, toilet and tub transfer, car transfer, functional ambulation for community mobility, and community mobility and driving. I understand why driving is the highest on the hierarchy because driving requires great attention span. When someone gets behind the wheel, their life is put at risk and the people around them. Also, it makes sense for bed mobility to be at the very bottom because it is the basis for doing everything else. The first thing a person does in the morning is getting out of bed. A person must get out of bed to operate a vehicle. I agree with this approach. I think it makes a lot of sense for the order it is in because each step builds on each other.

              The labs we have done where we are performing transfers have taught me a lot. It would be very stressful to not be able to move by myself and I am grateful the labs are teaching me to help people who cannot move by themselves. I think it is very cool the different types of transfers we have learned. Before lab, I did not realize there were specific ways to transfer a client, especially when they have a spinal cord injury. I am looking forward to becoming an OT and I believe what I have learned so far about the transfers will help me be the best OT as I can be!

blog post 9

Assistive devices are very beneficial to clients because they aid in their mobility. It is important to properly fit a client for an assistive device for many reasons. If the assistive device does not properly fit, then it could hurt the person to use. Also, if the assistive device is not properly fitted to the specific person then it could affect their balance and posture. For example, if a person is using a walker that is 4 inches too short then they would have to hunch over to use the device. In the long run, the walker would hurt the client more than it would be beneficial.

To properly fit a client for a cane the client should stand straight with their arms directly by their side. The handle needs to be in line with the wrist crease, ulnar styloid or the greater trochanter. For the axillary crutches and lofstrand crutches the hand grips need to be in line with the wrist crease, ulnar styloid or greater trochanter when the arms are at rest by the client’s side. The same goes for a platform walker, with the handgrips in line with the ulnar styloid, wrist crease or the greater trochanter when the arms are resting at the client’s side. The same goes for the rolling walker. When fitting for a cane or walker, the elbow needs to be relaxed, and flexed 20-30 degrees. To fit for crutches, the axillary will rest roughly 5 centimeters below the floor of the axilla. For each assistive device, it is important the client’s shoulders are relaxed and not elevated to get a proper fit. Loftstrand crutches are often used for people with long-term disables, whereas platform crutches are often used right after an injury.

proper posture and body mechanics

Proper posture and body mechanics are important for a person to practice for many reasons. Posture is defined as relative alignment of body parts. One of the reasons it is important for a client to practice proper posture and body mechanics is because it protects the spine from injury. The spine is crucial for a person because it provides mobility, stability, transmits and absorbs forces and protects the spinal cord. Another reason proper posture is important is because it prevents less fatigue. When a person does not sit or stand properly it overworks the muscles causing more strain, resulting in excess tiredness. Also, correct use of pushing, pulling and lifting are much easier for a person who practices good posture. Lastly, poor posture can result in abnormal development of bone, muscle, tendons, ligaments, and other soft-tissue. These reasons, among many others, are important to express to a client.

During an intervention with a client, I would first find out how often they sit or stand during an average day. If the client sits in a chair most of the day, I would advise they buy a chair that does not have a back to it, also known as unsupported sitting posture. For example, they could buy a balanced yoga ball so that it would require their back to sit straight up. This allows an open angle between the pelvis and thigh. If the client stands most of the day, I would go over proper ways to stand with correct posture. One way is to stand straight with the shoulders pulled backwards. Also, standing with the arms hanging naturally on the sides of the body will better a person’s posture. I would demonstrate these stances with the client, so they are aware of what it is supposed to look like. Also, I would let the client know every time they are either sitting or standing with poor posture, so they will become self-aware.

Man of the south

In the story “Man of the South”, an old man bets against a young soldier that he can light his cigarette 10 times in a row while running. If the soldier were the lose the bet, the old man would cut off his pinky finger and if he were to win the bet he would win the old man’s Cadillac. Assuming the soldier lost the bet, he would face many challenges regarding daily occupations going forward. Many believe the pinky finger is not very important, however it is significant to daily occupations such as fine motor skills and grip strength.  Since the young man is a soldier, he is required to perform many physical activities that require use of all his fingers to perform efficiently. Some physical activities the soldier must perform are pushups, pull ups and operating a gun. The main problem the soldier will face if he loses his pinky finger is grip strength. The pinky finger is incredibly important for grip strength and for opposition. The fingers align towards the scaphoid bone when making a fist, which will allow for a stronger grip to occur.

The main occupation the soldier would struggle with after losing his pinky finger would be operating a gun. Operating a gun requires tremendous grip strength. If the soldier is not able to hold the gun efficiently enough then his accuracy of his shot could be thrown off, resulting in possibly his life or someone else around him.

              One adaption the soldier would have to get used to is operating the gun minus his pinky finger. To maintain an accurate shot, the soldier would have to put in extra practice to get used to working the gun without his pinky finger. He would need to practice exercises for his fine motor skills and grip strength. Luckily for him, the middle finger is the most important part of holding the gun because that is the finger that pulls the trigger. However, the other fingers are important to because they help stabilize the gun for accurate shooting. The soldier would need to go to a shooting range and practice until he feels comfortable enough to work the gun around other people.

AOTA vision 2025

During the lecture today, we learned about the AOTA Vision 2025 and how we can relate it to public health. The AOTA Vision 2025 is designed for occupational therapy to maximize health, well- being and a client’s quality of life through communication that facilitates participation in everyday living. There are multiple important terms and concepts regarding this vision, with some of the concepts being health promotion, public health, social determinants, etc. I found the lecture very interesting today because it informed me about what exactly the vision entails. One thing I was shocked about was the video profession Flick showed regarding the clients that had a low reading level. I could not believe that clients go through with operations and sign documents without knowing what they are signing or doing to their body. I think it is very important to go over documents beforehand with our clients so that they are aware of everything that is about to happen to their bodies. Overall, I am grateful for the lecture and feel more informed about how to help my clients live their best quality of life possible.

blog post 3

The scapulohumeral rhythm is defined as the ratio of movement between the scapula and the humerus. This interaction is important for optimal movement of the shoulder. It is crucial for the scapula and humerus to work together. A dysfunction will occur if normal position of the scapula to the humerus changes. Also, the scapula works around rotations to the thorax. For full ROM, the humeral head must rotate laterally. Another important fact is that the glenohumeral joint is needed for efficient arm movement.

The scapulohumeral rhythm permits good length-tension relationships. It affects the ROM measurements of the shoulder by every 3 degree of shoulder movement, there is a 1 degree at the scapulothoracic joint and 2 degree at the glenohumeral joint. For example, for full 180 degree of motion there would need to be 60 degrees at the scapulothoracic joint and 120 degrees at the glenohumeral joint. This ratio is defined as a 2:1 movement between the glenohumeral joint and the scapulothoracic joint. If the individual has a properly coordinated scapulothoracic rhythm, there will be about 120 degrees of glenohumeral abduction and 60 degrees of shoulder upward rotation.