Case study 2 all treatments

Parkinsons Common Issues and Solutions:

-Stiffness - try stretching in the morning to help reduce morning stiffness and throughout the day. -Freezing - Try shifting weight back and forth, place a pen or something on the ground for them to step over, or have them visualize stepping over something, humming/signing/counting, recognizing triggers, listening to music, and marching in place.- Shuffling Gait - sometimes listening to music can help concentrate on a beat and reduce their shuffle gait.S Splinting:-To reduce deformities and hand contractures that result from parkinson's. The below examples are some splints you may find useful depending on what the issue may be and can be adjusted based on need.

CVI safety in the community

1 Use a guide dog but if not available hold on to physically hold on to a friend or family member and let them guide you this is important to avoid tripping and falling 2) do not be afraid to ask questions when alone in public 3) make sure that furniture and everyday needed items are in the exact same place always 4) Refuse strong light to avoid glare 5) Use strong phosphorescent colored to mark in important areas like the stairs 6) Use a braille labeler to able item like grocery and other items that are often used.

Exercise Program left CVA

1. Knee extensions From a seated position, extend your left leg until it ?s parallel to the floor. Avoid locking your knee. Then, slowly bring your foot back down to the floor.Repeat with your right leg, alternating back and forth between legs for a total of 20 repetitions (10 on each leg). 2. Knee to chest-From a comfortable lying position, bring you right leg into your chest. At the top, give your core squeeze, then bring your leg back down.Focus on engaging your core to do this movement instead of your leg. Repeat on each leg a total of 10 times. 3. Bicep Curls-Start with your elbow on a table with your arm bent at 90 degrees. Then, curl your arm up just a little, and then release it back down just a little. Slowly repeat 10 times.The upward motion activates your bicep, and the downward motion activates your triceps. Both are equally important, so focus on them equally, too. 4. Weight Bearing Lean- From a seated position, prop yourself up on your affected arm about one foot away from your body. Then lean into it.If it feels good, feel the stretch for 10 seconds or so. And if it doesn't feel good, stop the stretch immediately. After 10 seconds or so, place your other arm out beside you so that you?re supported by both arms. Then rock from side to side, shifting your weight from one arm to the next. 5. Pen Spin- Place a pen on the table and use your affected fingers to spin it. Try not to use your shoulder during this movement. If you can, try to spin the pen quickly 15 times.

RA 20 minute treatment plan

5 Hot moist pack Soft tissue massage and retrograde massage to control swelling Patient education making sure that patient understands the consequences of over doing it.minutes Modalities hot moist heat pack Try a little massage if to painful stop Inform the client that she cannot overdo it when it comes to her RA even on good days because overuse will irritate the RA and it will undo progress that has been made thus far. Hand exercise to warm up Theraputty exercises Google docs Voice typing tool Micro wave Home health aid wear splint as needed for support and pain control Patient education when working at home

Stroke OT Role 20 minute treatment

5 minutes Contrast bath, hot showers or hot moist heat pack to increase blood flow Retrograde massage Trunk stability is most important Try to get patient in a sitting position with a firm base Provide assistance if necessary Because the patient is a left side hemiplegic patient, it is best to perform AAROM exercises while she is sitting down Exercises 10 minutes sitting exercises Warm up Start in sitting position and do some trunk exercises PROM if necessary to warm up then move on to more complex exercises The most important thing with a stroke patient is to increase sitting balance Sitting balance exercises One good exercise would be having the patient sit in a chair and position a large ball in front of her and slowly let the patient move the ball back and forth stretching the left upper extremity for her warm up. Another exercise could be to let the patient sit on a matt on the floor and let her bend forward to stretch upper torso and upper left extremity Sitting at a table and reaching with the left upper extremity for an object could yet be another AAROM exercise. For the hands and wrist, the patient could perform SROM or AAROM as well as use a splint for support and pain relief For shoulder and wrist sit on a table and let patient reach for an object ( bottle of water) Wrist exercises for hand

Fibromialgia 20 minute treatment

5 minutes Pain Management Warm water and light exercise can help ease the pain put on a moist heat pack to increase circulation and relief pain in preparation of dynamic stretching exercises Because of fatigue do breathing exercises to relax Let the patient take it easy and go by his own pace Do dynamic stretching sitting exercises were you are moving the muscle and not just holding it in one position, so it is moving the muscle and then stretching it. The areas most affected are the neck, shoulders, chest, waist, hips, elbows, and knees. Do aerobic exercise, dancing swimming Walking. The Mayo Clinic lists walking as the number one form of exercise for fibromyalgia. Start off slowly, for example, with 10-minute walks. Then build up to 30 minutes of walking a day. Use the pool to perform aerobic exercises. Research published in the Journal of Physical Therapy Science showed that exercise in a pool was superior to gym-based exercise or home-based exercise in relieving symptoms. This may be due to the reduced impact on joints in pool-based exercise. Continue stretches from before. Never stretch to the point of pain.

Parkinson's 20 minute treatment

5 minutes and patient information Advise him about the hero pill dispenser it stores up to 10 medicines up to a moth long and dispenses pills with the push of a button Fine motor activities Peg board, picking up pennies or puff balls Following a maze exercise for Parkinson if patient present with a lot of tremors use a weight belt to stabilize him down Exercises Stretching Squats, throwing a ball back and forth with hand and then with feet. Alternate to which side to throw and then make the patient shout out the name of a state in the US or a name of an animal Resistance exercises with dun bells Freezing use music or let -Stiffness - try stretching in the morning to help reduce morning stiffness and throughout the day. -Freezing - Try shifting weight back and forth, place a pen or something on the ground for them to step over, or have them visualize stepping over something, humming/signing/counting, recognizing triggers, listening to music, and marching in place.- Shuffling Gait - sometimes listening to music can help concentrate on a beat and reduce their shuffle gait. Many stores offer home delivery services Use weighted gloves and utensils to control tremors

Medical fragile 20 minute treatment

5 minutes breathing exercises go slow and controlled Joints love movement motion is lotion 10 minute hip sitting exercises Let the patient lay in supine and gently pull on his feet by his ankles and hold for 10 seconds to warm up. If it does not feel good do not do it. Raise legs up in extension one first and then the other. Lie side ways and lift the leg up and down in and out do 10 reps. Lay on your stomach and lift legs backwards In bed the patient can bring knee up to chest to flex the hip Hip rotation is bending both knees and rotate them from side to side Flex on knee and cross over the leg Hip extension stretch come close to the edge of the bed and let the hip dangle/stretch while lifting up the other hip Let the patient sit on a firm surface chair torso at about 90 degree angle and raise keep up one by one Next is sit to stand slowly get up and the slowly sit pushing butt ox out. Any exercises that stretch the hip

Excises strength 20 minutes

5 minutes introduction If in bed perform PROM on upper and lower extremities Theraband resistive exercise for affected limb Do 15-20 repetitions if the patient is doing them easily than you must upgrade the activity and make it harder.. To make it harder you cab fold it in 2 If you need it to be easier do not use resistance band but simply just use body weight

RCVA Excise 20 minute therapy program

5 patients education Use Hero automatic pill dispenser. Provide verbal, visual, or tactile cues if neccessary Use micro wave Employ home heath aid Impulsive What is Right CVAIf the stroke occurs in the brain's right side, the left side of the body (and the left side of the face) will be affected and can lead to Paralysis on the left side of the body, Vision problems, and Memory loss Stretch and warm up exercises Trunk stability is most important Try to get patient in a sitting position with a firm base Provide assistance if necessary 10 minutes AROM AAROM or PROM using upper extremity Start in sitting position and do some trunk exercises PROM if necessary to warm up then move on to more complex exercises The most important thing with a stroke patient is to increase sitting balance Sitting balance exercises One good exercise would be having the patient sit in a chair and position a large ball in front of her and slowly let the patient move the ball back and forth stretching the left upper extremity for her warm up. Another exercise could be to let the patient sit on a matt on the floor and let her bend forward to stretch upper torso and upper left extremity. Fall prevention education Clean up clutter. ... Repair or remove tripping hazards. ... Install grab bars and handrails. ... Avoid wearing loose clothing. ... Light it right. ... Wear shoes. ... Make it nonslip. ... Live on one level.

Daytime Home care Services / Assistance

A home care service provider could be a valuable resource for this patient and their family since the patient has to be home alone until her daughter gets off of work at 5:30. Services that are available would include;

Medical fraglie

ADPATIVE EQUIPMENT (AE) Due to the pneumonia you are going to experience shortness of breath as well as fatigue. Also due to the osteoarthritis you don't want too much pressure on your joints. Some AE that would simplify dressing at home to reduce both factors & cut time include: LONG HANDLED SHOE HORN Long-handled shoehorn to help put on/ take off shoes. Or invest in slip-on shoes. SOCK AID Sock aid can help get the sock over their foot REACHER The reacher lets the person pick up items

MD Adaptive Equipment (AE)

AE are devices that help assist with completing daily living activities. My patient would benefit from the following AE:- Power scooter or power wheelchair- Chair and stair lift - Raised toilet seat/commode- Bath bench/chair - Removable shower head- Grab bars- Reacher- Portable laptop that flips into a writing/drawing pad and stylus pen (for work purposes/entertainment)- Built up utensils for writing and eating- Orthotic devices (wrist support)- Adapted equipment for ADLs and to play with children depending on what they like to do

Rheumatoid Arthritis

Adaptive Equipment: CookingIn the kitchen, electric can openers, food processors and mandolins (for slicing) make work easier. Reacher's can be used to retrieve items stored high or low. Built-up handles and grips make utensils easier to grasp and put less stress on finger joints. Install a fixed jar opener or keep a rubber jar opener in the kitchen.

Distal humerus fracture

Additional Information: Continue Active Range of Motion of the shoulder and hand at home. Massage scar with lotion. Go to therapy to further increase your range of motion of the elbow and help it function better.

SCI "Safety i

Always be Careful!" Wheelchair Pressure Relief Areas:Shoulder blade, posterior knee, sacrum and coccyx, ischial tuberosity, and the foot. Side-Laying Pressure Areas: Medical ankle, lateral ankle, lateral foot, medial knees, trochanter, iliac crest, rim of ear, spine of the scapula, and the side of head. Back-Laying Pressure Areas: Heel, sacrum and coccyx, elbow, dorsal thoracic area, occiput, and rim of ear. Education: Family and patient education on spinal cord injury-what to expect on the daily basis. Skin Inspection:The importance of checking the skin daily for ulcers and wounds.

Burns Exercises

Always stretch affected area against the flow of the contracture Palm stretch if palm wants to flex we will extend. Push up on the wall is a good exercise Abdomen stretch or hips and if they are hunched over we want to encourage them to stand upright. Let their back stand against the wall with their bottom and heels against the wall first to support the body and the slowly help them to get the abdomen and trunk up against the wall so that they are upright. Ankle stretch If burn is on top of their foot we will hold the ankle and we will push the foot up. Knee bend across the knees we want to move the knee back and forth, stretch. Children with other burns should be playing to get the burn tissue moving and flexible.

Fibromyalgia Exercises

Always use proper body mechanics and posture when lifting objects. Do not attempt to lift by bending forward. Bend your hips and knees to squat down to your load, keep it close to your body, and straighten your legs to lift. slow movements, stretching deep breathing and relaxation.

LVCA 20 minute treatment

Apasia Cognitive exercises are most important Conversations back and forth We can use drawing, gestures or AI Use a board with pictures and let the patient identify shapes, colors, 5 minutes introduction and back and forth conversation 7 steps 1) Describe an the word if they are not able to identify you can give a clue. Example it is a fruit that you eat. 2) Give them a letter cue if it is an apple you can say that it starts with an A 3) Phonemic give them the first sound of the AP and let the patient finish 4) Rhyming book rhymes with look 5) lets read open the patient is supposed to finish the sentence 6) Model just say the word and let patient repeat Verbal exercises 10 minutes First let the patient identify, shapes, objects, and colors on a picture Second present a picture or letter board cover the picture half way up and let the patient identify /Guess a word Describe pictures or objects Break the word down phonology Can you repeat these words Can you pick out a name and use it in a sentence If aphasia is severe answer yes or no to questions 5 minutes trunk stabilizing exercises Patient education: Patient needs a microwave and an home aid to help and supervise the patient and help with ADL's

MS Ambulation/Transportation: needs lighter wheelchair

As of now, Mike is using a cane indoors and manual wheelchair outdoors. However, I recommend changing this up a little bit. Because this is a progressive degenerative disease, the body is only going to get weaker; therefore, we need to be thinking a few steps ahead. In other words, utilizing a light wheelchair as necessary to avoid fatigue within the home could be appropriate in some/most cases. And for the outdoors, transitioning into a power wheelchair will make the work load a lot less when it comes to the upper extremity. Eventually, Mike may require the power wheelchair at all times and areas, but for now, we can see what occurs within the time frame(s).

CVI Intro

Asked the patient about his day and what they want to accomplish from treatment. Place a picture in front of the client and and divide it into different quadrants Let the patient identify an item from each quadrant, this will give the OTA an idea in which quadrant the visual impairment is most active. Use eye charts to see is patient can identify letters, objects, shapes this is also used with TBI I will look at the patients Visual attention and occulomotor skills I want to see how well the patient is doing some visual training exercises Visual pursuit and sarccades visual training exercises use an eye chart or a picture board to see how much vision the patient still has. Look at your visual ocular skills and you visual motor skills to see how well you would do with visual training exercises.

fibromyalgia Adaptive equipement

Assists in moving heavy objects, thus reducing risk for fatigue. Motorized cart in stores Reduces risk for fatigue and conserves energy. Shower chair/bench Conserves energy. Reacher Helps to pick items up off the floor without the need to bend over.Conserves energy. Slow cooker Conserves energy in the kitchen. Allows for healthy meals while requiring little energy to prepare it. Rolling chair, Allows for easy transport between locations. Recommended for both work and home.

LE amputee

BASIC PROSTHETIC TRAINING PHASE IS WHEN YOU RECEIVE THE PROSTHESIS, THE OCCUPATIONAL THERAPY PRACTITIONER WILL PROVIDE INSTRUCTION DONNING AND DOFFING, WEAR SCHEDULE, AND BASIC CONTROLS. AFTER THE YOU HAVE MASTERED THESE INITIAL ACTIVITIES, YOU WILL BEGIN TO USE THE PROSTHESIS FOR THOSE BASIC DAILY LIVING TASKS PREVIOUSLY IDENTIFIED AS CRITICAL FOR ACHIEVING SHORT- AND LONG-TERM PERSONAL GOALS. THE OCCUPATIONAL THERAPY PRACTITIONER WILL MONITOR YOUR

CVI environment

Best CVI environment is clean well organized and predictable

Guillain-Barré syndrome, Caused by a viral infection

Caused by a viral infection instead of the Immune system attacking the virus it attacks the nerves and cause demylination and then nerves do no longer conduct normally or they do not conduct at all. Muscles become weak or simply do not work at all. Most patients do recover with proper treatment.

Distal humerus fracture AE

Compensatory techniques: Since you can not feed yourself with the right hand, try eating with the left hand instead. It may take more time, be patient and persistent. You will have to rely on your left hand now for many cleaning and grooming activities such as wiping after using the toilet, washing body in shower, washing hair, dressing, etc.

CVI My client is a 43-year old father of 2 who was just returned home from acute care after removal of a brain tumor. The tumor was in his occipital cortex leaving him cortically blind. He remained in the hospital for 2 weeks following the surgery and is recovering remarkably well. At this time, no further cancer treatment is indicated. He was a high school English teacher, and his wife is a real estate agent. The children are 8 and 10 years old.

Cortical blindness is the total or partial loss of vision in a normal-appearing eye caused by damage to the brain's occipital cortex. Cortical blindness can be acquired or congenital, and may also be transient in certain instances.

Hand crush injury 20 minute treatment plan

Hot moist heat pack Start with simple AROM or PROM exercises if patient cannot do these on his own use PROM open and close hand Then have him flex and extend the thumb and index finger Use theraputty exercises for strength and flexibility if the injury allows it Perform fine motor skills activity like picking up pecks on peg board or picking up pennies.

Rheumatoid Arthritis

Hot moist pack Soft tissue massage and retrograde massage to control swelling Patient education making sure that patient understands the consequences of over doing it. Theraputty exercises Google docs Voice typing tool Micro wave Home health aid wear splint as needed for support and pain control

ADAPTIVE EQUIPMENT

Digital Tape Recorder Recorder that allows user to record up to 696 minutes (11 hours) of lectures, conversations, or meetings and convert them to text by downloading to a computer to read in the LP mode Talking Big Button Clock is a simple solution to assist blind, visually impaired, and hard of hearing individuals, Clearly Hear the Time, Date, Day of the Week and Optional Daily Alarm. Adjustable Folding Support Canes for the blind and visually impaired are one of the most important identification and mobility aids for people who are blind or have low visions. Guide dog advantages WHY A GUIDE DOG? One of the best things a blind person can acquire is a guide dog! Guide dogs are far more than excellent mobility aids; they also provide companionship as well as enhancing your quality of time, confidence, and independence. WITH A GUIDE DOG The person will feel more safe, comfortable, accepted, and just part of everyday life. Client will be experiencing more freedom and the ability to make their own decisions of what they want to do that day. Blind people with guide dogs are better equipped to tackle the everyday life challenges. OTHER BENEFITS OF A GUIDE DOG Impacts the health of their human companions. Psychological effect: feel more confident and secure Relieves depression, stress, and anxiety which also improves cardiovascular health. Improves client's motivation to exercise and walk

Fibromyalgia Exercises

Do breathing exercises the 1:3 ratio for exercise; For every 1 minute of exercise, allow 3 minutes of rest Walking. The Mayo Clinic lists walking as the number one form of exercise for fibromyalgia. Start off slowly, for example, with 10-minute walks. Then build up to 30 minutes of walking a day. Use the pool to perform aerobic exercises. Research published in the Journal of Physical Therapy Science showed that exercise in a pool was superior to gym-based exercise or home-based exercise in relieving symptoms. This may be due to the reduced impact on joints in pool-based exercise. Continue stretches from before. Never stretch to the point of pain. Always use proper body mechanics and posture when lifting objects. Do not attempt to lift by bending forward. Bend your hips and knees to squat down to your load, keep it close to your body, and straighten your legs to lift.

MS Dressing

Dressing: You can get mostly, if not fully, dressed while sitting down... so do it! First, be sure that you are sitting in a seat that has arm rests to support your balance. Some suggestions may include keep your clothing light if possible (avoid long sleeves, jackets, long pants, etc.). Not only with this help with making the dressing techniques a bit easier, it can also prevent you from getting too hot due to the low heat tolerance. Also, be sure to utilize any of the adaptive equipment you've been taught to use.

Guillain Barrre EQUIPMENT RECOMMENDATIONS

EQUIPMENT RECOMMENDATIONS Solid seat inserts (to provide support in w/c)•Gel foam cushion (to prevent further deterioration of skin and to allow healing of stage 2 ulcer) Lateral supports (to allow for upright sitting until trunk is strengthened) Lap tray (To support UE's and allow for self feeding) Calf/foot support (to prevent calves/feet from developing contractures) Reclining motorized wheelchair (to allow for propulsion across campus as activity tolerance increases To allow for re-positioning to prevent further breakdown of skin) Hip abductors (To prevent LE's from developing contractures)• Shower transfer bench (To allow for safe transfers as function returns) Bedside commode (To allow caregiver to get client to a toilet without having to transfer to another room) Universal cuff (When used with long handled utensils and lap tray, it will allow for some independence in feeding. Self-dispensing toothpaste (To allow client to apply toothpaste to brush since there is no AROM in hands) Suction toothbrush (To allow client to independently brush teeth) Arm trough for w/c Incentive spirometer (To increase respiratory muscle strength) Scoop bowl with suction base (To increase independence with feeding) Energy conservation and work simplification

Distal humerus fracture AE

Equipment: Equipment you can benefit from could be: to be used for non fractured hand Showering: 1. Removable shower head 2. Back brush 3. Waterproof sling to keep arm in while grooming 4. Pump bottles for the shampoo, conditioner and body wash. - Dressing: 1. Slip on shoes that do not require being tied.2. Button Aid

MS 20 minute therapy program

Fighting MS with exercise be careful environment not to hot and exercises not to strenuous to avoid fatigue Do warm up exercises to loosen the body up, to get heart rate going, to get blood flowing. Go slow do what yo can and take your time Sitting stretching exercise to warm up and then upgrade to thera band, dun bell, throwing a ball back and forth Working on trunk stability sitting in a chair holding a ball in you lab using your good arm to control the bad arm and rolling it back and forth promotes core stability for MS patients. Kicking the ball back and forth with feet is also a good exercise You can also lift the ball up and down You can rotate the ball from side to side Dunbell exercise must warm the body up first Squat Use 1 or 2 pound dunbell squat and as you come up extend arms You can do all kinds of dunbell excercises

Left CVA treatment /aphasia

Focus on the Cognitive Deficits Without neglecting other impairments, the OT needs to make the cognitive deficits a priority. Pull out relevant standardized tests that you are comfortable with administering to your patient. Bring out compensatory strategies such as picture books, communication boards, and auditory aids.

Hand crush injury Splint care -

Follow wear schedule for splint given by OT -Do not leave your splint in heated areas or use it in high heat. Do not leave it in the car, do not cook or bake with it, do not use around hot machinery. -No not get splint wet (other than cleaning splint). Do not shower or bath with it. -Clean spent by washing it with lukewarm water and a gentle soap or by using alcohol wipes to clean and disinfect. -If splint leave redness on the skin or becomes painful, contact OT right away

Parkinsons Energy Conservation Techniques:-

For a lot of Parkinson's patients, even on medications, they tend to have more tremors the more tired they get. These techniques are to help reduce fatigue and tremors as a result of fatigue.-Use a bath chair when showering to reduce the stress on the body when having to stand and maneuver in the shower while washing your body.-In the kitchen, keep things used often in easy to reach areas such as the counter or bottom shelf of the hanging cabinets. -When preparing food, try prepping as much as possible while sitting, and grab all the ingredients all at once to avoid having to walk back and forth a lot.-When doing your chores and daily activities remember to take breaks and spread them throughout the day to decrease the risk of fatigue.Exercise Program:-Flexibility Exercises such as Yoga or dancing-Aerobic Exercise such as a boxing program or cycling or dancing-Resistance Training or strengthening exercises for example a boxing program-Cycling - There are Parkinson's cycling classes such as Pedaling for Parkinson's at the YMCA.-Boxing - CORE has a Parkinson's Boxing class

CVA6) She is walking with a quad cane and minimal assistance but only for short distances.Safety precautions for the home are importan

For example: cleaning up clutter, clear paths to the kitchen, bedroom and bathroom, repair or remove tripping hazards, install grab bars and handrails, avoid wearing loose clothing as not to trip over your own pants etc., use good lighting, wear nonskid shoes and avoid slick surfaces, remove loose carpets and runners in hallways and stairwells, or fasten them with nonskid tape to improve traction, install handrails for support in going up and down stairs. Repair or remove tripping hazards. ... Install grab bars and handrails. ... Avoid wearing loose clothing. ... Light it right. ... Wear shoes. ... Make it nonslip. ... Live on one level.

CVI HOME MODIFICATIONS

For furniture choose upholstery with texture as it provides tactile clues for identification. Control glare in the home using window blinds and drapes by hanging mirrors at a level or in an area where they will not produce glare. Install grab bars in appropriate places. The bathroom is important and other areas of the home where they may be needed and provide railings that extend beyond the bottoms and tops of stairways Install no-skid flooring or clean floors with no-skid products to reduce shine. Use bright, contrasting colors throughout the home so that client can differentiate between items and areas.

Guillain-Barré syndrome, also called acute inflammatory demyelinating polyneuropathy (AIDP), About 50 percent of patients initially develop abnormal sensations such as tingling of the feet or fingers; twenty-five percent initially develop muscle weakness (e.g. difficulty climbing stairs, getting up from a chair and/or cramping) and 25 percent begin with a combination of abnormal sensations and weakness. Pain is also a common symptom, sometimes experienced as deep aching or cramping in the buttocks, thighs or between the shoulders. Disability caused by GBS generally progresses over the course of a few days to four weeks, with weakness starting distally and ascending in a matter of hours to days. At the peak of the condition's progress, many patients experience flaccid paralysis of nearly all skeletal muscles, with talking, swallowing and breathing frequently being affected. Seventy percent of patients lose some strength in respiratory muscles that can lead to shortness of breath; in about one third of patients, intubation and a ventilator temporarily become required. Consequently, most newly diagnosed patients are placed in an intensive care unit for monitoring. Plasma exchange (PE) or a high dose of intravenous immune globulins (IVIG) often hasten recovery. Corticosteroids are not helpful for GBS, but frequently are used to treat CIDP.

GBS typically is self-limiting with improvement usually beginning spontaneously after weakness maximizes. Most patients eventually reach a full or nearly full recovery. Many patients will walk without aid after three months and experience only minor residual symptoms by the end of the first year following onset. Nevertheless, recovery can be extremely slow (stretching over the course of six months to two years or longer) and five to twenty percent of patients are left with significant residual symptoms that leads to long-term disability and prevent a successful return to their prior lifestyle or occupation.

SCI Home Program

Home Modifications:AE for Eating:Long-handled utensilsUniversal cuffAE for Dressing:Reach stickRing pull zippersClothing loopsAE for Bathing & Grooming:Shower commode chairHandheld shower headLong-handled mirrorLong-handled brush/combAE for Toileting: Dependent with leg bagMobile shower w/ padded seat

MS father/husband

I can guarantee some days it feels almost impossible to continue in the this role, but you can do it. You just have to be smart and strategize more than before. And you also have to know that what you can do is enough. The kids and wife will see your effort and know you are doing everything in your physical being (literally) to take care of them. Use it as your motivation. Simply start planning ahead. In other words, since your mornings are when you have the most energy, use those couple hours to devote the "most" time to your family. Take the kids to school, get a cup of coffee with your wife, and then come back home to nap some before starting anything else. Find a base of support such as a babysitter or family members to step in to help during the afternoon/evenings. You may not always be able to do this routine, but take it to your advantage as much as your body allows you to. And again, know that whatever you do is enough.

COPD Safety information

It is important that the patient wears takes the oxygen tank with them Don't smoke. Smoking with oxygen on is an absolute no-no. It is important that the patient knows that smoking increases risk for burn injury because of oxygen's ability to quickly strengthen a fire. Wear oxygen during activities. Many people with COPD take off their oxygen when they climb stairs or walk to the mailbox, but these are the times when the body needs it most. It's fine to switch to a portable oxygen pack if the patient doesn't want to carry bulkier oxygen equipment with him, but he needs to return to the concentrator when he gets back. The potential hazard of not wearing oxygen is that the patient will become exhausted and put himself at greater risk for injury. Avoid open flames. Oxygen is not in itself flammable — but what it does is feed a fire. For safety, cook with a microwave. Or, if the patient must use a stove, he needs to take his oxygen off while he cooks. Also, steer clear of open fireplaces and wood-burning stoves.

MS Temperature Maintenance:

It is important to be aware of the temperature(s) a patient with MS is exposed to. The heat in itself is tiring, so just imagine an individual that already struggles with fatigue as one of their main concerns. It drains individuals like Mike Smith so fast. Therefore, we really want to encourage and apply strategies that can steer away from some of these heat intolerance's. Some ideas could include but not be limited to wearing light clothing, drinking cold drinks, take cool showers, spend more time in air-conditioned environments if possible, etc. Occasionally, it is okay to be around the warmer climates, but just be sure to limit the time as much as possible.

Message to Caregiver(s):

It is not easy to watch someone you love and care about go through this disease. Multiple sclerosis (MS) is so challenging because it is a degenerative disorder that continues to cause destruction to the areas of myelin sheath that ends up affecting the CNS patterns. As you may have seen, this causes much frustration but most clearly portrays ultimate fatigue. So, together, you all have to work as a team to continue to keep Mike in his best functional state- mentally and physically. Within this program, you will find information regarding the problems that may interfere with his success while also providing some resources to best benefit him.

Hand crush injury patient education

Keep fractured wrist wrapped/ compressed/in splint following therapist or physicians' orders, until it heals. Protect degloving injury by keeping it wrapped, clean and covered. To keep swelling down: Elevate and compress Elevate -Keep injured arm elevated to reduce risk of edema in fractured wrist and degloving injury. While walking during the day, keep injured arm up by chest or shoulder and NEVER down by your side When sitting throughout the day, keep injured arm on a high arm rest or on a table When sleeping, use pillows to keep injured arm elevated If possible -Retrograde massage. Use this technique to reduce swelling when the injuries are able to endure it and you have been cleared by your OT and physician. Massage from fingers toward to elbow to promote movement of fluid to the heart.

MS leisure

Leisure: I'd say this is one of, if not the most important, area to discuss. Leisure is the thing(s) we participate in because it's what brings us the most enjoyment. Maintaining these activities is another way to keep positivity and motivation flowing. I know you love to bowl, so let's get you back on the alleys. Utilize your power wheelchair as well as the bowling ramp when throwing the ball to conserve as much energy as possible. Don't overdo it by limiting yourself to 1 game (or less). You have to keep in mind that it won't be performed the same way prior to the condition, but take what you have and use it to its fullest. Also, swimming. It is another activity you strived in before. I encourage you to use the pool for so many different ideas. The only thing you really need to be mindful of though is the temperature. Overall, both these activities bowling and/or swimming, can be incorporated at least 1-2 days a week in your routine. You can use this time to be with family and friends or use it some time to enjoy to yourself.

MD Patient and Family Education

Making sure to educate patient, family, and caregiver on the progressive disease and what to expect. Making them aware that we would want to preserve his independency as long as possible and use what he does have (if you don't use it, you lose it). Making sure the diagnosis is fully understood by both the pt. and caregiver and knowing when adaptations are needed. Learning work simplification and energy conservation techniques and the importance/benefit it will have. Educating on encouragement and support in activities as this can be a very debilitating disease to have. Also helping pt. discover healthy coping skills, leisure activities that he enjoys participating in, and ways he can interact with his children.

Adaptive equipment

Microwave Bedside commode extended reacher rocker knife Dycem pads-plates with rim guards-one handed cutting board alphabet and picture boards for aphasia Front wheeled walker

9 She is minimal assistance for upper body dressing and moderate assistance for lower body dressing

Minimal assistance:Show the patient dressing skills that do not use AE: Example donning on and off a shirt since she is minimal assistance, she will perform 75% of the task and the husband or OTA will perform 25% if need be. Moderate assistance:The client performs 50 % of the task and the husband or OTA the other 50% if need be.

fibromyalgia exercise

Movement should be a key part of your overall well-being. According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, exercising regularly is one of the most effective ways to treat fibromyalgia. You can exercise during a flare, but reduce the amount of exercise by half, decrease exercise time, resistance, and intensity. Take frequent breaks as needed.Use proper breathing techniques during the break. Breath 2 seconds in through nose and the breathe 4 seconds out though mouth. "Smell the roses, blow out the candles." Split weight of items carried in fewer than 5-pound increments. Do not carry any more than you can handle. Take more trips or use equipment to help carry items. Don't push yourself It's ok to make plans and then not go if you feel unwell. Just explain to the other party that it's for a medical reason.

MD Exercise Program 20 minute treatment

Myotonic dystrophy is characterized by progressive muscle wasting and weakness. Atrophy of the muscles can be exasperated by a lack of activity and exercise. Warm up the muscles by doing upper body stretching Nutrition is important eating enough protein Warm up with sit to stand exercise do 10 times to feel muscle activity in thighs/ quad muscles and gluteal area Ouad muscles are important for going up the stairs and for balance If you have balance problems sitting to standing push yourself up on the bed or chair that you are sitting on For calf exercises lean against the wall and do calf raises 20 times to strengthen calf muscle. For chest and shoulders you could do wall push up exercises. And for upper body exercise do a bicep and triceps exercise leaning on a bench or a bed using a dun bell moving the arm back and forth 10 on one side and 10 on the other side. Or holding on to wall and raising a dun bell Thee are start up exercises to keep a patient going Next could be walking aerobic exercise, dancing depending on what the patient wants to do. To help maintain mobility he should either go to a gym or invest in a stationary bike machine where he can pedal his legs and arms. This will help with ROM, keeping up endurance, strengthening muscles, muscle memory for using LE and UE, and more. He should also participate in doing a stretching routine to help with flexibility.

Left CVA Aphasia Modify Their Own Communication Style

Normal intelligence is still there Make sure you have the person's attention before you start. Minimize or eliminate background noise (TV, radio, other people). Keep your own voice at a normal level, unless the person has indicated otherwise. Keep communication simple, but adult. Simplify your own sentence structure and reduce your rate of speech. Emphasize key words. Don't "talk down" to the person with aphasia. Give them time to speak. Resist the urge to finish sentences or offer words. Communicate with drawings, gestures, writing and facial expressions in addition to speech. Confirm that you are communicating successfully with "yes" and "no" questions. Praise all attempts to speak and downplay any errors. Avoid insisting that that each word be produced perfectly.

LE amputee home program CLIENT IS A 16-YEAR-OLD MALE WHO LOST BOTH LEGS AS HE WAS PINNED BETWEEN CONSTRUCTION EQUIPMENT. HE WAS WORKING A SUMMER JOB JUST BEFORE HIS SENIOR YEAR. HE USES A MANUAL CHAIR AND IS BEING DISCHARGED FROM INPATIENT REHAB TO RETURN HOME WITH PARENTS AND 10-YEAR-OLD BROTHER.

OCCUPATIONAL THERAPY WILL HELP YOU PROMOTES THE DAILY USE OF PROSTHETIC DEVICES BY ANY ONE WITH AMPUTATION OR LIMB LOSS USE OF A STUMP BOARD IMPROVES WHEELCHAIR COMFORT, PROTECTS THE STUMP, AND AIDS IN STUMP ACCEPTANCE COMPREHENSIVE INPATIENT REHABILITATION, INCLUDING OCCUPATIONAL THERAPY WITHIN 1- 3 MONTHS OF AMPUTATION, HELPS INDIVIDUALS RETURN TO OR EXCEED THEIR PRESURGICAL MOBILITY STATUS PARTICIPATION IN SPORTS AND PHYSICAL ACTIVITIES SUCH AS, SWIMMING, BASKETBALL, BASEBALL, WEIGHTLIFTING, AND CARDIO TO IMPROVED PHYSICAL HEALTH AND QUALITY OF LIFE TO HELP YOU WITH SELF-MANAGEMENT AFTER AMPUTATION OR LIMB LOSS FOR REDUCING DEPRESSIVE SYMPTOMS AND IMPROVING SELF-EFFICACY, FUNCTIONAL STATUS, AND QUALITY OF LIFE AFTER LIMB LOSS

MD Home ProgramMuscular DystrophyScenario: Your patient is a 35 year old man with myotonic MD. He has experienced a change in function and has poor motor control of his LE's and fine motor deficits. He has 4 children, and his wife left him just before the diagnoses due to an inability to tolerate his lack of help around the house. He is an architect who worked 40 hours a week, but his boss has agreed to allow him to work 20 hours in the office and do the rest from home. His children (2, 5, 8, 12) come to stay with him every other weekend.

OT Intervention OT's goal for working with any kind of muscular dystrophy is to delay deformity, gain maximum function within limits of the disease, plan ahead, maintain ADL independence as long as possible, educate on assistive devices/adaptive equipment, prevent contractures with positioning and splinting, wheelchair management, worksimplification and energy conservation techniques, avoiding fatigue, and patient/family education.

Medically fragile OT home DECONDITIONED/PNEUMONIA: Your patient is an 84-year-old gentleman who has been in the hospital for 2 weeks due to medical complications of his pneumonia, he has had sepsis and dehydration during this time in the hospital. His PMH (past medical history) includes HTN, severe OA, S/P R THA X 6 YEARS AGO, controlled by oral medications, HOH, and kidney disease. He was living alone with some help from his nephew who mows his yard every week and his nephew's wife who shops on the weekends for him. He has a small dog who is staying with the neighbors. Your patient is ambulating with a rolling walker 50 feet and is minimal assistance showering. He can dress with extra time. He is not currently performing IADL'S.

PNEUMONIA/ difficulty breathing OA osteo arthritis A type of arthritis that occurs when flexible tissue at the ends of bones wears down. It occurs when the cartilage or cushion between joints breaks down leading to pain, stiffness and swelling. HTN Hypertension high blood pressure Kidney disease

Guillain Barrre EXERCISE PROGRAM

Performance of ADLs to increase activity tolerance Grade up as function begins to return Passive stretch by caregiver to increase ROM in affected extremities Core strengthening exercises graded to level of function Rest often to prevent exhaustion as it may delay therapy Pursed lip breathing exercise Lite Gait to increase activity tolerance of standing/walking. Once function returns/increase, gravity eliminated treadmill to increase endurance Hand therapy

Precautions

Pneumonia causes a weakened immune system and because of this you will want to make sure you wash your hands: After being out doors After changing diaper After doing house work After cleaning the bathroom After touching bodily fluids such a mucus and blood. High potassium diet is good for hypertension plenty of fruits and vegetables Continue to move and exercise the hand is important for arthritis.

Guillain Barrre PATIENT IS A 22-YEAR-OLD NURSING STUDENT WHO IS ADMITTED TO MEDICAL REHABILITATION DUE TO A DX OF GUILLAIN BARRE. SHE PRESENTS WITH NO AROM IN BILATERAL LE'S AND POOR TRUNK CONTROL. SHE PRESENTS WITH 2/5 MMT BILATERAL SHOULDERS AND ELBOWS; 2-/5 MMT BILATERAL FOREARMS; AND NO AROM BILATERAL WRISTS AND HANDS. SHE LIVES WITH HER PARENTS AND HER MOM DOES NOT WORK AND WILL BE THE PRIMARY CAREGIVER AT HOME. PRIOR TO COMING TO REHAB, SHE HAD TO BE INTUBATED AND WAS ON A VENTILATOR FOR 4 WEEKS; SHE HAS SINCE GOTTEN OFF THE VENTILATOR AND IS BREATHING ON HER OWN, BUT SHE SUSTAINED A STAGE 2 PRESSURE SORE ON HER SACRUM AND HER RIGHT ISCHIAL TUBEROSITY WHILE SHE WAS IN THE HOSPITAL. SHE IS IN HER SECOND YEAR OF NURSING SCHOOL AND WAS VERY ATHLETIC BEFORE SHE DEVELOPED GUILLAIN BARRE. SHE RAN AND DID AEROBIC 4X PER WEEK.

Precautions Possible flaccid paralysis of all limbs Significant pain Inability to talk Inability to swallow Inability to breathe Intubation may be required for severe cases May experience extreme fear/anxiety May develop lesions Stage 2 Ulcer may worsen if gel mattress/cushions are not utilized

COPD Scenario: Your patient is a 72-year old man with COPD. He wears O2 round the clock at 2 L. He completed outpatient OT where he learned basic energy conservation and work simplification principles. He lives alone in a 1-bedroom apartment on the ground level. He has a daughter who lives in town. He has a valid driver's license. He becomes dizzy and fatigued if he stands more than 10 minutes at a time

Precautions: Energy conservation/work simplification Body mechanics Anti-breathing techniques/ Pursed lips: Breath in for 2 seconds through your nose and then breathe out for 4 seconds through your mouth. Pace breathing Relaxation and stress management No smoking Keep hot water temperature at 120 degrees or lower Do not rush, take your time with all tasks do not smoke

Rheumatoid Arthritis

Precautions: - Avoid fatigue -Respect Pain - Avoid static and stressful activities -Diet Treatment methods: RestRange: Complete bed rest to napsLocalized rest to individual joints: Splint (during activity or rest) EC/WSWear compression gloves for edema and ulnar drift splintA wheeled, swivel chair cuts down on the amount of twisting and reaching that you do during the day. Make sure the seat isn't too deepPosition the mouse as close to the keyboard as possible. Make sure your wrists, forearms, and elbows are in the same plane. Take Rest Breaks!!!!!

TBI 6 year old child 20 minutes treatment

Provide ADL training Gait training for children Taking the child on a walk using a gait belt so that the child can walk and practice balance. Treatment program Preparatory let the child warm up/ play a bit before beginning therapy Exercises writing skills exercises Hand writing: Start with letting the child draw straight/ vertical lines then horizontal lines, diagonal lines circles, squares, triangles. Let the child then trace his own name Depending on how severe the gait might be the child might need braces for his legs. To reestablish normal gait going for walks can help with balance and propioception as well as correcting the incorrect gait Secure gait belt on the child and take the child outside in nature, let the child walk and correct the gait by giving visual, directive, and verbal cues. Walking on a log Using a walker Pediatric leg brace Going for walks holding on to both parents hands Positioning ROM Care giver training Establish stimulation care program

COPD OT Role 20 minute treatment

Pursed lip/ paced Pace breathing: Learning how to breathe is most important for 5 minutes 5 minutes Introduction and Breathe into the nose for 2 seconds and then breathe out through mouth for 4 seconds 10 minutes exercise program COPD limits the airflow in the lungs making it difficult for patients to breathe. COPD is a progressive disease and it is treatable by stop smoking and exercise. Exercise is a powerful method of control to avoid that the symptoms of COPD are getting worse. Breathing and aerobic exercises need to be done a few times a day. Exercise helps to improve circulation to the lungs and it and helps with cardiovascular muscles and strengthens them. Exercise also can help patients to release stress and anxiety and being able to do this helps the patient out of his/her depression. Exercises can include walking, swimming, even bicycling, palates, staying active is an important part of health and can help teach patients how to breath to manage and alleviate their symptoms 5 minutes COPD energy conservation Avoid Unnecessary Tasks Wear a cotton robe to save yourself the extra task of toweling after bathing. Allow your dishes to air rather than towel drying them. Sit instead of standing to do your hair, shave, or put on your makeup. Sitting is known to use up 25 percent less energy than standing. Organize Your Activities Reorganize Your Closets and Shelves Invest in a Rolling Utility Cart Cook on Sunday for the Entire Week Practice Relaxation Techniques COPD work simplification 1. Set up proper working conditions: Sit whenever possible Adopt a good posture by setting up a work height that is appropriate for the job Plan ahead & collect all necessary tools/equipment before starting a task Schedule frequent breaks within the task Work in pleasant surroundings 2. Avoid unnecessary motions: Use wheels or slide objects rather than lifting & carrying Clean up areas as you go along to avoid a major clean up Arrange sequence of jobs to decrease repetition of movement 3. Avoid rushing: Pace yourself Use a slow relaxed speed Work to music if necessary Remember to schedule time for frequent rest breaks COPD Equipment Recommendations: Power Tilt and Reclining Wheelchair The benefits of a reclining wheelchair are they greatly improve the comfort factor of being in a wheelchair. The patient is conserving energy versus a manual wheelchair. The ability to recline helps distribute body weight and reduce pressure sores. They help improve circulation throughout the body. Transferring from a reclining wheelchair to a bed is much easier than a standard wheelchair because it can be adjusted to the same elevation as the bed. Transfer tub bench Hand held shower head Long handle bath sponge Reacher Utility car

RA Rheumatoid Arthritis Home Program Case Study Your patient is a 59-year-old female with severe rheumatoid arthritis. She has been seen in outpatient OT for recent flare up of her pain and swelling. You have made her a new splint for her ulnar drift and found that she had been working too much around her house on her "good days". She is unable to maintain a grasp on objects that are less than 2 inches in diameter. She works from her home consulting for social services, so she needs to do minimal typing, phone duties, and mailing. She lives with her elder brother who handles the heavy housekeeping but no cooking or assisting with his sisters' ADL.

RA is an autoimmune disease that causes pain and swelling of the joints. The normal role of your body's immune system is to fight off infections to keep you healthy. In RA, the immune system targets the lining of the joints, causing inflammation and joint damage. RA usually affects smaller joints, such as the joints in the hands and feet. However larger joints such as the hips and knees can also be affected.

CVI safety in home

Reduce clutter Make sure all furniture and every day household items are always place back into the same place so that client can find items by memory SAFETY PRECAUTIONS INCLUDE: Replace worn carpeting and floor coverings (remove rugs) Get rid of unwanted items to reduce clutter Ensure stairways railings are extend beyond the top and bottom steps Make sure that furniture and other necessary items are placed always same way so that client can remember were everything is located. Make sure lighting, color contrast, and the reduction of glare are important factors. Client should be able to trail the walls/hallways without encountering obstacle. (less decoration the better)

RCVA Safety

Safety Information -Have Client use walker at all times when ambulating-Install grab bars in appropriate places -Visual cues during medication management/cooking-Use AD/safety devices -Strengthening leg muscles and balance through exercise-Eating calcium-rich foods and taking calcium supplements to increase bone strength if necessary-Following your therapists' recommendations about limitations and walking needs-Recognizing that certain medicines may make you drowsy and taking precautions-Limiting walking when distracted-Clear paths to the kitchen, bedroom and bathroom-Wear nonskid shoes and avoid slick surfaces-Remove loose carpets and runners in hallways and stairwells, or fasten them with nonskid tape to improve traction-Listen to the advice of healthcare professionals and experienced caregivers. Usually doe not use adaptive equipment but uses manual techniques to get dressed

Distal humerus fracture Scenario: The pt is a 14 year old boy that has experienced a R distal humerus fracture from a fall out of a tree. He was seeing OT for swelling in his R hand. He is in a cast from his R axilla to his wrist and will wear this for 6 more weeks. He is being discharged home with his parents. He is NWB on his R UE. He is unable to feed himself because his R elbow is in 20 degrees of flexion. He enjoyed bike riding and writing. He had previously ridden a bike to and from school daily.

Safety Information: 1. Do not participate in any activity with the right arm that requires weight. 2. Try to stay clear of risky activities that could potentially harm the already fractured arm such as climbing trees, skateboarding or riding the bike. 3. If any traumatic events occur and you have pain, numbness, tingling or redness lasting over an hour around the elbow please call your doctor. 4. When going to bed or laying down at night be aware of the affected arm. Do not put any weight on the elbow or arm when laying down.

MS Scenario: Your patient is a 36-year-old male with multiple sclerosis. He is being discharged from outpatient rehab. He ambulates with a cane indoors and uses a manual wheelchair outdoors. He is married to a hairstylist and has 2 younger children. He is a CPA and wants to keep working for his current employer but requires a rest period every 4 hours due to fatigue.

Safety Precautions: Before and as we make small changes to Mike's daily routines, we also must be aware of the precaution(s) involved with this condition. It is pretty evident though that fatigue is the factor that weighs the most on patients that have multiple sclerosis. This fatigue could result in decreased cognitive awareness, higher risk for falls, etc. Therefore, those that are involved with Mike Smith, need to properly educated on some tips/recommendations that can help avoid some of this massive onset of fatigue.

Burns Intro 20 minutes treatment

Scar Management 5 minutes Once the skin is healed, you may begin to apply a non-perfumed lotion or moisturizer at least 4 times a day for 5 - 10 minutes at a time. Use a circular motion when rubbing the lotion into the skin. Massage the new skin with the lotion until you can no longer see the lotion. Lotion massage helps the skin be more elastic and smooth like uninjured skin, and also helps with itching. Continue scar massage regularly until the scar has matured, which appears pale, flat, and/or soft. 10 minutes Exercise programs Walking is an easy way to get aerobic exercise to promote endurance. Walk outside and start off slow. Increase the time your child walks by about 1 minute per day and build up to walking 20-30 minutes for 3 times a week. They should feel as if hey are working, but should not be so short of breath that they can't talk. When cleared by your doctor, trying increasing the time walk or try using a stationary bike. Play a simulated Wii game such as bowling, golf, Dance Kids to promote movement and coordination as tolerated. Carefully perform stretches as tolerated through yoga/ stretching exercises to promote flexibility and endurance. For example: 5 minutes AE equipement A reacher can help the child obtain items from the floor and assist with lower body dressing. A long-handled sponge and shower/tub chair can help the child wash their lower body during bathing tasks while seated. A light weight or powered wheelchair and/or walker can help the child move around in her surroundings while they continue to increase their endurance and stamina for walking. A zipper hook can help the child zip up their compression vest once it is on them. When skin heals over a joint there is a high risk of contracture meaning tightness, the tissues starts healing right away so if it heals with movement it will heal properly, move the joint as much as possible and the sooner the better. If the skin is not moved we can see the skin get tight over the joint and will need to be stretched over time which can be painful.

MS no hot shower hot causes fatigue

Showering/Bathing: As you can expect, showering or even being in the bathtub is going to cause fatigue. At first, it isn't going to hit hard; however, as the MS condition takes its course, the issue with fatigue is also going to get worse. I am recommending you to go ahead and start using a shower chair to sit in now, so when you can't tolerate standing for longer period of time, at least you're already used to having to use it. Also, insert sturdy grab bars to prevent you from losing your balance (decreases risk for falls). And do NOT take hot showers; even avoid warm showers too.

Hand crush injury Self care

Showering: Install grab bars for balance while getting in an out of tub, soaping body, and shampooing. You may not feel that your balance is being compromised from the injury, but if you slip or do lose balance, you will now only have one hand to help you. Installing grab bars will reduce risk of falling and shower injury. Use mounted shampoo and soap dispenser, or a pump bottle to access product with single hand. Use a long handles sponge by unaffected hand in order to reach parts of the body that would have normally been reached by injured hand.

CVA 8) She is going home refer 85-year-old husband who is a very active elderly man and can assist her as needed.

Since the husband is in good shape the wheelchair prescription will be for a light weight wheel chair and this will allow the husband to help his wife with the manipulation of the chair if need be.

CVA 7 You and PT have talked, and she will need a light weight wheelchair for longer distances and even to use independently in the house

Since the patient needs only minimal assistance OT will fill a prescription recommending a light weight wheel chair that the patient can use if she goes out for long distances. The patient can use the wheelchair when she is going for longer distances when visiting the doctor's office, church, the supermarket, her grandchildren etc.

Distal humerus fracture

Splinting: The splint you will have is called a "Long Arm Posterior Splint".- Wear:1. Wear splint throughout the day and night. 2. Do not take splint off and participate in any activities that require moving weight, you could potentially irritate or re-fracture the arm. 3. Only take splint off to bathe or shower. 4. If injured site becomes painful, swollen or has redness lasting over an hour please call the doctor right away. -Cleaning: 1. In order to clean the splint, use lukewarm water and soap. 2. Wash stockinette and Velcro daily and dry to prevent odor. Precautions: When taking the splint off, do not place near any heat sources such as the stove, radiator or in a car on a hot day.

CVI EXERCISE PROGRAMS FOR THE BLIND

TANDEM BIKE Since my client lives with his wife and two daughters, he can incorporate the use of the tandem bike. It's a highly social, immense fun, and good way to exercise. In addition to providing a great workout, the teamwork required by this form of exercise can strengthen friendship bonds and rapport between riders. STRETCHING AND EXERCISING EQUIPMENT low impact aerobics or exercise equipment such as a treadmill or stationary bike, can help with cardiovascular workouts. For muscle definition, try using hand weights, rubber bands, resistance equipment and body balls. Exercises helping with balance, flexibility, and stretching which can enhance muscle tone and enhance body awareness and movement in space. MARTIAL ARTS is very common with individuals who have visual impairments. Martial arts should be introduced by and learned with a qualified instructor who has experience with visually impaired individuals. Martial arts help focuses on movement and body awareness. This form of exercise will help develop your senses of hearing and touch which can help you become more aware of your body position in space and location of people around you.

CVI Adaptive equipment education Orbit reader

The Orbit Reader 20 is a twenty-cell, eight-dot refresh able Braille display which serves three major purposes: Reading books in electronic Braille, Taking and editing Braille notes, and serving as a refresh able Braille display (by Connecting via Bluetooth or USB) for a computer, smart phone, or tablet running a screen reading program.

Global Aphasia Left CVA

The affected person has a severely limited capacity for reading, writing, and speaking. The damage is extensive and often occurs to both Wernicke's and Broca's area of the brain. Although people with global aphasia can improve, the rate and extent of improvement really depend on the severity of the brain damage

Left CVA Aphasia is a language disorder

The intelligence is still completely there it is just kinda useless because of the fact that the communication cannot come out correctly. Having conversation back and forth, Use picture board and let the patient identify pictures and shapes. Knowing words saying words, even understanding words. If it is very severe we need to use a communicating device. Drawing, gestures, and writing can all help therapist communicate with aphasia patient.

SCI Exercise C5-C7 vertebrae with resultant C5 ASIA B Tetraplegia 20 minutes treatment

Theraputty hand and fingers hand strengthening exercises Lowe extremity stretching if possible Always be Careful!" Wheelchair Pressure Relief Areas:Shoulder blade, posterior knee, sacrum and coccyx, ischial tuberosity, and the foot. Side-Laying Pressure Areas: Medical ankle, lateral ankle, lateral foot, medial knees, trochanter, iliac crest, rim of ear, spine of the scapula, and the side of head. Back-Laying Pressure Areas: Heel, sacrum and coccyx, elbow, dorsal thoracic area, occiput, and rim of ear. Education: Family and patient education on spinal cord injury-what to expect on the daily basis. Skin Inspection:The importance of checking the skin daily for ulcers and wounds.

Hand crush injury Client: 27 Year old male, who is a farm worker from Mexico. Patient speaks little English and lives in an apartment with his three brothers. He has sustained an industrial injury involving a pecan crushing machine. He lost his right thumb, his index finger distal to the PIP and has had degloving up to the wrist. The crush also fractured two of his carpal bones. After several surgeries, he is being discharged from the hospital. He will be able to attend outpatient OT if he can manage the transportation. He is sent home in a protective splint that for his hand that cannot be used at this time. He has a driver's license but only has one car to share among him and his three brothers.

This home program will focus on all areas of occupation being affected by this injury sustained. It will include safety precautions, splint care, tips and strategies for self-care, public transportation, driving, adaptive equipment for the injured arm. This home program focuses on the use of one hand since physician's order are to restrain from using the injured hand for the time being. With any questions regarding this program, contact our office right away.

Left CVA Expressive Aphasia (Non-fluent)

This is also referred to as Broca's aphasia. The affected person knows, in their mind, what they want or what they want to say but when it is communicated the words (verbal and written) come out in shards. Commonly, the patient will utter single syllable sounds/words or sometimes nothing at all.

Adaptive devices

Toilet to tub sliding transfer chair- Bath tub bench Reacher Forearm crutches Manual power assist wheelchair- or a light wheel chair

TBI Home Program Your patient is a 6-year-old boy being discharged home after suffering a TBI from an MVA. He is able to perform self-care with maximum verbal cues. He walks slowly with a hip hike gait on the right. He is socially inappropriate and has little inhibition. He had enjoyed playing baseball and riding bicycles prior to his injury. He will be returning to school in 2 months with special education intervention. His handwriting is barely legible. He was in the first grade when he was injured. He lives with is father and stepmother and 2 stepsisters.

Treatment program Preparatory let the child warm up/ play a bit before beginning therapy Exercises writing skills exercises Hand writing: Start with letting the child draw straight/ vertical lines then horizontal lines, diagonal lines circles, squares, triangles. Let the child then trace his own name Depending on how severe the gait might be the child might need braces for his legs. To reestablish normal gait going for walks can help with balance and propioception as well as correcting the incorrect gait Secure gait belt on the child and take the child outside in nature, let the child walk and correct the gait by giving visual, directive, and verbal cues.

Guillain-Barré syndrome, 20 minute treatment

Upper and lower extremity PROM 4 minutes on each side Benefits of Passive ROM increases soft tissue flexibility and joint ROM improves function Prevent or improve existing contractures Promotes orderly healing of soft tissue Participation in a fall prevention Social Integration ADLs. For community integration of clients with GBS, a comprehensive strategic self-management approach should be prescribed for long-term recovery. Shoulder wrist exercises

R CVA Home Program Patient Patient is a 67 y.o. female who is being discharged home with her 70-year-old husband from inpatient rehab. She is unsafe with medications and cooking. She uses a hemi-walker and has had frequent falls. She needs verbal cues to remain on task. She exhibits low tone in her left UE, uses the arm only when instructed to, and has moderate left neglect.

Use Hero automatic pill dispenser Use micro wave Employ home heath aid Impulsive What is Right CVAIf the stroke occurs in the brain's right side, the left side of the body (and the left side of the face) will be affected and can lead to Paralysis on the left side of the body, Vision problems, and Memory loss

Parkinson's Home Program.Home Program for Parkinson's Patient: 74 year old male who has been living alone in a 4th floor condo for 10 years since his wife passed away. He has 2 children who live about an hour away, and they visit him on weekends. He has a neighbor who does his grocery shopping and a cleaning service which comes in every 2 weeks. He was seen in outpatient therapy while his physicians were changing his medication routine. His tremors had gotten so bad that he could not even manage his pill without dropping them. He is being discharged from OT.

Use an automatic pill dispenser called hero Hero stores, sorts and dispenses a month's supply of 10 different medications Push button for auto sort and dispense when Hero alerts you. From the dispenser the pill can be directly transferred into a Collapsible cup with pill holder - This allows you to prep the pills you are about to take with a cup of water where you keep your pill organizer. If you need to take your pills closer to the sink to get water you don't have to worry about potentially dropping them or you can bring them with you if you are going out when you need to take them.

fibromyalgia Energy Conservation at Home

Use equipment as needed to conserve energy. Equipment such as a laundry basket can help make cleaning and maintaining a home easier. It can help reduce the exertion normally used, conserving energy so you can use it for other avenues such as spending time with family. Keep most used kitchen items within reach to reduce overstretching and fatigue. Make a list of all tasks you would like to complete. Then rank them in order of most important to least important. Have your kids help with age-appropriate chores around the house. Sort and match their socks, clean up toys, etc. Keep an activity journal for one week. Write in the tasks accomplished, how long it took to complete them and the time of day you did them. Also write down when you took a break and/or when you felt you needed one. This helps you know when your high- and low-energy levels are throughout the day and plan accordingly.

RCVA Adaptive equipment maybe

Usually do not use AE with CVA patients

LCVA CLIENT DESCRIPTION Patient is a non-ambulatory 66-year-old fem ale. She suffered a stroke 5 weeks ago and is being discharged home with her 45 year old daughter after spending that time in rehab. He daughter works during the day but is home by 5:30 every night to assist with her mother. Her mother needs to be able to make her breakfast and lunch and toilet herself when her daughter is out. She is expressive aphasic. She was a professional cook prior to the CVA and has no cognitive deficits

W HAT TO EXPECT The left hemisphere of the brain is primarily responsible for language, time concepts, and analytical thinking. Individuals with left sided brain damage will often experience aphasia (loss of ability to understand or express speech) and apraxia (inability to perform particular motor actions). L CVA patients often achieve self care independence sooner than individuals with Right sided dam age however, they are at a greater risk for developing depression. CLICK THE ARROWS BELOW TO ADVANCE

My pt is a 12 y.o. girl that was burned over 32% of her body from a gas grill accident. She was enrolled in the 7th grade but missed 6 months due to rehab. She is being discharged from outpatient OT. She is independent with her LE garments, but needs assistance with her vest. Most of her limitations are picking up items and activities requiring trunk rotation due to tightness and lack of flexibility. She had played sports before, but her decreased endurance and lack of flexibility is limiting those activities. She will return to school next week.

What is OT's role? The OT and OTA may provide inpatient and outpatient personal daily living skills practice and follow-up with exercise treatment such as BTE technologies, Biodex, and adapted games. They can also make adaptations for support garments and clothing, remeasure patients for custom-fitted vascular support garments as assigned, and teach homemaking skills.

Hand crush injury Wound Care:-

When brothers or caregivers are assisting with wound care, ensure that they use gloves to reduce risk of infection. -Clean wound with water and saline to reduce risk of infection-Wrap injury with dry and clean dressings and be sure to change dressing when they become soiled or wet to reduce risk of infection.

CVA----Your patient is a 92-year-old lady with RA who had a right CVA with resultant left-sided hemiparesis. She has intact sensation in bilateral upper extremities, intact AROM right upper extremity but limited AROM in her left upper extremity. She presents with minimal AROM in the left shoulder and elbow and no PROM in the wrist and hand. She presents with edema to the left wrist and hand. She is going home to her 85-year-old husband who is a very active elderly man and can assist her as needed. She is walking with a quad cane and minimal assistance but only for short distances. You and the PT have talked, and she will need a wheelchair for longer distances and even to use it independently in the house. She is minimal assistance for upper body dressing and moderate assistance for lower body dressing

With RA the patient's joints are severely inflamed, swollen, and stiff. The first thing to do is to increase the blood flow to both hands and upper extremities in preparation of some light therapeutic exercises. This adjunctive treatment could be performed at a hand clinic performed by a certified Hand Occupational Therapist, or a COTA, by administering a moist heat pack or immersing the hands into a paraffin bath. At home the patient can submit her affected hands and extremities into hot water by taking a shower or just using a whirlpool.

Fibromyalgia Case Scenario: Your patient is a 35-year-old female with fibromyalgia. She has been seen by OT in outpatient for 3 weeks. She is performing stretches in the mornings. She is easily fatigued and, due to her pain, she cries at times throughout the day. She reports that most of her pain occurs with lifting more than 5 pounds. She is a single mother of 2 preschoolers and works as a secretary

Work Simplification and energy conservation at Work Stretch as needed between activities Use proper body mechanics and posture when needing to lift objects Break up weight as needed and when possible to carry object(s). Take advantage of team power to accomplish what you need to get done. Don't be afraid to ask for help if you need it!

MS Work

Work: Talk with your employer and request to do most of your duties within your own. You can compromise by being available 2-3 (no more) days for meetings/appointments as necessary. Schedule them at the time you are the least busy and can devote enough time to be out of the house. Explain to your boss, collogues, and the individuals you meet with that you will need to take a short 5-10 minute break every 30 minutes.

MD Safety Considerations in home

Would want to consider a power electric w/c for mobility in the community and at home, home modifications such as adding ramps, grab bars, widening doorways, having daily items used in a space where he can easily access them, installing voice control devices in the home or having one handy with him at all times, and etc. Using AE for IADLs and ADLs to make them easier and help keep his in-dependency

Excises strength

You can stand holding your arm for support to the wall and the side ways raise your amputates leg outside and inside/ hip abduction Or you can do it with hip flexion/ up and down Hip extension back and forth Knee flexion and knee extension Knee internal and external rotation To make these exercises harder we can do them against gravity/ laying down

Left CVA Receptive Aphasia (Fluent) Also referred to as Wernicke's aphasia

because of the area of the brain affected, receptive aphasia is demonstrated when the person can hear or read a language but is unable to comprehend the meaning behind it. Sometimes their own speech gets churned into non-sense sentence structures or they take speech very literally

SCI Home Program Scenario: Your patient is a 24-year-old police officer who fell from a high-rise balcony during a struggle with a perpetrator of a crime; he sustained fractures to C5-C7 vertebrae with resultant C5 ASIA B Tetraplegia. He is to be released from inpatient rehab to his parents' home. He is married with a 3-year-old son and his wife will continue to work part time to keep up with their mortgage payments. His mother is 52 and will stay home the other times of the week working part time to help out her son. The family is meeting with the OT department today to review both the home modifications needed and the safety issues to prepare for due to such a high-level injury. The wheelchair ordering and usage is being handled by the PT department. The family is both excited and scared about his return home.

tetraplegia is quadriplegia Cervical vertebrae C1-C7 Exercises Loss of function in arms and legs Thoracic vertebrae T1 top rib attaches -T12 trunk and legs Paraplegia Lumbar vertebrae 5 vertebrae in the lower back between the thoracic vertebrae were the ribs attach and the pelvis or hip bone Generally results in some loss of function in the hips and legs The sacral vertebrae run from the pelvis to the end of the spinal column