school OT crafts I want to try!

 One of my goals for this upcoming school year is to try more crafts. Here is a couple that look interesting that someone does with her home-schooled children. 🙂 I especially like the first and third link, all from Angry Chicken!

http://angrychicken.typepad.com/angry_chicken/2011/06/on-a-rainy-day.html
Making a cloud with rainbows

maybe this one too…
http://angrychicken.typepad.com/angry_chicken/2010/10/bone-digger.html

and I think this one is beautiful….rose petal drawings
http://angrychicken.typepad.com/angry_chicken/2010/10/rose-petal-drawings.html

and this one for Halloween…
http://angrychicken.typepad.com/angry_chicken/2009/10/that-silly-pumpkin-head.html

old OT reminders

I spend a lot of time while working trying to make sure I get the lingo down and know what I am talking about. I write myself a lot of cheat sheets with things I observe/read that I want to use in the future. I don't do a great job of organizing it though. But here is an example cheat sheet from when I worked in adult physical dysfunction last year. Now it's all alien to me since school OT is a whole other area! But when I read some of this stuff it reminds me how complex OT can be. :0

PS: None of this should be taken as advice down below – it could be wrong for all I know, and it's certainly all out of context. Just showing all the complex terminology and thought processes etc. I do notice when I read through this the lack of occupation-based terminology. Oops. 😉

PS2: I am down to under 100 new mails. That's why so many new OT blog posts lately, I'm getting close to everything being cleaned out. 🙂

Stroke:

PROM/AROM

Isometrics

Cocontractions

Rhythmic stabilizations

Scapular muscles

Weight bearing

PNF patterns

Abduction on sidelying

Regressive resistance

Short arc

Actaboski?

“composite digit flexion”

“Pt also demo intact LUE sensation to SWM 5.07 for protective sensation, however absent 2 point 1.0cm discrimination along L median nerve distribution/medial cutaneous nerve”

OT then applied gentle PROM to L digit flex/extend with differential FDP/FDS tendon gliding and pt instructed in joint blocking.

Increase facilitation of normal tone, neuro-re ed out of flexor synergy, activation of paraspinals and abdominals, long duration stretch with ext/sup patterning using deep tendon inhibition techniques, RUE through PNF D2 flexion patterns, OT maintaining flexor synergy inhibition points of contact for increased AROM while pt moved through PNF patterns

Ironing board/incline

Sliding board with wedges

Partial stands

Straight cane to activate external rotation with ace bandaged hand

Scapular mobilizatios – elevate, me do it, then u try to help

Supine uphill, cocontractions

Do some oscillations on shld while supine, quick approximations as well, externally rotate thumb while trying to do elbow ext

Prone on elbows or table top

Arm skate

Soques

Remiste

Concentric/eccentric

Closed chain/open chain

Lumbricals – tend to get clawed?

Intrinsic plus/minus positioning

Transfers to graded height surfaces

Recripocal patterning

No proximal activation palpated

Performed closed chain task

Dynamic reaching over weak limbs?

To improve postural stability, stand on variety of unstable surfaces

Try to self-correct and improve postural integrity, perturbations –v estibular

Change velocity, angle, distance

Unilateral UE release to challenge dynamic sitting balance

Air splint for neutral warmth to decrease tone

Max A to find initial placement on L

Unilateral UE downward reach and hip flexion needed for LE clothing management

Intermittent hands on assistance to maximize full elbow extension, keep postural integrity

Lowered concentrically with control

Paresthesias

Cross friction massage

Excursion

FPL – same, only move IP of thumb

FDS – same, to move PIP

Isolated FDS, FDP, FPL tendon     FDP – hol down palm up so can only move DIP

Scapulohumeral rythym discoordinated

Ulnar nerve paresthesias, 2/7 for 0.5 2 point discrimination

Stereognosis – no vision tactile search

Intrinsic: digit abd/add, interosseous lumbricals, so do pull apart fingers with resistance. Strengthen intrinsic plus position

Straighten elbow, FDP flatter stretch at IPS????????

Follow ulnar nerve tract up C8/T1 (brachial plexus)

Scaption to decrease impingement

Thumb up: coracobrachialis

Supination: biceps bracchi

Ulnar nerve glide ex: elbow extend etc

With OT correcting techniquers

CMC joint tightness

Resistive L digit extension

Difficulty with voluntary movement of thumb and digit opposite and lumbrical grip

Contract – isotonic

Hold – isometric

Agonist – pattern with limited motion

Antagonist – muscle shortened that limits range of agonist

D2 ext: ext add, int rot, flex abd ext rot, seatbelt  side on top, cross on bottom

D1: flex/add/ext, ext/abd/int, cross on top, side on bottom

PNF – proprioceptive neuromuscular facilitation, increase response of nm mechanism by stimulating prioprioceptors, fl/ext, abd/add, int/ext R, rotary component, balance of antagonists, sag, front, horiz

Trophic changes – ie swollen shiny skin and nails with ridges, sign of CRPS

TENS : transcutaneous, sensory to decrease pain, no visible contractions, bipolar 2, quad 4, crisscross pattern, black delivers shock, red grand/receiving. Further apart pads, shallow, close together deep. IFC – inferential current,

Ligaments – frozen shoulder, distraction, rythymic stabilization

Facilitate motor return

Respiratory rate – count number of times chest raises

BP manual, valve tight, pump up past 180, slowly release, listen to brachial artery, first and last heartbeat

Try to normalize movement patterns

Media positioned to facilitate BUE

For improved proximal stability for ADL tasks

Performed to improve BUE extensor strength

QD – once a day

BID – 2x a day

Cross tendon massage, subscapularis massage from axillary angle

UE assisted pelvic elevation

Shoulder capsular massage

Interosseous mobilization – supination and pronation, go up and down, radius and ulna

Neuro – don’t go past pain, ortho- go past pain

Pain increases tone so only go to tolerance

Ribcage elongation

Don’t stretch hypotonic

Manual protraction/retraction

Performed eval and pt has potential to increase functional skills, need to redo home program with 2 visits.

“composite flexure contracture”

Viscolas Flexigrip Hand exerciser

Vision: contrast, geographical vs spatial, inattention, poor vision, eyes jump/nystagmus, boundaries ie red tape to red tape

0—- bp, then 0 seated, standing etc

Dissociation of body and limbs

Active assist bow activity, bow positioned to inhibit compensatory R shld abduction and facilitate flexion in slight scaption. Occasional manual assist to inhibit compensatory R trunk lateral flexion.

Media positioned to promote RUE AROM in diagonal patterns and improve standing balance. Min A to maintain dynamic balance during task, ball placed to provide proprioceptive input to RUE and resisted trunk flexion, to improve postural integrity, decrease compensatory movements, improve tone for increased efficiency with ADL and mobility tasks.

Stickler’s syndrome: decreased visual acuity, nystagmus, increased risk of retinal detachment and amblyopia

Swivel spoon/wrist splint, steering wheel covers, HEP tendon glide, nerve glide, gentle strength, rubber band extension, towel crumble

OT rehab ideas

here were some of the ideas I had written down (some more occupation-based than others but just things to prompt my brain) while working in inpatient rehab….

PS: Belly dancing/fencing were two things I was into…belly dancing is GREAT for hip/core work (find just a basic video on youtube and they can work in the parallel bars, if not shy about it of course) and fencing (with foam swords) if you use the proper stance (google that too) is great for balance and strengthening/stabilizing lower body while also incorporating upper body. 🙂

Low Vision in Children

Tips for NBCOT Exam

I wrote this in 2009 and never finished posting it…the new test had just come out, with the CST part to it. So this is relevant to the new test, but I am NOT up to date on whether things have changed in the last few years, so read this with a grain of salt. Or maybe a salt shaker.

I didn't start studying nearly as early as I should have, but I used 3 sources: TherapyEd book & review course, NBCOT book + online practice exams, and friends.

If you can afford it, take the TherapyEd review course. If money is an issue, it's probably still worth it IF YOU HAVE TROUBLE TESTING (the cost of that course is cheaper than re-taking the exam). If you are a strong student, you can probably get by without it.

I liked the TherapyEd review book that came with the course. I basically memorized the vast majority of the book. You need to be able to spout off the information, NOT just “recognize” it. I did flashcards, not so much to actually use, but to help me concentrate so that I learned while making them. There is what, like, thirteen chapters? So depending on how slowly you study, try and give yourself a few days for each chapter if at all possible. DON'T SKIP ANYTHING. I really only glanced briefly at statistics/research/management, and I wished I had looked closer. Everyone's test is different, but everyone's test will most likely include a little bit of everything. The more you know, the more likely you'll pass, obviously, right?

Now, the TherapyEd questions are kind of weird, I admit. Long and oddly worded. Still good practice. And it has lots of CST to practice with.

The NBCOT book was much more like typical NBCOT questions, although oddly enough, the book didn't have any example CSTs…those new clinical simulation questions. (I ALWAYS confuse the words stimulation/simulation).

NEW NOTE: All this may have changed in the last few years with new editions!!

I HIGHLY recommend purchasing the NBCOT online exam that is 100 questions. According to a classmate who researched it, there is like a .9 (ie high) correlation between your score on that exam versus the real thing. I don't have the evidence though. Also, one of my classmates went up FIFTY points from practice to real thing so I guess um, well, ….anyway, it's still helpful to see how you do on that online exam. The other things you can buy I don't necessarily recommend…if you can afford it, great, it helps with confidence …remember you cannot necessarily go back and see the question though…and answers aren't always given I don't think. So examine everything carefully the first time, and jot down notes as needed.

My favorite study questions had to do with psych….here is a (very very) brief psych med overview. Like I said, it may or may not be on one of your tests, but you should know it regardless! It seemed like each study book had this same information in it.

Akathisia = restlessness, urgent need for movement, typically a psych med side effect.
(This is like my favorite word!)

Tardive dyskinesia = almost constant movement, more chronic and serious, does not go away, and is result of years of heavy psych meds. The movements are more writhing with a lot of oral motor involvement.

Make sure you know the difference between the two types of movement. 🙂

MAOIs = drugs used for depression. You have to be on a restricted diet on these medicines because of an amino acid blah blah – so they like to ask diet questions. They can't have like, pickled, smoked, cheesy things…and one of the first signs of toxicity is a headache. Your patients, whether you work in mental health or not, may be on this type of medication, so make sure you know the reasons for the special diet, etc.

Photosensitivity = lots of psych drugs cause people to be more sensitive to sunlight than normal. If you are doing psych activities/groups and it involves being outside, there is a good chance you'll need to remind the clients and/or be prepared to deal with that side effect.

***As far as I can tell after re-reading this repeatedly, I have not said anything inappropriate/proprietary….if anyone disagrees, please let me know. My intent is to share advice, not do anything illegal!! 🙂

HELP button, staples button hack

 http://www.engadget.com/2006/07/19/hacking-the-staples-easy-button/

http://www.youtube.com/watch?v=6OEFxc3zTls

http://www.springerlink.com/content/v743km042677w8w0/

I found these three things that might help me figure out a Staples button hack. I want it to say “help” instead of “That was easy!”. By the way, kids LOVE the Staples button and consider it a real treat to be able to hit the button after an activity. Even if the activity was actually somewhat frustrating, the kid gets a ghost of a smile on their face after hitting the button. The only problem is they usually try to hit it like six times in a row.

I have a child who doesn't like to ask for help….I wanted to make a Help button so she could hit it for fun. Seemed like a good idea. Only problem is, I'm not exactly handy with a drill so these hacks seem a little challenging for me. But wanted to throw out the idea of hacking out these buttons for basic communication needs or to be silly.

Other alternative….does anybody know of similar buttons you can buy to say whatever you want? I am sure there are OTs and/or SLPs out there working with AC who know way better than I do.

Exerting too much pressure when writing…OT school ideas

New OT blog

www.jezzabellasotexperiences.blogspot.com

New OT blog :) 

There is a blogpost a few down showing a Real Simple activity using half a balloon + a plastic cup that looks cool!
 

Return to OT blog

I basically didn't have wireless access this past week, so no blog posts. However this upcoming week I have more time. My goal is to COMPLETELY finish responding to OT blog comments/emails etc within next week (perhaps a slightly lofty goal) + finish filing my OT work mail + organize my computer documents for work. Phew.

I got contacted by Dycem and they will be sending me a few products to review and I also have a book to review! I am really excited! I love reviews!

I am in Alabama one more week – back to San Diego next Sunday. Fun times in the South.

I am trying to get up the energy to go work out! One of my biggest, biggest issues is almost constant low energy. Bleh.

Well, this was a pretty worthless posting, but I wanted to say I am back to having wireless, back to responding to blog emails etc (I went from over 1,400ish to only 210 in the past two weeks). Another goal of mine – although not this week – is to write an article for OT practice about Colombia!

Some AWESOME men Rehab OT ideas from a good friend

When I was helping out in physical rehab in the rural Deep South, it was often challenging for me to find ways to engage the men! One of my good friends, who happens to be a man from the South, sent me these ideas. Like two years ago. I love them ALL. 🙂 Now I am sharing with my blog with only minimal editing! He was meant to be an OT! It's too bad we can't bring in fake guns but I am sure that is a no no at any place. The laser refers to (probably, if my memory serves me right) doing something along the lines of fitting patient with a hand or arm weight, taping a laser light to it, and allowing them to point at a target with it. Gotta be careful about not getting it in anyone's eyes though.

As always, try any of this at your own risk! Consider insurance of your work, liability issues, etc.

Mail 1: Would they like outdoor magazines?  Would your organization allow hunting and fishing magazines?  Can they accept them if they are free?  There is a forum called Georgia Outdoors or Georgia Outdoor Network – can't remember right now.  If it didn't upset your bosses you could join it and ask for magazines, I think you would get a bazillion. 

Also could you take patients on field trips?  Shooting ranges often invite special needs shooters in for free days.  I don't know but I bet there are a lot of ranges in GA. 

On simple stuff, the laser taped to the hand weights is a really good idea.  LEDs could also work over a short range. 

Mail 2:
1.  On the weekends go to the various car dealerships in the area.  Get brochures of trucks, SUVs,cars, everything. You can cut up the catalogs, glue the pictures to index cards, and use them for sorting activities, guessing games (what kind of car is this?).  I bet you could even come up with card games. 

You are in the heart of NASCAR country.  You could also do the same with drivers, racing teams, cars, factories.
You could also do the same thing with football teams.

2. Go to Walmart and get a couple of the Popiel Pocket Fisherman fishing rods.  If y'all don't have the funds for buying stuff, I bet you can ask among the employees (Do y'all have an on campus BBS for lost and found, want ads, etc?) for a couple of old fishing rods.  Tie a washer or other weight on the end of the line.  Go to food service, get some large buckets, like pickle buckets.  Let the guys cast the weights into the buckets.  Sort of like fishing.  Maybe a better outdoor, springtime activity.

3.  Get a couple of old golf clubs (putters) and some big cups.  Put put time. 

4. Get a large piece of poster board and about two dozen large steel washers (about 1 to 1&1/2 inch diameter).  On the poster board mark lines every five inches.  Put designs on washers such as there are 6 different designs or colors on four washers each.   In other words, you come up with 4 red washers, 4 green washers, etc.

Place posterboard on floor with lines parallel to wall.  Have participants toss washers from appropriate distance.  Person with washer closest to wall wins.  Can be done standing, sitting left or right handed, etc.  Watch this one though – chance of gambling occurring.