Keeping Up With Kaylee

As  the activity demands of an individual increases, the need for greater confidence in mobility does too. The hierarchy of mobility skills, from the most stable to the least, is: bed mobility, mat transfer, wheelchair transfer, functional ambulation for ADL, toilet and tub transfer, car transfer, functional ambulation for community mobility, and community mobility and driving. This sequence is logical and decreases in support as the client progresses through the levels. The base of support varies for each skill. The largest base of support is with bed mobility, which is also the lowest level on the hierarchy. For the highest level, community mobility and driving, there is more maneuvering through environments other than the home. This means extra walking or transfers than the client would usually perform in the home. This is what I have observed in my past experiences. For a client who is very weak and in the hospital, ...

When deciding what assistive device is best for each client, there are many factors that need to be considered in order to have the best "fit." It is important to consider the physical condition of the client, including their disability, weight bearing status, strength, and balance. For example, if the client is not allowed to put any weight through one leg, you would not want to suggest they receive a cane.  Additionally, it is important to fit the assistive device to your client to ensure safety and proper body mechanics. If the client's crutches are too short and not adjusted to match their landmarks we use to fit, then they will likely have poor body mechanics.  If these factors are not considered, it can be detrimental to your client and cause an increase in risk for falls or further injury. To properly fit a cane or rolling walker to your client, the hand grip should be at the level of their greater trochanter to allow their elbow to be flexed 20-30 de...

It is very important to teach proper body mechanics and posture to our clients to prevent injuries. If a person does not have good posture or body mechanics, it can be harmful to their body and cause future injuries. The human spine is designed to be flexible, but also needs to stay in alignment.  For people who perform repetitive motions on a daily basis, we must see how they perform the task and determine if there would be a more efficient and optimal way for their body to move. For a person with exaggerated spinal curves, muscles on one side would be stretched and weakened, while the muscles on the opposite side would be shortened and tightened. For a person who stays in a flexed  position of their  spine will cause the intervertebral  dies material to glide backwards, possibly causing a herniation. Posterior herniations are most common because humans generally flex their spine repetitively. It is good to teach a proper lifting techniques and to keep a ...

If the soldier lost the bet, he was to lose his pinky. Although the pinky is the smallest finger, it still plays an important role in our daily activities. Without the pinky, our grasps would not be as efficient. To grasp something small, the pinky wraps tightly around the object to prevent it from slipping out of the hand. The pinky is involved in spherical, power, hook, and cylindrical grips. Without the pinky's help with these grips, it would be more difficult and cause greater use of the four remaining fingers.  An occupation that would be affected if the soldier lost his pinky thumb would be fighting in war. It would be difficult for him to accurately aim the gun to hit his intended target. He would have less stabilization than he would with all his fingers intact. Also, guns are heavy and without the pinky it would be more work on the other fingers to hold tightly to the gun. To adapt this difficulty for the soldier, he could use a gun that is ...

Professor Flick brought to light many important concepts and deepened my understanding on the importance of health promotion. As future occupational therapy practitioners, we must educate and teach those we work with about health. Social determinants of a person's health include: education, food, income, peace, shelter, social injustice and equity, stable ecosystem, and sustainable resources. If we are able to impact one or more of these areas in a person's life, it can greatly impact their health in a positive way. Additionally, she discussed how important it is to check for client understanding each session. It is not always outwardly obvious if a client is not able to read, so it is important to determine this and make sure they are aware of what is going on. Professor Flick discussed a study that evaluated readmission rates in hospitals. Occupational therapy proved to be the only service that positively impacted and reduced these rates. I believe that is because occupatio...

Scapulohumeral Rhythm refers to the relationship of the humerus and scapula during upper extremity movements.  The clinical relevance of this topic is to be aware that to obtain the full 180 degrees of motion, there must be a synchronized movement between the scapulothoracic and glenohumeral joint. There is a 2:1 ratio of these two joints. For every 2 degrees the humerus moves at the glenohumeral joint, the scapula moves 1 degree at the scapulothoracic joint. When the shoulder joint moves the full 180 degrees, the humerus moves 120 degrees and the scapula moves 60 degrees. Both joints contribute to the overall motion needed to complete full shoulder range of motion.  The shoulder joint has the greatest mobility of any joints in the body, so the muscles and ligaments that are a part of the joint are essential for maintaining stability. Scapulohumeral Rhythm allows for optimal length-tension relationships to prevent active insufficiency at the glenohumeral joint. The scapula ...

It is important to palpate bony landmarks when measuring ROM to place the axis of the goniometer in the proper position and to point the arms of goniometer towards the proper bony landmarks, too. By placing the goniometer on the bony landmark, it increases interrater and intrarater reliability. If two therapists were to measure ROM on a client, it is important that both perform the measure in the same way, using the same landmarks to ensure that the measurement is the most accurate.  Additionally, it is important to position the client in the proper position to measure the joint. If this is not done, the client’s full available range of motion may not be recorded or measured because it could not be obtained in that specific position. For example, when measuring knee extension, a towel should be placed under the client’s ankle to allow for the full extension to be obtained. If the initial therapist performs the measurement with the towel under the ankle, but the second therapis...