Let's Get Moving!

The order for restoring confidence in mobility as activity demands increase are these listed in order: bed mobility, mat transfer, wheelchair transfer, bed transfer, functional ambulation for ADL, toilet & tub transfer, car transfer, functional ambulation for community mobility, and community mobility & driving. I think the hierarchy is in this specific sequence because it allows a client to work and build on more basic and lower level skills (but imperative) in order to achieve higher level and more complex skills for everyday life for them to become more independent in their daily living. Their quality of life depends on it, so I agree with the lay order. I think of it as building blocks, and the more basic skills and activities, like taking care of yourself are the foundation, and like a house you build off the foundation. When you are able to take care of yourself it not only allows for independence, but as well as giving a person the ability to take care of others, or (like driving) being aware of yourself and others.

In my past observations, I never got to see this progression in mobility although I think that is the best part of therapy almost. I saw progress in different clients, but not to the degree of this type of regaining of confidence and independence in mobility. I do think that every person is different, and when you have one client who may not be in any worse of a medical situation but is more emotional or emotionally stable I do think that can impact progression in these steps.

I would love to see this type of progression in a client in the future, and honestly it is this type of impact on a client that I am eager to assist with in my profession as an OT.

Body Mechanics

Reasons to teach people/clients about proper body mechanics and posture are very important and include:

1.       Prevent injuries to the body such as muscle, joints, etc.

2.       Protect your body from back pain and or other parts from strain  

3.       Promote ideal balance and coordination

4.       Encourage safety for yourself and others

One way that I would teach a client on how to use proper body mechanics is by using something straight like a yard stick or something, and aligning it on my back along my spine, back of my head, and tail bone (to show them, and later allow them to try), and I will demonstrate how to properly pick a package up from the ground without bending over like most people do which is not proper body mechanics. The idea is that the stick stays on all those areas that I explained, and you lift with your legs when you grab the object from the ground.

Another way that I could show a client how to use proper body mechanics is informing on how to improve posture when sitting in a chair especially for long periods of time if that is your job. So, first adjust the height of the chair where your feet are nicely planted on the floor, and your knees are either in line or slightly lower than your hips (comfortably). Obviously sit straight up in the chair, and your hips all the way back in the chair as well. Lastly, the back of the chair needs to be slightly inclined also. This will reduce back pain, and promote good posture!

Interesting, Might I Ad!

So, I was trying to think of a popular ad, and it seems like every time I purposely try to think of something like a song, or anything specific, nothing comes to mind. So, I decided to look up popular ads, but then I thought they were too popular, so I went for something that I was wanting to connect with personally. A certain emotion I wanted to feel, and so that is what I searched and came up with... an ad that fit me. At the bottom I will post a link if you would like to watch it. In the ad, there are three individuals that are feeling stressed about just everyday life, and one trying to fall asleep. All three were wanting to experience some relaxation. This is something that I can relate to on a daily basis, and I may even get the app that they were advertising! Anyhow, in the nervous system you have your CNS and your PNS. The PNS (peripheral nervous system) connects the CNS (central nervous system) to the rest of the body. The PNS divides into the somatic (voluntary movement) and autonomic system (involuntary movement). The autonomic nervous system further divides into the sympathetic and parasympathetic nervous systems. I believe that this specific ad kicks both subdivisions into work. In the beginning there is immediate over stimulation, which quickly made my heart rate race a little because I could easily relate to the stressors given which is the sympathetic nervous system at play. It is your fight or flight response. Now, quickly into the ad they switch gears and advertise this app on the phone to help you relax and get away from all those stressors and connect with yourself again. This is where your parasympathetic nervous system comes into play. It is responsible for lowering your heart rate and blood pressure and bringing your body back down from a stress induced state. It is your rest and digest response. Both are very important and imperative. I hope this "Ads" to your knowledge!

https://www.ispot.tv/ad/dEi1/calm-reduce-your-stress

"Man from the South"

The daily routine of the soldier (with all fingers intact) would be normal in doing the very things he enjoyed. Now, had he taken the bet and lost, certain occupations would certainly be affected like specific sailor duties possibly pulling up a rope, or simply even grabbing a drink. His sense of gripping things would be decreased because that is a big function of the pinky finger. The wife of the of man betting against the soldier, I am sure that her daily routines are very difficult with only having a couple fingers, such as washing dishes, or even driving. I believe most of everything would be difficult and need to be modified in some way to improve function. Depending on what fingers were still intact, which I know the thumb was but I am unsure of the other one that was left, a way that washing dishes could be modified would be wearing a special glove that fit her hand with scrubbers/grippers on them to sufficiently grip the dishes and wash them as well.

My Neurotransmitter Depiction Picture: Gamma Aminobutyric Acid (GABA)

My OT Conceptual Model

https://drive.google.com/file/d/1IP-S224nurGcH1_DuMyCUcOeWIephvmK/view?usp=sharing

Implicit Bias

What is implicit bias? In my own terms I think of it as your personal experiences/attitude about things that are unknowingly influenced on our own choices and comprehensiveness on different aspects of life. With knowing what it is, do you think you have any implicit biases? Well, I think that everyone does in their own way, not even knowing it because it is an unconscious act. Maybe after recognition and reflection you then would figure out that you do. Bias has such a negative connotation to it, but these biases don’t just mean race, gender, or political standpoints. They could mean the way you feel about a simple tattoo that someone has, or their lifestyle choices. So, why is it important for students and OT practitioners to learn about this? Well, if you know and have reflected on what implicit biases that you have, or even just acknowledge that you have some, you can then decide how you will act in a certain situation with a client if they do or think a certain way that you may feel differently about.   

Not only that, but human communication is the basis of humanity, and if we are not all trying to help one another, or for the very least communicating with one another then why are we here? What is our purpose? It is about making connections and feeding off what we already know but most importantly what we learn on top of that. Being a consistent life-long learner invites a sense of diversity and a respect for the ever evolving and shifting of cultures. During a podcast interview with Dr. Lancaster she spoke about putting our implicit biases aside and unconscious assumptions on populations because if we don’t do that it could impact a client clinically and the opportunity for them to get the best and most efficient care possible. Dr Lancaster also said something that stood out to me which was, “Inclusion is not a favor, it is just the right thing to do all of the time.” We in OT, it is our duty to always make an effort to include others and the many walks of life. This does not mean we have to accept in their part, but it does mean that we should try to understand them, and use our empathetic, therapeutic self. This also means to have more cultural humility which in turn makes for a more client centered approach.  The first step to understanding your client is with asking the right open-ended questions, but more importantly understanding the importance of actively being present with your client or anybody. I learned this from a brief article that I read by Debbie Hall called “The Power of Presence.” Even in the times that you don’t have all of the right words to say, the value of being there for someone speaks volumes and it might seem like you are not doing anything, but in actuality, sometimes people just need a listening ear and a shoulder to lean on.

How can we reduce the impact of our biases? How do we even recognize that we have them? Because we all do, whether you know it or not. Well, the first thing you could do is understand what implicit biases are and recognize that you may have some. Second, if you want to know what some of them are then you could go to a website called Project Implicit. There is a test you can take, it is free, and it gives you insight on what you may have implicit biases on with certain populations or groups. Lastly, once you have examined and reflected on those biases you could look up a 7-day implicit bias cleanse to help with personal reflection. This is also free. These are just a few things to help widen our lenses and broaden our minds. 

My biggest take away from all of this is the fact that I discovered I have my own implicit biases that I never knew about. I have always tried to make inclusion such an important thing because I know what it feels like to be left out or see the effects of someone being left out or not understood. I too am going to take the steps to reduce my own implicit biases so that I can in turn become an outstanding OT practitioner for the sake of my future clients.