WalkAide. Long term cost effectiveness of FES. J of Rehab Med 2013; 45(2): Humphreys et al

Size: px
Start display at page:

Download "WalkAide. Long term cost effectiveness of FES. J of Rehab Med 2013; 45(2):154 60 Humphreys et al"

Transcription

1 WalkAide Long term cost effectiveness of FES J of Rehab Med 2013; 45(2): Humphreys et al 126 people (62 stroke, 39 MS, 7 SCI, 3 CP, 15 other) Mean time of FES use 3.6 years 33 using FES after 11.1 years MS walked 29% faster 40% increased Functional Walking Capacity 1

2 Gait DVDs Employment Issues in MS 2

3 Employment Issues Disease modifying drugs mean people with MS may work longer Should be addressed EARLY Don t wait until performance has declined Usually need to address multiple issues Employment Assessment Be aware of MS symptoms that may affect ability to maintain employment If patient is employed, always probe regarding possible problems Ask specifically about whether a particular symptom is affecting the job Don t offer support on disability application until modifications have been tried 3

4 Employment Treatable Symptoms likely to influence job performance: Spasticity Fatigue Cognitive problems Impaired gait Weakness Poor balance Decreased sensation Dizziness Pain Employment Treatment: Medications Disease modifying medication Fatigue meds Walking Ampyra Spasticity meds Bladder meds Botox Depression 4

5 Employment Modifications: Conserve Energy Separate exercise and function Obtain gait equipment Manage spasticity Decrease walking/lifting/stairs/prolonged standing Get and use a disabled parking space Identify a resting location Use power mobility equipment for long distances Substitute technology for physical and cognitive issues Employment Modifications: Technology Use technology to increase job performance Elevator Computers/tablets/smart phones Text Conference calls Webcasts Phone alert reminders Apps: Vbox, Dragon Dictate, Siri/Iris 5

6 Employment Modifications: Cognitive Issues Paper back up of steps to turn on/off technology Hints of bigger concerns Refer to other professionals for more in depth assessment and treatment Employment Modifications: Decrease heat Most people with MS are heat sensitive: Move to cooler location Air conditioning Use cooling vest Avoid prolonged exertion Work from home during hot periods D Meier, et al, Neurology 2010;75:

7 Employment Modifications: Ergonomic Changes Modify posture/positioning to decrease spasticity/fatigue Ergonomic work station Blue tooth, keyboard, tablet set-up, key pad for tablet, mouse, monitor, head set Individually fitted chairarmrests/headrest/height/back Head set/smart phone dock Voice activated software/apps Employment Resources for Modifications: Vocational Rehabilitation Employer National MS Society or other nonprofits Insurance for mobility equipment Building Owner Special grants Person with MS 7

8 Employment Disability Working people with MS may need to take disability Try modifying employment, behavioral changes, equipment before disability application Employment Disability Existing Functional Capacity Evaluations (FCE) often inappropriate for MS Existing FCE s based on orthopedic problems New MS FCE must capture relapsing remitting nature of MS as well as variable symptoms for each person 8

9 Employment Disability CMSC task force to develop new MS specific FCE May be used for reasonable accommodation recommendations Spasticity in MS 9

10 Assessing Spasticity in MS Evaluate spasticity routinely - regardless of specific complaint Spasm Frequency Scale Modified Ashworth Scale Dynamic Muscle Tone Multiple Sclerosis Spasticity Scale (MSSS-88) Clinical measure of pain intensity Spasm Frequency Scale Scor Criteria e 0 No spasms 1 No spontaneous spasm (except with vigorous stimulation) 2 Occasional spontaneous spasm and easily-induced spasms 3 More than 1 but less than 10 spontaneous spasms per hour 4 More than 10 spontaneous spasms per hour (Penn, 1989) 10

11 Assessing Spasticity in MS - Modified Ashworth Scale Score Criteria 0 No increase in tone 1 Slight increase in tone (catch and release at end of ROM) 1+ Slight increase in tone, manifested by a catch, followed by minimal resistance throughout remainder (less than half of the ROM) 2 Marked increase in tone through most of ROM, but affected part(s) easily moved 3 Considerable increase in tone; passive movement difficult 4 Affected part(s) rigid in flexion or extension (Bohannon & Smith, 1987) Dynamic Muscle Tone Observation of Movement Patterns Equinus gait Scissor gait Upper extremity flexion/adduction Mass movement postures Observation Tips Try observing with and without orthoses or ambulation aids Video taping can be very helpful 11

12 Symptoms and Signs Associated with Spasticity Excess: Spasms Hyperactive DTR Clonus Co-contractions Stiffness/heaviness Pain Sleep disturbance Fatigue Insufficient: Strength Dexterity Speed of movement Coordination Motor control Precipitating factors Exacerbation of MS Progression of MS DMT effects Antidepressant therapy Fractures/Skin lesions/urinary stones Fatigue/temperature/stress Menses/fever/infections Other noxious stimuli: tight clothing or constipation 12

13 Treating mild to moderate MS Spasticity Exercise Stretching/Yoga Rhythmic exercise Medications Oral Equipment Shoes Orthotics Assistive devices Wheeled mobility equipment Mild to mod spasticity (continued.) Behavioral and environmental changes ADL modifications 13

14 Exercise Treating moderate to severe MS Spasticity Stretching/Yoga Rhythmic exercise Medications Oral ITB Equipment Mod to severe spasticity (continued) Shoes Orthotics Assistive devices Wheeled mobility equipment Standing frame BWSTT/Lokomat Behavioral and environmental changes 14

15 MS Spasticity MS Spasticity: Take Control DVD Other Equipment in MS 15

16 Wheeled Mobility Equipment Manual wheelchairs Scooters Power wheelchairs Indications Excessive fatigue Severe weakness Ataxia Mobility Decisions Manual wheelchair vs scooter Manual wheelchair vs power wheelchair Scooter vs power wheelchair When to discontinue scooter When to add tilt and/or recline What about standing? 16

17 17

18 18

19 19

20 Equipment Examples Cooling vest Cane Lightweight forearm crutches Four-wheeled walker with seat and hand brakes Front-wheeled walker Hinged ankle-foot orthosis Standing frame Three-wheeled scooter Manual wheelchair Power wheelchair Seating Employment Wheelchair Vehicle lift, ramp, lock downs Hand controls Conversion van Equipment Examples Elevated toilet/seat Hard flooring surfaces Padded bath transfer bench Ramps Grab bars for toilet/shower Low shelves/drawers Superpole with trapeze Reverse or offset hinges Sliding board Electric door openers Overhead lifts Voice-activated software Partner-patient lift Electronic memory aids Hospital bed or elevating Environmental controls head/feet Cell phone/smart phones Bed Ladder Telephone headset Buttonhook Adjustable Horizontal or vertical eating spoon keyboard/mouse tray 20

21 21

22 22

23 23

24 24

25 Cognition and Multiple Sclerosis MS Cognitive Problems Affect 50% of people with MS Occur at any stage of disease Related to number & area of brain lesions Related to brain atrophy May vary from minimal to severe 25

Staying Mobile & Active Post Stroke. Kevin Lockette PT Ohana Pacific Rehab Services, LLC Honoulu- Kailua www.ohanapacificrehab.

Staying Mobile & Active Post Stroke. Kevin Lockette PT Ohana Pacific Rehab Services, LLC Honoulu- Kailua www.ohanapacificrehab. Staying Mobile & Active Post Stroke Kevin Lockette PT Ohana Pacific Rehab Services, LLC Honoulu- Kailua www.ohanapacificrehab.com 808 262 1118 Aging Process Changes in body composition Loss of muscle tissue/increase

More information

ALL ABOUT SPASTICITY. www.almirall.com. Solutions with you in mind

ALL ABOUT SPASTICITY. www.almirall.com. Solutions with you in mind ALL ABOUT SPASTICITY www.almirall.com Solutions with you in mind WHAT IS SPASTICITY? The muscles of the body maintain what is called normal muscle tone, a level of muscle tension that allows us to hold

More information

Mobility After Stroke

Mobility After Stroke Mobility After Stroke Issues facing stroke survivors and their families Regaining Mobility Moving around safely and easily is not something you may think about, until you have had a stroke. Each year more

More information

LUMBAR. Hips R L B R L B LUMBAR. Hips R L B R L B LUMBAR. Hips R L B R L B

LUMBAR. Hips R L B R L B LUMBAR. Hips R L B R L B LUMBAR. Hips R L B R L B 1 Patient Name In order to properly assess your condition, we must understand how much your BACK/LEG (SCIATIC) PAIN has affected your ability to manage everyday activities. For each item below, please

More information

Symptoms can come and go; some are much more responsive to treatment whereas others are more difficult to manage.

Symptoms can come and go; some are much more responsive to treatment whereas others are more difficult to manage. Choices Symptoms MS-UK believes that based on experience, people cope best when they look at what is happening, rather than what might be. MS can cause a long list of symptoms. This list is not exhaustive

More information

Assistive Technology Fact Sheet

Assistive Technology Fact Sheet What is Assistive Technology (AT)? Assistive Technology Fact Sheet The term assistive technology refers to both devices and services. An assistive technology device is any item, piece of equipment, or

More information

National Hospital for Neurology and Neurosurgery. Managing Spasticity. Spasticity Service

National Hospital for Neurology and Neurosurgery. Managing Spasticity. Spasticity Service National Hospital for Neurology and Neurosurgery Managing Spasticity Spasticity Service If you would like this document in another language or format, or require the services of an interpreter please contact

More information

Upper Arm. Shoulder Blades R L B R L B WHICH SIDE IS MORE PAINFUL? (CERVICAL PAIN SIDE) RIGHT LEFT EQUAL NOT APPLICABLE (N/A) CERVICAL.

Upper Arm. Shoulder Blades R L B R L B WHICH SIDE IS MORE PAINFUL? (CERVICAL PAIN SIDE) RIGHT LEFT EQUAL NOT APPLICABLE (N/A) CERVICAL. 1 NECK PAIN Patient Name In order to properly assess your condition, we must understand how much your NECK/ARM problems has affected your ability to manage everyday activities. For each item below, please

More information

How to Choose the Mobility Device that is Right for You. A guide for people with ms

How to Choose the Mobility Device that is Right for You. A guide for people with ms How to Choose the Mobility Device that is Right for You A guide for people with ms managing major changes Jason (cover photo), diagnosed in 2005. Kim (top), diagnosed in 1986. John (second from top), diagnosed

More information

PHYSICAL THERAPY INTERVENTION WITH ALS

PHYSICAL THERAPY INTERVENTION WITH ALS PHYSICAL THERAPY INTERVENTION WITH ALS Richard W. Briggs MA, PT Chair, APTA Hospice and Palliative Care SIG Amyotrophic Lateral Sclerosis (ALS) provides a challenge to those physical therapists charged

More information

Cerebral palsy can be classified according to the type of abnormal muscle tone or movement, and the distribution of these motor impairments.

Cerebral palsy can be classified according to the type of abnormal muscle tone or movement, and the distribution of these motor impairments. The Face of Cerebral Palsy Segment I Discovering Patterns What is Cerebral Palsy? Cerebral palsy (CP) is an umbrella term for a group of non-progressive but often changing motor impairment syndromes, which

More information

Knowledge Brochure Series MS & SYMPTOM MANAGEMENT

Knowledge Brochure Series MS & SYMPTOM MANAGEMENT Knowledge Brochure Series MS & SYMPTOM MANAGEMENT Identifying your multiple sclerosis (MS) symptoms 1 A chronic disease like MS can cause a number of different symptoms and spotting yours is the first

More information

What is Multiple Sclerosis? Gener al information

What is Multiple Sclerosis? Gener al information What is Multiple Sclerosis? Gener al information Kim, diagnosed in 1986 What is MS? Multiple sclerosis (or MS) is a chronic, often disabling disease that attacks the central nervous system (brain and spinal

More information

Equipment Distribution Program Application 375 Kings Highway North, Cherry Hill, NJ 08034 (800) 532-7667 Web: www.mymsaa.org

Equipment Distribution Program Application 375 Kings Highway North, Cherry Hill, NJ 08034 (800) 532-7667 Web: www.mymsaa.org Equipment Distribution Program Application 375 Kings Highway North, Cherry Hill, NJ 08034 (800) 532-7667 Web: www.mymsaa.org Application for Safety, Mobility, and Daily Living Products Individuals with

More information

Spine Care Centre (SCC) protocols for Multiple Sclerosis Update 1 August 2015

Spine Care Centre (SCC) protocols for Multiple Sclerosis Update 1 August 2015 Spine Care Centre (SCC) protocols for Multiple Sclerosis Update 1 August 2015 Introduction Multiple sclerosis (MS) affects nerves in the brain and spinal cord, causing a wide range of symptoms including

More information

Computer Workstation Ergonomic Self Evaluation

Computer Workstation Ergonomic Self Evaluation Computer Workstation Ergonomic Self Evaluation Use this guidance to perform a preliminary evaluation of your workstation, and make any adjustments that are necessary to achieve a correct neutral posture.

More information

Musculoskeletal System

Musculoskeletal System CHAPTER 3 Impact of SCI on the Musculoskeletal System Voluntary movement of the body is dependent on a number of systems. These include: The brain initiates the movement and receives feedback to assess

More information

Coping with Symptoms of Multiple Sclerosis

Coping with Symptoms of Multiple Sclerosis Coping with Symptoms of Multiple Sclerosis Josée Poirier B. Sc. Nursing, MSCN Outline What Is a Pseudo exacerbation? Awareness Advancement of Treatments Treatment of Symptoms Uhthoff s Phenomenon What

More information

Webinar title: Know Your Options for Treating Severe Spasticity

Webinar title: Know Your Options for Treating Severe Spasticity Webinar title: Know Your Options for Treating Severe Spasticity Presented by: Dr. Gerald Bilsky, Physiatrist Medical Director of Outpatient Services and Associate Medical Director of Acquired Brain Injury

More information

Quality Measures for Long-stay Residents Percent of residents whose need for help with daily activities has increased.

Quality Measures for Long-stay Residents Percent of residents whose need for help with daily activities has increased. Quality Measures for Long-stay Residents Percent of residents whose need for help with daily activities has increased. This graph shows the percent of residents whose need for help doing basic daily tasks

More information

Rehabilitation and the role of carers

Rehabilitation and the role of carers Rehabilitation and the role of carers Dr Jacinta Morgan Consultant in Rehabilitation Medicine National Clinical Lead, Rehabilitation Medicine Programme (HSE CSPD) EMSP Spring Conference Gibson Hotel Dublin,

More information

Fatigue in MS: 2005 update B. Colombo University of Milan - HSR

Fatigue in MS: 2005 update B. Colombo University of Milan - HSR Fatigue in MS: 2005 update B. Colombo University of Milan - HSR Fatigue in MS One of the more disabling symptoms Affects about 75/90 % of the patients May be the onset symptom Transient or chronic May

More information

Cerebral Palsy. www.teachinngei.org p. 1

Cerebral Palsy. www.teachinngei.org p. 1 Cerebral Palsy What is cerebral palsy? Cerebral palsy (CP) is a motor disability caused by a static, non-progressive lesion (encephalopathy) in the brain that occurs in early childhood, usually before

More information

FIM ITEM SCORING EXERCISE SHEETS 2015

FIM ITEM SCORING EXERCISE SHEETS 2015 FIM EXERCISE - EATING The helper applies the universal cuff on to the patient s hand before she eats. The patient then brings food to her mouth, chews & swallows by herself. The helper scoops all food

More information

CAPTURE Collaboration and Proactive Teamwork Used to Reduce. Best Practices in Safe Transfers and Mobility to Decrease Fall Risk

CAPTURE Collaboration and Proactive Teamwork Used to Reduce. Best Practices in Safe Transfers and Mobility to Decrease Fall Risk CAPTURE Collaboration and Proactive Teamwork Used to Reduce Falls Best Practices in Safe Transfers and Mobility to Decrease Fall Risk August 20, 2013 10 a.m. CST Dawn M. Venema, PT, PhD Jill Hassel, DPT

More information

Accommodation and Compliance Series. Employees with Multiple Sclerosis

Accommodation and Compliance Series. Employees with Multiple Sclerosis Accommodation and Compliance Series Employees with Multiple Sclerosis Preface The Job Accommodation Network (JAN) is a service of the Office of Disability Employment Policy of the U.S. Department of Labor.

More information

DROP FOOT AND TREATMENTS YOUNGMEE PARK

DROP FOOT AND TREATMENTS YOUNGMEE PARK DROP FOOT AND TREATMENTS YOUNGMEE PARK WHAT IS FOOT DROP Foot drop / Drop foot the inability to lift the front part of the foot not a disease a symptom of some other medical problems a sign of an underlying

More information

Stage A & C Sample Data Collection Form

Stage A & C Sample Data Collection Form Stage A & C Sample Data Collection Form Instructions: Review a minimum of 20 patient charts (or another number determined to be appropriate) from patients most recently admitted, and complete this Data

More information

Answer Key: MRADL: Mobility Related Activity of Daily Living. (Within the home) Example: Feeding, toileting, dressing, grooming.

Answer Key: MRADL: Mobility Related Activity of Daily Living. (Within the home) Example: Feeding, toileting, dressing, grooming. 1. Canes & Crutches 2. Walkers & 4 wheeled walkers 3. Manual Wheelchairs 4. Seat and Back Cushions for Wheelchairs 5. Power Wheelchairs and Mobility Scooters 6. Medicare Coverage Criteria 7. Repairs Answer

More information

Workplace Accommodations for People Living with Multiple Sclerosis

Workplace Accommodations for People Living with Multiple Sclerosis Employment and Disability Institute Employment and Disability Institute Collection Cornell University Year 2001 Workplace Accommodations for People Living with Multiple Sclerosis Kurt L. Johnson Susanne

More information

Multiple Sclerosis (MS)

Multiple Sclerosis (MS) Multiple Sclerosis (MS) Purpose/Goal: Care partners will have an understanding of Multiple Sclerosis and will demonstrate safety and promote independence while providing care to the client with MS. Introduction

More information

Indications for a PMD as Reasonable and Necessary and Types of PMD Categories Available

Indications for a PMD as Reasonable and Necessary and Types of PMD Categories Available Appendix K The face-to-face examination provides the clinical information needed to determine if a patient needs a Power Mobility Device (PMD) and what type of PMD may be needed. This information needs

More information

MOTOR VEHICLE ACCIDENT QUESTIONNAIRE

MOTOR VEHICLE ACCIDENT QUESTIONNAIRE MOTOR VEHICLE ACCIDENT QUESTIONNAIRE Thank you in advance for taking the time to complete this form, this will help us to better assess all of your pain concerns and provide you with the best treatment.

More information

Overview. Geriatric Overview. Chapter 26. Geriatrics 9/11/2012

Overview. Geriatric Overview. Chapter 26. Geriatrics 9/11/2012 Chapter 26 Geriatrics Slide 1 Overview Trauma Common Medical Emergencies Special Considerations in the Elderly Medication Considerations Abuse and Neglect Expanding the Role of EMS Slide 2 Geriatric Overview

More information

SCI Rehab. Stages of Pressure Sores. Prevention of Pressure Sores Develop due to pressure on skin, lack of blood supply, tissue death.

SCI Rehab. Stages of Pressure Sores. Prevention of Pressure Sores Develop due to pressure on skin, lack of blood supply, tissue death. SCI Rehab Basics of Bowel and Bladder Management, Skin Protection, Bathroom DME, Positioning, and Transfers SCI Rehab 101 Rehab Education Basics Skin, Bladder, Bowel Skin Protection and Pressure Sore Prevention!

More information

Parkinson s Disease. Signs. Your Care

Parkinson s Disease. Signs. Your Care Parkinson s Disease Parkinson s disease affects the part of the brain that controls muscle movement. The exact cause of this disease is not known, but there is a decrease in a chemical called dopamine

More information

Many people with MS use some form of conventional medical treatment, and many people also use complementary and alternative medicine (CAM).

Many people with MS use some form of conventional medical treatment, and many people also use complementary and alternative medicine (CAM). Complementary and alternative medicine (CAM) CAM therapies can generally be divided into the following categories: Biologically based therapies (eg, dietary supplements, diets, bee venom therapy, hyperbaric

More information

The WalkOn Range. Dynamic Lower Leg Orthoses. NeW. Information for physicians, orthotists and physiotherapists

The WalkOn Range. Dynamic Lower Leg Orthoses. NeW. Information for physicians, orthotists and physiotherapists The WalkOn Range Dynamic Lower Leg Orthoses NeW Information for physicians, orthotists and physiotherapists One Range Many Different Applications The WalkOn product range allows you to address the specific

More information

Living Safely at Home with Dementia

Living Safely at Home with Dementia Living Safely at Home with Dementia June 27 th, 2013 Sherri Howe, OT Reg. (Ont.) VHA & House Calls Team Cara Macanuel, OT Reg. (Ont.) Baycrest Community Behaviour Support Outreach Team (CBSOT) Objectives

More information

Rehabilitation Therapies

Rehabilitation Therapies Bluebonnet Medical Rehabilitation Hospital Rehabilitation Therapies 512-444-4835 or 800-252-5151 www.texasneurorehab.com Austin, Texas What Sets Us Apart Rehabilitation Therapies Physical Therapy - Neuromuscular

More information

Physical & Occupational Therapy

Physical & Occupational Therapy In this section you will find our recommendations for exercises and everyday activities around your home. We hope that by following our guidelines your healing process will go faster and there will be

More information

A step forward. MyGait. The functional electrical stimulation system for drop foot. Information for users

A step forward. MyGait. The functional electrical stimulation system for drop foot. Information for users A step forward MyGait. The functional electrical stimulation system for drop foot. Information for users "We were skiing in 2008 when the accident happened. Friends had already skied down to the valley;

More information

Treatment of Spastic Foot Deformities

Treatment of Spastic Foot Deformities Penn Comprehensive Neuroscience Center Treatment of Spastic Foot Deformities Penn Neuro-Orthopaedics Service 1 Table of Contents Overview Overview 1 Treatment 2 Procedures 4 Achilles Tendon Lengthening

More information

by Argyrios Stampas, MD, Carolin Dohle, MD, and Elizabeth Dominick, PT, DPT, NCS

by Argyrios Stampas, MD, Carolin Dohle, MD, and Elizabeth Dominick, PT, DPT, NCS by Argyrios Stampas, MD, Carolin Dohle, MD, and Elizabeth Dominick, PT, DPT, NCS Therapist Jennifer Metz (right) helps a patient use a body-weight support treadmill system. Up and Moving Blending dedication

More information

NICE Pathways bring together all NICE guidance, quality standards and other NICE information on a specific topic.

NICE Pathways bring together all NICE guidance, quality standards and other NICE information on a specific topic. Rehabilitation for movement difficulties after stroke bring together all NICE guidance, quality standards and other NICE information on a specific topic. are interactive and designed to be used online.

More information

Tone Management in Cerebral Palsy. Jenny Wilson, MD wilsjen@ohsu.edu OHSU and Shriners Hospital for Children October, 2015

Tone Management in Cerebral Palsy. Jenny Wilson, MD wilsjen@ohsu.edu OHSU and Shriners Hospital for Children October, 2015 Tone Management in Cerebral Palsy Jenny Wilson, MD wilsjen@ohsu.edu OHSU and Shriners Hospital for Children October, 2015 Disclosures I am involved in a Dysport sponsored research study Goals Describe

More information

Supporting MS-Related Disability Claims to Private Insurers: The Physician s Role

Supporting MS-Related Disability Claims to Private Insurers: The Physician s Role Supporting MS-Related Disability Claims to Private Insurers: The Physician s Role What Is This Guide? This guide was compiled by the National Multiple Sclerosis Society as an aid to health care professionals

More information

Accommodation and Compliance Series. Employees with Cerebral Palsy

Accommodation and Compliance Series. Employees with Cerebral Palsy Accommodation and Compliance Series Employees with Cerebral Palsy Preface The Job Accommodation Network (JAN) is a service of the Office of Disability Employment Policy of the U.S. Department of Labor.

More information

HEADACHES, NECK & EYE FATIGUE. Deep tissue massage. Regular upper body stretches. Consult Optometrist/Ophthalmologist

HEADACHES, NECK & EYE FATIGUE. Deep tissue massage. Regular upper body stretches. Consult Optometrist/Ophthalmologist HEADACHES, NECK & EYE FATIGUE Headaches Vision concerns Itchy and irritated eyes Overall Neck Pain Muscular tension See NECK PAIN and VISION CONCERNS below Need corrective lenses or new prescription Inadequate

More information

Loss Prevention Reference Note. Adjusting the Computer Workstation. Glare Viewing Distance. Line of Sight Neck Posture Arm Posture Back Posture

Loss Prevention Reference Note. Adjusting the Computer Workstation. Glare Viewing Distance. Line of Sight Neck Posture Arm Posture Back Posture Loss Prevention Reference Note Adjusting the Computer Workstation Line of Sight Neck Posture Arm Posture Back Posture Adjustability Glare Viewing Distance Work Surfaces Mouse Position Leg Space Leg Support

More information

Implementing a Fall Alarm Program to Reduce Fall Risk Rein Tideiksaar, PhD FallPrevent, LLC

Implementing a Fall Alarm Program to Reduce Fall Risk Rein Tideiksaar, PhD FallPrevent, LLC Implementing a Fall Alarm Program to Reduce Fall Risk Rein Tideiksaar, PhD FallPrevent, LLC This program was supported by a grant from Implementing a Fall Alarm Program to Reduce Fall Risk Rein Tideiksaar,

More information

Edited by P Larking ACC Date report completed 18 January 2010

Edited by P Larking ACC Date report completed 18 January 2010 Brief report Hart Walker Reviewer Adrian Purins AHTA Edited by P Larking ACC Date report completed 18 January 2010 1. Background Cerebral Palsy (CP) is a group of disorders that arise from brain damage

More information

Rehabilitation Integrated Transition Tracking System (RITTS)

Rehabilitation Integrated Transition Tracking System (RITTS) Rehab Criteria The patient must have a physical impairment requiring rehabilitation OR have a known cognitive impairment requiring ongoing rehabilitation support or services. The patient is medically stable:

More information

Mellen Center for Multiple Sclerosis

Mellen Center for Multiple Sclerosis Mellen Center Cleveland Clinic Marie Namey, RN, MSN, MSCN Mellen Center Cleveland Clinic Cleveland, OH Home of. Mellen Center for Multiple Sclerosis Mellen Center Mission The Mellen Center remains committed

More information

COMMON OVERUSE INJURIES ATTRIBUTED TO CYCLING, AND WAYS TO MINIMIZE THESE INJURIES

COMMON OVERUSE INJURIES ATTRIBUTED TO CYCLING, AND WAYS TO MINIMIZE THESE INJURIES COMMON OVERUSE INJURIES ATTRIBUTED TO CYCLING, AND WAYS TO MINIMIZE THESE INJURIES Listed are a few of the most common overuse injuries associated with cycling long distances. 1. Cervical and upper back

More information

Physiotherapy Database Exercises for people with Spinal Cord Injury

Physiotherapy Database Exercises for people with Spinal Cord Injury Physiotherapy Database Exercises for people with Spinal Cord Injury Compiled by the physiotherapists associated with the following Sydney (Australian) spinal units : Last Generated on Mon Mar 29 16:57:20

More information

Multiple. and spasticity. 2nD edition. Multiple Sclerosis Society of New Zealand

Multiple. and spasticity. 2nD edition. Multiple Sclerosis Society of New Zealand 6 Multiple Sclerosis and spasticity 2nD edition Multiple Sclerosis Society of New Zealand CONTENTS Introduction 3 What causes spasticity? 4 Common positions for spastic muscles 6 Controlling mild spasticity

More information

In recent years some doctors have treated spasticity in children with Botox, the musclerelaxing agent used cosmetically for wrinkles.

In recent years some doctors have treated spasticity in children with Botox, the musclerelaxing agent used cosmetically for wrinkles. The following excerpt has been taken from the Christopher & Dana Reeve Foundation Paralysis Resource Center website. http://www.christopherreeve.org/site/c.mtkzkgmwkwg/b.4453419/k.3757/spasticity.h tm

More information

Haifa, Israel. The. diabetes;

Haifa, Israel. The. diabetes; The Bnai Zion Medical Center Haifa, Israel The Rehabilitation Center Head: Kathelin Goldenberg, MD Head Nurse: Vered Cohen The rehabilitation center covers three major areas: 1. Neurological rehabilitation,

More information

Range of Motion. A guide for you after spinal cord injury. Spinal Cord Injury Rehabilitation Program

Range of Motion. A guide for you after spinal cord injury. Spinal Cord Injury Rehabilitation Program Range of Motion A guide for you after spinal cord injury Spinal Cord Injury Rehabilitation Program This booklet has been written by the health care providers who provide care to people who have a spinal

More information

Physiotherapy in Rheumatoid Arthritis. Information for patients Gina Wall Senior Physiotherapist

Physiotherapy in Rheumatoid Arthritis. Information for patients Gina Wall Senior Physiotherapist Physiotherapy in Rheumatoid Arthritis Information for patients Gina Wall Senior Physiotherapist What do Physiotherapists do? We conduct assessments by asking detailed questions about your symptoms, medical

More information

One Quadriplegic Woman s Relationship with Assistive Technology. Presented by Michaela Devins

One Quadriplegic Woman s Relationship with Assistive Technology. Presented by Michaela Devins One Quadriplegic Woman s Relationship with Assistive Technology Presented by Michaela Devins About Me: Pre-Injury Born and raised in AuSable Forks, New York Vocal Performance & Music Education Major at

More information

Auto Accident Description

Auto Accident Description Automotive Accident Form Billing Information Patient name: Date of injury: Time of injury: AM PM City and street where accident occurred: What is the estimated damage to your vehicle? $ Do you have automobile

More information

Wheelchairs. Strollers vs. Manual. Clinical Indicators

Wheelchairs. Strollers vs. Manual. Clinical Indicators Written By Michelle L. Lange, OTR, ABDA, ATP/SMS Strollers vs. Manual Wheelchairs Clinical Indicators When evaluating a client for a non-powered mobility base, either a stroller or a manual wheelchair

More information

CNR S SHORT TERM REHABILITATION

CNR S SHORT TERM REHABILITATION CNR S SHORT TERM REHABILITATION A Leader in Innovative Therapies A Member of the Beth Abraham Family of Health Services Center for Nursing and Rehabilitation Where Healing Hands Lead You Home CNR s innovative

More information

Range of Motion Exercises

Range of Motion Exercises Range of Motion Exercises Range of motion (ROM) exercises are done to preserve flexibility and mobility of the joints on which they are performed. These exercises reduce stiffness and will prevent or at

More information

Gait or Walking Problems the ba sic fac t s

Gait or Walking Problems the ba sic fac t s Gait or Walking Problems the ba sic fac t s multiple sclerosis Many people with MS will experience difficulty with walking, which is also called ambulation. The term gait refers more specifically to the

More information

Patient s Handbook. Provincial Rehabilitation Unit ONE ISLAND HEALTH SYSTEM ONE ISLAND FUTURE 11HPE41-30364

Patient s Handbook. Provincial Rehabilitation Unit ONE ISLAND HEALTH SYSTEM ONE ISLAND FUTURE 11HPE41-30364 Patient s Handbook Provincial Rehabilitation Unit ONE ISLAND FUTURE ONE ISLAND HEALTH SYSTEM 11HPE41-30364 REHABILITATION EQUIPMENT USED ON UNIT 7 During a patient s stay on Unit 7, various pieces of

More information

Gait with Assistive Devices

Gait with Assistive Devices Gait with Assistive Devices Review Last Lecture Weak dorsiflexors? Vaulting? Hip hiking? Weak hip abductors? Hip circumduction? Ataxic gait? Antalgic gait? Explain the line of gravity Ambulation with Assistive

More information

An Evidence Based Occupational Therapy Toolkit for Assessment and Treatment of the Upper Extremity Post Stroke

An Evidence Based Occupational Therapy Toolkit for Assessment and Treatment of the Upper Extremity Post Stroke An Evidence Based Occupational Therapy Toolkit for Assessment and Treatment of the Upper Extremity Post Stroke Brenda Semenko, Leyda Thalman, Emily Ewert, Renee Delorme, Suzanne Hui, Heather Flett, Nicole

More information

Physical Therapy Perspective on Ataxia. Roger Fong, MPT University of Chicago Medical Center March, 2010

Physical Therapy Perspective on Ataxia. Roger Fong, MPT University of Chicago Medical Center March, 2010 Physical Therapy Perspective on Ataxia Roger Fong, MPT University of Chicago Medical Center March, 2010 Definition: Physical Therapist Physical therapy dynamic profession with an established theoretical

More information

PHYSICAL CAPACITIES EVALUATION FORM/RESIDUAL FUNCTIONAL CAPACITY ASSESSMENT FORM

PHYSICAL CAPACITIES EVALUATION FORM/RESIDUAL FUNCTIONAL CAPACITY ASSESSMENT FORM PHYSICAL CAPACITIES EVALUATION FORM/RESIDUAL FUNCTIONAL CAPACITY ASSESSMENT FORM ACTUAL SAMPLE (Note: This is an example of the specificity with which this form should be completed to be useful for the

More information

Instructions & Forms for Submitting Claims to Medicare

Instructions & Forms for Submitting Claims to Medicare Instructions & Forms for Submitting Claims to Medicare The Centers for Medicare and Medicaid services have issued a national coverage policy for the WalkAide. CMS will cover patients who have a diagnosis

More information

Assistive Technology and Transition

Assistive Technology and Transition Assistive Technology and Transition Canfield, T & Reed, P. (2001) Wisconsin Assistive Technology Initiative 800 Algoma Blvd. Oshkosh, WI 54901 (920)424-2247 Acknowledgement The authors would like to thank

More information

B. TED MAURER, MD POSTOPERATIVE REHABILITATION PROTOCOL TOTAL KNEE ARTHROPLASTY

B. TED MAURER, MD POSTOPERATIVE REHABILITATION PROTOCOL TOTAL KNEE ARTHROPLASTY B. TED MAURER, MD POSTOPERATIVE REHABILITATION PROTOCOL TOTAL KNEE ARTHROPLASTY Goals addressed prior to discharge from hospital setting: Independence with bed mobility, transfers (supine to sit and sit

More information

Victorian Nurse Practitioner Project Phase 4, Round 4.11 - Chronic Disease Management

Victorian Nurse Practitioner Project Phase 4, Round 4.11 - Chronic Disease Management Victorian Nurse Practitioner Project Phase 4, Round 4.11 - Chronic Disease Management Eastern Health Multiple Sclerosis Nurse Practitioner Service Model April 2014 Prepared by Jodi Haartsen and Deanna

More information

Comprehensive Rehabilitation in MS Care: An Occupational Therapy Perspective

Comprehensive Rehabilitation in MS Care: An Occupational Therapy Perspective Comprehensive Rehabilitation in MS Care: An Occupational Therapy Perspective Tracy Carrasco, OT/L, MSCS Orlando Health MS Comprehensive Care Center of Central Florida Objectives 1. Recognize potential

More information

Managing the Symptoms of Multiple Sclerosis. Yolanda Harris, MSN, CRNP-AC CPODD Nurse Practitioner

Managing the Symptoms of Multiple Sclerosis. Yolanda Harris, MSN, CRNP-AC CPODD Nurse Practitioner Managing the Symptoms of Multiple Sclerosis Yolanda Harris, MSN, CRNP-AC CPODD Nurse Practitioner What is Multiple Sclerosis An autoimmune disease that affects the central nervous system (CNS) The immune

More information

The ergonomics of tablet use in business applications

The ergonomics of tablet use in business applications The ergonomics of tablet use in business applications An Ergonomic Solutions white paper by Melanie Swann MSc(Hons), Grad IOSH For more information and contact details, please go to ergonomic-solutions.net

More information

1/12/2015. Tom Ambury, PT, CHC

1/12/2015. Tom Ambury, PT, CHC Tom Ambury, PT, CHC Attendees will understand the key components of the initial evaluation Attendees will understand the importance of the initial evaluation in establishing the skilled need for therapy

More information

STANDARD OPERATING PROCEDURES (SOP) FOR COMPUTER WORK, DESK TOP

STANDARD OPERATING PROCEDURES (SOP) FOR COMPUTER WORK, DESK TOP STANDARD OPERATING PROCEDURES (SOP) FOR COMPUTER WORK, DESK TOP General Guidelines-Best Practices: The following guidelines are applicable to office workers who sit at a desk and/or work on computers.

More information

HOPE EXERCISE RECOVERY RESOURCES RELATIONSHIPS INFORMATION REHABILITATION PREVENTION SELF ADVOCACY RELATIONSHIPS MOVEMENT. A Stroke Recovery Guide

HOPE EXERCISE RECOVERY RESOURCES RELATIONSHIPS INFORMATION REHABILITATION PREVENTION SELF ADVOCACY RELATIONSHIPS MOVEMENT. A Stroke Recovery Guide INFORMATION REHABILITATION PREVENTION SELF ADVOCACY RECOVERY HOPE A Stroke Recovery Guide RELATIONSHIPS MOVEMENT RESOURCES RELATIONSHIPS EXERCISE www.stroke.org CHAPTER FOUR Movement and Exercise Moving

More information

Driving with Multiple Sclerosis MANAGING MAJOR CHANGES

Driving with Multiple Sclerosis MANAGING MAJOR CHANGES Driving with Multiple Sclerosis MANAGING MAJOR CHANGES Kim (front cover), diagnosed in 1986. Driving with Multiple Sclerosis BY PAT NIEWOEHNER, BS, OTR/L, CDRS AND FLORIAN P. THOMAS, MD, PHD, NEUROLOGIST

More information

Provincial Rehabilitation Unit. Patient Handbook

Provincial Rehabilitation Unit. Patient Handbook Provincial Rehabilitation Unit Patient Handbook ONE ISLAND FUTURE ONE ISLAND HEALTH SYSTEM Welcome to Unit 7, the Provincial Rehabilitation Unit. This specialized 20 bed unit is staffed by an interdisciplinary

More information

Progress in MS: Current and Emerging Therapies

Progress in MS: Current and Emerging Therapies Progress in MS: Current and Emerging Therapies Presented by: Dr. Kathryn Giles, MD MSc FRCPC The MS Society gratefully acknowledges the grant received from Biogen Idec Canada, which makes possible the

More information

Managing MS Fatigue in the Workplace

Managing MS Fatigue in the Workplace Managing MS Fatigue in the Workplace Outline Fatigue management strategies Getting to work At work Creative rest breaks Equipment & gadgets Entitlements Where to go for follow up? 1 MS Fatigue - Recap

More information

Update on Therapeutics in Neurology Evaluation Tabulation

Update on Therapeutics in Neurology Evaluation Tabulation Update on Therapeutics in Neurology Evaluation Tabulation June 23, 2011 Georgetown, Washington, D.C. I am a: What was your overall rating of the faculty Jeffrey Frank, MD? The learning objectives designated

More information

Fit to Drive Traffic Safety for Older Drivers

Fit to Drive Traffic Safety for Older Drivers Fit to Drive Traffic Safety for Older Drivers Are you fit to drive? The aging process may increase your risk of being in a traffic crash, and it affects the severity of injuries you experience. Drivers

More information

PT, OT, and SLP Services and the International Classification of Functioning, Disability, and Health (ICF) Mapping Therapy Goals to the ICF

PT, OT, and SLP Services and the International Classification of Functioning, Disability, and Health (ICF) Mapping Therapy Goals to the ICF PT, OT, and SLP Services and the International Classification of Functioning, Disability, and Health (ICF) Mapping Therapy Goals to the ICF Disclaimer Contents of this presentation are for educational

More information

SLEEP AND PARKINSON S DISEASE

SLEEP AND PARKINSON S DISEASE A Practical Guide on SLEEP AND PARKINSON S DISEASE MICHAELJFOX.ORG Introduction Many people with Parkinson s disease (PD) have trouble falling asleep or staying asleep at night. Some sleep problems are

More information

Muscular Dystrophy and Multiple Sclerosis. ultimately lead to the crippling of the muscular system, there are many differences between these

Muscular Dystrophy and Multiple Sclerosis. ultimately lead to the crippling of the muscular system, there are many differences between these Battles 1 Becky Battles Instructor s Name English 1013 21 November 2006 Muscular Dystrophy and Multiple Sclerosis Although muscular dystrophy and multiple sclerosis are both progressive diseases that ultimately

More information

Spinal Cord Injury Education. Common Medical Problems Following Spinal Cord Injury

Spinal Cord Injury Education. Common Medical Problems Following Spinal Cord Injury Spinal Cord Injury Education Common Medical Problems Following Spinal Cord Injury Common Medical Complications After SCI, your body is vulnerable to various complications This presentation gives a brief

More information

Job Ready Assessment Blueprint. Nursing Assisting. Test Code: 4058 / Version: 01

Job Ready Assessment Blueprint. Nursing Assisting. Test Code: 4058 / Version: 01 Job Ready Assessment Blueprint Nursing Assisting Test Code: 4058 / Version: 01 Measuring What Matters Specific Competencies and Skills Tested in this Assessment: Basic Nursing Assisting Skills Measure

More information

Fatigue Management in Neurology. Alison Nock MS Specialist Occupational Therapist

Fatigue Management in Neurology. Alison Nock MS Specialist Occupational Therapist Fatigue Management in Neurology Alison Nock MS Specialist Occupational Therapist Overview of Fatigue Common disabling symptom Some people rate fatigue as the worst symptom of their disease. Predominant

More information

SECTION 9. Mobility, positioning, and transfers. Moving after a stroke 9.1. Fatigue. Loss of sensation. Loss of motor function.

SECTION 9. Mobility, positioning, and transfers. Moving after a stroke 9.1. Fatigue. Loss of sensation. Loss of motor function. SECTION 9 Mobility, positioning, and transfers Section overview This section looks at: Moving after a stroke Assisting with mobility Positioning Managing the affected limb Transfers Wheelchair use Walking

More information

Cerebral Palsy Ages: 0-3 What kinds of physicians will my child need?

Cerebral Palsy Ages: 0-3 What kinds of physicians will my child need? Cerebral Palsy Ages: 0-3 What kinds of physicians will my child need? What other conditions may affect my child? Primary Care Physician - addresses general health needs of your child Orthopedic Surgeon/neuromusculoskeletal

More information

Understanding. Multiple Sclerosis. Tim, diagnosed in 2004.

Understanding. Multiple Sclerosis. Tim, diagnosed in 2004. Understanding Multiple Sclerosis Tim, diagnosed in 2004. What Is Multiple Sclerosis? Multiple sclerosis (MS) is a neurologic disorder that affects the central nervous system (CNS). The CNS includes the

More information

Catholic Mutual..."CARES"

Catholic Mutual...CARES Catholic Mutual..."CARES" BACK INJURY LOSS CONTROL FOR HEALTH CARE FACILITIES Occupational back injuries are a major loss exposure in the health care industry. Serious back injuries can result when employees

More information

Passive Range of Motion Exercises

Passive Range of Motion Exercises Exercise and ALS The physical or occupational therapist will make recommendations for exercise based upon each patient s specific needs and abilities. Strengthening exercises are not generally recommended

More information