Cambridge Brain Sciences (CBS) uses the latest technology and scientific data to get better insights from modernized versions of classic tasks – they only take a few minutes each. CBS has developed endless test sets, so there is negligible “test learning” risk for a test-retest situation. And, important in our new virtual world, the link for the testing can be emailed to our clients, where they are provided step by step instructions and even tutorials allowing them to perform the tests without therapy staff being present in their home environment. OTs can use some or all of these cognitive screens to not only assess cognitive difficulties but to also monitor progress of treatment which is helpful to illustrate when requesting more funding for occupational therapy services.
Based on literature and resources from Parkwood Hospital’s concussion program, this program is tailored to persons experiencing interruption of daily function due to post-concussion related symptoms. It facilitates a 10 week structured approach to managing energy aimed at preventing aggravated symptomology, which then allows the brain to heal, and function levels to increase. The program tracks activity and symptoms to determine when the level of activity can be increased safely while allowing the brain to heal.
OnTrack is a program designed to help youth who have experienced severe injury by providing access to a range of supportive personal and vocational services. The goal of this multi-disciplinary program is to support youth through key life experiences to help them get back “On Track” with their peers and achieve long-term success. Services include career and education planning, life skills coaching, and one-on-one support or academic tutoring. All services are coordinated to improve collaboration and seamless care outcomes.
Client’s interests, education and experiences are assessed to determine transferable skills. Labour Market Research and/or additional education are all considered. Position tolerance, pain levels and ability to focus are examples of areas assessed to help determine the vocational fit.
Following an injury, physical limitations may exist immediately or develop over time. Establishing the client’s safe maximum abilities once the benefits of physical rehabilitation have plateaued, an FCE is ideal for further planning and goal setting with respect to return to work, vocational exploration or other meaningful activities. (i.e. sitting tolerance, overhead reaching)
At a reduced combined cost, the Physical FCE can be combined with a Cognitive/Behavioural FCE to determine Global Functioning.
This assessment- as the name suggests – assesses global physical, cognitive and emotional functional capacity that one might need to perform a specific job or any job in general. Capacity is the key word here –a capacity assessment measures how much or how long one can perform a certain function. It also takes into account the effect of pain and fatigue on all the realms of function. This type of assessment is helpful to determine if a person who has physical impairments, as well as cognitive and/or emotional issues related to pain, brain injury and/or psychological disorder, can do their job or any job. It can also help to determine and provide opinion on what accommodations or adaptations they might need to succeed.
The Cognitive/Behavioural FCE is the next logical step in functional capacity evaluations. A Physical FCE examines only physical capacities, and ignores the cognitive and emotional ones that are often real barriers to returning to the workforce. Which is why at LDOT, we employ certified Matheson Cognitive/Behavioural Functional Capacity Evaluators to perform the Cognitive/Behavioural FCE assessment. The Cognitive/Behavioural FCE includes cognitive functional testing and integration of behavioural observations to ascertain functioning. Hands-on work tasks are also included and designed to reflect tasks that the client would typically complete on a daily basis. Tasks test sustained attention, multi-tasking, distraction tolerance, ability to retain information, effective organization and prioritization skills, and ability to persist through fatigue and pain.
At a reduced combined cost, the Cognitive/Behavioural FCE can be combined with a Physical FCE to determine Global Functioning.
At this time of year, the market is flooded with apparel and school supplies featuring a child’s favourite TV character and is often splashed with attractive colours and designs. But parents need to look beyond the flashy-ness when it comes to backpack shopping and ensure that the bag their child will be using promotes health and minimizes risk of injury. After all, they will be using it for almost 200 days of the year!
Check out the hot backpack tips below before hitting the mall for back-to-school shopping:
- Straps should be padded, wide and adjustable. Two straps are recommended rather than wearing a cross-body sling pack, which wouldn’t distribute weight evenly. Researchers say wearing a backpack slung over one shoulder can lead to poor posture and pain in the neck, shoulders, and back. Even if you switch it back and forth between shoulders, you are walking off-balance. This puts a strain on all of the bones and muscles of your upper body, not to mention your hips and core.
- The portion of the pack that rests against your child’s back should also be padded so sharp objects, such as the edges of books, don’t poke into the back.
- Get a pack that has a waist strap, especially if the load is typically more than 10 percent of your child’s weight. This will help distribute the load and take the weight off of the shoulders.
- Did you know that one size does not “fit all” when it comes to backpacks? Adjust the straps so the pack sits 2” above the waist and the pack is held close to your child’s body. If you can’t adjust the straps to achieve this, the pack is too long and you need to look for a pack made for a shorter torso.
- The weight of a backpack should not exceed 10-15% of the student’s body weight. That means that it should probably weigh 4 to 15 pounds at most.
- Make sure to organize the items with the heaviest closest to the student’s back and lighter items towards the outside. This will minimize shifting/sway and ensure the weight is distributed evenly.
- You may have to help lighten your child’s backpack. Only have your child carry what is necessary (this is another great reason you can use to convince junior that his electronics and toys need to stay home). If you can’t lighten the load enough, consider a rolling backpack for your child.
Best Practices in Fall Prevention – When you want to make a change for your health, you want to know about best practices. Best practices are strong recommendations that clinicians (doctors, occupational therapists, etc.) use to provide their patients with an effective intervention (treatment or modification).
The clinicians base these recommendations on evidence in the clinical unbiased literature. Evidence found that the intervention improved the health outcome, and the conclusion is that the benefits outweigh the harm.
This is a big deal. The evidence is what should guide all good practice. It is why you buy a car with safety ratings that are independently researched, and not just the word of the company that is trying to sell you a car.
Fall Prevention is a big thing. Here are a few startling statistics:
- 1 in 3 older adults in Canada fall each year (over 65)
- 50% of falls which resulted in hospital admissions occurred in those 65 and older
- Falls cause more than 90% of hip fractures in seniors and 20% die within a year of the fracture
(Public Health Agency of Canada, Report on Seniors’ Falls in Canada, 2005)
So, when our team at LDOT Services were looking at Best Practices for Fall Prevention; we looked at the literature and found what the American and British Geriatric Society recommended as best practice.
With respect to ‘Assessment’ – the following is recommended:
A multifactorial fall risk assessment should be performed by clinicians with appropriate skills and training, (Occupational Therapists have this training) including a focused history, physical examination, functional assessment (watching clients actually do things) and an assessment of their environment.
With respect to ‘interventions’ or ‘treatment’ – the following should be “Best Practice”.
- Assessment should include identifying hazards in the home, making recommendations to eliminate the hazards, and providing options to promote the safe performance of daily activities
- Adaptation or modification of the home environment based on the assessment criteria above
- Exercise, particularly balance, strength, and gait training
More importantly – the following was NOT recommended in that there was fair evidence found that the intervention is ineffective, or that harm outweighs benefits.
- Education should not be provided as a single intervention to reduce falls in older persons living in the community
Other evidence that was strong was that vitamin D supplements should be taken by persons proven to have insufficient vitamin D intake. The only way to know whether this is an issue is to consult a doctor – and this is our recommendation.
Our practice is best practice. We provide a multi factorial assessment. We provide recommendations to eliminate hazards within the home and provide options to promote the safe performance of daily activities.
We can provide a list of vetted contracting companies that specialize in home adaptations.
We can work with the contractors to ensure you get what you need to make the living safer, and avoid what may put you in harm’s way.
We provide in home and pool exercise programs though our team of Occupational Therapy Assistants. And by using Occupational Therapy Assistants we ensure these programs are accessible and financially feasible for the participants. For information on these programs or any of our Occupational Services; please contact us directly; you will reach a live knowledge representative at either our Hamilton Office: 905-481-1122 or our Toronto Office: 416-907-6287.
Alternatively, you can email us directly anytime and one of our helpful representatives will respond very quickly.
Once again we are happy to be supporting the 2016 Hamilton Brain Injury Association (HBIA) Dinner being held at the Liuna Station in Hamilton on November 17th, 2016. This will be the 10th annual fundraising dinner for Hamilton Brain Injury Association. LDOT is excited to be a centre piece sponsor this year and happy to show our support by purchasing a full table and will be attending as a team to show our support.
HBIA is an asset to our community providing support, education and advocacy for brain injury survivors and their families.
ABILITY – the correct skills and/or mental and physical fitness to perform in a competent way.
ABNORMAL – different from the average; inappropriate with regard to the standards of society, social role or the existing set of circumstances.
ABSTRACT ATTITUDE- an objective, detached, impersonal state of mind.
ABSTRACT CONCEPT – a concept or idea not related to any specific instance or object and which potentially can be applied to many different situations or objects. People with cognitive deficits often have difficulty understanding abstract concepts.
ABSTRACT THINKING – the ability to apply abstract concepts to situations and surroundings. It is characterized by adaptability in the use of ideas and generalization.
ACTING OUT – impulsive; anti-social behavior.
ACALCULIA – the inability to perform simple problems of arithmetic.
ACUITY – sharpness or quality of a sensation. Keenness of perception.
ACUTE – sharp, severe. 2. Having rapid onset, severe symptoms and a short course. The early stages of an injury (as opposed to chronic, which is long term).
ADAPTIVE / ASSISTIVE EQUIPMENT – a special device which assists in the performance of self care, work, play or leisure activities.
ADL – activities of daily living. Routine activities carried out for personal hygiene and health such as eating, dressing, grooming, shaving, etc. Nurses, occupational and physical therapists are the main coaches for ADL, which is sometimes called DLS or daily living skills.
ADVOCACY – support; help, promoting a cause.
AFFECT – feeling tones; emotions; the outward signs of individual emotions.
AFFECTIVE – having to do with emotions.
AGITATION – a state of restless activity such as pacing, crying or laughing without apparent reason.
AGGRESSIVENESS – a state of irritability; combativeness.
AGNOSIA – failure to recognize familiar objects although the sensory mechanism is intact. May occur for any sensory modality.
AMBIVALENCE – contradictory feelings about an object, person or action, emotion, idea, situation, etc. .
AMBULATION – to walk.
AMNESIA – lack of memory about events occurring during a particular period of time.
ANEURYSM – a balloon-like deformity in the wall of a blood vessel. The wall weakens as the balloon grows larger, and may eventually burst, causing a hemorrhage.
ANOMIA – inability to recall names of objects. Persons with this problem often can speak fluently but have to use other words to describe familiar objects.
ANOSMIA – loss of the sense of smell. SYN: anodmia
ANOXIA – a lack of oxygen. Cells of the brain need oxygen to stay alive. When blood flow to the brain is reduced or when oxygen in the blood is too low, brain cells are damaged.
ANTERIOR INJURY – front.
ANTEROGRADE AMNESIA – inability to consolidate information about ongoing events. Difficulty forming new memories. Shrot- term annesia.
ANTERO-LATERAL INJURY- front and to the side.
ANTERO-POSTERIOR INJURY- gront and to the back.
ANTICONVULSANT – meditation used to decrease the possibility of a seizure (e.g., Dilantin, Phenobarbital, Mysoline, Tegrtol).
ANTI-SOCIAL BEHAVIOR – behavior which is contrary to the customs, standards and moral principles accepted by society.
ANXIETY – feelings of apprehension, uneasiness, agitation, uncertainty and fear because of threat or danger.
APATHY – indifference. Lack of emotiom, concern or interest.
APHASIA – the change in language function due to an injury to the cerebral cortex of brain. It causes partial or total loss of ability to express oneself and/or to understand language.
APRAXIA – the inability to produce voluntary speech due to a deficit in motor (muscle) programming caused by brain damage.
ARACHNOID MEMBRANE – the middle of three membranes protecting the brain and spinal cord.
AROUSAL – being awake. Primitive state of alertness managed by the reticular activating system (extending from medulla to the thalamus in the core of the brainstem) activating the cortex. Cognition is not possible without some degree of arousal.
ARTERIAL LINE – a very thin tube (catheter) inserted into an artery to allow direct measurement of the blood pressure, the oxygen and carbon dioxide concentrations in arterial blood.
ARTICULATION – movement of the lips, tongue, teeth and palate into specific patterns for purposes of speech. Also, a movable joint.
ASSESSMENT – an evaluation of a patient based on the following information: 1. the subjective report of the symptoms by the patient. 2. the progress of the illness or condition. 3. the objective findings of the examiner based on tests, physical examination and medical history.
ATAXIA- a problem of muscle coordination not due to apraxia, weakness, rigidity, spasticity or sensory loss. Caused by lesion of the cerebellum or basal ganglia. Can interfere with a person’s ability to walk, talk, eat and to perform other self care tasks.
ATTENTION – the ability to focus on given task or set of stimuli for an appropriate period of time.
ATTENTION DEFICITS – impaired ability to concentrate.
AUDIOLOGIST – one who evaluates hearing defects and who aids in the rehabilitation of those who have such defects.
AUTOMATIC – spontaneous; involuntary
AUTOMATISM – automatic actions or behavior without conscious volition or knowledge. Such episodes might last for a few minutes or a few days. During such episodes, the person appears normal but, is actually in a trance like state. While in such a state the person is not responsible for his acts and should not be left alone. He may carry out complicated acts without remembering having done so. Such episodes have been associated with severe emotional distress and temporal motor epilepsy.
AUTONOMIC NERVOUS SYSTEM – the part of the nervous system that controls involuntary activities, including heart muscle, glands, and smooth muscle tissue. The autonomic nervous system is subdivided into the sympathetic and parasympathetic systems. Sympathetic activities are marked by the flight or fight emergency response, initiated by way of the transmitter norepinephrine (adrenaline). Parasympathetic activities are known by lowered blood pressure, pupil contradiction and slowing of
REDUCED AWARENESS – insight; understanding is not clear.
AXON – the nerve fiber that carries an impulse from the nerve cell to a target, and also carries materials from the nerve terminals back to the nerve cell. When an axon is cut, proteins required for
its regeneration are made available by the nerve cell body. A growth cone forms at the tip of the axon. In the spinal cord, a damaged axon is often prepared to re-grow, and often has available a supply of materials to do so. Scientists believe it is the toxic environment that surrounds the axon, and not the genetic programming of the axon itself, that prevents regeneration.