Rehabilitation and Therapy Commons^™

Identifying Strategies Early Intervention Occupational Therapists Use To Teach Caregivers., Jessica L. Colyvas, L Brook Sawyer, Philippa H. Campbell

Department of Occupational Therapy Faculty Papers

This study investigated early intervention occupational therapists' use of strategies to teach caregivers. A sample of 40 videotapes made by early intervention occupational therapists was randomly selected from an archival videotape data set of provider home visits. The sample included 20 videotapes illustrating traditional services and 20 videotapes illustrating therapists providing participation-based services. Videotapes were rated using the Teaching Caregivers Scale, which rates three variables on 30-s intervals: (1) routine, (2) provider role, and (3) strategies used to teach caregivers during early intervention home visits. Regardless of the model of service, explicit teaching strategies were rarely used during home visits.

The Significance Of Percutaneous Aspiration Of The Zygapophysial Facet Joint Synovial Cyst: A Case Series, S. Kamal Fetouh, Nicholas Kaffl, Linqiu Zhou

Department of Rehabilitation Medicine Faculty Papers

Cysts that are clearly associated with threat of progressive neurological loss or intractable, unremitting symptoms should be released by a decompression procedure.

In our case series, percutaneous aspiration has been successfully used for 3 of 4 PTs with marked decrease in size of cyst on imaging and clinical improvement.

Obstructing pathology and ultimately the location of the cyst can be major factors in determining the success of the procedure.

Our study demonstrated that a minimally invasive aspiration of a ZP SC can often achieve clinical improvement.

This may save the PT from undergoing an invasive surgical decompression.

The Significance Of A Triple Flexion Reflex In The Acute Spinal Cord Injured Patient: A Case Report And Review Of The Literature, S. K. Fetouh, S. Kolli, R. J. Marino, N. D. Martin, A. L. Schreiber

Department of Rehabilitation Medicine Faculty Papers

The TFR is a sign of upper motor neuron impairment. It does not typically appear for several days after an injury but in patients with pre-existing myelopathy, an early onset exaggerated Babinski response exhibited as a TFR may occur. It is important not to misinterpret such responses as volitional movements, particularly in patients with cognitive dysfunction where the history and physical examination may be limited. Failure to immobilize the spine and to administer adjunct steroid therapy may be detrimental to the patient. Education of initial response physicians may prevent overlooking an acute SCI.

Evolution Of The Sensory Integration Frame Of Reference., Roseann C. Schaaf, Patricia L. Davies

Department of Occupational Therapy Faculty Papers

No abstract provided.

Examining The Neuroscience Evidence For Sensory-Driven Neuroplasticity: Implications For Sensory-Based Occupational Therapy For Children And Adolescents., Shelly J. Lane, Roseann C. Schaaf

Department of Occupational Therapy Faculty Papers

When Ayres first presented the theory of sensory integration (SI), she grounded it in the neuroscience literature. Neuroplasticity was then, and is today, considered to be at the heart of this theory. This evidence-based review sought to critically examine the basic science literature to specifically identify evidence for the assumptions and tenets of Ayres' theory of SI. We reviewed literature between 1964 and 2005, within psychological, physiological, and biomedical areas, addressing neuroplasticity. The review focused on sensorimotor-based neuroplasticity; explored the data that addressed the links among sensory input, brain function, and behavior; and evaluated its relevance in terms of supporting …

Parasympathetic Functions In Children With Sensory Processing Disorder., Roseann C. Schaaf, Teal W. Benevides, Erna Imperatore Blanche, Barbara A. Brett-Green, Janice P. Burke, Ellen S. Cohn, Jane Koomar, Shelly J. Lane, Lucy Jane Miller, Teresa A. May-Benson, Diane Parham, Stacey Reynolds, Sarah A. Schoen

Department of Occupational Therapy Faculty Papers

The overall goal of this study was to determine if parasympathetic nervous system (PsNS) activity is a significant biomarker of sensory processing difficulties in children. Several studies have demonstrated that PsNS activity is an important regulator of reactivity in children, and thus, it is of interest to study whether PsNS activity is related to sensory reactivity in children who have a type of condition associated with sensory processing disorders termed sensory modulation dysfunction (SMD). If so, this will have important implications for understanding the mechanisms underlying sensory processing problems of children and for developing intervention strategies to address them. The …

Utilization Of Dantrolene In Stiff-Person Syndrome: A Case Report, John M. Vasudevan, Md, S. Kamal Fetouh, Md,, Nethra S. Ankam, Md, Adam L. Schreiber, Do, Ma

Department of Rehabilitation Medicine Faculty Papers

Setting: University hospital-based acute rehabilitation.

Patient: 75-year-old woman with Stiff-Person Syndrome (SPS) with a recent fall and Colles fracture.

Case Description: Four months prior to admission, the patient was diagnosed with SPS, negative for anti-GAD antibodies. Diagnosis was based on a 3-year history of progressive rigidity leading to frequent falls and fractures. Anxiety and fear of falling limited her mobility, and she sustained a sacral pressure ulcer during acute hospitalization. On admission, history was remarkable for unsteady gait and muscle cramps exacerbated when startled or excited. Examination was remarkable for rigidity in her axial and limb muscles. She presented …

Transverse Myelitis In Pregnancy: A Case Report, Brian P. Mcdonald, Do, Nethra S. Ankam, Md

Department of Rehabilitation Medicine Faculty Papers

Objective: Describe the clinical course and treatment of a patient with paraplegia secondary to transverse myelitis during her pregnancy.

Setting: Acute Inpatient Rehabilitation Unit, University Hospital.

Participant: 36 year old Caucasian woman at 18 weeks gestation.

Interventions: Provided education and training on basic childcare tasks at a wheelchair level, and on how to obtain wheelchair accessible baby furniture. Provided availability of a peer who sustained a spinal cord injury prior to pregnancy. Maintained a close working relationship with maternal fetal health department regarding management of nausea and pain management, and educated team members about the possibility of autonomic …

Development And Evaluation Of Health And Wellness Exhibits At The Jefferson Occupational Therapy Education Center In Second Life, Susan Toth-Cohen, Therese Gallagher

Department of Occupational Therapy Faculty Papers

Virtual worlds such as Second Life are increasingly used for consumer health and higher education. The present paper will describe the development and evaluation of public exhibits on health and wellness at the Jefferson occupational therapy education center in Second Life.

Piel- Manual De Enseñanza Para El Paciente Y La Familia Sobre Lesiones De La Médula Espinal, Thomas Jefferson University Hospital And Magee Rehabilitation

Manual de Lesión de la Médula Espinal (Español)

Introducción a la función de la piel

La piel es una parte fundamental del cuerpo y tiene muchas funciones necesarias:

• La piel lo protege del medio ambiente. Cuando la piel está intacta, existe una barrera contra las bacterias y las lesiones a los órganos que se encuentran en el interior del organismo. Evita que la luz solar en exceso o los químicos nocivos penetren en el organismo.

• La piel lo ayuda a mantenerse caliente o fresco. Las glándulas sudoríparas producen sudor y lo refrescan al evaporar el sudor de la piel.

• Las terminaciones nerviosas de la piel …

Introduction-Spinal Cord Injury Manual, Thomas Jefferson University Hospital And Magee Rehabilitation

Spinal Cord Injury Manual (English)

About this Manual:

This Spinal Cord Injury Manual is designed for use by the person with a spinal cord injury or dysfunction and his or her family. It is a guide to provide information on the many aspects of spinal cord injury and dysfunction. This handbook will help you and your family prepare for discharge from our comprehensive rehabilitation program and supplement lifelong learning about spinal cord injury and dysfunction. The handbook is divided into topic sections and bound in loose-leaf form so that a member of the health care team may use each section in addition to teaching and …

Activities Of Daily Living-Spinal Cord Injury Manual, Thomas Jefferson University Hospital And Magee Rehabilitation

Spinal Cord Injury Manual (English)

Introduction

Activities of daily living (ADL) include eating, drinking, functional bathing, grooming, dressing and toileting. Also included are functional transfers, EADL (Electronic Aids for Daily Living) and home management.

As soon as it is appropriate, you will be encouraged to perform as many of your own ADLs as you can. You may need to learn new techniques, use assistive devices to compensate for decreased muscle strength and range of motion or to compensate for decreased endurance.

ADL training will begin when your therapist determines that you have enough strength, balance and skill to do these tasks. You may practice these …

Psychosocial Issues-Spinal Cord Injury Manual, Thomas Jefferson University Hospital And Magee Rehabilitation

Spinal Cord Injury Manual (English)

Introduction

A sudden trauma like a spinal cord injury will have a significant impact on you and the people close to you. You may see parts of your life change a great deal. Other parts of your life may not change at all. Regardless of the extent of your injury and disability, being hurt and having a disruption to your life may present unexpected problems or changes. This chapter provides information about services that are available at Thomas Jefferson University Hospital, Magee Rehabilitation Hospital and in the community to provide assistance.

Coping with a Spinal Cord Injury

After a spinal …

Bladder-Spinal Cord Injury Manual, Thomas Jefferson University Hospital And Magee Rehabilitation

Spinal Cord Injury Manual (English)

Introduction

Your bladder and urinary system play a very important part in keeping you healthy by acting like a “filter” and getting rid of the waste products from food and fluid that you have eaten and absorbed. After you have had a spinal cord injury, you often lose your ability to control urination. You may not be able to feel that your bladder is full, and if you can feel it, you may not be able to empty it.

It is important to note here that the changes that occur in your bladder will be unique to you. Although there …

Sexuality-Spinal Cord Injury Manual, Thomas Jefferson University Hospital And Magee Rehabilitation

Spinal Cord Injury Manual (English)

Introduction

In this section, you will learn how spinal cord impairments can affect the way that you feel about yourself as a man or woman as well as how spinal cord impairments can affect the way that you function sexually. Information on sexuality, sexual functioning, birth control, erectile dysfunction and having a baby may be important to you today, or these issues may be something that you choose to put away and think about at another time. In either case, this information is just a starting point. Feel free to ask questions and share your concerns and thoughts with the …

Terapia Recreativa- Manual De Enseñanza Para El Paciente Y La Familia Sobre Lesiones De La Médula Espinal, Thomas Jefferson University Hospital And Magee Rehabilitation

Manual de Lesión de la Médula Espinal (Español)

Introducción

Su tiempo libre y la forma en que usa ese tiempo pueden ser una fuente de satisfacción, disfrute y realización personal. Usted probablemente tenga muchas preguntas sobre el efecto de su lesión en la capacidad de participar en sus actividades y deportes favoritos. Existe terapia recreativa disponible para ayudarlo a responder todas las preguntas e inquietudes y a planificar un estilo de vida para el tiempo libre que le resulte satisfactorio.

¿Qué es la terapia recreativa?

La terapia recreativa es una forma de tratamiento que utiliza actividades recreativas para trabajar sobre sus objetivos de rehabilitación. Mediante la utilización de …

Glosario Principal- Manual De Enseñanza Para El Paciente Y La Familia Sobre Lesiones De La Médula Espinal, Thomas Jefferson University Hospital And Magee Rehabilitation

Manual de Lesión de la Médula Espinal (Español)

Glosario principal para Manual de enseñanza para el paciente y la familia sobre lesiones de la médula espinal,

(29 páginas,458Kb)

The Spinal Column-Spinal Cord Injury Manual, Thomas Jefferson University Hospital And Magee Rehabilitation

Spinal Cord Injury Manual (English)

The spinal cord is a part of a system called the central nervous system. The central nervous system is made up of two main structures — the brain and the spinal cord. The spinal cord is delicate tissue protected by spinal bones, which are called vertebrae. The spinal cord sits in a space through the center of the vertebrae called the spinal canal. The vertebrae are stacked one on top of another. The job of the vertebrae is to provide support and flexibility for the body and to protect the spinal cord. Discs separate the vertebrae. Discs are tough fibrous …

Bowel-Spinal Cord Injury Manual, Thomas Jefferson University Hospital And Magee Rehabilitation

Spinal Cord Injury Manual (English)

Introduction

Spinal Cord Injury (SCI) changes the way your body works, especially your bowels. After a spinal cord injury, bowel movements (or stool) require more time, thought and planning. Usually, people with SCI cannot feel when stool is ready to come out; therefore, their bowels need re-training.

Anatomy

What Is the Bowel, and What Does It Do?

The bowel is the last portion of your digestive tract and is sometimes called the large intestine or colon. The digestive tract as a whole is a hollow tube that extends from the mouth to the anus (see illustration below). The function of …

Respiratory-Spinal Cord Injury Manual, Thomas Jefferson University Hospital And Magee Rehabilitation

Spinal Cord Injury Manual (English)

Introduction

Spinal cord injury can affect normal breathing. The level of your injury will determine the effect it will have. It can be different for everyone. For example, the higher the level of your injury, the more complications you may face. Good pulmonary care can assist in keeping you healthy after your spinal cord injury.

Normal

The process of breathing (or respiration) is a two-step process: taking in air (inspiration) and exhaling the waste products. The process of taking in air (inhalation) is an active process, requiring the use of many muscles, while the process of exhaling is a passive …

Respiratory Dependent-Spinal Cord Injury Manual, Thomas Jefferson University Hospital And Magee Rehabilitation

Spinal Cord Injury Manual (English)

Introduction

One of the most important aspects of spinal cord injury care is respiratory management. The previous chapter deals with the effect spinal cord injury has on your ability to breathe while this chapter deals with the management of individuals who are dependent on a ventilator to breathe. This dependency may be temporary or permanent, depending on your level of injury. Please review the previous chapter prior to reading this one.

Artificial Airways

The first step in trying to maintain normal respiratory function is to establish an airway. Spinal cord injury does not affect your airway. However, in order to …

Skin-Spinal Cord Injury Manual, Thomas Jefferson University Hospital And Magee Rehabilitation

Spinal Cord Injury Manual (English)

Introduction to Skin Function

The skin is a vital part of the body with many necessary functions:

• The skin protects you from the environment. When your skin is intact, there is a barrier against bacteria and injury to the organs inside of the body. It prevents too much sunlight or harmful chemicals from entering the body.

• The skin helps you stay warm or cool. Your sweat glands produce sweat and cool you off as the sweat evaporates from the skin.

• Nerve endings in the skin send messages to the brain to give you information about pain, temperature …

Cardiovascular-Spinal Cord Injury Manual, Thomas Jefferson University Hospital And Magee Rehabilitation

Spinal Cord Injury Manual (English)

Introduction

Cardiovascular problems affect all people who have a spinal cord injury. It has been noted to be particularly problematic for those over 65 years old and those who have been injured for more than 30 years. Due to this problem affecting many people, it needs to be addressed early in your rehabilitation as well as throughout your life.

Description of the Cardiovascular System

The cardiovascular system contains the heart and the blood vessels. The heart is a muscular pump in the chest that receives blood from blood vessels from all over the body. As the heart beats, it delivers …

Nutrition-Spinal Cord Injury Manual, Thomas Jefferson University Hospital And Magee Rehabilitation

Spinal Cord Injury Manual (English)

Introduction-Why Nutrition Matters

Nutrition is important for everyone to maintain good health. After a spinal cord injury, nutrition can be even more important to improve overall wellness, achieve and maintain a healthy weight and help regulate bowel and bladder function. Eating a well balanced diet can help prevent the long term complications associated with SCI such as weight gain, deconditioning and skin breakdown.

A well-balanced diet can provide all of the nutrients that your body needs. Foods high in fiber, along with plenty of water, help regulate bowel function. However, if you eat more than you need, you can gain …

Equipment-Spinal Cord Injury Manual, Thomas Jefferson University Hospital And Magee Rehabilitation

Spinal Cord Injury Manual (English)

Introduction

During your stay in the hospital, various pieces of equipment will be given to you or ordered for you. Your therapists or nurse will be instructing you in the use, care and repair of this equipment. Also, you will find materials in this section regarding specialized equipment that you may need during your hospital stay and following discharge. There are also reference materials about equipment you may need in the future.

If you have any questions about your equipment while in the hospital, contact your therapist, nurse or case manager.

As part of your follow-up program, equipment will be …

Vocational Services-Spinal Cord Injury Manual, Thomas Jefferson University Hospital And Magee Rehabilitation

Spinal Cord Injury Manual (English)

Introduction

Vocational services are available to you during the course of your rehabilitation to assist you in returning to work or school or exploring vocational and educational options. These services may be initiated while you are in the hospital and can continue after you are discharged. You may start to receive vocational services from the vocational counselor at Magee Rehabilitation Hospital, and at the same time, referred to the state agency designated to assist in vocational rehabilitation. Ultimately, you may return to your pre-injury job, or you may embark on a new educational or vocational path.

Vocational Consultation

During the …

Mobility-Spinal Cord Injury Manual, Thomas Jefferson University Hospital And Magee Rehabilitation

Spinal Cord Injury Manual (English)

Introduction

Mobility is defined as those activities involved in getting you out of bed into a wheelchair, movement in the wheelchair, standing and walking. This is accomplished by first stabilizing the spine through surgery, external immobilization (bracing, traction or casting), or both, so you can safely move without further damage to your spinal cord. Following your spinal cord impairment, you are limited in the ability to move because of muscle weakness, immobilization devices, bed rest, or a combination of these factors. Since staying in one position for long periods of time can lead to other medical complications such as skin …

Recreational Therapy-Spinal Cord Injury Manual, Thomas Jefferson University Hospital And Magee Rehabilitation

Spinal Cord Injury Manual (English)

Introduction

Your free time and the way you use that time can be a source of pleasure, enjoyment and self-fulfillment for you. You will probably have many questions about your injury’s effect on your ability to participate in your favorite activities and sports. Recreational therapy is available to assist you in answering your many questions and concerns and helping you plan a satisfactory leisure lifestyle for yourself.

What is Recreational Therapy?

Recreational therapy is a form of treatment that uses recreational activities to work on your rehabilitation goals. Through using your existing recreational skills and interests, recreational therapy can address …

Travel And Transportation-Spinal Cord Injury Manual, Thomas Jefferson University Hospital And Magee Rehabilitation

Spinal Cord Injury Manual (English)

Introduction

Travel and transportation includes driving or being a passenger in a car or van, or traveling in an airplane, bus, train or ship. After a spinal cord impairment, traveling for business or pleasure can be an overwhelming experience. Being well prepared in advance will decrease stress and make your trip enjoyable.

This chapter provides tips regarding traveling with a power or manual wheelchair, purchasing or renting durable medical equipment, medication management, bowel and bladder issues, traveling registrations and organizing recreational activities.

Driving

When you are ready to consider driving, it is suggested that you discuss financial coverage with your …

Follow-Up Care System-Spinal Cord Injury Manual, Thomas Jefferson University Hospital And Magee Rehabilitation

Spinal Cord Injury Manual (English)

Introduction

The Spinal Cord Injury Follow-Up Care System is a program that will assist you in your lifetime care once you are discharged from the hospital. The follow-up care system is structured with primary team members being you and your family, the physiatrist (doctor who specializes in physical therapies), nurse clinician and case manager. Team members available for consultation include physical therapists, occupational therapists, recreational therapists, speech therapists, dietitians, urologists, gynecologists, plastic surgeons and podiatrists.

The nurse clinicians are available in the Spinal Cord Injury Follow-Up Clinic at Magee Rehabilitation Hospital and act as the coordinator and liaison between the …