Body Mechanics

Why is proper body mechanics and posture an important factor? Body mechanics and posture work together to prevent injury and illness. Having poor body mechanics when lifting/moving things increases the risk of back pain. A benefit of having proper posture and body mechanics requires less energy to maintain a state of balance. Proper posture includes keeping your body centered over the base of support in regards to line of gravity when this is disturbed the individual increases risk of falling or injuring ones self. Proper posture and movement helps the body reduce stress applied to the spine and does not strain the body's muscles and ligaments. Posture is also involved in joint function and when the alignment is off it causes stress and the degeneration of different joints. Another factor associated to poor posture is a more difficult time breathing, if the body has proper posture the chest is able to expand. It is important to teach good body mechanics and posture to individuals because they are reducing their risk of injury, illnesses, and joint and muscle damage while increasing the spines stability. 

During an intervention of teaching a client body mechanics and posture the first thing I would do would be to have the client stand against the wall if possible to explain correct body posture. While against the wall the client needs to have their heels to the back of the wall, the shoulders against the wall, with the chin tucked and head down while against the wall as well to demonstrate proper posture. I could even have the client show me what they think correct posture is to them and correct where necessary. Next to assess body mechanics I will get the client to make sure they have their feet placed shoulder width apart or large enough to have a good base of support. Reminding the client that when lowering down to grab something and lift back up to bend at the hips and knees and not at the waist which stresses the back. They also may need to be reminded that when using proper body mechanics the neck pelvis and back should all be aligned remembering not to twist at the waist, which will cause back pain and or injury. Lift with the legs and arm muscles not your back and keep the object close to was it level. The client can practice this while using a stick placed on their back to make sure their alignment is correct or they can perform an activity while the therapist observes and corrects their posture. 

Man From The South

In the story, Man From The South by Roald Dah the soldier made a bet and if he lost this bet he would lose his pinky finger. If the soldier would have lost the bet, his ability to have a strong grip strength in his pinky would not as strong as needed. Upon losing the bet the wife might have to help with taking care of the man. One way that her life may be impacted along with his is going to the restroom. After using the restroom one must be able to wipe and if the grip strength is not present it would be difficult for him to clean himself so his wife may have to help it. They could work on exercises to increase grip strength of the other digits or make adaptions to going to the restroom.  They could also use a type of assistive device to help the man go to the restroom independently. Using a long handle bottom wiper that has a grip that includes only the three jaw-chuck grasp or even the lateral grip could make cleaning the bottom easier. Another way would be to have a device installed on the toilet to clean the soldiers bottom. This type of technology may have been more difficult to come by so using therapeutic exercise along with an assistive device to clean himself may promote more independence  for both the soldier and his spouse. 

Health and Occupational Therapy

Health promotion is the use of discipline specific techniques to assist people in achieving their health related goals. As an occupational therapist it is their job to have a holistic approach to health promotion while giving that client, or population their maximum health and quality of life. There are many different approaches that can have a negative impact on an individuals health like not being able to engage in occupations that can cause health issues known as occupation deprivation along with not being able to participate in occupations due to socioeconomic status, gender etc referred to as occupational apartheid. Therefore helping clients to engage and participate in these activities will increase or hopefully create a healthier lifestyle for them. As healthcare providers its best to think of healthy people 2020 and 2030 which is aimed to helping achieve a long healthy life. Healthy lifestyles are hard to understand to some individuals because they have limited health literacy. This is due to the fact that some individuals reading levels and understanding of healthcare is very low. Therefore its best to simplify health terminology, along with clear explanations, while asking questions to make sure the client understands the best approaches and techniques to live a full, healthy life.
As occupational therapist engage in helping a client live a healthy lifestyle they have the possibility to improve patient satisfaction and quality of care because they are client centered. While helping keep the cost per capita down, OT's are innovative and they think creatively to adapt to clients needs on the spot. Along with adapting they promote advice and the correct referrals so the client can live as independently as possible without returning to the hospital because they were taught and understood health literacy. Overall, it is best to understand that an occupational therapists' role in health promotion is important to not only prevent an injury or disease before it happens but also to limit the struggles of a disease already present. Health promotion not only is beneficial to clients, but also other healthcare providers and even family members.

It's All About The Rhythm

For the shoulder to have the greatest ROM the scapulohumeral rhythm is very important. Scapulohumeral rhythm is the muscle interactions within the scapula and humerus.  For every 3 degrees of shoulder movement, there is 1 degree of scapular movement and 2 degrees of humeral movement. This rhythm and its ratio is very important in the synchronization of the scapula and humerus movements.  The rhythm also helps maintain the subacromial space within the glenohumeral joint. This rhythm also allows for good length tension relationships to prevent active insufficiency. The two joints congruency results in decreased shear forces of the humerus in the glenoid fossa.  When the motion is distributed between the humerus and glenoid fossa it allows for stability, if the ROM is large there is a chance for instability. The scapulohumeral rhythm is important for therapist when looking at the overall muscle and shoulder joint functions. A poor rhythm could also cause shoulder impingements in the rotator cuff like bone spurs, humeral and scapular movement dysfunction, and changes in the acromion shape.

Modifications & Living Life

Many individuals do not think something as simple as an Alexa can help an older person who lives alone. One example in the podcast was that an elderly person had fallen and called 911 with the help of her assistive device, known as an Alexa. Many older individuals want to grow old in their homes or even remain as independent as possible in their homes or assisted living facilities. As occupational therapist strive to make aging in place safer this can be done with the use of assistive devices. An interdisciplinary team works together to make the best recommendations to home modifications and adaptive equipment. Some of the top modifications were putting grab bars into homes, elevated toilets, and even making a shower easier to get in and out of. 

Occupational therapist are not inventors and sometimes clients want something to work for them and no one else, so they have to reach out to other individuals to hopefully find the best product for that client. As a therapist it is their goal to make adaptive equipment as client centered as possible. Assistive devices can be incorporated into an individuals life not only by a therapist, but someone as simple as an employee at a home store. As stated in the Ted talk there needs to be a universal design. Different individuals need different requirements and we as by standers need to think of others needs to make it an easier world for us to all live in. Not only when someone has a disability in a public restaurant and needs help reading the menu but is blind, but also for older adults to grow older in their homes and to be as safe as possible. All individuals deserve to live life to the fullest and adaptive technology is an important part of life now of days. 

Test Positioning

It is important to use bony landmarks and proper positioning when measuring range of motion so the reliability between one therapist taking measurements and numerous therapist taking the same measurements is reliable. If the goniometer isn’t placed properly on the structure you are measuring this could decrease the validity.  Following the landmarks and correct positioning allows for more accurate repeatable results. The test position for MMT is important in the fact that you do not want to measure the start or the end of the motion. You want to measure the mid-line of a motion because this is the most optimal muscle contraction where the actin and myosin filaments overlap to form the best contraction. MMT is measured either with gravity applied or gravity eliminated.  If an individual struggle lifting their desired limb because gravity makes it hard difficult it may be best to use gravity eliminated movements. Gravity eliminated movements are possible by keeping the moving structure parallel to the ground, the client is not the one that needs to be parallel to the ground just the structure moving. When measuring knee flexion and extension with gravity eliminated the client needs to lie on their sideline with the moving structure on top, not in contact with the mat. Scores of 5-3 normally involves movements against gravity. If the individual struggles with barely moving a limb they are either on a scale of 2-0. Any score less than 3 should use gravity eliminated so you can get a true idea of muscle strength without over exerting or harming the patient.    

Analysis Of A Motion During A Daily Activity

Everyday I go to the restroom, it’s part of everyone’s daily life. I start in a standing position in front of the toilet; I squat down to place myself on to the toilet. This squat position going down involves the hips and knees going into flexion and the ankles in dorsiflexion. In osteokinematics, flexion of the knee occurs within the sagittal plane and frontal axis having a fixed distal segment which is a closed kinematic chain. The arthrokinematics movement in the knee involves the convex femur gliding posteriorly on the concave tibia. The primary movers when going down involve the quadriceps (rectus femoris, vastus intermedius, vastus lateralis, vastus medialis muscles.) The action of performing a squat is considered an eccentric contraction, because it is decelerating against the force of gravity.