Neurobiology Blog 2 - Social Determinants of Health

Everybody has different things that they have to deal with in life such as living conditions, socioeconomic status, employment, access to healthcare and the list could go on and on. As we evaluate clients and try to figure out the best treatment options for them we need to keep these factors in mind that are referred to as social determinants of health. Social determinants of health are anything in our social environment that could affect our health in some way which could be good or bad. It's things that are going on outside of our bodies that are affecting our body functions, organ functions, or occupational performance. As occupational therapist's, this goes right along with the concept of client-centered, holistic practice of looking at the person as a whole and not just at the problem they are having. A client profile is so important when considering their social determinants of health because we will be able to ask questions to help us get to know the client better personally and any special circumstances that they might be dealing/living with that is causing an observable effect. These social determinants of health could affect our nervous system by adding on excessive stress or altering our sleep wake cycles to where we're not getting the rest that we need to function. Also, the excessive stress could also cause sleep problems, headaches, anxiety disorders, etc.

I believe that the OT program at UTHSC really does a great job at allowing and encouraging us to see  and interact with people that are different than us that might have things under the surface that are affecting their health. Through the hours that we have to acquire of service/professional development we get to interact with people that may have very different social determinants of health compared to our own. Whether they are homeless, live in unsafe conditions, deal with abuse, are health illiterate, have a very physically demanding job, are unemployed, have a disability/take care of someone with a disability, etc., we get to talk with people that come from all walks of life and might have to deal with things that I would never dream of that will consequently affect their health. I'm thankful to be pursuing this career that encourages me to get out of my comfort zone and interact with people that are different than me that I can hopefully help and maybe learn something from in the end.

Biomechanics Blog 7 - Locomotion and Adaptive Devices

There are many situations where a person might need adaptive equipment to help with their ambulation and mobility. When picking what kind of AE the person needs, many factors need to be taken into account to make sure the most efficient and safe option is chosen for the client. Things such as disability, weight bearing status, strength, ROM, balance, and coordination will need to be assessed to make sure the correct assistive device is being chosen and if they need any added on equipment to the device. Other factors should also be looked at like age, endurance, and psychological condition. As an OT, we need to make sure that the device is comfortable for the client and doesn't cause any pain or breakdown of the skin, puts the client in a position to use correct body mechanics, and is practical and usable for the client in their day to day life.

Some devices that can be used to help with ambulation and mobility include canes, crutches (axillary and Lofstrand), and walkers (platform and rolling). A cane would be used when the least amount of stability needs to be added to the client. To fit a cane to the person, we need to make sure that the hand grip is at the level of the client's wrist crease and that their elbow is slightly flexed to hold on to the cane. There are also different types of canes that can be chosen from, for example, a standard or straight cane with one leg or a quad cane that has a wider base and 4 prongs to increase stability (base can be wide or narrow).

Crutches can give more added stability than canes. To fit crutches to a client, we would need to take the same measures as for a cane and add that the crutches, if axillary, should be around 5 cm below the floor of the axilla with the shoulder relaxed. This is for comfort and correct alignment of the shoulders while using the crutches. For Lofstrand crutches, these have an arm cuff that goes around the proximal forearm of the client. We would still need to make sure they are the right height and that the arm cuffs were a correct fit for the client. They provide less stability than axillary crutches, but are for long-term disabilities.

Finally, walkers are more stable than either canes of crutches. The same measures should be taken when fitting a walker to a client as with a cane. A platform or rolling walker will have 4 points of contact to the ground, but the rolling will be less stable than the platform. A platform or standard walker should be given to someone with fair balance that needs a large amount of added stability. A rolling walker is more efficient for a person that cannot lift a walker up to move.

Biomechanics Blog 6 - Transfers and Mobility

Mobility is a very important part of people's lives. We like to be able to get where we want to go without much resistance or problems. When a person loses that ability of moving themselves around, it in most cases becomes a goal of restoring that mobility as quickly and efficiently as possible. There is a hierarchy of mobility skills that can be followed in this kind of situation. The steps include bed mobility, mat transfer, wheelchair transfer, bed transfer, functional ambulation for ADLs, toilet and tub transfer, car transfer, functional ambulation for community mobility, and community mobility and driving. These steps set up a system that can be used to gradually restore the person's mobility in the most safe and efficient way possible and helps to also gradually restore the person's confidence in their mobility skills.

During high school I received my CNA license and during the time I spent in different facilities, I saw some of these steps, but not all and sometimes not in the same order. I think that the hierarchy was put in this order because it is the most functional and safe process to use for the patient, but sometimes people will progress differently causing the hierarchy to maybe be changed for some. This hierarchy of mobility skills I believe is effective in treatment of others because it goes from the basic needs of mobility and self care and proceeds to more difficult tasks that should be implemented at a later time when some/most mobility has been restored. As an OT, it will be my job to make sure that whenever someone of trying to restore their mobility that we are doing it in the safest, most efficient, and personally accepted way for the patient or client. This hierarchy seems to be a good guide to go by.

Biomechanics Blog 5 - Posture and Body Mechanics

Posture and body mechanics are two things that most people don't pay enough attention to. If they are neglected for long enough, permanent damage and stress can be made to structures. One thing that can happen is lower back pain. This is probably the most common result because of the stress that is put on the lumbar vertebrae and the intervertebral discs in between. With bad body mechanics, you have the risk of bulging or herniating your discs which is another reason to position your body correctly when performing a task. A third reason a person needs to have good posture and body mechanics is because nerves can become impinged primarily in the thoracic area of the back causing increased pain. Another reason is that when you are lifting something incorrectly or performing some other task incorrectly, you can possibly pull or strain the muscles being used along with the tendons, ligaments, or joints all resulting in problems.

One method that can be used to teach better posture to a person is slouch-overcorrect technique. If someone has to sit a lot during the day and for long periods of time, this would be a good technique to use. For this technique, you take someone with bad posture and have them flex their trunk further down and hold for 1-2 seconds. Then, have them sit upright as straight as possible to increase the lumbar lordosis and extend the trunk and hold for 1-2 seconds. They should return to a neutral position after this and be in a more upright sitting position.

As a therapist, we can show the use of good body mechanics and posture while in intervention by not doing things that might harm our bodies. We can do things like not lifting things with our backs bent, raising the bed when working on bed mobility with a client, and sitting with good posture as an example to them among many other things to protect ourselves.

Neurobiology Blog 1 - Advertisements and Our Brain

https://www.youtube.com/watch?v=K9vFWA1rnWc

I saw this advertisement on Facebook in the past and thought that it was very inspirational and thought provoking. It is actually from Thailand and promotes Thai Life Insurance. The advertisement shows a man that does things everyday to help others like putting a plant under water, giving money to a little girl for education, sharing his food with a dog, helping a lady get her food cart over a curb, and leaving bananas on the door handle for his elderly neighbor. At the end, it shows how all the people and things that the man helped were all affected in a positive way and, even though he didn't become famous or rich, he had more love and meaning in his life.

I think that in relation to our brain this advertisement is involved with a few different parts that I'm going to discuss. First, the autonomic nervous system would be functioning to keep your bodily functions and organs regulated so that you could see, hear, and understand the content of the advertisement. Also, the parasympathetic nervous system would be used because there is nothing in the commercial that would cause fear or make a person want to move and get away from it so the body would be conserving energy and in a quiet state. Second, the occipital lobe is being used for vision to see the video, the parietal lobe for hearing the words and sounds, and the frontal lobe for keeping your attention in the video and understanding the meaning of it. Third, some mirror neurons were definitely working while I was watching this advertisement. I could feel how much love the man felt in his heart seeing the good that had come from his small deeds. It made my heart happy as well to see the kindness that he showed to others. Finally, I think that this advertisement would play off of the emotional response from the limbic system by showing the others that judged the man for his good deeds, but then seeing all the good and happiness that came out of them. This could show that even though you might not be rich or famous, you still can live a good life and do good and should consider buying life insurance through their company because your life is worth it.

This advertisement definitely will tug at your heart strings and make you think about how you should do more good for others. Who knows, you might even end up with some life insurance in Thailand :)

Biomechanics Blog 4 - "Man from the South"

In the excerpt “Man from the South”, if the American sailor boy had lost his little finger in the bet it would have changed his day to day life more than he thought it would. As a sailor, I know that he would need to have exceptional grip strength and fine motor control and losing his finger would have affected that. Sailors would need to be able to pull on ropes, steer boats, shoot guns, and pick up heavy objects that all rely heavily on hand and finger strength and movement.

Compared to the sailor, the wife of the man in the story looked like she had been through and lost in a few of the man’s bets. She only had one finger and her thumb remaining on her hand. This could cause difficulty with her occupations of cleaning (using a broom), cooking (taking a dish out of the oven), fixing her hair (using a brush and hair dryer), putting on makeup (holding powder and a makeup brush), picking up an object (a box from the ground), and many more. 

A major occupation that was most likely affected for the wife when she lost her fingers could be driving her car that the man tried to use in the bet. It would be hard for her to control the steering wheel with her left hand, that has just one finger and her thumb, if her right hand needed to turn on the blinker or if the car was a stick shift and she had to change gears. Something that could help her with driving the car could be a knob (adaptive equipment) attached to the steering wheel to make it easier for her to grasp to give her more control of the car. She would need eduction on how to effectively and safely use the knob, and she should practice using it before actually steering the car with it. This could help to increase her independence and safety while on the road. 

Effects of Glutamate (GIF edition)

Too much glutamate

Causes overexcitation of the receiving nerve cells 

causing damage or even death to the cells 

Too little glutamate

Causes difficulty concentrating or mental exhaustion

Purpose of glutamate

Responsible for sending signals between nerve cells 

that are important for learning, memory, and 

brain development