Unity by Personal Disability

The advancement of modern technology has allowed for the implementation of assistive technology (AT) in the therapeutic setting. The purpose of AT is to facilitate the engagement of activities and occupations of individuals with disabilities who may otherwise experience difficulties. AT ranges from no/low-tech to medium-tech to high-tech. No/low-tech is considered to be the most intuitive in that it is the easiest to utilize and has a very clear understanding in terms of usage. Medium-tech AT may require a small extent of training and set-up. High-tech AT is the most complex and may prove to be challenging to program and maintain. When deciding which form of AT to implement, it is important to consider multiple aspects of the client such as strengths, weaknesses, and goals, as well as the availability of AT (Lancaster, 2018).

Assistive technology is simply one component of the countless that exist within the concept of universal design. The extent of a disability is not exclusive to those who have been branded with that label; every individual experiences challenge due to personal and potentially innate shortcomings that may not be considered a “disability” by society, such as height while playing for a basketball team or limited creativity on an art project. “Disability” is only a manifestation of the imperfect nature of man and unifies us as humans. If seen as a drawback instead, there is a strong implication that a step can be made forward toward one’s improvement of health and autonomy as opposed to being a quality of permanence. Because there is a need to cultivate a myriad of solutions to account for each blemish of man, universal design is essential to create “products and environments accessible to all people, to the greatest extent possible, without the need for adaptation or specialized design” (Nesmith, 2016).

~ Pam ♡

Citations

Lancaster, S. Introduction to Assistive Technology. 5 April, 2018. Prezi.

Nesmith, M. (2016). Why We Need Universal Design. Retrieved from https://www.youtube.com/watch?v=bVdPNWMGyZY&app=desktop.

ROM & MMT

It is important to palpate bony landmarks in order to properly position the goniometer and attain accurate and consistent measurements. When measuring the range of motion (ROM), the bony landmarks indicate where the fulcrum of the goniometer should be placed, as well as the positioning of the moving and stationary arm. The stationary arm should be aligned with the bone which remains fixed during the joint motion while the moving arm of the goniometer should be aligned with the mobile joint. The same landmarks are repeatedly used between therapists and the individual therapist. As a result, interrater as well as intrarater reliability is increased relative to, and they are dependent upon this consistency. It is important to take accurate measurements to ensure that the client receives quality treatment.

Manual muscle testing (MMT) is utilized to measure how strong or weak a muscle or group of muscles are. In order to secure the client’s safety, proper positioning during MMT is essential. Appropriate positioning also optimizes accuracy of measuring muscle strength. However, there are cases in which the client cannot produce enough or any muscle strength to yield a particular action. In these circumstances, placing the client in a gravity eliminated position will nullify the force of gravity on the specific action. In order to negate gravity’s force, the client must be positioned in such a way that the action is performed parallel to the ground allowing the client to demonstrate his or her muscle ability.

~ Pam ♡

Juggling

Every evening, after I finish a long run, I work on ball control by juggling my soccer ball for roughly 15 minutes. To initially get the ball in the air, I place my right foot on top of the ball. This involves elevating and lowering my foot with slight hip and knee flexion while the left foot remains planted. By applying a little more pressure to the ball, I am able to pull it backward by flexing my knee a little more. While it is rolling, I quickly extend my knee to plant my right foot in a plantarflexed position, allowing the ball to roll onto the dorsum of my foot. After timing it just right, I “flick” the ball up so it becomes airborne by flexing my hip and knee again while quickly dorsiflexing my ankle. The rest of the activity involves a repetitious pattern of planting my foot while the ball is in the air by extending my hip and knee and plantarflexing my ankle and lifting my foot by flexing my knee and hip and dorsiflexing my ankle in order to make contact with the ball to kick it back into the air. This series of motion ends when the ball falls to the ground out of my control, and I start it over again. 

All osteokinematic actions of hip flexion and extension, knee flexion and extension, and ankle plantar and dorsiflexion move along the sagittal plane and about the frontal axis of rotation. The arthrokinematics of the tibiofemoral (i.e. knee) joint involve the convex surface of the distal femur sliding anteriorly while rolling posteriorly on the tibial plateau. The prime movers involved in knee flexion include concentric contraction of the hamstring muscles (i.e. biceps femoris, semitendinosus, and semimembranosus) while the gracilis, sartorius, gastrocnemius, and popliteus muscles act as synergists.  

~ Pam ♡

Practice Empathy

My first experience shadowing was observing a variety of occupational therapists in an outpatient setting. As someone who had just changed her major from music, unfortunately, the interactions I witnessed were not helping me in convincing me that occupational therapy was something meaningful that I wanted to do for the rest of my life. Oftentimes, I would see therapists place their patients on the arm bike or have them perform tasks that were not engaging to the client. Meanwhile, they step out to the side with coworkers and chat or look at their phones as opposed to interacting with the client. It was disheartening to see individuals who have devoted their lives to "helping others" be so aloof toward their relationship with the client(s).

Since then I have had more positive experiences which inspired me to continue to pursue occupational therapy. Through observation and academic lectures, I have learned that a strong, positive relationship between the occupational therapist and the client is crucial within the field. In the field of occupational therapy, the holistic approach aims to consider all parts of a person, including physical, mental, and emotional. Having a strong capacity for empathy and active listening is encompassed within this approach and necessary to be incorporated into practice. With this, understanding how to interact, connect with, and collaborate with a client is of utmost importance in order to be conducive toward the therapeutic process. 

- Pam ♡

Taking the "Dis" Out of "Disabled"

Although seemingly normalized in modern day society, a residual negative stigma associated with disabilities still exists. Throughout the 20th century, individuals with a disability were depicted as criminals, a financial burden, and toxic to society. Presently, disability as its own culture is not a concept that is widely recognized and its acknowledgment as such is a current work in progress. Once accepted and fully integrated, it could play a significant role in shaping how people perceive the world. Although the echoes of history have mostly subsided, they've not been fully silenced. 

During this time, the institutionalization of those with disabilities was common practice. When institutionalization was at its peak in the 1960's, television as media began to broadcast documentaries which depicted the abhorrent living conditions and treatment of those with disabilities. Synergistic with the awareness of John F. Kennedy's daughter, Rosemary, controversy and a push for change arose. Implementation of legislative acts aided the facilitation of normalizing disabilities, and deinstitutionalization began to take its course.  Medicare and Medicaid (1965) federally subsidized health care; the Rehabilitation Act (1973) made discrimination in hiring practices illegal; the Education for All Handicapped Children Act (1975) denied exclusion from public schools; and the American With Disabilities Act (1990) granted civil rights protection. These measures allowed change by moving away from a deficit model and progressing toward a supportive approach. 

In the field of occupational therapy, it is important to consider the aforementioned developments throughout history. Although the prejudice against those with disabilities is much less prevalent, it is still present. A strong foundation of our practice is following a holistic approach which entails universal and unconditional inclusiveness. Individuals with disabilities are now more able to pursue meaningful aspects of living a normal lifestyle such as employment and marriage. As society continues to integrate and normalize the culture of disability, we as practitioners can utilize the outcomes in our favor to effectively treat and advocate for individuals with disabilities, and ultimately, augment their quality of [a normal] life.

~ Pam ♡