Neuro note - TBI 2

For my fourth neuro note, I chose to return to a neurological condition that intrigues me more than any other, traumatic brain injury.  The video I chose to watch is a speech by Kim Gorgens called, "Protecting the brain against concussion."  I chose to watch this video because I feel like prevention is key to many health problems in our society.

In the video, Kim uses her over protection of her son to lead into the reasoning of the prevention for concussions. Many people would disagree with her thoughts behind whether kids should play football or the law requiring all bicycle riders to wear a helmet, but she is promoting the safety and prevention of concussions.  She goes on to say that the three keys to preventing concussions are to study up, speak up and suit up.  Studying up on the signs of a concussion could play a big role, especially in coaches.  Speaking up about the topic can help promote the safety laws and implementations put into place by legislation.  Finally, suiting up by wearing a helmet to protect the most vital organ in your body, your brain.

The video is very short (~9 minutes) and provides a good insight of prevention methods from concussions.  There is not much scientific evidence in the video to back up her thought process besides the concussions statistics, however, this is a big topic around football players today and I believe that it should be strongly taken into consideration the prevention methods that she provides.  If you would like to hear her thoughts, I have provided the link below to the Tedtalk. Hope you enjoy!



Link: https://www.ted.com/talks/kim_gorgens_protecting_the_brain_against_concussion#t-536488



Gorgens, K. (n.d.). Protecting the brain against concussion. Retrieved from 
         https://www.ted.com/talks/kim_gorgens_protecting_the_brain_against_concussion#t-536488

Media Project - Chopsticks

The "Ah-ha" moment for me with the project came when I decided what I was going to put in the middle of the chopsticks to keep them pulled together on one end.  I already had it in my mind that I was going to create something similar to a pair of "pliers" for this project. I started off with rubber bands and several different objects as a spacer between the chopsticks but I knew it needed some sort of spring in the middle for the tension that would be required for the tasks. The clothes pin also provides enough tension that would help with pincer strength if any deficits were to occur due to his broken arm. 

                                                 

This project taught me that some of the most unexpected things, such as chopsticks, can be such a useful tool for someone in their everyday life. A combination of simple household objects can give a person just the right amount of assistance they need to be independent performing an ADL. Completion of this assignment has helped me use my OT think skills to use an intervention to help a client engage in their daily lives. This can carry over into future practice by making use of what is available in the moment to come up with an intervention for a client that can be temporary or maybe even for long-term use.

Neuro Note - Alzheimer's

Due to my love of Tedtalks, I chose to watch another for this neuro note!! I chose to watch the video, "What you can do to prevent Alzheimer's" with Lisa Genova.  I already had an understanding of Alzheimer's disease and it's effects on an individual, but I was very curious to learn ways in which you can prevent the disease. 

Lisa Genova spoke about the affects of the disease and how it makes people forget things such as where they have put their keys or maybe even what their keys are used for.  She then gave the reason as to why people develop this disease which is the build up in between synpases. This build up occurs over time and gradually gets worse and the body is unable to clean it out.  There is currently no medication to help with this or to cure the disease at all.  So many people think that you have to keep using your brain as you get older or you will develop Alzheimer's which is not necessarily true, but it can be beneficial. 

Lisa talks about a group of women who had developed Alzheimer's disease but did not show any symptoms before they passed away.  How could this be?  It is believed that the women had a high cognitive reserve which means that they had more synapses in their brains than normal.  So the more synapses you have, the less likely you are to see the effects of this disease.  She explains it in further detail by explaining that if you know her as an author, a Tedtalk spokeswoman and a neuroscientist and then develop Alzheimer's, you have a greater chance of remembering who she is because you have more than one synapse connecting your memory to who she is. So if the synapse of her being an author and a neuroscientist is destroyed, you still remember her from the Tedtalk.

I recommend anyone who studies or is interested in neurodegenerative diseases to watch this because this links back to neuroplasticity in the brain. This is a quick ~13 minute video with some really good information to think about with Alzhiemer's disease.  The link is below and I hope you enjoy it as much as I did!

Link: https://www.youtube.com/watch?v=twG4mr6Jov0

TED. (2017, May 19). What you can do to prevent Alzheimer's | Lisa Genova. Retrieved August 19, 2019, from https://www.youtube.com/watch?v=twG4mr6Jov0

Neuro Note - Parkinson's Disease

I chose to watch a Tedtalk for the topic of Parkinson's Disease. The title is called, "Simple hacks for life with Parkinson's." Being an OT student, the title immediately drew my interest as I thought I was going to see some homemade adaptive equipment using everyday objects around the house. I did see some modified equipment, but I gained insight of using basic "technology" to help people live an independent life with Parkinson's.

The spokeswoman began talking about how she developed a cup that would not spill with someone who had tremors and she demonstrated how the rounding of the top of the cup would just splash the liquid back down into it.  This was only a solution for one symptom of Parkinson's.  It led her to begin thinking of other adaptive equipment she could make and she starting with walking. Her father had Parkinson's and he took small steps and turned very slowly, but the walker helped with most of his problems.  She started thinking about how he could possibly climb stairs with as much trouble as he has walking on flat ground, so she had him attempt to climb up and down stairs. To her amazement, he went up and down the stairs very well.  He moved quickly and smooth without the use of any assistance. He was able to due this because going up and down stairs is one continuous motion.  She had the idea to have a 3-D picture of stairs laid out on the floor and have him stare at it while he walked across the flat ground.  When she had her father do this, he walked across the flat ground just as quick and smooth as he did when he was going up and down the actual stairs. This brought her back to thinking of basic ideas to help individuals with Parkinson's in their daily lives.

I chose this assignment because as a future OT, I could implement this thought process she uses and even the idea of using the image of the stairs to promote independence in individuals with neurological conditions. You can manipulate the mind into doing something while using low-tech, low-cost things such as this, which is exactly how OT's operate. I highly recommend watching this video because it gives you another perspective to see things from and it really focuses in on the client-centered thought process that we use as OT's.

Link: https://www.ted.com/talks/mileha_soneji_simple_hacks_for_life_with_parkinson_s#t-401266


Soneji, M. (n.d.). Simple hacks for life with Parkinson's. Retrieved August 13, 2019, from https://www.ted.com/talks/mileha_soneji_simple_hacks_for_life_with_parkinson_s#t-401266

Neuro Note - TBI

I watched a Tedtalk called, "Can the brain repair itself" under the list for TBI.  I chose this topic because I personally know people who have suffered from a traumatic brain injury and I was interested in learning if the brain could in fact repair itself.  I know there is no cure for a TBI and the title of the video caught my attention as to wonder if there were new discoveries that could benefit a person with a TBI.  I am always interested in learning about advances in medicine and this video was perfect for me to watch!

The gentleman in the video began by talking about new hope for the future for individuals with neurological disorders and shared a story and video clip of a man named John who also has motor neuron damage.  Images of the brain were shown to distinguish the differences in a normal brain and one that has been damaged. As we learned in class, a ABI can be traumatic or non-traumatic.  The neurological conditions that were shown were a result from other disorders which lead to the brain injury.  This would be classified as a non-traumatic brain injury.  After seeing all of this damage and learning that the annual cost for neurological conditions is 700 billion dollars, the doctor finally reveals to us the hope for the future, stem cells!

We have known about stem cells for a long time and we have the understanding that they can regenerate new healthy cells while killing off the bad cells.  We have stem cells already in our brain, but the thing that we have not figured out is how to activate them to work when we have an issue.  This doctor performed a study where they injected stem cells into an individual who had multiple sclerosis and that results where an increase in the optic nerve size, whereas the person was suffering from a decline in the size of the nerve due to MS.  He stated in the video that he did not believe that the new stem cells actually took over but that they activate the stem cells that were already in the person which is ground breaking advances in this medicine.  He believes that a drug needs to be produced to make these stem cells become activated because of the timely process that it takes to produce these stem cells in a lab. Making these discoveries could lead to finding a cure for many individual neurological conditions in the future and I am looking forward to seeing more news about stem cells in the near future!


I encourage you to watch this video, which I have provided the link for below. This is really an eye opening discovery that could lead to many improvements in the field of medicine and could mean finding cures that have been studied for so long!

Link: https://www.ted.com/talks/siddharthan_chandran_can_the_damaged_brain_repair_itself#t-774658



Chandran, S. (2013). Can the damaged brain repair itself? Retrieved July 22, 2019, from 
         https://www.ted.com/talks/siddharthan_chandran_can_the_damaged_brain_repair_itself#t-
         774658

Restoring confidence in mobility

The hierarchy of mobility skills begins with bed mobility then goes to mat transfer, wheelchair transfer, bed transfer, functional ambulation for ADL, toilet and tub transfer, car transfer, functional ambulation for community mobility, and finally community mobility and driving.  This is very close to what I expected the "stages" of mobility skills to be like because each one builds on the other. I have seen this used when working with clients and I agree that it is the correct way to work with individuals on mobility.
From class and labs, I have learned that you start working with clients on tasks that are not as complex and then grade the individual up or down based on their performance.  This is why the hierarchy of mobility skills is in the correct order in my eyes because each one builds up to being able to perform the next. 

Fitting Assistive Devices

Fitting assistive devices to clients is very important and specialized to each person.  It is crucial to fit the device to the person so that they are able to use it for a long period of time.  As discussed in class, insurance companies expect a device to be used for a certain length of time before they will pay for another.  This is especially for children who may outgrow the device.  Another reason it is important to appropriately fit assistive devices is so that the client can use it safely. If a walker is too low when a person is using it, it could cause them to be flexed at their back and cause additional injuries to that person.  Another example would be a cane being too short cause the person to lean further to one side and could also cause them to fall when supporting themselves on it.

To fit an individual for a cane, they should be wearing shoes and the cane should be adjusted to the height of their greater trochanter.  They should use the cane on their uninvolved side as well.  To fit a person for axillary crutches, the axilla rest should be approximately 5 cm below the person's axilla. The handgrips also need to be adjusted to the height of the greater trochanter of the person with their shoes on.  The lofstrand crutches should attach the arm band approximately 2/3 up the forearm with the handgrips at the height of the greater trochanter and facing forward. 
A platform walker should have the handgrips adjusted to the height of the greater trochanter of the individual with shoes on. The platform should be set with the individual's elbow flexed at 90 degrees to allow weight bearing through their forearms.  The proximal forearm should be 1-2 inches off the platform to avoid compressing nerves.  The handgrip of the platform should be slightly medial for comfort of the individual.  Finally, a rolling walker should have the height adjusted to the person's greater trochanter while wearing shoes.  The front and back legs should be at the same height allowing the handgrips to be level as well.