knOTts' thoughts...

            As part of our Neuro Aspects course we were assigned a case study and supplies to make an intervention or adaptive device for our client. I was assigned to Barbara who is a 64 year old woman diagnosed with relapsing-remitting multiple sclerosis (RRMS). She recently had a relapse and was admitted into an acute care hospital. Her relapse caused a significant decline in upper and lower body strength as well as lower extremity spasticity. She also has problems with memory and fatigue.           We were all given three materials of which we were to use at least one. I was given a milk jug, cotton balls, and paint sticks. For my media project I chose to make a priority to do list. I used a paint stick, clothespins, and paint for this project. I chose to make the priority to do list because it targets three different aspect of Barbara's RRMS. The first is to limit Barbara's fatigue by having her prioritize t...

            For my sixth neuro note I chose to read a short story about a patient named June (June, 2023). At the age of two, June started to walk oddly (June, 2023). After a few weeks her mother realized something must be wrong and they went to the Seattle Children's Hospital ER (June, 2023). Eventually, the doctors performed a lumbar puncture which allowed them to come to the conclusion that June had Guillain Barré Syndrome (GBS) (June, 2023). June was not getting better at the rate she was supposed to so the doctors then diagnosed her with chronic inflammatory demyelinating polyneuropathy (CIDP) which is very rare (June, 2023). June has since gotten some better, but because of the CIDP she may have long term effects (June, 2023).           I chose this resource because I like to read patient stories as they are more personal and truthful than just an article discussing the disease or interventions. Also, I chose this sp...

            For my fifth neuro note I chose the resource, "Meg Young: Beyond My Personal Battle with Multiple Sclerosis." This article is written like an interview where Meg answers a few questions about her diagnosis of multiple sclerosis. Meg first explains about how she was diagnosed and what exactly multiple sclerosis (MS) is, which she does a great job of defining (Young, 2021). She also talks about how MS has impacted her life and how it has made her feel as a person (Young, 2021).            I chose this resource because, first and foremost, it was an article and I am able to learn more from articles than videos. Another reason I chose this resource is because one of my best friend's mom has MS and I wanted to know more about what she is going through so I could be a better support for my friend. In relation to the course content Meg mentions she has secondary progressive MS (SPMS) which we learned in class is ...

        For my fourth neuro note I read the article, "A Meaningful Life" by Francesco Clark. Francesco Clark suffered a spinal cord injury due to a diving incident when he was twenty four (Clark, 2017). Clark talks about how his injury has caused him to think about life differently (2017). From his experience, he has learned to not live in the past or future, but to live in the moment as it is precious and can be taken at anytime (Clark, 2017). I chose this source because of the title, "A Meaningful Life." I thought that it would be a good source to read if it showed how a person with a spinal cord injury still feels they have a meaningful life.           Based on the course content and context clues of the article, I can deduce that Francesco probably had a traumatic, incomplete tetraplegia spinal cord injury. I have deduced this due to knowing that he was injured due to diving into a pool which would likely be a traumatic cervical...

          For my third neuro note I read the article, "How to Improve Gait in Parkinson's Disease," by John Hanc. This article discusses different approaches to aid in the "freezing" that people with Parkinson's disease experience such as the use of internal and external cues (Hanc, 2022). An internal cue is when you would walk to an imaginary beat or say, "ready, set, go" to get moving, and external cue would be using walking sticks or a laser pointer to guide your movements (Hanc, 2022).           I chose this source because I wanted to know different methods of improving gait as I could use them as future interventions. In our course we have discussed how having Parkinson's can cause akinesia or dyskinesia which is the inability or having difficulty moving. This article provides interventions for these symptoms and would be a good resource for anyone who has a client with Parkinson's that is exhibiting these symptoms or for ...

         As part of our Neuro Aspects course in OT school, we participate in clinical simulations. For our first SIM we completed the SLUMS (Saint Louis University Mental Status) Examination on a client (actor) who was being admitted into a rehab facility after having a cerebrovascular accident (stroke) due to COVID-19. The SLUMS examination assesses a person's cognition which is how someone takes in information and is able to process it. As an occupational therapist there are times where we will work with clients who have cognitive disorders. For example, like in the simulation we could work with a client who has had a stroke and is having problems with their memory and loves cooking. As an intervention we could have the client work on memory by the therapist reading a recipe aloud and the client having to cook without reading it.           The client I had for my SIM scored a 21 on the SLUMS examination which indicates m...

Emilia Clarke           For my second neuro note I chose to read the article "A Battle For My Life" by the actress Emilia Clarke. Emilia had just finished filming the first season of "Game of Thrones," and was working out with her trainer when she suddenly had a stroke (Clarke, 2019). More specifically she had an aneurysm that led to a subarachnoid hemorrhage which is bleeding in the space around the brain (Clarke, 2019). Two years later, Emilia had a brain scan show that she had another aneurysm that had not burst and she was to have surgery to resolve the problem (Clarke, 2019). However, during surgery the aneurysm bursted and it became an open brain surgery (Clarke, 2019). Emilia survived the surgery and suffered from anxiety and panic attacks the month following the surgery (Clarke, 2019). Emilia was very lucky that she had no consequences post-brain surgery such as memory or speech loss.           I chose this resource as ...

Image           For my first neuro note I read the article, "Should You Play Along With Dementia Patients' Realities?" by Carol Bradley Bursack. In this article Carol describes how her father suffered a brain injury resulting in dementia (Bursack, 2021). He experiences different delusions that she chooses to support rather than telling him it never happened (Bursack, 2021). I felt this was wonderful of her to do as it was a way to not cause him distress. She was allowing him to engage in his chosen occupations without causing further harm.             I chose to read this article because I have a grandmother that has been diagnosed with dementia and I wanted to know more so I could help her. To further my learning, I researched the different stages of dementia and how to identify each stage. Based on my research, I believe that my grandmother has moderate to moderately severe dementia (stage 4 or 5) (WebMD, 2023)....

        It is extremely important to properly fit a client for a device. Proper fit increases safety and security as wells as decreases strain on the body. If the equipment was not fit properly, the client may fall or be unable to properly use it. Strain is also decreased as equipment being at the proper height, allows for better mechanics of the body.  Cane           For a cane, the hand grip should be at the level of the ulnar styloid, wrist crease, or greater trochanter. The elbow should be in a relaxed position where it is flexed 20-30 degrees. The therapist should also ensure that the shoulders are relaxed and not elevated.            For sit to stand, the client should scoot to the edge of the seat with their feet flat on the ground with toes under knees. The cane should be straight on the ground in the hand of the uninvolved side. The client should place their other hand on the armrest or ...

          For me, the Super Bowl always has the best advertisements. One ad that has always stuck out to me is the Doritos ad " Keep Your Hands Off My Doritos ." This ad impacts me because of how comedic it is. The mom in the commercial is getting ready to go on a date and leaves her son and date out in the living room. The date then tries to eat one of the boys Doritos and he slaps the man and tells him to put it back. The child then says the iconic line, "Keep your hands off my mama. Keep your hands off my Doritos."           The reason this ad was so successful has to do with how our brains react to it.  In the video, " The Neuroscience of Film ," Dr. Fahd Yazin talks about how the brain reacts to watching videos or movies. In the nervous system, the most active parts of the brain when watching something are the amygdala, corpus striatum, and hippocampus. The amygdala is what allows us to experience different emotions. ...

           A transfer is a safe movement of an individual from one surface to another such as, a tub, shower, toilet, vehicle, bed, chair, or the floor (Weisser-Pike, 2023). There are many things one has to consider before performing a transfer. The first thing to consider is the client's capabilities. Does the client have good balance and strength? Depending on the answer, is what tells the therapist what kind of transfer would be the best course of action.            The second thing to consider is the therapist's capabilities. Is the therapist strong enough to transfer the client with good body mechanics or do they need to ask for assistance? If the therapist thinks they will need assistance, they need to acquire that before setting up the transfer.            Another thing to consider before performing a transfer is the environment. When performing a wheelchair transfer the ...

           Back in 2013, Paul Erway, Aaron Roux, and Grant Berthiaume decided to complete 50 marathons in 50 states in 50 weeks. All three men have a spinal cord injury and are competing in wheelchairs. The two races out of the 50 I have chosen to focus on were on September 16, 2013 in North Dakota and September 17, 2013 in South Dakota.           Race number twenty-nine was in Bowman, North Dakota at Bowman-Haley Lake. However, they encountered many mishaps before even getting to the race. They flew into Omaha, Nebraska and the rental car company did not have their car ready (as they needed a car with hand controls). The only car they had with hand controls was a Ford Excursion, however it was so tall they had a lot of trouble getting in and out of it, especially getting in after races when they were already so tired. I cannot conceive the exhaustion they felt after propelling their wheelchair for 26.2 miles, ha...

    Three Images of People Doing Everyday Activities: Pinal is eating on the floor while studying     Allison is studying at a desk Matthew is riding a bike   Image Three Analysis:           When biking, the body is in dynamic posture because it is in motion. The pelvis is posteriorly tilted, the cervical vertebrae are in extension, the thoracic vertebrae are in slight kyphosis, and the lumbar vertebrae are in slight flexion. Both femurs are in hip flexion, the scapula's are protracted, and the head is forward. This position is more efficient for mobility than stability because of the body being in motion. This makes it more difficult for the body to change out of this position. The base of support is large as it encompasses his hands on the handlebars, his bottom on the seat, his feet on the pedals, and the wheels on the ground. The upper extremities are being used for support of the upper body as the trunk is leaning. This places ...

Image Source         White and gold or blue and black? Under normal circumstances, "l ight enters the eye through the lens---different wavelengths corresponding to different colors. The light hits the retina in the back of the eye where pigments fire up neural connections to the visual cortex, the part of the brain that processes those signals into an image" (Rogers, 2015).  However, with this image our brain can't figure out what it is seeing because the camera does not have chromatic adaptation like the brain does. Chromatic adaptation  is where under different lights our brain can still tell that a banana is yellow despite the brightness or darkness of the environment. This is a great example of neuroplasticity which is, t he ability of the brain to modify its neural connections to adapt to challenges in the environment (BrainFacts/SfN, 2012). Within this example the brain has modified how it perceives color based on the time of day or light al...

          In the short story, "Man from the South," an old South American man bet an American navel cadet that if the cadet could light his lighter 10 times in a row he could have his brand new Cadillac, but if he lost the old man could cut off his pinky finger. Luckily, the old man's wife stopped them before the bet could be completed. However, the cadet noticed she only had one finger and thumb left on one of her hands.            If the cadet had lost the bet, many of his daily occupations would be impacted by just the loss of one pinky on his left hand. The pinky finger provides a lot of our hand strength and without it we lose the strength to do simple things like opposition (grip between the thumb and pinky) and grasping (grip between all of the fingers). As the navel cadet was training to be a sailor as well as a soldier he would not be able to perform many of his previous duties. His hand dexterity and strength wou...

        Scapulohumeral rhythm is the ratio of movement between the scapula and humerus. The ratio is that every time the scapulothoracic joint moves 1 degree, the glenohumeral joint moves 2 degrees. Scapulohumeral rhythm affects range of motion (ROM) measurements at the shoulder because two joints are working together. Having two joints work together then increases the ROM at the shoulder joint. Scapulohumeral rhythm also results in a good length-tension relationship. This means that the muscles do not shorten as much as they normally would if the scapula was not rotated upward, which causes the muscles to maintain force longer. Scapulohumeral rhythm also causes decreased shear forces as the motion is distributed between the two joints. Scapulohumeral rhythm is clinically relevant when looking at a client who has complaints of shoulder pain or injury. Clinically, a client could come in with shoulder impingement which means their rotator cuff (RTC)...

          Test Positioning is the position the client is in while they are being  measured for range of motion (ROM) and manual muscle testing (MMT).  When measuring ROM, the therapist will have the client in the optimal testing position and use bony landmarks to know where to place the goniometer. For example, when measuring elbow flexion ROM the proper positioning of the client would be supine with arms at their sides. The goniometer's axis will be placed on the lateral epicondyle, the stationary arm will be on the lateral part of the humerus pointing towards the acromion, and the moveable arm will be on the lateral part of the radius in line with the radial styloid process. When the elbow flexes, the moveable arm moves with the radius, but the stationary arm and axis stay in the same position. The bony landmarks where the goniometer is placed allow for a reference point so the therapist can accurately measure ROM. If the goniometer was not plac...

          Everyday I open cabinets in my bathroom and in the kitchen. This activity is mainly accomplished by the elbow joint. The elbow starts in extension, the hand grasps the knob, and the elbow moves into flexion which opens the cabinet. The elbow is moving in the sagittal plane along the frontal axis. The osteokinematics of the elbow would be from extension to flexion in an open kinematic chain. The arthrokinematics of the elbow would include the convex surface of the humerus and concave surface of the trochlear notch on the ulna. During flexion the concave trochlear notch on the ulna rolls and glides anteriorly on the convex humerus. The agonist of this action is the biceps brachii as it is eccentrically contracting during elbow extension and concentrically contracting during elbow flexion. 

          Occupational therapy is a hard thing to understand as well as explain. If I were to explain occupational therapy to a six year old child who was just referred for OT services I would say, "Occupations are the activities that we participate in everyday that allow us to live a self dependent life. Occupations can be getting dressed, learning at school, coloring, playing a game, or even going to the bathroom. Occupational therapists can work with any age in many different places. We can work in schools, hospitals, or in private practices. We are also client centered which means I am going to help you with the occupations you do and would like to be able to do better."             To me, occupational therapy is teaching people how to live. I wanted to be an occupational therapist because I wanted to help improve people's lives, especially children. I think that early intervention in children can give them more access...

  Concept Map

            Research shows that people who are homeless only sleep an average of four hours a night. This is due to unsafe, uncomfortable, and noisy conditions that keep them awake. Lack of sleep causes them to not be able to think clearly and make decisions. Research also shows that people who are homeless do not have access to preventative healthcare. They only visit the emergency room when it is absolutely necessary. The things keeping this population homeless are the mental illness, substance use, and traumatic brain injuries that cause them to not be able to think.            Quinn Tyminski gave a TEDx Talk on how occupational therapy practitioners can help those who are or have been homeless. She talked about a lady named Mary who had a history of substance abuse and trauma, but could not get back on her feet even though she was recovering. Mary was referred to where Quinn works and was able to participate ...

          Culture impacts occupational engagement in many ways. Culture can be defined as, "the knowledge, beliefs, values, assumptions, perspectives, attitudes, norms, and customs that people acquire through membership in a particular society or group" (Hammel, 2013). This means that how and where a person live and who they are around influences their culture. The article, "Occupation, Well-being, and Culture: Theory and Cultural Humility," talks about the different dimensions of cultural diversity which are: well-being, cultural humility, positioning, race, class, gender, sexuality, and ability (Hammell, 2013). These different dimensions all relate back to the Occupational Therapy Practice Framework's personal and environmental factors (OTPF-4, 2020).           Well-being is defined as, "a state of contentment--or harmony--with one's physical/mental health, emotional/spiritual health, personal and economic security, self-wort...

       Today in class Bruce Keisling, PhD talked about the history of disability. We also watched the CBS  documentary by Bill Baldini, "Suffer the Little Children." The presentation as well as the documentary showed how the intellectually disabled (ID) and developmentally disabled (DD) have been treated in the past within the United States.       In the early 1900s, the intellectually and developmentally disabled were seen as "feeble-minded." This led to the Eugenics Movement from 1920-1965 (Keisling, 2023). The Eugenics Movement was a terrible time for our country because they only wanted people with absolutely no medical or mental issues to breed. The Eugenics Movement thought that they could rid society of crime, poverty, and mental illness within just three generations.      "Suffer the Little Children" was about the conditions of Eastern PA State Institute for the Feeble-Minded and  Epileptic (Pennhurst). This d...

Image Source     Ruth Zemke, PhD, OTR, FAOTA, Professor Emeritus, was a professor at the USC Department of Occupational Science and Occupational Therapy (Rado, 2004). Ruth was the co-principal investigator of the Well Elderly Study which showed the importance of occupational therapy in elderly individuals (Rado, 2004). She received the Eleanor Clarke Slagle Award, which is one of the most distinguished awards an occupational therapist can receive.  I chose the 2004 lecture by Ruth Zemke,  "Time, Space, and the Kaleidoscope of Occupation" because I was intrigued to see how Zemke connected a kaleidoscope to occupation.        In this lecture, Zemke talks about how occupational therapy can be compared to a "kaleidoscope." She says that like a kaleidoscope interacts with multiple reflections, occupation interacts with multiple elements. The main elements Zemke describes are time and space. She explains how we view time differently based on the oc...

Welcome to knOTts' thoughts...     Hi my name is Olivia Knotts. I am a first year Occupational Therapy student at the University of Tennessee Health Science Center in Memphis, Tennessee. I went to Freed-Hardeman University in Henderson, TN for my undergrad where I majored in Kinesiology with an emphasis in exercise science. I got married July 30, 2022 to my husband, Matthew. I love the outdoors, reading, painting, and spending time with my friends and family.