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Author Archive for: jentwistle

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Functional, Yet Fashionable Clothing for All

Julie Entwistle, MBA, BHSc (OT), BSc (Health / Gerontology)
Co-Written with Jacquelyn Bonneville, Occupational Therapist

As occupational therapists, we often see clients experience issues with dressing after an injury or as a result of a disability.  How do you dress when you have one arm?  Or, how can you don pants, socks and shoes when you have not feeling or movement in your lower body?  What about managing zippers and buttons with reduced fine motor control?  Spasms, reduced range of motion, the inability to stand for dressing, or body changes that make clothing options limited?  There are many reasons why dressing can become a problem.

As a society, we use fashion for several reasons – to manage the weather, for privacy from sensitive parts, and as an expression of ourselves.  Clothing and clothing choices are important.

Business-wear and athletic wear are two areas of fashion that are generally limiting for persons with dressing challenges.  For this blog, we wanted to introduce some simple, but still fashionable and functional, adaptations that can help manage the task of dressing if this has become difficult!

Lock Laces or Elastic Shoe Laces

Elastic and lock shoelaces are permanently tied, and allow for stretch of the shoe when putting it on or taking it off. This makes it a functional, inexpensive solution for anyone who doesn’t want to worry about their laces coming undone (especially athletes!), or for people who struggle with tying their shoelaces tight enough, or with the intricacies of actually tying the laces.  Note that often these are great in combination with a long-handled shoehorn.

Nike Flyease Sneakers

Nike has a line of slip-on ‘wrap-around-fasten’ shoes that are fashionable, including running shoes, kids shoes, and basketball style high-top sneakers (designed with basketball superstar LeBron James). Though designed for young adults with Cerebral Palsy initially, these shoes are suitable for anyone who wants some stylish sneakers, without the hassle of laces.

Under Armour Magzip

Zippers are often an integral part of our Canadian Fall and Winter attire to help secure our clothing to keep us warm. Zippers can actually be very challenging to co-ordinate for many reasons, and Under Armour tackled “fixing the zipper” in 2014 with their Magzip technology in a variety of unisex athletic-wear styles. The bottom part of the zipper is magnetic, meaning that it is far easier to ‘thread’ and pull up than a standard zipper, without sacrificing athletic hoodie style. See the press release for more information and a video explaining the technology.

IZ Adaptive Jeans

Jeans are a staple of many wardrobes, but they certainly shift and move when people are sitting or standing. For people who spend a lot of time sitting, including office workers and people who use wheelchairs, jeans can be extremely uncomfortable; jeans regularly have rivets on the back pocket which can cause discomfort while seated, they have the same rise around the waist so when you sit they are either too low or bunch up, and the front button can dig into your waist when you sit down.

IZ Adaptive has designed a line of jeans designed for wheelchair users that offer an easier ring to work the zipper, a clasp instead of a front button, and are overall designed with the different body position of a person while sitting instead of standing. Be sure to look online for other companies offering similar adaptive jean designs!

Part of the role of Occupational Therapy is to have insight and knowledge about products that will help an individual function independently, without sacrificing style, priorities, or efficiency. For more information about customized products that may work for your individual needs, speak with an Occupational Therapist!

As a last inspiring thought, check out this link to the story of a beautiful model with Down Syndrome, Madeline Stuart, who is changing perceptions of disability, while being stylish at the same time.

Previously posted January 2016

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The Benefits of Hydrotherapy

Guest Blogger: Carolyn Rocca, Occupational Therapist

Water has long been associated with health and healing, making it an excellent tool for rehabilitation. Hydrotherapy, also referred to as pool therapy or aquatic therapy, is one way in which water can be used for therapeutic purposes following injury or illness.

Hydrotherapy refers to water-based treatments or exercises aimed to enable physical rehabilitation, fitness, and relaxation for therapeutic purposes. Treatments and exercises are performed while floating, partially submerged, or fully submerged in water, usually in specialized temperature-controlled pools. The key difference between this form of therapy and land therapy is that movement is facilitated by the physical properties of water, particularly it’s density and specific gravity, hydrostatic pressure, buoyancy, viscosity, and thermodynamics (Becker, 2009).

Due to the specific facilitating properties of water, hydrotherapy can have several benefits for people who have loss or restriction of joint motion, strength, mobility, or function as a result of a specific disease or injury. Aquatic therapies are beneficial in the management of musculoskeletal issues, neurological conditions, and cardiopulmonary problems. More specifically, there is evidence to support that people with fibromyalgia, arthritis, multiple sclerosis, cerebral palsy, stroke, and chronic pain, as well as people who have undergone surgeries such as total knee and total hip replacements, can significantly benefit from aquatic therapy (CARI, 2014).

The benefits of hydrotherapy will depend on the purpose of why it is being used in your rehabilitation plan, what it is aiming to target, and the type of exercise being completed in the water. In general, there is evidence to support that within a wide range of ages and abilities, hydrotherapy may help people to increase their endurance and strength, improve balance and postural control, reduce perceived pain and muscle spasms, reduce joint pain and stiffness, aid in gait retraining, and improve functional mobility. Additional benefits can include the facilitation of relaxation, improved quality of life, as well as providing opportunities for socialization (CARI, 2014).

A key to the success of many hydrotherapy procedures is the constant attendance and guidance provided by a trained therapist. This can be any rehabilitation professional, such as a physical therapist, occupational therapist, PTA/OTA, etc., who has taken additional and specific training in basic or advanced aquatic physical therapy. The rehab professional’s expertise will be able to match your abilities with the appropriate properties of water to achieve an optimum balance between facilitation and challenge. By adjusting the immersion temperature, type, and intensity of activity, level of resistance, use of equipment, and treatment duration the therapist will be able to assist your recovery by gradually increasing the amount of challenge to eventually help you to transition to land exercises.

An added bonus to the therapeutic benefits of aquatic therapy is that it can help to introduce or re-connect you to a leisure interest, and can offer a social outlet. For example, a current client of mine has recently begun pool therapy following injuries sustained in a motor-vehicle collision. Not only will this help in her recovery while she begins to regain strength and function in her legs, but will also re-connect her to her passion for swimming, as this was something she loved to do with friends prior to her accident. Additionally, there is evidence to support that infants and toddlers with mobility impairments that engaged in aquatic therapy can experience significant functional gains in mobility compared to children who solely received land therapy, and that their parents noticed an increase in their socialization and enjoyment while in the pool. In this particular study, the children’s parents then reported an increased willingness and comfort in bringing their children to community pools following aquatic therapy (McManus, & Kotelchuck, 2007), therefore further increasing their future leisure and social opportunities.

Thus, hydrotherapy has the potential to improve physical function, as well as increase community involvement, socialization opportunities, and participation in physical activities. Additionally, this form of therapy can be appropriate and beneficial for all ages and abilities. If you feel that hydrotherapy may be a great addition to your rehabilitation and recovery, speak to your rehabilitation professional about some of the opportunities available in your community.

References & Resources

Becker, B. E. (2009). Aquatic therapy: scientific foundations and clinical rehabilitation applications. PM&R, 1(9), 859-872.

Canadian Aquatic Rehab Instructors (CARI) website: http://www.aquaticrehab.ca/

Canadian Aquatic Rehab Instructors (CARI) website link to research (2014). Retrieved from http://www.aquaticrehab.ca/research

McManus, B. M., & Kotelchuck, M. (2007). The effect of aquatic therapy on functional mobility of infants and toddlers in early intervention. Pediatric Physical Therapy, 19(4), 275-282.

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Weekly Mind Bender

A word with horizontal symmetry is one whose letters are a mirror image of themselves.  If you drew a horizontal line across the word and folded it over, it would overlap on itself.  Examples include EXCEEDED and ICEBOX. 

What is the longest word with horizontal symmetry?

Answer

CHECKBOOK

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Try Yoga for Improved Focus and Self-Regulation in Children

Guest Blogger Jana Maich, Occupational Therapist

Working as an occupational therapist in pediatrics, I am always on the lookout for simple strategies I can offer to parents and classroom teachers that can be easily be implemented. One of the main difficulties expressed to me by concerned parents or teachers is that a child is having difficulty controlling their activity level, focusing or attending, or controlling emotional outbursts. In other words, a child is having difficulty self-regulating.

What does this mean? Self-regulation is our ability to monitor and control our body’s arousal level (in other words, our level of alertness) in order to remain in an optimal state that is appropriate for the current situation. Self-regulation is critical to being able to attend, focus, and learn (1). When our body’s arousal level gets too “high,” we may feel anxious, nervous, or stressed. When our body’s arousal level gets too “low,” we may feel lethargic, sluggish, or tired. Often unconsciously, adults participate in a variety of self-regulation strategies to remain in an optimum state throughout our day. For example, in a boring meeting where your level of alertness may be “low,” you may tap your pencil, shift in your chair, apply pressure to your mouth or chin with your hands, or drink water in order to bring your arousal level up. After an intense day of work when you may be feeling too “high,” you may take a bath, read a book, or participate in some other sort of relaxation promoting activity (1). There are many ways to regulate ourselves, and just as adults require self-regulation strategies, children do too. Yet, in today’s changing and fast-passed society, children are more stressed than ever before. School demands have increased, daily schedules are jam-packed, and they don’t have as much play or “down” time as kids once did. Unfortunately, unstructured play activities that are critical to a child’s innate self-regulation needs have been replaced by TV and electronics. All of this has ultimately stressed our young generations, resulting in disrupted self-regulation.

Yoga is one activity that has become recognized as a suitable and helpful regulation activity – for people of all ages. (2). For children, yoga offers many potential benefits – both physically and emotionally. Benefits include improved postural control, immune functioning, body awareness, strength and flexibility, emotional control, attention, sleep, and a decrease in stress and anxiety. Yoga is a simple strategy with a variety of exercises that can be completed anywhere including at home, when on vacation, while lying in bed, or as a group in the classroom. Depending on the current needs of the child, there are various poses and breathing exercises designed to bring arousal levels up or down as appropriate. Over time, children begin to develop an enhanced mind-body connection and an improved ability to monitor and manage their own levels of arousal (2).

In my personal experience, using simple breathing strategies and poses in my practice, has demonstrated firsthand how yoga can positively affect children with both physical and mental disabilities including autism, ADHD, emotional difficulties, mental health conditions, and motor coordination difficulties. In older children, learning how to control their own emotions and arousal levels empowers them and creates both self-esteem and self-control.

So what are you waiting for? Search out local yoga programs for you or your child. Try these links: www.yoga4classrooms.com or www.childlightyoga.com. Consider that many places will let you try a class without a commitment, or offer great starter incentives. Or, buy a CD or DVD, or check out some poses and breathing exercises via online videos to see if this might work for you or your family.

Originally posted July 2014

(1) Williams, M., & Shellenberger, S. (2012). “How does your engine run?” A leader’s guide to the Alert Program for self-regulation.” Albuquerque, NM: Therapy Works

(2) Flynn, L. (2010). Yoga 4 classrooms. Tools for learning, lessons for life. Dover, NH: Yoga 4 Classrooms.

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Pedestrian Safety for Older Adults

Julie Entwistle, MBA, BHSc (OT), BSc (Health / Gerontology)

The other day I was driving through a busy parking lot.  I noticed an elderly man who parked his car, got out, and proceeded to walk through the parking lot without ever surveying his surroundings.  He did not see my vehicle approaching him, and did not appear to notice the other cars that had to stop to let him pass.  The other drivers looked both annoyed and perplexed that he could be so clueless.

According to the CDC “Increasing frailty may leave the elderly more vulnerable to being hit by traffic. Age-linked declines in mental function, vision and physical disabilities might place older adult pedestrians at greater risk for being struck by a vehicle.”

With this man, what I noticed was quite telling.  He was looking at his feet.  Many seniors do this when walking.  Why?  Because they are afraid to fall.  With a decline in physical ability comes problems negotiating uneven terrain.  Parking lots and sidewalks are full of holes, stones, and cracks that could be problematic for someone with declining mobility.  So, they stare at the ground to avoid falling, the entire time being unable to also look around at other risks in the environment.  And when you combine this with reduced peripheral vision, they may not notice vehicles approaching. 

Society expects seniors to “know better” in that they have been trained, over a lifetime, about the perils of traffic.  With children, we don’t expect them to know better because they are carefree and often move before thinking.  As driver’s, we watch for children and take extra care when we see them around roads or in parking lots.  We also tend to take the same precautions when we notice someone who is more visibly disabled using a wheelchair, or white cane.  But disabilities are not always visible and we have to be careful to not make assumptions – especially with seniors who may have an unnoticeable visual, cognitive, physical or auditory problem.  

My message here is that drivers should be cautious with all pedestrians, but need to be especially mindful of seniors – much like they are with children or other people with visible disabilities.  Seniors deserve our patience and the extra time it might take to help them safely go about their day and negotiate the sometimes challenging outdoor environment.

Previously posted July 2013

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Recognizing Sensory Sensitivity in Children

In a previous post, Recognizing Sensory Seeking in Children, we discussed the “sensory seeking” child. On the other end of the spectrum is the sensory defensive child. Unlike sensory seekers who have high thresholds for sensory input, sensory sensitive children have very low sensory thresholds. Due to these low thresholds, they experience sensory input much more intensely or notice sensory input much more often than their peers. This means that sensory input that may not bother you and I may be very aversive, distracting, threatening, or even painful for that child.

Our OT-V episode (below), will help you to understand this sensitivity and provide you with the solutions an Occupational Therapist can recommend.

Summer Programming Note:

Summer vacation is here and we will be taking a break from our regular schedule.  We will be posting some of our popular seasonal blogs just once a week throughout the summer but will resume our regular three weekly posts in September, filled with new and exciting content including our popular O-Tip of Week series.

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Weekly Mind Bender

A man is asked what his children look like. He states: “They are all blondes, but two; all brunettes, but two; and all redheads, but two.”

How many children does he have?

Answer

Three: one blonde, one brunette and one red head.