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Rehab News
April is Occupational Therapy Month
The American Occupational Therapy Association designates April as
Occupational Therapy month. What is Occupational Therapy? O.T. is a skilled
rehabilitation treatment that assists individuals in achieving independence
and safety with performance of everyday activities that can include:
dressing oneself, feeding self, functional transfers, and personal grooming
activities.
Inpatient services at UAMS typically include:
• Performance skills assessments and treatment
• Customized treatment programs to improve one’s ability to perform daily
activities
• Adaptive equipment recommendations and usage training
• Splinting arms and legs
• Therapeutic range of motion and strengthening
• Coordination activities
• Balance and safety training
Who benefits from Occupational Therapy? A wide variety of people can benefit
from Occupational Therapy, including those with the following:
• Deficits from a stroke or heart attack
• Total hip or knee replacement
• Burns, spinal cord injuries or neurological disorders
• Broken bones or other injuries from falls or accidents
• Cardiac and pulmonary diseases
• Feeding difficulties from infant prematurity
• Lymphedema
• Cancer, amputations and general weakness
Every day, individuals have or develop health conditions that can
significantly affect their ability to manage their daily lives. With the
help of occupational therapy, many of these individuals can achieve and
regain a higher level of independence and safety. When skill and strength
cannot be developed or improved, Occupational Therapy can offer creative
solutions for carrying out daily activities.
For Occupational Therapy consults call 686-6121 or fax consults to 296-1227.
Reference from www.aota.org Silent Aspiration: A Silent
Epidemic
By: Lesley Quinn
One of the primary responsibilities of Speech Language Pathologists (SLP’s)
in acute care settings is to assess and treat patients with disorders of
deglutition or swallowing. Dysphagic patients may have difficulty in any of
the stages of swallowing from chewing food to its passage from the lower
esophagus into the stomach. One of the primary concerns of SLP’s, however,
is aspiration. Aspiration occurs when a foreign substance such as food or
liquid enters the airway and passes beyond the level of the vocal cords into
the trachea and lungs. Aspiration may result in respiratory complications or
infection such as pneumonia, and hospital stays may be lengthened as a
result.
Coughing, throat clearing, wet “gurgly” voice, respiration changes, watery
eyes and nose, and widening of the eyes are all indicators of aspiration.
SLP’s look for these signs when performing clinical swallow evaluations at
bedside. A patient may aspirate without such overt signs being present
however. This is known as silent aspiration. Researchers conservatively
estimate that silent aspiration occurs in over half of all patients with
dysphagia in acute care settings (Smith, et al., 1999).
Silent aspiration cannot be diagnosed without the aid of instrumentation,
since patients display no overt signs (coughing) and often deny symptoms of
swallowing difficulty. As a result, SLP’s recommend performing a Modified
Barium Swallow (MBS) Study or a Fiberoptic Endoscopic Evaluation of Swallow
(FEES) to rule out silent aspiration in patients who are at risk. Patients
who have been found to silently aspirate include those with altered mental
status and decreased awareness; those with decreased sensation due to
stroke, neurological disorders, or head and neck cancers; patients with
gastrointestinal problems; and patients who are generally weak or
deconditioned. Researchers have also found that very young and elderly
patients are more susceptible to silent aspiration (Smith, et al., 1999).
Due to the high incidence of silent aspiration in acute care settings, SLP’s
do not rely solely on the absence of signs/symptoms to rule out dysphagia.
Patients determined to be at risk, but who are without cough or complaint,
warrant further evaluation. If you suspect that a patient or family member
is at risk for silent aspiration, or if you feel that you may be at risk,
please consult a member of the Speech Language Pathology team at UAMS for an
assessment.
For more information and for referrals call 686-8378 and/or fax: 526-6848.
Smith, C., Logemann, J., Colangelo, L. Rademaker, A. & Pauloski, B.R.
(1999). Incidence and patient characteristics associated with silent
aspiration in the acute care setting. Dysphagia, 14: 1-7.
Stroke Awareness
By: Colleen Sanders, PT and Chad Womack, PT
Every year 730.000 Americans have a stroke or cerebrovascular accident (CVA). It
is our nation’s third leading cause of death and the leading cause of adult
disability. Seventeen percent of adults over age 50 can not name a single stroke
symptom (NSA/Gallup Survey, 1996).
One of the largest obstacles to emergent treatment of a stroke is that many
people do not even know that they are having a stroke. Stroke symptoms and
warning signs include but are not limited to:
Sudden weakness or numbness of the face, arm
or leg on one side of the body
Sudden dimness or loss of vision, particularly in one eye
Loss of speech, difficulty talking or understanding speech
Sudden severe headache with no known cause
Unexplained dizziness, unsteadiness or sudden falls
A stroke is essentially a “brain attack.” This terminology was begun by the
National Stroke Association in 1990 in order to accurately portray the
seriousness of the event more clearly to the general public. The appropriate
response to a “brain attack” is emergency action, both by the individual it
happens to and by the medical community. It is critical to “Be Stroke Smart” and
to learn the 3 R’s of stroke: Reduce risk, Recognize symptoms, Respond by
calling 911.
Strokes are largely preventable, but first it is important to identify and
manage stroke risk factors. There are a number of uncontrollable risk factors:
age, gender, race, family history of stroke, and a personal history of diabetes.
There are also many controllable risk factors and treatable medical conditions
that can increase stroke risk such as: smoking, weight, alcohol, and high blood
pressure.
Depending on the severity of a stroke, multiple aspects of a person’s life can
be affected. Often persons who experience a stroke exhibit deficits in decreased
muscle or motor control, changes in muscle tone, difficulty with speech and/or
swallowing, reduced sensory response and/or mental impairment.
Recovery from a stroke often involves rehabilitation services. The
rehabilitation staff at UAMS provides a multitude of services to address the
deficits one may experience following a stroke. Services include physical
therapy, occupational therapy, hand therapy and speech therapy. All services are
available on an inpatient and outpatient basis with a physician referral. For
information regarding stroke rehabilitation services available at UAMS, you may
call 296-1500.
“Working hand-in-hand for your care"
Hand Therapy Week
June 14-18th, 2004
The American Society of Hand Therapist is sponsoring an integrated national
program to increase awareness of hand therapy. Hand Therapy is a highly
specialized field of occupational or physical therapy focusing on rehabilitation
of the shoulder, elbow, forearm wrist and digits with the ultimate goal of
returning patients to a productive lifestyle following an injury. Specific
problems or diagnoses referred for treatment might include shoulder, elbow,
forearm, wrist or finger fractures; wounds, scar management, burns, repetitive
motion/cumulative trauma disorders such as carpal/cubital tunnel, tennis/golfers
elbow; DeQuervains Tenosynovitis, arthritis; amputation, Dupuytrens disease,
Nerve or Tendon Lacerations, trigger finger, tennis/golfers elbow,
sprains/strains and poor work station ergonomics. Hand Therapists work in
conjunction with upper extremity physicians and surgeons to evaluate and
identify upper extremity problems, assess sensory function, provide proper
positioning through splinting, and provide post op or conservative treatment.
UAMS Hand Therapy is dedicated to staying current in the latest trends,
surgeries, techniques and treatment by continued education. Therapists have
attended national and local conferences including: the American Society of Hand
Therapist 26th Annual Meeting; the National American Society of Hand Surgeons
Conference Concepts in Hand Surgery, Advances in Nerve and Tendon Repair, The
Scaphoid Fracture Repair and Reconstruction. In addition they have participated
in local workshops with presentations on “CMC Arthritis Rehabilitation” and
“Flexor Tendon Rehabilitation” and provided hand exercises and modality pictures
for Golf is Forever the Spine and More A Health Guide to Playing the Game by
Jackson T. Stephens and T. Glenn Pait.
UAMS Hand Therapy is located in the outpatient center and is staffed by state
and nationally licensed therapist and 3 certified hand therapist. Treatment is
available on an outpatient or inpatient basis with a referral. For Hand Therapy
Consults call 686-6102 or fax your prescription to 296-1216
Reference from http://www.asht.org
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