Human Performance and Rehabilitation Centers, Inc.

Five Tips to Prevent Falls in Your Home

A health concern that is common among adults is the fear of sustaining a fall, especially in the home. The CDC reports that each year, one in every four Americans over the age of 65 will fall. Falls are also the leading cause of fatal injury and the most common cause of trauma-related hospital admissions for the same population. Given these statistics, there are five easy tips that you can implement in your home to help reduce the risk of falling.

First, make sure walkways and high traffic areas are free from clutter. Rugs do make your home lovely, but they present a tripping hazard. You may have to rearrange some furniture to keep your paths clear. Please make sure that cords are secure behind furniture and do not run across the floor. You will also want to clearly mark any transitions in the flooring as well, such as moving from tile to carpet.

Second, have plenty of lighting available and turned on! Night time falls are common, as you have awakened from sleep and may not be as alert as you would be during the day. When you get out of the bed, turn on your bedside lamp. Make sure that there are night lights along your path, usually to the bathroom. A simple act of turning on a light can make a huge difference! Also, if you have stairs, either inside or outside your home, place a light nearby so that you can turn it on before ascending or descending the stairs.

Third, consider the use of assistive devices. This does not have to be a walker or cane! Installing grab bars in the shower or close to the commode can help. Also, ensure that any stairs or steps have rails, preferably on both sides. Other assistive devices that could benefit you include a chair or bench in the shower to allow for a place to sit, as well as a raised commode seat so that you don’t have to sit down and get up from a low surface.

Fourth, invest in good footwear. Most people prefer to be comfortable in their home, but wearing shoes is a must. Slippers and flip flops increase the risk of tripping or having your foot slide out of the shoe. Wearing a supportive, closed shoe will help reduce this risk factor.

Finally, keep moving! Performing simple exercises on a daily basis can help keep your muscles strong and flexible. Walking is also a great exercise. For the majority of my patients, I recommend getting up and walking somewhere in the home at least once an hour. This could be a trip to the bathroom, to the kitchen to get a glass of water, or to a window to look out in the yard. Regardless of the activity, preventing joint and muscle stiffness will go a long way toward preventing a fall.

If you have sustained a fall or would like more information on fall prevention, consider obtaining a referral to physical therapy for an individualized exercise program!

Call Today To Request An Appointment With A Therapist At St. Francis Rehab Main Street Village. Learn more about the authoring clinician Julie King, PT, DPT.

Play At Home: Sidewalk Chalk Obstacle Course

Sidewalk chalk is a magic tool for every therapist, teacher, and parent alike. Whether you are learning letters, drawing artwork, or just drawing a hopscotch board – sidewalk chalk can keep your kiddos busy for hours! Have you seen all of the chalk art challenges that are on social media during the quarantine? Well, we have a new challenge for you! Use your sidewalk chalk to build an obstacle course for your kids! Here are a few ideas on how to make this an effective exercise activity to promote milestone achievement in your child:

1. Build a bridge or balance beam

Challenge your child to walk across the bridge (don’t fall off, the floor is lava!), or if gymnastics is more of their style, create a colorful balance beam! Having your child simulate walking across a balance beam is a great way to challenge their balance in encourage tandem stance walking.

2. Hopping

Hopping and jumping is a great exercise for kids in so many ways. This is where you can get creative! Depending on the skill level of your child, some ideas for hopping include two feet jumps from color to color, single leg jumps with one foot on purple and one foot on pink, frog hops to each “lilly pad”, etc. Here you see Ellie using both feet to hop and “stomp” out each color as she hops along the course.

3. Bear Crawls

This is another exercise where you can get very creative! I asked Ellie to choose two shapes – one for her hands and one for her feet. The shapes are a great cue for kids to know where to place their hands and feet for learning to bear crawl – which then becomes a challenging exercise. Make this more advanced by having kids jump from shape to shape (frog jumps) or spacing the shapes out further away so they have to go a longer distance.

4. Agility Ladder

If you’ve ever competed a workout with an agility ladder – you know how challenging it can be! The great thing about drawing an agility ladder is it provides so many ways to challenge your kiddo. Have them step over the line forward, sideways, backward to promote standing on one foot. Have them jump over the line forward or sideways to further encourage jumping skills. If you have an older kiddo, use this as a true agility ladder and try hopping in and out of the boxes, grapevines, or seeing how fast they can hop through!

5. Swirly Walks

This is such a fun way to send your obstacle course! Use your imagination and “walk into outer space” or to “the center of the earth” or anywhere else your kiddos creative mind takes them! The swirly walk will challenge your child’s vestibular system and make them a little dizzy – which is usually a sensation they enjoy.

Download the full PDF here!

Learn more about the clinician behind this article, Shelbi Moxley, PT.

A Look Into Occupational Therapy At St. Francis Rehabilitation Main Street

Occupational Therapy at the Main Street location focuses on encouraging and assisting each patient and their caregivers through their disability, illness, or injury to regain essential life skills and decrease the burden of care. The patient population at this location typically ranges from young adult to older adult. Areas of focus at this location include:  Neurological recovery, Upper Extremity impairments/injuries, and Older Driver Evaluations.  Neurological recovery(including Stroke, Traumatic Brain Injuries, Spinal Cord Injuries, etc.) at this location includes, but is not limited to, education/regaining of activities of daily living such as dressing skills, grooming skills etc.Neuromuscular Re-education through weightbearing and PNF patterns(Proprioceptive Neuromuscular Facilitation Patterns),  decreasing fall risks through safe functional training and dynamic sitting/standing techniques , issuing/recommending braces/splints as needed, performing range of motion techniquesdecreasing tone tightness if present through compensatory strategies, Sensory Re-education as needed, use of Modalities as needed,  regaining gross and fine motor coordination, caregiver education, and addressing safety concerns.   

Upper Extremity impairments and injuries addressed at this clinic include but are not limited to Carpal Tunnel Syndrome and Carpal Tunnel Release, Medial Epicondylitis,  Lateral Epicondylitis, De Quervain’s Tenosynovitis, Trigger Finger, Nerve Entrapments, Ulnar Nerve Release, and Spondylolisthesis upper extremity symptomsWorkplace setup/ task analyses  are also discussed and suggestions are issued by OT when patient presents to the clinic with a repetitive injury and/or and injury caused by poor mechanics. Strengthening and coordination of the large and small muscles of the upper extremity at the Main Street Clinic includes, but is not limited in, the use of  weighted therapy balls, theraplast, dumbbells,  theraband, and various other methods.    Modalities and sensory re-education are also used for Upper Extremity impairments and injuries as needed. Manual Therapy is also performed at this location to address soft tissue adhesions which are limiting patients to include Astym(Augmented Soft Tissue Mobilization), soft tissue mobilization, and retrograde massage. 

Older Driver In-Clinic Evaluations are performed at this location to assist patients, family members, and physicians with determining whether a patient is safe to continue driving and/or safe to return to driving following an illness/injury or an accident.  If any impairments are noted during the inclinic driver evaluation, OT will recommend further evaluation from physicians and/or adaptive equipment that would assist patient with returning to driving.  

All patients at the Main Street Clinic receive individualized home exercise plans to assist them and their caregivers to reach Max I with ADLS and IADLS at home, work/school, and in the community in a timely mannerThe Occupational Therapy Department at the Main Street Clinic is part of an interdisciplinary team consisting of Speech Therapy and Physical Therapy in one facility for the convenience of each patient and their family.  

Call Today To Request An Appointment With A Therapist At St. Francis Rehab Main Street Village. Learn more about the Occupational Therapist behind this article, Jennifer Webster, OT.

 

Tips For Helping Elderly Relatives Stay Healthy During The Quarantine

The COVID-19 quarantine has been particularly tough on the elderly, but you can help your older loved ones stay strong and feel less isolated with this simple idea: encourage them to engage in gentle movements throughout the day.

Stay-at-home orders are very likely preventing your elderly loved ones from enjoying their regular routines, which might have included social outings or exercise classes. Without these activities and without face-to-face visits from friends and family, seniors are spending a lot of time sitting and engaging in passive activities. Sitting for long periods isn’t healthy for any of us, but it’s especially bad for the elderly because it increases stiffness and impedes circulation.

It is very important to encourage your older loved ones to get up and move or exercise from a seated position every 30 minutes. They should also stay hydrated by drinking lots of water.

What sorts of exercises can your elderly loved one perform? There are lots of safe and appropriate options.

Seated Exercises

Even those with limited mobility can perform regular exercises from a chair. Make sure the chair has arms and is pushed against a wall so that it provides stability and doesn’t slip.

Seated exercises include heel-toe raises, marches, leg lifts, hamstring stretches, straight leg raises, shoulder presses, bicep curls, overheard arm raises and finish with sit to stand.

Standing exercises

Standing exercises are great for those who are comfortable exercising in a standing position while holding onto a counter or sturdy table for balance.

Standing exercises include heel raises, marches, hip abduction, hip extension, hamstring curls, mini squats

Dynamic exercises

These kinds of exercises are for those who are steady on their feet. They should still be executed while placing one hand on a wall or counter for balance. A hallway works well for these exercises, or anywhere your loved one can walk several steps without impediments.

Dynamic exercises include standing with feet together, standing with staggered along the instep, walking with high knees, backward walking and side stepping along the wall.

Remind your senior loved one to set alarm on their phone to move every 30 minutes. Or better yet, have family members call or text them throughout the day to periodically remind them. It’s a great way to stay connected and ensure they stay as healthy as possible during the quarantine.

Call Today To Request An Appointment With A Therapist At St. Francis Rehab Main Clinic.

Lindsey Martindill, PTA, is a licensed Physical Therapist Assistant and has been employed with HPRC since 2017. She earned her PTA degree in 2012 from Darton College and previously earned a B.S. degree in Exercise Science in 2010 from Columbus State University. She is a member of the American Physical Therapy Association (APTA), and Physical Therapy Association of Georgia. She is ASTYM (Augmented Soft Tissue Massage) certified. Her interests include orthopedics, sports injuries and pain science.

Work From Home Ergonomics

How To Take The Pain of Working From Home Away

Chances are if you are reading this, you are working from home or know someone who is.  Maybe this is your everyday normal or maybe your job has you working from home to avoid the Coronavirus / Covid-19.  Whatever your situation, you are likely finding yourself spending a significant amount of your time sitting in front of a computer somewhere other than a desk or workstation that is ideally set up.  With the number of “Stay at Home” orders that are in place in most states of the United States right now, more and more people are performing their everyday work activities from their couches, beds, dining room tables, kitchen countertops, front or back porches, etc.  While for some this is a great opportunity to have some freedom during the day, for others, it just plain hurts.  We are not talking about financial or emotional pain, but the physical pain that comes on from improper work conditions and prolonged periods of time in bad posture performing repetitive tasks.  Here are some tips on how to make your current work at home less painful for you to endure.

 

work from home ergonomics

Select an “Ideal” Work Environment

The couch or bed sounds like a comfy place to work does it not?  While in the short term this sounds great, in the long run you are only hurting yourself.  Think of watching television in bed.  After a while you are shifting positions, your back hurts, your neck/shoulders hurt, you are just not that comfortable, and the worst thing is you are only halfway through the second episode of your favorite binge worthy show.  According to Google, the average sitcom show length is 42 minutes.  If you are only making it 45 to 60 minutes before you are in pain watching your favorite show in bed, how does 8-hours “at work” sound?  Find somewhere in the house that resembles your desk at work.  You want a workstation that allows your knees and elbows to be bent at 90-degree angles with your wrists resting comfortably on the edge of the table.  If your table has a sharp edge, use a folded towel or small pillow to soften the edge.  Your shoulders should feel at rest when you are using your workstation, not too high or too low.  It is just like Goldilocks, go for the Baby-Bear’s chair if that is what works for you.  Most kitchen / dining room tables and chairs are just not right.  You will likely need to either raise/lower the table or the chair.  Since hacking off table legs is probably not good in the long run, you can use books or old boards (cutting boards you have not used in years work great) under table or chair legs to raise these.  Put your feet on a stool or stack of old books, etc. to get your knees at 90 degrees.  You can also sit on a pillow to get the proper sitting position for eye level and arm height.  Chairs should support your back.  You should be able to sit all the way to the back of the chair with your back at an angle of 90 to 100 degrees.  This will support your lower back but also not cut you off at the knees.  If you cannot sit all the way back on the seat cushion without slumping to reach the back, then sit with a pillow behind your back.  Also, you want at least two to three finger widths between the back of your knees and the edge of the chair.  The biggest thing is to find what works for you and use what you have lying around to make it better.

Laptop Computers are Just a Pain (and phones and tablets are worse)

The best thing about your laptop, phone, or tablet is that they are portable.  These devices aid in the ability to work from home, but they do nothing for your posture and more than likely are just causing you pain.  The ideal work position is with your computer screen straight in front of you with the center of the screen at eye level, and a full arm length from your eyes.  Never put your monitor out to the side, it needs to be directly in front of you to avoid irritation to your neck.  There is no way that your portable device is going to give you this set up.  When your shoulders, elbows, and wrists are in the correct position, the screen is below your natural line of sight.  If you have an external keyboard and mouse, great now is the time to dust them off and put them to use.  If you do not, see what you can cook up.  It may be time to look into the cutting boards and cookbooks, not to make lunch or supper, but to stack under the laptop to get the correct position.  Maybe you can hook up an external monitor but keep your laptop keyboard at the appropriate position.  Most devices will allow you to transfer your screen to an external monitor (now is the time to dust off the old small flat screen tv you have been storing since you bought that 50-inch last Christmas).  Minimize your time on your phone and tablet for work, they just are not a great option for hour after hour of work-related activities.  Sure, your phone or tablet helps you organize your life, but if you need to reply to a lengthy email, use the computer that is set up as we talked about.

Watch Your Head 

Sitting at the computer or looking at a portable device too long and you will notice that your head is drifting toward the screen.  It is normal reaction and most everyone does it.  The world is in front of us and usually we are trying to get closer to it, get more involved in it, and become more focused on whatever draws our attention.  Because of this we tend to end up in a forward head posture.  Being in this posture for a long period of time causes stress in the neck and shoulders.  As with all aspects of life, when life/work tries to beat you down, keep your chin up.    Thinking about keeping your chin up will make sure you do not put undue stress on the neck, shoulders, and back of your torso.  This also helps to restore the natural curvature of your spine in your neck.  This also serves as a good reminder not to spend too much time looking down at your phone, tablet, or paperwork.  Sit up straight, keep your chin up, and keep your shoulders back and relaxed.  Not only does this help with your posture, but anyone who sees you (even if it is just the dog) will say to themselves, “man they look really confident in what they are doing”.  It is a win-win situation.

Get Up and Move

Whether working from home or working in the office, avoiding prolonged sitting is the key to avoiding pain.  Keep objects you use frequently close at hand so you do not have to reach for them.  This could be your phone, mouse, keyboard, paperwork, etc.  But for the other objects that you only use occasionally, place them somewhere where you must stand up and go get them.  This will encourage you to get up and move frequently.  Sitting for longer than 25-30 minutes at a time starts to put undue stress on your back and other joints.  True ergonomic office chairs are designed to be sat in for extended periods, but most of us do not have a $500 office chair in our home (or office for that matter).  This means that if we are working from home and sitting at the kitchen or dining room table, we need to get up and move often.  Most fitness trackers we are wearing now a days have a stand up and move reminder.  Pay attention to them (or turn them back on), they are another tool to help.  If you do not have one, then set a timer on your microwave for 30 minutes.  Besides telling you it is time to move, you will have to stand up and go and turn the annoying sound off (obviously, do not do this if you are going to be on a call or on a video conference with your teammates).  Research has shown that workers that move more often during the day have less reported pain.  If your neck and shoulders are bothering you, then you could try some simple neck and shoulder movements and stretches.  The same goes for your back, knees, etc., but any movement is better than nothing.  So, it is time to get up and get moving, you have been reading this article for long enough now.

If your pain persists, contact your physical therapist.  Together, we will get through this.

Sources:

A Look Into Occupational Therapy at St. Francis Main Campus

Despite the circumstances of this current season, I love the month of April. The trees are blooming, the weather is warming up, and it’s National Occupational Therapy Month! One question I’m asked a lot by patients and family members alike is “what is the difference between OT and PT?” and my typical response is “I’m so glad you asked!”. Physical therapy and occupational therapy look very similar in my setting, which is our outpatient St. Francis Hospital location where we focus on orthopedic, upper extremity conditions. Although they are similar, our goal as OTs is to evaluate and treat musculoskeletal disorders of the elbow, wrist, and/or hand.

Most of our clients have something wrong with either upper extremity that typically effects how a person functions during their everyday life. It can range from a broken bone that resulted in surgery or it can be a nagging pain or ache that just won’t go away. Just a few examples include pain at the elbow when lifting a glass, finger numbness that prevents restful sleep, pain in the forearm when lifting weights, pain at the base of the thumb when turning a key, or wrist stiffness that makes brushing hair or getting dressed difficult, just to name a few.

Some specific diagnoses we treat are carpal tunnel syndrome, tennis/golfer’s elbow, trigger finger, finger/wrist/elbow fractures, tendinopathies, and arthritis, but that list is far from exhaustive. Regardless of the diagnoses, every patient is thoroughly evaluated, and a plan of care is established with input from the client, addressing goals or activities that are most important. This facilitates a team approach between therapist and patient that ensures optimal patient outcomes. We use a variety of techniques to promote those outcomes: custom thermoplastic splinting, exercises, stretches, massage, pain management modalities, and various types of soft tissue mobilization that help decrease inflammation.

If any of those symptoms above sound all too familiar, give us a call at (706)256-0830 to schedule an appointment and let us lend you a helping hand!

Call Today To Request An Appointment With A Therapist At St. Francis Rehab Main Clinic. Written by Katherine M. Branch, OTR/L.

10 Activities to do with Easter Eggs

As you spend time at home around the Easter holiday, go ahead and break out those plastic Easter eggs a little early! They aren’t just for hiding candy! Did you know that just breaking apart and pushing together plastic Easter eggs promotes fine motor strength and coordination in your little one?  Keep reading to discover 10 fun activities you can do at home using your plastic eater eggs, all the while working on important skills for your child! Let us know how you like them!

Build the Egg

This activity is great for improving your childs visual perception skills and following directions! On a piece of paper, use marker or crayon to color a “mismatched” egg (you can also have your child do this step). Next, have your child recreate it using plastic Easter egg halves.

Match Upper case and Lower Case Letters

This activity targets letter recognition and FM strengthening! Using a sharpie, write the uppercase letter on the top half of an egg and the lower case letter on the bottom half. Keep the halves separated and mix up in a bowl or plastic tub. Have your child match the letters together!  To make it a little harder, use different color halves for the same letter.

Counting Objects

This activity works on fine motor coordination and strengthening, as well as number recognition and counting skills! Using a sharpie, write numbers on your Easter eggs. Have your child count out the appropriate number of small objects (buttons pictured, but can use pompoms, small erasers or even balled up pieces of paper) and place in each egg! To make it harder, have them use tongs to pick up the small objects.

Color Match

This activity focuses on color recognition, fine motor strengthening and coordination. Using small colored objects, have your child match the object to the correct colored egg, and then close the egg! Let them use tongs to pick up the objects and place in the eggs. Is your child struggling to get their egg back together? This is a hard step for young ones. Line it up for them and then have them “push” it until is clicks together!

Get MOVING

Write different gross motor activities on slips of paper and place in eggs. Hide the eggs in your yard or house and let your child hunt for them! When they find one, have them do the movement back to you! Some ideas are bunny hops, crab crawls, bear crawls, stomping and walking backwards! Choose movements that your child can do safely depending on their age!

Egg painting

Squirt some washable paint on your child’s paper. Have them dip half an egg into the paint, and press onto the paper like a stamp to make a picture! To make it harder, have them use their “stamp” to make letters. If they get some paint on their hands, that’s OK! This can be a great sensory activity, as well as working on fine motor coordination. This activity is limitless!

Egg Towers

See how high your child can stack their egg halves! This activity is harder than it looks. In addition to working on coordination and pressure grading, this activity can promote healthy emotional regulation as your child deals with the disappointment of their tower falling over. Be sure to stay positive and encourage them to keep trying!

Egg Bath

Does your child like to get their hand dirty or do they avoid anything sticky and slimy? Either way, this is a great activity to promote tactile play and participation in ADLs! Have one bowl with shaving cream and another with water! Let them explore and play with the eggs in the shaving cream, then have them “wash the eggs” in the water. Let them use a toothbrush to scrub their eggs, especially if they don’t like brushing their teeth! Using a toothbrush during play time can help them get comfortable with it!

Sensory Bin Play

Options for sensory bins are limitless! Rice, beans, dirt, water…you name it! Plastic eggs are a great addition to any sensory bin as you can use them to scoop, pour and dig. Get creative with your sensory bin and let your child explore! This is fun do do in the yard if you want to avoid a mess.

Cookie Cutter

Does your child enjoy helping out in the kitchen? Whip up a batch of your favorite cookies together, pull some premade dough out of the refrigerator or use play dough, and have your child roll it out. Then let them use their Easter eggs to cut out the dough! This activity targets fine motor strengthening and sensory exploration!

 

vital signs

Do You Know Your Movement Vital Signs?

Most people think of heart rate or blood pressure when they think of vital signs. It is common to use numbers to quantify health and risk of disease. The American Heart Association encourages people to “know their numbers” referring to blood pressure, blood cholesterol, blood glucose, and weight. However, research is now showing the importance of moving properly for health. Let’s take a look at some of the numbers you can use to quantify your movement health:

Walking Speed

Walking speed has been called the “sixth vital sign” in medical literature recently. It is easy to measure, and takes into account strength, balance, coordination, confidence, cardiovascular fitness, tolerance to activity, and a whole host of other factors. It has also been shown to be predictive of future hospitalizations, functional decline, and overall mortality. Normal walking speed is considered to be approximately 4 to 4.5 feet per second or 2.7 to 3.2 miles/hour.

Push Ups

Push ups are popular to build strength, but a recent study found that they can show us a lot about your heart too. Researchers found that men who could do 40 or more consecutive push ups were at a 96% lower risk for cardiovascular disease than were men who could do less than 10. The push up test was also more useful in predicting future cardiovascular disease than aerobic capacity measured on a treadmill.

Grip Strength

Hand grip strength has been shown to be strongly correlated with health. The stronger your hand grip is, the less likely you are to suffer from cardiovascular disease, respiratory disease, COPD, and all types of cancer. In the study, muscle weakness was defined as grip strength <26 kg for men and <16 kg for women. Grip strength below these numbers was highly correlated with an increase in disease.

Standing From the Floor

If you can’t easily get down on the floor and back up your health might be in trouble, according to a study that looked at more than 2,000 people. The study asked people to go from standing to sitting on the floor and back up with as little support as needed. They found that if you need to use more than one hand to get up and down from the floor that you were 2 to 5 times more likely to die in the next 7 years than someone who can do it with just one hand, or even better, no hands at all.

Moving well is obviously important to overall health and longer life. These tests can give a snapshot of how you’re doing. If you’re having trouble with any of them, considering seeing a movement specialist – your physical therapist.

 

References

For the push up test:
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2724778
Gait speed:
https://jamanetwork.com/journals/jama/fullarticle/644554
Floor Rise test:
https://journals.sagepub.com/doi/10.1177/2047487312471759
https://www.dailymail.co.uk/health/article-2247402/Can-floor-using-hands-If-heading-early-grave.html
This is a grip strength study that was mentioned in the newsletter item:
https://www.ncbi.nlm.nih.gov/pubmed/28549705

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