I am an avid reader of this list, and now seek some advice!
I am a Physical disability community OT and am currently seeing an MND patient. 
We are addressing her environmental/adaptaion needs as they arise she is having 
a wet room installed, and a closomat toilet currently. She is now wheelchair 
dependent, but independent with transfers. 
 
We are also looking at symptom management and quality of life. One area we are 
looking at is fatigue and anxiety management. Fortunately this patient is very 
realistic and fully engaging in therapy.
 
I am aware of basic relaxation techniques, and deep breathing is a core element 
of these techniques. I have heard that as MND is synonimous with breathing 
difficulties, teaching deep breathing techniques can actually result in 
increasing anxiety as it draws attention to an area of concern...... 
 
Does anyone have advice on MND specific relaxation techniques or re general 
relaxation resources?
 
be grateful for any input


Kind Regards 

Lucy Payne


For Quality Stationery and Greetings Cards check out this website: 
www.phoenix-trading.co.uk/web/lucysimpson 
Save it in your favourites for the next time you need cards.
 

--- On Sun, 18/1/09, [email protected] <[email protected]> wrote:

From: [email protected] <[email protected]>
Subject: Re: [OTlist] Fn. Mobility ~vs~ Gait Training
To: [email protected]
Date: Sunday, 18 January, 2009, 7:29 PM

I don't have a direct answer to that.? I guess it depends on where your
level of expertise falls in this area.? I have it easy, because I work with an
amazing group of PTs who teach me on each patient how they want them to walk.?
That way I can help the patient receive the much needed practice in this
area,but at the same time I can consult with the PT since I did not have this
area taught in school.? I always attempt to complete the sit to stands and the
low level functional mobility in a context of an occupation that the patient has
determined important a) walking to dresser to gather clothes b) walking to the
toilet to complete toileting c) walking to the dining room chair for meal time.
It is then amazing when the patient can perform the functional mobility, and
then carryout out the occupation!.? 

Ninety nine percent of the time when I ask a patient what their goals are for
rehab they state to "walk better".? I then ask them why they want to
walk better.? They often look at me strangely and then state so I can get to the
kitchen and cook, do the laundry, go out to eat with my friends, etc etc.? The
occupational goals nearly write themselves.

Chris Nahrwold MS, OTR


-----Original Message-----
From: Ron Carson <[email protected]>
To: [email protected] <[email protected]>
Sent: Sat, 17 Jan 2009 7:38 pm
Subject: Re: [OTlist] Fn. Mobility ~vs~ Gait Training



I like your definitions.

In  the  two  cases  you mention, the patients are already ambulatory.
What if they weren't and still wanted to achieve the same outcomes?

----- Original Message -----
From: [email protected] <[email protected]>
Sent: Saturday, January 17, 2009
To:   [email protected] <[email protected]>
Subj: [OTlist] Fn. Mobility ~vs~ Gait Training

cac> To me functional mobility is the process of getting to point A to
cac> point B regardless of compensation techniqes in the context of an
cac> activity  or  a desired functional outcome.? Just the other day I
cac> had  a  patient  who  wanted  to  cook  and set the table for her
cac> family,  to  achieve  this  desired  outcome a walker tray had to
cac> implemented  with  further practice of safe strategies.? Just the
cac> other  day  I had a hip replacement patient who wanted to be able
cac> to   get   to  the  bathroom  safely  without  breaking  her  hip
cac> precautions,  so?  raised  toilet  was  implemented  with further
cac> practice of safe strategies.

cac> Gait  training  is when a therapist observes a patient's gait and
cac> objectively  determines what movement functions?cause the patient
cac> to  walk  "abnormally".?  They then use therapeutic
techniques to
cac> faciliate  a normal gait pattern.? I see this being used by PT in
cac> neurological rehabilitation.?

cac> Chris





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