Yes I am comfortable with faciliating the patient to take steps.??Why???Because 
I have been trained to do it the correct way.

And yes I feel comfortable with advancing the patient's mobility aide when they 
are improving with ambulating to the toilet.?Why? Because I am an occupational 
therapist and bathroom mobility is often my game.

Again, I do not have a direct answer for this.? I have never been challenged in 
the area of scope of practice or denied via insurance?so I guess after 8 years 
I'm still doing ok.? I think the key is to take a team approach.? I agree with 
the prior letter.? Why does it all come back to PT versus OT?

Chris 


-----Original Message-----
From: Ron Carson <[email protected]>
To: [email protected] <[email protected]>
Sent: Mon, 19 Jan 2009 8:02 pm
Subject: Re: [OTlist] Fn. Mobility ~vs~ Gait Training



So Chris, if you had a patient that could only stand, but not ambulate
are  you comfortable in facilitating the patient to take steps? Why or
why not?

And  if the GOAL is for the patient to ambulate to the toilet with the
lease restrictive aid, can OT advance patient's mobility aides? Again,
why or why not?

P.S.,  ANYONE  feel welcome to reply. Messages on the list are usually
meant for general discussion, or at least they should be!!!!!!

Ron

----- Original Message -----
From: [email protected] <[email protected]>
Sent: Sunday, January 18, 2009
To:   [email protected] <[email protected]>
Subj: [OTlist] Fn. Mobility ~vs~ Gait Training

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

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

cac> Chris Nahrwold MS, OTR


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



cac> I like your definitions.

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

cac> ----- Original Message -----
cac> From: [email protected] <[email protected]>
cac> Sent: Saturday, January 17, 2009
cac> To:   [email protected] <[email protected]>
cac> 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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