I'm sorry MND stands for Motor Neurone Disease. Thanks for your advice David, I saw my patient today who currently does not suffer airway symptoms. We discussed fatigue and anxiety management and she is to practice simple relaxation techniques of deep breathing and imagining the sun/warmth on her body concentrating on different parts of the body from top of head down to her toes. Interestingly the patient enquired re a technique she had previously learnt in Yoga which involves isometric muscle contractions and for the reasons you state I advised against this. She is going to keep an activity diary for a week and rate her levels of fatigue in relation to her activities so we can identify any patterns and strategies to reduce fatigue e.g. adapting task, environment, or delegating tasks to others. Within the weekly diary I have encouraged her to put aside time daily to practice her relaxation techniques. I return in 2 weeks to go through the diary and see how she is getting on with the relaxation.
Thanks again Lucy Kind Regards Lucy Simpson 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 Mon, 19/1/09, David Harraway <aura...@optusnet.com.au> wrote: From: David Harraway <aura...@optusnet.com.au> Subject: Re: [OTlist] MND - relaxation techniques To: OTlist@otnow.com Date: Monday, 19 January, 2009, 12:48 AM Motor Neurone Disease. I think it's called ALS in the States. In response to the question - the use of breath based relaxation techniques is going to depend on the presentation of the person's MND. Some types have less "airway" symptoms - I know a few of the OTs at the specialist neurological disorder facility here and am pretty sure they use some guided imagery based relaxation with their clients. I'd caution against techniques that involve progressive isometric muscle contractions though due to fewer motor units being present in people with this set of conditions. I think the role of OT in the lives of these clients can be a very significant one and certainly often gain a great deal of professional satisfaction from working with these people and their families. Wishing you well with your interventions. cheers, David Harraway OT Melbourne Australia Ron Carson wrote: > I'll be the "dumb"one and ask, what's MND? > > ----- Original Message ----- > From: Lucy Simpson <lucy_simpso...@yahoo.co.uk> > Sent: Sunday, January 18, 2009 > To: OTlist@OTnow.com <OTlist@OTnow.com> > Subj: [OTlist] MND - relaxation techniques > > LS> I am an avid reader of this list, and now seek some advice! > LS> I am a Physical disability community OT and am currently seeing > LS> an MND patient. We are addressing her environmental/adaptaion > LS> needs as they arise she is having a wet room installed, and a > LS> closomat toilet currently. She is now wheelchair dependent, but independent with transfers. > LS> > LS> We are also looking at symptom management and quality of life. > LS> One area we are looking at is fatigue and anxiety management. > LS> Fortunately this patient is very realistic and fully engaging in therapy. > LS> > LS> I am aware of basic relaxation techniques, and deep breathing is > LS> a core element of these techniques. I have heard that as MND is > LS> synonimous with breathing difficulties, teaching deep breathing > LS> techniques can actually result in increasing anxiety as it draws > LS> attention to an area of concern...... > LS> > LS> Does anyone have advice on MND specific relaxation techniques or re general relaxation resources? > LS> > LS> be grateful for any input > > > LS> Kind Regards > > LS> Lucy Payne > > > LS> For Quality Stationery and Greetings Cards check out this website: > LS> www.phoenix-trading.co.uk/web/lucysimpson > LS> Save it in your favourites for the next time you need cards. > LS> > > LS> --- On Sun, 18/1/09, cmnahrw...@aol.com <cmnahrw...@aol.com> wrote: > > LS> From: cmnahrw...@aol.com <cmnahrw...@aol.com> > LS> Subject: Re: [OTlist] Fn. Mobility ~vs~ Gait Training > LS> To: OTlist@OTnow.com > LS> Date: Sunday, 18 January, 2009, 7:29 PM > > LS> I don't have a direct answer to that.? I guess it depends on where your > LS> level of expertise falls in this area.? I have it easy, because I work with an > LS> amazing group of PTs who teach me on each patient how they want them to walk.? > LS> That way I can help the patient receive the much needed practice in this > LS> area,but at the same time I can consult with the PT since I did not have this > LS> area taught in school.? I always attempt to complete the sit to stands and the > LS> low level functional mobility in a context of an occupation that the patient has > LS> determined important a) walking to dresser to gather clothes b) walking to the > LS> toilet to complete toileting c) walking to the dining room chair for meal time. > LS> It is then amazing when the patient can perform the functional mobility, and > LS> then carryout out the occupation!.? > > LS> Ninety nine percent of the time when I ask a patient what their goals are for > LS> rehab they state to "walk better".? I then ask them why they want to > LS> walk better.? They often look at me strangely and then state so I can get to the > LS> kitchen and cook, do the laundry, go out to eat with my friends, etc etc.? The > LS> occupational goals nearly write themselves. > > LS> Chris Nahrwold MS, OTR > > > LS> -----Original Message----- > LS> From: Ron Carson <rdcar...@otnow.com> > LS> To: cmnahrw...@aol.com <OTlist@OTnow.com> > LS> Sent: Sat, 17 Jan 2009 7:38 pm > LS> Subject: Re: [OTlist] Fn. Mobility ~vs~ Gait Training > > > > LS> I like your definitions. > > LS> In the two cases you mention, the patients are already ambulatory. > LS> What if they weren't and still wanted to achieve the same outcomes? > > LS> ----- Original Message ----- > LS> From: cmnahrw...@aol.com <cmnahrw...@aol.com> > LS> Sent: Saturday, January 17, 2009 > LS> To: OTlist@OTnow.com <OTlist@OTnow.com> > LS> 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 > LS> techniques to > cac>> faciliate a normal gait pattern.? I see this being used by PT in > cac>> neurological rehabilitation.? > > cac>> Chris > > > > > > LS> -- > LS> Options? > LS> www.otnow.com/mailman/options/otlist_otnow.com > > LS> Archive? > LS> www.mail-archive.com/otlist@otnow.com > > LS> -- > LS> Options? > LS> www.otnow.com/mailman/options/otlist_otnow.com > > LS> Archive? > LS> www.mail-archive.com/otlist@otnow.com > > > > LS> > LS> -- > LS> Options? > LS> www.otnow.com/mailman/options/otlist_otnow.com > > LS> Archive? > LS> www.mail-archive.com/otlist@otnow.com > > > -- > Options? > www.otnow.com/mailman/options/otlist_otnow.com > > Archive? > www.mail-archive.com/otlist@otnow.com > > > __________ NOD32 3775 (20090118) Information __________ > > This message was checked by NOD32 antivirus system. > http://www.eset.com > > > > -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
