Start a Risk Free Trial Today! Patients Clinicians

Strengthening a Spastic Muscle. Why the Kerfuffle?

Henry Hoffman
Wednesday, August 19th, 2015


Not as much now, but in the recent past, discussing strength training a hyperactive or spastic muscle was a very controversial topic amongst clinicians at happy hour, in the clinic, or at CEU’s. For many, the thought of having upper motor neuron lesion clients squeeze their hyperactive finger flexors or flex their spastic biceps in the late 1980-90’s (and earlier) would have made many clinicians cringe. The visual that comes to mind for me is something out of a CSI show, but instead of a homicide, you were looking at a clinical “assault and battery” where security would have been called and the crime scene tape would have been wrapped around the patient and the plinth. The suspected serial criminal then would have collected his or her belongings and performed the famous perp walk out of the clinic for all of the fellow clinicians to see. Yes, the media would have eventually covered this story and learned that this inept clinician, known publically now as “high toner”, would be linked to previous clinical crimes ranging from “excessive upper trap activation” to “absence of manual cues”. OK, maybe a bit melodramatic and a tad over-exaggerated, but I think you get the idea.

Read more…

De-icing the Mystery Behind Hemiplegic Frozen Shoulder

Henry Hoffman
Wednesday, January 21st, 2015


If you have attended a Saebo course in the past, you most likely have heard the comment “it is the hand that guides the arm”. Although this is theoretically true when discussing the importance of incorporating one’s hand functionally, broadly speaking however, we should avoid providing too much importance to the hand as it is only one element of the interdependent kinetic chain. Yes, the hand mainly guides the arm to interact and problem-solve the environment, however, if pain and limited motion exists proximally (i.e., shoulder), function will be compromised regardless of the hand’s ability to participate.

Read more…

Neurorehabilitation; What Are Some of the Things We Know?

Shannon Scott, OTR/L
Monday, May 5th, 2014


There is alot we still don’t know about what constitutes “best practice” when it comes to neurorehabilitation and how to affect optimal recovery and outcomes, but there are some things that we do have a better understanding of. Let’s take stroke recovery and rehabilitation as an example, specifically upper extremity (UE) recovery, since it is reported that at least 50% of individuals who suffer a stroke have UE involvement and impairments (though the numbers vary depending on which study you are reading).

Read more…

Stroke, Not so Old…

Shannon Scott, OTR/L
Thursday, December 19th, 2013


Social Issue

According to the American Heart Association (AHA, 2013) stroke can occur at any age however recent studies indicate that over the past 15 years there has been an increase in the incidence of ischemic stroke occurring in young adults (George, Tong, Kuklina, & Labarthe, 2011). Risks associated with increased obesity, hypertension, diabetes, and tobacco and alcohol use have been proposed factors contributing to this rise (George et al., 2011). With increased rates of survival, younger individuals are living longer with disability and the direct and indirect costs associated with healthcare and lost productivity can be significant (George et al., 2011; Wolf, Baum, & Connor, 2009). According to AHA (2013), loss of earnings is projected to be the highest costs associated with stroke.

Read more…

Bridging the Gap to Evidence Based Neurorehabilitation Practice

Shannon Scott, OTR/L
Wednesday, October 2nd, 2013


The term “evidence based practice” is now ingrained in our clinical knowledge and discussions though there still remains a gap between knowledge and actual implementation of evidence based interventions.  Much research has been done on why this gap persists in order to find methods of bridging this gap. I recently read an article by Fleming-Castaldy & Gillen (2013) in the American Journal of Occupational Therapy that discussed some of these issues. As Director of Clinical Services at Saebo Inc, I couldn’t help but feel a sense of satisfaction when reading this article as it fully validates that Saebo is providing current and evidence based education and products. I will provide a summary here but strongly advocate that clinicians working in neurorehabilitation should read this article.

Read more…

How Effective is Botox in Improving UE Function?

Shannon Scott, OTR/L
Monday, July 22nd, 2013


Muscle spasticity is a negative symptom which can occur following a central nervous system disorder (Kinnear, 2012). The use of Botulinum Toxin Type A (BTX-A), commonly referred to as Botox, is used extensively in the treatment of muscle spasticity following stroke and other neurological conditions. Following BTX-A injections, physical and occupational therapy are typically provided and include stretching, casting, splinting, strengthening, and functional movement retraining (Kinnear, 2012).

Having provided the above types of occupational therapy interventions with numerous individuals who have received Botox injections to the UE, I have formulated my own opinions as to the functional benefits of Botox injections in the UE.  I recently did a literature review to find out what the research reports.

Read more…

Good News; Healthcare Reform and Changes in Medicare

Shannon Scott, OTR/L
Thursday, June 6th, 2013


As clinicians, our ability to provide therapy services to clients is influenced by federal laws and regulations, administrative laws from agencies, and sometimes case law. It becomes challenging to keep track of all the changes that occur in the laws, rules, and regulations that impact our practice. More often, we are aware of changes that negatively impact our ability to provide comprehensive and medically necessary skilled services to achieve optimum client outcomes, such as therapy caps. We are also aware of changes in regulations that impact what we document and the way we document.

Read more…

Is What You’re Doing Working? How Do You Know?

Shannon Scott, OTR/L
Thursday, April 25th, 2013


As many of you are already aware, those billing to Medicare for therapy coverage now have to report functional outcome data for clients in the form of new non-payable G codes. The G codes are designed to capture the primary issue for which therapy is being provided for. This includes issues such as mobility, changing/maintaining body position, carrying/moving/handling objects, and self-care to name a few. G codes are accompanied by modifiers which indicate the client’s area of limitation and are designed to help track functional changes over time which subsequently results in payment information. These codes are required to not only to be included in the claim to Medicare but also in the client’s medical record with an indication of what tools and outcome measures were used to assess functional outcome. Reporting started in January for a trial 6 month period and beginning July 1/13 claims will not be accepted without the required functional data.

Read more…

April is OT Month! Saebo Supports the AOTA Centennial Vision.

Shannon Scott, OTR/L
Monday, April 8th, 2013


The AOTA Centennial Vision

In celebration of April being OT month, it seems appropriate to discuss AOTA’s Centennial Vision (CV) for the profession. Many will already be familiar with the CV, but there are many that likely are not.

In 2006, The American Occupational Therapy Association established the Centennial Vision as a “strategic plan” (AOTA, 2006, p.1) for the profession as it approaches its 100th anniversary in 2017. It was established to provide strategies for occupational therapists at all levels of service, to enable the profession to remain “viable and contemporary” (Baum, 2006, p. 610) in light of changes in society, health care, and technology.

Read more…

New Acronyms in the Neurorehabilitation Literature; What Do They Mean?

Shannon Scott, OTR/L
Monday, March 11th, 2013


For those working in upper extremity (UE) neurorehabilitation, the acronyms CIMT (constraint induced movement therapy) and mCIMT (modified constraint induced movement therapy) are now very familiar.

CIMT is an intervention approach which involves restraint of the non-involved UE for 90% of waking hours over a two week period, to include weekends, with repetitive training of the involved UE using shaping principles for 6 hours per day on the weekdays (Kunkel, Kopp, Muller, Villringer, Villringer, Taub, & Flor, 1999).

Read more…

Don't miss out on our upcoming featured webinar! On Wednesday, September 18th at 2:00 PM EDT, we will be introducin... https://t.co/1aSG6dH6ij