26 October 2008

New drugs for psoriasis

25 October 2008

Disability Takes Many Forms

A discussion concerning how worry can affect us so strongly that it can become a disability.

http://www.bellaonline.com/articles/art43293.asp/zzz

October is National Disability Employment Awareness Month. I was surprised myself to stumble across this information on the internet. I have never heard this before but certainly feel that it is newsworthy.

This day of recognition began in 1945 as an effort to educate Americans about disability issues. At that time Congress enacted a law officially declaring the first week of October each year to be "National Employ the Physically Handicapped Week." Seventeen years later in 1962 the name was changed to "National Employ the Handicapped Week" by this time the country had realized the need to accommodate persons with all types of disabilities. Finally, in 1988 the week was expanded to a month and the name was changed once again to "National Disability Employment Awareness Month."

In a statement from President Bush regarding National Disability Employment Awareness Month, 2008 we are told that America as a nation is reaffirming its commitment to make sure that our Nation's promise extends to all citizens of our great county. This is an extraordinary opportunity and all Americans should be made aware particularly those willing to gainfully employ those with disabilities. News of this kind should definitely acquire more airtime on our radio and television stations.

Census 2000 indicates that there are approximately 49.7 million people in our country with some type of disability or long term condition. According to the Census they represent 19.3 percent of the population and this does not include those who are institutionalized. When broken down this comes to nearly one person in five, shocking statistics when you think about it! How many of us have ever stopped long enough to realize the number of our fellow citizens that are disabled?

Unfortunately, these numbers are due to increase as our population increases. Having a family member with a disability I know that we often believe that our government and society do not offer enough assistance to our disabled citizens. Nevertheless, in comparison to other countries we actually do have a great deal of support in this country for the disabled. For those who have never dealt with disability it is often a shock when we discover all that must be done to obtain these services. I know from previous experience the road is long but nothing of value is ever free. It also goes without saying that there is much more that should and needs to be done but, we really are very blessed with resources in America.

In the past few years it seems that more people and resources are getting on the bandwagon so to speak to reach out to those with various needs. In the past few years I have learned of many organizations that participate in programs for the disabled. There is information available to anyone who desires to learn how to teach, support and be a valuable resource to our disabled citizens.

For a variety of information please visit the website National Council for Support of Disability Issues http://www.ncsd.org/Newsletter/ncsdnews.htm


I also hope you will take a few moments of your time and visit the Library of Congress web page on "National Disability Employment Awareness Month" at the link provided below.

http://www.loc.gov/topics/disabilityawareness/

Deborah Pipas, Disabilities Editor

A World Without Fear

Everyone has an idea of a perfect world would look like, for them. But most of the time I would believe that are only singular. Meaning we probably don't see the full spectrum, I believe this to be true because we all do it, and for me to write this article I will have to use both a singular and plural approach.

I've heard it said that this world waits for no one, that it won't adapt for those with physical limitation. I realize that I'm already stepping on hollow ground here, but that's okay. Just because our world chooses not to adapt for certain people. Does not excuse us a humanity to look down on one another.

Allow me to ask a very simple question:

What is this world coming to?

I ask this because as a physically challenged person, it feels rather embarrassing when you slip and fall at a restaurant because the was a slick spot on the ground. After you do your best not to make a scene, you look around to see that everyone has heard that sound of your crutches hitting the floor and the thud of your body hitting the ground.

But a good majority of people just glance, and then go back to eating their burgers made with some pink in the middle. I mean sure, the staff of the restaurant came rushing over to see if I was okay. Which I was, I shook it off and tried my hardest to act like nothing happened.

What happened to the good samaritans of our day? The kind that would stop at anything to see if one was alright. I don't think that their gone, rather I believe that they're in all of us. Its the fear in us that prevents us from acting and being a hero. So I suppose that this where my vision for a perfect world would begin. This is a singular and plural approach because it speaks of community.

If you turn on the news and watch for ten minutes, you'll probably notice it has to do with the "Us Versus Them" Factor. The democrats versus republicans. This gets annoying quickly, because a bigger picture is always missed. I really don't care what one believes is true, more times than none I care about what we do with time we are given in this short life.

Its more beneficial to our world, when two people who have nothing in common with one another, can find a means to come together as one for a greater good. This may seem so small, but its because we cannot see the edification of our actions.

This kind of vision for our world is more than possible, but as I've said more than a million times. It starts with you first, you must know and realize that your life means something. And that no one can tell you different, okay? We've been told this growing up from our parents I'm sure.

This saying was ingrained in me, by my parents, and I'm very thankful because of it. I heard a quote today and it went a little something like this: "Even if you don't believe in God, He believes in you". In his eyes, we are all his sons and daughters. And know one is above one another.

Even if you don't believe in God, we need to wrap our minds around the fact that know one is above anyone else. Our blood still is the same color. We all get covered in dirt when we die, so with the little time that we have in this life. Why can't we allow ourselves the time change and become the type of people that are not paralyzed by fear?

With love.

-Brandon Ryan

Providing Holidays for People with Disabilities

We enable YOU to have the holiday YOU want by supporting YOU with what YOU need.

Hi,

Supported Holidays was formed in 2002 by Sue Osman. The company provides holidays for people with disabilities on the Costa Del Sol, Spain.
The Mission Statement of the company is;
“To provide the very highest level of care and support to enable guests to experience the best holiday that they can have”.
Sue has worked in the field of care since leaving school 17 years ago, initially as a care assistant and for many years and as both a Registered Care Home Manager and Supported Living Housing Manager within the following registered categories:

o Learning Disabilities
o Physical Disabilities
o Mental Health
o Hearing & Visually Impaired
o Older People
o Challenging Behaviour


The desire to offer something new for holidays was born out of the frustration to book quality holidays for her Service Users. The usual week of a cottage in the Cotswolds or a caravan at Great Yarmouth came with the problems of quality and staffing costs. She has always sought to encourage her service users to achieve and experience the very best they can and the opportunity for foreign travel should be amongst those experiences.

Guests are now flying to Spain from all over the UK. Each holiday booked in the culmination of many hours of discussion. Every guest is different, the emotional and physical requirements of the guest is the primary concern. Activities and trips are discussed and can be as simple as lying by the pool to boat trips to see the dolphins.

The holiday that is provided is one that guests have chosen; there are no restrictions, no must haves, no dos or don’ts, other than health and safety issues.
Care is provided as required, from 1 – 2 hours personal care to 24 hour full support. Individual guests, couples and small groups usually stay in the purpose built accommodation within the family villa. Larger groups can be accommodation in another 5 bed roomed villa less than 100 meters away. Our holidays are usually based upon 3 guests to 1 staff ratio.

We also have a new project under the ‘Supported Holidays.co.uk’ umbrella based in Antequera run by a couple that worked for us in 2007.
Supported Holidays is a unique service, individually tailoring two different types of holiday packages to meet the needs of our guests. The '24-Hour Fully Inclusive Supported Holiday (FISH) and the (FLEXI) Holiday Package'.

The Fully Inclusive Supported Holiday (FISH);

Our accessible user-friendly database allows guests to make decisions about their day, from going on a day trip to where and what they want to eat.

Prices include:

• Return flights from UK airports
• Support at the Airports ~ This is arranged with the airline & the Passenger Handling Dept at time the of booking flights to ensure all your support needs will be met
• Return private air-conditioned transfers ~ A member of our team will greet you at Malaga Airport and to drive you to your accommodation, and again for your return journey.
• Accommodation ~ The private fully wheelchair accessible apartment is in the grounds of our family villa which means you have support at hand when needed. The apartment consists of two twin bedrooms, large wet room, specialised equipment, internal alarm systems, TV video & DVD player , stereo, play-station and drinks making facilities. Outside there are terraces, gardens, fruit trees, laundry room, bar area, swimming pool & BBQ.
We also have many luxury villas and apartments nearby for larger groups.
• Towels, Linen & Bathrobes ~ Bath & Beach towels provided and changed daily.
• On Site Toiletries – A selection of toiletries are available, this includes: shampoo, shower gel, soap, toothpaste, sun lotions, aftersun, etc
• Medication Administration ~ All staff are trained to administer M.A.R.R / Dosset Box medication. We require information regarding medication contraindications and side effects.
• Money Management ~ We support guests with all aspects of money management i.e. budgeting spending money, safe keeping and advice on value for money.
• Welcome Packs ~ Includes typical Spanish & English snacks & a bottle of bubbly!
• Professional Support ~ At hand 24 hours a day
• All Meals ~ including, served breakfast, packed lunches & meals out. We can also provide a packed snack for guests return journey.
• Full Day trips ~ Everyday. Visiting attractions of your choice from our ‘Activities Folder’ i.e. boat trips, horse riding, animal & adventure parks etc. All attractions are audited for suitability. All entrance fee’s are included.
• Evenings Out ~ Every night. Restaurants, bars & shows
• Personalised Photo Album ~ Photos are taken throughout the holiday and an album is presented to you at the end of your holiday so you can take your memories home with you. We may need to post the last day’s photo’s to you.
• Laundry Service ~ Most clothes will be washed ready for you to take home clean with you.
• Cleaning Service ~ The bedrooms and en suite wet room will be freshly prepared daily.
• Shopping Service ~ We go to the shops most days so if you need anything just let us know, or if you want and you’ve got time you can always come with us.
• 24 hour on-call service ~ A pre-programmed mobile phone is provided.
• Communication ~ All guests can be contacted on either the villa’s landline or on the On-Call Managers mobile.
• Daily Reports ~ For those guests that require a written daily report
• Snacks & Drinks ~ Freely available at the villa
• FREE Bar ~ at the villa
• Phone Calls ~ Guests are welcome to use the villa telephone to call their families and carers (within reason of course!)
• Supported Holidays Souvenir
• Destination Souvenir
• Public Liability Insurance
• Returned Forgotten Items (within reason)
• Christmas Card & Gift
• Birthday Card

What’s NOT Included:

• Travel & Medical Insurance
• Extra drinks when out
• Transport to and from UK departure airport
• Any invasive treatment that is needed, however we do provide escort, advice and translations of medical services
• Any spending money for gifts, postcards & other personal items

2009 Prices;

Our 2009 prices are based upon guests confirming their holidays dates during 2008.The total cost for the above package is £999 per person per week; any additional weeks are at a discounted rate of £899.

Holidays booked in 2009 are £999 plus flight costs to Malaga. If booked in advance flights can cost as little as £50 return, short notice flights may cost up to £200 return plus.

During 2009 we are also offering the following packages (please contact us for further details):

• Winter Sun Packages: Jan, Feb & March 2009 (Includes skiing)
• Portugal: 7 – 14 April 2009
• 4 day mini-cruise to Amsterdam: 15 – 18 May 2009
• 5 day Mediterranean cruise: Dates to be confirmed
• Christmas 2009 in Tenerife

Our other project are specialising in holiday for families with children with disabilities. Further information available upon request.
If you, a family member, a friend or service user would like to experience Spain and all that it offers review the website, read the testimonials but most importantly call or email to let Sue know.
Please advise us on your preferred holiday dates ASAP to avoid disappointment as we are getting booked up already for 2009 with repeat bookings from our regular guests.
FREE no obligation booking forms are available upon request.
We look forward to hearing from you,



Sue Osman
Supported Holidays ©

Wii used in hospital physiotherapy





Nathan Ellis, 12, with physios Zoe Pilborough and Julie Sutcliffe

By Aasma Day
When 12-year-old Nathan Ellis was knocked over by a car he suffered devastating injuries and was lucky to live.
The youngster then faced 12 months of intensive physiotherapy to regain full use of his shattered limbs.

But it was then that Nathan, of Ashton, Preston, came up with a bright idea to make the exercises and treatment more fun.

And his concept of using the highly contagious Wii Fit computer game for treatment proved such a success it has now been introduced for patients in both the Royal Preston and Chorley and South Ribble Hospitals

The Nintendo Wii Fit is a video game which encourages exercise through active games interacting with the screen.

It has now been introduced into physiotherapy departments to aid the rehabilitation of young patients.

Nathan was knocked down by a car on Riversway, Preston, in September 2007 and broke both his legs and his right arm.

Nathan said: "I had a severe accident. I was in hospital for two weeks and had 12-months' physiotherapy and support to help get fit and get my mobility back and now I'm walking and back to normal.

"I thought it would be a good idea to get a Wii Fit for patients like me to help with their exercises. I'm pleased it is here and it's great fun."

As a result of Nathan's brainwave, staff at Lancashire Teaching Hospitals NHS Foundation Trust have purchased two consoles and the fitness games to benefit youngsters undergoing treatment.

Lesley Walters, head of physiotherapy at Lancashire Teaching Hospitals NHS Foundation Trust, said: "We provide a paediatric and adolescent physiotherapy service.

"One of our patients suggested it would be a good idea and new and fun way to get youngsters to undertake physiotherapy.

"Physiotherapy sessions for children and young people often use play or diversion techniques to get them to overcome any discomfort or stiffness they may feel.

"Wii Fit is a great way of using computer games to stimulate interest while performing exercises which can be uncomfortable.

"We encourage people to have fun while undergoing physiotherapy and the use of a computer games console which encourages fitness is a fantastic innovation for physiotherapy.

"Two consoles have been purchased and we will be using them in our paediatric and adolescent physiotherapy services at Royal Preston and Chorley and South Ribble hospitals.

"It is being used in an increasing number of NHS Physiotherapy departments and I'm sure that it will prove very popular in Lancashire."

The consoles were bought with funds from the Incubator Appeal which uses donated loose change, old money and foreign currency for good causes at the trust.

17 October 2008

Nintendo Wii + Wii Sports - Good for fitness in children?

by: Karen Bennett

The Nintendo Wii it seems, puts pay to the concerns in recent years over the inactivity in children due to their interest in video games consoles. The Wii console really sets itself apart from the rest with its revolutionary motion sensitive controller, which actually requires movement in order to play the games. The Nintendo Wii comes with the game Wii Sports, which includes tennis, baseball, bowling, golf and boxing. In tennis you will be swinging the remote as if it were a tennis racket and flicking it up to toss the ball into the air with a quick swing to serve. The other Wii Sports games work in a similar way simulating controller movements for like movements onscreen. Boxing however is the only Wii Sports game that uses the nunchuk attachment and is the most physically exhausting game of them all. In order to hit your opponent in the head or body, you will have to aim high or low with your swings. There are three different activities with each game. In training mode, you will participate in random challenges, after which you will be assigned a fitness age, based on your performance. Sound familiar? The Nintendo DS game, Brain Training comes to mind...a physical version perhaps? The important thing here is that gamers are becoming more physically active without even realising it - you could say it has a 'kill two birds with one stone' effect, combining video game play with physical activity. Given this 'physical' nature of the Wii, I wouldn't be suprised if parents rushed out to buy the Nintendo Wii just to get their kids off the sofa! Another great thing about the Nintendo Wii is that it appeals not only to children and teens but to adults too, so its something the whole family can enjoy. Could the Nintendo Wii revolutionize the way we play video games in the future? It will be interesting to see what Nintendo's competitors come up with next - this could be a tough one to beat!
About The Author
Karen Bennett For more information on the Nintendo Wii and to find cheapest prices, visit my website http://www.compareconsoleprices.co.uk

A Love Like Rahab

Last night I decided to kick back and have a beer, and I got to thinking about a man named Joshua. He married a young women named Rahab who was a prostitute. I mean its kinda cool how it happened, Joshua and his army are preparing for the fight of their lives, but before anything happens that take refuge in her home.

Rahab pleads with Joshua not to destroy her home, and her place of business. She even hides him and a few of his mates. Until some sneaky snitch decides to tell their enemies of the Israelites plan of attack. (According to some scholars and experts on this particular time in history.)

Rahab decides to hang a red cord out her window, so Joshua and his troops know not to touch her home. Now... that is a small piece of background. But then, I started to put myself in Joshua's shoes (or rather sandals) based on some drawings that portray her, she seems to be a very attractive lady at that.

So at first glance I would like to think that when their eyes met, there was a subtle attraction. Because they couldn't show it, they probably couldn't show the radiation of their smiles. And the entire time Joshua was at war, I bet he thought about her, and I bet his prayer was to make it back alive so he could see Rahab again.

Please understand that this is just my assumption. But what made me so intrigued by the two of them, was how counter culture their relationship was. I mean Joshua was no an idiot he knew she was a prostitute and how she made money, but he didn't know how many partners she could have had, unless she just came out and told him.

However, in my assumption. I believe Joshua didn't go up to rahab and say to her: "Hey lets date!" He probably saw this beautiful women who needed love like anyone else, and that its hard to make a living in this life. And Rahab knew that she could not live the life she was leading anymore. After awhile it gets old and you start to wonder if this all adds up to how much she is worth.

So theirs a connection between them already. The reason I say this is so counter culture is because it is very, very difficult to find love and acceptance. The kind of total, pure acceptance that leaves us in awe, and leaves us wondering why we haven't be thrown to the side of the road. Our society is very rush, when one is honest about his or her past with some one they care for or love. The opposite person is left in a state of disbelief. We say things like: "Wow.." "Not you, this just can't be true can it?" Or "I don't think we can have a future anymore, because you've got to much baggage, and my future is just to important to me."

This is true and we cannot deny... These response are so very painful. Nothing in me senses that Joshua did this with Rahab. He didn't throw a "purity rocks" T-shirt at her or say something like "True love waits." Now I have no problem with these stances, the keep us free from having a life of having to take medicine and learning to cope with any horrible sickness.

I don't see Christ doing that, so what gives us the right? Sure, I'm in no way shape or form saying go out in live a reckless care free life. Don't take what I'm saying out of the proper context, all I am saying is that God just sees the son or daughter. And he speaks well of the good that is already in them. Which is what people mean when they say: "God bless you" It is meant to say that I think well of you and so does God. Again, let me state that God does convict and points our sins, but he in no way gives a saying that thousands of other people crowd around.

Rather, I believe he gets down on his knees, wraps his hands around the head of his son or daughter. And quietly and lovingly rebukes the nature they're living. Why can't we do this for one another? Regardless of wether it'd be a sexual past or whatever the case may be? The Bible clearly states that we are to become more and more like every single day, hence this is his will for all humanity. But we are unaware of our short comings. Now, to the person who has these high standards of morality. I say well done to you. But are your standards so high that you are far from the loving the Un-Pure?

We scare people to the point where if they do sin, their done for. And God is just standing there ready to crack that whip. Not true. Mistakes are bound to happen they will. There're so many people who live in shame in this hour, because of something they've done. Let me tell you that there is a huge difference between conviction and shame. And lets be very honest with ourselves for a minute.

What exactly do we want? We want a love like Rahab has received. And it may be from another human being, or it very well be God himself or maybe even both. Whatever the case this love is life changing, this kind of love leaves us dumbfounded. If only we all could share our love like this, the chains would be broken. We'd throw down the heavy burdens of life and seek rest. We'd have a love like rahab.

-Brandon the writer.

2008 GOWRIE NEWSLETTER ISSUE 02




Page 4: HOLIDAY IN SPAIN

Last year I went on holiday to Spain in October with a company called Supported Holidays run by Sue Osman. I liked it so much that I went again in December and have booked to go again this year and would like to tell you all about it.

I heard about Supported Holidays from my Support Workers, who knew other service users who had enjoyed their holidays in Spain. I wanted to go abroad but didn’t want to go on my own so I thought a supported holiday would be just right for me. I caught a flight from Edinburgh to Malaga airport where I was met by staff from Sue’s project. It is quiet a long drive from the airport to the house in Nerja. This is a quit secluded area of Malaga and you can see the mountains in the distance. We drove up there one day and I saw a huge Dam which was very educational.

Now we come to the most important part of the project – the house itself! When you arrive you see 2 long green gates to the south of the property and a ramp down the side of the house which leads to bedrooms suitable for people in wheelchairs. The house is guarded by 2 big dogs called Cass & Monty, I was a bit scared of them at first but once they know you they are very friendly. There is a large enclosed garden with a swimming pool that the residents can use. I had my own bedroom and shared a bathroom with 2 to 3 other guests. The staff make lovely meals and even got my favourite cooked for me – a big Sunday roast with ice-cream for dessert!

There are lots of things you can do during your holiday; Sue organises trips for her visitors and the staff drive us in the project mini-bus. I went on a trip on a cable car with one staff called Sean. I was a bit nervous before I went on but once I was up it was just like sitting on a bus! The view was beautiful, it felt like you could see all over Spain and right across the sea. Other days I chose to go around the shops with Sue. There are a lot of cafes and bars in Malaga too where we went out with the staff in the evening. One night I saw a wonderful fireworks display with pinks, reds, blues and yellow lighting up the sky.

I cant wait to go again this October.

FRANK WYNEE

15 October 2008

Blow for parents as NHS refuses to pay for son’s specialist walker

£1,800 equipment would have given disabled five-year-old a new lease of life, say couple
By Ryan Crighton



A north-east couple have been left “devastated” after NHS Grampian refused to fund a specialist walker which has given their disabled son a new lease of life.

Five-year-old Alfie Arthur, who is a pupil at Anna Ritchie School’s nursery in Peterhead, was diagnosed with severe cerebral palsy when he was just a few months old.

The Ardallie youngster is unable to speak, walk, stand, feed himself or do any of the daily tasks that others take for granted.

A section of his brain stopped developing in the womb and he was left with very low muscle tone and body control.

He also suffers from scoliosis of the spine, which means he has to wear a back brace to support and strengthen his spine.

His parents, Gary and Colette Arthur, of South Hawkhillock, found a ray of hope during the summer when Alfie stepped into a specialist walker for the first time – allowing him to strengthen the muscles in his legs and spine as well as giving him improved mobility.

It even helped him play football and splash in puddles with his sisters, Lauren, 11, and Georgia, 7.

However, NHS Grampian has told the family that it does not have the funds to pay for Alfie to get the £1,800 walker full-time, so the family have decided to raise the money for it themselves.

An NHS Grampian spokesman said last night new devices came on to the market all the time, and not all were proven to be clinically useful to patients.

He added: “We see hundreds of people in the course of a year and clearly need to be convinced that such equipment would benefit patients.”

Last night Mrs Arthur said the family were not angry at the decision by NHS Grampian, “because that won’t change it”.

“We as a family were devastated,” she said.

“We would happily trade in all his other equipment for this as he’s gained so much from it. So, we have decided to raise the money for it ourselves.

“However, at the same time as needing to raise money for a walker, Alfie is going to be moving up to a wheelchair which means that we also need to find funds for a deposit on a mobility car and for renovations to our home to accommodate a wheelchair. This is where our friends and family stepped in and offered to help and raise funds.

“As Alfie loves music so much, it was decided he would approve of a ceilidh – this then developed into a Burns night and ceilidh complete with guest speakers, pipes and Highland dancers.”

The Burns night and ceilidh is being held at the Station Hotel , Ellon, on Saturday, January 24.

For more information, to book tickets or to donate a raffle prize for the event, contact either Kirstie Moar on 01358 711324 or themoars@btinternet.com, or Mrs Arthur on 01358 711385.

Anyone who is unable to attend the event, but would still like to support the cause, can donate by debit or credit card at the website www.giftshare.com/alfie

California Physical Therapists Promote Nintendo Wii for Core Strength and Fitness

'Wiihabilitation' is Fast Becoming an Accepted Form of Therapy at Physical Therapy Clinics Statewide

SACRAMENTO, Calif., Oct 14, 2008 /PRNewswire via COMTEX/ -- With October being National Physical Therapy Awareness Month, expect Nintendo Wiis to be flying off the shelves. Among the first in line will be members of the California Physical Therapy Association (CPTA), who stand by the video game console and its accompanying sports and fitness games as one of the best therapeutic technology inventions to roll out in a long time.
"As physical therapists, we are movement specialists engaged in the CPTA-sponsored MoveCalifornia campaign to get people active and fit again. In the midst of this, we're seeing a therapeutic phenomenon of sorts with kids, grown-ups and geriatric patients getting off the couch and learning how to properly use the Wii for core strength and balancing exercises," said CPTA member Amy Calhoun Sanchez, PT, DPT, CSCS, NSCA-CPT.
Sanchez is a doctor of physical therapy working in the outpatient rehabilitation department at a local Los Angeles hospital and provides pediatric home health care for developmentally delayed children.
"In the clinic setting, we treat patients with acute and chronic pain, those recovering from surgery or stroke and many other conditions with specific balance and strengthening exercises and manual therapy, and they respond to that," added Sanchez. "But the Wii sports games are interactive, fun and entertaining, and patients become more engaged playing with them. By teaching patients how to use the Wii in a clinic setting, we empower them to continue their exercise, fitness and training with the Wii Fitness in the comfort of their own homes."
While Sanchez emphasized Wii is helpful in preventing injuries and falls and increasing functionality, she cautions that anyone with undiagnosed pain or untreated injuries should refrain from using the Wii without professional guidance.
"Playing a Wii game too soon after an injury can be extremely harmful to a person's health and even set back recovery or lead to re-injury if he or she is not properly evaluated by a physical therapist first," said Sanchez. "A therapist will help to decrease pain and improve posture before recommending or advancing a Wii regimen tailored to the individual's specific needs."
Sanchez noted most physical therapy includes core stability training, but often it is difficult to teach people how to engage their core. "They tend to arch their backs and put too much weight on their heels in a way that causes further pain with movement."
"What's so great about the Wii is it allows a patient to know where the body is in space by showing real-time movements on a screen in simulated yoga, aerobics, strength training and balance exercises," stated Sanchez. "The Wii is the next best thing to simulating an environment on the golf course or tennis court, so we can see first hand what a person is doing wrong and correct that movement. The Wii makes for simple and fun therapy and, right now, is the coolest, new therapy around."
MoveCalifornia is a CPTA-sponsored statewide public education campaign designed to call attention to the importance of wellness and daily physical exercise and the unique role physical therapists play in these areas. For more information about MoveCalifornia, visit the MoveCalifornia Web site at http://www.movecalifornia.org.
SOURCE California Physical Therapy Association

Occupational therapists unite: Wiihabilitation is more fun than prescribed exercises!

15 October 2008, 05:31:21 | adiemusfree



As the proud possessor of a brand new Wii and WiiFit, I’m a convert to the addictive powers of the Wii. I’m not the only, and certainly not the first person to think of the rehabilitative potential of the Wii - in fact it’s been one of the most successful ‘cross-over’ toys that the computer geeks have come up with.

I am planning to use the Wii and WiiFit to study whether it can help develop balance, activity tolerance and especially increase proprioceptive awareness in people experiencing persistent pain and complex regional pain syndrome. There are clinical guidelines I’ve just discovered here at RehabCare who have produced a podcast covering clinical practice guidelines for using the Nintendo Wii. And I’ve just found an occupational therapist’s site called WiiHab!


I’ve had mine for two days now, I don’t want to admit to the number of hours I’ve spent on it (sad but true!), and there are a few quibbles about it for my purposes: the main problem with the WiiFit component is that it’s not modifiable so as a therapist I can’t select the exercises I want to prescribe for the people I work with; and I haven’t yet worked out how to transfer the cumulative graphical information into another format. But I do like the English (UK) instructors accent, and that it’s possible to view how to do the exercises from front or back. I also love the portability of it, and the relative lack of bits and pieces apart from the controller and WiiFit platform.

With a bit of tweaking from some geeky types, I’m sure it will be possible to modify the bits I’m less than happy with, or perhaps Nintendo will work out that this is a feature that it could provide in a ‘therapy-specific’ version of the programme. From the search I completed on Google just using the term ‘Wiihabilitation’ which came up with 9,920 hits, it seems clear that there is a demand for it within health and rehabilitation settings.

For pain management? Well apart from my specific study, I think the Wii has further application as an alternative to the many gym-based exercise programmes that are funded by major rehabilitation funders such as ACC or WorkCover.

To date there is no conclusive evidence that any specific fitness programme is superior to any other for the management of chronic pain (particularly low back pain), so it seems reasonable to think that any activity that is engaging, motivating and appeals to families might be able to be purchased or loaned as part of a pain management programme. Under the supervision of a therapist (occupational therapist or physiotherapist) a person with chronic pain can be guided through the process of gradually regulating their engagement in activity while at the same time learning how to integrate pain management skills.

It would be even more appropriate if the therapist can select and grade the level and type of activities the person uses. Hey, adding in a couple of biofeedback elements (like a heart rate monitor or skin conductance monitor) would make it even more useful!

The main concern I have with any exercise-focused pain management is that in the enthusiasm to engage in ‘fitness’ it becomes the goal rather than a means to develop activity tolerance, reduce avoidance, and a method for developing appropriately paced activity.

I think a time-limited loan or rental of something like the WiiFit could be a great way for someone to develop the skills until they move into the next phase of learning to live with chronic pain - returning to ‘normal’ activities. And if fitness or exercise becomes part of the person’s general pain management regime, and a Wii is something they use, it might be helpful. Of course, if they prefer to salsa dance, go rock climbing, trot around the shopping mall at full tilt, or perhaps go to a local tai chi class - then that might be a better option!

The main thing is that here is a gadget that is fun, well-accepted, and emininently modifiable. Oh, and it makes for team-building as well as family fun while the therapist/s are learning to use it!!

Flexible Fitness: Just a 'Wii' bit of exercise

By Lisa Brown

Just when the obesity crisis in the United States seems to be hitting its peak, who would have thought that a video game would come to our rescue? Haven't we been telling our kids to get off the couch and stop playing their video games?

A recent study published in the British Journal of Sports Medicine says that playing a new generation of virtual reality video games - such as the Nintendo Wii - will expend 65 percent more energy than playing a sedentary game.

The remote hand controls are used while interacting with your television screen. With the motion-sensitive remote, players can simulate active games such as baseball, boxing or even swimming. There are training modes for practice, and competitive modes to test your skill.

The journal goes on to caution that this does not burn as much energy as playing the actual sport, and does not meet the recommended daily amount of exercise, but it's a start.

In fact, these virtual reality gaming systems are demonstrating benefits well beyond the entertainment of the adolescent age group to whom they are marketed. The Nintendo Wii is being used in outpatient physical rehabilitation centers throughout the United States, with the term "Wii-habilitation" used as an adjunct to conventional physical therapy.

Maintaining balance on the Wii Fit board can be used to help an 18-year-old gain strength and improve sensory feedback after an ankle sprain as well as improve the standing balance of an 88-year-old whose goal is to be able to stand for a longer amount of time and reach for something without losing her balance.

The sometimes tedious and often boring exercises of physical rehabilitation are replaced with interactive games that also promote visual tracking, sequencing, coordination, range of motion, endurance and mental focus. Patients have an opportunity to be distracted from the pain or fear of falling, and are more motivated to participate in a program that is enjoyable.

Virtual reality devices are being used in a variety of settings. Hospitals are using virtual reality to promote relaxation and pain control in the emergency and operating rooms. Nursing homes and senior centers use the Wii as a social activity.

The Wii game system promotes movement and allows people who may not be able to hit a golf ball on an actual golf course to at least get a feel for the game on a virtual course. Scientific research has demonstrated that people with disabilities are able to learn with virtual systems, and that movements patterns obtained within the virtual system are carried over into the real world.

According to Beth Grill, an advanced physical therapist at Spaulding Framingham, "Use of the Wii has added another exciting dimension to our treatment of patients with orthopedic and neurological problems. Patients are having fun in therapy which only adds to their success."

Lisa Brown is an expert level physical therapist at Spaulding Framingham Outpatient Center. Lisa specializes in the treatment of patients with neurologic disorders, and is certified in the treatment of balance and vestibular disorders. If you have any questions about the use of virtual reality systems in rehab, Lisa can be contacted at lbrown12@partners.org, or by phone at 508-8720-2200, ext. 4428.

14 October 2008

Wii and Rehabilitation

Laura Schlobohm of Emporia enjoyed a game of bowling recently, cheering on her spares and attempting to coax the ball to hit the pins. Only Schlobohm wasn’t at a bowling alley. She was participating in Wii-habilitation and was one day from returning home from Newman Regional Health’s inpatient rehabilitation unit. The amazing thing: She had broken her hip just over two weeks earlier.

Part of Schlobohm’s rehabilitation exercises was to use the Nintendo Wii system, which is being used around the country not only for entertainment purposes but now for rehabilitation programs. The program is called Wii Fit and Wii Sport. The results are proven to speed up the rehabilitation process in patients who have had injuries or strokes, said Kim Bales, program director of Newman’s inpatient rehabilitation unit.

Bales said the whole purpose of inpatient rehabilitation is to get patients home and have them be as safe as possible when going home. The Wii system is another tool to work toward that goal. It’s now being used in several different wards for strengthening and balance.

Bales added that patients from 39 to 89 years old have enjoyed using the system. “Our average age is 79 that comes in (inpatient rehab) and they all love it (Wii).”

Dale Barb, a physical therapist at Newman, said there are many ways the Wii game system can be used in rehabilitation. Barb said the system helps patients practice tasks they will have to perform when they go home from the unit, including standing, balance and coordination.

The game helps patients stand longer and distracts them from the task at hand and gives them something fun to focus on, Barb explained as Schlobohm cheered in the background with her registered occupational therapist, Julia Gotchall.

“It’s fun,” Schlobohm said after she was done with her session. “I think it’s wonderful. It’s terrific exercise. It’s a wonderful program and the whole thing up here is wonderful.”

“My friends ask me if I can walk,” she said. “I said, ‘Run, no; walk, yes.”‘

12 October 2008

Cerebral Palsy and Physical Therapy





Visit http://www.cpdiscovery.com for more videos - When a child is diagnosed with Cerebral Palsy, a parent might wonder what's in store for them in terms of therapy. Which ones should they participate in? What is available? How long various interventions are expected to last?Noreen Scott is a Physical Therapist and owner of Tender Ones Therapy Services in Dacula, Georgia. She believes in the power of Physical Therapy when it comes to children with Cerebral Palsy."When we work with children with CP, our ultimate goal is for them to be as functional as they can possibly be and as independent. In order to be able to do those skills and be independent, you have to have the building blocks. What those building blocks are...are getting your range of motion through an acceptable amount, being flexible, being strong, having good balance...so that child can stand and walk and be independent on their own and as they grow older," says Noreen.In the following video report, Noreen explains how Cerebral Palsy affects children, goals associated with Physical Therapy, and how long parents should expect their child to see a Physical Therapist. For more information on Noreen Scott or Tender Ones Therapy Services, Inc: www.tenderones.comFor more information on CP related therapies: http://www.cpdiscovery.comFunding for CP Discovery is provided by http://www.rehabmart.com

Children with disability

Dr Sheila Shribman talks about how parents and health professionals can work together to support children with disability

Watch the video

Nintendo Wii Latest Tool in Physical Rehabilitation

Wiihabilitation




Patients use Wii video games for therapy, recovery from injury or surgery. Video shot by Herald-Times reporter Dann Denny

11 October 2008

Supported Holidays - Winter 2009

Winter Sun 2009


Due to popular demand we are offering for the first time the opportunity of some winter sun. Our winter sun ‘Supported Holidays’ are based on a 3 guests to 1 staff ratio. We are offering this package in addition to our all year round holidays in Nerja & Antequera.

This holiday suits the more active guest who are up for a laugh and a fun packed week. All activities are fully supervised. The weather on the coast for January, February & March is usually very mild (23 degrees). Access to the ski resorts is less than 1.5hrs drive it is therefore possible to lie on the beach and ski within the same week. Should a guest not wish to ski or toboggan it is possible to spend those days sight-seeing.

Itinerary as follows:


Wednesday Arrive at Malaga then in the evening have a meal and go to a show

Thursday Arrive at Sierra Nevada’s Ski Resort. Tobogganing & Skiing, then in the Evening there is a meal out and staying at Hotel in Granada


Friday Tobogganing & Skiing - back to the villa late evening.

Saturday - Natural Hot Springs at Alhama De Granada - Meal Out & Show

Sunday Day at the beach / pool for the Rest day - BBQ at the Villa and a live music show

Monday Gibraltar – St Maichael’s Caves - Cable Car Battlements

Tuesday Local Sight-seeing show and the a show in the evening

Wednesday
Depart

* The timetable is subject to availability and weather conditions.

Weeks available:

Jan 14 – 3 places remaining
Jan 28 – 3 places remaining
Feb 11 – 3 places remaining
Feb 25 – 3 places remaining
March 4 – 3 places remaining
March 11 – 3 places remaining

£999 per person fully inclusive + flight costs to Malaga (complete breakdown of the fully inclusive package available upon request in a separate email)

Please contact us for further details on the numbers or email address below.

Sue Osman

Supported Holidays

Camino De la Exotica No22
La Exotica
Nerja
Malaga
Spain
29780

www.SupportedHolidays.co.uk
info@supportedholidays.co.uk

0034 952521475

Holidays for People with Physical and / or Learning Disabilities.

We enable YOU to have the holidays YOU want by supporting YOU with YOUR needs!!

10 October 2008

Fan gets apology from Setanta

TELEVISION channel Setanta has apologised to a football fan with cerebral palsy after a call centre worker laughed at his speech problems.

Lee Kingsberry was trying to take out a new subscription to the pay-per-view sports channel after moving to a new flat.

The 23-year old says the person taking his call started laughing at him - and then hung up.

Lee said: "I wanted to watch the Man City versus Chelsea game. I know that the person who was on the line could understand what I was saying but he kept saying `What?' and `Sorry?'. We had been speaking for a few minutes and he started to laugh at me and put the phone down.

"I thought it was very inconsiderate and very unprofessional. If he had been trained professionally, he would have had a better understanding of how to speak to people. If you find it difficult to understand people you should say `I'm sorry, can you repeat that'."

The M.E.N contacted the sports station to point out Lee's appalling treatment. Managers listened to the recorded call and have now taken disciplinary action against the call handler. Station bosses have also offered Lee free subscription to the channel for a year.

A Setanta spokeswoman said: "We have dealt with the customer service agent who took Mr. Kingsberry's call and also spoken to him to apologise and offer him a 12 month free subscription.

"This is a matter that we have taken very seriously and we would not want this to happen again."

Lee uses a wheelchair and has speech difficulties because of his cerebral palsy - but he lives independently and enjoys clubbing and holidays to Ibiza.

The former pupil of Abraham Moss School in Crumpsall, Manchester, does voluntary work and has starred in a video about living with a disability. He is currently working on a TV documentary about nightlife in Manchester.

Cerebral palsy is a disorder which affects the parts of the brain that control movement - sufferers often find speaking difficult, but are not usually mentally impaired by the condition.

Lee says he is used to prejudice and offensive comments - but that his treatment on the phone was the last straw.

He said: "I'm used to people thinking that because my speech is slow that I'm not all there.

"People make judgments about me all the time but you expect a better level of service from a big company."

Rehab patients: Wii would like to get better

Deborah Thompson, a 62-year-old mother who thrives on heart-pounding challenges like mountain climbing and biking, can't stand video games.

"I hate them," she said. "My son plays them, but I think it's the worst waste of time."

But there she stood recently, cheering herself on and pumping her fist each time she scored a point against her computer opponent - the Wii.

Thompson is recovering from a nagging knee injury and is now taking part in the latest video game craze for her rehabilitation.

Under the supervision of physical therapist Wen-Chih Shih at Harvard Vanguard Medical Associates in Burlington, Thompson is one of about 40 patients who are boxing, bowling, playing tennis, golf, and baseball, all in the name of Wii-habilitation.

"It doesn't feel like work, and I guess that's the benefit," said Thompson of Lexington. "You can pretend you're Roger Federer."

Shih said she came up with the idea of using it for patients while playing her son's Nintendo Wii last winter. She did some research online and saw that she wasn't the only one who saw the game had potential to help her patients recover.

Across the nation, senior centers and rehabilitation centers are turning to the Wii to help the elderly improve balance and core muscle strength and patients heal from certain injuries. At the Littleton Senior Center, residents have even formed a weekly bowling league.

Though the Wii was developed for fun, Nintendo officials said they are thrilled the game is being used in other ways. They attribute the Wii's popularity to the fact that it's not intimidating to use and can be played with other people.

"We developed Wii to be a video game console that everyone could enjoy, regardless of their age, gender, or prior experience with video games," said Denise Kaigler, vice president of corporate affairs for Nintendo of America.

"We're glad that so many people are finding new ways to enjoy Wii and its games."

Shih said the interactive games force people to simulate the action they would make if they were playing the sport. Unlike traditional video games during which players sit in front of a screen, Wii players move around to swing the controller like a tennis racket, golf club, or bowling ball.

Shih said many of the games work on arm and shoulder movements, but other body parts can be worked as well. In tennis and bowling, for example, players must take steps similar to lunges, a traditional physical therapy exercise.

Now, when patients are far enough along in their rehabilitation to really work their bodies, Shih turns on the Wii for a tennis match instead of having them lunge back and forth across the room. She said it breaks up the monotony for both patients and therapists.

"If you swing, you automatically lunge," Shih said. "Instead of lunging five repetitions back and forth, they are actually doing something and getting feedback."

After a player completes a game or exercise, the Wii reports how he or she did and how to improve.

Shih said she thought the Wii would be a good motivating tool for teenagers, but it has worked well for all age groups - even those, like Thompson, who are adamantly opposed to video games.

"It's much more fun and you can keep challenging yourself," Thompson said. "To people who are used to exercising, it feels good."

Harvard Vanguard started the Wii-habilitation at its Burlington site, but Shih said she'd like to add it at other locations as space permits.

New England Rehabilitation Hospital at Billerica also started using the Wii during its physical therapy sessions about two months ago.

Joana Ingram, manager of the hospital's outpatient clinic, said about 50 patients have used the game and many have purchased one for their home.

The outpatient clinic, specializing in physical therapy, occupational therapy, and sports injuries, works primarily with the Wii Fit because it has a program that allows patients who have injured an ankle, for example, to work on regaining balance, Ingram said.

"It's been a wonderful thing for the patients," Ingram said. "It allows them to take their mind off their injury and be a kid by playing a game."

The Wii has also found its way into senior centers across the region, including Lexington, Littleton, Tewksbury, and, soon, Concord and North Andover.

Council on Aging officials said the Wii provides a way for seniors to get exercise and work on improving strength and balance, all in a fun, nonthreatening environment.

Donna Delaney, outreach coordinator for the senior center in North Andover, said seniors are looking forward to the new game.

She said the Wii will be available after the center completes its renovation project in the coming months.

"I understand there are a lot of good balance and coordination exercises for the seniors," Delaney said. "If they can improve their balance, they'll be more safe walking and have less falls and broken bones."

Concord also has a Wii that will be available for seniors later this month.

Lori Kalinoski, the program supervisor for the Concord Council on Aging, said many seniors are eager to try it because they've seen their children or grandchildren play video games.

Kalinoski said the center offers many exercise programs but the Wii will be another option for seniors who aren't interested in taking a high-impact class.

"It's a way of using new technology that's a nonthreatening way to have fun and get some exercise," she said. "It seems like it's a nice way to exercise."

The seniors in Littleton have been using the Wii since the spring after a high school student group did a project testing seniors' reflexes and reactions to different games. The seniors liked the games so much, the center bought its own.

Roberta Ware, 73, and three friends have formed an informal Wii bowling league.

"We're having a lot of fun with it, and it's great exercise," Ware said. "We play once a week here, and hopefully the group will grow."

Alex is on the road to freedom

by Andy Passant, Evening Gazette
LITTLE Alex Waters has a whole world to explore after getting a new set of wheels.
The three-year-old from Stockton has cerebral palsy, which means he has limited mobility.
But thanks to a new specially adapted tricycle he can now get out and about more with his mum, dad and older brother.
Alex has been given an £800 tricycle by national charity Caudwell Children.
The charity provides direct donations of treatments, therapies and specialist equipment to sick and disabled children throughout the UK.
It is hoped the tricycle will help Alex with his muscle tone and development, as well as stimulating his movement.
Mum Jacqui and dad Ian, of Coombe Way, Hartburn, Stockton, said they hoped it would make a real difference to Alex.
Ian, 41, Alex’s full-time carer, said: “He can’t walk, he just shuffles about. He is registered partially sighted as well.
“He is totally dependent on us really at the moment.”
He said Alex recently underwent brain surgery at London’s Great Ormond Street Hospital to stop him having epileptic fits.
Ian said: “He had very severe epilepsy. We are hoping he won’t have any more fits.”
Alex, who has limited verbal communication skills, has enjoyed using a similar tricycle at his nursery in Thornaby.
But his only means of transport at home has been his buggy.
Ian said: “He can get a bit frustrated. He knows what he wants but he can’t express himself like a normal three-year-old.”
Now he will be able to enjoy the benefits at home with his own bike.
He will be able to get out more with his parents and eight-year-old brother James, who goes to Holy Trinity School in Hartburn.
Ian said: “This donation will mean Alex can be included in more family activities. We can get out and about as we all have bikes.
“When everyone else is riding their bikes he can get irritated and doesn’t like sitting around much, so this will get him out and about and moving again.
“He will hopefully end up being able to use his legs more.”
Specially designed, the equipment meets vital physiotherapy needs.
Making friends and being involved in outdoor activities also play a crucial part in a child’s self-esteem.
Trudi Beswick, chief executive officer for Caudwell Children, said “The tricycles play a vital role in the inclusion and development of the child in question.
“It is not easy for a youngster with a disability to feel fully accepted by their peers, but the tricycle is often a great booster to make and engage with friends.
“We would encourage any other families in the area in need of a similar donation to contact the team on 0845 3001348.”

07 October 2008

The Mystery’s of the Brain


Interview with Dr David Loewenstein is a Professor of Psychiatry and Behavioral Sciences at the Miller School of Medicine at the University of Miami. He obtained his Ph.D. in clinical psychology from Florida State University and did a psychology internship at the University of Washington School of Medicine in Seattle, Washington. He is board certified in clinical neuropsychology. Dr. Loewenstein joined the faculty of the University of Miami in 1986. He is Director of Psychological Services and Neuropsychology Laboratories for the University of Miami Department of Psychiatry and is Director of Research and Neuropsychology for the Wien Center for Alzheimer’s Disease and Memory Disorders at Mount Sinai Medical Center in Miami Beach, Florida.Dr. Loewenstein is the author of almost 90 scientific journal articles and book chapters on aging, Alzheimer’s Disease, neuroimaging and diagnostic as well as cross-cultural issues in neuropsychology.


Susie Hi David
David Hi Susie - Just got back from Washington DC from my grant reviews. Good to be home!
Susie Good to have you back!!!!!
David Thanks! How are you
Susie I am fanatic
David Great!
Susie I seem to have moved another big milestone which I am pleased about
David Tell me
Susie it seems I have hit some new neuro issues that I haven’t before and have lots of questions that I would love to get answers too but we don’t know who to ask, even my physio is struggling a little to be able to answer my questions and understand what and why things are happening because she is not a neuro therapist she is a musculoskeletal and we both would love some answers but we don’t know where to go because it seems they are profound issues that we would both like to know more about or it maybe what I am asking and wanting to know might not have answers. it is hard and bit profound to explain but when u have a period of time when not too busy maybe u might be interested and point me in directions from your own field or maybe ask someone in the brain field for me I suppose you could say I been bursting to tell you but knew you were away and very busy.

David If you can, send me the questions in an e-mail to dloewenstein@att.net and I can see if I can be helpful. If I don't know or can't research the answers perhaps I can ask others.
Susie that would be cool if u could help us as I think I’m giving my physio nightmares because I like to know what’s happening and understand what’s going on but with this we can’t. As a result she has gone off to do some reading. It might be a long email if that’s ok
David No problem. Give me a couple of days to think about the questions.
Susie Oh its ok take as long as you need it might take a while for me to get it out of head and down on paper
David No problem.
Susie But this link might give u a little insight if I can get it up as strong as my mind is if we could possibly get some answers then I believe I might be a step closer to understanding Cerebral Palsy
David That would be terrific.
Susie It’s just like watching your baby take first steps I believe I am that close to understanding it, I just can’t touch it yet
http://www.livingwithcerebralpalsy.com/blogger/2008/09/in-gym.html
Is the link
David Let me check it out for a minute....
Susie This is the follow on http://www.livingwithcerebralpalsy.com/blogger/2008/09/sunday-is-my-rest-day.html
David Looks great! Probably outside of my area of expertise...
Susie
The main question is what is connecting to allow me to be able to walk one handed that hasn’t connected before now, and what has made it possible for it to connect. This is just one area of many questions I have asked and my Physio has gone off to read up on it. I suppose to start with it’s a case of knowing the brain function of what parts of the brain what functions is what I need to look at first.

David
I think that the question is a) have existing connections been altered; b) have other pathways been activated; c) is there some compensatory mechanisms that work around direct pathways or d) is it something else that has not been considered? We often see behaviour and infer changes that may or not occur in the brain. That is why functional neuroimaging such as MRI or PET scans (Positron emmssion) tomography would be the best way to see if there are any changes in brain activation in response to treatment or different therapies.
Susie The only problem is I am not sure if I can still have MRI scans
David Is that because of the magnet?
Susie Yes and the metal in my spine
David
Well, PET does not require a magnet but it is investigational for the brain and you would have to find someone that does it. It measures changes in brain oxygen or cerebral metabolism (how the brain is using glucose).
Susie Right, it just intrigues me and as I say it might just unlock the reasons for cerebral palsy, well in my opinion anyway.


David
Without measuring the brain directly, since everyone’s' brains are wired somewhat differently and because CP has many manifestations in the brain, it would be difficult to isolate neural mechanisms. However, it something works for someone, which is very important! Just harder to understand why...
Susie yes I can understand that because the next question would be from that , would be if it works for one how easy would it be to manipulate it so that all types of CP gets results? And if it could be then we have unlocked it
David
I think one would first have to show that a treatment generalizes to several individuals with a specific type of CP, comparing it to an adequate control condition.
Susie
Yes you read my mind there because I was thinking of saying all forms - so all with Spastic Diplegia and so on
David
In a number of studies things work for a few people but do not generalize to the group as a whole. So even with one form, there may be high responders, medium responders and no responders. So the first step would be to see what the high responders have in common.
Susie because technically according to most of the books I have looked at most of them say in diplegia say only certain limbs effected now in reality it does differ
David
Yes and in ages
Susie
To see if say I had had this stimulation for want of a better word at the age of Rachel say, would the same things of happened or is it because I’m older it’s happened. Now my mind says would have been better at Rachel’s age because I would be more receptive at that age but I don’t know. As a result this leads to me asking or explaining that I felt as though my cp had gone and there is some evidence of this in me, in that I am moving better and I no loner have the spasticity etc


David
That is why it is so important to have a controlled study with pre and post measures with a control group and persons that are relatively homogeneous for a condition. Age has a tremendous effect because brain plasticity is much greater than when you are younger. When the radiologist sees the white-matter damage in Rachel, he is amazed that her cp is not worse... but she worked around the deficits by rewiring part of her brain
Susie But my Physio also say’s it is because I perceive it differently to how I did ten yrs ago when I first met her and I also agree.
David
Exactly. CP by definition is a poorly described term. It merely describes motor system impairments that result from central nervous system deficits at birth. EEG is another way I forgot to mention in looking at brain function. Structural MRI only looks at the structure of the brain... it does not measure functional connectivity.
Susie
I doubt I will never fully understand it but I would like to give it ago
David
It is a very complicated area indeed. As a scientist, I lead my whole life looking for break-troughs and if I am lucky. An experiment will yield some better understanding but never explain the whole complexity of memory disorders. However, I think that if you don't ask questions, you never get answers so I am pleased that you are investigating this! If it were memory disorders, I probably could be more helpful...
Susie
You see years ago this never crossed my mind but in last three years I have wanted to know
David
The brain is the great unsolved mystery of the universe! Keep searching... whatever you find, the journey itself is often worth it for a bright, curious mind so this then leads to the question as something connecting in the part of brain that’s responsible for learning
Susie Yes which then asks what’s made we curious all of a sudden

David
Of course motor and procedural memory is modulated by the basal ganglia system, episodic memory is mediated by the hippocampus and they all work together in complex feedback loops. It just blows my mind!
Susie
Yes so you see that cp is governed by memory isn’t it for example I am able to put one foot in front of other so to speak and somewhere my brain remembers this
David
That is procedural or motor memory. These are automatic programs modulated by the deep frontal lobe systems, most notably the basal ganglia and putamen.
Susie
But in some conditions they start off automatic and then switch off like patients with Alzheimer’s
David
But interestingly enough, Alzheimer's patients do not lose these abilities until very late in the disease. They lose short-term memory which is mediated by the hippocampus and related structures. So there are many different types of memory...
Susie
The reason is mention this is my uncle in Canada has just passed away from this
David
Very sorry to hear this...
Susie he was able to walk and then gradually because wheelchair dependant although this also interestingly wonders ok they might switch off so to speak gradually but then does this happen in older age anyway, but is maybe accelerated in people who have a underlying condition ? I suppose it works the other way?? In people who are always in a wheelchair.
David
What happens in Alzheimer's is that as the disease progresses it starts encroaching on these procedural memory structures and kills brain cells and their connections. However, the recent memory deficits precede this by as much as decades. A good model for older people in the basal ganglia system is Parkinson's Disease.
Susie
The procedural memory isn’t triggered so person isn’t able to walk because maybe the cell has already died from birth or maybe this is missing in some people in the genetic structure, like when people have a missing chromosome oh wow this is amazing stuff for me
David
In every disease, something attacks the neuron, the dendrite connections to other neurons and neurotransmitters. In some cases, the primary motor neurons are damaged and there is not motor function. In other cases, the modulating system like the basal ganglia does not properly use signals. In MS, it is actually demyelisation of the axons so the nerve impulses are not transmitted. Thus, brain dysfunction can occur because of cell damage, dedritic thinning or damage. Neurotransmitter difficulties etc. It is like a very complicated car engine. So many things can happen that will make the car fail to run 1) no gas; 2) damaged engine; 3) no starter; 4) loose wires etc.
The brain is simply the most complex and wondrous organ in the body. There is so much we have yet to understand. It is important to ask the right questions as you are...

Susie
So in CP the brain is full of loose wires and it hasn’t worked out where they are to go to
David
Could be... or damaged areas or areas that are damaged in their connectivity in some way...
Susie And it kind of wires them wrongly and sort of fuses them but in some areas they do wire properly and the motor fires up when the oxygen gets through.
David
Or the brain tries its best to rewire around the deficits to the best of its capability. The younger you are, the easier it is to rewire although plasticity can occur when one is older...
Susie So it’s a bit like a pinball machine
David
The question is that with billions of brain cells and over a trillion connections how can be best understand what happens...

Susie
In that you have the ball at the start and you pull the plunger and it fires it up and hits the sensors, So that it's like a message is getting sent and it hits the sensors the lights come on and connect And sometimes it fails and drops through the flippers

David That a good analogy. Now consider that every sensor is dependent on the integrity of every other sensor. You can have a malfunction at any point in the pathway.
Susie and sometimes if the timing is correct it flips it back and tries reconnecting the ball jams along the pathway and it needs a nudge to getting it going and that might be a hand or leg movement
David Exactly, and it can reset in some circumstances. It is like an intermittent problem. For some persons, if the primary sensors are deficient however, resetting is very difficult.
Susie Or your lungs inflating to force air back to nudge it and the harder u pull the plunger the further the ball/message goes.
David Thus, some persons may have more or less problems resetting or even setting at all relative to the extent of their problems. You can put all the gasoline that you want in a car, if it lacks certain mechanism it is not going to start no matter what you do. In certain cases you can help it to turn over.
Susie
Therefore stimulating the primary sensor
David
The messages that are sent by the brain are not only one way; they are always self-modulating and often reciprocal.

Susie
Yes and it’s the reciprocal nature that kind of stimulates the primary sensor? Because sometimes no matter how many times you use the flippers the ball still fails

David
Thus, I would expect the efficacy of any therapy to be dependent on a) the integrity structures that are involved; b) the communications between structures. You are right; there are feedback loops all along the way. Different therapies may target different structures or functional subsystems of the brain. We have long known that aspirin is effective only recently have we understood why. The only way to think about new things is to explore all the possibilities. You are very intelligent and I enjoy how you frame this.

05 October 2008

Typewriter Art - Can you believe that this art was created using a typewriter?

Paul Smith, the man with extraordinary talent was born in Philadelphia on September 21, 1921 with severe cerebral palsy.

Not only had Paul beaten the odds of a life with spastic cerebral palsy, a disability that impeded his speech & mobility but also taught himself to become a master artist as well as a terrific chess player even after being devoid of a formal education as a child.



"When typing, Paul used his left hand to steady his right one. Since he couldn't press two keys at the same time, he almost always lo cked the shift key down and made his pictures using the symbols at the top of the number keys. In other words, his pictures were based on these characters .... @ # $ % ^ & * ( ) _ .

Across seven decades, Paul created hundreds of pictures. He often gave the originals away. Sometimes, but not always, he kept or received a copy for his own records.

As his mastery of the typewriter grew, he developed techniques to create shadings, colors, and textures that made his work resemble pencil or charcoal drawings."

This great man passed away on June 25, 2007, but left behind a collection of his amazing artwork that will be an inspiration for many.

Bowling Power Throws

Earned a silver medal - 519 points

Returning Balls

Earned a silver medal - 26 points

Swing Control

Earned a bronze medal - with 34 points

Working the bag

Earned a bronze medal - 23 points

Baseball Hitting Home Runs

Earned silver medal with 9 hommers - 1532 Metres!!!!!!

My Personal Results with Wii

I have been using my Wii for about a month now and I thought I would share some of my results

Surgeons Hone Skills on Nintendo Wii

by Jacob Goldstein

Don’t worry about that guy about to operate on your gallbladder. He trained on the Wii.

According to a very small, very preliminary study, playing certain video games on the Nintendo Wii helps surgical residents to hone their fine motor skills and improve their performance on a serious surgery simulator.

OK, so a simple video game helps these docs with a slightly more complicated one. But bear with us here because the more sophisticated simulator is the sort of thing that’s used right now to help doctors do a better job on keyhole surgery using tiny instruments outfitted with video cameras.

Improvements in simulator performance didn’t come from just any Wii (see image), or any game. Marble Mania is good, for example. Tennis (astonishingly fun to play on the Wii, which uses a motion-sensitive wireless control) isn’t so helpful. “The key is to have subtle hand movements,” Kanav Kahol one of the authors of the study, told the Health Blog. “You can’t hit a tennis swing and expect to become a better surgeon. You need fine motor control.”

Kahol, a biomedical informatics expert affiliated with Arizona State and a hospital chain called Banner Health, worked with Marshall Smith, a Banner surgeon, to see if playing the Wii (Wii-ing?) improved residents’ scores on a standard simulator for minimally invasive, or laparoscopic, surgery.

So they bought a standard golf-club add on for the Wii (”It was like 10 bucks,” Kahol said) then cut off most of the golf club and added a laparoscopic probe (their creation is shown in the picture, above).

Out of a group of 16 residents, eight were assigned to play the Wii (Marble Mania and a suite of games called Wii Play), with the specially-rigged controller. The other eight didn’t get to play. Then all 16 did a simulated laparoscopic procedure (something having to do with a simulated gallbladder).

The ones who had played the Wii showed 48% more improvement on the procedure than those who hadn’t, according to a standard score that measures performance on the simulation, Kahol said. They plan to present the results at the Medicine Meets Virtual Reality conference in a couple weeks.

Next, Kahol and Smith plan to develop a full-blown surgery simulator for the Wii. Among other things, it would allow residents, forced by work-hour caps to spend more time outside the hospital, to practice surgery while they’re at home.

In the meantime at Smith’s hospital there’s a Wii in the room where residents take cat naps while they’re on call. We asked if the residents get competitive about the Wii. “They’re surgery residents, what do you expect?” Smith said

Wii Fit Nintendo game makes physical therapy fun



by jmorona

Thomas Ondrey/The Plain DealerRecovering stroke patient Marilyn Smigelski gets into the rhythm of a Wii Fit hula game with the help of physical therapist Nancy Ditzel at LakeEast Hospital in Painesville. Fit is used in conjunction with other therapy modalities.

Physical therapy is best served with a little camaraderie and light conversation, but therapist Nancy Ditzel also dished out some fun to recovering stroke patient Marilyn Smigelski recently.

The LakeEast Hospital therapist put Smigelski to work on the latest Nintendo Wii video system game, called Fit. While the American Physical Therapy Association magazine recently reported widespread use among members of Wii games that simulate sports like tennis and bowling, the Lake hospital system is the first locally to use the Fit game in physical therapy.

The $90 Fit game -- a white plastic platform motion detector operated through a $250 Nintendo Wii console -- translates a person's real-time movements onto a screen and offers 40 activities in yoga, aerobics, strength training and balance, many appropriate for therapy, Ditzel said. And with so many possibilities, therapists can tailor patient sessions, monitoring carefully to avoid the overuse common with Wii's simulated sports.

Ditzel's hoping that even patients who cannot walk or stand will also get in on the fun by sitting on the platform, called a balance board. That application has yet to be tested, though patients in wheelchairs already can use some Wii sporting games.

The game is also useful in occupational therapy, which helps patients relearn daily living skills, like getting dressed.

In addition to weakness in her right side, Smigelski, a retired ICU nurse, is frustrated by double vision. But she persevered, using her balance to steer a bubble down a river without bumping into the river bank and, later, to head-butt virtual soccer balls while dodging shoes and helmets.

She was also challenged to keep a penguin from sliding off an ice floe while helping him catch fish jumping out of the water. The fish are assigned different values based on color, so a laughing Smigelski could see her improvement in successive games.

"There's a learning curve," said Ditzel, firmly clutching a safety belt encircling Smigelski's middle. "The average person isn't excellent right away."

The Hula-Hoop game was the most physically demanding, requiring Smigelski to swivel her hips like she was using one of the toys. Slowing down too much caused the hoop to fall, thus ending the game, while speeding up increased her score, as well as her heart rate. And when another hoop was virtually thrown her way, she had to lean to the left or the right to catch it with her whole body and then resume her swiveling.

"Get those hips going! Big circles! Big circles," Ditzel coached.

Dressed for action in khaki shorts and running shoes, Smigelski was panting after a few rounds and just a tad embarrassed that some patients and staff had clustered to watch her.

"In my 15 years as a therapist, it's the coolest thing to come along," Ditzel said. "It's an interactive fun adjunct to conventional therapy."

At Smigelski's urging, Ditzel took a turn at the Hula-Hoop game. When she finished a lively performance that drew cheers from spectators, she felt for her pulse in her neck and pronounced the activity "aerobic."

The games are most challenging to patients unfamiliar with video games and computers.

"They're timid and unsure of themselves," Ditzel said. But once patients are up and running, they're happy. "Time passes quickly, and it's not drudgery. If they're scared, they forget they're doing something fearful."

Lake physical therapist Chris Haladyna said the Fit has gotten good reviews from her patients, too. "It's work, but it's fun. One grandpa bought one for home after he was discharged."

The game is slowly making its way into physical therapy around the country, said Lisa Rubin Falkenberg, the hospital's system's director of rehabilitation. She ordered it on a hunch in March, a couple months before its release, and has been delighted with the outcome.

Thomas Ondrey/The Plain DealerMarilyn Smigelski gets into the rhythm of a Wii Fit exercise under the guidance of physical therapist Nancy Ditzel at LakeEast Hospital.
"It's a way to make rehab less tedious. You're not counting repetitions. You're playing a game," she said. "The patients love it. And the therapists are thrilled with it." She plans to purchase it for the hospital's other sites.
Because Wii Fit lets the patient see how they affect the game by changing their balance, a therapist can better explain center of gravity and help patients use that knowledge. Most people in rehab have balance problems, Rubin Falkenberg said.

"Stroke patients are afraid to shift their weight. They can have a weakness on one side of their body, so they lean toward their 'good side,' and therapists are always trying to straighten them up. It's easier when they have feedback like Wii."

If she hadn't pre-ordered the game, she probably still would be waiting to buy one. They've been in very short supply, said Tom Vitko, gaming supervisor at Best Buy, Brookpark Road, Cleveland.

In the first three weeks that they were available, only 100 were delivered to the store. "The same with the Wii consoles," he said. "They're not in our warehouse. They're always on order. We have people waiting when the store opens, looking for Wiis."

It doesn't help to be a Best Buy employee. You'd still have to wait in line, Vitko said, and be "off the clock."

Wii-therapy

New Form of Physical Therapy

By Lindsey Tanner,

CHICAGO (AP) -- Some call it "Wiihabilitation.''Nintendo's Wii video game system, whose popularity already extends beyond theteen gaming set, is fast becoming a craze in rehab therapy for patientsrecovering from strokes, broken bones, surgery and even combat injuries.

The usual stretching and lifting exercises that help thesick or injured regain strength can be painful, repetitive and downrightboring.

In fact, many patients say PT -- physical therapy'snickname -- really stands for "pain and torture,'' said James Osborn, whooversees rehabilitation services at Herrin Hospital in southern Illinois.

Using the game console's unique, motion-sensitivecontroller, Wii games require body movements similar to traditional therapyexercises. But patients become so engrossed mentally they're almost obliviousto the rigor, Osborn said.

"In the Wii system, because it's kind of a gameformat, it does create this kind of inner competitiveness. Even though you maybe boxing or playing tennis against some figure on the screen, it's amazing howmany of our patients want to beat their opponent,'' said Osborn of SouthernIllinois Healthcare, which includes the hospital in Herrin. The hospital, about100 miles southeast of St. Louis, bought a Wii system for rehab patients latelast year.

"When people can refocus their attention from thetediousness of the physical task, oftentimes they do much better,'' Osbornsaid.

Nintendo Co. doesn't market Wii's potential use inphysical therapy, but company representative Anka Dolecki said, "We are happyto see that people are finding added benefit in rehabilitation.''

The most popular Wii games in rehab involve sports --baseball, bowling, boxing, golf and tennis. Using the same arm swings requiredby those sports, players wave a wireless controller that directs the actions ofanimated athletes on the screen.

The Hines Veterans Affairs Hospital west of Chicagorecently bought a Wii system for its spinal cord injury unit.



Pfc. Matthew Turpen, 22, paralyzed from the chest down ina car accident last year while stationed in Germany, plays Wii golf and bowlingfrom his wheelchair at Hines. The Des Moines, Iowa, native says the games helpbeat the monotony of rehab and seem to be doing his body good, too.

"A lot of guys don't have full finger function so itdefinitely helps being able to work on using your fingers more and figuring outdifferent ways to use your hands'' and arms, Turpen said.

At Walter Reed Army Medical Center, the therapy iswell-suited to patients injured during combat in Iraq, who tend to be in the 19to 25 age range -- a group that's "very into'' playing video games, saidLt. Col. Stephanie Daugherty, Walter Reed's chief of occupational therapy.

"They think it's for entertainment, but we know it'sfor therapy,'' she said.

It's useful in occupational therapy, which helps patientsrelearn daily living skills including brushing teeth, combing hair andfastening clothes, Daugherty said.

WakeMed Health has been using Wii games at its Raleigh,N.C., hospital for patients as young as 9 "all the way up to people intheir 80s,'' said therapist Elizabeth Penny.

"They're getting improved endurance, strength,coordination. I think it's very entertaining for them,'' Penny said.

"It really helps the body to loosen up so it can dowhat it's supposed to do,'' said Billy Perry, 64, a retired Raleigh policeofficer. He received Wii therapy at WakeMed after suffering a stroke onChristmas Eve.

Perry said he'd seen his grandchildren play Wii games andwas excited when a hospital therapist suggested he try it.

He said Wii tennis and boxing helped him regain strengthand feeling in his left arm.

"It's enjoyable. I know I'm going to participatewith my grandkids more when I go visit them,'' Perry said.

While there's plenty of anecdotal evidence that Wii gameshelp in rehab, researcher Lars Oddsson wants to put the games to a real test.

Oddsson is director of the Sister Kenny Research Centerat Abbott Northwestern Hospital in Minneapolis. The center bought a Wii systemlast summer and is working with the University of Minnesota to design a studythat will measure patients' function "before and after this 'Wiihab,' assomeone called it,'' Oddsson said.

"You can certainly make a case that some form ofendurance related to strength and flexibility and balance and cardio would bechallenged when you play the Wii,'' but hard scientific proof is needed toprove it, Oddsson said.

Meantime, Dr. Julio Bonis of Madrid says he has proofthat playing Wii games can have physical effects of another kind.

Bonis calls it acute "Wiiitis'' -- a condition hesays he developed last year after spending several hours playing the Wii tennisgame.

Bonis described his ailment in a letter to the NewEngland Journal of Medicine -- intense pain in his right shoulder that acolleague diagnosed as acute tendonitis, a not uncommon affliction amongplayers of real-life tennis.

Bonis said he recovered after a week of ibuprofen and noWii, and urged doctors to be aware of Wii overuse.

Still, as a Wii fan, he said in an e-mail that he couldimagine more moderate use would be helpful in physical therapy "because ofthe motivation that the game can provide to the patient.''

Wii Therapy And Exercise

The Wii is all about innovation and opening up gaming to a whole new audience. With the console now being used for exercise and therapy, has it gone beyond Nintendo’s wildest expectations?

Simple answer to the question, yes. When Nintendo started bleating on about the Wii a couple of years ago they constantly talked about expanding the gaming horizon. They wanted to get new people playing videogames and to create a system with a hugely varied userbase. What they’ve got, is a cultural revolution. When something catches the imagination of the world like the Wii has it tends to get some fairly interesting press.

The other day a story popped up about how the Wii is being used by the US Army as a means of healing the wounded. Never in Nintendo’s wildest dreams could Nintendo have expected this. Over the last few months we’ve seen it being used in old folks homes, as part of exercise regimes and even as a method of shedding the pounds to get into shape. All of these cases have demonstrated one thing: the Wii can move beyond the videogames industry and into wider culture. Once there, the world of ‘self help’ is its oyster. Fitness and gadgetry are two of the biggest obsessions in Western culture, and the Wii is able to tap into both. The media has an obsession with telling us how we can get fit and healthy and there are always new and ‘exciting’ ways of doing so popping up. The Wii is perhaps the biggest new entry on the scene.

At the Sedgebrook retirement community in Lincolnshire (USA), where the average age is 77. A report in the Chicago Tribune details how the residents, most of whom have never picked up a video game controller in their life, are turning to the Wii for entertainment.

"I've never been into video games," said 72-year-old Flora Dierbach last week as her husband took a twirl with the Nintendo Wii's bowling game. "But this is addictive...They come in after dinner and play," she said. "Sometimes, on Saturday afternoons, their grandkids come play with them. A lot of grandparents are being taught by their grandkids. But, now, some grandparents are instead teaching their grandkids." Sunday afternoon at the home is now all about the Wii. This sort of thing is great publicity for the Wii.

Over the years the industry has gotten some very bad press, but feel good stories about the Wii bringing together kids and grandkids and helping keep the eldery healthy and entertained is a glowing endorsement of what Nintendo are doing. It would seem that in one swift move, all the negative stigmas about gaming in the mainstream press have somewhat been ebbed away.

In an article published on the online version of the US military newspaper Stars and Stripes, it has been revealed that in certain cases the Wii can prove to be a useful tool for healing the wounded. Army Spc. Shawn Roberts who is assigned to the 581st Signal Company in Kuwait, volunteered to use the game as part of his therapy routine. The Wii is being used to help him regain full movement after he broke his wrist and elbow and partially tore his rotator cuff when the vehicle he was in rolled over. He couldn’t move his wrist for more than a month because of the screws holding it together.

“I wasn’t expecting much out of it,” said Roberts after using the game. “You know, it’s a video game. How much could it really do? But you don’t notice it while you’re doing it because your mind’s on the game. But then when you’re done? I was sore....I do all the same exercises, but with the Wii, your mind’s off of it, and you do it a lot more. It’s more fast paced and that kind of thing.”

Staff Sgt. Bryan Vallerie, an occupational therapy technician, said the game wouldn’t replace anything in the department’s physical therapy repertoire but could enhance treatment for some patients. “It’s a healthy, fun alternative to doing these things,” he said. The department are going to analyse the results of using the Wii for therapy. The advantage of using the system, they claim, is that it gets rid of the monotonous tedium of physical therapy. With the Wii, you’re doing the exercise but at the same time you’re having fun.

The most detailed analysis of the Wii’s impact on personal health came thanks to one man’s idea to use the Wii to get into shape. Entitled the ‘Wii Sports Experiment’, it aimed to prove that playing Wii was a viable method of exercise. Mickey DeLorenzo, a 25-year-old living in Philadelphia, decided to meld exercise and gaming together and form a full report on what he found. The blog he kept attracted a huge amount of interest from publications such as the New York Times, CNN, the BBC, TIME, The LA Times, The Sydney Morning Herald and also on TV through FOX and NBC. The media circus that surrounded one mildly plump man playing Wii to get a bit more toned was somewhat ridiculous. But it worked. Mr. DeLorenzo got into shape, lost 9lbs, his body fat percentage went down from 19% to 17.2% and his body mass index (BMI) went from 25.2 to 24.0. The full results of the experiment can be read through here:

http://wiinintendo.net/2007/01/15/wi...iment-results/.

So what does all this tell us? Well, whilst industry analysts go on about how the Wii is making a huge difference to the demographic of the gaming market and Nintendo drone on about how many units they are selling, perhaps this is the real story of the Wii. It is a cultural phenomenon, albeit a somewhat brief one so far, and it is really making a difference. Little by little the Wii is changing the world...sort of.