Nordic Walking Poles Are Helping Many with Balance and Stability Issues - Including Many of Our Recovering War Heroes

When a thank you letter arrived from The American Red Cross for the one-piece Nordic Walking Poles that were donated to Walter Reed Veterans Hospital by SkiWalking.com and The American Nordic Walking System it was one of hundreds of confirmations that one-piece Nordic Walking poles prove to be safer, lighter and much more durable than twist-locking adjustable length/telescoping/collapsible poles.

Glen Arbor, MI, April 15, 2009 ---- Nordic Walking instructor, running and ski coach, Pete Edwards, discovered five years ago that Nordic Walking Poles were not just for expert skiers deprived of snow, but doubled as an aid for those with balance and stability issues. He started volunteering to host free Nordic Walking Clinics at Multiple Sclerosis (MS), Parkinson's (PD) and Diabetes support group meetings. A couple years later he donated dozens of pairs of durable one-piece Nordic Walking poles to Walter Reed Veterans Hospital in Washington, DC. He has also shipped free Nordic Walking poles directly to injured soldiers returning from Iraq and Afghanistan after talking to their spouses and/or parents. Family members, doctors and physical therapists have been amazed by the improvement in posture, balance, stability and gate thanks to the use of Nordic Walking Poles in the correct lengths.For over 25 years Edwards has been coaching runners and skiers. His skiers have been ski walking and hill bounding with poles during the warmer months when snow could not be found.

After a knee injury ended his marathon running career, his Nordic Walking Poles saved the day – allowing Edwards to Nordic Walk and even Nordic Run (running with poles) pain free.Using the perfect length Nordic Walking Poles helps us to automatically walk with a super straight back - better walking posture is biomechanically a good thing. This improved walking posture when combined with the unique 4-Wheel-Drive type action of walking with poles radically reduces the stress to the shins, knees, hips and back. Nordic Walking is low impact and yet provides a highly effective workout - burning more calories and working more muscle groups than regular walking.Nordic Walking has been the fastest growing fitness activity in Europe for several years. Over seven million Europeans are walking with poles - in the city, in the country and up in the mountains. Walking with poles helps to burn more calories than regular walking, improves balance/stability, radically reduces the stress to the weight bearing joints and provides a workout for your upper body by engaging your arms and legs – a lot like cross country skiing.Nordic Walking’s winning combination of improved posture, a unique 4-Wheel-Drive type action and shock absorbing benefits are helping many individuals to walk comfortably again.

Nordic Walking Poles are helping individuals with balance issues, knee issues or new knees, hip issues or new hips, back issues (including those with rods in their back), weight issues, multiple sclerosis (MS), parkinson’s disease (PD), neuropathy, arthritis, bursitis, scoliosis, lumbar stenosis, fibromyalgia, post polio, osteoporosis, stroke recovery, cancer recovery and other limitations to walking. Nordic Walking poles are helping thousands of Americans get off the couch, successfully get outside, start walking safely and effectively launch much needed walking campaigns.Individuals that use canes and/or walkers often find that Nordic Walking Poles are much more comfortable and stable than their canes or walkers. Individuals that find pushing a shopping cart comfortable find that Nordic Walking poles provide even more support and much improved balance, stability and versatility. The feedback from amputees, individuals with head trauma and others with balance issues is consistent – the poles really do improve balance and stability.From a fitness standpoint, walking with the correct length poles and proper technique can burn up to 40% more calories than regular walking. Walking with Nordic Walking Poles can turbo charge any walking campaign.Real Nordic Walking Poles are equipped with comfortable fingerless glove type straps, durable metal tips (for use on trails, the beach, snow and ice) and special rubber tips/paws that are removable and designed for use on pavement and other hard surfaces. All poles from http://www.skiwalking.com/ and The American Nordic Walking System are also equipped with patented straps (patented by the Salomon Ski Company).Thanks to the efforts of Pete Edwards, SkiWalking.com and The American Nordic Walking System, individuals of All ages and All fitness levels, are safely unlocking the calorie burning and aerobic benefits of walking, hiking, trekking and running with poles. These durable one-piece poles prove to be safer, lighter and much more durable than cheap twist-locking adjustable length/telescoping/collapsible poles. Nordic Walking Poles from SkiWalking.com and The American Nordic Walking System also includes a free Nordic Walking DVD and there are a variety of exertion options to choose from regardless of age, balance and/or fitness level.

Years of pain - but Neurofibromatosis sufferer Kirsty Ashton just wants to help our kids

Years of pain - but Neurofibromatosis sufferer Kirsty Ashton just wants to help our kids

By Mandy Appleyard

Kirsty Ashton has had years of surgery to battle an incurable disease. But instead of feeling sorry for herself, she raised £75,000 to make other children’s wishes come true.

Like any 18-year-old, Kirsty Ashton is full of dreams for the future. She’s hoping to go to university soon, then to become an actress, a model or a TV presenter.
But Kirsty has already seen more of life and confronted more of its challenges than most of us ever will.

Kirsty needs crutches to walk far. She has been in hospital countless times, undergoing surgery every year since she was 14.

A lot of the time she’s in severe pain and her body bears the scars from operation after operation to remove tumours from her neck, legs, knees, ankles and feet.
She takes a cocktail of drugs every day, has physiotherapy every week and has some learning difficulties.

But Kirsty shows not a trace of self-pity. In fact she finds time to raise thousands of pounds so that other children with serious illnesses, often terminal, can visit special places like Lapland and Center Parcs.

She says: “I just want to do something for other people. Helping others is what makes me happy.”

Kirsty, who lives with her family in Wythenshawe, Manchester, has every reason to be angry at life, but she isn’t.

She was 11 weeks old when she was diagnosed with neurofibromatosis (NF) – a genetic disorder which can cause multiple tumours to grow on nerve endings on or inside the body.

It affects the nervous system and can even lead to an earlier death.
Her mum Julie, 49, explains: “I have NF but less severely than Kirsty. I knew there was a 50-50 chance of passing it on so when my first child Christopher was born, it was a relief that he was clear.

“But as soon as Kirsty was born I noticed brown patches on her skin, which is a symptom, and a small tumour on her back.”

Despite the diagnosis, life went on as normal until Kirsty was eight, when a check-up revealed curvature in her spine and she was diagnosed with scoliosis. Tumours growing on her spine were pushing it to one side.

It was bad news. But Kirsty and her family didn’t give up.

“In fact my brother Chris knew I’d always wanted to go to Lapland,” Kirsty says. “He said I had been so brave that he wrote to When You Wish Upon A Star – a charity that makes dreams come true for children with life-threatening illnesses – and told them about me.

“I had a great day and I met a girl there that I really liked but she passed away not long after we got back. That’s when I realised that without the charity she would never have got to see Lapland in her short life.”

Julie adds: “The trip really moved Kirsty. She went with her dad John and saw children with cancer and terrible conditions.”

Kirsty decided to start helping local charities, selling bric-a-brac and giving the money to charity.

Meanwhile she still had to deal with her own disease.
When she was nine she started wearing a Boston Brace 23 hours a day to help support her back and ease the pain.

A hard “jacket” reaching from the top of the chest to the bottom of the hips, it was hot and uncomfortable. But Kirsty amazed doctors with how quickly she got used to it, and she wore it permanently for the next six years.

“Kirsty had to have major surgery at 14, where the surgeon put titanium rods into her spine to straighten it,” Julie says.

“Removing the tumours was too risky because of the danger of paralysis so the rods were seen as the next best thing. But even the surgery could have paralysed her.”
She spent two weeks flat on her back and three months in hospital – yet still she stuck to her mission to make life easier for other sick children.

In the past three years she has raised an incredible £73,740 for When You Wish Upon A Star. Kirsty explains: “I organised a charity ball which raised £24,801 and a Valentine’s ball which raised £23,000. I did a sponsored spell – because I’m dyslexic and thought it would be a challenge – in my lunch hour and raised £170.”
She’s also sold home-made Christmas cards, organised a rugby tournament and sold more than 800 pin badges.

A total of 94 children have been able to travel to Lapland in the last three years as a result of Kirsty’s fund-raising.

But Kirsty, who has written a book about her struggle with NF and is now looking for a publisher, has no intention of stopping there.

“I want to raise a further £75,000 in the next year to send 30 to 40 families to Center Parcs with children who are too poorly to fly.”

Maria Moseley, the charity’s events manager, says: “Kirsty is an amazing young lady. She is our own fairy godmother – and she’s a fantastic role model to other young people. She helps make magical memories for some courageous children.”
And Kirsty’s own battle goes on. She has endured serious surgery every year for the last four years.

Each time she’s had five tumours removed and has been left with three particularly severe scars on her back.

Her mum says: “Neurofibromatosis can be very cruel and we don’t know whether her life expectancy will be impaired.

“But Kirsty’s a very bright and happy child in spite of all the
challenges she faces.

“She never complains and is always thinking of other poorly children.
“She’s one in a million – I love her more than words can say.”

Kirsty’s wish... to be a model
We treated Kirsty to a day living her dream – to be a model.
Courtesy of the Mirror, the young campaigner was whisked to our photographic studios in London, where a top stylist was waiting to meet her.
She was given a luxury makeover before strutting her stuff in front of the camera – producing a portfolio of shots.

She says: “I loved every minute of the day, it was brilliant from start to finish.
“Having my make-up done, and trying on all of the clothes made me feel like a real model.

“The photos are great and I’m just so pleased I had a chance to do it.”
In recognition of her hard work and dedication, Kirsty was named
a “UK Huggable Hero” in 2008 by Build-A-Bear Workshop. Kirsty has
her own website at www.kirstysstory.co.uk and When You Wish
Upon a Star can be reached at www.whenyouwishuponastar.org.uk
or by calling 0161 477 7277.

Oxygen Therapy Is Valuable, Sometimes

By JANE E. BRODY
Published: March 9, 2009
Hyperbaric oxygen therapy was long called a treatment in search of diseases. But in recent years, laboratory and clinical studies have found more than a dozen serious diseases for which it is considered a valuable — and sometimes life-saving — treatment.

Although the administration of pure oxygen in a high-pressure chamber has been around as a therapy for more than 300 years, it is only now beginning to reach its potential, according to a report in the November issue of the journal Emergency Medicine.

At the same time, hyperbaric oxygen therapy has joined the ranks of unproven remedies for many conditions, especially incurable ones like cerebral palsy and autism. The use of the therapy in these situations often borders on quackery that exploits desperate patients and parents. One family I know spent $40,000 in a futile attempt to reverse their child’s cerebral palsy; another spent more than that and even bought a home hyperbaric unit to treat their child’s autism.

The Credibility Factor

The Undersea and Hyperbaric Medical Society, the professional organization in this field, recognizes 13 conditions for which it is legitimate to place patients in high-pressure chambers that force pure oxygen into their blood and tissues. Eleven of those conditions have been approved by Medicare for reimbursement, indicating that solid evidence supports these uses of hyperbaric oxygen.

The list includes decompression sickness (“the bends”), necrotizing fasciitis (flesh-eating disease), carbon monoxide poisoning, gas gangrene, the bone infection osteomyelitis, nonhealing wounds and delayed radiation injury to bone and soft tissue.

But nowhere in the list are cerebral palsy, autism, multiple sclerosis, stroke, macular degeneration, spinal cord injury, sports injuries, heart attack, postpolio syndrome, Lyme disease, migraine, cirrhosis, myasthenia gravis, fibromyalgia or chronic fatigue syndrome — among the dozens of conditions that independent clinics claim to treat with hyperbaric oxygen. Not to mention the claims of celebrities like Michael Jackson, who used it in the hope that it will keep him alive to 150, and Keanu Reeves, who used it for insomnia.

“Credibility is a huge problem,” said Richard E. Clarke, director of the Baromedical Research Foundation, which sponsors scientifically sound research. “We are all tarred by the same brush.”

“Although hyperbaric oxygen therapy has been suggested as beneficial in several other conditions, unfortunately, clinically valid evidence is virtually nonexistent,” he said. “This is relatively expensive and time-consuming therapy, and it makes sense to ask whether it is cost-effective and whether the benefits are long-lasting.”

Even for conditions approved by Medicare, supporting evidence is often contradictory. “A persistent criticism of hyperbaric medicine regards the lack of large-scale, multicenter, randomized studies for several of the primary indications,” noted Dr. Chris Maples and Dr. Moss Mendelson of Eastern Virginia Medical School in Norfolk, in the Emergency Medicine report. “Data are conflicting, particularly on carbon monoxide poisoning, crush injuries and some soft tissue infections. Some trials demonstrate benefit while others show no difference.”

Problems and Risks

One problem in conducting good studies is the difficulty of randomly assigning patients into treatment and control groups in a way that “blinds” them to the group they are in, Dr. Charles S. Graffeo, a specialist in hyperbaric medicine at the Eastern Virginia Medical School, said in an interview. Another problem is finding enough patients with the same condition, which is crucial in gathering statistically significant data.

Dr. Graffeo said there was “a good theoretical basis and some promising evidence that hyperbaric oxygen therapy could help treat clots on the retina, acute frostbite, recluse spider bites and thermal burns.”

“But there are just not enough scientific studies,” he said. “Conducting controlled clinical trials of hyperbaric oxygen is a bit more challenging than testing drugs.”

He cautioned patients to steer clear of independent hyperbaric centers owned by a single doctor or small medical group that is not affiliated with a major hospital or medical school. Commenting on claims commonly made by such clinics, he said: “No legitimate organization would condone treating cerebral palsy with hyperbaric oxygen therapy. I haven’t seen anything that is even potentially promising to support such a use. If I had a C.P. child, I wouldn’t even consider it.”

Furthermore, the therapy is not without risks, though most are mild and usually short-lived and there has been no documented fatality in more than 75 years of use in North America. The risks include ear and sinus pain, low blood sugar, nearsightedness that can last for weeks, and anxiety attacks resulting from confinement in the chamber. Also, the therapy is clearly dangerous for some patients, including those with a collapsed lung and those receiving chemotherapy with cisplatinum or adriamycin. The therapy may also be hazardous for pregnant women and people with poorly controlled asthma or active cancer, among others.

Established Benefits

Hyperbaric oxygen can be life-saving for patients with the bends, like divers who have surfaced too quickly. For those suffering from severe carbon monoxide poisoning, the most rigorous study so far found that three hyperbaric treatments decreased cognitive damage later. Traumas like crush injuries and thermal burns that deprive tissues of adequate oxygen also benefit from high-oxygen therapy, as do life-threatening infections called necrotizing fasciitis, if the condition is treated in its early stages, the experts in Virginia reported. The therapy may also be useful for sepsis, a potentially life-threatening bacterial infection in the blood and tissues.

Dr. Graffeo said the therapy was useful in treating diabetic foot ulcers and bone infections. It is beneficial for patients whose tissues were damaged by radiation therapy — cancer patients, for example, who can develop oxygen-deficient wounds that do not heal well. Hyperbaric oxygen promotes the release of growth hormone and helps to form blood vessels in irradiated tissue, he said.

A study published last September in the International Journal of Radiation Oncology, Biology, Physics found hyperbaric oxygen helpful for patients with radiation proctitis, which can cause bleeding, rectal ulcers and loss of bowel control. Though the costly treatment can involve as many as 40 two-hour sessions, “the net effect is reversal of the problem in the majority of patients, which in the end is cost-saving and greatly improves quality of life,” said Mr. Clarke, whose foundation sponsored the study.

Oxygen therapy is being tested in patients with new diagnoses of head or neck cancer to increase the tumor’s sensitivity to radiation treatments, Mr. Clarke said. Future studies will test benefits to patients with cancers of the larynx, skin and gynecological organs.

“The most important question to answer, in addition to cost-effectiveness,” he said, “is whether the therapeutic benefit lasts and clearly improves patients’ quality of life.”

Cameron: 'If we can't look after him, we have failed'

The Times
February 26, 2009

In an extract from their book, David Cameron's biographers explain the impact of Ivan
Francis Elliott and James Hanning

Ivan Cameron was born in Queen Charlotte's Hospital in London on Monday, April 8, 2002. The birth was by a Caesarean section, made necessary at the last minute because Ivan was the wrong way round in the womb. Otherwise it was a normal delivery of an apparently healthy baby boy. It was a joyful event but even then a period of mixed emotions: in nearby Hammersmith Hospital at the same time, David Cameron's godfather Tim Rathbone, Ian Cameron's schoolfriend and a significant personal and political inspiration, was having tests for cancer. He visited Samantha in hospital but was to die some weeks later. “The fact that he was dying while my son was being born seemed to have some kind of symbolism. It made his birth all the more poignant and moving,” Cameron later told a friend.

Although Ivan was their first child, they quickly sensed that something was wrong. At Queen Charlotte's he seemed to have occasional spasms. Otherwise he seemed a very sleepy child and Samantha struggled with breast-feeding. But the health visitor paying the routine postnatal call to Ginge Manor, where mother and baby had gone after leaving Queen Charlotte's, saw no reason to be alarmed.

Within a week of his birth it was clear that Ivan, still very sleepy, was losing weight. Sometimes his hand would spring open in a series of small but repetitive impulses. As first-time parents, David and Samantha Cameron had nothing to compare their son's behaviour to and, reassured by the advice of the health visitor, showed off their son to Dominic and Tif Loehnis that weekend.

But, as Ivan entered his second week, the jerks were becoming more pronounced. Annabel Astor had become sufficiently concerned to drive her daughter - on her birthday - and grandson to the local GP.

The doctor's initial diagnosis was that the newborn was suffering from a kidney malfunction. He directed them to the accident and emergency department of the John Radcliffe Hospital in Oxford. It was here that the baby had his first major seizure in front of a doctor.
The nature of Ivan's condition was beginning to be shockingly apparent.

David Cameron, joining his wife at the hospital, shared her distress as their tiny child was subjected to 48 hours of blood tests, brain scans and lumbar punctures. Of all the tests, the one that was picking up the most identifiable evidence of Ivan's problem was the electroencephalogram (EEG). The EEG records brainwave patterns from electrical signals emitted by the brain. This showed the high-voltage “spikes” that occur in epilepsy, but they were followed by very little activity.

After one last confirming EEG, Mike Pike, a paediatrician, took the couple into a side room to talk. With ominous purposefulness, he placed a box of Kleenex beside them. He told them that this was very serious, that the pattern he had seen was consistent with “a very poor outcome and severe disability”. Ivan, he said, would have “very serious difficulties”. Cameron, struggling to take the gravity of the diagnosis on board, said: “When you say he's got serious difficulties, does that mean he's going to have trouble doing his maths, or does that mean he's never going to be able to walk and talk?” Pike said simply: “I'm afraid it means he probably won't walk or talk.” Within a few days they had a name for Ivan's condition: Ohtahara syndrome.

The National Institute of Neurological Disorders and Stroke (NINDS) provides the following definition: “a neurological disorder characterised by seizures ... most commonly caused by metabolic disorders or structural damage in the brain, although the cause or causes in many cases can't be determined”. Most infants “show significant underdevelopment of part or all of the cerebral hemispheres. The course of Ohtahara syndrome is severely progressive. Seizures become more frequent, accompanied by physical and mental retardation. Some children will die in infancy; others will survive but be profoundly handicapped.” Unsure whether Ivan would live for weeks or years, Cameron ensured that his son was christened at the earliest opportunity.
Cameron has said that the news hit him “like a freight train”. A friend observes that the couple entered “a very, very grim and difficult period” Emotionally, they had to overcome the discrepancy between the elation they had felt at the birth of their first child and the reality of what lay ahead. “You are depressed for a while because you are grieving for the difference between your hopes and the reality,” he has said.

There were immediate practical issues to address, the most pressing of which was how best to manage his condition. Ivan went through further tests at Great Ormond Street and Queen Mary's hospitals in London as doctors experimented with cocktails of drugs. David and Samantha Cameron, taking it in turns to sleep beside their son on hospital floors, were given a brutal lesson in the reality of life as the parent of a disabled child. After his initial shock Cameron has described how he began to surface. “There was a moment driving home from hospital and just thinking ‘We are going to get through this. If we can't do a good job and look after him, then we have failed'.” Initially the Camerons tried to look after Ivan themselves, without the support of their local authority's social services department. For a year the couple struggled with the situation largely on their own, although they had help from a special-needs-trained nurse during the day. Three and a half months after Ivan was born, Samantha had returned to work - as planned - for two days a week, and after five months she was back doing nine-day fortnights. It was a difficult decision.

On the one hand she worried inconsolably about Ivan's minute-to-minute care, but, on the other, her career was important to her and she had always intended to carry on working.
Childcare was shared between them. Journalists spotted Cameron bottle-feeding his son in Westminster that summer and cited it as evidence of the changing nature of the Tory party, not knowing the fullness of that truth. The young Tory MP also took Ivan to meetings at Carlton, where he remained a consultant. Former colleagues could hardly fail to notice the difference in him. At Edwina Paine's engagement party, one said he seemed a “different man ... he seemed much less frivolous”. Another senior colleague said: “He'd walk around with that baby in a basket, he'd come to every meeting.” Where previously Cameron had appeared “arrogant”, “this was a real leveller”.

Giles Andreae has said that Ivan's handicap had given Cameron “more humility”. Cameron has admitted as much himself. “Having a severely disabled son does bring you into contact with a lot of other elements of life. You do spend a lot of time in hospitals, you meet a lot of other parents and families in the same situation. It's an eye-opener.” At one point, Ivan's blood pressure shot up and he had to be rushed to the renal unit at Great Ormond Street. Cameron found that hospital visit in particular a strange experience. “He was struck by the fact that there were all these kids there who had been on dialysis for months, being incredibly courageous with these awful, awful problems,” says a friend. “I think it made him realise that there are other people in similar situations. On one occasion he was there all night, and at about 4am he was reading Jack and Jill to someone else's kids, and then had to go to Parliament early the next day to carry on with life as normal.”

© Francis Elliott and James Hanning 2007. Extracted from Cameron: The Rise of the New Conservative (Fourth Estate, £18.99) Available from Times BooksFirst for £17.09, free p&p. 0870 1608080, timesonline.co.uk/booksfirst. The Times, on behalf of the authors and the publisher, has made a donation to Mencap and St Mary's Hospital

Stem cell transplant reverses early-stage multiple sclerosis

12 Feb 2009

Researchers from Northwestern University's Feinberg School of Medicine appear to have reversed the neurological dysfunction of early-stage multiple sclerosis patients by transplanting their own immune stem cells into their bodies and thereby "resetting" their immune systems.



"This is the first time we have turned the tide on this disease," said principal investigator Richard Burt, MD, chief of immunotherapy for autoimmune diseases at the Feinberg School. The clinical trial was performed at Northwestern Memorial Hospital where Burt holds the same title.

The patients in the small phase I/II trial continued to improve for up to 24 months after the stem cell transplant and then stabilised. They experienced improvements in areas in which they had been affected by multiple sclerosis including walking, ataxia, limb strength, vision and incontinence. The study will be published in the March issue of the Lancet Neurology.

Multiple sclerosis (MS) is an autoimmune disease in which the immune system attacks the central nervous system. In its early stages, the disease is characterised by intermittent neurological symptoms, called relapsing-remitting MS. During this time, the person will either fully or partially recover from the symptoms experienced during the attacks. Common symptoms are visual problems, fatigue, sensory changes, weakness or paralysis of limbs, tremors, lack of coordination, poor balance, bladder or bowel changes and psychological changes.

Within 10 to 15 years after onset of the disease, most patients with this relapsing-remitting MS progress to a later stage called secondary progressive multiple sclerosis. In this stage, they experience a steady worsening of irreversible neurological damage.

The 21 patients in the trial, ages 20 to 53, had relapsing-remitting multiple sclerosis that had not responded to at least six months of treatment with interferon beta. The patients had had MS for an average of five years. After an average follow-up of three years after transplantation, 17 patients (81 percent) improved by at least one point on a disability scale. The disease also stabilized in all patients.

In the procedure, Burt and colleagues treated patients with chemotherapy to destroy their immune system. They then injected the patients with their own immune stem cells, obtained from the patients' blood before the chemotherapy, to create a new immune system. The procedure is called autologous non-myeloablative haematopoietic stem-cell transplantion.

"We focus on destroying only the immune component of the bone marrow and then regenerate the immune component, which makes the procedure much safer and less toxic than traditional chemotherapy for cancer," Burt said. After the transplantation, the patient's new lymphocytes or immune cells are self-tolerant and do not attack the immune system.

"In MS the immune system is attacking your brain," Burt said. "After the procedure, it doesn't do that anymore."

In previous studies, Burt had transplanted immune stem cells into late-stage MS patients.

"It didn't help in the late stages, but when we treat them in the early stage, they get better and continue to get better," he said.

"What we did is promising and exciting, but we need to prove it in a randomised trial," Burt noted. He has launched a randomised national trial.

(Source: Northwestern University : Burt R. Stem cell therapy for patients with multiple sclerosis failing interferon A randomised study. Lancet Neurology. : February 2009)

Speech-language pathologist

Speech-language pathology is the study of disorders that affect a person’s speech, language, cognition, voice, swallowing (dysphagia) and the rehabilitative or corrective treatment of physical and/or cognitive deficits/disorders resulting in difficulty with communication and/or swallowing. Speech-language pathologists (SLPs) or Speech and Language Therapists (SLTs) address people’s speech production, vocal production, swallowing difficulties and language needs through speech therapy in a variety of different contexts including schools, hospitals, and through private practice.

Communication includes speech (articulation, intonation, rate, intensity), language (phonology, morphology, syntax, semantics, pragmatics), both receptive and expressive language (including reading and writing), and non-verbal communication such as facial expression and gesture. Swallowing problems managed under speech therapy are problems in the oral, laryngeal, and/or pharyngeal stages of swallowing (not oesophageal).

Depending on the nature and severity of the disorder, common treatments may range from physical strengthening exercises, instructive or repetitive practice and drilling, to the use of audio-visual aids and introduction of strategies to facilitate functional communication. Speech therapy may also include sign language and the use of picture symbols (Diehl 2003).

The practice is called:

Speech-language pathology (SLP) in the United States and Canada
Speech and language therapy (SLT) in the United Kingdom, Ireland and South Africa
Speech pathology in Australia
Speech-language therapy in New Zealand
Other terms in use include speech therapy, logopaedics and phoniatrics.

Contents
1 Scope of practice
2 Professional roles
3 Education
4 Methods of assessment
5 Patients/clients
6 Place of work
7 Colleagues
8 See also
9 External links




Scope of practice
The practice of speech-language pathology involves:

Providing prevention, screening, consultation, assessment and diagnosis, treatment, intervention, management, counseling, and follow-up services for disorders of:
speech (i.e., phonation, articulation, fluency, resonance, and voice including aeromechanical components of respiration);
language (i.e., phonology, morphology, syntax, semantics, and pragmatic/social aspects of communication) including comprehension and expression in oral, written, graphic, and manual modalities; language processing; preliteracy and language-based literacy skills, including phonological awareness;
swallowing or other upper aerodigestive functions such as infant feeding and aeromechanical events (evaluation of esophageal function is for the purpose of referral to medical professionals);
cognitive aspects of communication (e.g., attention, memory, problem solving, executive functions).
sensory awareness related to communication, swallowing, or other upper aerodigestive functions.
Establishing augmentative and alternative communication (AAC) techniques and strategies including developing, selecting, and prescribing of such systems and devices (e.g., speech generating devices.)
Providing services to individuals with hearing loss and their families/caregivers (e.g.,auditory training; speechreading; speech and language intervention secondary to hearing loss; visual inspection and listening checks of amplification devices for the purpose of troubleshooting, including verification of appropriate battery voltage).
Screening hearing of individuals who can participate in conventional pure-tone air conduction methods, as well as screening for middle ear pathology through screening tympanometry for the purpose of referral of individuals for further evaluation and management.
Using instrumentation (e.g., videofluoroscopy, EMG, nasendoscopy, stroboscopy, computer technology) to observe, collect data, and measure parameters of communication and swallowing, or other upper aerodigestive functions in accordance with the principles of evidence-based practice.
Selecting, fitting, and establishing effective use of prosthetic/adaptive devices for communication, swallowing, or other upper aerodigestive functions (e.g., tracheoesophageal prostheses, speaking valves, electrolarynges). This does not include sensory devices used by individuals with hearing loss or other auditory perceptual deficits.
Collaborating in the assessment of central auditory processing disorders and providing intervention where there is evidence of speech, language, and/or other cognitivecommunication disorders.
Educating and counseling individuals, families, co-workers, educators, and other persons in the community regarding acceptance, adaptation, and decision makes about communication, swallowing, or other upper aerodigestive concerns.
Advocating for individuals through community awareness, education, and training programs to promote and facilitate access to full participation in communication, including the elimination of societal barriers.
Collaborating with and providing referrals and information to audiologists, educators, and health professionals as individual needs dictate.
Addressing behaviors (e.g., perseverative or disruptive actions) and environments (e.g., seating, positioning for swallowing safety or attention, communication opportunities) that affect communication, swallowing, or other upper aerodigestive functions.
Providing services to modify or enhance communication performance (e.g., accent modification, transgendered voice, care and improvement of the professional voice, personal/ professional communication effectiveness).
Recognizing the need to provide and appropriately accommodate diagnostic and treatment services to individuals from diverse cultural backgrounds and adjust treatment and assessment services according.

Professional roles
Speech-language pathologists serve individuals, families, groups, and the general public through a broad range of professional activities. They:

Identify, define, and diagnose disorders of human communication and swallowing and assist in localization and diagnosis of diseases and conditions.
Provide direct services using a variety of service delivery models to treat and/or address communication, swallowing, or other upper aerodigestive concerns.
Conduct research related to communication sciences and disorders, swallowing, or other upper aerodigestive functions.
Educate, supervise, and mentor future speech-language pathologists.
Serve as case managers and service delivery coordinators.
Administer and manage clinical and academic programs.
Educate and provide in-service training to families, caregivers, and other professionals.
Participate in outcomes measurement activities and use data to guide clinical decision making and determine the effectiveness of services provided in accordance with the principles of evidence-based practice.
Train, supervise, and manage speech-language pathology assistants and other support personnel.
Promote healthy lifestyle practices for the prevention of communication, hearing, swallowing, or other upper aerodigestive disorders.

Education
In the UK( United Kingdom) , SLTs undertake a three to four year degree course devoted entirely to the study of clinical language sciences and communicative disorders. This qualifies them to work in any of the three main clinical areas. The course, which varies according to university, includes intensive study of core theoretical components underpinning competence to practice , Linguistics, Psychology and Medical science, in addition to the study of a range of communicative disorders in children and adults. Students are also expected to become familiar with a range of policies, processes and procedures relevant to working in different contexts, including health and education. The course is very demanding, and is assessed via coursework, exams and clinical placement. Some universities require students to assess and diagnose an ‘unseen client’ prior to completing their degree course; all require the completion of a pilot study related to the field of Speech and Language Therapy. Throughout the course, students undertake a variety of clinical placements in which their ability to practise is continually assessed. All courses require students to complete a certain amount of hours of clinical placement, although the structure of placement differs from course to course.

Upon qualifying SLT’s enter the profession as a newly-qualified practitioner. The recommended career course is that they then achieve a number of competencies, which qualify them to work autonomously. The Royal College of Speech and Language Therapists, the professional body representing Speech and Language Therapists in the UK, provides a framework of competencies which therapists are expected to achieve within 12–18 months of beginning clinical practice. Access to supervision during this period varies from trust to trust, and each individual therapist is expected to provide documentary evidence of competencies achieved to a senior colleague (usually a manager) who determines whether a therapist meets the required criteria for admission to the ‘full register’.

Speech and Language Therapists in the UK are required by law to register with the Health Professions Council, a regulatory body governing a range of health professions. The Health Professions Council has the power to discipline members who do not meet the rigorous standards for effective and safe clinical practice, and may ’strike off’ or deregister members who fail to maintain these standards.

In the United States, Speech Language Pathology practice is regulated by the laws of the individual states. However, by 2006, the minimal requirements to be a certified SLP member of the American Speech-Language Hearing Association were: a graduate degree in Speech-Language Pathology, which typically entails 2 years of post graduate work; a completed clinical fellowship year, which is generally employment for a year while supervised by a practicing SLP who is also ASHA certified; and passing the Praxis Series examination. The graduate degree work to acquire a Master’s in Speech-Language Pathology is rigorous and demanding, requiring many hours of supervised clinical practica, and intensive didactic coursework in medical sciences, phonetics, linguistics, phonology, scientific methodology, and other subjects.

Certification by ASHA is noted as carrying one’s “C”s. (Certificate of Clinical Competence) It is noted after an SLP’s name as: CCC-SLP.

In Australia, Speech Pathologists either undertake a four year undergraduate degree, or a two year Masters degree to qualify. These dual pathways are considered by Speech Pathology Australia to produce equally prepared graduates. To be eligible for optional membership of Speech Pathology Australia, students must study in one of the accredited courses outlined on their website. Speech Pathology degrees in Australia vary in curriculum, but always include streams teaching anatomy and physiology, professional practice, communication and swallowing disorders, and often some elementary psychology and audiology. Most include no or minimal elective subjects. All degrees include a heavy clinical component, and many also include a research component in final year. Once graduated, students become fully qualified Speech Pathologists and are eligible for any Level 1 position, without the need for an internship or general examination. Registration is only required in the state of Queensland, and membership of the professional organization is optional, although it is encouraged.


Methods of assessment
There are separate standardized assessment tools administered for infants, school-aged children, adolescents and adults. Assessments primarily examine the form, content, understanding and use of language, as well as articulation, and phonology. Oral motor and swallowing assessments often require specialized training which includes the use of bedside examination tools and endoscopic/modified barium radiology procedures.

Individuals may be referred to an SLP for the following: Traumatic brain injury; Stroke; Alzheimer’s disease and dementia; Cranial nerve damage; Progressive neurological conditions (Parkinson, ALS, etc); Developmental delay; Learning disability (speaking and listening); Autism Spectrum Disorders (including Asperger Syndrome); Genetic disorders that adversely affect speech, language and/or cognitive development; Injuries due to complications at birth; Feeding and swallowing concerns; Craniofacial anamolies that adversely affect speech, language and/or cognitive development; and Augmentative Alternative Communication needs.

There are myriad Speech-Language Assessment tools used for chidren and adults, depending on the area of need.


Patients/clients
Speech and language therapists work with:

Babies with feeding and swallowing difficulties
Children with mild, moderate or severe:
learning difficulties
physical disabilities, language delay
specific language impairment
specific difficulties in producing sounds (including vocalic r and lisps)
hearing impairment
cleft palate
stammering
autism/social interaction difficulties
dyslexia
voice disorders
Adults with eating and swallowing and/or communication problems following
stroke
head injury (Traumatic brain injury)
Parkinson’s disease
motor neuron disease
multiple sclerosis
Huntington’s disease
dementia
cancer of the head, neck and throat (including laryngectomy)
voice problems
mental health issues
learning difficulties, physical disabilities
stammering (dysfluency)
hearing impairment
transsexual women seeking voice therapy
In the United States, the cost of speech therapy for a child younger than three years old is likely covered by the state early intervention (zero to three) program.

In Britain, the majority of Speech and Language therapy is funded by the National Health Service (and increasingly, by partners in Education) meaning that initial assessment is available cost-free to all clients at the point of service, regardless of age or presenting problem. The large numbers of referrals contribute to high caseloads and long waiting lists, although this differs from area to area. To meet the needs of many of these clients, it has become necessary for many services to focus heavily on training and consultative models of service provision. The number of hours of direct therapy available to clients varies widely from trust to trust and most areas operate strict guidelines for prioritisation to meet the high clinical demand.


Place of work
Speech and language therapists work in community health centres, hospital wards and outpatient departments, mainstream and special schools, further education colleges, day centers and in their clients’ homes. Some now work in courtrooms, prisons and young offenders’ institutions.

Some speech and language therapists who work independently will see children and adults in their own homes, and may offer appointments on a Saturday.


Colleagues
SLTs/SLPs work closely with others involved with the client, for example difficulties with eating and drinking may also involve an occupational therapist. Speech and language therapists also work closely with parents and caregivers and other professionals, such as audiologists, teachers, nurses, dietitians, physiotherapists, and doctors.

Risks of online stem cell clinics

The science behind stem cell treatment is still in the early stages
“Patients with debilitating diseases such as multiple sclerosis and Parkinson’s risk being exploited by websites offering expensive stem-cell treatments.” The Times reported. It said that a study had investigated the websites of 19 companies that offer such therapies. Researchers found that most make inflated or over-optimistic claims about the benefits, are not backed by evidence and make little or no mention of the risks involved.

This study highlights the extent of the problem of direct-to-consumer advertising of stem cell therapies.

There are risks in buying anything claiming to have a health benefit over the internet. Stem cell treatment offered by seemingly legitimate clinics is no different. Stem cells are an accepted treatment for blood cancers, but this science is still in its infancy in terms of neurological treatments. The MS Society warns there is no evidence yet that the treatment repairs multiple sclerosis damage.

Anyone considering this sort of treatment is strongly recommended to discuss it with their GP first. The Department of Health has recently released a warning on unproven stem cell treatment.

Where did the story come from?

Darren Lau and colleagues from the Department of Public Health Sciences and Faculty of Law at the University of Alberta in Edmonton, Canada carried out this research. The work was funded by a grant from the Stem Cell Network. The study was published as correspondence in the peer-reviewed science journal, Cell Stem Cell.

What kind of scientific study was this?

The researchers say despite the fact that stem cell medicine is in an immature state, there is still an ‘early market’ for the supposed stem cell therapies, and people are beginning to buy the therapies directly. They believe that direct-to-consumer advertising through the internet is likely to play an important role in how this market develops. This cross-sectional descriptive analysis was aimed at answering three specific questions:

What sorts of therapies are being offered?
How are they portrayed?
Is there clinical evidence to support the use of these therapies?
To investigate this, the researchers took a ‘snapshot’ of online stem cell clinics in August 2007, by carrying out a Google search using the terms ‘stem cell therapy’ or ‘treatment’. This search returned 19 websites claiming to use stem cells to treat the disease. The researchers took the clinics’ uses of the ‘stem cell’ label at face value, meaning that they did not assess if the clinics were truly offering therapies with stem cells.

The researchers noted that the sites often offered other services including cosmetic treatments of otherwise healthy patients or health ‘enhancements’. Importantly, these clinics also gave information on how the stem cells were given to patients.

They also say that it is usually difficult to sort the stem cells from other cells and that it is therefore likely that the ‘stem cell therapies’ referred to by the websites contain numerous other cells in addition to the stem cells.

What were the results of the study?

The researchers found that the most commonly provided stem cells were adult and taken from the patient’s own body (nine websites or 47%). These were followed by stem cells sourced from a foetus, cord blood or embryo. The stem cells were most often obtained from the patient’s bone marrow (seven sites or 37%) and/or blood (five sites or 26%). Some websites did describe getting the stem cells from patient fat, blood or marrow donors, aborted foetuses, patient’s skin, animal tissues and human placental tissue.

The websites claimed that treatments were most commonly administered by infusion into cerebrospinal fluid by lumbar puncture (six sites or 32%). Injection into a vein was equally common. Four websites described procedures for injecting the stem cells into deep body cavities, such as the space around the brain or by injection directly into the spinal cord.

The conditions treated were diverse, including neurological conditions or brain diseases such as multiple sclerosis, stroke, Parkinson’s disease, spinal cord injury and Alzheimer’s disease. The sites also claimed to treat allergies and congenital diseases, mainly cerebral palsy, autism and Duchenne muscular dystrophy.

Regarding the portrayal of risks and benefits, all 19 websites advertised improvement in the disease state as a benefit of therapy and most (14 or 74%) of the sites did not mention particular risks.

The last part of the study was to look for the evidence supporting stem cell treatments. For this, the researchers performed a database search (Pubmed) in July 2008. They looked for human studies that reported the clinical effects of stem cell therapies for any neurological or cardiovascular conditions mentioned 10 or more times by the websites. This search provided a range of trials (mostly randomised controlled trials) of low-level evidence (i.e. varying quality) for neurological conditions and four systematic reviews with meta-analyses for stem cell treatments after heart attack.

All of the systematic reviews reported a small but statistically significant advantage of about 2-3% in a measure of heart function, but the researchers say this was of uncertain clinical importance. For stem cell therapies for multiple sclerosis, Parkinson’s disease, stroke, Alzheimer’s disease, and spinal cord injury they found that the treatments offered on stem cell websites are generally unsupported by the clinical evidence.

What interpretations did the researchers draw from these results?

The researchers concluded that direct-to-consumer portrayal of stem cell medicine is optimistic and unsupported by published evidence. They also suggest that the results have other implications including:

Providers are making inaccurate claims in their direct-to-consumer advertising.
Importantly, patients may not be receiving sufficient and appropriate information and may be being put at increased risk.
Clinics may also be contributing to a public expectation that exceeds what this field of research can reasonably achieve.
What does the NHS Knowledge Service make of this study?

The researchers mention some limitations to the methods that they used to collect the data:

The information available from websites may not be the same as the information actually shared with patients in the clinic.
The overall data was collected from a diverse range of clinics. The results cannot therefore be used to evaluate the claims of any particular clinic.
The researchers did not directly assess the accuracy of the websites’ claims by analyzing the results of treatment they had carried out.
These are valid points. The researchers also say that even if improvements had occurred, it would be impossible to say with confidence that these were due to the treatment. If on the other hand the treatments did not work, then patients would have been subjected to inappropriate risk and the cost of the treatment. The average cost of a course of therapy among the four websites that mentioned costs was $21,500, excluding travel and accommodation for patients and caregivers.

There are well-publicised dangers in buying anything claimed to have a health benefit over the internet. Stem cell treatment offered by seemingly legitimate clinics is no different, especially considering the various sources of the stem cells, the deeply invasive methods in which they can be delivered and the fact that this science is still in its early stages.

New guidelines have just been released by the International Society for Stem Cell Research (ISSCR).

A patient handbook is included that also lists some of the claims made by the websites, those that patients should interpret with caution.

We’re in the money but some will go to a charity that supports us so much

DEVOTED dad plans to treat his disabled son and a charity to a slice of his luck after scooping a share of a £25,000 jackpot.

Tom Blair, 67, and his daughter Joanne Blair, 38, shared the money after winning in the People’s Postcode Lottery.

Tom, of Acklam Road, Middlesbrough, has devoted his life to looking after his son Ian, 31, who has cerebral palsy and requires round-the-clock care.

Tom was an analyst in the steel industry but had to give up work 11 years ago, after his wife Norma died of cancer, to become Ian’s carer.

He said: “This win is wonderful. Ian has cerebral palsy and care costs are really high. Though we get grants, it doesn’t cover everything and money is tight. This will make a big difference.

“I was surprised, but not as elated as my daughter because she needed the cash a lot more - she’s now in the black!”
His £12,500 will go towards a new wheelchair-friendly vehicle and alterations to the house where he has lived for 32 years. Tom’s commitments mean that he hasn’t been on holiday in 22 years but thanks to charity Teesside Ability Support Centre (TASC) he gets four days off once a year.

And as a 12-year TASC committee member, Tom plans to give some of the money to the charity that provides social care and life skills learning opportunities for disabled adults like Ian.

Tom said: “They provide an excellent service. It deserves more publicity than it’s getting. They’ve got good staff and I think the facilities are very good.

“But the facilities can always be improved and expanded, which is what we are doing.”

Joanne, who works as a volunteer counsellor with domestic violence support centre My Sister’s Place, said: “My money’s going to pay off debts - it’ll be great to be free of them.”

The winning postcode was TS5 8BE, and 67 other households matched part of it to win cash prizes.

New stem cell treatment gives hope to stroke patients

by The Hindu News Update Service


New Delhi (PTI) : For the first time, Indian researchers claimed to have successfully used stem cells to treat brain damage resulting from stroke in mice, thus taking a step nearer to give hope to stroke patients suffering from permanent paralysis, disability and dependence on others.
"We found that stem cells, developed by us, when injected in the damaged portion of the brain did trigger development of new brain cells without any life-threatening side-effects," S Prabhakar, head of the department of neurology, PGI Chandigarh said.
"This is the first time that interactions between the two kinds of cells (injected cells and host cells) worked out," he said.
Five centres across the country, including AIIMS, are conducting studies on the stem cell treatment of stroke, according to Prabhakar.
Brain stroke occurs when a blood vessel carrying oxygen and nutrients to the brain is blocked by a clot or bursts, causing the brain to starve.
"If deprived of oxygen for even a short period of time, the brain cells begin to die. Once this happens the part of the body controlled by that section of the brain is affected, causing paralysis," M V Padma, a neurologist at AIIMS, said.
Human trials for the study will begin this month. "From January onwards the trials in human being will start. In our experiment we wanted that once the stem cells were injected, it should reach and form new cells in the damaged destination and it really did." Prabhakar said.
There are two types of strokes. In the first, blood clots in vessels leading to blocking of the arteries in the brain. The second type occurs when a blood vessel ruptures causing a bleeding also known as hemorrhagic stroke.
There are also "mini-strokes" which is often ignored and which if left untreated will lead to full blown strokes.
Brain stroke is the third largest killer in India after heart attack and cancer and the second largest in the world, according to the World Health Organisation.
A WHO study, stated that the incidence of the disease in India to be around 130 per 100,000 people every year and says about 20 per cent of heart patients are susceptible to it.
"For this study, we injected human stem cells into adult mice only after deliberately inducing brain stroke in them," Prabhakar said while explaining the experiment on the mice.
For this, the blood supply in the brain of mice was cut off for just 15 minutes and then restored. "That causes massive damage to the brain. It's the sort of thing that happens when you have a cardiac arrest. Then human cells were injected and within about a week, the responses of mice improved dramatically," he said.
Compared to a heart attack, the awareness about brain strokes, is limited," Prabhakar added. New stem cell treatment gives hope to stroke patients
New Delhi (PTI) : For the first time, Indian researchers claimed to have successfully used stem cells to treat brain damage resulting from stroke in mice, thus taking a step nearer to give hope to stroke patients suffering from permanent paralysis, disability and dependence on others.
"We found that stem cells, developed by us, when injected in the damaged portion of the brain did trigger development of new brain cells without any life-threatening side-effects," S Prabhakar, head of the department of neurology, PGI Chandigarh said.
"This is the first time that interactions between the two kinds of cells (injected cells and host cells) worked out," he said.
Five centres across the country, including AIIMS, are conducting studies on the stem cell treatment of stroke, according to Prabhakar.
Brain stroke occurs when a blood vessel carrying oxygen and nutrients to the brain is blocked by a clot or bursts, causing the brain to starve.
"If deprived of oxygen for even a short period of time, the brain cells begin to die. Once this happens the part of the body controlled by that section of the brain is affected, causing paralysis," M V Padma, a neurologist at AIIMS, said.
Human trials for the study will begin this month. "From January onwards the trials in human being will start. In our experiment we wanted that once the stem cells were injected, it should reach and form new cells in the damaged destination and it really did." Prabhakar said.
There are two types of strokes. In the first, blood clots in vessels leading to blocking of the arteries in the brain. The second type occurs when a blood vessel ruptures causing a bleeding also known as hemorrhagic stroke.
There are also "mini-strokes" which is often ignored and which if left untreated will lead to full blown strokes.
Brain stroke is the third largest killer in India after heart attack and cancer and the second largest in the world, according to the World Health Organisation.
A WHO study, stated that the incidence of the disease in India to be around 130 per 100,000 people every year and says about 20 per cent of heart patients are susceptible to it.
"For this study, we injected human stem cells into adult mice only after deliberately inducing brain stroke in them," Prabhakar said while explaining the experiment on the mice.
For this, the blood supply in the brain of mice was cut off for just 15 minutes and then restored. "That causes massive damage to the brain. It's the sort of thing that happens when you have a cardiac arrest. Then human cells were injected and within about a week, the responses of mice improved dramatically," he said.
Compared to a heart attack, the awareness about brain strokes, is limited," Prabhakar added.

Wii system helps local patients recover from stroke, disabilities

-BLOOMINGTON -- "Nice shot," David Wickenhauser said as Judy Erickson's chip shot made it onto the green. Wickenhauser then helped Erickson to select the correct club for putting.

Wickenhauser, 36, and Erickson, 56, weren't golfers on one of Bloomington-Normal's many golf courses. They are BroMenn Adult Day Services' clients recovering from serious illnesses. They were swinging a remote while walking around in front of a large-screen television in the family room at Adult Day Services, 202 E. Locust St., as other clients watched.

The Wii -- the popular video game system -- is being used as a part of rehabilitation with patients on the Acute Rehabilitation Unit of BroMenn Regional Medical Center in Normal and with clients at Adult Day Services.

Balance, coordination, endurance and fine motor skills are among body functions that may be improved through use of the Wii, said Rebecca Wheat, manager of Adult Day Services.

Erickson, of Bloomington, a GTE retiree recovering from a stroke, said playing the Wii has helped her arm strength and hand-to-eye coordination.

"You have to use your brain," she said with a smile.

But, mostly, the Wii is fun, she said. "I like doing it (playing the Wii) with David."

"It's just fun," said Wickenhauser, of El Paso, who suffered severe memory loss and lost his ability to walk without assistance after getting kidney cancer, a rare liver disease called Stauffer's Syndrome and encephalitis.

Wickenhauser said playing the Wii has helped him with concentration, patience, endurance and balance.

Erickson and Wickenhauser illustrate why BroMenn acquired two Wii systems several months ago and the subsequent success.

"We sometimes, as therapists, get a bad rap from patients who think therapy is work," said Paul Trumbull, a physical therapist and director of rehabilitation services at BroMenn Regional Medical Center. "The Wii makes therapy fun. It makes it easier for them (patients and clients) to participate."

Trumbull became aware of Wii systems being used as part of rehabilitation elsewhere in the country and began investigating.

He found that it was too early for any conclusive studies about the Wii in therapy. But therapists talked and wrote about the benefits their patients had experienced. In addition, the Rehabilitation Institute of Chicago was beginning a course for therapists on how to use the Wii in therapy.

"For most therapists, it's intuitive that it would work well," Trumbull said.

The Wii requires players to move while playing a game being shown on a television screen. Players, holding a remote, mimic motions for the game, whether it's golf, bowling, tennis, boxing, dancing or a cooking activity. Characters on the screen represent the players and do what the players do, so the players can see the accuracy of their moves.

"We can vary the situations that the patients are in," Trumbull said.

Trumbull and other BroMenn rehabilitation leaders discussed potential benefits and decided to acquire two Wii systems last spring.

Adult Day Services already had a large-screen TV in its family room, so only had to spend about $400 for a Wii. The Acute Rehabilitation Unit received a $1,500 grant from Sam's Club for a Wii and a large-screen TV, which BroMenn put in the unit's therapy gym.

Acute rehab patients -- whose ages range from their 40s to their 90s -- are hospital patients who need more intensive therapy before returning home, Trumbull said. Often, they have had a stroke or a brain tumor, or have had orthopedic or spine surgery.

The Wii is used as a part of therapy in acute rehab three to four days a week, Trumbull said. About 60 percent of acute rehab patients are using the Wii. The typical patient stays in acute rehab for 11 days.

"One of the nice things about the device is you could find an appropriate way to use it with just about any patient," Trumbull said. "The bowling is most often used.

"I don't have any hard and fast data saying that people are getting better faster (because of the Wii)," Trumbull said. "But it feels as if they are. What I'm really finding is they're enjoying it."

Adult Day Services averages 20 to 30 clients each day. Most of the clients are older adults who want some place to go during the day for socialization and mental and physical stimulation while their family members are at work, Wheat said.

"A lot of our clients need help with fine motor coordination (using their fingers, hands and arms) because of a stroke or physical weakness that came with age or lack of use," Wheat said. Cutting up food and writing are among daily activities that become more difficult with fine motor weakness.

Wii helps because clients are moving their entire body without realizing it, Wheat said. Knowing where to stand and swing helps with balance and coordination, she said.

For example, during their Wii golf game on Dec. 8, Wickenhauser and Erickson walked around to get themselves into the proper position, clicked the remote buttons to select the right golf clubs and swung the remote to simulate a golf swing. They did that for about an hour.

"There's a lot of hand-to-eye coordination to get the characters to do what you want them to do," Wheat said.

"I would say a dozen or more of the clients use the system," she said. "The others benefit by watching it."

When he began using the Wii in the summer, Wickenhauser -- still undergoing rehabilitation for his life-threatening illnesses -- needed help standing and was frustrated with anything that required concentration.

"It (Wii) makes you use your brain," he said. "If you want to do well, you have to concentrate."

The Wii has helped Wickenhauser to improve his coordination and fine motor skills, Wheat said.

Erickson still uses a quad cane to walk but doesn't use it while she's playing with the Wii. "It's helping to improve her balance and endurance," Wheat said.

Another client, who was withdrawn, has become more sociable since playing the Wii, she said.

Wheat said the Wii is an example of therapists reaching out to people who may have played video games.

"We're trying to keep our programming up to date," she said.

Wickenhauser said playing the Wii reminds him of his teen years playing video games in the arcade at the mall and his college years when he worked and played golf at El Paso Country Club.

Then he laughed.

"I still can't putt."

------

What's a Wii?

For novices, here's a quick lesson on the Wii:

--Wii is the popular home video game system released by Nintendo in 2006. Nintendo said it chose the name because Wii sounds like "we," which emphasizes that the Wii system is for everyone.

--The distinguishing feature is its wireless controller, the Wii remote, which is used as a handheld pointing device to detect movement in three dimensions.

--Holding the Wii remote, players mimic motions for a game, such as golf, tennis or dancing. Characters on the television screen do what the players do, so the players can see how well they are performing.

SOURCES: Nintendo, Wikipedia

Health Sense: Three important questions can reduce your risk of stroke

Strokes are both common and preventable: 80 percent of strokes are preventable. Recognizing the symptoms and acting fast to get medical attention can help save lives and limit ensuing disabilities a stroke victim may suffer.

In medical jargon, a stroke is a cerebrovascular accident (CVA) and it occurs when a blood vessel in the brain suddenly becomes blocked or bursts. When this happens, blood fails to flow to that area in the brain, cutting off oxygen and nutrients to the brain cells there.

With no blood supply, the brain cells and nerves will die and the capacities that area of the brain controls will be lost, temporarily or permanently. When strokes are severe the sufferer can become paralyzed, unable to speak, or even go into a coma, depending on where the stroke occurs and how much of the brain is damaged.

Strokes can strike anyone at anytime, regardless of sex or age. Typically, stroke symptoms start suddenly, within seconds to minutes, and in most cases do not progress further. On average, two million brain cells die every minute following a typical stroke, which increases the chance of permanent damage, disability or death.

Stroke is the leading cause of disability among adults in the world today and one of the leading causes of death after cancer and heart disease. Disability affects 75 percent of stroke survivors, which can hamper their ability to work.

"The effects of stroke often place a significant burden of care on the patient's family because the stroke survivor often needs assistance in everyday activities we take for granted -- walking, eating, going to the toilet, talking," said Dr. Keith Goh, consultant neurosurgeon at International Neuro Associates, part of Novena Medical Centre and East Shore Hospital in Singapore.

"In addition to physical disabilities, 30 to 50 percent of stroke survivors suffer post-stroke depression -- they may be irritable and withdrawn, have trouble sleeping, and their self-esteem may suffer. In some cases, depression can reduce motivation and worsen patient's condition," he said.

With the effects of stroke being so often drastic, it's good news that they can be prevented. Three vital facts about stroke can help those at risk prevent them from occurring. First, what are the risk factors? Second, what tests can be done to assess an individual's risk? Third, what can be done to prevent a stroke?

Risk factors


Stroke occurs more often in people who fit the following categories. Strokes are more frequent in men than women, more frequent in the over-50 set. Habits and lifestyle choices mark other higher risk groups, including people who are overweight; have high blood pressure or diabetes; smoke tobacco, drink alcohol, and are under stress; do not exercise; and eat a diet high in salt and fat. Anyone with a history of heart disease in themselves or their families has a higher risk of stroke as well.

Signs, symptoms and medical tests


If you have one or some of the following signs or symptoms, even for a short time, you may have experienced a stroke. These include: sudden loss of vision; weakness in the face, an arm or a leg; difficulty talking or understanding speech; or severe headaches, dizziness or loss of balance. Your doctor may advise testing such as computerized tomography (CT) or magnetic resonance imaging (MRI) which provide images of the brain so she or he can look for signs of a stroke. Often the doctor will also ask for an angiogram, to study the blood vessels, or a perfusion scan to assess the pattern of blood flow. Several blood tests are commonly ordered to assess the overall risk of stroke.

F.A.S.T is a simple test for detecting stroke symptoms early. This will allow for immediate and appropriate medical care, which can help prevent death from strokes, and reduce the severity of disability after one occurs.


F = FACE


Ask the person to smile. Does one side of the face droop?


A = ARM


Ask the person to raise both arms. Does one arm drift downward?


S = SPEECH


Ask the person to repeat a simple sentence. Does the speech sound slurred or strange?


T = TIME


If a person has trouble with any of these simple commands, emergency services should be called immediately.


Stroke prevention


If you have any risk factors described above, your doctor will advise you on how to reduce the likelihood of a stroke. Regular medical check-ups to monitor and treat high blood pressure, diabetes mellitus, high cholesterol and heart disease; leading a healthy lifestyle, regular exercises, stress reduction and not smoking will help to prevent an onset of stroke.

"Sometimes medication will need to be given, such as anti-platelet drugs or anti-coagulant drugs, to prevent blockage of a blood vessel. And if there are blood vessel abnormalities, which may lead to bleeding in the brain, then surgery may be needed," said Dr. Charles Siow, a consultant neurologist, also on staff at International Neuro Associates.

Everyone has some stroke risk. While some factors are beyond your control, regular check-ups and early detection can help reduce the likelihood and reduce the severity of any stroke you do experience. The Neurosurgery and Neurology Specialists of International Neuro Associates provides a stroke risk assessment consultancy service, where a panel of blood and radiology tests are performed to assess a patient's risk of stroke. Costing S$1,500 (US$1,015), the stroke risk screening package includes; MRI and MRA scans; blood tests (FBC, renal panel, HBA1C, lipid panel, CRP, PT/PTT); ECG; clinical assessment and consultation with a neurologist or neurosurgeon.

Challenge Air Events Give Disabled Individuals Free Flights

Challenge Air Events Give Disabled Individuals Free Flights

Children and adults with disabilities, including Cerebral Palsy, as well as individuals with certain types of cancer, such as mesothelioma, have the opportunity to take flight with the Challenge Air program, which provides free flights for children and adults & their families. Other constraints include that of breathing in which case children would require nebulizers.

The program operates in about 16 different U.S. cities, and an event costs about $13,000. Generally, local businesses sponsor the event. Challenge Air has been providing flights for the last 16 years and recruits volunteer pilots to give plane rides.


Children and adults with Cerebral Palsy experience various degrees of learning disabilities and may be at a heightened risk of developing certain health problems, including heart defects and ear infections.

None of that matters, however, when a disabled child is up in the air at a Challenge Air event.

Founder Rick Amber believed that “every disabled person should see the world from a different view…out of their wheelchairs and crutches and from the sky.” Amber, who lost the use of his legs while serving in the United States Navy, was passionate about providing disabled individuals with new and unforgettable life experiences. Amber passed away in 1997, but his wish is carried on by the staff at Challenge Air.

To contact Challenge Air, please visit www.challengeair.com.

Sounds of Healing: Music Therapy

"Music hath charms to soothe the savage breast,
To soften rocks, or bend a knotted oak."
-William Congreve

Have you ever felt so overwhelmed by a mellifluous strain that tears have streamed down your eyes in a wave of catharsis? Or has a soulful melody opened the flood gates of old memories, to transport you back in time to a beautiful reverie? How often have you rocked your blues away listening to feet tapping music?

From infants to the infirm, music’s appeal is universal and nonpareil, wafting its way to the heart!

Dan Ellsey, a 33 year old cerebral palsy patient couldn’t agree with this more, for him music has become a novel way of expression. On his specially designed computer program called hyper score, Ellsey breaks into a composition to convey the innermost feelings in his heart. Just like Ellsey and for a many others, the repertoire of musical notes has helped convey a myriad of emotions, which words often fail to do.

The quintessence of communication, sound, is evident right from the instant of birth. A baby’s cry is endowed with a certain rhythm, pitch, intensity and purpose, to attract an appropriate response from the parents.

Our hearts beat to an internal rhythm. It is further believed that sounds influence the complete human energy system, increasing our response to them, which is perhaps one good reason why we are also called ‘musical beings’.

Music Therapy is "the prescribed use of music by a qualified person to effect positive changes in the psychological, physical, cognitive, or social functioning of individuals with health or educational problems" (American Music Therapy Association 1999).

Sound of Music in Medicine

The connection between music and healing dates back to the time of Plato and Aristotle when vibrations of sounds were employed to alleviate physical pain and relieve psychosomatic disorders.

Music therapy rose to prominence during World War I and World War II; at that time musicians were employed to render appropriate musical notes to alleviate mental trauma and physical pain to veterans of war. The response was so good that many hospitals began to employ musicians.

With the increasing popularity of music in medicine, the need for formal training in music therapy was felt. Thus, the first music therapy degree program was created in 1944 in Michigan State University. Many numbers of colleges have grown since then which enable degree programs in music therapy.

During the 1960’s, in Scandinavia and Britain, musical vibrations were used to heal. Popularly called as music baths, clients in Norway were bathed in sound and music.

The more recent form of music therapy called as vibroacoustic therapy, is an extension of music baths, where sound is transferred directly from the air into the body of the patient. Certain medical conditions like cerebral palsy, asthma, constipation, abdominal pain, and sleeplessness have responded well to the treatment.

Music therapy involves the methodical application of music by a qualified music therapist to treat psychological and physiological aspects of illnesses. It also lends itself as a diagnostic tool in locating developmental delays and psychological issues in children. Further, music therapy supports other forms of medical treatment.

Broadly music therapy is used to alleviate pain, control stress, build communication, assist in physical rehabilitation, enhance memory, and aid expression. The services of music therapists’ are sought in hospitals, mental health departments’ nursing homes, psychiatric rehabilitation centers, and schools.

Music learning is known to give an impetus to communication skills, so the services of music therapists are sought in schools for helping special learners. It also helps people with mental health problems understand their feelings better, and leads to positive changes in their mood, enabling better control over their lives.

Music also provides the background support for physical exercise and takes away boredom while performing routine chores. It can be employed for reducing stress even among healthy people.

Music therapists initially make an assessment of the person against a set of parameters which includes – cognitive skills, physical health, emotional health, and communicative abilities. The therapists tailor music to meet the specific health needs of the individuals, which also involves periodical evaluation and follow up.

Body Tunes into Melody

Wondered why a baby sleeps peacefully hearing a lullaby?

Human behavior is profoundly influenced by music, according to the book ‘Biomedical Foundations of Music as Therapy’ by Dale B. Taylor. According to Dale, the brain is absolutely captivated by music and this positive influence is transmitted to the rest of the body.

"Musicophilia”, a book by neurologist Dr. Oliver Sacks, tries to delve into a deeper understanding of the brain’s responses to music. Offering an explanation he says, “It’s unclear why humans are so uniquely sensitive to music - certainly music shares many features with spoken language, and our brains are particularly developed to process the rapid tones and segments of sound that are common to both."

It is said that the moment we hear a tune, deep breathing increases, which is a good way to beat stress. Music also reduces heart rate, and regulates the body temperature appropriate for relaxation to set in. Further, the body secretes more of serotonin, in response to music. This is perhaps why a lullaby calms the baby, soothing it to sleep.

Research Sings Paeans

"Music washes away from the soul the dust of everyday life." -Red Auerbach

The state of ‘happiness’ while listening to a favorite number shows up in brain scans as evidence of positive response to music, report Scientists from the Montreal Neurological Institute. Appealing music is thought to titillate certain regions in the cortex of the brain, importantly regions associated with ‘thinking’. There have been many scientific studies that have enumerated the benefits of music therapy. Results of some of these are enlisted below:

• A 2001 study conducted on burn patients, whose burns required to be periodically scraped to lessen the formation of dead tissue, found that music therapy helped alleviate extreme pain occurring during the procedure.

• A 2007 endeavor by Cochrane Collaboration, studied the data from 51 ‘pain’ studies and it showed that music helped reduce pain and the requirement for narcotic drugs.

• Cochrane Collaboration also found the immense benefits of music therapy in the improvement of certain mental conditions, for instance schizophrenia.

• Premature infants who listened to lullabies were found to be quick in learning the art of ‘sucking’ which helped them gain weight faster, compared to preemies not exposed to the benefits of music therapy.

• Hospitalized children suffering cancer showed a boost in their immune system when they sang, played and listened to music as compared to children who were not exposed to music therapy according to Deforia Lane, director of music therapy at the Ireland Cancer Center in Cleveland. Stroke patients and music therapy for regaining speech: Music’s impact on the brain is certain, according to Dr. Gottfried Schlaug, chief of the Cerebrovascular Disorder Division and Stroke-Recovery Laboratory at Beth Israel Deaconess Medical Center. Dr. Schlaug found those suffering a stroke on the left side of the brain, with their speech centers damaged, responded very well to “melodic intonation therapy." Using two tones to sing and communicate this form of music therapy helped patients graduate into actual speech much faster than others.

• Paralysis and Music Therapy to regain gait: Music therapy has helped patients suffering partial paralysis to regain their gait, according to research from the Center for Biomedical Research in Music at Colorado State University. Walking to the rhythms of music, patients retrain to walk much faster than patients who were not exposed to music therapy for rehabilitation.

• Autistic children and music therapy: To understand how the autistic brain processes music, a new study is proposed to be conducted by Istvan Molnar-Szakacs, a researcher at the UCLA Tennenbaum Centre for the Biology of Creativity. Explaining the background of the study, Istvan Molnar-Szakacs said, "Music has long been known to touch autistic children. Studies from the early days of autism research have already shown us that music provokes engagement and interest in kids with ASD. More recently, such things as musical memory and pitch abilities in children with ASD have been found to be as good as or better than in typically developing children."

Healing is undoubtedly a divine manifestation of music. From ‘touching a chord’ to ‘touching a cure’ the world of medicine is swaying to the boundless repertoire of music. ‘Without music, life is a journey through a desert’, Pat Conroy said, and medicine agrees to it wholeheartedly!

Bucket List

I am a fan of Morgan Freeman so when Bucket List came out I couldn't wait too see it, and Last night I got too see it, What a great moving film it is and although it is sad it is well worth a look. It moved me and also had a profound effect on Mum, to the point where for the first time ever when watching a film she actually cried, I knew why it hit us the way it did and that's because we have lost family to Cancer. Although it was sad it was also very funny, and it proved that no matter what's happening in life you can live life to the full because you never know what is around the corner. It also proved that as a world we are complete strangers but we do have the ability to come together and become the best of friends, no matter what age sex religion and disability we are