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The Neurological Therapist – Interview your therapist

The Neurological Therapist – Interview your therapist

Blog, Neurological Rehabilitation

The Neurological Therapist – Interview your therapist

Neurological therapy is a specialized area requiring devoted time and training.

When looking for a neurological therapist, whether for hiring or collaborating, it’s crucial to consider several factors to ensure they possess the necessary knowledge and skills in neurological rehabilitation.

Qualifications and Credentials

  • Do they hold any additional certifications relevant to neurological rehabilitation, such as Certified Stroke Rehabilitation Specialist (CSRS), Certified Brain Injury Specialist (CBIS), or Neuro-Developmental Treatment (NDT) certification?
  • Have they pursued advanced training or completed post-professional education programs focused specifically on neurological rehabilitation?
  • Are they members of professional organizations related to neurological rehabilitation, such as the American Occupational Therapy Association (AOTA) or the American Physical Therapy Association (APTA)?
  • Have they participated in continuing education courses or workshops related to specific neurological conditions, assessment tools, or treatment approaches?
  • Can they provide evidence of ongoing professional development and commitment to staying abreast of advancements in neurological rehabilitation practice?

Experience

  • What is the extent of their experience specifically in neurological rehabilitation, including the number of years dedicated to this specialty area?
  • Have they worked with a diverse range of neurological conditions, including stroke, traumatic brain injury, spinal cord injury, multiple sclerosis, Parkinson’s disease, etc.?
  • In what settings have they practiced neurological rehabilitation, such as acute care hospitals, inpatient rehabilitation facilities, outpatient clinics, community-based settings, or specialized neurological rehabilitation centers?
  • Can they demonstrate versatility in adapting their skills and expertise to different practice environments and patient populations?
  • Can they provide specific examples or case studies of patients they’ve treated for neurological conditions, highlighting successful outcomes achieved through their interventions?
  • Are they able to articulate their approach to managing complex neurological cases, including the development of individualized treatment plans, goal-setting strategies, and ongoing assessment and modification of interventions based on patient progress?
  • Have they encountered challenging cases or situations in neurological rehabilitation, and how did they approach and overcome these challenges to achieve positive results for their patients?

Knowledge of Neurological Conditions

  • Do they have a comprehensive understanding of different neurological conditions, such as stroke, traumatic brain injury, spinal cord injury, multiple sclerosis, Parkinson’s disease, Alzheimer’s Disease, Dementia, etc.?
  • Are they familiar with the specific impairments and challenges associated with each condition?
  • Can they tailor treatment plans to address the unique needs of individual patients with neurological disorders?
  • Can they integrate the principles of neuroplasticity, motor learning, and task-specific training into their treatment approaches to promote recovery, maximize functional independence, and enhance quality of life for individuals with neurological disorders?

Evidence-Based Practice (EBP)

  • Do they stay updated on the latest research and evidence-based practices in neurological rehabilitation?
  • Are they able to integrate evidence-based interventions into their treatment plans?
  • Can they critically evaluate the effectiveness of different treatment approaches based on research findings?

Assessment and Evaluation Skills

  • How do they assess and evaluate the functional abilities and limitations of patients with neurological conditions?
  • Are they proficient in using standardized assessment tools commonly used in neurological rehabilitation?
  • Can they conduct comprehensive evaluations to identify specific impairments and set realistic goals for therapy?

Treatment Techniques and Modalities

  • What treatment techniques and modalities do they utilize in neurological rehabilitation?
  • Are they skilled in neurorehabilitation approaches such as neuroplasticity-based therapy, constraint-induced movement therapy, task-specific training, etc.?
  • Do they have experience with assistive devices, adaptive equipment, and technology used in neurological rehabilitation?

Interdisciplinary Collaboration

  • Are they accustomed to working collaboratively with other healthcare professionals, such as neurologists, physiatrists, speech therapists, etc.?
  • Do they ask you about your experience and your team at the time of your evaluation?
  • Do they seek to offer referrals and recommendations for other professionals at the time of your evaluation?
  • Can they effectively communicate and coordinate care plans with other team members to optimize patient outcomes?

Patient-Centered Care

  • Do they prioritize patient-centered care and actively involve patients in goal-setting and treatment planning?
  • Are they empathetic, compassionate, and able to establish rapport with patients and their families?

Bottom Line:

For anyone seeking neurological physical therapy or occupational therapy, it’s essential to do some research and be ready to ask questions when meeting with your therapist. Since health insurance often limits the number of sessions and out-of-pocket costs for neurological rehabilitation can be high, it’s crucial not to waste time with the wrong therapist. Take the time to research your provider before committing to treatment.

Traumatic Brain Injury Rehabilitation TBI

Traumatic Brain Injury Rehabilitation TBI

Conditions We Treat, Neurological Rehabilitation, Traumatic Brain Injury

Traumatic Brain Injury (TBI) Rehabilitation and Support Services

TBI and Concussion in Teens

Traumatic Brain Injury Treatment Buffalo NY - Blue Fill

TBI and Concussion in Adults

Traumatic Brain Injury and Brain Health
Concerned about your brain health? Contact Us.

What is a Traumatic Brain Injury (TBI)

A traumatic brain injury (TBI) can occur after a fall,  sport injury, motor vehicle accident, blunt force trauma, accident at work, or any other occurrence causing the brain to be jolted or damaged in some way. The severity of the injury can range from mild to severe, and you may experience symptoms lasting days, weeks, months, or even years. 

Most people will begin the recovery process of a TBI in an inpatient hospitalization setting where you will regain physical, sensory, behavioral, and cognitive function. If you experienced a TBI resulting in concussion, but is not so severe that you require inpatient hospitalization, you should be immediately beginning community-based outpatient occupational therapy. In a more severe case, outpatient occupational therapy will be part of the continuum of care. Making sure you see a therapy team familiar with the symptoms and recovery process of a traumatic brain injury is crucial to maximizing your outcomes. 

Symptoms of

Traumatic Brain Injury (TBI)

Physical Symptoms

  • Headaches and migraines
  • Impaired balance and dizziness
  • Neck and lower back pain
  • Upper body and lower body muscle weakness
  • Loss of coordination
  • Difficulty sleeping and staying asleep

Emotional Symptoms

  • Mood changes
  • Personality changes
  • Increase volatility and short-tempered 
  • Unable to balance emotions 
  • Increased desire to be alone

Cognitive Symptoms

  • Confusion
  • Decreased executive functioning 
  • Short attention span
  • Short term memory deficits
  • Impaired information processing speed
  • Impaired multi-tasking ability
  • Impaired working memory skills
  • Word finding difficulties

Sensory Symptoms

  • Tremors in hands, legs, or feet
  • Neuropathy, paresthesia, numbness, or tingling in hands and feet
  • Depth perception difficulties
  • Visual perceptual deficits 
  • Sensitivity to light and sound
  • Ringing in your ears (tinnitus) 
  • Taste changes or lack of appetite

For more information, check out the Brain Injury Association

Meaningful Activities (Occupations) affected by a Traumatic Brain Injury (TBI) 

ADLs 

  • Bed mobility 
  • Cleanliness and thoroughness while toileting
  • Showering and maintaining safety 
  • Dressing 
  • Mobility (standing tolerance, walking, getting up and down without dizziness)

IADLs

Other Occupations (meaningful activities)

  • Maintaining volunteer roles 
  • Participating in hobbies or extra-curricular activities
  • Going to church 
  • Exercising 

Why is outpatient occupational therapy imperative for Traumatic Brain Injury 

What are some problems an occupational therapy can help solve? 
References

Altman, I. M., Swick, S., Parrot, D., & Malec, J. F. (2010). Effectiveness of community-based rehabilitation after traumatic brain injury for 489 program completers compared with those precipitously discharged. Archives of Physical Medicine and Rehabilitation, 91, 1697–1704.

Kim, H., & Colantonio, A. (2010). Effectiveness of rehabilitation in enhancing community integration after acute traumatic brain injury: a systematic review. American Journal of Occupational Therapy, 64, 709–719. https://dx.doi.org/10.5014/ajot.2010.09188

Traumatic brain injury. (2019, March 29). Retrieved March 13, 2020, from https://www.mayoclinic.org/diseases-conditions/traumatic-brain-injury/symptoms-causes/syc-20378557

Traumatic brain injury. (2019, March 29). Retrieved March 13, 2020, from https://www.mayoclinic.org/diseases-conditions/traumatic-brain-injury/symptoms-causes/syc-20378557

Lewy Body Dementia and Rehabilitation

Lewy Body Dementia and Rehabilitation

Conditions We Treat, Dementias, Neurological Rehabilitation

Lewy Body Dementia 

Schedule an appointment to establish care
Learn more about Lewy Body Dementia
Lewy Body Dementia LBD Explain Lewy Body Proteins

Lewy Body Dementia is a condition that looks different for each person, but the way the disease works in the brain, known as pathogenesis, follows the same general pattern. Some specialized physical, occupational, and speech therapists are trained in understanding how the disease spreads through the brain and how it impacts different functions over time. These changes are specific to Lewy Body Dementia, making your journey with LBD different from someone with Alzheimer’s, frontotemporal dementia, or Parkinson’s.

If you’ve been diagnosed with LBD, it’s important to start building your long-term management team. While you won’t need therapy or medical appointments all the time, you will benefit from having periods of therapy when changes in your body or function start to appear. Having someone to contact when these changes happen ensures you can get the right support at the right time. Early diagnosis and intervention are key to maintaining as much independence and function as possible throughout the course of the disease.

What is Lewy Body Dementia?

Lewy Body Dementia (LBD) is the second most prevalent progressive neurodegenerative diagnosis causing dementia. It is second to Alzheimer’s disease (AD), but differs in many ways. It is signified by lewy body proteins that appear in various parts of your brain affecting thinking, functional activities, judgement, executive function, functions of the autonomic nervous system, and mobility.

The Lewy Body Association  has more information regarding the difference between Alzheimer’s Disease (AD) and Lewy Body Disease (LBD).

Learn more about Lewy Body Dementia
Schedule an appointment to establish care

What do I do if I’ve been diagnosed with Lewy Body Dementia (LBD)?

After receiving an LBD diagnosis, it is important to establish a long-term therapy team including occupational therapy, speech therapy, and physical therapy familiar with the progression of this diagnosis. By establishing a small therapy team that will be able to remain with you throughout the stages of Lewy Body Dementia, you will be able to maximize your physical function, maintain your performance in functional activities, and ensure you remain in control of your symptoms instead of the other way around.

Schedule an appointment to establish care

Symptoms of Lewy Body Dementia

  • Runny Nose
  • Visual hallucinations (detailed)
  • Delusions 
  • Agitation and frustration
  • Difficulty multi-tasking or remaining on task 
  • Information processing difficulties 
  • Stooped posture (similar to Parkinson’s disease)
  • Overall movements and mobility slowing down
  • Balance and coordination decline 
  • Walking turns into a ‘shuffle’ 
  • Voice becomes more quiet 

For more symptoms of Lewy Body Dementia, head to Alzheimer’s Association. 

What are my options after receiving an LBD diagnosis?

Although there are neurocognitive enhancement medications, one of the most important things you can do for yourself is to seek out a team of therapists as early as possible. With the right early intervention strategies you can improve your symptoms and/or control the speed at which you experience decline.

What type of intervention is used by a neuro-centered rehabilitation team?

Learn more about Lewy Body Dementia
Schedule an appointment to establish care

How can outpatient occupational therapy help after a dementia diagnosis?

  • Once given a dementia diagnosis, we can ‘stage’ your dementia progression through specific screens and assessments so that you always feel in control of your circumstances.
  • Make recommendations for adaptive equipment, durable medical equipment, and mobility aids throughout each stage
  • Provide a hybrid approach to rehabilitation and maintenance grounded in neurocentric principles offering you an inclusive rehab program.

Multiple Sclerosis and Rehabilitation

Multiple Sclerosis and Rehabilitation

Conditions We Treat, Neurological Rehabilitation, Progressive Neurological Diseases

Multiple Sclerosis and Rehabilitation

Authored by Michelle Eliason, MS, OTR/L, CKTS, C.D.S.

Common Symptoms of Multiple Sclerosis

Multiple sclerosis (MS) is a neurodegenerative disease affecting the central nervous system (brain and spinal cord). During the progression of MS, the immune system attacks the myelin covering your nerve fibers. Myelin is the protective covering surrounding your neurons allowing your brain to communicate with the rest of your body. When this covering begins to breakdown, the ability for your brain to communicate with your organs and muscles also begins to breakdown. Over time, this lack of communication affects physical function and skills for independence. After receiving a diagnosis of Multiple Sclerosis (MS), it is crucial to find a trustworthy long-term therapy team consisting of occupational therapy, speech therapy, and physical therapy to ensure you are maximizing function throughout every stage of its progression. Early intervention and oversight of symptoms will greatly benefit you during this journey. 

Common symptoms include:

  • Increased fatigue (most prevalent) 
  • Numbness or tingling in the hands and feet 
  • Muscle weakness
  • Severe stiffness at times (spasticity) 
  • Walking difficulties
  • Slurred speech
  • Cognitive changes 
  • Depression

For additional warning signs of Multiple Sclerosis check out this article. Discover more information regarding the resources for the National Multiple Sclerosis Society through the  Multiple Sclerosis.

Meaningful Activities (Occupations) affected by Multiple Sclerosis

  • Moving and turning (stiffness and decreased flexibility)
  • Walking (numbness and tingling in feet) 
  • Standing tolerance while cooking a meal, using cooking utensils, and holding a pot/bowl/plate 
  • Taking care of children or parents due to fatigue and muscle weakness 
  • Coordinating large movements
  • Eating, fastening buttons, putting on makeup, shaving, turning a key, opening a jar, and writing (decreased dexterity, fine motor coordination)
  • Decreased endurance and stamina for all tasks
  • Decreased memory, problem-solving skills, executive function, and motor planning  affecting all ADLs and IADLs

What does occupational therapy address during outpatient therapy?

It is important to understand the body’s response to neurodegenerative illnesses  and to always look for a second opinion if you have been diagnosed and told therapy will not be effective. Remember that your brain has a desire to find new pathways and new ways of accomplishing meaningful activities (IADLs or ADLs)  after an injury (neural plasticity) and the function of neural plasticity exists until the day you die. 

What are some additional problems outpatient occupational therapy can address?
References

Multiple sclerosis. (2019, April 19). Retrieved from https://www.mayoclinic.org/diseases-conditions/multiple-sclerosis/symptoms-causes/syc-20350269

American Journal of Occupational Therapy, April 2016, Vol. 70, 7003395010. https://doi.org/10.5014/ajot.2016.703001

Ghahari, S., & Finlayson, M. (n.d.). A RESOURCE FOR HEALTHCARE PROFESSIONALS .

Godman, H. (2017, August 11). The Role of Occupational Therapy in MS. Retrieved March 12, 2020, from https://health.usnews.com/health-care/patient-advice/articles/2017-08-11/the-role-of-occupational-therapy-in-ms

Helpful Page Definititions

Functional Plateau

What is a functional plateau or functional baseline?

It can be confusing when you are told that you have stopped making progress and no longer qualify for therapy - nobody wants to hear this! A functional plateau label is given when the therapist you are seeing stops seeing progress being made toward the goals he/she set during the evaluation process. It is also considered 'reaching a new functional baseline'. This means they believe you have reached maximum progress or you will not make any measurable gains in the near future. They can no longer justify restorative therapy (therapy to bring back function). 

Remember that there are other therapists with other perspectives! There are specialty therapists for each individual diagnosis and they may see different therapeutic potential! Always get a second opinion before accepting the idea that you or your loved one has reached all of your maximum potential! You may just need another approach! 

 

Neural Plasticity

What is neural plasticity or brain plasticity? 

Neural plasticity or brain plasticity is a concept known by neurological-centered medical professionals. It is your brain's ability to create new pathways to work around injured ones! This is the foundation of rehabilitation (your body's ability to repair itself). Whether you are re-learning to put weight through your joints after surgery or re-learning to open and shut your hand after a stroke -- neural plasticity is involved! If someone has had a stroke, brain injury, diagnosed with Alzheimer's or another form of dementia, multiple sclerosis, etc. ---the body's desire to maintain its ability to function does not disappear it just needs to be guided in a specific way. 

Functional Activities

Occupation-based interventions are the most functional-based approach to rehabilitation. When you are invested in the activity and understand why you are doing something, your brain's ability to heal and re-learn motor patterns improves exponentially! Occupational therapists are functional rehabilitation specialists which means we are experts in translating physical strategies into functional activities! We understand that performing a sit-to-stand in the studio is much different than getting up from your favorite recliner chair! Likewise, re-learning how to move your arm or walk in the studio is much different than feeling confident entering your home or moving about the community! Buffalo Occupational Therapy always bridges this gap and includes these real-life elements as part of our outpatient rehabilitation process!

Activity Analysis

Occupational therapists specialize in activity analysis. Activity analysis is breaking down a task into its basic parts and you master each part of the whole activity in order to enable maximum independence.

Instrumental Activities of Daily Living (IADLs)

Instrumental Activities of Daily Living (IADLs) are essential for independence in life roles and required for aging in place. There are 8 activities core activities for independence including cooking, cleaning, communication, taking and managing medication, handling your personal finances, transportation and community mobility, shopping

Cooking - The ability to follow a recipe and having the stamina to prepare a meal for yourself and/or your family

Cleaning -   The ability to perform light housekeeping including making your bed, doing your laundry, washing the dishes, taking out the trash, vacuuming, sweeping, cleaning your bathroom, etc. 

Communication - The ability to use the telephone, the computer, have conversations with people (familiar and strangers), communicate your needs clearly.

Taking medication - The ability to sort and organize your medication or determine a compensatory method to do so as well as taking the appropriate dosage at the appropriate time. 

Personal Finances - The ability to establish an organization method to understand financial responsibilities and pay your bills on time. 

Transportation - Whether you are driving, calling for a driving service like a taxi or Uber, or taking public education. You must have a defined action plan for community mobility and transportation.

Shopping - The ability to plan transportation, plan a grocery/clothing list of needs for yourself and your home, have the stamina to collect your items at the store, and be able to get them into your house. 

Activities of Daily Living

Occupational therapists are trained in occupations and activity analysis. An occupation is an activity that you believe is important to your life. There are many levels of occupations, but activities of daily living (ADLs) are the most personal activities and are usually the ones people find most important if they were to lose the ability to complete them.  

ADLs include:

  • Bathing and showering
  • Getting dressed
  • Going to the bathroom
  • Walking and getting up and down from a chair or car
  • Eating and swallowing
  • Feeding 
  • Sexual activity 
  • Personal hygiene and grooming
  • Being able to use personal care devices like adaptive equipment and durable medical equipment 
Mobility Aid

As occupational therapists, we can assess functional movement and recommend adaptive equipment as well as durable medical equipment that will enhance your community mobility. Before we can make any recommendations, we must assess your ability to move and determine how you are walking and holding your posture, if you are presenting with muscle imbalances, the status of your upper body and lower body range of motion and flexibility deficits and finally, determine the status of your muscle stamina. After we complete this assessment, we can help you decide what mobility aid would be most appropriate for you, if any.

Types of mobility aids include cane (single point, quad cane, tripod cane), crutches, knee scooter, cane-crutch combination, walkers (4 wheeled walker, 2 wheeled walker, standard walker), walker-cane hybrid, hemi-walker, gait trainer, scooters, wheelchairs and more. 

We will help decide what device would be most appropriate, help with positioning, and then train you on best practices to maximize your mobility! 

Comprehensive Evaluation

Occupational therapists treat the entire person. Much like your primary care physician, we were required to learn elements of the entire body so that we could treat holistically (a one stop shop). Because of this, your outpatient rehabilitation specialist will perform an evaluation that assesses the following things: 

  • Personal history
    • Who are you? What do you do? What makes you tick? Why are you seeking outpatient therapy?
  • Physical function (upper body and lower body)
    • Strength, range of motion, and flexibility 
  • Neuromuscular function (brain to muscle communication)
    • Coordination, speed, agility, and reaction time 
  • Cognitive and Mind health
    • Short term memory, recall, information processing, and perception of illness 
  • Occupational Inventory (Activity and role inventory)
    • Roles you play like a caregiver, spouse, parent, employee, etc. 
    • Mobility inventory like the places you need to go 
    • IADL inventory and what activities are required for you to be independent 
    • Other activities that are important to you

Parkinson’s Disease

Parkinson’s Disease

Conditions We Treat, Neurological Rehabilitation, Progressive Neurological Diseases, Walking Conditions

Parkinson’s Disease Treatment 

Parkinson’s Disease Therapy and Management 

Parkinson’s Disease treatment; Parkinson’s Disease therapy; PD; Parkinson’s Physical Therapy

Common Symptoms of Parkinson’s Disease

Parkinson’s disease is the second most common neurodegenerative disease affecting the amount of dopamine your brain produces and stores. After receiving a diagnosis of Parkinson’s disease, it is crucial to find a trustworthy long-term therapy team consisting of occupational therapy, speech therapy, and physical therapy to ensure you are maximizing function throughout every stage of its progression. Early intervention and oversight of symptoms will greatly benefit you during this journey.

Common symptoms include:

  • Increased stiffness in your upper and lower body (starting with hands)
  • Small hand tremors
  • Decreased speed when you are walking or moving
  • Small handwriting
  • Decreased coordination in your upper body and lower body movements
  • Decreased strength in the muscles used by your voice making your speech decrease in volume
  • You find yourself ‘stooping’ more or standing/walking with rounded shoulders
  • Difficulty sleeping

For additional warning signs of Parkinson’s disease check out this article. Discover more information regarding the resources for Parkinson’s Disease through the  Parkinson’s Foundation.

Meaningful Activities (Occupations) affected by Parkinson's Disease

  • Moving and turning (stiffness and decreased flexibility)
  • Taking a first step (decreased movement initiation)
  • Controlling walking speed and stopping (walking speeds up over time)
  • Coordinating movements when changing direction or turning
  • Eating, fastening buttons, putting on makeup, shaving, and writing (decreased dexterity, fine motor coordination) 
  • Decreased endurance and stamina for all tasks 
  • Decreased problem-solving skills, executive function, motor planning, confusion, safety awareness affecting all ADLs and IADLs

What does occupational therapy address during outpatient therapy?

  • Progressive resistance training (strengthening for upper body and lower body)
  • Joint mobilization (stretching and range of motion)
  • Postural stability (posture, strong back and core)
  • Balance training
  • Gait and mobility training (walking, stairs, traversing obstacles in your path)
  • Aerobic fitness
  • Functional performance during ADLs and IADLs
  • Recommendations for adaptive equipment, durable medical equipment, and mobility aids.

It is important to understand the body’s response to neurodegenerative illnesses  and to always look for a second opinion if you have been diagnosed and were told therapy will not be effective- regardless of age. Remember that your brain has a desire to find new pathways and new ways of meaningful activities (IADLs or ADLs)  after an injury (neural plasticity) and the function of neural plasticity exists until the day you die. Research has demonstrated that with consistent, correct therapeutic interventions for 6+ weeks, walking and fluidity of movement can improve. 

References

Foster, E. R., Bedekar, M., & Tickle-Degnen, L. (2014). Systematic review of the effectiveness of occupational therapy– related interventions for people with Parkinson’s disease. American Journal of Occupational Therapy, 68, 39–49. https://dx.doi.org/10.5014/ajot.2014.008706

Almeida, M. J. (2017, September 13). Occupational Therapy for Parkinson’s Disease. Retrieved March 11, 2020, from https://parkinsonsnewstoday.com/occupational-therapy-for-parkinsons-disease/

Sturkenboom, I. H., Graff, M. J., Borm, G. F., Adang, E. M., Nijhuis-van der Sanden, M. W., Bloem, B. R., & Munneke, M. (2013). Effectiveness of occupational therapy in Parkinson’s disease: study protocol for a randomized controlled trial. Trials, 14, 34. https://doi.org/10.1186/1745-6215-14-34

Helpful Page Definititions

Functional Plateau

What is a functional plateau or functional baseline?

It can be confusing when you are told that you have stopped making progress and no longer qualify for therapy - nobody wants to hear this! A functional plateau label is given when the therapist you are seeing stops seeing progress being made toward the goals he/she set during the evaluation process. It is also considered 'reaching a new functional baseline'. This means they believe you have reached maximum progress or you will not make any measurable gains in the near future. They can no longer justify restorative therapy (therapy to bring back function). 

Remember that there are other therapists with other perspectives! There are specialty therapists for each individual diagnosis and they may see different therapeutic potential! Always get a second opinion before accepting the idea that you or your loved one has reached all of your maximum potential! You may just need another approach! 

 

Neural Plasticity

What is neural plasticity or brain plasticity? 

Neural plasticity or brain plasticity is a concept known by neurological-centered medical professionals. It is your brain's ability to create new pathways to work around injured ones! This is the foundation of rehabilitation (your body's ability to repair itself). Whether you are re-learning to put weight through your joints after surgery or re-learning to open and shut your hand after a stroke -- neural plasticity is involved! If someone has had a stroke, brain injury, diagnosed with Alzheimer's or another form of dementia, multiple sclerosis, etc. ---the body's desire to maintain its ability to function does not disappear it just needs to be guided in a specific way. 

Functional Activities

Occupation-based interventions are the most functional-based approach to rehabilitation. When you are invested in the activity and understand why you are doing something, your brain's ability to heal and re-learn motor patterns improves exponentially! Occupational therapists are functional rehabilitation specialists which means we are experts in translating physical strategies into functional activities! We understand that performing a sit-to-stand in the studio is much different than getting up from your favorite recliner chair! Likewise, re-learning how to move your arm or walk in the studio is much different than feeling confident entering your home or moving about the community! Buffalo Occupational Therapy always bridges this gap and includes these real-life elements as part of our outpatient rehabilitation process!

Activity Analysis

Occupational therapists specialize in activity analysis. Activity analysis is breaking down a task into its basic parts and you master each part of the whole activity in order to enable maximum independence.

Instrumental Activities of Daily Living (IADLs)

Instrumental Activities of Daily Living (IADLs) are essential for independence in life roles and required for aging in place. There are 8 activities core activities for independence including cooking, cleaning, communication, taking and managing medication, handling your personal finances, transportation and community mobility, shopping

Cooking - The ability to follow a recipe and having the stamina to prepare a meal for yourself and/or your family

Cleaning -   The ability to perform light housekeeping including making your bed, doing your laundry, washing the dishes, taking out the trash, vacuuming, sweeping, cleaning your bathroom, etc. 

Communication - The ability to use the telephone, the computer, have conversations with people (familiar and strangers), communicate your needs clearly.

Taking medication - The ability to sort and organize your medication or determine a compensatory method to do so as well as taking the appropriate dosage at the appropriate time. 

Personal Finances - The ability to establish an organization method to understand financial responsibilities and pay your bills on time. 

Transportation - Whether you are driving, calling for a driving service like a taxi or Uber, or taking public education. You must have a defined action plan for community mobility and transportation.

Shopping - The ability to plan transportation, plan a grocery/clothing list of needs for yourself and your home, have the stamina to collect your items at the store, and be able to get them into your house. 

Activities of Daily Living

Occupational therapists are trained in occupations and activity analysis. An occupation is an activity that you believe is important to your life. There are many levels of occupations, but activities of daily living (ADLs) are the most personal activities and are usually the ones people find most important if they were to lose the ability to complete them.  

ADLs include:

  • Bathing and showering
  • Getting dressed
  • Going to the bathroom
  • Walking and getting up and down from a chair or car
  • Eating and swallowing
  • Feeding 
  • Sexual activity 
  • Personal hygiene and grooming
  • Being able to use personal care devices like adaptive equipment and durable medical equipment 
Mobility Aid

As occupational therapists, we can assess functional movement and recommend adaptive equipment as well as durable medical equipment that will enhance your community mobility. Before we can make any recommendations, we must assess your ability to move and determine how you are walking and holding your posture, if you are presenting with muscle imbalances, the status of your upper body and lower body range of motion and flexibility deficits and finally, determine the status of your muscle stamina. After we complete this assessment, we can help you decide what mobility aid would be most appropriate for you, if any.

Types of mobility aids include cane (single point, quad cane, tripod cane), crutches, knee scooter, cane-crutch combination, walkers (4 wheeled walker, 2 wheeled walker, standard walker), walker-cane hybrid, hemi-walker, gait trainer, scooters, wheelchairs and more. 

We will help decide what device would be most appropriate, help with positioning, and then train you on best practices to maximize your mobility! 

Early Memory Loss and Confusion

Early Memory Loss and Confusion

Conditions We Treat, Dementias, Neurological Rehabilitation, Progressive Neurological Diseases

Early Memory Loss and Confusion

Authored by Michelle Eliason, MS, OTR/L, CKTS, C.D.S.

Symptoms of Early Memory Loss and Confusion You Should Take Seriously

If you are experiencing signs and symptoms of early memory loss, it is important to take them seriously. Although there are a variety of factors why you would be having difficulty remembering information, any brain changes should be a concern.

Some symptoms of early memory changes include:

  • Word-finding difficulties to items you should know 
  • Forgetting details of what was said in a conversation or phone call that took place less than 10 minutes ago
  • Frequently forgetting why you entered a room (more than 3 times a day) 
  • Getting lost when driving to locations you have frequently visited 
  • Personality changes (lethargic, increased desire to be alone, irritable, short-tempered)
  • Sleeping more
  • Harder time managing finances and appointments
  • Increasing difficulty managing tasks you are used to managing (multi-tasking) 
  • Work performance is being affected at your place of employment

Causes of Early Memory Loss and Confusion

  • Stress
  • Alcohol and Drugs Misuse
  • Anxiety and Depression
  • Prescription side-effects
  • Neurodegenerative Illness
  • Stroke
  • Traumatic Brain Injury 
  • Oxygen Loss
  • Brain Infections

Neurodegenerative Illnesses

  • Alzheimer’s disease
  • Vascular cognitive impairment
  • Dementia with Lewy bodies 
  • Stroke
  • Frontotemporal dementia
  • Parkinson’s disease
  • Huntington’s disease
  • Traumatic brain injury

Find out more specific information about your diagnosis:

How can occupational therapy benefit you if you are having early memory loss? 

Occupational therapy can greatly benefit you if you are concerned about specific symptoms. Early memory loss is a sign that something somewhere in your brain is not functioning as optimally as it could. Just as you would not ignore your right arm if you were having difficulty raising it, you should not ignore memory loss. With the right early intervention strategies, you can improve your symptoms. You will also have a healthcare professional to monitor your confusion each year in order to provide early intervention if the need arises.

    Occupational Therapy Interventions to Improve Your Memory

    What type of intervention is used by a neuro-centered rehabilitation team?

    Helpful Page Definititions

    Instrumental Activities of Daily Living (IADLs)

    Instrumental Activities of Daily Living (IADLs) are essential for independence in life roles and required for aging in place. There are 8 activities core activities for independence including cooking, cleaning, communication, taking and managing medication, handling your personal finances, transportation and community mobility, shopping

    Cooking - The ability to follow a recipe and having the stamina to prepare a meal for yourself and/or your family

    Cleaning -   The ability to perform light housekeeping including making your bed, doing your laundry, washing the dishes, taking out the trash, vacuuming, sweeping, cleaning your bathroom, etc. 

    Communication - The ability to use the telephone, the computer, have conversations with people (familiar and strangers), communicate your needs clearly.

    Taking medication - The ability to sort and organize your medication or determine a compensatory method to do so as well as taking the appropriate dosage at the appropriate time. 

    Personal Finances - The ability to establish an organization method to understand financial responsibilities and pay your bills on time. 

    Transportation - Whether you are driving, calling for a driving service like a taxi or Uber, or taking public education. You must have a defined action plan for community mobility and transportation.

    Shopping - The ability to plan transportation, plan a grocery/clothing list of needs for yourself and your home, have the stamina to collect your items at the store, and be able to get them into your house. 

    Activities of Daily Living

    Occupational therapists are trained in occupations and activity analysis. An occupation is an activity that you believe is important to your life. There are many levels of occupations, but activities of daily living (ADLs) are the most personal activities and are usually the ones people find most important if they were to lose the ability to complete them.  

    ADLs include:

    • Bathing and showering
    • Getting dressed
    • Going to the bathroom
    • Walking and getting up and down from a chair or car
    • Eating and swallowing
    • Feeding 
    • Sexual activity 
    • Personal hygiene and grooming
    • Being able to use personal care devices like adaptive equipment and durable medical equipment 
    Progressive Neurological Disorders (PND)

    Progressive Neurological Disorders (PNDs) are diagnoses that are progressive in nature and cause a decline in function throughout their progression. They are also known as neurodegenerative diseases. The decline can be seen over decades, years, months, or even weeks. 

    Some common examples of PNDs include Multiple Sclerosis, Parkinson's disease, Lewy Body Dementia, Lou Gerhig's Disease, Alzheimer's disease, Motor Neuron Disease, and Huntington's disease. 

    Early intervention for any neurodegenerative disease is critical to maintaining function for as long as possible. Restoration in early stages and maintenance throughout a disease progression can benefit your quality of life and reduce caregiver burden. 

    Neuromuscular Re-education

    NMRE is used by neurocentric occupational therapists to improve communication between your muscular system and nervous system. By promoting this stream of communication, you close the circle of recovery. Without NMRE, you can have the biggest muscles in the world and still experience mobility deficits due to poor reaction time, coordination, and mixed signals. 

    Heavy Work

    Heavy work is also known as resistance training and can utilize isometric and isotonic movements with or without external weights while focusing on eccentric and concentric muscle contractions. By partnering heavy work with visual perceptual tasks and neural recruitment visualization, increased carryover and recovery is experienced. 

    Neurodevelopmental Techniques (NDT)

    NDT is a hands-on approach used by occupational therapists to provide deep pressure to key parts of your body during repeated movements. Your movement mixed with repetition and deep pressure creates and stores new motor patterns in your brain in order to re-establish mobility and speed up recovery. 

    Proprioceptive Neuromuscular Facilitation (PNF)

    NDT is a hands-on approach used by occupational therapists to provide deep pressure to key parts of your body during repeated movements. Your movement mixed with repetition and deep pressure creates and stores new motor patterns in your brain in order to re-establish mobility and speed up recovery. 

    Cross Crawl Techniques

    A cross-crawl technique is used in movement and mobility training of both upper body and lower body. By recruiting both sides of your brain using opposite movement patterns we strengthen the communication across the two sides of your brain known as your corpus collosum. 

    Neurocognitive Strategies

    When combining neurcogitive skills and functions with motor elements, true cognitive rehabiliation can take place (memory, recall, sequencing, etc.). We include the domains of neurocognition like language, calculation, executive functioning, complex attention, perceptual-motor, and reasoning while training your body in order to increase neural plasticity and neural re-patterning. 

    Comprehensive Evaluation

    Occupational therapists treat the entire person. Much like your primary care physician, we were required to learn elements of the entire body so that we could treat holistically (a one stop shop). Because of this, your outpatient rehabilitation specialist will perform an evaluation that assesses the following things: 

    • Personal history
      • Who are you? What do you do? What makes you tick? Why are you seeking outpatient therapy?
    • Physical function (upper body and lower body)
      • Strength, range of motion, and flexibility 
    • Neuromuscular function (brain to muscle communication)
      • Coordination, speed, agility, and reaction time 
    • Cognitive and Mind health
      • Short term memory, recall, information processing, and perception of illness 
    • Occupational Inventory (Activity and role inventory)
      • Roles you play like a caregiver, spouse, parent, employee, etc. 
      • Mobility inventory like the places you need to go 
      • IADL inventory and what activities are required for you to be independent 
      • Other activities that are important to you