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>> Hi. My name is Blake and I'm
an occupational therapist at the Johns Hopkins Ataxia Center.
My job as an OT is to increase
your independence and safety with activities of daily living.
This means your activities that you need to do for
everyday life like bathing, dressing, toileting.
Today I'm going to review universal design,
adaptive equipment, energy conservation,
and different types of equipment and exercises.
But keep in mind that these are
just general guidelines and
exercises and might not be for everyone.
I will say though that research has shown that there is
good evidence that repetition of
task can help you actually get better at that skill.
So it is important to continue to do exercises and
continue to be as independent and
safe with your activities as you can.
Universal design includes zero step entrances,
wide hallways, wide
doorways that make spaces accessible for everyone.
This is important for somebody that has
ataxia because you can actually
modify your own home to be more accessible and safe for you.
They actually have funding for
most states that would help cover the cost of
some of these modifications that are actually going to
be in your home typically in the bathroom,
widening doorways, and potentially in the kitchen as well.
Adaptive equipment are just pieces of
equipment that can help you be more successful and
independent with different activities that you
need to perform everyday like bathing,
feeding and cooking,
as well as dressing.
This is an example of a shower transfer bench.
Typically it's used over top of
the tub so that you can sit on the edge of
the bench and get into the tub safely
without having to actually step over the tub lip.
This is helpful for patients that have difficulty with
standing or don't necessarily have support at home to help them.
This is an example of grab bars that are used around the toilet.
I recommend installing grab bars into the studs
in the wall instead of using this suction cup grab bars.
Just for stability and safety,
I believe installing the grab bars into the studs is
safer and more sturdy than using the suction cup grab bars.
During feeding you can use different pieces of equipment.
This is a scoop bowl.
You're actually able to scoop the food and use
the extra lip on the side to secure the food onto the utensil.
This helps you to reach your mouth easier with the food.
So you can be more independent while you're feeding and
hopefully keep it contained in the bowl itself.
They also have plates that have the lip on it as well.
There's several types of
utensils that can be used for feeding as well.
The first type that I have pictured here
is actually a weighted utensil.
This can help somebody that has
those extra ataxic movements or a more of a tremor.
So that when you're bringing the food to your mouth it's going to
be a sturdier, more fluid motion.
They also have utensils that have built up handles,
so that it can be easier to grip for the person.
Then they have a combination as well
of the built-up handle with the weight in it too.
Lastly, they have
swivel utensils which I
don't have a demonstration or a picture of.
But essentially, the end of the utensil is able to swivel.
So it helps with those tremors or those ataxic movements.
The utensil moves with you and then the food stays level.
For dressing, I have pictured a dressing stick which is
helpful when you don't have
a lot of motion in your arms or strength in your arms.
It just assists you in
navigating putting on different pieces of clothing.
I also have pictured a reacher.
This is helpful if you're needing to
reach different items like your shoes or your socks.
It can also be helpful to actually pull up
your pants and just helpful in
general if you're unable to reach for a far distance.
Then I also have pictured a button hook
which can actually be used one-handed if needed.
So you're able to hold on to the handle
and thread the end of the button hook through the button hole,
grab the button and then pull the whole thing back through.
Next I'm going to talk about energy conservation.
There are four P's to energy conservation.
The first P is planning.
Making sure that you're planning your day,
you have built-in break times in there if you need to have a rest.
This is to make sure that you're not getting
fatigued too much throughout the day.
The next P is actually pacing.
Making sure that you're picking activities that you
can then take a break after you've completed that activity.
Prioritizing.
Making sure that you are prioritizing
the activities that you need to
do towards the beginning of the day,
so that you're not as
fatigued and you're able to actually complete those.
Then lastly is positioning.
Typically, I tell people to try to do all of
their activities sitting if
possible and of course you can stand as you're able.
But making sure that you have a setup where you're able
to sit so you can take those rest breaks.
Sitting during dressing I think is important.
You can sit on the edge of the bed,
you can sit in a chair,
you can also sit when your meal
prepping and anything that you need to do.
If you can position yourself where you're saving your energy,
that would be the premise behind that one.
Then for the last part of the video I'm going to review
different exercises and a couple of pieces of equipment.
Again, these are more general exercises.
They might not all be the right fit for you.
So I would encourage to make an appointment with
an occupational therapist that
can tailor the program to your specific needs.
The first one that I'm going to review is actually the theraputty.
Different colors are different resistances.
The first exercise is a gripping exercise.
This is the gripping.
This is what it looks like.
You don't have to do these exercises quickly.
You can do them slow.
Then the next exercise is actually
pinching with the thumb on the top.
Your thumb is going to be pushing down,
so it looks like this motion.
Then the last one I'll demonstrate today is
pinching with your thumb and your two fingers.
So thumb and your first two fingers.
There are lots of other exercises that can
be performed with this type of theraputty.
I would just encourage you to reach out to
your occupational therapist to see
what exercises might be right for you.
The next piece of equipment that I wanted to
go over is called theraband.
This is a rubber band
that you're able to use for different strengthening exercises.
I just wanted to demonstrate two exercises today.
The first one is going to target the shoulder muscles.
By strengthening the entire body,
you're really going to get
more controlled movements with the hands.
The first one is you're just coming out to the side.
You want to go slow and controlled.
You don't want to go fast.
Then the second one is actually punching.
I like to hold the band pretty close and then I like
to actually wrap my hands too just so I don't let go of the band.
You're punching straight out in front of you.
This is good to target
those muscles pretty much in the entire arm.
Again, there are a ton of
other exercises that you can do with the theraband as well.
Next I wanted to talk about weight-bearing.
Weight-bearing is a good way to incorporate some of
these strengthening activities just in everyday life.
So if you're standing at
your sink and you're brushing your teeth,
you can use your other hand to bear
weight while you're brushing your teeth,
while you're combing your hair and then you can switch.
So by bearing weight you're increasing
that strength and you're actually decreasing
some of those tremors and
ataxic movements while you're
bearing weight through that extremity.
Then lastly I wanted to talk about coordination.
There's fine motor and then there's gross motor coordination.
Fine motor skills are just activities that use
this fine precision movements with your fingers.
Think about if you have to pick
something up really small like picking up
a penny or picking up a peanut to put into your mouth.
All of those are considered fine motor skills.
Gross motor skills are typically larger movements.
Reaching out to grab something,
that would be gross motor coordination.
You can work on these activities or
these skills by targeting specific activities.
For fine motor skills you can stack pennies,
you can flip pennies.
For gross motor you can flip your hands up and down,
seeing how quickly you can go.
You can touch your nose and then touch an object out in
front of you and then seeing how quickly you can do that.
All of those activities would be targeting
that fine and gross motor coordination.
That's all that I have for today.
Thank you so much for watching
and I hope that you found this information helpful.
If you think that any of these exercises might be beneficial,
please make an appointment with
an occupational therapist. Thank you.