NEW Faculty Member – Christina Finn

Education Resources Christina Finn Christina Finn[/caption]

We are thrilled to introduce Christina Finn as a new member of Education Resources’ faculty.

Christina Finn MS, OTR/L is a clinical specialist in visual perceptual rehabilitation at the Rusk Institute of Rehabilitation Medicine at NYU Medical Center in NYC and an adjunct professor at Long Island University in Brooklyn.  Christina graduated from the University of Scranton in 2004 with a Masters Degree in Occupational Therapy.  She has advanced training in vision therapy and holds a certification in adult vestibular rehabilitation. Christina has experience in all areas of rehabilitation across the spectrum of care, including acute care, inpatient, and outpatient rehabilitation.  She lectures nationally on the topics of vision rehabilitation, perceptual rehabilitation, management of concussion, and neurological rehabilitation.  She has developed competencies for training staff in management of concussion/mild traumatic brain injury and for management of visual perceptual deficits. 

Christina Course:
Post Concussion Syndrome

 

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Help needed from pediatric PT’s and OT’s! Positioning for a complex 13 month old.

DEAR ERI COMMUNITY:

Posting from Megan:

Hi folks!
I am hoping to start a brainstorm thread for a really complicated kid I have picked up.
He 13 month old boy, one of triplets – his identical brother did not survive and there was twin-to-twin transfusion resulting in my guy losing most of his frontal lobe. He is a very involved kid. The biggest concern at this point is that he needs to be held – practically all the time, even asleep – because if he is not held in a tight “clamshell” he goes into extreme extensor tone and screams and cries. He can tolerate his belly on a rigged up cushion from an OT for about 30 seconds. I have been brainstorming a list of things to try with him but would love any ideas.
His positioning when he is comfortable is sitting on mom’s leg, hips and knees flexed, spine kyphotic except cervical spine hyper extended (strangely he has pretty good head control) but this cervical posture is concerning in the long term. He hates any pressure on the back of his head that would bring his spine into better alignment.
Basically the family is looking for something that will hold him in his comfortable position without their hands.
My thoughts to try:
Theratogs
Full seating/positioning eval with a very skilled vendor
Stander? He would need AFOs
He is getting started with Perkins (MA school for the blind)- maybe they could build him a chair that would work??
Togrite to hold him in the clamshell on his side on floor (OT gave them a gait belt to try for this, didn’t work)
Nada chair?
They have a clamshell seat thing – maybe was some kind of stadium seat – which has been a little bit useful inside a baby hammock – but he still extends out of it. Thought about drilling holes in it for belt at key points of pelvis to keep him in it.

Any other thoughts and suggestions, things you’ve tried or found helpful for a very involved kid like this would be fantastic! Thank you! 

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Whats on the horizon for stroke rehab?

Researchers at Ohio State Wexner Medical Center may have found a way to help prep a stroke victim’s brain prior to physical therapy to aid a more complete recovery. A non-invasive transcranial magnetic stimulation, or TMS,  prepares a stroke patient’s brain for physical therapy by sending low-frequency magnetic pulses painlessly through a victim’s scalp to suppress activity in the healthy part of the motor cortex. This allows the injured side to make use of more energy during physical therapy, which immediately follows the TMS.

Please click here for the full article found in the Washington Post

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Richard Clendaniel – Vestibular Expert, Publishes Paper in the Journal of Neurologic Physical Therapy

Richard Clendaniel, PT, PhD Richard Clendaniel, PT, PhD[/caption]

Richard Clendaniel, PhD, PT, vestibular expert and instructor for Education Resources publishes a paper in the Journal of Neurologic Physical Therapy (34:2): 111-116, 2010 

Summary: 
The efficacy of both habituation and adaptation exercise interventions in the treatment of unilateral vestibular hypofunction has been demonstrated in several prior studies. The purpose of this paper, by Richard Clendaniel, was to describe the preliminary results of a study that compared the effects of these two different exercise approaches on outcomes related to vestibular function. 

Seven participants with unilateral vestibular hypofunction completed a 6-week exercise intervention after randomized assignment to either habituation (H) exercises, or gaze-stability (GS) adaptation exercises. The following measures were taken pre-treatment and post-treatment: Dizziness Handicap Inventory (DHI) to measure the symptom impact, motion sensitivity quotient (MSQ) to assess sensitivity to head movements, and the dynamic visual acuity test (DVA) as a measure of gaze-stability during head movements.

Gaze-stability and habituation exercises have previously been shown to decrease symptoms of dizziness and increase function in individuals with vestibular disorders. The preliminary results of this study indicate that both exercise interventions lead to a reduction in the self-report measure of the impact of symptoms on the ability to function, a decrease in the sensitivity to movements, and an improvement in the ability to see clearly during head movements. The author states: “Continued investigation will be needed to determine if these results will hold, to determine if there are different effects of the two interventions, and to determine the mechanisms of improved visual acuity.”

The actual mechanisms underlying the improved dynamic visual acuity test (DVA) for either intervention are not known. Analysis of the eye movements during the DVA test both pre- and post-intervention may help elucidate these mechanisms but were considered beyond the scope of this paper.

Dr. Clendaniel, recently appointed to the Medical Advisory Board for VEDA; Vestibular Disorders Association, teaches a number of Vestibular Rehab courses for Education Resources including the new Cervicogenic Dizziness online course:

Vestibular Rehabilitation: Evaluation and Management of Individuals with Dizziness and Balance Disorders

Vestibular Rehabilitation: Advanced

Online Course:Vestibular Rehabilitation: Cervicogenic Dizziness

Clinicians: What has been your experience treating patients with unilateral vestibular hypofunction? Do you utilize habituation exercises, gaze-stability adaptation exercises or both? Will this research change what you do clinically?

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