Health Literacy and Health Promotion

After going through and listening to the lecture about health literacy, health promotion, and the social determinants of health, I learned that there is progress still to be made in the United States. As for example, the mission for Healthy People 2020 was to make sure that health was a priority and that it needs to be improved. Also, it said to make sure the public is aware and understands what the social determinants of health are and making progress with them. The social determinants of health are food, education, social justice and equity, stable ecosystem, income, peace, sustainable resources and shelter. However, our country has come in last when it comes to public health and to these determinants. Something else we need to take into consideration is that we are still experiencing occupational alienation, apartheid, and deprivation. All of these can occur simultaneously or can be isolated. It is important as a country and worldwide to make sure that everyone has the same rights, accessibility, engagement and meaning and purposeful activities in life.
What was a huge eye opener to me, were the videos on health literacy and how the medical and healthcare professionals need to do a better job explaining and comprehending medical terminology to clients and patients. It is important that we ask to make sure that the client's understand what they are reading or hearing so health and well-being can be optimized, instead of them feeling incompetent, afraid, insecure, uncertain, etc. We do not need to assume that everyone has the same level of education and be sure to use simple, nontechnical language. When this is achieved, there is a better sense of acceptance, relationship, rapport and support. We need to be better as a country and worldwide to make strides in advocating and educating about health literacy and promotion. We need to improve the patient experience of care, improve the health of populations, and reduce the per capita cost of health care. (IHI Triple AIM)

Scapulohumeral Rhythm

Scapulohumeral rhythm is important and relevant clinically because it shows the joint congruency or the ratio of movement between the scapula and humerus. If there is any dysfunction in the shoulder complex, it can affect the range of motion, function, and there can be pain or impingement. With every 3° of shoulder movement, there is 2° at the glenohumeral joint and 1° at the scapulothoracic joint. Furthermore if the client is properly coordinated (full 180° ROM), there should be 120° of glenohumeral abduction and 60° of upward rotation of the scapula. Knowing this ratio can help with seeing if range of motion has been affected, so if there are any problems with any movements with the scapula or humerus, the ROM of measurements will be different.This scapulohumeral rhythm also needs to have a good length-tension relationship to be able to carry out optimal function. Without optimal function, the ROM will be compromised especially with the osteokinematics and arthrokinematics of the shoulder complex. In detail, if the shoulder cannot elevate, the primary movements, (upward rotation, posterior tilt, and lateral rotation) cannot be carried out with full ROM.

AT & Home Modification/ Living in Place

After reading and going through the instructional online unit about the topic of assistive technology, I learned some things that I did not know before. This included the different categories of assistive technology, which included low, medium and high tech. I always thought that AT was just one whole category, but it makes sense to break it down like that. Also, I learned that there is a process to making a decision for assistive technology. There needs to be consideration of strengths and weaknesses, trials with the different materials, and implementation by issuing and training the AT. It is awesome to know that OT practitioners have the opportunity to specialize in this type of practice, as well as getting to consult, be involved in creating and developing, and have such a huge part in helping clients reach their full potential and to function independently.
As for the home modification and living in place podcast, this is an emerging area of practice and something I have been interested in because I believe home needs to feel like home even if someone has a disability. When living in place, everyone wants to feel safe, have accessibility, and feel comfortable and this is when an OT practitioner along with a team steps in to help. The podcast kept emphasizing the importance of an interdisciplinary team that involves an OT practitioner, construction, interior design, home inspectors, and so on. Also, the people speaking in this podcast were from the Living in Place Institute and discussed how their approach is for all homes and individuals. Also, they want there to be a sense of personal, unique and customized way of setting up a home or discussing certain types of adaptive equipment to the client. Some of the common items that are used within home modification are elevated toilets, grab bars, shower bench, two-hand rails, going away from a standard shower and bath tub, etc. Something else they mentioned that people can do to ensure a better living space is to remove throw rugs, have LED lights, detectors, first aid kit, and even electronic modifications (which is up and rising) like Alexa and Google Echo or Google Home are very beneficial and helpful, as well. It is important as OTs that we stay up-to-date with this emerging area of practice because the medical and health professional world is constantly changing and we want the best for our clients.

Importance and Purpose of ROM & MMT

As for ROM purposes, it is important that the client is in the right position and the goniometer is placed at the right bony landmark to get the most accurate reading. This ensures intrarater and interrater reliability. Also, you want the patient to be in the correct position for use of full ROM and being able to palpate and stabilize segments that are being measured. The purpose for the test position in regards to MMT is to make sure the client is comfortable and in the safest position, as well as in the correct position to be able to test the appropriate muscles being tested and have optimal muscle contraction (have client in MID ROM). As for the gravity eliminated position, this is used for the client's who have trouble holding the resistance of the break test against gravity. Placing the client in the gravity eliminated position, if needed, helps to facilitate greatest contraction because the joint being moved is not having to go against resistance because it is positioned parallel to the ground.

                                       

Everyday Action

Every morning when I leave for school, I have to open the door to my apartment. When I reach out to twist the door knob to open the door, my elbow extends, my shoulder flexes just a little, and there is slight supination of the forearm. As I open the door my elbow flexes, shoulder goes back in a neutral position (0°) and my forearm stays supinated. Flexion and extension of the elbow and flexion of the shoulder are in the sagittal plane about a frontal axis. Supination of the forearm is moving within the transverse plane about a vertical axis. The osteokinematics of the elbow are extension to flexion in a closed kinematic chain. As for arthrokinematics, the moving ulna is the concave part which glides in the same direction on the stable convex part of the humerus. The prime movers for elbow flexion are the biceps brachii, brachioradialis, and brachialis, which results in a concentric contraction.