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A Plaintiff's Attorney's Perspective on Life Care Planning
Published in Roger O. Weed, Debra E. Berens, Life Care Planning and Case Management Handbook, 2018
A life care planner cannot testify about hearsay conversations with the injured plaintiff, his/her family member, caregivers, and health care providers to prove the truth of the matter asserted by those individuals, but they can be referenced by the life care planner in explaining the foundation for the life care plan opinions. For example, a life care planner can explain an opinion for the inclusion of a standing wheelchair for a quadriplegic based on conversations with the injured plaintiff and the recommendation of his/her physicians. Likewise, the pricing guides or calls to durable medical equipment providers would typically constitute inadmissible hearsay but can be referenced to explain the foundation for the pricing of items in a life care plan. The key is to explain that all life care planners rely on this type of hearsay information in formulating their opinions because that is the accepted methodology.
Exoskeletons as an Assistive Technology for Mobility and Manipulation
Published in Pedro Encarnação, Albert M. Cook, Robotic Assistive Technologies, 2017
Jaimie Borisoff, Mahsa Khalili, W. Ben Mortenson, H. F. Machiel Van der Loos
Another concept merging powered orthoses with wheels is the ABLE project, described as a “biped-type leg-wheeled robot system” (Mori et al. 2011). With the ABLE prototype, a user is supported through sit to stand and passive standing with the powered orthosis. The feet of the orthosis are attached to small wheeled platforms that enable rolling mobility somewhat akin to a power standing wheelchair. Although walking function is not supported, the device can enable stair climbing by locking the wheeled platforms and using the powered orthosis to perform stepping up or down stairs. Perhaps other concepts that merge orthoses and wheels for improved mobility outcomes will emerge in the future.
Acceptance and Commitment Therapy (ACT) After Brain Injury
Published in Giles N. Yeates, Fiona Ashworth, Psychological Therapies in Acquired Brain Injury, 2019
Values – a compass for adjustment?: Frequently following brain injury, clients can become stuck on how unfair their predicament is and will often make conditional statements (e.g., if I cannot walk again, life is not worth living). The use of values can be a powerful and collaborative way of helping a client adjust to whatever disability and handicap their brain injury related impairment is affecting. The example given earlier is one that I’m sure that most professionals working in neurorehabilitation have encountered. A person has lost or reduced physical ability, and the combined effect of rigidity, egocentricity and reduced impulse control results in the person becoming stuck and making conditional statements. Usually when we walk we do it in the service of doing something else. It is true that we can walk just for the sake of walking, but even that is not an isolated experiential exercise. We could say, ‘I really value walking on the moors’, but we wouldn’t realistically walk with a blindfold and earmuffs on. ‘Walking on the moors’ also involves appreciating the sights and sounds of the moors so whilst we value the physical act of walking, we are always exposed to other facets of an activity in most things we do. Returning to our brain injury survivor it is true that they might value walking per se, but it is also the case that they value what walking ‘gives’ us, predominantly independence. Using values then it is productive to explore with the client what walking ‘gives’ them that they are missing. In doing this ways can be explored to find alternative methods of gaining access to the same valued experience. For example, one client related that he was not interested in rehab if he could not walk. Exploration of his values suggested that this was predominantly because he was an avid golfer premorbidly. Given that he had a dense left hemiplegia, the prospect of him walking or playing golf again was greatly reduced. He stated in the values assessment however that he really missed playing golf. Using a standing wheelchair, short-range clubs and interdisciplinary working with Occupational Therapy, Physiotherapy and Psychology, he was able to participate in ‘pitch and putt’ golfing activity. This inevitably bought up cognitive evaluations such as, ‘If I can’t hit a ball 250 metres with a driver, it’s not worth playing’. Such evaluations can then be tackled using cognitive defusion, acceptance and self as context techniques, as if the person really values the playing of golf, then playing is what matters.
Participation and engagement in family activities among girls and young women with Rett syndrome living at home with their parents – a cross-sectional study
Published in Disability and Rehabilitation, 2022
Ditte Kruse Gyldhof, Michelle Stahlhut, Eva Ejlersen Waehrens
The HAS is used to categorize ambulatory status into five levels as proposed by Vogel et al.; I: Community ambulator (walks indoors and outdoors for most activities with or without support/walking aid. A wheelchair for long trips might be needed), II: Household ambulator (walks indoors for most activities with or without support/walking aid. Uses wheelchair for some indoor activities and for all community activities), III: Therapeutic ambulator (walks in therapy sessions or with parents at home, school or day center with moderate to maximal support), IV: Non-ambulant/standing (requires wheelchair for all daily mobility needs but is able to stand with or without support or in a standing wheelchair or standing frame), V: Non-ambulant/non-standing (requires a wheelchair for all mobility needs). The HAS is administered through interview or observation [22].
Physical and occupational therapist rehabilitation of lower extremity fractures in veterans with spinal cord injuries and disorders
Published in The Journal of Spinal Cord Medicine, 2022
Marylou Guihan, Kayla Roddick, Tomas Cervinka, Cara Ray, Christopher Sutton, Laura Carbone, Frances M. Weaver
Participants acknowledged that many patient characteristics can affect post-fracture care include age, medical history, comorbidities and wounds: The more comorbidities patients have, the less likely … [their fracture is to be] surgically managed. (2/26, G40)[We work closely together] to manage [co-morbid] symptoms – extra precautions with the splinting and skin care … seating [adjustments], … reviewing their [transfer] techniques. (3/9, lines 87–90)Respondents indicated that SCI factors (e.g. duration of injury, level of injury, completeness of injury, ambulatory status) have the potential to affect post-fracture rehabilitation: [SCI] duration [matters]. The longer they’ve been sitting, the more osteoporotic they are – just trying to stabilize that, … getting them back to their activities [is more challenging]. (2/26, F57)[Orthopaedics typically isn't] considering … use … [of a] standing wheelchair [or a] standing frame … We may advocate for surgical fixation for patients who are able to weight bear. (3/13, D62)