Category Archives: Occupational Therapy

The Value of Therapy Balls and How Best to Store Them

Body Awareness, Daily Living, Gross Motor, Hippotherapy, Occupational Therapy, Strength & Rehab

by Shoshanah Shear

I have had the joy of working in four different countries and a number of different facilities. Some equipment regardless of the setting one works in or what the age of the client is. Therapy Balls definitely fit into this category. I have enjoyed using these in treatment with head-injured or stroke patients just as much as with children with learning problems, or even the blind.

I think balls of various sizes, textures, and shapes are a tell-tale sign that you have stepped into an OT room or department. They assist in meeting so many goals and certainly show how dynamic OT is and how creative we need to be with every treatment plan and session. Let’s face it, balls are fun for most ages. They are colorful and versatile. Being round means that they are dynamic, resulting in the ability to grade therapy sessions by working on an unstable surface.

Therapy balls are beneficial for improving:

  • motor control
  • muscle tone
  • trunk control or strengthening core muscles
  • upper limb function for clients with orthopedic or neurological disorders
  • introducing fun games and exercises into therapy
  • eye-hand coordination
  • righting and balance reactions
  • weight shift

Balls can encourage a child to feel excited to come into a treatment room or to prepare a blind child for hippotherapy. Balls can be just as important to an older woman needing to reduce internal scarring from repeated abdominal surgery.

There is one problem with therapy balls: storage. Without due care, your therapy room can quickly become messy, cluttered, and a potential safety hazard. We don’t want our clients tripping over equipment!

If you’ve ever worked in an OT department or been involved in developing a therapy department in limited space, then you can appreciate the need to organize physio/Gymnic balls. There are times that facilities will look into securing a suitable shelf, setting up a hammock specifically for therapy balls, or acquiring an array of other wall or ceiling fittings.

But what can do you do if your practice is in rented space that doesn’t permit attaching anything to the walls or ceilings? Or if your OT room is in a building with prefabricated walls and ceilings, reducing the strength and stability of the internal structure?

When I started in private practice, one of the first pieces of equipment I obtained was a large therapy ball with bells inside. Amongst my first private clients was a child who was blind from birth and severely sensory-deprived, hence the bells within the ball. It was wonderful to introduce a ball game in which he could participate because he could hear where the ball was.

The problem was how to store the therapy ball. I grappled with this dilemma until I discovered the wonderful Ball Stacker. It looks professional and neat and makes a good impression when a parent comes into the therapy room for the first time. Now you can use therapy balls even if you can’t attach brackets, shelves, or hammocks to the wall or ceiling.

Another valuable accessory to the therapy ball, is the Ball Handpump which offers the freedom to alter the pressure in the ball according to the goals of your client.

 

Shoshanah Shear

Occupational Therapist, healing facilitator, certified infant massage instructor, freelance writer, author of “Healing Your Life Through Activity – An Occupational Therapist’s Story” and co-author of “Tuvia Finds His Freedom”.

Brain Gym, Occupational Therapy and the Figure Eight

Occupational Therapy, Uncategorized

by Shoshanah Shear

I came across Educational Kinesiology in the early 1990s when searching for tools or techniques to help healing from a chronic illness. Little did I know that it would become an integral part of much of my OT practice. I began with Brain Gym I and II and loved the fact that the two trainers in South Africa were experienced occupational therapists trained in both SI and NDT.

Brain Gym is wonderful for assisting with goal setting, whole brain learning, stress release, and re-patterning. Although there is a specific process to follow, many of the exercises are both beneficial and transferable into a regular OT session. One that I use a lot is the Lazy 8 – a figure eight that lies on its side like the infinity sign.

What is the Lazy 8 used for?

In Brain Gym terms, the Lazy 8 turns on or activates the eyes while also crossing the mid-line.

It can be used to improve ocular motor function, which assists with reading, and crossing the mid-line improves integration between the two hemispheres of the brain.

The repeated action of the Lazy 8 is also very calming. It can be used in several different formats – using the eyes, drawing the figure of 8 in the appropriate orientation, and in motion, as we shall see shortly.

The Lazy 8 can also be carried out as a motor activity, having the client walk, skip, or run around a figure eight. I love to use two hoops placed side by side on the floor to provide a visual cue. Varying the space between the hoops elongates or enlarges the figure eight. Make it more fun by having the client clap while moving around the figure of eight in time to music.

For added motor integration, combine the cross crawl with the Lazy 8. This often has to be carried out in stages:

  • having the client carry out their cross crawl while standing until they are sufficiently at ease with the exercise
  • upgrade to carrying out the cross crawl while walking on a straight line
  • upgrade further to doing cross crawls while walking a figure eight

When I first began using components of Brain Gym in my treatment sessions, I would often make up my own worksheets. I am delighted to discover that Therapro has a range of products that bring the figure eight into practice for all occupational therapists. Two examples include:

The development of these tools shows how Brain Gym is becoming accepted as a beneficial modality to use within OT. It also provides an added level of professionalism, which is important for anyone who is skeptical of either how Brain Gym combines with OT or the extent to which OT itself is a recognized profession.

Once clients are familiar with the Lazy 8 through either Trace the 8s or Race the 8s, introducing the Alphabet 8 helps improve their motor memory. The Alphabet 8 incorporates lower-case letters with the Lazy 8 and is wonderful as a pre-writing activity to enhance work to meet writing goals. It’s designed for English letters but, with some creativity and practice, cursive letters for Hebrew can also be used. Note, I am not sufficiently familiar with other alphabets to know how well they can be used in the Alphabet 8.

I mentioned earlier the benefit of improving a sense of calm. The rhythmic movement of drawing or moving in a figure eight is a wonderful addition to your toolbox for assisting clients in need of stress management and improving relaxation.

Shoshanah Shear

Occupational Therapist, healing facilitator, certified infant massage instructor, freelance writer, author of “Healing Your Life Through Activity – An Occupational Therapist’s Story” and co-author of “Tuvia Finds His Freedom”.

Creative Uses for the Elevated Writing Surface, Handwriting Tools and Positioning Cushions

Fine Motor, Handwriting, Occupational Therapy, Uncategorized

by Shoshanah Shear

Handwriting and writing position are often discussed in a school setting but what about our other clients. Let us consider a patient who is in hospital. Enabling a patient to engage in drawing, art, a pre-writing task, or writing itself following an illness or injury is invaluable. However, it can be a challenge to provide the necessary angle for a writing surface when working at the bedside. Some hospital-based OT departments have a table surface that adjusts in height as well as the angle of the writing surface. But such equipment is not always available or, if it is, there are times that a portable version is preferable.

The various slanted writing surfaces available through Therapro offer the solution. I particularly love the Collapsible Writing Surface. It opens the door to varying both the activity used in treatment as well as the location for the session.

Imagine for a moment a patient in an orthopedic ward following an MVA. The patient has multiple fractures with exoskeleton / P.O.P. and is depressed and uncooperative with all staff members. After persuading the doctor to refer to OT, a brief history reveals that the patient is an artist and the thought of not being able to draw is what depresses them enough to interfere with function on all levels.

As an OT, we can build up the grips of a pencil or paint brush. Another option to easing use of writing implement is through Triangular Crayons and Pencil Crayons. Triangular writing implements can also enable a patient of this nature to return to drawing by easing the demands of the small muscles in the hand. Although strengthening these muscles will be important, the first step might be to encourage return to meaningful activity, hence the need for an easier means of holding the writing or drawing implement.

Using the portable, collapsible slanted writing surface or easel, one can now take the patient out of the ward (whether on a trolley or in a wheelchair) and into either the OT department or, better still, the garden. A change of environment does wonders for the patient psychologically, not to mention the hope offered by enabling an artist to return to what they love best – drawing, painting or creating. Many artists gain inspiration from nature, hence being able to get into the garden can literally be a breath of fresh air that instills a desire to regain function.

Through this brief example, we can see that writing and being involved in creative pursuits is a necessary skill and activity for various age groups and types of clients, not only for children at school. The tools and equipment that are beneficial in the classroom can be equally important in a hospital or other setting.

The write slant boards or Better Board Slant Boards are also of benefit to:

  • a woman who is expecting and is placed on bedrest.
  • the elderly who has limited space due to downsizing and increasing need to take care of their backs. The fact that the slant boards are light and collapsable makes handling and storage easy for an older person.

Still related to positioning, two cushions that I have used quite often in my practice are the Disc‘O’Sit and the Movin’ Sit Air Cushion. I love the fact that they are portable and adjustable in terms of air pressure. This makes it possible to take these cushions to a treatment or evaluation in a home or workplace.

One group of clients I have found to benefit from these cushions is a pregnant woman who is experiencing lower back pain. Pregnancy related lower back pain is a common complaint which can be alleviated with appropriate exercise and positioning.

Shoshanah Shear

Occupational Therapist, healing facilitator, certified infant massage instructor, freelance writer, author of “Healing Your Life Through Activity – An Occupational Therapist’s Story” and co-author of “Tuvia Finds His Freedom”.