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Balance Treatment Using Household Items

Balance Treatment Using Household Items
Kenneth L Miller, PT, DPT, CEEAA
November 5, 2014
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Objectives and Background

The first objective for this course is to introduce how to use the ICF.  You will see much more use of the ICF in the coming months to the next coming years, because it is a nice way to framework our patients and to try to classify our patients beyond disease.  The next thing is the STEADI program and Otago Exercise Program.  Have you heard of these programs and use them in your practice? The third item is to list three household items for balance training.  We will go over more than three different items.  Number four is how to incorporate balance confidence into a comprehensive treatment program.  This is an area that I see lacking at a lot of agencies, especially in my own, when I see patients who are afraid to move, afraid to get up and about, limiting themselves from participating in their ADLS.  When you ask the patient why they are not doing it, the two most common reasons are they are afraid of doing it because they may fall, and the second thing is they are depressed and do not have any motivation to do it.  The third thing is they have pain.  Those are the three most common areas we see for people self-limiting their activities in the home.  Those three things all need to be addressed.  Traditionally, therapists will address pain, but confidence and depression are two areas where therapists need to be more involved with trying to get behavior change with the patients, and getting them to do more activities. 

That leads to the last topic, as far as the objectives, which is how to engage patients and improve adherence to the programs that we are putting in place.  That adherence is critical to improving the outcomes of our patients.  Does anyone use balance confidence skills in their practice with their assessment at this point?  I will go over how to incorporate balance confidence measures as a part of the program.  The overall topic is using household items in balance training and a big part of the balance training is using the items to help improve confidence, in addition to performance.

Pretest

Below is a pretest.  I want you to jot on a piece of paper the answers for yourselves.  I will go over the answers at the end of the presentation. 

  • True/False. The International Classification of Function, Disability and Health (ICF) is a classification system based on the medical model of disease.
  • True/False. The STEADI Program and Otago Program use the same chair stand test assessment tool.
  • True/False. Balance confidence is a metric that is predictive of fall risk.
  •  

kenneth l miller

Kenneth L Miller, PT, DPT, CEEAA

Dr. Miller is a Clinical Educator for Catholic Home Care where he provides staff development, competency training and assessment, continuing education, orientation program development and training to the therapy staff using best practice and evidenced-based practice tools. He serves as a guest lecturer and adjunct teaching assistant in the DPT program at Touro College in Bay Shore, New York. He serves as chair of the Practice Committee of the Home Health Section (HHS) of the American Physical Therapy Association (APTA) and a member of the Practice Committee of the Academy of Geriatric Physical Therapy (AGPT) of the APTA. He is a member of the Editorial Boards of the GeriNotes publication and Journal of Novel Physiotherapy and Physical Medicine. Additionally, he is a manuscript reviewer for the Journal of Geriatric Physical Therapy. He has authored numerous articles for the Journal of Geriatric Physical Therapy; GeriNotes and The Quarterly Report Newsletter of the HHS. He is a sentinel reviewer for MORE Rehab through McMaster University, where he reviews articles in order to provide evidence based research to the rehab professions. 



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