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OCTOBER 8, 2012
Reducing Hemiplegic Shoulder Pain UE Function & Home-Based CIMT Stroke & Ankle Foot Orthotics Community Integration & More
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Occupational Therapy News Going Beyond the Vote: AOTPAC Continuing Education Employment Opportunities
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Chief Operating Officer: Christopher Bluhm Director of Communications: Laura Collins Director of Marketing: Beth Ledford Editor: Ted McKenna Associate Editor: Andrew Waite CE Articles Editor: Maria Elena E. Louch Art Director: Carol Strauch Production Manager: Sarah Ely Director of Sales & Corporate Relations: Jeffrey A. Casper Sales Manager: Tracy Hammond Advertising Assistant: Clark Collins
FEATURES
Shoulder Pain and Stroke
Reducing Hemiplegic Shoulder Pain Through Practical Handling Skills
Donna Costa: Chairperson, Education Special Interest Section Michael J. Gerg: Chairperson, Work & Industry Special Interest Section Dottie Handley-More: Chairperson, Early Intervention & School Special Interest Section Kim Hartmann: Chairperson, Special Interest Sections Council Gavin Jenkins: Chairperson, Technology Special Interest Section Tracy Lynn Jirikowic: Chairperson, Developmental Disabilities Special Interest Section Teresa A. May-Benson: Chairperson, Sensory Integration Special Interest Section Lauro A. Munoz: Chairperson, Physical Disabilities Special Interest Section Linda M. Olson: Chairperson, Mental Health Special Interest Section Regula Robnett: Chairperson, Gerontology Special Interest Section Tracy Van Oss: Chairperson, Home & Community Health Special Interest Section Jane Richardson Yousey: Chairperson, Administration & Management Special Interest Section
AOTA President: Florence Clark Executive Director: Frederick P. Somers Chief Public Affairs Officer: Christina Metzler Chief Financial Officer: Chuck Partridge Chief Professional Affairs Officer: Maureen Peterson
2012 by The American Occupational Therapy Association, Inc. OT Practice (ISSN 1084-4902) is published 22 times a year, semimonthly except only once in January and December, by The American Occupational Therapy Association, Inc., 4720 Montgomery Lane, Suite #200, Bethesda, MD 20814-3449; 301-652-2682. Periodical postage is paid at Bethesda, MD, and at additional mailing offices. U.S. Postmaster: Send address changes to OT Practice, AOTA, 4720 Montgomery Lane, Suite #200, Bethesda, MD 20814-3449. Canadian Publications Mail Agreement No. 41071009. Return Undeliverable Canadian Addresses to PO Box 503, RPO West Beaver Creek, Richmond Hill ON L4B 4R6. Mission statement: The American Occupational Therapy Association advances the quality, availability, use, and support of occupational therapy through standard-setting, advocacy, education, and research on behalf of its members and the public. Annual membership dues are $225 for OTs, $131 for OTAs, and $75 for student members, of which $14 is allocated to the subscription to this publication. Subscriptions in the U.S. are $142.50 for individuals and $216.50 for institutions. Subscriptions in Canada are $205.25 for individuals and $262.50 for institutions. Subscriptions outside the U.S. and Canada are $310 for individuals and $365 for institutions. Allow 4 to 6 weeks for delivery of the first issue. Copyright of OT Practice is held by The American Occupational Therapy Association, Inc. Written permission must be obtained from the Copyright Clearance Center to reproduce or photocopy material appearing in this magazine. Direct all requests and inquiries regarding reprinting or photocopying material from OT Practice to www.copyright.com.
STROKE
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Jan Davis provides guidance for occupational therapy practitioners on reducing the incidence of shoulder pain in their poststroke clients.
DEPARTMENTS
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AOTA to Cast Historic Shadow on Capital
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Improving Upper Extremity Function Through a Home-Based Modified Constraint-Induced Movement Therapy Program
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Careers
Perspectives
Calendar
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Ellen Herlache, Donald Earley, Jill Ewend, Alissa Pasant, Caleb Johnson, Chelsea Schwab, Nicole Farrand discuss the benefits of home-based therapy for increasing the use of upper extremities poststroke.
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Discuss OT Practice articles at www.OTConnections.org in the OT Practice Magazine Public Forum. Send e-mail regarding editorial content to otpractice@aota.org. Go to www.aota.org/otpractice to read OT Practice online. Visit our Web site at www.aota.org for contributor guidelines, and additional news and information.
OT Practice serves as a comprehensive source for practical information to help occupational therapists and occupational therapy assistants to succeed professionally. OT Practice encourages a dialogue among members on professional concerns and views. The opinions and positions expressed by contributors are their own and not necessarily those of OT Practices editors or AOTA. Advertising is accepted on the basis of conformity with AOTA standards. AOTA is not responsible for statements made by advertisers, nor does acceptance of advertising imply endorsement, official attitude, or position of OT Practices editors, Advisory Board, or The American Occupational Therapy Association, Inc. For inquiries, contact the advertising department at 800-877-1383, ext. 2715. Changes of address need to be reported to AOTA at least 6 weeks in advance. Members and subscribers should notify the Membership department. Copies not delivered because of address changes will not be replaced. Replacements for copies that were damaged in the mail must be requested within 2 months of the date of issue for domestic subscribers and within 4 months of the date of issue for foreign subscribers. Send notice of address change to AOTA, 4720 Montgomery Lane, Suite #200, Bethesda, MD 20814-3449, e-mail to members@aota.org, or make the change at our Web site at www.aota.org. Back issues are available prepaid from AOTAs Membership department for $16 each for AOTA members and $24.75 each for nonmembers (U.S. and Canada) while supplies last.
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AOTA CEonCD
Occupational Therapy in Acute Care is designed specifically for therapists working in a hospital setting to acquire better knowledge of the various body systems, common conditions, diseases, and procedures. Students and educators will find this new publication to be the most useful text available on the topic. The book features color illustrations of the human bodys systems and functions, as well as tables delineating the signs and symptoms for various diseases.
Order #1258 AOTA Members: $109 Nonmembers: $154
Earn .6 AOTA CEU (7.5 NBCOT PDUs/ 6 contact hours). Enjoy the portability of this CEonCDTM. CDs will play in DVD players. Order #4875 AOTA Members: $210, Nonmembers: $299
News
Association updates...profession and industry news
AOTA News
Attention Students
nterested in being a student leader on the national level? Run for a position on AOTAs Assembly of Student Delegates. The deadline to apply is October 22. For more, visit www. aota.org/students/asd.
Industry News
f you work with older adults, be sure to attend the AOTA Adults With Stroke Specialty Conference, to be held from November 30 to December 1 in Baltimore, Maryland. An estimated 5.4 million people in America live with the disabling effects of stroke, and that number is predicted to increase as the population ages. Occupational therapy helps those recovering from a stroke resume valued activities through a holistic approach to intervention. Join keynote speaker Carolyn Baum, PhD, OTR/L, FAOTA, and other renowned experts offering comprehensive sessions, while earning up to 13 contact hours (1.3 CEUs/13 NBCOT PDUs). Register now at www.aota.org/ confandevents/stroke.
Chats Ahead
now someone interested in joining the occupational therapy profession? Direct him or her to AOTAs prospective student chats this fall, to be held on October 17 and November 15 at 7 p.m. EST. To participate or listen to archived chats, head to www. aota.org/students. Meanwhile, AOTAs next pediatric chat, OT Excellence in the Inclusive Classroom: The ASD Nest Model, will be held October 19 at 2:30 p.m. EST. For more, visit www.talkshoe.com/tc/73733.
ccupational therapy students and soon-to-be new practitioners can get a head start on a successful career by attending the 2012 AOTA/NBCOT National Student Conclave, to be held from November 9 to 10 in Columbus, Ohio. For more information, or to register, go to www.aota.org/ confandevents/conclave. The Conclave will provide attendees with evidence-based knowledge about current issues and emerging practice areas, exclusive opportunities to speak with leaders and experts, opportunities to meet with job recruiters and have rsums critiqued, and much more.
OT PRACTICE OCTOBER 8, 2012
he Middle Class Tax Relief and Job Creation Act of 2012 requires that outpatient therapy claims of more than $3,700 ($3,700 for occupational therapy services, and $3,700 for physical therapy and speech-language therapy services combined) be subject to manual medical reviews. Last month, the Centers for Medicare & Medicaid Services announced that reviews would begin on October 1. Occupational therapy practitioners providing services to Medicare beneficiaries will be affected, including those working in private practice, Part B skilled nursing facilities, home health agencies (TOB 34X), rehabilitation agencies (outpatient rehabilitation facilities), and comprehensive outpatient rehabilitation facilities. For updates, visit www.aota. org/news/advocacynews.
A O TA B u l l e T I N B O A r d
OUTSTANDING RESOURCES FROM
Using the Occupational Therapy Practice Guidelines for Adults With Stroke to Enhance Your Practice
(CEonCD) J. Sabari Earn .2 AOTA CEU (2.5 NBCOT PDUs/2 contact hours). ourse participants will learn key considerations for occupational therapy intervention, whether their clients are in the acute phase after stroke, the rehabilitation phase, or the continuing adjustment phase. Findings from published research that guide best practice in occupational therapy intervention with the stroke population are presented. For those interested in this area of practice, Occupational Therapy Guidelines for Adults With Stroke is essential reading. $68 for members, $97 for nonmembers. Order #4845. http://store. aota.org/view/?SKU=4845
J. Sabari etails the significant contribution of occupational therapy in treating adults with functional limitations after stroke. Appendixes include valuable resources, such as CPT codes related to occupational therapy for stroke survivors. $59 for members, $84 for nonmembers. Order #2211. http://store. aota.org/view/?SKU=2211
the profession. The World Federation of Occupational Therapists is partnering with www.promotingot.org to support OTGDS. In addition, OT4OT (www.ot4ot.com) is hosting an OT 24-Hour Virtual Exchange from October 29 to October 31 (depending on participants locations). The virtual exchange is a way for occupational therapy practitioners around the globe to share ideas about occupational therapy practice, education, and research.
Nebraska chapter of AIGA, which was originally founded as the American Institute of Graphic Arts. The AOTF-sponsored participants were Julie Bass, PhD, OTR/L, FAOTA; Charles Christiansen, EdD, OTR, FAOTA; Lisa Ann Fagan, MS, OTR/L, CALA; Ren Padilla, PhD, OTR/L, FAOTA; Dory Sabata, OTD, OTR/L, SCEM; Patricia Schaber, PhD, OTR/L; and Catherine Sullivan, PhD, OTR.
Resources
What Is OT?
ant to help others understand OT? The new AOTA What Is Occupational Therapy? brochure is a valuable resource for consumers and other professionals to better understand the role of occupational therapy and the important service it provides for people with injuries, disabilities, and illness. For more, search What is OT? on the AOTA store at myaota.aota.org/shop_aota/ index.aspx.
S. Gutman & A. Schonfeld rovides detailed steps for cognitive, functional-visual, perceptual, sensory, motor, cerebellar function, cranial nerve function, neuropathy and peripheral nerve function, and dysphagia screening, as well as a new section on mental status. Each chapter has screening forms that can be printed from the enclosed CD. This book is ideal for occupational therapy students and remains an essential tool for clinicians working in community and home health settings. $59 for members, $84 for nonmembers. Order #1226A. http:// store.aota.org/view/?SKU=1226A
Questions? Call 800-SAY-AOTA (members); 301-652-AOTA (nonmembers and local callers); TDD: 800-377-8555
even occupational therapists sponsored by the American Occupational Therapy Foundation (AOTF) participated in a 3-day workshop organized by The Evangelical Lutheran Good Samaritan Societys Vivo: Innovation for Well-Being to develop new services for seniors and their families. The 3-day workshop, held in Omaha, Nebraska, involved nearly 60 individuals organized into four design teams who were challenged to imagine creative new ways for addressing age-related issues such as isolation, dementia, and informal caregiving. The Good Samaritan Society, which is the largest nonprofit provider of senior care and services in the United States, plans to apply the concepts in developing services for a 20-acre mixed-use site under development in Papillon, Nebraska. The event was co-sponsored by AOTF and AIGA-Nebraskathe
c A p Ii T A l B r Ii e f Ii N G a ta b ng
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OTA has been working diligently throughout 2012 to expand its reach and presence on Capitol Hill. Attendance at AOTAs annual Capitol Hill Day in Washington, DC, has grown by more than 400 participants over the past 5 years, with attendance at the latest Hill Day, on September 24, totaling more than 500. In addition, local universities within driving distance of the capitals of New York, North Carolina, Ohio, and other states have scheduled their own Hill Days with the help and support of AOTA Federal Affairs staff. This year, AOTAs advocacy on the ground in Washington was emphasized by two Congressional briefings that helped educate Congress about the scope and breadth of the profession of occupational therapy. In May, AOTA held the first ever Congressional briefing on occupational therapy mental health practice, featuring AOTA Vice President and President-Elect Ginny Stoffel, PhD, OT, BCMH, FAOTA. The briefing was well attended by Congressional staff and advocates from the American Psychiatric Association, the Mental Health Liaison Group, and the Consortium for Citizens with Disabilities, who learned details about occupational therapys contributions to the treatment and recovery of people with mental health conditions. More recently, AOTA partnered with the American Physical Therapy Association (APTA) and the American Speech-Language-Hearing Association (ASHA) to organize and present a Congressional briefing sponsored by Representative Mike Michaud (D-ME) on the value of rehabilitation for veterans and wounded warriors, including
Careers
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PHOTOGRAPHS COURTESY OF RICARDO BARROS PHOTOGRAPHS
An Entrepreneurial Vision
Diane Vitillo
hemiplegia. He lived alone and was determined to be totally independent with his dressing. Although Joe was making marvelous progress with his upper body dressing, he was unable to independently don his AFO and shoe. In my experience, both occupational therapists and physical therapists have found the task of donning an AFO with one hand to be particularly problematic. Joe was so determined to succeed with this task that he challenged me to make something that would help him achieve his goal. It was his challenge that re-ignited my dream to make something that could change someones life for the better. I went home that evening and searched for items in my garage that could be used to keep an AFO in a stable position to allow placement of the foot using a one-handed approach. Lo and behold, I spotted a plastic mitre box (yesthats the box a carpenter uses to cut special angles in wood). It was light enough to easily maneuver and wide enough to accommodate Joes AFO, and its flat bottom would keep it stable during the donning process. With some minor adjustments, I was excited that this first prototype would be successful. The following morning, Joe arrived in the gym and I couldnt wait to begin our training. As he sat in his wheelchair watching me, I demonstrated for him how to use the device using only one hand. While seated in a long-sitting position on the mat, I placed the adapted mitre box near my foot and positioned the AFO within the mitre box. I then used a leg lifter to lift and place my leg into the AFO. Success! Needless to say, I was thrilled, and Joe couldnt wait to try his luck at it.
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am a polio survivor. Im also a dreamer. Perhaps thats why over the past 2 decades in my career in the rehabilitation profession, I have tried my best to develop innovative ways for my clients to complete meaningful tasks that are problematic for them due to their disability. Since I was 4 years old, I have not had the use of my right shoulder due to the effects of polio. As an inquisitive child, a blossoming adolescent, a young adult, and now an active senior, I have stockpiled an arsenal of strategies that have facilitated my lifes journey while living with a disability. As a therapist, I have shared many of these strategies with those under my care. Ive always had a dream of inventing something that could change the life of at least one person. This is my story of how my dream, plus one challenge, created a life-changing moment for a client. My career in the rehabilitation profession as both an occupational therapist and a physical therapist assistant has given me the opportunity to work with clients ranging in age from birth to end of lifemany of whom have personally touched my life. However, one in particular, a person recovering from stroke, gave me the opportunity to make a real difference in his. For many people recovering from stroke, the occupational performance area of lower body dressing specifically, independently donning an ankle foot orthosis (AFO) and shoesis quite daunting. Throughout my years of practice, when it came time to assist a client with hemiplegia with donning an AFO, I would often say (with some frustration in my voice), I wish someone would make something
that would hold the AFO in an upright position so you could easily slip your foot into it before it falls over. Joe was a 35-year-old male who had a stroke that resulted in right
The device can be used to facilitate the donning of different types of foot orthotics.
He was successful on his first attempt and his smile said it all. On the days that followed, Joe and I discussed my plans to add another design feature to this device. The current design allowed him to don the AFO while in a long-sitting position. But what about clients who preferred to sit at the edge of the bed or in their favorite chair to don the AFO? Back to the drawing board for me! I now enlisted the help of my husband (an engineer by trade and a skilled craftsman) to come up with a design that would allow the AFO to articulate from the originally designed long-sitting position to either a 90 or 45 angle, depending upon the clients donning preference. The design of this device evolved over many months of beta testing a prototype (made from wood and PVC) not only with clients recovering from stroke but also with clients who had other medical conditions that warranted the use of an AFO for safe ambulation. My dream of becoming an inventor came true, but, more importantly, my dream of changing the life of at least one person, Joe, became a reality. n
Diane Vitillo, MS, OTR, PTA, is the owner of Home Heart Beats, LLC and the inventor of The Original AFO Assist (patent pending). Home Heart Beats provides evaluative home assessments to clients who wish to successfully and safely age in place. For more information, contact Vitillo at homeheartbeats@comcast.net or visit www.homeheartbeats.com.
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JAN DAVIS
ne day, as I was walking through the dining room of a rehab center, I overheard a physician tell a family member, Shoulder pain is one of those things that goes along with having a stroke. I nearly stopped in my tracks. I was shocked and saddened at the same time. But not surprised. I used to feel the same way before I learned how to prevent shoulder pain. Many years ago, our inpatient rehab center was experiencing the same problem. Nearly half of our clients who were recovering from stroke experienced debilitating shoulder pain at the time of discharge. We tried everything we could think of, reviewed the literature, and consulted physicians, but nothing seemed to make a difference. Then I took courses from master clinicians who provided the in-depth knowledge and practical handling skills I needed to be successful. I learned how the structures of the shoulder were compromised following a stroke, how to prevent trauma, and specific handling methods for preparing the upper extremity for skilled function. I took meticulous notes, practiced the clinical skills in class, and returned to work to give it a try. The results were immediately evident. Not only did fewer of my clients complain of pain, but those with pain began to improve.
Guidance for occupational therapy practitioners on reducing the incidence of shoulder pain in their poststroke clients.
shoulder. Occupational therapy practitioners today face a dilemma in trying to determine the evidence and best practice for treating HSP. A full literature review can be an overwhelming and daunting task, as it entails reading through hundreds of articles, many with opposing views and each supported with evidence. Numerous studies address questions related to HSP such as: Does subluxation cause shoulder pain? Should slings be used? What are the causes of HSP? With an abundance of research, but few practical guidelines for intervention, even well-informed therapists often look elsewhere for guidance in determining effective therapeutic treatment methods based on evidence. I encourage occupational therapy practitioners to implement an evidence-based approach using their own clinical experiences. Sharpen your observation and handling skills. Expand your knowledge. Reevaluate your client. Do you observe any changes? At the end of every treatment session, you should be able to observe positive changes. Every practitioner should be able to see, however small, changes that demonstrate effectiveness during each treatment session. If no measurable changes are observed, then your handling methods and treatment plan must be modified. If occupational therapy practitioners are to be effective change agents in treating clients with stroke, we must have the clinical skills to make a difference.
but the results are often inconclusive. Problems involving soft tissue typically do not show up on an x-ray, and most physicians decide that expensive tests (such as MRI or arthrogram studies) are not warranted for a painful upper extremity that is also nonfunctional. Consequently, physicians and practitioners are at a loss of how to proceed and often fall back to old ways of practice based on common misconceptions. For decades, the HSP spotlight has been on glenohumeral subluxation as the major source of pain, with reducing subluxation a treatment priority. In fact, no fewer than 19 studies have been published on the association between shoulder subluxation and pain (eight studies supported the role of subluxation in pain, and 11 studies did not support the role of subluxation in pain).1 This is where a review of the most current literature can be extremely helpful. Fortunately for all of us, Robert Teasell, MD, and his team have created an excellent resource, available on the Internet (www.ebrsr.com), that reviews, summarizes, and provides conclusions based on a comprehensive
review of evidence related to stroke. Included in the review are lists of the possible sources of HSP, such as muscle imbalance, spasticity, trauma of the rotator cuff, humeral fracture, bursitis, tendonitis, glenohumeral subluxation, adhesive capsulitis, and reflex sympathetic dystrophy.1 Contrary to what many occupational therapy practitioners have learned in the past, the evidence does not support subluxation of the glenohumeral joint as the primary source of hemiplegic shoulder pain. The strongest evidence, according to Teasells team at www. ebrsr.com, supports the following conclusion: Although many etiologies have been proposed for hemiplegic shoulder pain, increasingly it appears to be a consequence of spasticity and the sustained hemiplegic posture.1 Based on the current evidence, occupational therapy practitioners should focus on the following guidelines to get a head start on reducing the incidence of shoulder pain in their setting: 1. Develop an in-depth understanding of the shoulder complex. 2. Know what to avoid. 3. Learn advanced clinical skills.
OCTOBER 8, 2012 WWW.AOTA.ORG
therapies and range of motion (ROM) performed incorrectly are also sources of HSP.1 Avoid the use of inappropriate exercise equipment, such as overhead pulleys, as there is strong evidence that they contribute to a markedly increased incidence of shoulder pain.1 For more on proper handling, see Figures 1 and 2 on pp. 10 and 11.
moving in and out of the Wheelchair (3,4) When transferring clients, helping
them stand, or repositioning in the wheelchair, always assist through the scapula and trunk. Never pull on the involved arm.
Most functional movements require a combination of all three planes of motion. There are 16 muscles that attach to the scapula, and care must be taken to maintain full excursion in order to maintain mobility and avoid impingement. Every time clients are handled, they are at risk for injury. Even well-intentioned health care providers or family members can unknowingly cause trauma to the shoulder. Moving clients incorrectly (such as taking hold of their arm to help them out of a chair) or poor positioning (an arm trapped or pinned beneath them) can contribute to impingement and HSP. Aggressive
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F O R M O R E I N F O R M AT I O N
resources for Stroke: http://www.aota.org/Consumers/consumers/Adults/Stroke.aspx Functional Treatment Ideas & Strategies in Adult Hemiplegia (2nd ed.). By J. Davis, 2009. Port Townsend, WA: International Clinical Educators. (Earn 1.5 CEUs [18.75 NBCOT PDUs/15 contact hours]. $195. To order, call toll free 888-665-6556 or shop online at http://www.icelearningcenter.com.) Teaching Independence: A Therapeutic Approach to Stroke Rehabilitation (2nd ed.). By J. Davis, 2009. Port Townsend, WA: International Clinical Educators. (Earn 1.5 CEUs [18.75 NBCOT PDUs/15 contact hours]. $195. To order, call toll free 888-665-6556 or shop online at http://www.icelearningcenter.com.) Treatment Strategies in the Acute Care of Stroke Survivors. By J. Davis, 2007. Port Townsend, WA: International Clinical Educators. (Earn 1.5 CEUs [18.75 NBCOT PDUs/15 contact hours]. $195. To order, call toll free 888-665-6556 or shop online at http://www.icelearningcenter.com.) CD Course. ASHT Management of Upper Extremity Problems: Cadaver Demonstrations and Therapeutic Management. By P. Bonzani, D. Kline, K. Landrieu, M. Robichaux, & H. Stokes. Mt. Laurel, NJ: American Society of Hand Therapists. (Earn .6 AOTA CEU [6 NBCOT PDUs, 6 contact hours]. $70 for members, $95 for nonmembers. To order, call toll free 877-404-AOTA or shop online at http:// store.aota.org/view/?SKU=4851. Order #4851. Promo code MI) DVD: Basics and Beyond: Everything You Need to KnowShoulder To Finger: Part 1 (CHT Prep Course). By N. Falkenstein & S. Weiss, 2011. St. Petersburg, FL: Treatment2Go. (Earn 3 AOTA CEUs [30 NBCOT PDUs, 30 contact hours]. $399 for members & nonmembers. To order, call toll free 877-404-AOTA or shop online at http://store.aota. org/view/?SKU=4858A. Order #4858A. Promo code MI) CD: Basics and Beyond: Everything You Need to KnowShoulder To Finger: Part 2 (CHT Prep Course). By N. Falkenstein & S. Weiss, 2011. St. Petersburg, FL: Treatment2Go. (Earn 2.5 AOTA CEUs [25 NBCOT PDUs, 25 contact hours]. $349 for members & nonmembers. To order, call toll free 877-404-AOTA or shop online at http://store.aota.org/ view/?SKU=4858B. Order #4858B. Promo code MI) CD: Basics and Beyond: Everything You Need to KnowShoulder To Finger: Part 1 & 2 (CHT Prep Course). By N. Falkenstein & S. Weiss, 2011. St. Petersburg, FL: Treatment2Go. (Earn 5.5 AOTA CEUs [55 NBCOT PDUs, 55 contact hours]. $649 for members & nonmembers. To order, call toll free 877-404-AOTA or shop online at http://store.aota. org/view/?SKU=4858. Order #4858. Promo code MI) DVD: Cumulative Trauma Disorders: An EvidenceBased Approach. By P. Bonzani. St. Petersburg, FL: Treatment2Go. (Earn 1.2 AOTA CEUs [12 NBCOT PDUs, 12 contact hours]. $359 for members and nonmembers. To order, call toll free 877-404-AOTA or shop online at http://store.aota.org/view/?SKU=4863. Order #4863. Promo code MI) Hand and Upper Extremity Rehabilitation: A Practical Guide, 3rd Edition. Edited by S. Burke, J. Higgins, M. McClinton, R. Saunders, & L. Valdata, 2006. St. Louis, MO: Elsevier. ($93.95 for members, $133.50 for nonmembers. To order, call toll free 877-404-AOTA or shop online at http:// store.aota.org/view/?SKU=1348. Order #1348. Promo code MI) Occupational Therapy Practice Guidelines for Adults With Stroke. By J. Sabari, 2008. Bethesda, MD: AOTA Press. ($59 for members, $84 for nonmembers. To order, call toll free 877-404-AOTA or shop online at http://store.aota.org/view/?SKU=2211. Order #2211. Promo code MI) DVD: Orthotics: Creative Mobilization Splinting Dynamic & Static Progressive Splinting (SPS) By D. Schwartz, 2011. St. Petersburg, FL: Treatment2Go. (Earn .9 AOTA CEU [9 NBCOT PDUs, 9 contact hours]. $299 for members & nonmembers. To order, call toll free 877-404-AOTA or shop online at http://store.aota.org/view/?SKU=4857. Order #4857. Promo code MI) DVD: Orthotics: Creative Static Splinting Made Simple. By D. Schwartz, 2011. St. Petersburg, FL: Treatment2Go. (Earn .7 AOTA CEU [7 NBCOT PDUs, 7 contact hours]. $249 for members & nonmembers. To order, call toll free 877-404-AOTA or shop online at http://store.aota.org/view/?SKU=4856. Order #4856. Promo code MI)
scapula in upward rotation, the third plane of motion, is last. Only when the scapula has been prepared and glides in elevation/depression and protraction/retraction can upward rotation of the scapula be attempted. For step-bystep instructions, see Figure 3 on p. 12.
Summary
The incidence of shoulder pain in clients who have had a stroke can be dramatically reduced. Clients who are managed correctly can avoid many of the painful syndromes that frequently occur during recovery, allowing for greater participation in activities of daily living (ADLs) and instrumental ADLs and improved quality of life. Each and every person working with the client, including all practitioners, nurses, family members, and caregivers, should be trained in protecting the shoulder from injury. Occupational therapy practitioners, with skilled expertise and an in-depth knowledge of the shoulder complex, can take the lead in training staff, educating families, and empowering patients in properly managing and caring for the hemiplegic shoulder. n references
1. Teasell, R., Foley, N., & Bhogal, S. K. (2011). EBRSR: Evidence-based review of stroke rehabilitation, module 11: The painful hemiplegic shoulder. Retrieved from http://www.ebrsr.com/ uploads/Module-11_hemiplegic-shoulder.pdf 2. Chae, J., Mascarenhas, D., Yu, D. T., Kirsteins, A., Elovic, E. P., Flanagan, S. R.,Harvey, R. L. (2007). Poststroke shoulder pain: Its relationship to motor impairment, activity limitation, and quality of life. Archives of Physical Medicine and Rehabilitation, 88, 298301. 3. Davis, J. (2009). Teaching independence: A therapeutic approach to stroke rehabilitation (2nd ed.). Port Townsend, WA: International Clinical Educators. 4. Jonsson, A., Hallstrom, B., Norrving, B., & Lindgren, A. (2007). Prevalence and intensity of pain after stroke: A population-based study focusing on patients perspectives. Journal of Neurology, Neurosurgery and Psychiatry, 77, 590595. 5. Cailliet, R. (1980). The shoulder in hemiplegia. Philadelphia: F. A. Davis. 6. Davies, P. (2000). Steps to follow: The comprehensive treatment of patients with hemiplegia (2nd ed.). Heidelberg, Germany: Springer-Verlag.
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Discuss this and other articles on the OT Practice Magazine public forum at http://www.OTConnections.org.
with the feet flat on the floor and pelvis in a neutral position (not in a posterior pelvic tilt). Mobilization begins with scapular elevationit is safe, does not cause impingement, and helps you evaluate excursion of the scapula. Is there any resistance? A scapula that has been immobilized may feel tight and, if there is an increase in tone, you may feel resistance against movement. In conOT PRACTICE OCTOBER 8, 2012
trast, a flaccid or low tone arm will feel heavy but the scapula will glide easily.3 After the scapula is gliding in elevation, carefully bring the arm into forward flexion, no more than 90. With your hand on the scapula, glide the scapula forward into protraction. Never pull on the humerus to bring the scapula forward; use only the scapula. With repetition, the scapula will begin to glide more easily. Mobilizing the
Jan Davis, MS, OTR/L, is president of International Clinical Educators. She specializes in creating stateof-the-art training materials filmed with real patients and real therapists. For more information, go to www.icelearningcenter.com or e-mail jandavis@ icelearningcenter.com.
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Improving Upper Extremity Function Through a Home-Based Modified Constraint-Induced Movement Therapy Program
ELLEN HERLACHE ALISSA PASANT DONALD EARLEy CALEB JOHNSON JILL EWEND CHELSEA SCHWAB NICOLE FARRAND
A research project found home-based constraint-induced movement therapy (CIMT), for increasing the use of upper extremities, to be as effective at home and often more convenient than at a clinic or other facility.
very 40 seconds, someone in the United States has a cerebral vascular accident (CVA), also known as a stroke.1 CVA is the third-leading cause of death in the United States and the leading cause of serious, long-term disability. CVA involves a sudden interruption of blood supply to the brain that can be caused by occlusion or hemorrhage in the arteries that lead to the brain. When the brain loses part of its supply of oxygen, many functions of the body, such as speech, vision, and motor abilities, can be seriously impaired. An individuals ability to participate in meaningful or necessary daily tasks, including activities of daily living (ADLs), depends on the effects of the CVA and the various anatomical structures compromised.2 One consequence of CVA that is experienced by many stroke survivors is learned nonuse. Learned nonuse is a loss of extremity function resulting not from damage to the nervous system itself, but rather from learned suppression of movement in an extremity that has been affected by the CVA. Learned nonuse is a behavioral phenomenon
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PHOTOGRAPHS ON PAGES 14-15 COURTESY OF ADAM BAUDOUX AND SAGINAW VALLEY STATE UNIVERSITY
that results from constant negative feedback. When a person with hemiparesis tries to use an affected extremity and experiences failure at task performance, a downward spiral often occurs, in which the person knowingly and progressively begins to suppress use of the affected limb. This downward spiral continues to grow based on a number of factors associated with lack of practice and failure when attempting to use the extremity, which ultimately can lead to a near complete loss of upper extremity use.3 The continued suppression of motor activity in the affected limb becomes reinforced by the brain. However, learned nonuse resulting from CVA does not necessarily need to become permanent. The behavioral aspect of learned nonuse is just that: learned. With proper retraining, practice, and motivation, learned nonuse can be overcome.3 After insult to the central nervous system, the brain can oftentimes be reprogrammed.4 This is particularly true for persons who have gross functional use remaining in the affected upper extremity after neurological insult.
affected by CVA.5 The unaffected arm is constrained for a set number of hours a day, to force use of the affected arm, leading to improvements in function of the affected upper extremity. During treatment, the client is expected to use his or her affected upper extremity to perform tasks, while the unaffected arm is placed in a constraint.4 Traditional CIMT involves an intense 2-week training protocol during which the participants nonaffected limb is constrained during therapy sessions (which are 6 hours in duration), and 90% of his or her waking hours outside of therapy sessions, including weekends. During therapy, fine motor tasks, gross motor tasks, and ADLs are performed on a one-on-one basis. Unfortunately, the large number of hours of direct therapistclient interaction required with traditional CIMT can make it difficult to obtain third-party reimbursement for this form of intervention.4 A week of CIMT therapy at two major centers in the United States costs between $3,000 and $3,500; this does not include the cost of transportation, housing, and meals for each participant. Thus, traditional CIMT is not a therapy regimen that many people have the resources to participate in.6 In response to these barriers, modified constraint-induced movement therapy protocols have been developed. Modified constraint-induced movement therapy (mCIMT) can include a number of different protocols, but it
Facing page: A participant learns to don the constraint. This page: During sessions in the clinic, subjects participated in repetitive task practice. At home, participants engaged in more purposeful activities.
frequently involves intense therapy for at least 5 days per week, for at least 3 hours a day, over a minimum of 4 weeks, for a total of 60 hours of therapy time distributed over 20 sessions.7 The mCIMT approach decreases time spent in the clinic and increases accessibility of this form of therapy for patients.8 Both CIMT and mCIMT have been found to be effective in increasing the use of upper extremities in patients who have experienced a stroke.9
travel to and from the clinic for therapy, adding to the ease of accessibility.10 Additionally, treatment programs involving home- and community-based rehabilitation programs are becoming a more popular approach to rehabilitation as third-party payers are moving toward decreasing coverage for inpatient rehabilitation services.11 Limited research has examined outcomes associated with home-based rehabilitation programs, particularly for persons with upper-extremity limitations post-CVA. One of the most recent studies, a meta-analysis completed by Coupar et al., reviewed randomized controlled trials comparing home-based therapy interventions focusing on upper-extremity limitations post-CVA to placebo, no intervention, or usual care.11 The results of the review indicated that the home-based programs were no more or less effective than the clinic-based programs (although the authors noted that there was a lack of good-quality evidence upon which to make recommendations regarding the effectiveness
of home-based versus placebo, no intervention, or usual care services). The authors emphasized that additional research focusing on the effects of home-based rehabilitation programs for persons with upper-extremity impairments post-CVA is necessary. It seems that for some clients, a home-based approach to mCIMT may be more realistic than traditional CIMT. Putting an mCIMT program in the participants control (including times of constraint wear, and identification of treatment activities that are most meaningful) may make the program more convenient and appealing.12 Furthermore, home-based mCIMT programs would not likely require the large amount of face-to-face clinic time that traditional CIMT programs do, therefore increasing accessibility for persons with limited financial resources and/or those with difficulty attending regular clinic-based therapy. After an extensive review of research on mCIMT, the authors concluded that a home-based form of mCIMT, though its use has not been explored in depth, could potentially be beneficial to persons who experience a CVA. The proven effectiveness of mCIMT, combined with the cost-effectiveness of performing therapy in the home, could be beneficial and convenient for clients and therapists alike.
he 2012 elections are almost here and, as AOTA members prepare to select the candidates they will support, the American Occupational Therapy Political Action Committee (AOTPAC) is sharing its list of supported candidates for the 2012 federal elections at www.aota.org/ aotpac-support. AOTPAC wants all occupational therapy practitioners to vote in the November 6 elections, regardless of which candidates they choose. Meaningful policy and legislation requires a bipartisan approach, and that is why AOTPAC supports candidates from both parties who support the occupational therapy profession. Voting is an exercise of our power in choosing legislators who represent our interests, says AOTPAC Chairperson Gail Fisher, MPA, OTR/L. Some people take voting for granted, and so many people dont vote, but really it is a privilege to be able to select our own representatives and feel that we have a personal stake in what they do. AOTPAC supports candidates in many states, including Tammy Duckworth, who is a big fan of occupational therapy. Duckworth was one of the first women to fly combat missions in Iraq, but she lost both of her legs and part of the use of her right arm in a helicopter crash. Duckworth spoke at AOTAs Annual Conference & Expo in 2012, praising army occupational therapy for assisting in her recovery. Duckworth is running for Illinois 8th district in the U.S. House of Representatives. Tammy Duckworth is a huge proponent of occupational therapy, says Fisher. Certainly having legislators like her who totally understand what we dowe wont have to explain itmeans they will fight for other peoples right to access our services when they need it. AOTPAC is a vital link to making sure congressional candidates who support occupational therapy are elected. A political action committee (PAC) is the legally sanctioned vehicle through which organizations such as AOTA can engage in
By becoming politically aware and contributing to AOTPAC, occupational therapy practitioners can ensure some influence in the decisions that affect their professional lives so directly.
therapy practitioners can ensure some influence in the decisions that affect their professional lives so directly. The money raised by AOTPAC is through direct AOTA member contributions. Without member contributions, AOTPAC would not have the high profile needed to support occupational therapy in the political process. No matter the amount of the contribution, the support that occupational therapy practitioners give AOTPAC will help its ongoing efforts on behalf of the profession. As an added incentive, members who contribute $1,000 or more to AOTPAC by November 1 will be eligible for a drawing to win a trip to Washington to attend the presidential inaugural events with Fisher and AOTA policy staff. Members who contribute $365 or more by November 1 will be eligible for a drawing to win a trip to Washington to attend the Congressional Swearing In Day activities. More information may be found at www. aota.org/aotpac-contest. In addition to voting and supporting AOTPAC, occupational therapy practitioners can also volunteer their time. You can go beyond voting and spend an afternoon working for a candidate, says Fisher. Work on the campaign, support them financially, or go to a town hall meeting the candidate is holding. Fisher hopes to use the excitement of the upcoming elections to help AOTPAC have many more successful years. I feel that AOTPAC is much more visible than it used to be, says Fisher. Former Chairperson Amy Lamb has done a tremendous job in bringing us to this point. I want to keep it going. n
Stephanie yamkovenko is AOTAs staff writer.
otherwise prohibited political action and work to influence the outcome of federal elections. AOTPAC is a voluntary, nonprofit, and unincorporated committee of members of AOTA. For 35 years, AOTPAC has furthered the legislative aims of AOTA by influencing and supporting candidates. AOTA is in charge of educating legislators. AOTPAC is in charge of making contributions to legislators, says Fisher. The two work very closely together. AOTPAC follows strict criteria when selecting candidates to support, including analyzing congressional support for occupational therapy legislative issues. AOTPAC supports candidates for the U.S. House of Representatives and U.S. Senate, and it supports AOTA members running for public office. AOTPAC does not endorse presidential candidates. When AOTPAC is successful in helping congressional candidates who support occupational therapy get elected, it allows the profession to be at the table for discussions about health care reform, the Medicare outpatient therapy cap, funding for research, and other issues that affect the practice of occupational therapy. AOTPAC has made political contributions to candidates for election in almost every state in both House and Senate elections, enabling AOTA to broaden its contacts in Congress. By becoming politically aware and contributing to AOTPAC, occupational
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CALENDAR
Order #WA1010, AOTA Members: $25, Nonmembers: $36. http://store.aota.org/view/?SKU=WA1010
Community Partnerships: Panel Presentation by Autism Society and Easter Seals, by Marguerite Kirst Colston and Patricia Wright. Panel discus-
sion on parent challenges, policies and programs, Autism Society services, and Easter Seals interventions for autism treatment. Earn 1 Contact Hour. Order #WA1011, AOTA Members: $25, Nonmembers: $36. http://store.aota.org/view/?SKU= WA1011
Occupation-based practice with a focus on postacute care practice settings for older adults and strategies for integrating occupation throughout the OT process to maximize clinical application. Earn .6 AOTA CEU (7.5 NBCOT PDUs/6 contact hours). Order #4875, AOTA Members: $210, Nonmembers: $299. http://store.aota.org/view/?SKU=4875
Dysphagia Care and Related Feeding Concerns for Adults, 2nd Edition, edited by Wendy Avery.
CEonCD
Skilled Nursing Facilities 101, by Christine Kroll and Nancy Richman. Importance of documentation, re-
rated PowerPoint presentations provide learning from prominent experts and designed to enhance knowledge and skills. With value pricing, purchasing the entire webcast series provides a specialty conference from home or work computer. These webcasts do not require a course exam. Earn up to 13.5 contact hours. Full Set Order #WA1000K. AOTA Members: $175, Nonmembers: $250. http:// store.aota.org/view/?SKU=WA1000K
quirements for different payers, significance of managing productivity, understanding billing considerations, and maintaining ethical practice standards. Earn .3 AOTA CEU (3.75 MBCOT PDUs/3 contact hours). Order #4843, AOTA Members: $108, Nonmembers: $154. http://store.aota.org/view/?SKU=4843
Up-to-date resource in dysphagia care written from an occupational therapy perspective for OTs at entry and intermediate skill levels. Earn 1.5 AOTA CEUs (18.75 NBCOT PDUs/15 contact hours. Order #3028. AOTA Members: $199, Nonmembers: $299. http://store.aota.org/view/?SKU=3028
CEonCD
Seating and Positioning for Productive Aging: An Occupation-Based Approach, by Felicia Chew and Vickie Pierman. Manual wheelchair mobil-
MENTAl hEAlTh
health interventions for children that can be applied in all pediatric practice settings. Earn 2 AOTA CEUs (25 NBCOT PDUs/20 contact hours). Order #3030, AOTA Members: $259, Nonmembers: $359. http:// store.aota.org/view/?SKU=3030
Mental Health Promotion, Prevention, and Intervention With Children and Youth: A Guiding Framework for Occupational Therapy, edited by Susan Bazyk. Framework on the role of OT in mental
ity through review of seating and positioning from evaluation to outcome with a concentration on interventions applicable to a variety of settings. Earn .4 AOTA CEU (5 NBCOT PDUs/4 contact hours). Order #4831, AOTA Members: $97, Nonmembers: $138. http://store.aota.org/view/?SKU=4831
tive, computer-based learning to present the anatomical basis and clinical presentation of problems in the hand and forearm and preparation for Hand Therapy Certification Exam. Earn 1.6 CEUs (20 NBCOT PDUs/16 contact hours). Order #3017, AOTA Members: $182, Nonmembers: $252. http://store. aota.org/view/?SKU=3017
The Hand: An Interactive Study for Therapists, by Judy C. Colditz. Written coursework with interac-
CEonCD
Occupation-Focused Intervention Strategies for Clients With Fibromyalgia and Fatiguing Conditions, by Rnee R. Taylor. Evidence-based strate-
Online Course
of recent advances and trends in mental health practice, including theories, standards of practice, and evidence as they apply to OT with content from federal and non-government entities. Earn 2 AOTA CEUs (25 NBCOT PDUs/20 contact hours). Order #3027, AOTA Members: $259, Nonmembers: $359. http://store.aota.org/view/?SKU=3027
Occupational Therapy in Mental Health: Considerations for Advanced Practice, edited by Marian Kavanagh Scheinholtz. Comprehensive discussion
prevention to support OTs in providing evidencebased fall prevention services to older adults at risk for falling or that seek preventive services with sections on prevalence, consequences, and evaluation of fall risk. Earn .6 AOTA CEU (7.5 NBCOT PDUs/6 contact hours). Order #OL34, AOTA Members: $210, Nonmembers: $299. http://store.aota.org/view/?SKU =OL34
Falls Module IFalls Among Community-Dwelling Older Adults: Overview, Evaluation, and Assessments, by Elizabeth W. Peterson and Roberta Newton. First module in 3-part series on fall
gies for managing fibromyalgia and other fatiguing conditions, such as chronic fatigue syndrome, with interdisciplinary treatment approaches and collaboration with other professionals. Earn .2 AOTA CEU (2.5 NBCOT PDUs/2 contact hours). Order #4839, AOTA Members: $68, Nonmembers: $97. http:// store.aota.org/view/?SKU=4839
CEonCD
Pain, Fear, and Avoidance: Therapeutic Use of Self With Difficult Occupational Therapy Populations, by Rene R. Taylor. Examines strategies
Online Course
PRODUCTIvE AGING
with older adults, approaches to and prevention of occupational problems, health conditions that affect participation, and practice in cross-cutting and emerging areas. Earn 3 AOTA CEUs (37.5 NBCOT PDUs/30 contact hours). Order #3024, AOTA Members: $245, Nonmembers: $345. http://store.aota. org/view/?SKU=3024
Strategies to Advance Gerontology Excellence: Promoting Best Practice in Occupational Therapy, edited by Susan Coppola, Sharon J. Elliott, and Pamela E. Toto. Core best practice methodology
module in 3-part series on fall prevention with overview of falls that occur in the hospital setting and identification of older adults at risk, factors that contribute to fall risks, and assessment strategies. Earn .2 AOTA CEU (2.5 NBCOT PDUs/2 contact hours). Order #OL35, AOTA Members: $68, Nonmembers: $97. http://store.aota.org/view/?SKU= OL35
Falls Module IIFalls Among Older Adults in the Hospital Setting: Overview, Assessment, and Strategies to Reduce Fall Risk, by Roberta Newton and Elizabeth W. Peterson. Second
for managing client pain, fear, and avoidance in OT practice with six distinct modes of interacting based on the authors conceptual practice model. Earn .2 AOTA CEU (2.5 NBCOT PDUs/2 contact hours). Order #4836, AOTA Members: $68, Nonmembers: $97. http://store.aota.org/view/?SKU=4836
CEonCD
Occupation-based intervention to enhance hand rehabilitation protocols without sacrificing productivity or detracting from the concurrent client factor focus. Earn .2 AOTA CEU (2.5 NBCOT PDUs/2 contact hours). Order #4832, AOTA Members: $68, Nonmembers: $97. http://store.aota.org/view/?SKU=4832
Online Course
Falls Module III: Preventing Falls Among Community-Dwelling Older AdultsIntervention Strategies for Occupational Therapy Practitioners, by Elizabeth W. Peterson and Elena Wong Espiritu.
professional competency through AOTA Specialty Certification in Low Vision Rehabilitation (SCLV) with information on evaluation and lessons related to psychosocial issues and low vision, eye conditions that cause low vision in adults, and basic optics and optical devices. Earn 2 AOTA CEUs (25 NBCOT PDUs/20 contact hours). Order #3025, AOTA Members: $259, Nonmembers: $359. http://store.aota. org/view/?SKU=3025
Low Vision: Occupational Therapy Evaluation and Intervention With Older Adults, Revised Edition. 2008, edited by Mary Warren. Support for
Third module in 3-part series on fall prevention with evidence-based intervention strategies to reduce falls among community-dwelling older adults that include both older adults who are well and those who are living with chronic diseases. Earn .45 AOTA CEU (5.63 NBCOT PDUs/4.5 contact hours). Order #OL36, AOTA Members: $158, Nonmembers: $225. http://store.aota.org/view/?SKU=OL36
Online Course
CEonCD
An Occupation-Based Approach in Postacute Care to Support Productive Aging, by Denise Chisholm, Cathy Dolhi, and Jodi L. Schreiber. 26
tent and updated links on research, tools, and resources to help advance knowledge about instrumental activity of daily living (IADL) of driving and community mobility. Earn .6 AOTA CEU (7.5 NBCOT PDUs/6 contact hours). Order #OL33, AOTA Members: $180, Nonmembers: $255. http://store.aota. org/view/?SKU=OL33
Driving and Community Mobility for Older Adults: Occupational Therapy Roles, Revised, by Susan L. Pierce and Elin Schold Davis. Expanded con-
We envision that occupational therapy is a powerful, widely recognized, science-driven, and evidencebased profession with a globally connected and diverse workforce meeting societys occupational needs. Join us on the road to the Centennial Vision at
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EMPLOYMENT OPPORTUNITIES
Faculty Faculty
Department of Rehabilitation Sciences Master of Occupational Therapy Program College of Health Sciences Midwestern University
Occupational Therapy Program Downers, Grove, IL Open Faculty Position: Assistant Professor
POSITION DESCRIPTION: This position is a tenure-track, nine-month academic year appointment with the possibility of summer teaching. Faculty duties include teaching graduate occupational therapy courses; advising graduate students; mentoring master's and doctoral students; engaging scholarly research and publication, including external grant proposals; and participation in service opportunities within the department, college, university and profession. The anticipated appointment date is Fall 2013. Preferred candidates will have practice and/or teaching expertise in the areas of mental health or adult physical/neurological dysfunction. THE PROGRAM: For more information about the program, see the Occupational Therapy program website at http://chs.utep.edu/ot/ REQUIRED QUALIFICATIONS: Candidates must (1) have an earned doctorate degree in occupational therapy, (2) be eligible for Texas licensure, (3) be an active member of the American Occupational Therapy Association, and (4) have a minimum of 5 years of experience in occupational therapy practice. Candidates are expected to (5) demonstrate a commitment to, or potential for, teaching excellence at the university level, (6) be able to use technology in instruction, and (7) demonstrate a potential for or record of scholarly research and publication, including development of grant proposals and attracting external funding. (8) Finally, candidates will demonstrate the ability to work effectively with faculty, staff and students from diverse ethnic, cultural, and socioeconomic backgrounds. Preferred candidates will also show a record of active participation or leadership roles in the profession of occupational therapy or relevant organizations. APPLICATION PROCEDURE: Applicants should submit: (1) a cover letter; (2) a curriculum vitae; and (3) the names, addresses, phone numbers, and e-mails of three professional references. Candidates will be notified before references are contacted. Applications will be reviewed immediately and received until the position is filled. Applicants are encouraged to apply by November 30, 2012. For more information and to apply, please contact: Dr. Stephanie Capshaw OT Search Committee Chair University of Texas at El Paso College of Health Sciences Department of Rehabilitiation Sciences Ocupational Therapy Program 500 W. University Ave. El Paso, TX 79968 Tel. 915-747-7269, email: scapshaw@utep.edu The University of Texas at El Paso is an Equal Opportunity/Affirmative Action Employer. The University does not discriminate on the basis of race, color, national origin, sex, religion, age, disability, genetic information, veteran status, or sexual orientation in employment or the provision of services. F-6164
Assistant Professor
Therapy Program The Occupational professional mastershas immediate opportunities to join an established occupational therapy degree
program. The spacious 105-acre, wooded, Downers Grove, IL campus is located just 45 minutes west of downtown Chicago. Applications are invited for a full-time, tenure track faculty position. Successful applicants must possess (1) an earned doctorate (or ABD) in occupational therapy or a related field; (2) eligibility for licensure as an occupational therapist in Illinois; (3) at least 5 years of clinical experience; and (4) instructional experience in a college or university academic program. Experience in pediatrics, geriatrics, or adult rehabilitation is needed. A record of scholarly productivity or potential to develop an active research program and professional service will enhance the candidates application. Preference will be given to candidates with a doctoral degree; teaching experience in an academic program; and whose background, experience and interests complement those of current faculty members. A faculty member in the Occupational Therapy Program has responsibilities in teaching, scholarship, and service. Teaching responsibilities include conducting class sessions and designing learning activities that will lead to student mastery and success in their professional and personal development. This role also encompasses the general areas of academic advising and student development. Scholarship responsibilities include pursuing on an ongoing basis the continuance of scholarly growth, engaging in scholarly/creative activity, and disseminating the results through critical peer review. Service responsibilities include participating actively in program, college, and university committees; assisting with the student recruitment and admissions process; professional role-modeling; and participating actively in the professional activities of state and national occupational therapy organizations. Midwestern University is an independent institution of higher education committed to the education of health care professionals. The salary and benefits are competitive. Rank and salary are commensurate with qualifications and experience. Interested applicants should apply online at www.midwestern.edu and send a letter of application, curriculum vitae, and the names and contact information of three professional references to the Chair of the OT Program Faculty Search Committee: Mark Kovic, OTD, OTR/L Chair, OT Program Search Committee, Occupational Therapy Program 555 31st Street, Downers Grove, IL 60515 mkovic@midwestern.edu F-6173
OT PRACTICE
Issue: Size:
Faculty
September 24th and October 8th issue - deadline TODAY 4/9 page sq = 4.687 x 5.937 Chair, Department of
Occupational Therapy
The University of Tennessee Health Science Center is conducting a nationwide search for Chair of the Department of Occupational Therapy. The Search Committee invites letters of nomination, applications (letter of interest, resume/CV and references), or , expressions of interest to be submitted to the search firm assisting the University. For a complete position description, refer to Current Opportunities on www.parkersearch. com. Gary L. Daugherty, Senior Vice President | Ryan Crawford, Principal gdaugherty@parkersearch.com | rcrawford@parkersearch.com Phone: 770-804-1996 x 110 Fax: 770-804-1917
The University of Tennessee is an EEO/AA/Title VI/Title IX/Section 504/ADA/ADEA institution.
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register now at www.aota.org/confandevents/stroke A stroke can take meaning out of life, but occupational therapy can restore it.
An estimated 5.4 million people in America live with the disabling effects of stroke and that number is bound to increase in the years to come. Occupational therapy must take the lead in stroke rehabilitation for survivors, families and caregivers, so join us this fall at Adults With Stroke and take advantage of top-level continuing education!
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for a free information kit including costs, exclusions, limitations and terms of coverage or visit us at www.aotainsurance.com.
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