this is a place for me to share my collection of comments, things found on the web and announcements about my research and clinical work. There are comment buttons for friends and colleagues to interact. Or else discuss over on twitter!
Packed with practical tools and examples, this state-of-the-art workbook provides a holistic framework for supporting clients with acquired brain injury. Clinicians are guided to set and meet collaborative treatment goals based on a shared understanding of the strengths and needs of clients and their family members. Effective strategies are described for building skills and teaching compensatory strategies in such areas as attention, memory, executive functions, mood, and communication. Particular attention is given to facilitating the challenging process of identity change following a life-altering injury. In a large-size format for easy photocopying, the volume features 94 reproducible client handouts. Purchasers get access to a Web page where they can download and print the reproducible materials.
Introduction – the usual explanation and caveats – see previous posts. NB Italics are direct quotes and BB = Bobath! In the icsp a discussion, compensation has come up several times – about how much of a problem it is and whether it should be discouraged. There are mixed views. Jackie W feels the reason…
Andrew Bateman's insight:
just picking up on one phrase from Prof Tyson
"Some patients became functional BECAUSE they used their sound limb to compensate and/or use compensations/ abnormal activity in their weak limb"
lots of discussion going on Prof Sarah Tyson's blog site (that was a break out into the open from iCSP discussion). scooped just here today because then there has been a fair bit of banter on twitter between various folk. I realised probably a bit too late that the use of the word 'compensation' has a positive use in my world of neuropsychological rehabilitation, but that for some, this is a kind of perjorative word, as if by compensating for deficits you might impede recovery. I don't think there's much evidence for that position, and it seems to me a kind of urban myth or meme that perpetuates. In memory rehab we hear patients say "if i use a diary - and i never needed one before - that'll stop my memory getting better". In my view and experience a pragmatic approach to _impaired_ memory is to use a strategy such as a date-book to compensate, improve participation in life and generally live more successfully. This is what I think of when i read the word compensation. In PT it also exists in the plural, seemingly describing something else. I have always thought that in physiotherapy, particularly in the care of people who are a long time post injury (which after all is what we do at OZC), there comes a point where I think adjustment and acceptance has to come in - "this is a paralysed body part, therefore to be successful I will compensate by doing ... (_fill in the compensatory strategy_). It's not in my view a failure of rehabilitation to help someone live successfully with paralysis (an impairment). However it does seem to me that some think this would be a failure?
Polly Peers, Tom Manly, Duncan Astle, John Duncan and Andrew Bateman (Cambridgshire Community NHS Trust) have been awarded a Stroke Association grant to investigate the effectiveness of new on-line attention and working memory training packages for people...
Andrew Bateman's insight:
part of this story is that we are mid way through a study looking at attention training and working memory training with stroke survivors
the important message conveyed in this picture is that as Natalie says in the survivor stories book (see pinned scoop at the top of this page)
"I think it is really important to really listen to the individual and be patient and give them enough time to think and talk and to say what they want to say as it can take longer and be harder to express what you're feeling and what you want to say after a brain injury.." (p36)
Some years ago, while at the theatre, the cloak room attendant was giving out a glossy magazine for free. It turned out the magazine, C21 was a non-partisan high quality publication geared to raising awareness of topics of interest to all involved in some way with Cancer. I thought this a superb idea and immediately said we should do some thing in the Brain Injury Sector. Enormous work by Fiona North and many other friends supporting, this is finally seeing the light of day. Boxes of the magazine arrived at the OZC today - we will hope to give these away at lectures, conference exhibition stands and other awareness raising events. Hopefully this will bring on board more supporters. Do contact us if you're interested in being involved in someway, whether as a partner, subscriber, or writer!
B21 Magazine is dedicated to coping with Brain and Spinal Injury in the 21st Century. We provide a range of articles, expert opinion and professional help with Brain and Spinal Injury.
Andrew Bateman's insight:
I wondered if friends have seen the new edition of the B21 Magazine. The link here provides an image of the film competition from last year's UKABIF conference. so the image is a bit confusing. But you can download the whole magazine. The editorial by Fiona North provides a bit of the story behind this magazine. Just before the back cover there's an article by me making some links with our local cathedral! Colleagues are cordially invited to get involved in forthcoming issues. Interested to know what you think!
By Andrew Bateman in Physiotherapy and Clinical Sciences.
Andrew Bateman's insight:
I thought I;d write a few words about my perhaps inevitably entrenched position about Bobath here on my scoop.it page
I seem to have been drawn into a discussion that I have stood on the sidelines and watched for more than 25 years Back around 1989/90 i was a physio student at a hospital where a bobath course was going on, while i was on a longish neurosurgery placement. I remember it was a very good placement with a supervisor i adored. I got to attend this 3 or 5 days course (i can't remember how long,beyond the fact that it was quite intense). Bonus! i do remember that it was to my memory for free, as long as i didn't mind being the model a lot of the time. no problem. It was very fascinating and enjoyable. I was near the end of a 4 year BSc hons course where the 4th year was essentially like a masters programme these days. mainly dissertation work and a few specialist placements.
However I guess it was around this time that I was really also getting into the psychological aspects of physiotherapy that led me off onto my own track of studying for a phd in psychology at University of Birmingham.
Fast forward a few years. 2004. Note that at this point OZC hadn't been opened. But I was already hooked on the concept of holistic rehabilitation as defined by Ben Yishay and Diller. So back in the days before the existence of the lively physiotherapy only chat room (iCSP) our journal was the place for us to discuss stuff using good old-fashioned letters. Here's a link (and pasted in below) to a letter I wrote. What fun finding this! I don't remember writing it. But this looks like an output of a supervision session with my PhD supervisor Jane Riddoch who also wrote her own letter. I do remember taking that new Kidd,Lawes&Musa book in, as we were both excited by a bit of awakening in our profession.' I do remember with great fondness those times where Jane was encouraging me to write, to articulate my views and get involved.
What I don't really know is if things have changed much, from what I'm reading on iCSP and twitter & Sarah Tyson's blog. It's just all that much more instant than a monthly letters page!
Well here is a copy of the letter I wrote: Physiotherapy 1994, 80,8, p565
MADAM would like to express my support for the opinions published by Ms Stachura in the June issue of Physiotherapy. Acceptance of a Bobath approach as the majority view in neurological rehabilitation has led to a relative neglect of other areas of psychosocial mportance. I would reject Burton’s statement that ‘the Bobath concept is holistic in the treatment of central nervous system damage’ (letters, July). The Bobath literature contains little or no consideration of the importance of cognitive and perceptual effects that follow as a result of (permanent) brain damage. Equally there is little said about the importance of patients being helped to a position of understanding and acceptance of their disability (Ben Yishay and Diller, 1993). Consequently, how these two areas (cognitive domain and self-acceptance) interact is also missed. As long as the focus is on regaining what is termed ’normal’ movement, there is an implicit rejection of, for example, an impaired gait. This means that at the end of a formal rehabilitation process, patients who have an impaired gait, and who are always likely to have an impaired gait as a result of cortical lesion, now have to start a process of acceptance of their ability who they are now, and not who they were before the stroke. This self-acceptance has to take place in the face of perhaps six months of treatment where the goals as set in the physiotherapists’ notes were to ‘attain normal movement’ in this or that part of the body. This rejection of a ‘probable’ outcome in the pursuit of an ‘ideal’ leads to a hijacking of the concept that fully rehabilitated patients have to discover alongside the change in motoric ability. The time that we have in contact with patients is a period when not only manual handling skills are important, but also psychological or ‘person handling’ skills are necessary. This needs to involve consideration of the (probable) eventual outcome.
Andrew Bateman BSc MCSP
Reference Ben Yishay, Y and Diller, L (1993). ‘Cumulative remediation n traumatic brain injury Update and issues’ Archives of Physical Medicine and Rehabilitation, 74 2, 204-213
This week I am travelling to see my colleagues in Oslo. I have been set the challenge of entering into a debate about cognitive training, so the next collection of 'scoops' are going to be around this topic. Here's the first one, a useful overview nicely anchored around the studies of Thorndike (1906) (that I've not read in the original, but great so have the reference mentioned here).
The Pixar movie <Inside Out> is now available on DVD. I enjoyed going with my family to see this film and thought that they have done well to convey some of the issues associated with our emotional functions. Here is a bit of useful background information. In our field the loss of memories and the impact on identity are a very present topic in our therapeutic work.
Blog: lots of twitter activity today about exercise and disability, a chance for me to reflect on the progress of the #NeuRowRehab project mentioned earlier this year. Anyway there are some things I haven't got near to tackling yet but this wiki seems especially worth noting. I'm guessing the wonderful folk at http://www.remap.org.uk/ will be another group to turn to when we need to!
Imagine being unable to recognise your spouse, your children, or even yourself when you look in the mirror, despite having good eyesight and being able to read well and name objects.
Andrew Bateman's insight:
Here is the latest book by Wilson Robertson and Mole. Oliver Zangwill Centre's founder Barbara Wilson who worked with service user Claire. My view is that patient involvement in dissemination is being redefined here, not just a vignette or quote, but a full publication of scholarly merit as well as a compelling human story. This will be of clinical benefit to many others who are afflicted by this often overlooked condition.
[rowsafe|3.3]Rowability about removing barriers to participation in the sport for anyone who has a physical, sensory or learning impairment. The first rowing club for those with a disability was affiliated to British Rowing in 1998 and there are now a number of clubs that offer, or are dedicated to, Rowability. Advances in the equipment available for rowers with a disability and the ever-increasing number of accessible rowing venues has meant that rowing is truly becoming a sport for all.
Andrew Bateman's insight:
So this is to put on record my announcement that this spring I will be teaching OZC service users to row. I recently qualified as a rowing coach and this merging of work-life activities seems particularly appealing. If you'll excuse the "dad-pun", NeuROWhabilitation seems a good term for this and I'll publish more about the pilot work we do and what our service users say here on scoop.it
The key point is that I think anyone can be part of the rowing story in some way, it is a tremendously accessible sport. As physio and neurorehab manager I am seeking to see how we can improve our work to help people live their lives after brain injury. Doing real things in nature, taking risks, joining a sports club, challenging yourself etc are key, prized achievements that even the most marginalised can do.
This is another reason I am proud to do this work.
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