1. Remediation Ideas for Therapeutic Handling Dr. Traci O’Connor Dr. Lisa Tekell

2. Therapeutic Handling Difficulties Students are not effectively using their hands to guide clients’ motor control They may be unsure what to do with their hands, where to place them, how to normalize tone with their hands, or how to change the response the clients are showing This requires guided practice to comprehend and master Students have probably practiced on “normal” bodies but may be feeling spasticity or flaccidity for the first time http://www.goodshepherdrehab.org/file s/images/occupational-therapy.jpg

3. Ways to Improve Therapeutic Handling Have students write plans with specifics of what needs to be done, muscle groups or specific muscles with abnormal tone, types of abnormal tone, specific handling techniques to normalize the tone, and positions to perform techniques; review tables with students prior to sessions Example Table MusclesTypes of ToneHandling Techniques for Normalization Positions

4. Ways to Improve Therapeutic Handling Have students: Practice procedures on “normal” people; identify bony landmarks, palpate muscle bellies, and place hands to facilitate movements. You may have “clients” move in specific ways, such as reaching in various planes, and ask students to identify changes muscle changes. Practice techniques on you and provide immediate feedback; consider weight of hands, amounts of pressure, gliding of hands to promote movements, support provided proximally to maintain balance, and cues to help you move. http://www.skyridgemedicalcenter.net/Our%2 0Services/PublishingImages/shutterstock_182 95735_physical_therapist.jpg

5. Ways to Improve Therapeutic Handling Ask students questions while you are modeling specific techniques on clients. Be sure to tell students ahead of time to ease anxieties. Ask them to identify where your hands are, which techniques you are implementing, which muscles are showing tone changes, and why you move hands to new locations or change techniques. Refer students to textbooks for review of motor control theories (Bobarth, Brunnstrom, Rood, PNF) and compare/contrast with the students. Have students practice with a variety of clients in various recovery stages and with different abnormal tones; the more students feel, the more they will understand about the normal movement process.

6. Ways to Improve Therapeutic Handling When students verbalize information correctly but seem impatient with techniques, they may believe these are “all or nothing” concepts. Explain that relaxation may take more than 20 minutes or occur in stages as they work proximally to distally. Review benefits of slow, steady stretching to elongate muscles in preparation for movement. Have students watch videos of therapists demonstrating handling techniques on clients and describe what they see and learn. If you do not have any videos available in your department, consider making some or call UTHSC Academic Fieldwork Coordinator Lisa Tekell to request to borrow some.  (901) 448-8072  ltekell@utmem.edu ltekell@utmem.edu http://www.wellnessandhealth.net/cerv _800x600.jpg