Milliken Research in Journal of Hand Surgery

Milliken Hand Rehabilitation Center Hand Therapists, Macy Stonner, OTD, OTR/L, CHT & Logan Berlet, OTD, OTR/L were recently published in The Journal of Hand Surgery for their paper, “The Impact of Social Deprivation and Hand Therapy Attendance on Range of Motion After Flexor Tendon Repair.” The purpose of the paper was to examine the influence of social deprivation and hand therapy attendance on active range of motion (AROM) outcomes following flexor tendon repair.

Below is information about the Milliken research that was included in the paper. It discusses how the study was performed and the overall team conclusions.

Method

We performed a retrospective analysis of patients who underwent primary zone I–III flexor tendon repair between November 2016 and November 2020. Area deprivation index (ADI) was used to quantify social deprivation. Medical record review determined each patient’s demographic characteristics, injury details, total hand therapy visits, and final AROM outcome. Active range of motion was converted to Strickland’s percentage for analysis. Spearman correlation and simple and multivariable linear regression models were used to assess relationships between explanatory variables and outcomes.

Results

There were a total of 109 patients, with a mean ADI of 53 and mean therapy attendance of 13 visits. Higher ADI and lower therapy attendance were correlated, and each was associated with significantly decreased Strickland’s percentage. In the multivariable model, therapy attendance, ADI, zone 2 injury, and age maintained significant associations with Strickland’s percentage.

Conclusions

Socially deprived patients attend fewer therapy sessions and obtain poorer AROM after flexor tendon repair. Social deprivation is likely to contribute to poor outcomes both by its association with decreased therapy attendance and by other potential pathways that make it difficult for deprived patients to achieve good surgical outcomes.

Access The Publication and Paper

 

Summer Eye & Vision Safety

As we enjoy the summertime outdoors engaging in activities such as hiking, gardening, swimming, and home maintenance projects it’s important to consider the effects of the sun and protecting your eye & vision health! July is healthy vision month and while spending time outdoors and getting exercise are vital, so are your eyes. The American Academy of Ophthalmology and National Eye Institute offer the following recommendations that can be followed to protect your eyes from sun exposure and other hazards.

  • Wear sunglasses with 100% UV or UV400 protection or sunglasses that block UV-A and UV-B rays on sunny AND cloudy days. Keep in mind that the sun’s damaging rays can penetrate clouds, fog, and haze.
  • Wear a hat in addition to sunglasses; a broad-brimmed hat is the best option.
  • Remember that the sun’s rays are strongest in the afternoon and at higher altitudes.
  • Avoid getting an “eye sunburn”. This is called photokeratitis and can occur when the sun’s UV rays reflect off water or other surfaces and burn the eye. Symptoms include pain, redness, blurry vision, and possibly temporary vision loss.
  • Do not look directly at the sun at any time (including during an eclipse). This can cause significant damage to the retina.
  • Avoid tanning beds because they expose you to the same risks as outdoor sunlight and UV rays.
  • Other tips:
    • Prevent swimmer’s eye by wearing good swim goggles and splashing your closed eyes with fresh water after swimming.
    • If you have a condition called “dry eye”, wear wrap-around glasses to protect yourself from wind and sun exposure and use artificial tears recommended by your doctor to keep your eyes refreshed.
    • Wear protective eyewear when mowing the lawn, gardening, completing home maintenance tasks, and playing sports to avoid a serious eye injury.

Following these recommendations, this summer and year-round will allow you and yours to enjoy all outdoor activities fully and safely. If you are having issues with your vision consider taking a look at our low vision services.

Fireworks & Hand Safety

As we approach the 4th of July, it is important to keep in mind that the use of even the smallest fireworks can result in devastating injuries. Sparklers reach temperatures over 1000 degrees and can easily burn skin or ignite clothing. Larger fireworks can fracture fingers or amputate portions of the hand.  While these injuries may seem extreme, they are injuries that the Hand Therapists at the Milliken Hand Rehabilitation Center commonly see in their clinics every July.  According to the U.S. Consumer Product Safety Commission 2020 Fireworks Annual Report, hands and fingers were the most frequently injured body parts, accounting for 30% of the injuries sustained by fireworks.

The safest way to enjoy fireworks is at a public display conducted by professionals. But, if you choose to use fireworks, the Consumer Product Safety Commission has the following tips:

  • Never allow young children to hold or ignite fireworks.
  • Never place any part of your body directly over a firework device. Back up to a safe distance immediately after lighting the fuse, and only light one at a time.
  • Never try to re-light or pick up fireworks that have not ignited fully.
  • Never point or throw fireworks at another person.
  • Keep a bucket of water or a garden hose handy.
  • Never carry fireworks in a pocket or shoot them off in metal or glass containers.
  • After fireworks complete their burning, wait 20 minutes, and then douse them with plenty of water before discarding in a trash can.

Our team at the Milliken Hand Rehabilitation Center wishes everyone a Safe and Happy 4th of July Holiday! If you do experience a hand or upper extremity injury, we are here to help!

Firework & Hand Safety Tip Sheet pdf (Download)

 

 

 

 

 

 

 

 

 

 

Summer Activities For The Kids

The start of summer is such a fun and exciting time for kids!  But, for many the lazy, hazy days of summer can start to drag if the kids are bored or spend too much time in front of the screen.  However, with a little bit of planning, it’s easy to keep kids engaged in a variety of activities.  Summer is a great time to try out some new, exciting learning opportunities.  Engaging, hands-on activities over the summer help to ensure kids are ready for the grade ahead and don’t regress.

  1. Explore local attractions. Within the St. Louis metropolitan area, there are so many great local attractions to check out.  Even if you have been to these places before, there are always new things to explore and new ways to keep your child learning throughout the experience.  If you go to the zoo have your children plan out on the map how they are going to get around to see their favorite animals.  Of, if you go to the botanical gardens have them practice their reading skills by reading out loud the posted signage.   Even a small trip to a local park or trail can be a great time to search out different species of wildflowers, trees, or birds.  Regardless of where you go, there are so many opportunities to keep children learning while at our local attractions.
  2. Attend a local summer camp. While all camps are great for keeping kids engaged, if you want to keep your kids learning over the summer look for camps that focus on science, art, and other educational skills.  Washington University Program in Occupational Therapy actually offers its own summer camp for children ages 9-16 with executive function difficulties (difficulty with planning, organization, goal-setting, task monitoring, etc.).  If interested in learning more about this camp, see link below.

https://otservices.wustl.edu/items/trainyourbrain/

  1. While swimming is often a go to over the summer, especially in the St. Louis heat, swimming can have great benefits for kids who struggle to manage sensory input.  Swimming provides vestibular input by moving in all directions, proprioceptive input by the resistive muscle activity with the water, and tactile input as swimmers are constantly feeling pressure from the water.   Regardless if kids have sensory needs or not, swimming is also a great form of exercise to help keep active over the summer and improve coordination skills.
  1. STEM Projects. STEM (science, technology, engineering, and math) projects are great for kids of all ages.  On a rainy summer day, stay inside and create a marshmallow catapult, make slime, make ice cream in a bag, experiment with various versions of the same chocolate chip cookie recipe to learn how each ingredient affects the overall cookie, or figure out what household materials you could use to build a bridge.  These activities are great to help build problem-solving skills, teamwork, direction following, etc.  In addition, they all result in a final outcome your kid will be proud to show others.
  1. Fuel their passions. While there are certainly many ways to try and keep kids engaged and learning over the summer, the best way to do that is to incorporate their passions and favorite things into learning experiences.  Whether they are into sports, Minecraft, gymnastics, space, or history find age-appropriate ways to feed their interests through books, movies, games, and other hands-on experiences.  The more they are interested in what they are learning the more they will get out of it.

No matter how you choose to keep your kids engaged, the value of any learning over the summer cannot be overstated.  Parents can feel good about keeping their kids engaged in tasks that don’t involve spending hours in front of a screen and kids can look forward to trying new things that keep their minds and bodies active.

 

Mental Health Awareness Month

Occupational Therapy is a profession that assists people throughout their lifetime and believes that participation in daily activities (aka occupations) is vital to mental health and well-being.

Your Washington University Occupational Therapist may help you utilize familiar activities as coping mechanisms, such as listening to music, playing cards, writing, doodling, cooking, or cleaning to help provide calming or grounding strategies.

OTs are also well versed in sensory strategies. A person’s sensory system helps process information from the environment. For individuals with mental health conditions, their ability to process this information may be compromised, which can cause the patient to feel upset and not safe.

One important qualification that sets occupational therapists apart from other qualified mental health professionals is their background in physical rehabilitation. Mental health issues are often accompanied by issues of physical health. In a mental health setting, you may find an OT addressing general strengthening, adjusting wheelchairs, recommending adaptive equipment, or any other task that is within the scope of practice in the field of occupational therapy.

Ultimately, your Washington University OT will work to assist you in participating in daily activities. If your condition is keeping you from being able to participate in daily activities, speak to your occupational therapist about your concerns. If they do not have the tools to assure that your needs are being met, they can serve as a resource in getting you the necessary help. Learn more about our self-management services.

Milliken PT publishes paper in Springer Nature’s publication

Nerve transfers are a surgical technique used to restore function in people with a nerve injury. The Milliken Hand Rehabilitation Center is well known in the hand therapy world for its work with these patients due to their close relationship with the Washington University Physicians who are world-renowned for developing this type of reconstructive surgery. In the past 15 years, this surgery has been applied to individuals with cervical spinal cord injuries to help them regain some volitional movement in their hands. Following surgery, it is important for the patients to have adequate therapy to optimize outcomes. Lorna Kahn, PT, CHT has worked closely with Dr. Ida Fox for the past 15 years to develop such a program.  After 4 years of writing, submitting, editing, and reediting their paper was finally published this month in Springer Nature’s Spinal Cord Cases and Series. Read the paper here. 

The paper is a retrospective case series that reviews 9 individuals who had surgery and hand therapy at Washington University. A chart review was performed and data points that highlight the timing of recovery and the specific functional changes noted by the patients were gathered. Additional objective measures were included. The paper is designed to give therapists a general guideline for treating individuals who have had this surgery. The timeline for recovery is protracted and often both the individual and therapist discontinue treatment before the recovery is completed. We hope this paper will provide a framework for motor re-education after nerve transfers and improve outcomes for the patients.

Cancer Survivorship Services

Cognitive changes are a common side-effect of cancer treatments for many adult cancer survivors. Increased fatigue, stress, and anxiety are also among the most common symptoms experienced. The combination of these symptoms and side effects can profoundly impact participation in daily activities and reduce quality of life. The interventions used in our Cancer Survivorship Program target functional cognitive performance and help participants become more aware of what situations and factors may present a greater challenge.

During the first couple of sessions, the OT completes a comprehensive evaluation tailored to the individual’s cognitive concerns and other physical or psychosocial factors that could further impact their performance. Such factors may include coordination, visual perception, hearing, balance, fatigue, sleep quality, anxiety, stress, depression, and/or social considerations.

An evidence-based metacognitive strategy training intervention called “The MultiContext (MC) Approach” (https://multicontext.net/treatment-approach) provides the foundation from which executive function deficits are addressed. In the MC approach, the therapist uses specialized mediation methods to coach and guide individuals in a way that facilitates their own thinking. This helps the person become more aware of factors and situations that pose greater challenges. Ultimately, this therapeutic approach empowers the person to generate and use cognitive strategies to manage cognitive errors across a variety of everyday activities (Toglia & Foster, 2021).

Fatigue, anxiety, and stress management are also core components of the program. Participants are offered education and opportunities to practice a variety of adaptive strategies to manage these symptoms as they relate to activities they want and need to do.

Potential outcomes for participants of this include increased independence, maintaining or returning to home and community roles, improved confidence with social relationships, reduced stress and anxiety, lowered fatigue, and improved use of strategies to successfully complete cognitive tasks.

If you or someone you know could benefit from our Cancer Survivorship services, please call 314-286-1669 to inquire about scheduling an appointment.

 

References:

Toglia, J., & Foster, E. R. (2021). The multicontext approach to cognitive rehabilitation: A metacognitive strategy intervention to optimize functional cognition. Gatekeeper Press.

OT Month Celebration

Washington University Occupational Therapy works with many healthcare providers, physician groups, living facilities, and community organizations to provide the best care, When & Where our patients need it most. During the month of April, we will be celebrating OT Month and promoting all that our providers and colleagues in the field do for our adult and pediatric patients. To our Community Practice Therapists and Therapists at the Milliken Hand Rehabilitation Center, thank you for all that you do for our patients our clinic wouldn’t exist without you and the expertise that you bring to the field of OT.  Please take a moment and see what the field of OT has been able to contribute to the daily well-being of patients. Learn more about Occupational Therapy from AOTA.

Chronic Condition Spring Safety Tips

Spring is a time of awakening.  As we wake up from our winter slumber, we are eager to be more active.  This could mean getting back to recreational activities such as hiking, biking, or participating in an outdoor sport.  Or it could mean doing housekeeping activities such as spring cleaning or gardening.  Returning at full force may lead to an injury or a flare-up of a chronic condition.  Here are some tips to consider should you reengage a chronic condition: 

  • It is always a good idea to warm up before and cool down after an activity. 
  • Gentle stretching prior to an activity can prevent a muscle strain while gentle stretching after can decrease soreness. 
  • While it may be tough to slow down, breaking down the activities into short intervals can prevent fatigue. 
  • Eating a healthy diet of lean proteins and vegetables can improve your endurance. 
  • Even when the weather is mild, be sure to drink plenty of fluids to prevent dehydration. 
  • To boost your confidence and enjoyment, set realistic goals. 
  • To improve your performance, seek professional tips from a tennis or golf coach.  
  • Maintaining your equipment and tools in proper condition can decrease stress on your joints. 
  • Building up the handles on your tools will lessen hand pain. 
  • Wearing sunscreen will not only protect your skin from harmful UV rays; it will preserve its youthfulness.  

Following these tips will help you to enjoy the cool spring weather but if you do encounter a chronic condition in your hands or upper extremity our team at The Milliken Hand Rehabilitation Center is here to help!

Parkinson’s Disease Awareness Month

April is Parkinson’s Disease Awareness Month. Parkinson’s Disease (PD) is a chronic, progressive neurologic condition that affects dopamine production in the brain. Approximately one million people in the U.S. are living with PD. Parkinson’s is a movement disorder and is characterized by motor symptoms that include slow movement, stiff joints, impaired coordination, and tremor; as well as non-motor symptoms like impaired cognition, fatigue or lack of energy, apathy, and depression.  All of these symptoms can lead to difficulties in accomplishing everyday tasks. Whether you are newly diagnosed or have been living with PD for some time, OT can offer strategies to help navigate the difficulties of everyday life. Washington University Occupational Therapy offers in-home and clinic-based services that are personalized to help individuals analyze and solve problems related to performing everyday activities that can be complicated by PD. The goal of our program is to ensure that you are able to live independently and safely at home and to maintain your quality of life. PD, like many chronic conditions, can change over time. Occupational therapists help to teach self-management skills and address barriers across all stages of this disease by adapting tasks and the environment to support performance. Listed below are areas that we commonly address:

  • Medication management
  • Activity and exercise programs
  • Home safety and fall prevention
  • Driving assessments
  • Care partner education and training

WUOT also offers LSVT BIG®, a program targeted specifically for people living with PD. Read more about LSVT® here https://www.lsvtglobal.com/.

Local resources for PD can be found by visiting the American Parkinson Disease Association St. Louis Chapter https://www.apdaparkinson.org/community/st-louis/.

Learn more about Washington University Occupational Therapy Services for Parkinson’s Disease.

Credits:

LSVT® is a trademark of LSVT Global, Inc., registered in the U.S. and other countries.

Expanding To Washington

Ryan Risley, MPM, meets with contractors just weeks before OT Services’ new clinic in Washington, Mo., is set to open. The 2,500-square-foot space is located approximately 50 miles west of downtown St. Louis in Franklin County. It is the culmination of four years of research, strategizing and planning for Risley, the manager of practice development for the Program in Occupational Therapy’s clinical operations. OT Services therapists will provide general and specialty patient care in the clinic and in home, school, workplace and community settings in Washington and the surrounding area. Risley has not only a professional, but also a personal, stake in the clinic’s future success: Washington is his hometown, and he is fully invested in the health and well-being of his community.

Expansion planning

Risley recalls discussing expanding OT Services’ footprint in his first interview with Pat Nellis, OTD, OTR/L, the director of the Division of Clinical Operations, more than four years ago. “Right off the bat, we discussed what the one-, three- and five-year plan should be for clinical services. One of the five-year goals was to be experiencing growth at a level where we could branch out to another satellite clinic,” Risley says. “Pat is a big proponent of rural communities having access to health-care services, so I conducted competitive market analyses of surrounding counties north, west and south of metro St. Louis.”

Risley dove into key data points such as population growth, demographic data, chronic disease prevalence, insurance provider options, and payment mechanisms. There also had to be future marketing opportunities and economic development in the area. “We wanted to offer that access to health care, but it had to be a solid investment as well. I put together market scorecards for each area to present to Program leadership and discuss which location made the most sense for us. Washington checked all the boxes, even though it is in a competitor’s area. However, they don’t offer the same services that we do,” Risley says. “That being said, we knew we could leverage our existing brand and bring our personalized, one-on-one approach to the area and beyond.”

“Washington University has such a reputation for excellence, and our occupational therapy services are vastly different than what anyone else offers,” adds Nellis. “We’re committed to making sure those living outside our urban reach have access to what we have to offer. Rural Missouri deserves the best, too.”

A hometown perspective

Risley was 4 years old when his family moved to Washington after his father was relocated there for his job and has lived there ever since. He has seen the area go through a period of tremendous growth in recent years.

“In high school, I remember the downtown area being somewhat stagnant. Downtown Washington, Inc., a coalition formed in 1989, had a vision for the town to serve as a center of commerce in Franklin County. Farmland at the main intersection of highways 100 and 44 were sold, and businesses started moving in. Fast-forward to today, and the real estate market is much different . Downtown is booming with commerce, so finding clinic space that fit our needs was a challenge,” Risley recalls.

After traveling extensively over the county, Risley eventually found a space for lease in a former sporting goods store situated in a complex adjacent to a Walmart Superstore and next door to a Department of Veterans Affairs Clinic Office with a flat parking lot and spots right by the entrance. In November 2020, he and Nellis presented the pro-forma report to Program leadership and to the Faculty Practice Plan (FPP).

“The original space was 5,000 square feet, but we only needed half of that. We set up meetings with FPP and worked with the Dean’s office to negotiate the lease. Then we started working with the architects and a design group to build out the space. We wanted an open floor plan and treatment space in addition to private rooms for one-on-one and telehealth services. Accessibility was a priority; we want to accommodate all clients, including those with mobility issues. They can park right in front of our clinic and enter without any obstacles,” he says.

Forging partnerships

While finding the right clinic space was certainly a priority, so was forging partnerships with local community providers and organizations to promote the clinic and its services.

“I met with the Franklin County Health Department, the Franklin County Community Resource Board, assisted living facilities, and area physicians to name a few,” Risley says. “Another health-care system has been firmly planted in the area for decades, but my approach has always been to offer our services as another option for providers and patients. Therapy, especially at the beginning, can require two or three appointments a week. We may be able to see the patient sooner, or the clinic might be easier to access. We’re here to serve the community in whatever way we can.”

Risley anticipates that the expertise of Milliken Hand Rehabilitation Center therapists will serve the needs of people who have experienced a work injury or the effects of aging. “Washington and the surrounding area are home to many manufacturing and agricultural industries. I’ve met with several workers’ comp physicians who see patients with hand, shoulder and upper extremity injuries or who experience ‘wear and tear’ on hands or joints from repetitive tasks. Hand function also decreases with age due to rheumatoid arthritis, osteoporosis and even Parkinson’s disease. Our therapists provide services to address and support all of these conditions.”

The move to Washington is also an opportunity to expand existing community partnerships. Pediatric therapist Karen Balk, MOT, OTR/L, will provide services to families with school-aged children, and Katie Bogan, OTD, OTR/L, will be able to use the clinic as a base for early intervention services through the state’s First Steps program for children from birth to 3 years of age who have disabilities or developmental delays. Aging Ahead, which supports older adults and their caregivers, provides programming in senior centers throughout the area. “We are already connected with Aging Ahead in the St. Louis region, and they are interested in working with us in Franklin County,” says Risley, who attends the agency’s monthly meetings. “The Four Rivers YMCA will be hosting their annual adult literacy event; we plan to be a part of it.”

Open for business

The Washington clinic officially opens its doors on April 11. Several existing patients who drove to other locations for care are now able to schedule their visits closer to home. Therapists Stacy Baker, MS, OTR/L, CHT, and Jill Jonas, MSOT, OTR/L, who also live in the area, are looking forward to seeing familiar faces and meeting new patients.

“Patients I’m currently treating at our Milliken Hand Rehabilitation Center Chesterfield location are eager to come see me at our new Washington clinic because it is closer to their homes, and they appreciate that,” Baker says.

Risley is already planning to bring the latest service line to the Washington clinic. “We now have therapists providing support, recovery, and rehab services for COVID ‘long haulers’ that address lasting effects such as fatigue, brain fog, and task management. Jamie Archer, MOT, OTR/L, and Debbie Turley, OTR/L, are already seeing clients in St. Louis; I imagine those services will be needed in Washington as well,” Risley says. “I’ve long referred to occupational therapists as ‘the engineers of the healthcare field.’ They provide solutions so people can manage their health and get back to the activities they want and need to do. I’m proud to bring our therapists to the Washington community.”

Photos of new clinic in Washington, MO

The Importance of Lymphedema Therapy

Following breast cancer, your risk of developing lymphedema may increase based on risk factors such as radiation or lymph node removal. Being able to receive lymphedema therapy is key to your long-term health outcome.

Signs and symptoms of lymphedema include heaviness, tightness, or fullness of the affected area. You may notice that clothes or jewelry begin to feel tighter. Lymphedema tends to happen gradually over time and progresses slowly. Most often, lymphedema onset is within 3 years of initial breast cancer treatment.  If you experience any of these things, it is important to speak with your doctor and get referred to a certified lymphedema therapist.

At The Milliken Hand Rehabilitation Center, we not only offer therapy following lymphedema diagnosis but have a specialized program for early detection and prevention. Early detection improves therapeutic outcomes and often results in more successful treatment. Utilizing bioimpedance spectroscopy technology, we can detect early changes in fluid before standard circumferential measures notice the change. This allows for early intervention to prevent the progression of lymphedema.

With therapy, you can expect manual treatment as well as compression therapy to reduce swelling. Therapy focuses on reducing the swelling as much as possible before fitting patients with maintenance garments. For those at risk, we provide routine screenings to address swelling changes as early as possible.

For further information about lymphedema or the therapy programs offered, please visit The Milliken Hand Rehabilitation Center or Washington University Division of Plastic & Reconstructive Surgery. 

Winter Tips For Walking Your Dog

Walking your dog is seen as a good way to reach weight loss goals, keep in shape, decrease stress and socialize but it could also increase your risk of injury. During the winter months and times of inclement weather, odds for an injury are at an even higher risk.  NBC News did an additional story regarding seniors and injuries resulting from dog walking a few years ago. The injuries seen by incidence are hip fractures, wrist fractures, and injuries of the upper arm.  The mechanism of injury is usually due to a tangled or wrapped leash, trying not to step on the dog, or pulling of the dog, and of course ice during these cold winter months. Booties are an option for helping your dog gain more traction and protection from salt and ice, however, just like our boots, they’re not perfect. Watching where you’re both walking, going slow, and taking breaks are all good ideas. If your dog is high energy work on training your dog to walk slowly during walks.

Here are some key points to remember when taking your dog for a walk:

  1. Do not wrap the leash around your hand or wrist. Most trainers say that you should place the leash loop on your thumb and let it dangle down past your hand then bring it up loosely and around your thumb again and through the palm, then make a fist to hold onto the lease.
  2. Wear appropriate shoes when walking your dog.
  3. Pay attention to your dog and your surroundings. No phone use, no zoning out.
  4. Do not use a long leash. It is best to keep the dog next to you on either side.
  5. Don’t put fingers under the collar, they can get caught in the collar or leash.
  6. Keep your dog by your side, to decrease pulling.

Walking your dog should be an enjoyable activity for both of you.  So be safe and have fun!

In case you do sustain an injury while walking your dog, our team at the Milliken Hand Rehabilitation Center is here to help!

Driving Evaluation Program

Washington University Occupational Therapy offers Comprehensive Driving Evaluations for persons who are recovering or have been impacted by a medical condition and want to know if they are safe to drive.

The driving evaluation program is coordinated by a certified driving rehabilitation specialist Peggy P. Barco, Associate Professor who specializes in research related to older adult driving and cognition for over 20 years. We have a team of professionals to assist you in scheduling and answering your specific questions.  Our goal is to help all people drive as long as they are safely able to. At this time, we specialize in adults and older adults with varied medical conditions.

All driving evaluations require a physician referral. These evaluations are very comprehensive and take around 3 hours to complete.

Many people ask, what happens during a driving evaluation?

  • During a driving evaluation, an occupational therapist will meet with patients (and a significant other) to get to know their specific concerns and questions.
  • The therapist will then screen for vision, motor, sensory, and cognitive skills which are specifically relevant to driving.
  • An occupational therapy driving rehabilitation specialist will then take the individual out for a drive (in a vehicle equipped with a passenger-side brake) on a route arranged in complexity according to what type of driving is desired in the future.
  • Individualized recommendations for driving are usually provided the same day – upon completion of the evaluation process.
  • The referring physician will review and finalize approval of the recommendations once they receive the report.

For questions or to make a referral please call, 314-286-1640 and we will be more than happy to assist you!

Physicians:  Please email us directly at OTClinical@wustl.edu and we will email you our EPIC 3-step short guide to put in referrals or visit our Driving program webpage to learn more.

Thank you for considering our services, we look forward to working with you!

5 Ways To A Healthier You In 2022 – Stroke Prevention!

While our title, “5 Ways To A Healthier You In 2022 – Stroke Prevention!” is focused on this year, we must make note that In December 2021, the beloved American icon, Betty White passed away of a stroke at 99 years old. We feel the time to increase awareness of strokes and ways to prevent them is now! In recent years, younger adults are also experiencing strokes. Because up to 80% of strokes are preventable, you can practice the actions below to help reduce your risk.

  1. Nourish your body with vegetables, fruits, whole grains, low-fat dairy products, fish, legumes, and nuts. Limit salt, sweets, and red meat.
  2. Increase physical activity. Engage in moderately-intense aerobic activity for 10 minutes 4 times per week, or vigorous aerobic activity for 20 minutes twice per week. Find a partner to exercise with you – you and your partner will both benefit.
  3. Begin a smoking cessation program if you smoke, and limit alcohol consumption. Tobacco and alcohol use significantly increases the risk of stroke.
  4. Take prescribed medications as directed to manage health conditions that may contribute to stroke risks, such as diabetes, hypertension, and high cholesterol.
  5. Keep an open line of communication with your healthcare provider, and collaborate on managing health by asking questions, exploring options, and sharing decision-making about other conditions that may increase stroke risks, such as sleep apnea or birth control use.

An occupational therapist can help you develop skills to better manage your health and to implement lifestyle changes. If you would like guidance and support to incorporate these actions into your daily routine, take a look at our services or give us a call at (314) 286-1669 #1.

American Stroke Association (stroke.org)

5 Tips for a Healthy Thanksgiving

Thanksgiving only comes around once a year, so why not go ahead and splurge? Year after year, we can all attest that during the holidays thinking about healthy eating may not be our primary consideration.
But Thanksgiving does not have to sabotage your diets. With a little self-control, we can satisfy our desire for traditional favorites and still enjoy a guilt-free and healthy Thanksgiving feast.

1. Get Active

Create a calorie deficit by exercising to burn off extra calories before you ever indulge in your favorite foods. Eat less and exercise more is the winning formula to prevent weight gain during the holidays. Increase your steps or lengthen your fitness routine the weeks ahead and especially the day of the feast.

Make fitness a family adventure. Many communities have created “Turkey Day” 10K, 5K, and 1 – mile fun runs and walks to help you start off Thanksgiving with exercise so that you are burning those exercise calories in preparation for your afternoon and evening meals.  It is a wonderful way for families to get physical activity and enjoy the holiday together.

2. Eat Breakfast

While you might think it makes sense to save up calories for the big meal, experts say eating a small meal in the morning can give you more control over your appetite. Start your day with a small but satisfying breakfast — such as an egg with a slice of whole-wheat toast, or a bowl of whole-grain cereal with low-fat milk — so you won’t be starving when you arrive at the gathering.

Eating a nutritious meal before you arrive takes the edge off your appetite and allows you to be more discriminating in your food and beverage choices.

3. Police Your Portions

Thanksgiving tables are bountiful and beautiful displays of traditional family favorites. Before you fill your plate, survey the buffet of options and decide what you’re going to choose. Then select reasonable-sized portions of foods you cannot live without.

Don’t waste your calories on foods that you can have all year long. Fill your plate with small portions of holiday favorites that only come around once a year so you can enjoy desirable, traditional foods.

4. Be Realistic

The holiday season is a time for celebration. With busy schedules and so many extra temptations, this is a good time to strive for weight maintenance instead of weight loss if you have decided to work on a diet ahead of the new year.

9. Focus on Family and Friends

Thanksgiving is not just about the delicious bounty of food. It’s a time to celebrate relationships with family and friends. The main event should be family and friends socializing, spending quality time together, not just what is on the buffet. Your mental health and wellbeing are equally as important as your overall body health.

Most importantly our team at Washington University Occupational Therapy wishes each and everyone a Happy & Healthy Thanksgiving and Holiday season.  We’re thankful for all of our colleagues in the healthcare field, community organizations & partners, and the patients that give us the opportunity to help them focus on the daily tasks they need and want to do.

USAWR Brings Home Silver Medal!

Washington University Occupational Therapist & Instructor, Sue Tucker, OTD, OTR/L, ATP is an Assistant Coach for USA Wheelchair Rugby (USAWR), and this past week Sue was helping guide the team as they played on the big stage in the Paralympic Games Tokyo 2020!

The USAWR Team had an outstanding showing at the Paralympic Games Tokyo 2020, with the team going undefeated in the pool play portion of the tournament and continuing on to reach the Gold Medal Final against Great Britain.  A tough match against Great Britain saw Team USA bring home the Silver Medal during these Paralympic Games!

We want to highlight and congratulate Assistant Coach Sue Tucker, OTD, OTR/L, ATP who is a Therapist & Instructor for Washington University Occupational Therapy. Sue has been coaching with the USA Wheelchair Rugby team since 2013 and has more than 17 years of experience in coaching adaptive sports. When not coaching or teaching, Sue is a practicing therapist and works with adults and adolescents with neurological and orthopedic conditions affecting their mobility to provide comprehensive assessments to assist patients in obtaining the mobility device, seating systems, and/or assistive technology that best meets their needs for their preferred daily activities through our Wheelchair, Seating, Mobility & Assistive Technology program.

Once again we want to congratulate all Paralympic athletes, the USA Wheelchair Rugby team, and especially our Washington University OT, Sue Tucker.