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April is Parkinson’s Awareness Month

Parkinson's Awareness

Parkinson’s disease is a movement disorder that is chronic and progressive, meaning that symptoms continue and worsen over time.

As many as one million individuals in the US live with Parkinson’s disease. While approximately four percent of people with Parkinson’s are diagnosed before the age of 50, incidence increases with age.

Its major symptoms vary from person to person, but can include tremor, slowness of movements, limb stiffness, and difficulties with gait and balance. The cause of the disease is unknown, and although there is presently no cure, there are treatment options such as medication and surgery to manage the symptoms.

If you have questions about wheelchair accessible vehicles and are in the New England area give us a call @ 508-697-6006

 

Parkinson’s Awareness

Parkinson's Awareness

Parkinson’s disease is a movement disorder that is chronic and progressive, meaning that symptoms continue and worsen over time.

As many as one million individuals in the US live with Parkinson’s disease. While approximately four percent of people with Parkinson’s are diagnosed before the age of 50, incidence increases with age.

Its major symptoms vary from person to person, but can include tremor, slowness of movements, limb stiffness, and difficulties with gait and balance. The cause of the disease is unknown, and although there is presently no cure, there are treatment options such as medication and surgery to manage the symptoms.

Congenital Heart Defects: Frequently Asked Questions

What is a congenital heart defect?

  • Congenital heart defects (CHDs) are problems with the heart’s structure that are present at birth.
  • Common examples include holes in the inside walls of the heart and narrowed or leaky valves. In more severe forms of CHDs, blood vessels or heart chambers may be missing, poorly formed, and/or in the wrong place.

How common are congenital heart defects?

  • CHDs are the most common birth defects. CHDs occur in almost 1% of births.
  • An approximate 100-200 deaths are due to unrecognized heart disease in newborns each year. These numbers exclude those dying before diagnosis.
  • Nearly 40,000 infants in the U.S. are born each year with CHDs.
  • CHDs are as common as autism and about twenty-five times more common than cystic fibrosis.
  • Approximately two to three million individuals are thought to be living in the United States with CHDs. Because there is no U.S. system to track CHDs beyond early childhood, more precise estimates are not available.
  • Thanks to improvements in survival, the number of adults living with CHDs is increasing. It is now believed that the number of adults living with CHDs is at least equal to, if not greater than, the number of children living with CHDs.

What is the health impact of congenital heart defects?

  • CHDs are the most common cause of infant death due to birth defects.
  • Approximately 25% of children born with a CHD will need heart surgery or other interventions to survive.
  • Over 85% of babies born with a CHD now live to at least age 18. However, children born with more severe forms of CHDs are less likely to reach adulthood.
  • Surgery is often not a cure for CHDs. Many individuals with CHDs require additional operation(s) and/or medications as adults.
  • People with CHDs face a life-long risk of health problems such as issues with growth and eating, developmental delays, difficulty with exercise, heart rhythm problems, heart failure, sudden cardiac arrest or stroke.
  • People with CHDs are now living long enough to develop illnesses like the rest of the adult population, such as high blood pressure, obesity and acquired heart disease.
  • CHDs are now the most common heart problem in pregnant women.

What causes congenital heart defects?

  • Most causes of CHDs are unknown. Only 15-20% of all CHDs are related to known genetic conditions.
  • Most CHDs are thought to be caused by a combination of genes and other risk factors, such as environmental exposures and maternal conditions. Because the heart is formed so early in pregnancy, the damage may occur before most women know they are pregnant.
  • Environmental exposures that may be related to risk of having a CHD include the mother’s diet and certain chemicals and medications. Maternal diabetes is a recognized cause of CHDs. Maternal obesity, smoking, and some infections also may raise the risk of having a baby with a CHD. Preventing these risk factors before a pregnancy is crucial.
  • A baby’s risk of having a CHD is increased by 3 times if the mother, father, or sibling has a CHD.

Driving Assessment Program: Spaulding Outpatient Centers

Driving Assessment Program

Man driving with evaluator New EnglandThrough their Driving Assessment Program, Spaulding Outpatient Centers offer evaluations for people experiencing functional changes due to trauma, surgery, a neurologic incident, or the aging process. It is an essential part of the assessment to address any deficits that may influence your safety and independence behind the wheel and as a licensed driver.
Medical conditions that may affect driving skills include stroke, Parkinson’s disease, dementia, Alzheimer’s disease, acquired or traumatic brain injury, macular degeneration, glaucoma, neuropathy, cardiac disease, arthritis and cerebral palsy. These conditions may affect your vision, memory, attention, and ability to problem solve and react quickly.
If you are unsure if your condition affects your driving abilities, or if you need a doctor’s order to medically clear you to drive, you may benefit from a driving evaluation. If you are concerned about the driving abilities of a family member or friend, you may want to recommend that they participate in a driving assessment.
We will assess your vision, spatial awareness, ability to shift attention, problem solving, sequencing, and awareness of others on the road. We also will assess your own strengths and weaknesses, ability to read traffic signs, ability to identify and safely respond to hazards, gas/brake/steering reaction time, and other physical and cognitive abilities. This evaluation may also examine the need for adaptive equipment to make driving easier for you. 

Our approach is to assess all of the abilities of a person who is driving – physical, cognitive, visual, perceptual, as well as driving behaviors. We start with a clinical assessment that takes one to two hours.  Following this, a person may be recommended for an in-vehicle assessment coordinated between the patient, their family/support, the occupational therapist, and one of our partner driving schools.
Following both assessments, recommendations are made to resume driving safely, pursue retraining on the road, pursue modifications/training for vehicles, pursue additional therapy to address areas of concerns, or refrain from driving. Alternative transportation options may be discussed as well. Reports are sent to the referring physician and may be sent to the Registry of Motor Vehicles.

A Driving Assessment is conducted by an occupational therapist at one of our six centers specializing in this evaluation. The occupational therapist has the opportunity to participate in training in the most advanced assessment tools and methods to ensure competent decision making both clinically and on the road.
The Spaulding occupational therapists who perform driving assessments have a unique benefit of being able to consult with each other as part of a team to allow the best quality of service for their patients. Our Spaulding occupational therapists are skilled in the assessment of vision, perception, cognition and mobility, as well as the complex interaction of all of these components during driving.

The Spaulding Rehabilitation Network is dedicated to researching innovative treatments for our patients who may need assistance with driving evaluations.

 

Program
In-Vehicle Assessment

Description
An on-the-road evaluation may be performed to determine your ability to drive safely in a closely supervised environment. This involves an in-traffic evaluation, helping to correlate the findings from the clinical tests with your on-the-road performance. This evaluation is performed in a vehicle that has an instructor’s brake, an occupational therapy, and a certified driving instructor. Results of both the clinical and road evaluations are sent to the referring physician along with specific recommendations, such as medical follow-up, outpatient therapy, driving lessons, or adaptations to your car to allow for safe driving. The evaluation is given on a self-pay basis and takes between two and three hours to complete.


Clinical Assessment
The clinical assessment utilizes evidence-based testing correlated to the skills required for driving. This includes vision, cognitive, and physical/reaction time testing.

 

Driving Assessments are offered at these Spaulding Outpatient Centers:

Outpatient
Spaulding Outpatient Center Sandwich
Spaulding Outpatient Center Wellesley
Spaulding Outpatient Center Braintree
Spaulding Outpatient Center Boston


Inpatient
Spaulding Hospital North Shore
Spaulding Rehabilitation Hospital Boston
Spaulding Rehabilitation Hospital Cape Cod

 

Assistive Technology Services

Image Goes HereIn the past decade, advances in computer technology and materials science have revolutionized the field of assistive and adaptive technologies. Assistive technologies can open new worlds for individuals with physical, communication, and cognitive limitations.
Technologies can help someone who is learning to live with a new disability compensate for his or her limitations. A new technology may also help someone with a chronic or progressive disabling condition maintain or improve his or her independence.
At Spaulding Rehabilitation Network’s (SRN) Assistive Technology Center in Boston, dedicated and experienced clinicians in physical therapy, occupational therapy, and speech-language pathology provide assessments and training with different types of assistive technologies.
Alternative Computer Access
 – People who are unable to use a standard keyboard or mouse due to physical, visual, or cognitive limitations may be able to operate a computer with alternative computer access technologies such as voice recognition, adaptive keyboards, a specialized mouse, or assistive software.


Assisted Memory and Information Processing
 – Electronic memory aids can benefit outpatients following brain injury, as well as individuals with dementia or other forms of memory loss. Small portable computing devices such as PDAs and smart phones can successfully aid individuals with memory loss.


Communication
 –  Spaulding’s Augmentative and Alternative Communication (AAC) program provides comprehensive evaluations and interventional strategies for those needing alternative or augmentative means of communication through use of a variety of different communication devices.  Augmentative and Alternative Communication is a set of strategies and methods to assist people who are unable to meet their communication needs through speech or writing. AAC strategies may include low-tech options (such as letter boards or communication books) or high technology devices that produce speech. These devices can be customized to meet the individual’s communication needs at home, at school, at work, and in the community. The goal is to provide communication skills that extend beyond simply conveying of basic wants and needs, and provides the means to allow each individual to be heard, and to express emotions.


Electronic Aids to Daily Living
 – People who have difficulty using their arms and hands to control objects during everyday activities can gain control through remote switches to operate household appliances and devices such as TV, stereo, lights, call bell devices, door openers, and thermostats.


Ergonomics
 – Repetitive Strain Injury can make it difficult to use a standard computer set-up. Many people with wrist, shoulder, or neck pain may benefit from using ergonomic keyboards and mice, and from workstation modifications and body mechanics education.


Mobility, Seating, and Positioning
 – Wheelchair users may gain further independence through advanced wheelchair technologies. Some people may require modifications to a manual wheelchair; others may need a power wheelchair controlled by a joystick or a specialized switch, activated by sip and puff, or head movement.
Wheelchair users who have difficulty sitting upright, or who have postural abnormalities, may also benefit from customized seating and positioning systems. The systems use modified back supports, seating components, and tilt or recline features to meet an individual’s needs. The systems are designed so that users can achieve the best possible posture and can improve their performance of everyday activities.