Occupational Therapy

Stayce

Hi everyone,


Can anyone recommend an occupational therapist in the London area who specialises in neurological vocational rehabilitation? For assistance with return to work/college type practicalities

Many thanks

Best wishes

Noah

I'm afraid I don't know any OT's in London. Are access to work able to put you in contact with someone? Maybe try asking the same question to our OT in " talk to a community advisor section". Has Googling produced any results? In the area I live we have a special number you can call anytime and request an OT under the nhs. Although this is more for daily living, rather than specialist rehabilitation.

I hope you find what you are looking for, please keep us posted, and let me know if I can be of any further help.

Noah

Stayce

Thanks for this Noah. Much appreciated.

It's one of those red tape referral conundrums. I see a really great Neurologist really helpful and supportive. He referred me to the exact place I needed to go to a vocational occupational therapist to assist with right sided Hemi and RSI in unaffected side (what a combo in relation to my job. I was then unfortunately taken off the waiting list and told had to be re-referred to a supposedly more local service, which turned out was not accessible for me to get to (the irony) nor even in London. I have thankfully just been put back on the orginal waiting list I was meant to be on in the first place after some perseverance on my part. But if anyone has any recommendations in the interim that would be great.

I have sent a post to Chris the adaptive technology community advisor as I suspect a lot of my solutions will be in the form of hands- free technology, I guess. Do you use any tech you would recommend?

Thanks again Noah

Best wishes

Stayce

Noah

Well done with your perseverance - I hope you get the outcome you need.

I have a very large mouse, and some gel pads the help prevent RSI. I also use a tablet computer to help with my visual impairment. Access to work many years ago did suggest I try voice recognition software, but I work in a shared office and it's not that practical. Although it is something I would like to try and make more use of in the future. Epecially as voice recognition is improving all the time. I find myself using the voice recognition via my smartphone a lot, which is very effective.

Is there anything that your consultant can recommend to help your RSI recover? What about a wrist brace or something from DM orthotics? Has your osteopath got any suggestions? Such as using kinetic tape?

I love my new lycra splints btw, the sensory feedback is amazing. Yet I have got some issues with my right foot and not being able to give it enough lateral support, despite Nero insoles, two lots of ankle braces and the extra lateral support straps. But it's work in progress and I will be in a better position to give a full appraisal once I've had them for a few more weeks.

Stayce

Thanks for this Noah much appreciated. My RSI is very much associated with overuse of one limb so is affecting pretty much whole upper limb system (hand/ arm /shoulder). Both physio and osteopath have used kensio taping which is great stuff. Physio is against splinting at moment as concerned will weaken my dominant arm, which I have to say I am relieved about as already wear DMO glove for Hemi side. I have also had steroid injections and rest to help recovery.

I use Dragon Naturally Speaking voice recognition in an open plan office (and shared your concerns) If your employers use a standard windows / Mac desktop it will work pretty well with a headset recommended by the manufacturers of the software. I taught myself the basics okay. You can feel a bit of a fool talking to yourself all the time, but I would say give it a go. My employers work on the Cloud which creates problems for Dragon to run as efficiently as it could. I am not using it completely hands free at the moment finding it difficult to move between different programmes via voice so am having some professional training on the package shortly.

I am currently testing out a couple of trackball mouse and a track pad. What is
your large mouse and gel pads like?

I am really glad you are enjoying the sensory feedback with your lycra splints. DMO may be able to add some additional pannelling to your right sock or perhaps even harder reinforcements like they use in their scoliosis suits. Alternatively ask them if a neuro Beagle ankle brace would be suitable. I have one of these that fits over my lycra Sock to give me further lateral support when I injured my ankle Really light weight. (just a thought)

Best wishes

Noah

Thank you for the suggestions, I will look up Beagle ankle braces - I've currently got some trilock ankle braces which I'm guessing are similar. I'm at work tomorrow, and I will find out for you who makes my extra large mouse.

I can understand why the voice recognition software may be more of a challenge to use if you use cloud based software which is bespoke to your organisation. I imagine you can configure voice recognition software to carry out very specific tasks on a voice command, which may help.

I'll try and do some research on that to, because with cloud based software applications increasing, it's very important that it's possible to fully navigate via voice recognition software, to enable the software to be fully accessible.

Thanks again

Stayce

Thanks Noah - That would be really useful as I am keen to keep trying out mouse and gel rest options until I find one that works best for me.

Is the Trilock ankle splint a Bioskin product?

This is the Beagle splint I have http://www.beagleorthopaedic.com/products/foot-and-ankle/neurodyn-foot-lift-orthosis
It's the best ankle brace I have experienced (most others have hurt me)

Maybe ask @ your review appointment if they think it would be suitable for you. I got mine on the NHS. It's fabric based which makes it work really well with the lycra splints if need something a bit extra laterally. There is also a figure of 8 one which may offer even more. Given they are a neuro range may work better.

Yes, I totally agree with you about cloud based applications. For a long time I had two separate desktops one with Dragon on and another with my Cloud desktop which meant Dragon could not talk to any application on the Cloud it was most frustrating. I am hoping the professional training being arranged for me will assist with some answers to this problem in the form of some shortcut commands. I would be very interested in anything you come across on this.

Best wishes

Stayce

Noah

I'm glad you are getting some professional training, I'm sure it must be possible to create your own short cut commands so that you can use the voice recognition software with a cloud based application. Out of interest which company is doing your training? let me know how that goes, I would be most interested. I'm planning on getting in contact with access to work in the near future to arrange a reassessment and refresh of some of my adaptations/ specialist equipment I require to be able to do my job well. Yes the triloks are a bio skin product. Do you know if the beagle splint gives more lateral support and is easier to put on? With the triloks, lycra splints and extra strapping, it's quite a performance to fit them on each morning and can take over 20minutes!

Thanks again

Stayce

My employer are going to arrange training with Hands-free computing (Scope recommended this firm - Thank you J Will keep you posted once I know when it is.

The Beagle splint is definitely easy to put on I can do it one handed You have made me think of the first few weeks of lycra splints. I used to have to get up earlier to allow for time to get it on. Once your muscle tone calms down through wearing the lycra socks fitting becomes much much easier. Not sure if the Trilock gives more lateral support but Googled picture and it does look like a very complicated strapping system. The Beagle slips on like a Sock you then do two velco cross straps (which are numbered 1 and 2) then one side panel strap (3)

Best wishes

Noah

I'm glad that you have contacted hands free computing. I'm sure they will be able to help as it's their specialised area.

My mouse is
http://www.posturite.co.uk/contour-mouse.html?mkwid=EtGDN2CP&pcrid=45767286285&pdv=m&gclid=CjwKEAiAova1BRDS15OXjcug_FMSJACWNAKZ6GK46e847Ci4VwblnWNsL3whdlLs5auklO9yu3ZtJxoCyAXw_wcB

My gel pads are made by Belkin and just give some wrist support when typing and using the mouse.

Hope that's of some help,

Noah

Stayce

Thanks Noah - Most helpful. I will definitely look into these. Have a lovely weekend.

Stayce

Hi Noah - Hope you are keeping well. How is it going with the lycra splints?

Are you aware of an ergonomic showroom for trying out ergonomic equipment mainly mice. Been through 4 so far so looking for somewhere to try out before buying. Any thoughts welcome

Best wishes

Noah

Hi Stacye

Are Postrite able to advise? Maybe they can send you out a demo so you can work out if it's suitable. I would think you would be covered under the distance selling act and should be able to return and get a refund if unsuitable. Another option, maybe to go to a large technical exhibition like the bett show in London - all the top providers of specialist assistive technology are there and you can try out all the latest hardware and software. The bett show is once a year around January time, I'll research tomorrow some other possible ideas for you.

Today I received in the post some trilock ankle braces that are the next size up as the old ones were a bit tight and painful after wearing all day, so that should help and I have a further appointment at the RNOH in about a weeks time, so I will be making lots of notes to feedback, and hopefully a solution can be found to give further lateral support to my right foot. The last few days I've had to go back to plastic afo's, planning to wear new setup again tomorrow now I have better fitting ankle braces. Still work in progress :-)

Thanks for asking

Noah

Noah

I have noticed that some of the Ergonomic mice can be trialed for 14 days before you buy, not sure if this is helpful to you http://www.contour-design.co.uk/

Also it might be worth contacting https://www.abilitynet.org.uk/ they maybe another good source of advice and are also a charity.

What operating system do you use on your work computer? Have you had an assessment from hands free computing yet?

Wish you all the very best and hope that you are able to find something that works for you.

Much happier with my new Lycra splints, the larger ankle braces are not as unconformable, and today I have bought some new boots that have a flatter and wider sole rather than slightly tapping up at the edges, this seems to have at least improved the lateral support issue, so some very positive steps forward!

Noah

Stayce

Thanks Noah - This is really helpful. Yes finding a company that offers a trial period is a good idea. Was orginonally suggested an evoluent left hand mouse this was good but in my last RSI flare up it was suggested this was perhaps not helping the shoulder. I have since been suggested a trackball and trackpad but it turns out I don't have the dexderity in my last two fingers or wrist/ elbow mobility to operate it without my forearm burning. We use Windows 8.1 at work and the whole organisation platform is run off the Cloud. I have not had an assessment from hands free computing yet but am looking forward to the prospect. I am also on waiting list for occupational therapy ( est 4 month waiting list though).

That's really great that you are making positive steps forward with your lycra splints and new orthotic set up. I wear trainer boots with a flat sole. Have you ever tried Nike High Dunks? - These work really well for me.

Best wishes

Stayce

Just seen your first post too only sent notification of second- Thank you for this. I will give posturite a call tomorrow and see if they offer trial of products. I was not aware of the Bett Show most interesting. I think I will definitely give this a go next year already taking bookings for 2017

Let me know how you get on at your review appointment for your lycra splints.

Best wishes

Noah

Thanks - Not heard of Nike High Dunks, I will have to give them a go!

The Bett show is mainly aimed at technology within Education, yet a great place to go and talk to all the assistive technology suppliers and try out the latest solutions.

It is possible to control the windows 8.1 operating system computer just from voice commands without any additional software, although I imagine it would take some quite a lot of practice and possibly some training!

A link that you might find helpful http://windows.microsoft.com/en-gb/windows-8/using-speech-recognition

Let me know how you get on.

Noah

Stayce

Thanks Noah - This is very helpful indeed. I will give this a try. I am making progress with sorting out organising hands free training. They believe that a user can be trained to use the package 90% hand free and can set me up with some shortcuts so very exciting. Will keep you posted. Best wishes

Stayce

Hi Noah -  I hope you are keeping well. I am still waiting for Hands free computing training on Dragon Naturally Speaking software, payment issue @ my employers end! Hope will be resolved soon. 

I had my first occupational therapy session yesterday. They feel I have the right equipment - so all that research does pay off

I am however having a few sessions of occupational therapy on fatigue management, which I hope will prove very useful. ( so will write another post soon on that)

The RSI is okay thanks; still working really hard on rehabilitation. I feel like a prime athlete near retirement at times, without the athleticism (i.e. in 30s push myself hard and keep picking up muscularskeletal injuries) Have tendon injury in foot not healed @ mo so got to have ultrasound scan on it - my house looks like a physio treatment room

How are you - How is it going with carbon fibre AFO design?

Brest wishes

Noah

I'm good thanks,

A post on fatigue management, would be good, I look forward to reading that.

You clearly have a lot of very useful information to share with the Scope Community and we really appreciate having people like you on here, thank you for all your very interesting and helpful posts.

Picking up muscular-skeletal injuries is very much part of having CP in my experience, it sounds like you are doing all the right things though to help your body get heal and recover, and you are certainly are good at doing your research. 

We all push our bodies tremendously hard, are extremely determined, and we hate giving up, so having CP has a look in common with being an athlete apart from we don't retire!

I wish you a speedy recovery, and I hope you continue to discover smarter not harder ways of doing things so that you can keep going, and doing the things you are passionate about. We are learning all the time, how to do our best to avoid the injuries that seem to be a regular part of life with CP.

The AFO's that are being made for me at the RNOH are not going to be Carbon Fibre, not just yet anyway. They are working on a brand new bespoke design, which hopefully will be less bulky, and improve function. It is being made out of traditional plastic so it easier to modify etc, if the concept works, then we will look at our options regarding carbon fibre construction!

My fitting appointment is early June, unless a cancellation should become available sooner. The team at the RNOH know me very well, and I speak to them most weeks to see if a cancellation has become available!

Noah 

Stayce

Thanks Noah - Your comments are much appreciated.  The team know me well too, think it's the best way  Let me know how your fitting goes. 

Best wishes