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51 Cards in this Set
- Front
- Back
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examples of physical and environmental barriers
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Front entrance/reception access (turn styles)
Spacing of equipment Inaccessible or inadequate change rooms Inaccessible equipment- must transfer out of wheelchair; large consoles on exercise bikes… Lack of accessible cardiovascular equipment Surface areas- slippery Transportation |
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examples of Psychosocial Barriers
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Attitudes and beliefs of patrons and staff
Knowledge of staff Contraindications of exercise Adaptations/modifications Progressive medical conditions Disability awareness and education Lack of social network (perceived or actual) Administrative resistance to inclusive programming Program procedures and policies Informational barriers Limited resources |
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Barriers to participation due to lack of:
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physical access
cost scheduling untrained staff (Rimmer et al., 2005) |
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Six Objectives of Community Based Model
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1-Dispelling misperceptions
2-Fostering collaborative relationships 3-Developing effective and achievable solutions for barrier removal 4-Addressing specific needs of individuals wishing to use facility 5-Identifying the cost of removing barriers to accessibility 6-Providing a mechanism for monitoring compliance |
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Readily Achievable Barrier Removal
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Barriers that can be removed without great cost
Examples: Re-arrangement of exercise equipment Modification of facility policies Removal of obstacles Adding or replacing signage |
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Benefits to the facility:
for improving accessibility |
Enhance image
Improve customer service to people without impairment Reduce likelihood of accessibility complaints Avoid legal action Help plan and manage change Open up new market and attract new patrons/customers |
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Health Promotion
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Promotion—Process of enabling individuals to increase control over their health and to improve it
Process requires personal participation and supportive environments. |
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what is used for a supportive transitional setting?
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Utilized to transition person from rehabilitation to community setting
Learn information specific to impairment type and function Examples: University based clinics Hospital wellness centers Private clinics Work related facility Module approach to intervention |
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Challenges facing families during transition from child to adult
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Child to adult care continuum
Lack of adult services in many fields Lack of integrated care Arbitrary age point Disorder trajectory Complexity and interdependency of services and care Financial implications Transition is a time of uncertainty and stress Transition is a time of great stress because many of the systems upon which young people and their families have grown to depend on are now being withdrawn. There can be a significant breakdown of care between childhood and adulthood |
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what are the 7 core principles of the service development cycle
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Identify care group or user population
Identify the key dimensions of transition Bring stakeholders together Identify transitional needs Transitional planning and agreement Identify/provide the resources Audit and Evaluation |
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Direct Transition Model
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Focus on structural factors (communication and information sharing)
Focus on relations between services Continuity of information and cross boundary and team continuity Appropriate model for when disease and impairment has minimal impact on youth’s ability to develop naturally. |
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Sequential Transition Model
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Recognize that person’s needs are changing and require preparation if they are to adjust to adult care
Constructed as extension of child provision or jointly between adult and child providers Flexible and longitudinal continuity Increase autonomy given in making decisions about care. Appropriate when youth’s role and responsibility for care will change significantly. |
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Developmental Transitional Model
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Needs some help in acquiring skills and support
Active focus on personal growth and development Developmental continuity Re-defining of family’s role in care provision in parallel with personal development Appropriate for vulnerable youth and youth with physical or learning impairment |
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Professional Transitional Model
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Focus not on young person rather on professional’s response to young person’s needs
Releases concentration of expertise from within one service type Develop relational or personal continuity Appropriate for youth with short life expectancy or where expertise is within one service area |
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Focus not on young person rather on professional’s response to young person’s needs
Releases concentration of expertise from within one service type Develop relational or personal continuity Appropriate for youth with short life expectancy or where expertise is within one service area |
Models are not mutually exclusive
Highlight 2 important continua Focus continuum: young person—service Developmental process continuum: implicit—explicit The level of importance of the different continua within the transitional needs of the youth should guide approach |
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what are the treatment approaches at the glenrose for patients
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Person centered approach
Targets functional goals Goals are patient/family identified Goals addressed through: Individual treatment Group treatment Transition to community programs |
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what is the ICF
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The International Classification of Functioning, Disability and Health
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interventions must consider interaction of ____ and _____
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person and environment
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Three Dimensions that impact health
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Body functions and structures
Activities Participation *Each affected by personal factors and environmental factors |
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what is the role of technology for people with disabilites
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functionality
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Camber
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is the degree to which the tops of the wheels slant inward
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Casters
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front small wheels (allow for quick sharp turns)
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FES
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is a process by which an electric current is applied to the muscles, which have lost nervous control, using surface electrodes
A current supplies stimulation to illicit a muscle contraction with the aim of providing functional useful movement |
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Who can use FES
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Clients may have SCI, MS, Stroke and CP
Clients must have an intact reflex loop Reflex Loop: introduce stim, sensory neurons carry signal to spinal cord, synapse, motor neurons carry signal to muscle, elicit contraction Clients must be assessed by a physiatrist prior to treatment |
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Factors that determine sufficient current flow to cause an action potential
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Impedance of body tissues: conductivity of body tissues is based on its water and ion content. Muscle is a good conductor, adipose tissue is a better insulator
Electrode size and placement Stimulation parameters |
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Benefits of FES
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Increase muscle area and fiber size
Reduce spasticity Reduce contractures Increased blood flow due to contracting muscle, improved capillarisation Improved lower extremity edema, reduced occurrence of pressure sores Improved bladder, bowel function Improved sleeping pattern Improved cardiovascular fitness, increased cardio output and oxygen uptake Lower blood pressure Improved gas exchange kinetics Improved body composition Improved general health, physiologically and psychologically |
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Benefits for individuals with SCI
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Reduce Secondary complications of SCI:
Infections Muscle atrophy Poor circulation Risk of Cardiovascular Disease (CVD) |
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Contraindications and Precautions regarding FES
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FES safety is not known in pregnancy
Cancer: FES increases blood flow and could increase the rate of spread of cancer Cardiac Demand Pacemakers Electrodes should not be placed over broken skin, rashes, blisters or burns FES may trigger symptoms of Autonomic Dysreflexia |
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Autonomic Dysreflexia (AD)
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AD is elicited by a noxious stimuli below the level of injury.
Characterized by increase in blood pressure above the level of injury and a decrease below the level of injury Signs and Symptoms: bradycardia (HR < 60 bpm), hypertension (BP > 200/100mmHg), goose bumps and cold clammy skin, profuse sweating, headache, nasal congestion and nausea |
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1-What are the different types (categories) of barriers to community fitness facilities/program
participation? |
Physical/Environmental Barriers
-Front entrance/reception access (turn styles) -Spacing of equipment -Inaccessible or inadequate change rooms Psychosocial Barriers -Attitudes and beliefs of patrons and staff -Knowledge of staff -Lack of social network (perceived or actual) Pragmatic Barriers to Access -Noticeable absence of PWD in community fitness centres physical access cost scheduling untrained staff |
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2- pragmatic noticeable absence of people with disabilities
Barriers to participation due to lack of: |
physical access
cost scheduling untrained staff |
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Community readiness and individual readiness. What do these two terms refer to when
discussing community exercise programs for people experiencing disability? |
individual readiness is when they have the skills, proper independance and self esteem to thrive in the community.
community readiness is when the community staff is trained with programs and know how to deal with specific disabilities, the facilities are accessible, transportation is available, the social atmosphere is accepting and inclusive. as well as having different opportunities present giving people choice. |
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Identify key goals of the TSC transition program.
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Bridge the gap between health care, rehabilitation and the community.
Optimize programs to maximize access and independence. Decrease TSC wait times through increased programming and options. Develop stable working partnerships with local fitness facilities and community physical activity programs. Assist in improving the accessibility of community fitness facilities through Universal Design principles and accessible equipment resources. Advance the exercise and disability knowledge of fitness professionals and provide professional adapted physical activity services to community fitness facilities. the key idea behind the steadward centre transition program is comprised of four parts: they try to work on creating individual readiness through learning discovery and citizenship,2-connecting with community staff readiness so talented people specialized in this field, 3-searching and providing community opportunities (connecting communities together) 4- working on the physical/environmental barriers and how to limit or get rid of the, (transformative organizational support) |
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4- How does the community benefit from increased participation of people with disabilities in
community recreation facilities? |
Enhance image
Improve customer service to people without impairment Reduce likelihood of accessibility complaints Avoid legal action Help plan and manage change Open up new market and attract new patrons/customers |
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What is the concept of liminality? Explain. What role might it play in the lives of individuals
with impairment? |
Liminality refers to a lack of social status that can be created when a minority group attempts to access services provided by the majority group.
Liminality can be characterized by: anonymity obedience humility conformity -conformity to codes of conduct of the mijority group because of impositions created by the minority 6 degrees -freedom of choice -self respect -dignity of space -taking risks -peer learning -living an ordinary live needs these to live a good life |
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6-What were some of the key messages from the panel discussion on community physical activity
and sport opportunities? |
. Accessibility of rec centres and attractions. Working with disability organizations to look at needs, gaps, issues, how to partner up to work things out.
Partnerships – creating partnerships within the community, offering programs. (Ex: Film Festival – lost funding for it). Non-profit disability organizations. Applying for grants. Developed successful transition for adults, trying to apply this to youth over the past few years. (Partnered with YMCA). 3. Initiatives 4. Barriers 7. Challenges 8. Promotion of full participation 12. What would you wish for your program? |
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7-Describe the new approach Glenrose is taking with its outpatient program? How does this differ
from its current approach? Proposed impact? |
Transition Process
Discharge Planning Community Program Identification or Development. Coordinated Interdisciplinary Discharge Planning. Agency transition stages: a. disorienting orientation addresses psychological and social anxiety. b. Orientation to details of agency program requirements. c. Focus on integration experience with confidence. d. Discharge possible. |
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8- Provide an overview of the disability sport governance structure.
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The International Paralympic Committee (IPC) is the global governing body of the Paralympic Movement. The IPC organizes the Summer and Winter Paralympic Games, and serves as the International Federation for nine (9) sports, for which it supervises and co-ordinates the World Championships and other competitions.
over see 26 sports |
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9. What role does classification play in para (disability) sport?
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It is “systems” designed to:
Create a fair, equitable and level playing field with the intention to encourage the pursuit of sport excellence. Athletes with disabilities are grouped in classes defined by the degree of function presented by the disability. Six different disability groups in the Paralympic Movement: amputee, cerebral palsy, visual impairment, spinal cord injuries, intellectual disability les autres. Objectives: To support and co-ordinate the ongoing development of accurate, reliable, consistent and credible sport focused classification systems and their implementation. |
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10. What are key factors that influence the advancement of technology for sport?
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making the users of these devices more functional
Antecedents: Accidents Medical conditions War Social Changes: Sport as rehabilitation Legislation Actualization of fitness needs Role of technology: |
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12. Define the term “Readily Achievable Barrier Removal”. What are some examples?
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Barriers that can be removed without great cost
Examples: Re-arrangement of exercise equipment Modification of facility policies Removal of obstacles Adding or replacing signage All barrier removal is dependent on facility’s size, financial condition and existing site condition |
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11. Describe the Community Based Framework presented by Riley et al (2008). What are the key
components? How does this compare to The Steadward Centre Community Exercise Transition Model? |
Dispelling misperceptions
Fostering collaborative relationships Developing effective and achievable solutions for barrier removal Addressing specific needs of individuals wishing to use facility Identifying the cost of removing barriers to accessibility Providing a mechanism for monitoring compliance Produce change at the community and facility level Considerations Accessibility needs of individuals Specific barriers to access community facilities Available resources to remove barriers Provides a process for identifying accessibility guidelines specific to a facility in response to barriers Refers to collaboration and direct participation Term Community-Based refers to the collaboration and direct participation of various community members in the accessibility-improvement process, including individuals with impairment, facility owners and staff residing in the community. |
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13- Community transition models demonstrate the different levels of support needed for youth
requiring transition support. What are some of the factors that may dictate the type of transition model utilized? (What are the four different transition models?) |
Direct Transition Model
Focus on structural factors (communication and information sharing) Focus on relations between services Continuity of information and cross boundary and team continuity Appropriate model for when disease and impairment has minimal impact on youth’s ability to develop naturally. Sequential Transition Model Recognize that person’s needs are changing and require preparation if they are to adjust to adult care Constructed as extension of child provision or jointly between adult and child providers Flexible and longitudinal continuity Increase autonomy given in making decisions about care. Appropriate when youth’s role and responsibility for care will change significantly. Developmental Transitional Model Needs some help in acquiring skills and support Active focus on personal growth and development Developmental continuity Re-defining of family’s role in care provision in parallel with personal development Appropriate for vulnerable youth and youth with physical or learning impairment Professional Transitional Model Focus not on young person rather on professional’s response to young person’s needs Releases concentration of expertise from within one service type Develop relational or personal continuity Appropriate for youth with short life expectancy or where expertise is within one service area |
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14. How does Rimmer (2002) describe health promotion as it pertains to people experiencing
disability? |
Health Promotion—Process of enabling individuals to increase control over their health and to improve it.
Process requires personal participation and supportive environments. -a supportive transtioning setting for persons with disabilities to manage their health |
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15. What is the Travel Training Program provided by Edmonton Transit Services?
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a simulated bus tour with a member from the ats staff
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Rights Based Paradigm
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Self Determination
Independence Empowerment Dignity |
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Community Benefits
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Community physical activity opportunities and community integration for people with physical disabilities are an important and beneficial means to maintain physical, social and mental health
Physical inactivity among people with physical disabilities is a complex issue that includes physical, social, and attitudinal barriers as well as a lack of internal motivation. Increased opportunities for persons with disabilities to be physically active within their communities Persons with disabilities would experience increased access to community fitness facilities through accessibility and disability awareness by staff and able-bodied facility members Persons with disabilities will experience increased emotional support from staff to assist with the transition from rehabilitation to community. Increased and enhanced social networks for persons with disabilities |
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Six Degrees of Liminality
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Freedom of Choice
Self-respect Dignity of space Peer Learning Living an ordinary life Taking Risks |
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Service Development Cycle
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Identify care group or user population
Identify the key dimensions of transition Bring stakeholders together Identify transitional needs Transitional planning and agreement Identify/provide the resources Audit and Evaluation |
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Transitional Mod
Highlight 2 important continua |
Focus continuum: young person—service
Developmental process continuum: implicit—explicit |
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Role of Technology is to provide
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functionality
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