Friday, 24 May 2019

Evidence for your Practice: Early subthreshold aerobic exercise for sports related concussion

Image credit: Photo on Foter.com
Study: Leddy, J. J., Haider, M. N., Ellis, M. J., Mannix, R., Darling, S. R., Freitas, M. S., Suffoletto, H. N., Leiter, J., Cordingley, D. M., Willer, B. (2019). Early subthreshold aerobic exercise for sports related concussion: A randomized clinical trial. Journal of the American Medical Association Pediatrics. 173(4):319-325. doi:10.1001/jamapediatrics.2018.4397


Aim: A randomized clinical trial to assess the efficacy of subsymptom threshold aerobic exercise vs. a placebo-like stretching program for adolescents in the acute phase recovery from sports-related concussion (SRC).

Participants:  Adolescents (13-18 years of age), presenting within 10 days of SRC injury. Participants were either assigned to a placebo-like stretching program, or subsymptom threshold aerobic exercise group.

Intervention:
  • No intervention was prescribed for 48 hours from onset of injury
  • Subsymptom threshold aerobic activity was determined through the Buffalo Concussion Treadmill Test (BCTT), by sports medicine physicians
  • Daily 20 minutes of exercise was prescribed at target heart rate, or if concussion symptoms increased, whichever came first
  • Rest included avoiding excessive computer or mobile phone use, gym class, team sports or practice, in addition to avoiding stretching before and after prescribed exercise.

Results: Aerobic exercise participants recovered in a median of 13 days, whereas stretching participants recovered in 17 days, in addition to a nonsignificant difference in delayed recovery in favour of the exercise group.

Conclusion: Individualized subsymptom threshold aerobic exercise treatment prescribed to adolescents
with concussion symptoms during the first week after SRC speeds recovery and may reduce
the incidence of delayed recovery.

Limitations:
  • Study results should not be generalized to young children or adults with a history of cardiac conditions, or concussions sustained through other mechanisms (e.g. motor vehicle accidents)
  • Delivering exercise intervention by health care providers without a nuanced understanding of exercise-based assessment and treatment for concussion may diminish intervention efficacy

Clinical Relevance:
  • This RCT study adds to the body of evidence demonstrating that there is benefit to engagement of physical activity within one week for pediatric patients
  • Standard of care for SRC was prescribed rest until symptom resolution, where exercise training is typically avoided
  • Preventing delayed recovery is significant due to the negative impact of persistent symptoms on academic and social functioning in adolescence.

Post by Kay Chan, fieldwork student with CAOT-BC

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Tuesday, 21 May 2019

CAOT-BC 4th Annual OT Day at the Legislature


On May 16th, 2019 CAOT-BC hosted the 4th annual Occupational Therapy Day at the Legislature. Following attendance at question period, CAOT-BC staff and representatives held an open house for Ministers and MLAs which focused on the critical role our profession plays in improving health and well-being for British Columbians. Our key message included the need to strengthen the BC OT workforce, in addition to highlighting our role in key health areas, including primary care.


We would like to thank Minister of Health, Hon. Adrian Dix for his introduction of the delegation in the legislature [start time 10:06:24am].

Occupational Therapy Representatives 
We wish to express our sincerest thanks and gratitude to our volunteer delegates for your support and dedication to our profession.

Volunteer Delegation
  • Laura Bulk – CAOT-BC Advisory Committee Chair
  • Giovanna Boniface – CAOT Board Director for BC
  • Tricia Earl – CAOT-BC Private Practice Business Network
  • Dr. Susan Forwell – Department of Occupational Sciences and Occupational Therapy, University of British Columbia
  • Kelly Bethune – CAOT-BC Advisory Committee member, Vancouver Island Health Authority
  • Jeanette Boily – Vancouver Coastal Health
  • Marie Bullock – CAOT-BC Interior BC Practice Network Chair
  • Devon Cochrane – CAOT-BC Advisory Committee Member, Tall Tree Integrated Health Centre
  • Diane Graham – CAOT-BC Pediatric Practice Network member, KidsCan Therapy Services
  • Elisha Williams – Northern Health Authority
  • Kay Chan – CAOT-BC Fieldwork Student (UBC MOT)
BC Government
Those in attendance included:
  • Hon. David Eby (Attorney General)
  • Hon. Shane Simpson (Minister for Social Development and Poverty Reduction)
  • Hon. Judy Darcy (Minister of Mental Health & Addictions)
  • MLA Marvin Hunt (Official Opposition Critic on Social Development and Poverty Reduction)
  • MLA Simon Gibson (Official Opposition Critic for Advanced Education)
  • MLA Shirley Bond (Official Opposition Critic for Finance)
  • MLA Anne Kang (Parliamentary Secretary for Seniors)
  • MLA Mitzi Dean (Esquimalt-Metchosin)
  • MLA Linda Larson (Boundary-Similkameen)
  • MLA Ronna-Rae Leonard (Courtenay-Comox)
  • MLA Nicholas Simons (Powell River-Sunshine Coast)
  • MLA Ben Stewart (Westside-Kelowna)
  • MLA Jane Thornthwaite (North Vancouver-Seymour)





A sincere thank you to CAOT-BC members who reached out and personally invited MLAs to attend and have made contributions to our public awareness initiatives. Your efforts make all the difference!
Moving forward, CAOT-BC will continue to engage stakeholders and government officials to advance on issues pertinent to BC occupational therapists.

Follow us on Twitter and  Facebook to stay connected.


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Friday, 17 May 2019

Resource for your Practice: Stroke Best Practices new website

Heart & Stroke has launched an all-new Canadian Stroke Best Practices (CSBP) website to provide you with easy access to the most current evidence-based stroke recommendations, resources, webinars, and events. 

Recommendations include Stroke Rehabilitation, with Module Sections and Resources for: 

  • Delivery of Inpatient Stroke Rehabilitation
  • Delivery of Outpatient Stroke Rehabilitation
  • Management of the upper extremity Following Stroke
  • Rehabilitation of Visual Perceptual Deficits
  • and more!
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Monday, 13 May 2019

CAOT-BC Regional Forums: We want to hear from you!

Join CAOT-BC staff Tanya Fawkes-Kirby and Sarah Charles for an update and interactive discussion on association activities, advocacy initiatives, promotion and representation events and member benefits. Bring your questions, comments and ideas!
Free for any occupational therapist to attend (public or private sector, member or non-member).

Lunch will be provided. Please register at least one week prior to the session date.


June 6, 2019
12:00-1:00pm

12:00-1:00pm

June 20, 2019
12:00-1:00pm

12:00-1:00pm
WebEx option for those unable to attend in person

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Wednesday, 8 May 2019

Update from FNHA: New Partnership to Deliver Improved Health Benefits Program to First Nations People in BC


Leaders from the FNHA and Pacific Blue Cross (PBC) signing the new services agreement between the two organizations. Standing, left to right: Richard Jock, FNHA Chief Operating Officer;  Leza Muir, PBC Senior Vice-President and Chief Operating Officer; John Mah, FNHA Vice-President, Health Benefits; Rob Chiarello, Vice-President, People and Culture, PBC. Seated, left to right: Joe Gallagher, FNHA CEO; John Crawford, PBC President and CEO).
The First Nations Health Authority (FNHA) recently announced that it has partnered with Pacific Blue Cross to administer a suite of health benefits to First Nations residents of BC.

Starting this September, Pacific Blue Cross (PBC) will administer benefits on behalf of the FNHA for dental, vision, medical supplies and equipment, and drugs not covered by PharmaCare. Currently, approximately 144,000 First Nations people in BC receive these benefits primarily through Non-Insured Health Benefits (NIHB)—a national program that provides coverage to registered First Nations for a specified range of medically necessary items and services that are not covered by other plans and programs.

At a signing ceremony held on April 16, 2019 at the Vancouver Aboriginal Friendship Centre, the Chief Executive Officers of the FNHA and PBC signed a Declaration of Commitment to Cultural Safety and Humility safety and a five-year services agreement.


Further updates will be communicated through healthcare professional associations for changes to the First Nations Health Benefits program. If you have any questions, please contact us at provider@fnha.ca.   


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Monday, 6 May 2019

Deadline approaching: CAOT-BC grant applications


Four weeks left to submit your application to the CAOT-BC grant programs. Both grants are open to all CAOT-BC members. The deadline for submission is May 31, 2019.


The CAOT-BC Research & Education Grant provides up to 2 grants of $500 annually to support CAOT-BC members to present occupational therapy research and/or education at either the CAOT national conference or other related conferences. This grant is a member benefit contributing to the growth of evidence on occupational therapy and occupational science.

2019 CAOT-BC Dianna Mah-Jones Memorial Grant for Innovation


The CAOT-BC Dianna Mah-Jones Memorial Grant for Innovation was established in memory of Dianna Mah-Jones, who was a creative and tireless advocate and activist for innovation and excellence in client care. This is an annual grant of up to $500 to support CAOT-BC members to participate in continuing education that will enable them to gain skills, knowledge, and competence to deliver innovative direct client care. This grant can be used towards registration fees to any course, workshop, conference, or other educational session that is relevant to the applicant’s area of practice.

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Thursday, 2 May 2019

Update from ICBC


More than 50% of the inquiries to the Health Care Inquiry Unit since April 1 have been regarding invoicing and reporting.

To help address these questions, ICBC has created an Invoicing and reporting  FAQ document, which also addresses the questions that arose in the webinars. Questions answered include:
  • How do we handle obtaining patient consent and sharing reports with ICBC?
  • Is tax applied for invoicing?  
  • How will I know when invoices have been paid?

Patient consent clarification
ICBC has been made aware that some stakeholder groups have received information citing restrictions for health care providers in giving patient information to ICBC representatives. Please be aware that it is ICBC’s position that the Personal Information Protection Act (PIPA) does not override the Insurance (Vehicle) Act or its Regulation.

While it is always preferred to receive information with client consent, there is a provision in PIPA, s. 18(1)(o), that allows disclosure of information without consent if the disclosure is required or authorized by law. The Insurance (Vehicle) Act requires health care practitioners, upon request, to provide ICBC with reports containing medical information, to the extent that the information is known by the health care practitioner. Therefore, it is ICBC’s position that the provision of the information is required by law, and PIPA allows disclosure of medical information for the purposes set out in the Insurance (Vehicle) Act. 

ICBC is here to help. Providing the best possible care for your patients remains ICBC’s top priority. As such, a patient consent considerations document has been created to outline some of the consent considerations that may arise related to ICBC reports in your practice. For further support, please consult your regulatory college or association.

Regulation amendment on receipt submission timeline
The B.C. government recently announced amendments to the Insurance (Vehicle) Regulation, which establishes a 60-day time limit for submitting receipts for medical care or rehabilitation expenses to ICBC.

The new limit gives a reasonable amount of time to submit receipts while ensuring ICBC receives the information it needs to accurately assess the severity of claims, provide additional support to injured people, as needed, and better forecast future costs. Exceptions may be allowed in cases where people cannot meet the deadline due to the nature of their injuries or other factors which would constitute a reasonable excuse.

Health Care Provider Invoicing and Reporting (HCPIR) application
Since April 1, ICBC has had over 25,000 invoices successfully submitted via the HCPIR application.
To apply for a vendor number, submit an invoice or report, and learn how to use the HCPIR application, visit ICBC’s invoicing and reporting and support and resources pages.

How ICBC is supporting you
As a first resource to find answers to your questions, visit ICBC’s Health Services Business Partners site at www.icbc.com/partners/health-services. If you have any further questions, the Health Care Inquiry Unit (HCIU) is available to assist you Monday-Friday, 8:30am-4:00pm

Lower Mainland: 604-587-7150 Toll free: 1-888-717-7150

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Wednesday, 1 May 2019

Your mOnTh at a Glance

UPCOMING EVENTS


Arthritis Talks: Nourish & Flourish
When: May 4th, 2019 | 8:30am PST
Where: Webinar
Experts in nutrition, physical activity and medical cannabis will bring current research and information about arthritis to you via your computer in the comfort of your own home.


CAOT-BC Regional Forums - We want to hear from you!
Join CAOT-BC staff Tanya Fawkes-Kirby and Sarah Charles for an update and interactive discussion on association activities, advocacy initiatives, promotion and representation events and member benefits. Bring your questions, comments and ideas.

Lunch is provided. Free for any occupational therapist to attend (public or private sector, member or non-member). Registration is required.
When: June 2019
Where: Nanaimo, Surrey, Vancouver, Kelowna (WebEx option for those unable to attend in person) 


Walk for Arthritis
When: June 1st, 2019
Where: Vancouver, Parksville, Victoria, Kamloops Kelowna
CAOT-BC needs volunteers for Vancouver and Parksville Walk for Arthritis “Ask an Expert” table! Email scharles@caot.ca for details

CAOT-BC Pediatric Practice Network Meeting
When: June 17th, 2019; 6:00-7:30pm

Where: In person (Vancouver) and webinar
Topic: Parent-Child Interaction Therapy: Evidence Based Treatment for Disruptive Behaviour in Young Children


Neil Squire Society Party in the Parking Lot
Where: Neil Squire Society’s Head Office, 3999 Henning Drive, Burnaby BC
When: Friday, June 21st, from 11:00am - 3:00pm.
What: Food trucks, live music, tours and cake!


OPPORTUNITIES 


Volunteer for Health Expo in Victoria BC
We are looking for one more volunteer to join CAOT-BC staff at the Pharmasave Broadmead Health Expo on May 4th from 2:30-4pm. CAOT-BC will be collaborating with Pharmasave Broadmead and the Arthritis Society to guide community members through the Arthritis Symptom Checker (an online survey) and provide education on managing daily activities with arthritis. 

Submit your application for a CAOT-BC grant
Both grants are open to all CAOT-BC members. The deadline for submission is May 31, 2019.

The Canadian Association of Occupational Therapists welcomes applications from qualified individuals to serve as Editor of the third edition of its textbook Enabling Occupation.
The position is a 2.5 day per week and shall be from a start date of August 1, 2019 and an end date of July 31, 2021. 
Complete application must be received not later than April 30, 2019. Learn more

Join ECHO for Pain – BC
ECHO for Pain - BC is a free virtual learning community comprised of specialists and community health care providers (including occupational therapists) who will use didactic and case-based learning to gain improved competence in providing care for complex pain cases. Learn more


The 36th International Seating Symposium: Call for Abstracts
The ISS is returning to Vancouver for March 3-5, 2020. 
Abstract submission deadline: May 14, 2019

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Monday, 29 April 2019

Evidence for your Practice: Somatosensory retraining for improving sensory function in the arm post-stroke

Photo credit: flickr

Study
Turville, M. L., Cahill, L. S., Matyas, T. A., Blennerhassett, J. M. & Carey, L. M. (2019). The effectiveness of somatosensory retraining for improving sensory function in the arm following stroke: A systematic review. Clinical Rehabilitation. DOI: 101177/0269215519829795

Aim
To evaluate the efficacy of somatosensory discrimination skills programmes post-stroke to improve somatosensory discrimination and arm functioning. After applying the study criteria, this systematic review resulted in an analysis of 10 studies, of which the following information summarizes.

Population
Post-stroke with somatosensory impairment but typically without significant communication difficulties,  previous neurological conditions or perceptual difficulties e.g. unilateral spatial neglect

Intervention
Of the 10 studies analysed, the most common treatment principles included:
  • Use of vision and unaffected hand to facilitate relearning of sensation
  • Focus on functional or meaningful tasks
  • A variety of graded somatosensory discrimination tasks
  • Use of attention when exploring sensory features
  • Feedback of task performance
On average, retraining occurring for 16 sessions over 4-8 weeks, 2-3 times per week at 70 minutes each session
15-90 minutes of homework per day was prescribed in half the studies


Key Findings
  • Somatosensory discrimination retraining improves upper limb somatosensory impairment after stroke
  • Evidence of impact of somatosensory discrimination retraining on arm function and participation is currently limited

Post by Kay Chan, fieldwork student with CAOT-BC

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Friday, 26 April 2019

Working for You

What did CAOT-BC do for you this month? 

  • Met with Attorney General David Eby to discuss occupational therapy workforce in BC
Questions, comments or ideas? Email caotbc@caot.ca

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