Neurotransmitter Project: Dopamine

Implicit Bias

Implicit bias is the brain’s involuntary response that shapes our unconscious stereotypes. The brain organizes patterns based on our experiences and environment. I think that it is important for OT students and practitioners to learn about implicit bias because we can miss out on learning and growing opportunities, if we refuse to explore our implicit bias. Additionally, the decisions that healthcare workers make can be influenced by implicit bias. As an OT student, I want to understand why unnecessary sufferings can be caused by implicit bias. I know that by understanding my implicit bias, I will be able to respectfully treat my future clients with inclusiveness and generosity. 

In order to examine implicit bias, one has to be courageous enough to explore. One way to do this is by taking the Implicit Association Test (IAT). Also, one should have the willingness to be vulnerable and actively engage in conversations with a generous spirit. One should acknowledge that everyone has implicit bias because that is what makes us human. Additionally, one should challenge their current negative bias, be empathetic, and recognize that it is painful and stressful to be victimized by assumptions.

My biggest takeaway from this session was that implicit bias is not formed overnight. It is something that takes years to form and years to break. With effort and respect, stereotypes can be countered and replaced with positive perspectives. Lastly, one should not allow their ego to hinder he or she. As long as one keeps an open mind and generous heart, one can train the brain to think of more positive patterns and reshape implicit bias for the better.  

The Scapulohumeral Rhythm

The scapulohumeral rhythm is defined as a ratio of movement between the scapula and humerus. It is the collective movement of the scapula to maintain congruency of the glenoid fossa and the head of the humerus. This rhythm consists of upward rotation, posterior tilt, and lateral rotation, and the movement between the glenoid fossa and humeral head has to be synchronous. The scapular rotation allows for the shoulder abductor muscles to maintain an ideal length-tension relationship. The upward scapular rotation helps sustain the subacromial space that is located between the subacromial arch and head of the humerus, preventing impingement. The scapulohumeral rhythm is needed for efficient arm movement, full ROM, and a good muscle length-tension between the shoulder abductor muscles, which are the deltoid and supraspinatus muscles. Additionally, the rhythm increases congruency of the glenoid fossa and the head of the humerus. For every 3° of shoulder movement, 1° is at the scapulothoracic joint, and 2° is at the glenohumeral joint. Likewise, the ratio of the scapulothoracic motion and glenohumeral motion is 1:2. For example, if the shoulder is flexed to 180°, 120° is produced at the glenohumeral joint and 60° is produced at the scapulothoracic joint. The scapulohumeral rhythm helps prevent active insufficiency of the glenohumeral joint. If there is dysfunction of the scapular movement, there will be an increase of friction at the glenohumeral joint, which will cause pain to the structures in the subacromial space. Lastly, the clavicle, scapula, and humerus all function together to produce a kinetic chain. If there is dysfunction in one joint, that could result in a loss of total motion, impingement, and pain. 

Conceptual Model of the Field

Test Positioning

It is important to use bony landmarks and proper positioning to know how to position the goniometer for measuring ROM. If a therapist uses the wrong body landmark to measure ROM, the results would be incorrect and would not reflect an accurate measurement. The next time the client is accessed, the past measurements would not be reliable. Additionally, if the positioning of the patient or goniometer is not precise, the measurement will also be unreliable. The purpose of MMT is to determine muscle weakness. When examining the purpose of the testing position, it is important to consider the plane of movement for the muscle that is being tested. The purpose of the test position is to place the muscle in a position for optimal muscle contraction, which is in mid-range. In a gravity eliminated position, the desired movement should be carried out so that it is parallel to the ground. When the patient’s muscle that is being tested is too weak, the patient should be tested in a gravity eliminated plane. MMT is most sensitive to changes in the lower grades, (0-3). Thus, a therapist will not apply resistance against gravity if the client’s MMT grade is between (0-3). Also, it is important to notice muscle compensations during testing in order to determine any lack of muscle strength. Compensatory movements may give the appearance of greater ROM. Thus, muscle compensation could lead to inappropriate movement patterns and could cause more damage. 

Biomechanics Activity Analysis

Every morning I retrieve and drink orange juice from my refrigerator.

The starting position of my right arm is elbow extension by my side and it is functioning in a sagittal plane about a frontal axis. Next, I reach forward to open the refrigerator door. My right hand grips the refrigerator door and pulls back. Here, my elbow is moving into flexion as it pulls the refrigerator door back. During this movement, my right shoulder experiences slight shoulder extension, and the end position of my right arm is elbow flexion.  

Next, I reach forward with my left arm towards the orange juice. The starting position of my left arm is elbow extension by my side, and my left shoulder is flexed, which are both functioning in a sagittal plane about a frontal axis. After I have grasped the orange juice with my left hand, I pull the orange juice towards my mouth. The end position of my left arm is flexion at the elbow, which occurs in the sagittal plane about a frontal axis.   

The osteokinematics of the left elbow is extension to flexion in an open kinematic chain. 

In terms of arthrokinematics, elbow flexion occurs at the humeroulnar and humeroradial joints. For the humeroulnar joint, the concave ulnar segment rolls and glides anteriorly on the stable, convex humerous. For the humeroradial joint, the concave radial head rolls and glides anteriorly on the stable, convex humerous.

The prime movers for elbow flexion are the biceps brachii, brachialis, and brachioradialis muscles, which perform a concentric contraction. 

Health Literacy

After engaging in lecture today, I learned that health is not just the lack of illness; it includes physical, mental, and social wellbeing. Occupational therapists support health in many ways, and one of those ways is prevention. In relation to healthcare, prevention involves interventions that reduce potential danger to health. A form of prevention is secondary prevention, which is inhibiting the effect of an illness or injury from getting worse by discovering it early. An example of secondary prevention used in occupational therapy is screening for development delays. 

Furthermore, I learned about health literacy and a client’s perception of health. Health literacy involves the amount of basic healthcare understanding that a client has that is also needed to make appropriate health discussions. As a future healthcare professional, it will be my responsibility to help my clients comprehend and participate in their health decisions. I thought that it was helpful to learn that occupational therapists can help clients reduce their fear and challenges by being sensitive to their vulnerability. Moreover, healthcare professionals should support clients while they navigate through a complex healthcare system. 

Lastly, it was inspiring to learn that patients who are health literate are more likely to make healthy lifestyle choices, have better communication with healthcare providers, and manage their chronic illnesses. Additionally, I learned about a couple different health literacy strategies. Providers do not always know if a patient has limited health literacy. So, healthcare providers should look for behavioral clues. These clues can be missed appointments, not taking medications, and not completing paperwork. Another strategy that I learned was using audio-visual aids instead of written words. This will help patients understand their conditions.