Tuesday, February 26, 2013

Why use Vibro-acoustics as part of your MSE treatment?

Linda Messbauer,  OTR/L

First, Vibro-acoustics is a process using two sensory systems in the body; the auditory and the touch system.  The response to the music through the auditory system is pleasurable based on the individual’s tastes and preferences in music or that which is meaningful to them.  But it is the touch system that plays a major role in response to the vibration and the one that will be discussed here.  Think about it, the skin is really the largest organ in the body with more receptors than any other sensory system.  Skin is the boundary between “Me” and “Not Me” and the “container” for all function, whether that be our organs or skeletal system. It provides our physical connection to the world and serves to keep us comfortable and safe.

One postage stamp size piece of skin contains:  9’ of blood vessels, 30 hairs, 300 sweat glands, 4 oil glands, 13 yards of nerves,  9,000 nerve endings, 6 cold sensors, 36 heat sensors, 75 pressure sensors and 600 pain sensors*1…WOW

One of the sensory receptors is the Pacinian Corpuscles which is a type of mechanoreceptor. It is located in connective tissue of bone, body wall and body cavity. Depending on its location it can be cutaneous (skin), proprioceptive (pressure & movement) or visceral (organs).  It is sensitive to vibration and pressure; it transmits vibration to the brain to allow perception of distant events and is also part of tactile discrimination for feeling smoothness and textures.  It is considered “rapid adapting” meaning its firing potential is generated when force is first applied, and then becomes unresponsive to steady pressure.

Why is this important to know? Well, when using it to affect change of the human reaction to stimuli, we need to be cognizant of keeping variation or novelty occurring to keep the receptor firing. When vibro-acoustic equipment is utilized the music provides the novelty and variation to promote the firing of the receptor. And when the person moves, for example taps their foot to the beat, they receive more input. We know that when two sensory inputs are simultaneously combined the brain gets more than the summation of the two inputs. It also gets secondary and tertiary areas of the brain involved.  “Voila” as the French say, we are getting more potential synapses and possible neuroplasticity and this of course, is what we want. It also feels good to most people.

So why incorporate Vibro-acoustic equipment into your MSE? Using Vibro-acoustic equipment  increases the potential for changing the Brain and as a result, our behavior or response.

Studies have also shown that Vibro-acoustics contributes to:
  • Reduce stress
  • Facilitate the Relaxation Response
  • Decrease pain
  • Relax muscular hyper-tonicity
  • Increase communication potential
  • Increase  social engagement
  • Promote muscle tone
  • Increase range of motion

As with any form of new experience it should always be voluntary. With individuals who cannot verbalize their likes or dislikes, it is imperative to keenly observe their response. In my experience a facial expression in less than 3 seconds will tell you they don’t like it or it is too much. This has occurred only a very few times but, the aim here is to promote joy and fun and this equipment certainly does that.

Some precautionary information:
Always know your client; some contraindications include individuals with pacemakers, thrombus, active bleeding disorders, extreme low blood pressure, severe PDST or psychotic episodes. When in doubt, always consult a physician.

1* Credited to Patricia Wilbarger, M.Ed, OTR, FAOTA
References: Music and Spatial-Temporal Relationships, Rausher, FH, et al., Neurological Research, 19, 2-8
                        Molecular mechanisms of mechanotransduction in mammalian sensory neurons, Nature Reviews Neuroscience 2011 March
                        Somatosensory Systems, Neuroscience Online, UTA.tmc.edu

Monday, February 25, 2013

Hunting for the Perfect Therapeutic Activity

Deanna Macioce, MS, OTR/L

Many times we find that we are looking for activities that give us the “biggest bang for our buck” so to say.  Well, scavenger hunts or treasure hunts can offer you just that.  Whether you need to address gross or fine motor skills, sequencing and direction following, coordination, peer interaction or problem solving, you can basically cover all your therapy goals and deliver sensory input in a variety of ways with a hunt. They can take on almost any theme, and can be adapted for various ages and skills levels. 

There are a variety of ways to put together scavenger hunt activities.  A basic approach for younger and lower functioning children that does not require reading is to list the activities numerically, draw a map with picture descriptions or even have them find items by color, shape, or pictured icon.  So, for example, you may have a picture of crab walking to find something that is the color red, followed by a picture of riding the scooter board to find something that is in the shape of a circle, etc. For older children with reading skills, having a clue at different pieces of equipment that will tell them what to do or give them a riddle to find out what comes next.

Scavenger hunts are a great way to work on team building and peer interaction, making them ideal for social groups or class environments.  Working together in pairs or small groups allows children to work on verbal skills through problem solve with others.  In addition, partner activities can be incorporated, such as catching ball, zoom ball, or scooter board pushes within the scavenger hunt.  Incorporate team building by having different puzzle pieces gathered at each spot, and then as a group the children put construct a simple puzzle together. 

Creativity is endless when designing your hunt, and it can be adapted for each child differently if need be.  Making them theme or holiday focus can increase the interest and imaginative play. Fine motor skills can be added by having children gather puzzle pieces, Mr. Potato Head pieces, blocks, or peg board pieces to complete at a table at the end of the hunt.  In addition, you can also use it as a way to gather materials for doing a simple craft of meal.  Or even pull in writing skills by having the child list the steps after he or she are done which is also a great way to work on recalling steps.

Sensory components are definitely intertwined throughout the hunt, and being able to work on so many different therapeutic needs truly makes a scavenger hunt an all-in-one activity…so have some fun planning and gear up for some great hunting!