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This year, make resolutions you can keep.

Occupational Therapy practitioners help individuals of all ages accomplish new year’s resolutions.

Approximately 50 percent of individuals make at least one New Year’s resolution each year. However, research suggests a third of these resolutions are dropped within the first week, and less than a quarter survive the six-month point. So, how can you make a New Year’s resolution that will stand the test of time? The American Occupational Therapy Association (AOTA) says resolutions rooted in research-based occupational therapy practices are the most likely to be successful.

“Occupational therapy is a scientifically-driven, evidence-based profession that enables people of all ages live life to its fullest by helping them preven—;or live better regardless of—injury, illness or chronic disability. This is accomplished through designing strategies for everyday living and customizing environments to develop and maximize potential,” said AOTA president Penelope Moyers Cleveland, EdD, OTR/L, BCMH, FAOTA.

“By taking the full picture into account—a person’s psychological, physical, emotional, and social make-up—occupational therapy assists people in achieving their goals, functioning at the highest possible level, concentrating on what matters most to them, maintaining or rebuilding their independence, and participating in the everyday activities that they need to do or that simply make life worth living,” she continued. “So, when developing your New Year’s resolutions, put on your ‘occupational therapy hat,’ and keep your goals clear and appropriate to your lifestyle and circumstances. Set achievable milestones to keep you motivated throughout the year, and keep the resolutions sensible and straightforward.”

Examples of achievable New Year’s resolutions, broken down by age range, from AOTA include:

Under Age 20
Reduce the stress of homework. As students go back to school after holiday break, there’s no need to return to previous homework struggles. Research has shown that parents should provide a consistent environment where homework is completed. Doing homework in a different place every day or in cluttered spaces doesn’t provide much-needed order and structure. Additionally, research has shown that multitasking doesn't save time because you're more likely to make a mistake or forget something. So, get rid of unnecessary distractions.
Get more sleep on a regular basis. Sleep is essential for mental alertness and peak performance. According to the National Sleep Foundation, children who get an optimal amount of sleep are less apt to display behavioral issues. Analyze the context of children’s or teenagers’ sleep—what goes on before bedtime is critical. Good sleep habits include avoiding caffeine intake and limiting electronic use, such as TV and the computer, near bedtimes.

Ages 20 to 40
Organize living spaces. Research has shown that clutter leads to dust and mold collection, increases risks of falls by narrowing pathways and poses potential fire hazards. Organizing cabinets, desks closets and work areas helps to keep items accessible. Examine things like rushed schedules that can lead to creating clutter, rather than just looking at the clutter itself.
Make family dinnertime a priority. Dinnertime provides a unique opportunity for family togetherness. Research has shown that teens who rarely eat dinner with their families are 3.5 times more likely to abuse prescription drugs than their counterparts who frequently eat family dinners. Open channels of communication by introducing topics at dinnertime for family discussion to help children learn calm and easy ways to share their successes and problems.

Ages 40 to 60
Increase physical activity. Sixty-five percent of American adults are overweight, and obesity is the leading modifiable risk factor contributing to early mortality and many diseases and disorders. Examine your routines that inhibit activity. Think of something that has meaning for you and link it to the activity. Are you a social person who would want to walk with a friend instead of sitting for a phone conversation? If you like technology, then try the Wii Fit to get you off the couch.
Take care of the caregiver. Caring for an older adult can be rewarding and fulfilling but can also place great physical, emotional and financial demands on those who take care of them. Research has shown that caregivers age between four and eight years faster than non-caregivers. Occupational therapists recommend caregivers join a therapy or discussion group, share the caring responsibility, develop a schedule that distributes caregiving responsibility and create moments of joy throughout the day by participating in activities you enjoy.

Ages 60 to 80
Modify my home to make it more livable. While most people want to stay in their homes as long as possible, only a small percentage make changes in their home environments allowing safety and independence. Research has shown that removing environmental barriers in the homes of older adults improves their ability to do routine activities in the home. Changes can be small—like adding lever-style door handles—or large—such as creating a zero-step entrance or adding or converting space on the main floor for a bedroom and accessible bathroom.
Take up gardening again. Gardening, America's number-one outdoor leisure activity, can be difficult if a person has health conditions that limit movement or stamina. But, there are ways to decrease the aches, pains and strains that often occur during gardening. Research has shown that protecting your joints, sitting while working, limiting lifting, starting in a small area and varying your tasks make gardening easier and more comfortable.

Over Age 80
Stay safe behind the wheel. Although many older adults modify their driving habits as they age by driving less often—choosing to limit trips to daylight hours or residential areas, and avoiding unprotected left turns—make a resolution to learn about strategies that may work for you.
Consult an occupational therapist or take a class in safe driving. There are alternatives to losing driving privileges. Considering safe driving habits along with ensuring your access to public and private transit alternatives may prolong a lifestyle of independence and choice.
Make the most of my remaining eyesight. Low vision can cause difficulty in seeing detailed letters and numbers when reading; recognizing the slope of a curb, steps or facial features; and distinguishing between similar colors, such as black and blue. Adults who have these problems may have trouble maintaining their independence and completing typical day-to-day activities. Research has shown that there are four major age-related eye diseases—glaucoma, cataracts, age-related macular degeneration and diabetic retinopathy—that affect seniors. But, compensations for vision loss can be designed by occupational therapists, including making modification in the environment, training in low vision techniques and the use of devices to enhance safety and independence.

Resource: www.aota.org

Industry News

Physical therapy offers evidence-based solution to musculoskeletal-pain.

New Study Shows Manual Physical Therapy and Exercise Produces Significant Improvements in Neck Pain.

Alexandria, VA, December 12, 2008 — The American Physical Therapy Association (APTA) is urging patients with musculoskeletal pain to consider treatment by a physical therapist, in light of a new federal survey showing that more than one-third of American adults and nearly 12 percent of children use alternative medicine - with back and neck pain being the top reasons for treatment. Results of the 2007 survey of more than 32,000 Americans were released December 11 by the National Institutes of Health's National Center for Complementary and Alternative Medicine.

According to APTA, physical therapy offers an evidence-based, time-tested solution to these common conditions in comparison to alternative treatments.

For neck pain, for example, a recent study published in the medical journal Spine found that when patients received up to six treatments of manual physical therapy and exercise, they not only experienced pain relief, but were also less likely to seek additional medical care up to one year following treatment.

"This study, demonstrating the efficacy of physical therapy for a condition as widespread as neck pain, is particularly relevant in today's challenging economic environment," according to the study's lead researcher and APTA spokesman Michael Walker, PT, DSc, OCS, CSCS, FAAOMPT. "The Kaiser Foundation, for instance, recently found that more than half of all Americans are not taking prescribed medication and postponing needed medical care in an effort to save money. It is important for consumers to know that there are effective, conservative solutions such as physical therapy available.¹"

Walker's study compared the effectiveness of a three-week program of manual physical therapy and exercise to a minimal intervention treatment approach for patients with neck pain.

Study participants consisted of 94 patients with a primary complaint of neck pain, 58 (62%) of whom also had radiating arm pain. Patients randomized to the manual physical therapy and exercise group received joint and soft-tissue mobilizations and manipulations to restore motion and decrease pain, followed by a standard home exercise program of chin tucks, neck strengthening, and range-of-motion exercises. Patients in the minimal intervention group received treatment consistent with the current guidelines of advice, range-of-motion exercise, and any medication use prescribed by their general practitioner. Patients did not have to complete all six visits if their symptoms were fully resolved.

Sample exercises to relieve neck pain can be found on the APTA Web site, www.apta.org/consumer.

Results show that manual physical therapy and exercise was significantly more effective in reducing mechanical neck pain and disability and increasing patient-perceived improvements during short- and long-term follow-ups. These results are comparable with previous studies that found manual physical therapy and exercise provided greater treatment effectiveness (Hoving et al, 2002)² and cost effectiveness (Kothals-de Bos et al, 2003)³ than general practitioner care.

"Physical therapist intervention can be an effective, high-value, conservative solution for treatment of musculoskeletal pain," said Walker.

Resource: www.apta.org

Tips Section

Exercise to Prevent Osteoporosis.

The American Physical Therapy Association (APTA) is reaching out to women and men about the benefits of exercise in preventing osteoporosis, as a result of the National Institutes of Health’s decision to halt a study on Hormone Replacement Therapy (HRT) because of an increase in the incidence of breast cancer and other side effects.

An estimated 20 million women currently use HRT to alleviate symptoms associated with the onset of menopause, protect bone density and reduce the risk of developing osteoporosis. Many of these women are now searching for alternative ways to get the treatment and preventive benefits they seek.

For some, physical therapy can provide an answer. With osteoporosis already a threat to 44 million people over age 55, preventing the abnormal loss of bone density is a critical public health issue.

Physical Therapy Can Provide Relief

"If you already have osteoporosis — or you’re at high risk for developing it — a physical therapy treatment program can make the difference in keeping you active and mobile," said physical therapist Lucy J Buckley, APTA member. "Exercise has always been an important component of osteoporosis prevention, management, and treatment," Buckley explained. "Women who chose not to have hormone replacement therapy may wish to be even more mindful of the benefits of regular physical activity in prevention. Exercise makes bones strong and resilient, while inactivity leads to diminished bone mass and weakness."

Weight-bearing exercise and strength training are essential in the prevention and treatment of osteoporosis. Strength training of the lower extremities, shoulder, neck and back improves strength and balance, which help prevent falls that lead to fractures. Training in proper posture and body mechanics is also a key component of a physical therapy program. Because of physical therapists’ knowledge of body mechanics and function, they are able to design programs that focus on the unique needs of the individual.

For women looking to replace HRT with alternative methods of treating and preventing loss of bone density, APTA also recommends the following:

1. Exercise Regularly - Do some form of weight-bearing or resistance exercise regularly to bring long-term benefits (at least 30min/day).
2. Get Milk - One of the most important ways to help prevent osteoporosis is by including enough calcium and Vitamin D in your diet.
3. Maintain Good Posture - Good posture can’t prevent osteoporosis, but it may help minimize the effects of the disease.
4. Avoid Certain Lifestyle Choices - Alcohol, smoking, caffeine, poor diet, and certain drugs can all increase your risk of developing osteoporosis.
5. Take Preventive Steps Early in Life - "The younger you are, the greater your opportunity to prevent osteoporosis," said Buckley. "Because we are living longer and eventually run out of bone mass, it is very important for a young person to make regular ‘deposits’ of exercise and calcium into his or her ‘bone bank.’"

Resource: www.apta.org

The Spotlight

New research shows that combining aerobic exercise with high-force eccentric resistance training improves glucose control in patients with diabetes.

Alexandria, VA, October 31, 2008 — Patients with diabetes who participate in a program combining aerobic and high-force eccentric resistance exercise demonstrate improvements in glucose control, physical performance, and body fat composition, according to a study published in the November 2008 issue of Physical Therapy (PTJ), the scientific journal of the American Physical Therapy Association (APTA).

"Although aerobic exercise is what is typically recommended for treating people with diabetes, this study shows that adding a high-force strength training component has significant advantages," says APTA spokesperson Robin L Marcus, PT, PhD, OCS, assistant professor at the University of Utah's Department of Physical Therapy and the study's lead researcher. Diabetes affects approximately 24 million adults and children in the United States.1 The onset of type 2 diabetes - a chronic illness marked by decreased insulin sensitivity and overall poor glucose control - is fostered by decreased physical activity.

"This study, which comes as the nation marks American Diabetes Month, is especially pertinent in light of new research highlighting the escalating costs and serious side effects of certain diabetes drugs," said Marcus. "Patients with diabetes and their health care providers should be encouraged that physical therapy has been shown to be a cost-effective and safe treatment alternative."

The PTJ study, "Comparison of Combined Aerobic and High-Force Eccentric Resistance Exercise With Aerobic-Only Exercise for People With Type 2 Diabetes Mellitus," evaluated 15 people with type 2 diabetes who participated in a 16-week supervised exercise training program: seven in a combined aerobic and eccentric resistance exercise program, and eight in a program of aerobic exercise only.

A podcast titled "Fat, Muscle, and the Benefits of Exercise for People With Diabetes" is available at: www.ptjournal.org/misc/podcasts.dtl. The podcast highlights PTJ's Diabetes Special Issue: "People With Diabetes: A Population Desperate for Movement." (November 2008). Marcus and other experts discuss new information about the roles of fat in people with diabetes, especially fat in muscle, and about how this fat appears to impair muscle function. Paul LaStayo, PT, PhD, the study's senior author, notes that the eccentric resistance exercise program was specifically designed to increase strength and muscle size, using a recumbent stepper that produced a lengthening contraction, such as when lowering the dumbbell in a bicep curl.

After 3 months, Marcus and LaStayo found that both groups showed improved glucose control and physical performance in a 6-minute walk, as well as a decrease in fat composition within the leg muscles. "This study is particularly interesting because the patients who did both aerobic and resistance exercise had additional improvements, most notably a decreased overall BMI and a gain in leg muscle," Marcus said.

"Although aerobic exercise is still key in treating diabetes, it should not be used in isolation," Marcus observes. "As people age, they lose muscle mass and, subsequently, mobility, resulting in a greater risk of falls. Adding resistance training to the diabetes treatment regimen leads to improved thigh lean tissue which, in turn, may be an important way for patients to increase resting metabolic rate, protein reserve, exercise tolerance, and functional mobility, she notes. This study is part of PTJ's special issue on diabetes, which illustrates that physical therapy interventions can have a dramatic and positive effect in fighting the complications associated with diabetes. As the movement experts, physical therapists are ideally suited to help this population safely and to effectively address their movement dysfunctions.

Resource: www.apta.org

	Success Stories

	"The work conditioning program has been an enormous help and has improved my ability to function ten-fold since starting. I worked mostly with Doug and felt very comfortable with him as he was very knowledgeable and the therapy he assigned was very effective." - Aaron "Don't change anything, just keep on giving the superb service you give." - Goitam " I would definitely recommend WorkAble Solutions. Very friendly and fun staff. I also appreciate knowing the exercise equipment is wiped down after each use." - Lora “The program really helped me get back into shape. The focus on function and core will really be a benefit in my job. The staff is great! - Marcia B. Firefighter “Well thought out circuits, they watched me all the time so you always are doing things right. Great staff and location. In all I am very happy with my time at WorkAble Solutions.” - Michael C. Painter “WorkAble Solutions has been the place for me to retrain my mind and body. I would have never thought I would feel NO PAIN. Their attention to detail and personalizing your program is truly remarkable. WorkAble Solutions is the only place to find success. -Molly P. Edmonds This is an awesome facility with great staff. -Sandra Granite Falls The therapists were organized, helpful and were a cohesive group. They did a good job of paying attention to the details. -Claire Lynnwood WorkAble Solutions is the best. You guys are all great! -Jorge Shoreline “I had a wonderful experience at your facility, and the quality of staff is top notch! I will highly recommend your facility to folks I know.” - Bill Building Operation Supervisor

	“I just want to say thank you all, for everything you’ve done to get me better. You made my recovery a very pleasant time. You all are very motivating and helpful. If I ever need therapy again (hopefully not) I will gladly come back for your help. Thank you again for everything.” - Laurie Sales Merchandiser

	“I feel 100% better, this is a 5 star establishment!” - Joe Mountlake Terrace

	“Everyone here was a joy to be around, the therapists explained things to you & they went out of their way to help you.” - Suzanne Everett

	On the Work Conditiong Program - When my doctor first suggested coming to WorkAble Solutions for post surgical therapy for my knee I was some what apprehensive. Committing to 2 hours a day 5 days a week sounded excessive, but I decided to give it a try. From the 1st day I felt totally at home. Everyone is beyond nice and completely committed to helping in every way possible to make sure of a complete recovery. I know that had I passed up my opportunity to come here recovery would have been much longer. - Sherry G Coach Operator

	Dear WorkAble Solutions Staff: I want to thank you and your team for an excellent presentation of presenting positive building of my health. I have learned a great deal about myself in the past twenty one days. Tasks and care that were provided to me was exceptional! I wish I could continue to get paid full time and come here on a daily basis for the tender care that has indeed challenged me! When I arrived I was frustrated and a bit angry about my inability to target the pain area in my right arm and hand. All I knew was that it was difficult for me to get through a day without a high pain level. Your staff understood this frustration and listened to me. I know this must be a little tough at times because we all come in with aches and pains. Although I brought my positive attitude with me,some of my workout buddieslacked this. I watched your team build and push those individuals by reinforcing their success and allowing them to work up to a point to where they started seeing and feeling their own success. As a result, you did not see too many workout buddies without a smile after a short period of time. This is a wonderful and healthy environment and I appreciate all that your team has done. I am off to my full time job with a different approach. Taking care of me is the most important part of my job now, so my co-workers will see me stretching on a wall, or at my desk, walking at least ten minutes for every hour spent on a keyboard, and getting to the gym either during my lunch hour or after work three times a week. Sincerely, Paulette

	"I felt a big improvement. The staff was very friendly and I would definitely recommend it to someone." - Alberto P Construction To everyone at WorkAble Solutions – It’s very discouraging when you have been physically active to realize you can’t do certain things anymore, the body just isn’t willing. My grandson loves baseball and I’ve tried to coach and encourage him. When I came to WorkAble Solutions I couldn’t throw overhand. Now I can. It may seem like small improvements, but it means the world to my grandson and me. Grandpa’s back! Thanks to you I have regained some of my abilities, thus a richer more active life. I will always be grateful for your help. Byron – Mountlake Terrace, WA.

	Thanks to WorkAble Solutions I'm in the best shape I have been in in over two years. Thanks to the staff for their support. - Richard T. Mountlake Terrace , WA When I began the program I had next to zero strength due to a shoulder injury. Gradually with the help of the great PT & OT staff my strength improved incredibly. Thanks! - Scarlet H. Bothell , WA An evaluation done at WorkAble Solutions often provides the information that I need to move forward with identifying the basis for my vocational recommendations. The treatment that injured workers receive has, in many cases, allowed them to return to work with their employers. Terry and her staff provide thoughtful and effective job modification recommendations, and are ready to implement suggestions. They understand the documentation requirements vocational counselors need and can move quickly on complex cases. - Judith P. Vocational Counselor Bothell

	"Everyone here was wonderful. They were all friendly, professional and respectful. They worked well in communications with me as well as my Doctor. I believe they did a fair assesment of my progress and were not so strict in their regimine that they didn't allow for input from the patients." - Ann N. Custodian "I was in a car accident and had back surgery. WorkAble Solutions was a good facility for rehab. I thought I would never be strong enough again but with the home exercises they gave me and the work out at the center I became much better and have now been back to work part time for 4 months! I keep doing the back exercises, it will be a part of my lifes program. I learned that the right exercises and consistency pays off. Thanks WorkAble Solutions!" - Annette K Respiratory Practitioner "My back has not felt this good since before I was injured. The therapists were sincerely interested in my recovery. This is the best facility with the best therapists. My recovery is now a reality." - Judy K Water Meter Reader "WorkAble Solutions is a better program than other physical therapy centers. You have a team of excellent and friendly therapists and staff members." - Jagit D Coach Operator "I'm asking my boss and co-workers to try your therapy." - Robert P Mailing Machine Operator

Health Conscience Recipe

Seared steaks with carmelized onions & gorgonzola.

In our humble opinion, steak is best topped with sweet caramelized onions and salty Gorgonzola cheese. We recommend seeking out good-quality Gorgonzola for the best flavor, but any will work. Serve with garlic mashed potatoes and steamed carrots.

ACTIVE TIME: 30 minutes
TOTAL TIME: 30 minutes
EASE OF PREPARATION: Easy
Makes 4 servings

Ingredients:

2 tablespoons canola oil, divided
2 large onions, sliced (about 4 cups)
1 tablespoon brown sugar
1/2 cup reduced-sodium beef broth
1 tablespoon balsamic vinegar
1/2 teaspoon salt, divided
1/4 teaspoon freshly ground pepper
1 pound beef tenderloin (filet mignon) or sirloin steak, 1-1 1/4 inches thick, trimmed and cut into 4 steaks
1/4 cup crumbled Gorgonzola or blue cheese

1. Heat 1 tablespoon oil over medium heat in a large skillet. Add onions and brown sugar and cook, stirring often, until the onions are very tender and golden brown, about 15 minutes. Add broth, vinegar and 1/4 teaspoon salt and cook, stirring, until the liquid has almost evaporated, 3 to 4 minutes more. Transfer the onions to a bowl; cover to keep warm. Clean and dry the pan.

2. Sprinkle the remaining 1/4 teaspoon salt and pepper on both sides of each steak. Heat the remaining 1 tablespoon oil in the pan over medium-high heat. Add the steaks and cook until browned, 3 to 5 minutes. Turn them over and top with cheese. Reduce heat to medium-low, cover and cook until the cheese is melted and the steaks are cooked to desired doneness, 3 to 5 minutes for medium-rare. Serve the steaks with the caramelized onions.

Nutritional Information
Per serving: 338 calories; 16 g fat (5 g sat, 7 g mono); 69 mg cholesterol; 11 g carbohydrate; 36 g protein; 2 g fiber; 468 mg sodium; 565 mg potassium. Nutrition bonus: Zinc (40% daily value), Potassium (16% dv), Iron (15% dv).

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