WHAT IS SENSORY INTEGRATION?

Sensory integration is the ability to synthesize, organize and process the sensory information received from our body and the environment.

Sensory integration theory is a neurological process that organizes the senses coming from our body and our environment to enable us to use our body effectively in our interaction with our environment. The brain uses this process in daily life activities.

Sensory integration, in other words, is to create meaningful and purposeful responses to our sensory experiences, it is the ability to synthesize, organize and process sensory information received from the body and the environment.

It is to provide sensory-motor development by developing the brain with meaningful sensory-motor activity in order to realize its learning. For sensory-motor development, the individual must be in contact with the environment. Meaningful sensory-motor activity is important in sensory integration therapy, as correct communication shapes brain development and provides the nervous system’s capacity to change (plasticity).

What are the Principles of Sensory Integration Therapy?

According to sensory integration theory, learning is a function of the brain and learning difficulties indicate deviations in nervous system functions. Individuals with learning difficulties have motor and sensory problems; they have difficulty in perceiving and integrating sense information. The inability to integrate sensory stimuli causes behavioral and learning problems. This condition is defined as “Sensory Integration Disorder”.

Sensory Integration Approach; unlike other approaches to learning disabilities, it does not employ specific skills. It aims to increase the brain’s understanding, perception and motor planning capacity.

Who Has Sensory Integration Disorder?

• Attention deficit hyperactivity disorder
• Children with learning difficulties
• Autism (pervasive developmental disorders)
• Cerebral Palsy
• Developmental delay (fine motor impairment, gross motor impairment, visual motor disturbances, coordination disorders)
• Hearing language speech disorders
• Development delay due to premature birth
• Genetic disorders, chromosomal disorders

What Are Sensory Integration Symptoms in Occupational Therapy?

• Responding slowly
• Reduced attention span
• Inability to speak at the right tone and speed
• Constant tiredness
• Inability to concentrate in noisy environments, ear closure
• Concentrating on the wrong sound and missing the target
• Memory difficulties
• Not reacting to the sound, unable to find the direction of the sound
• Choosing food, sniffing food
• Not brushing teeth, cutting hair and nails
• Fear of falling
• Fingertip walking
• Clumsiness
• Constant desire to move

How is Sensory Integration Treated?

Pre-therapy sensory integration problems; Sensory processing problems and the effects of these problems on daily life activities are evaluated by considering the sensory systems.

In therapy, first of all, the child’s intrinsic motivation should be in balance, child should participate actively and should be able to tolerate stimuli. Active participation of the child always facilitates learning. The child easily adapts the information learned during communication and play to daily life activities.

Sensory stimuli are always planned according to the individual needs of the child using sensory strategies and the appropriate sensory diet is selected. Every child shows different sensory characteristics as they are different from each other. So it includes different intervention plans.

In order to continue the treatment effectively at home, the family is trained and the home, school and play environment is arranged according to the sensory characteristics of the child.

ERGOTHERAPY FOR INDIVIDUALS WITH DOWN SYNDROME

Ergo therapy improves the physical, cognitive, sensory, psychological, social skills and abilities of the person through meaningful and purposeful activities; It is a person-centered health profession that aims to increase the level of independence and participation in daily life activities and to improve health and well-being. In individuals with Down syndrome; problems such as slow learning, difficulty in problem solving and decision making, drooling, difficulty in speaking, delay in motor development, frequent falls and bumps, low muscle tone and delay in fine and gross motor development due to laxity in joints are experienced. Occupational therapists in the treatment of these problems uses sensory integration, vestibular stimulation, oral-motor therapy, cognitive therapy, daily living activities training and activity-oriented neurodevelopmental therapy methods.

What do occupational therapists do during the rehabilitation process of individuals with Down syndrome?

Individuals with Down syndrome who have sensory integration problems such as dropping objects on the ground, taking objects in their mouth, difficulty in adjusting body position, falling frequently, not combing hair, etc., are provided with a correct adaptive response with sensory integration therapy. With sensory integration of individuals with Down syndrome; awareness of their body and environment increases.

By providing sensory integration, visual perception skills, body awareness and visual motor coordination training, the foundations of cognitive rehabilitation are laid. Academic skills are also supported by improving cognitive skills such as attention, memory, problem solving, and orientation. It is easier for individuals with Down syndrome to learn with cognitive rehabilitation.

In early childhood, with activities including auditory-visual stimulation, neurodevelopmental intervention methods for laxity in the joint-ligaments and low muscle tone; it enables them to perform independent motor skills such as sitting, standing and walking. Individuals with Down syndrome with ergo therapy exhibits controlled motor behavior.

Developing strength and coordination in the arm, wrist and hand with activities meaningful for the person increases the level of independence in fine motor skills and daily living activities. The increase in the quality of life of individuals who develop fine skills such as holding a pencil and holding a spoon increases internal motivation.

Individuals with Down syndrome can be independent in daily living activities.

Children with Down syndrome have problems with nutrition, saliva control and speech due to weak tongue, lip and cheek muscles. Occupational therapists intervene with oral motor therapy, positioning methods, and nutritional techniques.

Vestibular stimulation techniques enable early motor behavior to be revealed. Equilibrium reactions, movement quality is increased, gravity insecurity is prevented. Individuals with Down syndrome can climb stairs and swing without fear.

Neurodevelopmental and behavioral methods are used for the development of social skills such as initiating, maintaining and ending verbal and non-verbal transmission, and communicating with meaningful purposes. Individuals with Down syndrome can understand you and express themselves.

CARDIOPULMONARY REHABILITATION

Pulmonary rehabilitation is a relatively late topic on the medical agenda. Although COPD (chronic obstructive pulmonary disease) is one of the first diseases that comes to mind when it comes to pulmonary rehabilitation, it has application areas in many respiratory tract diseases.

Exercise constitutes the most important part of pulmonary rehabilitation programs. With exercise, heart and lung functions improve, muscles become stronger and the feeling of shortness of breath decreases.

Exercise programs in pulmonary rehabilitation should be determined according to individual needs. Aerobic and strengthening exercise programs such as walking, cycling, treadmill (walking belt) to be applied individually or in groups should be among the first choices. In addition, breathing exercises, relaxation, energy use techniques during daily activities and methods of reducing shortness of breath should form other parts of the pulmonary rehabilitation program.

What is Pulmonary Rehabilitation?

Pulmonary rehabilitation can be described as a treatment method that uses individuals with clinical and / or physiological respiratory diseases to maintain their daily personal and life functions at the highest level. Those with respiratory problems restrict their physical activities due to fear of developing shortness of breath. When physical activity is restricted, strength and endurance will decrease. In addition, the degree of life satisfaction and independence of individual’s job will decrease.

To Whom is Pulmonary Rehabilitation Applied?

As an exercise, endurance (aerobic, endurance) and strengthening (resistance) exercises and respiratory muscle exercises should be planned. Exercise training should be adapted to the needs of the individual. Diseases in which pulmonary rehabilitation is applied;

• Obstructive lung diseases, (COPD, asthma, bronchiectasis, cystic fibrosis)
• Restrictive lung diseases (interstitial lung diseases, chest wall diseases, neuromuscular diseases)
• Other (lung malignancies, primary pulmonary hypertension, pre / post cardiac surgery, ventilator dependent patients, etc.).

What Should Be the Goals in Pulmonary Rehabilitation?

• Increasing exercise capacity, muscle resistance and endurance,
• Increasing awareness about lung disease by increasing compliance with recommended treatments,
• Reducing the severity and frequency of the symptoms, thus reducing the dependence on the environment,
• To maximize the functional and psychological status of the person, to increase motivation,
• Participation in daily life and increasing the quality of life,
• Prolonging the life span by controlling the disease.
• Reducing hospital admissions and hospitalizations.

What Are The Exercise Methods Applied In Pulmonary Rehabilitation?

• Aerobics (endurance exercises): With these exercises, vascularization in the muscles increases and the protein and myoglobin contents of the muscles increase. Thus, the distribution of oxygen in muscle tissue becomes easier. As a result of the increase in the aerobic capacity of skeletal muscles, an improvement in shortness of breath is observed. Improvements occur in daily life activities and functional abilities, and as a result, an increase in the quality of life is observed.

Generally, treadmill, free-time walking or bicycle ergometer should be used for the lower extremities of the patients. This group of exercises will affect large muscle masses.

• Muscle strengthening exercises: These types of exercises are also exercises that have very positive effects on general health. It affects speed, balance and coordination positively. Strengthening the upper arm and back muscles should be aimed in this group.
• Upper limb and shoulder girdle exercises: The muscles we call the shoulder girdle on the upper part of the body also contribute to respiration. Developing these muscles with weight exercises will improve respiratory functions. Exercises such as swimming will increase the development of this group of muscles in the upper extremities.
• Respiratory muscle exercises: Especially the dysfunction that may occur in this group of muscles causes shortness of breath and exercise restriction in all lung patients, especially COPD. Exercises that increase the strength and endurance in the respiratory muscles will increase the exercise capacity and quality of life. For this purpose, there are various working methods to strengthen the respiratory muscles. Exercises for the respiratory muscles should be applied if symptoms related to the respiratory tract persist despite the strengthening of the peripheral muscles and endurance exercises.

Apart from these exercise methods, there are many different forms of exercise used in respiratory diseases. The main purpose of all is to increase muscle strength and strength, especially respiratory muscles.

What Are the Benefits of Pulmonary Rehabilitation in a Patient with COPD?

Pulmonary rehabilitation program can be combined in patients with COPD. In this way, an increase in exercise capacity and significant improvements in muscle strength can be achieved. In training programs, exercises such as cycling, climbing up and down stairs, and walking should be combined to increase muscle mass and strength. The benefits of pulmonary rehabilitation in patients with COPD;

• Increasing exercise capacity,
• Improving the quality of life, increasing independence,
• Decrease in hospital admissions and hospital stay times,
• Reduction in anxiety and depression related to COPD
• Increasing muscle resistance and endurance.

WHAT IS PELVIC FLOOR REHABILITATION?

Pelvic floor muscles provide support to the bladder, intestines, uterus in women and prostate in men. Therefore, a malfunction in the pelvic floor muscles prevents these organs from functioning properly. At the same time, disorders in these organs cause dysfunction in the pelvic floor muscles.

Pelvic floor rehabilitation is a treatment method aimed at optimizing pelvic floor muscle function. The goal in rehabilitation is to ensure that the muscles work in a balanced and coordinated manner. It is a method applied by expert therapists in this field.

Pelvic floor muscles are affected during pregnancy, birth and menopause in women. Prostate problems in men cause pelvic floor disorders. In addition, abdominal-genital area surgeries, excess weight, and diseases that cause chronic cough can cause pelvic floor problems. During these periods, pelvic floor rehabilitation helps to eliminate problems in disorders that occur.

What are the Benefits of Pelvic Floor Rehabilitation?

• Provides regulation of pelvic floor muscle functions.
• It increases the circulation of the pelvic floor area.
• It provides regulation of waist, hip and respiratory functions.
• It provides the regulation of urine and stool functions.
• It helps to eliminate sexual disorders.
• It improves the life quality.

What are the Application Areas of Pelvic Floor Rehabilitation?

• Frequent urination: Urinating more than 7 times a day is not normal and requires treatment.
• Incontinence: It means urinary or fecal incontinence. Coughing, laughing, sneezing, or incontinence while exercising are not normal.
• Difficulty passing urine / feces: Not feeling full relief during the discharge process means that the discharge process is not complete. In addition, it is not normal to feel pain during the discharge process and to discharge with a long effort.
• Bed wetting at night: Bedwetting at night is not normal in children after the age of 5.
• Constipation: Defecating less than 3 times a week is an indication of constipation. Feeling pain during defecation, inability to provide complete discharge, excessive straining are other signs of constipation.
• Chronic pelvic pain: It is the pain felt in the lower abdomen, waist, hip and genital area. This may be caused by musculoskeletal disorders in the area. Endomtriosis is a common condition in painful menstruation.
• Painful sexual intercourse / Vaginismus: Inability to have sexual intercourse or pain during sexual intercourse. Tense pelvic floor muscles can cause this condition.

What Are Treatment Methods In Pelvic Floor Rehabilitation?

• Patient training
• Pelvic Floor Exercises
• Manual Therapy
• Biofeedback applications
• Electrical stimulation

Who is Pelvic Floor Rehabilitation Applied to?

Pelvic floor rehabilitation can be applied to all patients with pelvic floor problems. The methods used in women, men and children are different from each other. Treatment is applied by determining the appropriate methods for the age, gender and clinical condition of the person. In addition, neurological patients also benefit from treatment.

How is Pelvic Floor Rehabilitation Performed in ROMMER?

In our center, pelvic floor rehabilitation is applied to patients diagnosed by a specialist physician. The patient coming for treatment is evaluated in detail and an individual treatment program is created for the patient. The treatment is started by determining the appropriate methods for the needs of the patient. The treatment program is constantly revised in accordance with the progress of the patient.