1. Parkinson’s Disease: Assistive Technology for Farmers  Lindsey Bonsall, OTR/L  Joni Jones, COTA/L Fletcher Allen Healthcare Burlington, VT

2. Farming Independently with Parkinson’s Disease (PD)  Occupational Therapists (OT) assist in providing alternative ways to remain independent with daily occupations.

3. What is a daily occupation?  In everyday life, it can be as simple as getting dressed.  A career is also an occupation, but most of all the tasks that make up an activity are occupations too.

4. Common symptoms of PD include: –Hand tremors –Decrease fine motor control –Impaired gait –Decreased strength –Heat sensitivity

5. How does Parkinson’s Disease affect my ability to do these daily occupations?  Hand tremors/Fine Motor Control  Impaired Gait  Decrease in Strength  Heat Sensitivity

6. Assistive Technology for the Occupations of Farming  Adaptive Equipment (AE) is used to aide in the completion of various tasks  AE allows individuals more independence with daily occupations

7. Adaptive Equipment Options for Farming  PVC pipe attachments  Ergonomic Handles  Built up handles  Added weight to handles  Canopies for tractors  Tractor lifts

8. Adaptive Equipment for hand tools  The following examples of AE will help to compensate for decreased grip strength, decreased fine motor control and tremors in the hands.

9. PVC Pipe 1.used to lengthen tool handles http://agebb.missouri.edu/hort/meg/archives/v6n15/meg2.htm

10. Bicycle Grips 2. Tool handles can be modified by using bicycle grips or electrical tape  http://agebb.missouri.edu/hort/meg/archives/v6n15/meg2.htm

11. Tools with ergonomic handles can be purchased

12. Adapting tools “Add-on” handles can be purchased and attached to various tools

13. Ergonomic handles for hand tools  www.activeforever.com www.activeforever.com  1-800-377-8033

14.  Adding handles to larger tools such as rakes and shovels will allow more control while performing agricultural tasks.

15. Ergo handles  www.rakehandle.com www.rakehandle.com  1-800-685-0315

16. Add-on Handles for Tools  www.activeforever.com www.activeforever.com  1-800-377-8033

17. Weight Adding weight to handles decreases hand tremors when using tools

18. STRAIGHT LEAD KNIFE - WEIGHTED Wooden handle with hammer

19. Activities of daily living require fine motor skills too! AE for clothing can be used to allow continued independence self care. Activities of daily living require fine motor skills too! AE for clothing can be used to allow continued independence self care.

20.  Magnum Service Zipper

21. Adaptive Equipment for heat sensitivity  Symptoms of PD are frequently worsened by increased temperatures and prolonged labor in hot and humid weather  Canopies or sun shades can be purchased and applied to any tractor to help shade the farmer from direct sunlight.

22. Tractor Shade  www.sears.com www.sears.com

23. Adaptive Equipment for decreased balance and uncoordinated movement  Many farmers with PD need to make the transition from walking through fields all day long to riding a tractor  Access onto a tractor may become difficult as well.  A lift can be added to a tractor to ensure a safe, consistent transfer onto the tractor seat.

24. Common Types of Tractor Lifts  Platform lift- for individuals who can stand but not climb. - example: Lectralift  Chair lift- for individuals who can transfer from a wheelchair to a chairlift - example: Pilot Lift from Life Essentials

25. LectraLift  www.lectraaid.com

26.  Portable/Independent Multipurpose lift- this type of lift can be used for more than one piece of equipment - example: Freedom Lift from Freedom Technologies

27. Energy Conservation Techniques  Conserving energy while completing everyday work tasks and life tasks will help support a decrease in symptoms of Parkinson’s Disease

28. 1. Pace yourself. 2. Take frequent rest breaks rather than long required breaks after you feel tired. 3. Breathe easy 4. Sit rather than stand whenever possible

29. 9. Think about the ground you will be walking on and the distance you will be traveling. 10. Modify your work routine gradually always keeping your disease in the forefront of your mind. 11. Get work areas ready before beginning your tasks to prevent unnecessary trips.

30. 12. Plan to use commercial projects/services to release time and energy when practical. 13. Use highest/lowest storage areas for seldom used items.

31. Proper Body Mechanics  Being aware of how you move your body can do the following: –Decrease fatigue –Protect your joints –Conserve energy –Prevent worsening of symptoms

32. 1. Posture- stand, walk, and sit tall. 2. Stretch throughout the day- (Specific, helpful stretches will follow.) 3. Change position frequently

33. 4. Avoid repetitive movements, such as twisting, for long periods of time. 5. Keep loads as close to your body as possible when lifting, carrying, or working

34. 6. When reaching to perform a task, try to brace your knees/legs to help stabilize your spine. 7. Lift safely- have a good base of support.

35. 8. Push, pull, or slide heavy objects whenever possible. 9. Avoid sudden or jerky movements when lifting or moving heavy items. 10. REST FREQUENTLY!!!!!!!!!

36. The Benefits of Stretching  Increases range of motion of joints  Helps with good posture  Protects against muscle strains or sprains  Improves circulation  Releases muscle tension

37. Do’s and Don’ts of Stretching  DO stretch until you feel a gentle pull  DON’T stretch to the point of pain  DON’T bounce while you stretch.  DON’T hold your breath while you stretch.  DON’T compare yourself to others.

38. Examples of Stretches:  Overhead stretch –Sit tall in a chair and interlock fingers together. –Turn palms facing out and slowly lift arms overhead. –Gently allow neck to fall back and look up at hands

39.  Seated side stretch –Sit to one side of a chair with arm rests –Reach one arm down toward floor –Reach other arm up and over to side –Keep feet flat on floor

40.  Seated rotation stretch –Sit tall in a chair with one arm behind back of chair –Reach around in front of you with other arm to grab the back of chair –Turn your neck and look back over your shoulder

41.  Standing back stretch –Stand with feet hip width apart –Place palms on low back –Gently lean trunk and neck back

42.  Standing shoulder stretch –Stand tall with feet hip width apart –Clasp hands behind back –Gently lift arms up and away from the back, keeping head up.

43.  Ankle circles –Kick foot in front of you –Move foot in slow, complete circles –Repeat in both directions

44. The AgrAbility Project  Therapists perform worksite evaluations  Look at each work environment and make recommendations based on ability and limitations

45. Resources for Adaptive Equipment  When seeking adaptive equipment, farmers can contact the state Vocational Rehabilitation program or other charitable organizations for support.

46. In Conclusion  The information brought forward today was designed to educate farmers and professional clinicians about the various adaptive equipment available to maintain or increase independence with the occupation of farming.  We thank you for your time today!