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SMA Patients Get a Boost in China

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6P5A4178To honor Spinal Muscular Atrophy (SMA) Awareness Month this August, the first China SMA conference was held successfully in Beijing on August 6, 2016. Organized by Beijing Meier Advocacy & Support Center for SMA, nearly 200 SMA patients and their families attended the conference to gain important knowledge about the condition as well as treatment and therapy options. The speakers included leading experts in clinical SMA, genetics, genetic screening, prenatal diagnosis, rehabilitation therapy, and drug research areas from the USA, Taiwan, Hong Kong and the mainland. LIH Olivia’s Place was proud have Eva Ma, Occupational Therapist at our Beijing Clinic, as a speaker during the conference.

Spinal muscular atrophy (SMA) is a disease that robs people of physical strength by affecting the motor nerve cells in the spinal cord, taking away the ability to walk, eat, or breathe. It is the number one genetic cause of death for infants. SMA is caused by a mutation in the survival motor neuron gene 1 (SMN1). In a healthy person, this gene produces a protein that is critical to the function of the nerves that control our muscles. Without it, those nerve cells cannot properly function and eventually die, leading to debilitating and often fatal muscle weakness. SMA affects approximately 1 in 10,000 babies, and about 1 in every 50 people is a genetic carrier. SMA can affect any race or gender.

Though there is not yet an effective pharmaceutical treatment for SMA, various nursing services and therapies can delay progression of the disease, improve life quality, and earn more time for drug research. With the current progress in genetics research, SMA has been identified by the US National Institute of Health (NIH), as one of the neuromuscular diseases which will likely yield promising breakthroughs. However, in China, therapy and rehabilitation services available to SMA patients in China are underdeveloped and a lot of work remains on increasing clinical research and therapy, rehabilitation and education. SMA patients and their families lack the knowledge, access to resources and treatment/therapy options that are the standard for SMA patients in the rest of the world.


Eva Ma, Occupational Therapist, offered a dynamic presentation, demonstrating key concepts to conference participants
















LIH Olivia’s Place aims to help to close the gap when it comes to providing high-quality rehabilitation services to pediatric SMA patients in China. Eva Ma’s 90-minute presentation was titled “Positioning Children and Teenagers for Function,” and included valuable information about how to effectively position children with SMA for effective skeletal and muscular development and to maintain the most efficient respiratory (breathing) functions and feeding and nutritional status. Eva emphasized the importance of regularly changing a child’s position, which is critical for developing gross and fine motor skills, maintaining functional use of their hands, and preventing further deformities. It is critical to provide solid support for a child with SMA in all different positions so that they have the stability needed in order to maintain proper body alignment throughout the day.

ThiIMG_2416s functional presentation was very well-received by conference participants, and the Q&A session spilled over its allotted time, as many parents sought out Eva’s expertise on specific challenges their children are facing.

With the large demand of SMA patients needing access to high-quality rehabilitation services in China, LIH Olivia’s Place and Olivia’s Foundation are now partnering with Beijing Meier Advocacy Group to assist these children and their families. We look forward to making a difference in the lives of children with SMA!

Meier Advocacy & Support Center for SMA was founded by actress Feng Jiamei and SMA Type III patient Ma Bin. It is a non-profit organization dedicated to helping people with SMA and supports families through networking, information, and services and sponsorships. The organization maintains the Chinese SMA Patient Registry and collects clinical and genetic information of individuals affected by Spinal Muscular Atrophy to promote clinical trials in China.

Clinician Profile: Zhang Yan (Irene Zhang), Occupational Therapist

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Irene Zhang

Irene Zhang, Occupational Therapist, LIH Olivia’s Place Shanghai

Zhang Yan (Irene Zhang)

Irene is a Hong Kong-registered occupational therapist. She has a Bachelor of Science in Occupational Therapy from Hong Kong Polytechnic University and a diploma in Rehabilitation Science from West China Center of Medical Sciences, Sichuan University. She has worked with adults and children in rehabilitation center, hospital, and school settings. Her clinical interests are in working with children with a variety of special needs, including sensory processing difficulties, handwriting difficulties, ADHD, ASD, dyslexia, Down syndrome and cerebral palsy.Languages: English, Mandarin, Cantonese


Why did you choose to work at LIH Olivia’s Place?

LIH Olivia’s Place is the pioneering service provider in China that offers world class, multidisciplinary pediatric therapy services. In addition, I was attracted by the mission to make high standard therapy universally available in China.


Why did you choose your field?

After having worked with adults with disabilities, disaster victims, and children with special needs. I found I was really enjoying teaching children new skills while playing with them. Pediatric occupational therapy offers me the opportunity to enjoy every minute of my life and meanwhile fulfill my career aspirations.


What are some of the most rewarding experiences you have had in your chose profession?

After regular visits to a welfare center for a year, all bed-bound children now have adaptive chairs and a daily routine to access these chairs. The quality of life for these children has changed and the staff at the center have started to understand how important a positive attitude and praise are for teaching and training children.


What’s your favorite thing about living in China and working at LIH Olivia’s Place?

The not very fast-not very slow pace of living in Shanghai and the international environment and culture compatibility at LIH Olivia’s Place.


What would you like to be doing in 5 years’ time?

Besides personal professional development, as a pediatric OT working mainly with expatriate families in Shanghai currently, I would like to contribute as much as I can to promote a holistic occupational therapy service to children with special needs all over China. This would include visiting more local schools and extend OT service in local schools and establishing long-term relationships and regularly visiting two more welfare centers.

Radio Show “Rehabilitation Classroom” Improves Awareness

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The Rehabilitation Classroom, a public benefit broadcasting program co-created by Kunming LIH SkyCity Rehabilitation Hospital and Yunnan News Radio Station, has been broadcast over FM105.8 since 1 July 2016. The program has been well-received, with excellent audience ratings.


Nelson Chow, CEO of LIH Healthcare, broadcasts at Yunnan News Radio Station.

Nelson Chow, CEO of LIH Healthcare, broadcasts at Yunnan News Radio Station.

The first guest of Rehabilitation Classroom was Nelson Chow, CEO of LIH Healthcare. In telling the story of his young daughter Olivia, who has Down syndrome, Nelson emphasized the important role that therapy has played in Olivia’s development. In another broadcast, Professor and Occupational Therapist Fengyi Gou (Taiwan), also with LIH Healthcare, introduced geriatric disease rehabilitation and shared experiences in how to live healthily and happily in one’s senior years. So far, seven experienced clinicians have been invited to this program to impart rehabilitation knowledge to listeners. By using plain language and related stories, the experts have made this program easy to understand and enjoyable to listen. Topics in July and August have included:

  • Olivia’s Story (presented in two parts)
  • Cervical Spondylosis Rehabilitation
  • Early Rehabilitation of Fracture
  • Give Yourself a Chance of Recovery
  • Healthy and Happy Old Age
  • To know CPR, To Improve Life Quality


Yunnan News Radio Station has an audience of 6.5 million throughout Kunming, many of whom are seniors. This program helps listeners learn more about rehabilitation and contributes to improve national awareness. The partnership between Kunming LIH SkyCity Rehabilitation Hospital and Yunnan News Radio Station will continue to invite rehabilitation medicine experts to provide community-based education to our audience, especially on topics that positively impact the lives of seniors, in the near future.

LIH Olivia’s Place Moves to Digital Assessments

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The Speech-Language and Psychology teams at LIH Olivia’s Place Shanghai have recently made the exciting transition to digital assessment administration for many formal assessments.  Since LIH Olivia’s Place opened in 2010, we have been committed to using leading industry standard assessments and to safeguarding the intellectual property of the assessment authors and publishers. This has always meant dealing with a number of challenges to ensure that test materials from international assessment publishers could be readily and consistently available. The opportunity to explore another way of maintaining our high standards while we continue to grow in China, while protecting the integrity of the assessments themselves, was exciting to us.


kid hands ipadThe decision to change from paper-and-pencil test formats to the use of iPad and computer-based testing was no easy task. Our teams had to consider the ease of use for children and parents, comfort levels with necessary technology, and the learning curve of new administration techniques. However, after trials by our speech and psychology staff, it was clear that these formats would be of significant benefit to the families we serve and our clinicians. Once a struggle because most assessments must be purchased outside of China, digital assessment platforms will allow LIH Olivia’s Place clinicians to immediately access the most up-to-date versions of some of our most widely used tools. They will also allow us to stay immediately informed of any changes or improvements in the tests we use.


Digital administration is now offered through several assessment publishers and LIH Olivia’s Place will migrate to digital platforms as they become available and well-tested. One of these platforms is Q-Interactive, offered by Pearson, the publisher of many of the most reputable and evidence-based tests. It can be used to both administer and score tests that are traditionally given by examiners in a paper-and-pencil format. Using the digital version of the assessment, testing takes place on two iPads using an app called Assess. The first iPad is used by the examiner to access the test administration instructions, score and record responses, and control visual stimuli. The person who completing the assessment uses the other iPad to view and respond to stimuli. Q-interactive can also generate summary information for assessments administered on the iPads.


Pearson has conducted substantial research to ensure that the use of its digital system does not detract from the quality of assessments administered. Prior to inclusion in the Q-interactive library, each new type of subtest underwent an equivalency study to evaluate whether scores from digital testing were interchangeable with those scored from paper-and-pencil testing. Results of these studies support the validity of Q-Interactive as a method of administration for all tests included.


The transition to digital assessment is an intensive process. While familiar with the paper and pencil versions of these tools, our clinicians have undertaken additional training to solidify their competency in each assessment they will be administering with the new systems.  Clinicians and families at LIH Olivia’s Place Shanghai will be the first to use these advanced digital platforms, other LIH Healthcare clinics and hospitals can anticipate having access to this technology and specialized training in the near future.

Keeping Our Own Team Healthy: Staff Physical Therapy Workshop

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Physical therapists ZiLi Wang and Ilija Dimitrovski gave staff at LIH Olivia’s Place Shanghai a workshop on managing workplace postures, including short assessments for staff with work or sports related pain. The health of our clinicians and support staff is very important, as having a pain-free body allows us to perform at our best.

Staff learned about the basics of core muscle strengthening to help maintain proper posture, and how to manage their works pace. Specific problems, such as neck, back, and shoulder pain were individually addressed, with the physical therapists showing their assessment flow – from asking subjective questions to the actual physical examination. Suggestions for exercises to relieve neck stress and stretch the neck and shoulder muscles were also given and demonstrated.

Here are a few of the exercises that were included:


Neck Extension: This exercise helps relieve pain from the neck after too much time spent looking down at laptops or paperwork.

Neck Extension


Tuck your chin in and slide your whole head backward. Slowly extend your neck as you look up. Slowly right your head, then repeat the movement 10 times. Do not repeat this exercise if it worsens your pain!


Neck Muscle Stretches: These exercises help stretch out the neck muscles on both sides.


Neck Stretch


Look down and turn the head slightly (45 degrees) to either side. Take the arm on the side turned to, and gently pull the head down. Maintain the stretch for 30 seconds.


Core and Back Exercise: This is a general exercise that can be used to improve core strength and back stability. If it is too difficult to maintain, do only the legs or arms component.


Kneel down so that your back is flat and your knees and shoulders are flexed to 90 degrees. Slowly raise up one leg and at the same time raise the opposing arm, keeping your back flat. Hold the posture for up to 1 minute. Repeat using the opposite limbs.



LIH Announces Technical Advisory Board Members

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LIH Olivia’s Place is thrilled to announce the addition of Dr. David Cifu and Dr. Denise Challis to our Techinical Advisory Board, joining our standing members who have recently committed to continued service: Dr. Ao Lijuan, Professor Jean Deitz, Professor Sharon DeMuth, and Dr. Henry L. Lew.

We warmly welcome our new Technical Advisory Board members and thank each of our continuing members who have renewed their commitment to our organization. Each shares the vision, mission, and values of LIH Healthcare and brings the kind of creativity, energy, and commitment that LIH Olivia’s Place needs to build on what we have accomplished together over the last several years. Their distinctive knowledge, experience, and expertise in rehabilitation will support our efforts in increasing our impact on China’s rehabilitation services.


Dr. Ao 1Ao Lijuan, MD

Dr. Ao is the Department Chairperson of Kunming Medical University’s Rehabilitation Medicine Department. She is also the Vice Chairperson of the China Association of Rehabilitation Medicine, the Secretary General of the Yunnan Provincial Association of Rehabilitation Medicine, the Chief Physician in the Rehabilitation Department of the Second Affiliated Hospital of Kunming Medical University, the Chief Medical Officer of the Yunnan Disabled People’s Federation Rehabilitation Hospital, and on the editorial boards of multiple medical journals. Dr. Ao has made very significant contributions to the development of rehabilitation medicine, physical therapy, occupational therapy and speech and language pathology in China. Among other things she has been instrumental in starting the first degree programs in these three latter fields. Dr. Ao has a passionate commitment to the development of pediatric therapy in China, assessment of children with cerebral palsy, and methodology for treatment.


DCHALLISDenise Challis, MA., MB., Bchir., Msc., DCH., FRCPCH

Dr Challis has specialized in neuro-pediatrics over the past 44 years, having trained in the Universities of Cambridge and London. She consulted at The Portland Hospital, London, England, until autumn 2015. Her specialism was in the assessment and treatment of children from all over the world with neurological conditions, including autism, cerebral palsy, epilepsy, neurodegenerative diseases, and a wide range of congenital disorders. Her continued special interests include the holistic management of the care of children with complex, chronic disorders from initial assessment, particularly using the Griffiths Mental Development Scales (GMDS). She lectures regularly in the UK and abroad, particularly in China, partly to facilitate the growing use of assessment in diagnosis and provision of therapy for children with disabilities Dr. Challis is presently a Consultant Pediatrician specializing in Neurodevelopment and Neurodisability. She is the Past President of the Association for Research in Infant and Child Development. She is also a member of the Member of the British Paediatric Neurology Association and the British and European Academies of Childhood Disability.


DCIFUDavid Cifu, MD

Dr, Cifu is Chairman and the Herman J. Flax, MD Endowed Professor (tenured) of the Department of PM&R at the Virginia Commonwealth University (VCU) School of Medicine in Richmond, Virginia. He is also Chief of PM&R Services of the VCU Health System and Founding Director of the VCU-Center for Rehabilitation Sciences and Engineering (CERSE). He is the Senior Traumatic Brain Injury Specialist for the U.S. Department of Veterans Affairs. He has been funded on 39 research grants of over $130 million, including currently serving as Principal Investigator of the VA/DoD $62.2 million Chronic Effects of Neurotrauma Consortium (CENC). In his more than 25 years as an academic physiatrist, he has delivered more than 500 regional, national, and international lectures, published more than 200 scientific articles and 65 abstracts, and co-authored or edited 31 books and book chapters. He is also the Past President of the American Academy of PM&R (2007-8) and Editor-in-Chief of the 5th Edition of Braddom’s Physical Medicine and Rehabilitation textbook (2015).



Dr. Deitz was a professor in the Department of Rehabilitation Medicine, School of Medicine, University of Washington (UW) for 30 years. During her tenure at the University, she was involved in curriculum design, development, implementation, and evaluation; taught undergraduate, masters, and doctoral level courses; served as Graduate Program Coordinator for the Department; mentored graduate students in occupational therapy, physical therapy, prosthetics and orthotics, and education; chaired the committee that developed the UW interdisciplinary PhD program in Rehabilitation Science; was the principal investigator or project coordinator for numerous federally funded grants related to either program development or research; and was elected to the UW Graduate School Council.

She has published extensively with a focus on pediatrics, measurement, and assistive technology. She has 80 research publications in peer-reviewed journals and has contributed chapters to major textbooks in her field. Nationally, she served as an American Occupational Therapy Foundation (AOTF) Regional Research Consultant and chaired the AOTF Research Advisory Council;served on the National Advisory Board for Medical Rehabilitation Research (National Institutes of Health); and was on the editorial boards of peer-reviewed journals appropriate to her field.   Her primary awards include American Occupational Therapy Foundation Academy of Research; Fellow of the American Occupational Therapy Association; Lifetime Honorary Membership in the American Academy of Orthotists and Prosthetists (in recognition of her leadership in helping them move their educational programs to the master’s level); and two American Occupational Therapy Foundation Meritorious Service Awards (2003 and 2008).  The latter was for being an “effective and articulate advocate for the relationship among occupation, participation, and health”; and for sharing a “wealth of knowledge” and an “interdisciplinary perspective, as both a scholar and teacher.”



 Dr. DeMuth developed the clinical pediatric physical therapy curriculum in the Doctor of Physical Therapy program at the University of Southern California (USC) where she taught for 16 years until she retired in 2013. Her contributions to the Division of Biokinesiology and Physical Therapy were recognized with the Division Tribute Award in 2014. Dr. DeMuth especially enjoyed supervising students in providing care for children and families in Fit Families (the pro bono clinic at USC) and at volunteer sites in Mexico. She has continued volunteering as a clinician and teacher of physical therapists and orthotists caring for patients with cerebral palsy and polio internationally. Prior to teaching at USC she served as a clinician, and supervising therapist at Boston Children’s Hospital and Children’s Hospital of Los Angeles as well as acting director of physical therapy at the Children’s Hospital of Philadelphia. Dr. DeMuth directed the Los Angeles collection of normative data for the Test of Infant Motor Performance, a multi-center NIH funded research project with Suzann Campbell, PT, PhD, to develop a new test for evaluating motor performance in infants born prematurely. She was also co-lead investigator on the Pediatric Endurance and Limb Strengthening Study (PEDALS) that evaluated the effect of a stationary bicycling intervention on strength and endurance in children with the spastic diplegic form of cerebral palsy. She has served as the co-chair of the education committee and as the chair of the nominating committee of the Pediatric Section of the American Physical Therapy Association. She was recognized for her service to the Pediatric Section with the G E “Bud” DeHaven service award, one of the sections highest honors. Dr. DeMuth was an article reviewer for the journal of Pediatric Physical Therapy. She has written chapters on orthopedic pediatric physical therapy in two texts and has published abstracts and articles in peer reviewed journals on idiopathic scoliosis, cerebral palsy, orthotic practice and wound healing using electrical stimulation.


HLEWHenry L. Lew, MD, PhD

Dr. Lew is a board-certified physician in Physical Medicine and Rehabilitation (PM&R) in the USA. He completed his PM&R residency training and Traumatic Brain Injury (TBI) fellowship at the University of Washington in Seattle, Washington. Dr. Lew served as Clinical Assistant Professor of PM&R at Stanford University School of Medicine, Associate Professor at Harvard Medical School, and currently holds two Professor appointments, one at the University of Hawaii School of Medicine, and the other at Virginia Commonwealth University School of Medicine.Dr. Lew has been awarded multiple federal and state grants to study the diagnosis and rehabilitation of brain injury, with emphasis on promoting evidence-based clinical practice. He has published more than 120 scientific articles, 10 book chapters, and authored 3 textbooks (Electromyography, Polytrauma Rehabilitation, and Braddom’s Textbook of PM&R, as Associate Editor, with Dr. David Cifu as the Editor).  He has been recently appointed as Chair of the Education Committee for the International Society of Physical and Rehabilitation Medicine (ISPRM).


For inquiries about our Technical Advisory Board, please contact Dr. Jie Zhang., Director, LIH Healthcare Training Division

What is the Role of Medications in ADHD?

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by Susan Cadzow, MD, Director Developmental-Behavioral Pediatrics, LIH Olivia's Place

by Susan Cadzow, MD, Director Developmental-Behavioral Pediatrics, LIH Olivia’s Place

Children and adults with severe attentional difficulties are sometimes prescribed medications. This is generally only when their symptoms are having a significant impact on learning and general function.

Medications should only be considered after other non-pharmacological supports and strategies have been implemented and there are still major concerns that the child is functioning well below their ability level due to concentration deficits.

Before considering medications, a pediatrician will do a thorough medical history and examination. Co-existing medical conditions that might be affecting the child’s performance can be identified and treated if necessary. The evaluation will also focus on assessing the nature and the severity of the problem. Information will be gathered from parents, the child’s school, and the child him/herself if they are old enough. In some cases, another referral may be made during this process, for example, to a psychologist to undertake formal assessment of the child’s learning profile and abilities).

Regarding ADHD medications, it’s important to recognize that they are aimed at reducing specific “target symptoms,” namely hyperactivity, impulsivity, and distractibility. They generally do not have specific action in terms of behaviours such as defiance and aggression. However, there can be some positive benefits for behavior and social skills if the problems are resulting from impulsivity or poor self-regulation.

If everyone agrees that a trial of medications may be helpful and is appropriate for the individual child, generally a 1 to 2 month trial of a stimulant medication will be started as the “first line” treatment. If stimulant medications are prescribed appropriately, approximately 70-80 % of people show a beneficial response (that is, significant reduction in the target symptoms).

In general stimulant medications are very safe and have been in use since the 1980s for treating children with ADHD. Reduction in appetite during the day is a common side effect of stimulant treatment. Children must be monitored carefully to ensure intake is adequate and growth is not affected. The pediatrician will follow up on a regular basis to assess dose adequacy, ongoing effects, and side effects. ADHD medications do act on chemical transmitter levels in the brain so there are many other possible side effects involving the neurological system but fortunately these are very rare and normally immediately reversible when the medications are stopped.

Since the main time that the medication effects (improved concentration, planning, and focus) are needed is the school day many families choose to not give the medication on weekends and school holidays. If for any reason stimulant medication is not effective or not well tolerated there are some alternate medications that can be tried. For example, Strattera (atomoxetine), is one that is often used and which is also available in China. Occasionally this may be tried first, particularly in children with significant anxiety symptoms as it also has an anti-anxiety effect.

Key Points

1. ADHD medications should normally be considered only in children with severe symptoms who have already tried non-medication therapies.
2. Medications are only part of the treatment plan for children with ADHD. Behaviour management, school support, classroom strategies, and counselling are also very important.
3. Children need to be assessed thoroughly before a trial of medications and monitored closely during treatment.
4. The main aim of medication is to reduce specific target symptoms in order to allow the child to reach their learning potential. Improvements in social skills and relationships may be seen if impulsivity and self-regulation have been a problem.
5. Approximately 70-80% of people with a diagnosis of ADHD respond positively to treatment with stimulants.
6. Stimulant medications have been used in ADHD since the 1980s and are well-researched and generally very safe.

Stand Up for Healthier Sitting

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Ilija Dimitrovsk, Lead Physical Therapist, LIH Olivia's Place Shenzhen

Ilija Dimitrovsk, Lead Physical Therapist, LIH Olivia’s Place Shenzhen

Nowadays our way of living is more passive than ever. There are lot professions which use various electronic devices to help and get the job done properly. This trend impacts even children in the classroom. But that also has a, negative influence’’ on our health condition. One of the most affected body parts with this so called, modern age disease’’ is the back. Sitting is the most common culprit. Long and incorrect sitting can create weakness in our muscles (back, abdominal, gluteal and leg muscles), poor peripheral blood circulation, poor lungs ventilation, … Less physical activities can certainly influence our body weight, and increased body weight leads to worsening symptoms. So people who are required to sit for long periods of time or in incorrect seating are more exposed to these problems.

When talking about children, we need to mention increased use of computers and tablets for school work, in their spare time, and during recreational activities. Parents should be aware that excessive time spent in incorrect body positions can be harmful for children. Long periods of sitting daily can cause decreased heart and brain function (slow circulation), improper lung ventilation, slow digestion, and obesity. Children who are sedentary for too long can experience posture problems like neck and shoulder strain and back problems including pain and weak muscles (scoliosis, kyphosis, loose abdominal muscles, low back pain). Parents should look at the posture of their children and if they notice some changes, consult a healthcare practitioner or PE teacher for advice. These problems are not harmless or irrelevant and can negatively influence a children’s growth and development. Spinal deformities, weak muscles, and childhood obesity can all be linked to a sedentary lifestyle that features too much time sitting.

We all should encourage our children to take breaks during long sitting periods and do some movement. Established advice is 30 to 60 minutes per day of some physical activity. That could be activities like walking, riding a bike, slow running, stretching exercises, walking up and down stairs, climbing up a slide instead of sliding down, swinging, crab walking, jumping jacks, skipping rope, etc. Swimming is also highly recommended. One great free resource for movement breaks at home or in the classroom is Go Noodle ( Your child can also exercise while seated (stretching and breathing exercises).
Always check that your child is seated in the correct position, which means:
• Elevate feet from the floor at less than a 20° angle (books or cushions can be used for elevation)
• Lean back on the chair’s backrest
• Do not fold legs under bottom
• Do not hook shins and feet under the chair on which they are seated.

Adults often complain about back problems, which are typically neck or low back pain problems. With time, symptoms can worsen and pain can radiate all the way through a person’s arms and legs. That level of severity certainly reduces effectiveness in the workplace and quality of life in general. All around the world, employers and employees try to find the best models to organize their workplaces and activities to decrease that negative health influences’. There are two steps we can take to achieve that.

One is to adjust work environment and the other is to do a few exercises during worktime. If you are sitting a long time at work you should consider adjusting the height of your desk, the position and angle of your computer or other electronic device, and use accessories such as wrist or arm supports if it is necessary. When seated, lean your back fully on the backrest of the chair (back support part of the chair). Do not position your shins under the chair or sit on your bent legs; try to put your feet on a platform at a 15-20° angle with the floor, and wear comfortable clothing and shoes.

Stand Up 1

Next are exercises. Performing physical exercises during the day helps to decrease symptoms, improve physical abilities, prevent possible future problems, and increase work efficiency. They can be performed in a chair at your desk, at the chair using it as a support, or simply stand up and do your exercises in a free space. Stretching is a main component of these exercises, then comes strength and endurance. You can stretch your upper or lower limbs, use some weight accessories for strength, and do as many repetitions as you can for endurance. Start with short duration, no/low weight, and fewer repetitions for start and then increase over time to avoid muscle inflammation, muscles spasms (higher muscle tone), fatigue, and pain.
We all should have regular physical activity, especially those of us who are sitting too long or in an inadequate way. In order to prevent pain, deformities, weakness, and poor work efficiency we can adjust our work space and exercise at work. However, before beginning any exercise at work, consider your present health condition. If you are currently experiencing pain or other symptoms, have a medical condition that could affect your physical abilities, or are just not “in shape, “ask for advice from a qualified healthcare professional or physical trainer first.

LIH Healthcare Graduates First Class from CARF-Supported Nursing Rehab Training Program

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“LIH has been doing the cutting edge things.”

– Dr. Kristen Mauk, Past President, Association of Rehabilitation Nurses (US)

Graduate Class of 2016 LIH Healthcare Nursing Rehabilitation Training Program

Graduate Class of 2016 LIH Healthcare Nursing Rehabilitation Training Program


It was a special day on 18 June 2016 for a group of nurses as they came to say goodbye to their classmates and teacher on the last day of a special training program, the first CARF-supported nursing rehabilitation training program in China. Smiling and holding their certificates, graduates captured the memory in a traditional group photo.


The Moments of the first CARF-Supported Nursing Rehab. Training Program

Demonstration of transporting a patient by presenting a detailed breakdown of each caregiver’s role in this task.

Demonstration of transporting a patient by presenting a detailed breakdown of each caregiver’s role in this task.

On 5 June 2016, LIH Healthcare reached a new milestone by presenting the first CARF-supported Nursing Rehabilitation Training program. “Professionally designed and implemented, this new training program was introduced in early May and received many inquiries and interest from the nursing community all over China, from the first day registration opened,” said Michelle Wang and Shirley Gao of the LIH Healthcare Training Division.

It was the first time for the nursing community in China to experience a full-length nursing course offered by Dr. Kristen Mauk, the recent Past President of the Association of Rehabilitation Nurses (ARN) of the United States. Many participants reflected on the final day that the training program provoked participants’ learning experience in various effective learning formats, such as case studies, group activities, skills demonstration, and real practice with equipment. Dr. Mauk also sees a great potential to deliver these types of training programs in the long run, to support more nursing professionals in China. “The collaboration with LIH has been great, they’ve been doing the ‘cutting edge’ things in China,” said Dr. Mauk.


“New, refreshing, and eye-opening learning experience”

-Miss Zhao, Training Participant, Class of 2016

Training program participants working on a case analysis in a multidisciplinary team setting.

Training program participants working on a case analysis in a multidisciplinary team setting.

With little emphasis on training for clinical teamwork, especially working in multi-disciplinary teams in their prior experience, training participants had the opportunity to immerse themselves in rich learning formats such as group discussion, case studies about collaboration, and problem solving and presenting solutions based on real case scenarios. Two additional guest instructors, Peter Drzymala (Professional Practice Lead, Occupational Therapy) and Marla Blazer (Professional Practice Lead, Physical Therapy) of LIH Kunming SkyCity Rehabilitation Hospital were invited to co-teach the class on a regular basis. Miss Zhao, one of the participants in the class, reflected that conversation with the guest therapists was an eye-opening experience and led her to believe in the importance of working with different disciplines to provide the best course of action for treating patients.


Therapists Peter Drzymala and Marla Blazer share their perspective during a group discussion.

Therapists Peter Drzymala and Marla Blazer share their perspective during a group discussion.

Throughout the course of the training program, the class was given tremendous opportunity to have hands-on learning experiences. Skill demonstration and practice of evidence-based rehabilitation techniques were heavily applied to strengthen participants’ learning experience. As one of the training participants recalled, “I’ve seen the mechanical lift all my life but have never been able to try it by myself, it never occurred to me that I should and now I know why I should.”


Training participants take a close look at catheterization equipment that has not been well introduced in the practice of Chinese nursing community.

Training participants take a close look at catheterization equipment that has not been well introduced in the practice of Chinese nursing community.

 “Elder mistreatment and abuse” scenarios assess participants’ ability to identify the signs of elder mistreatment and abuse and distinguish normal conduct from abnormal conduct.

“Elder mistreatment and abuse” scenarios assess participants’ ability to identify the signs of elder mistreatment and abuse and distinguish normal conduct from abnormal conduct.


Dr. Mauk provides instruction and explanation on use of a mechanical lift.

Dr. Mauk provides instruction and explanation on use of a mechanical lift.

Was it a Success?

When the program came to a close, the LIH Healthcare Training Division immediately conducted a comprehensive evaluation and analysis. According to Michelle Wang, Training Supervisor, the learning format was the highest participant rated aspect of the program. Though experienced in more passive and traditional learning methods through their former education, almost ALL of the training participants showed an extremely high level of adaption and preference toward the new learning method introduced, even those that seemed to be out of their comfort zone. “Participants seemed very eager to jump out, ask questions, and experience practice regardless of the language barrier…,” recalled Ms. Wang. This successful learning experience resulted in 97% of participants claiming that they are willing to participate in more locally-offered training similar to this one provided by LIH in the future and would offer their assistance if the training was scheduled in their local area.

What comes next?

Since early this year, LIH Healthcare has developed and offered a series of groundbreaking training programs as the leading rehabilitation healthcare provider in China. With successful completion of the first CARF-supported Nursing Rehabilitation Training Course Series, LIH Healthcare will continue to focus on providing state-of-art training programs featuring more series on general competency learning and practices, advanced learning for senior nurses, and CARF Standards and Accreditation for Rehabilitation Nurse Leadership.

For more information, contact Dr. Jie Zhang, Director, LIH Healthcare Traning Division, at

LIH Olivia’s Place PT Speaks at CARM Exercise Therapy Congress

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Marc 1The 14th annual Exercise Therapy Congress organized by the Chinese Association of Rehabilitation Medicine (CARM) was held in Chengdu this year from July 16th – 17th. The 2-day conference saw speakers from all over China, the CARM leadership, as well as guest speakers from Canada and Germany present on the latest developments in the field of exercise therapy.

Marc 2Marc Innerhofer, LIH Olivia’s Place Physical Therapist (Beijing clinic) was invited by Du Qing (杜青), Director of the Rehabilitation Department at Shanghai Xin Hua hospital (上海新华医院), to deliver a talk on “Physical Therapy Intervention for Children with Autism Spectrum Disorder” as part of a sub-series of talks relating to the field of pediatric rehabilitation.

The presentation was well received by local therapists and health care professionals from all over the country. Among the attendees who were interested in learning more about therapy for children with autism was a delegation from Chengdu Xi Nan Children’s Hospital (成都西南儿童医院) (see photo below).

Marc 3

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