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KNSS 240: Keith Shaw (Cystic Fibrosis)

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scott gresham

on 13 September 2013

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Transcript of KNSS 240: Keith Shaw (Cystic Fibrosis)

Case Study: Keith Shaw
By: Matt, Pat, Chase,Kayla & Scott
Video #2
Video #3:
Video #4
Who is Keith Shaw?
Social Place:
Grand Prize winner!
Hugh Gresham (above riding) and
(below left) Hugh with winning smile
"Airfare & Accommodations for two to Las Vegas, 2 tickets to Celine Dion's show"
Cystic Fibrosis
Attribute Thinking:

Cystic fibrosis is an autosomal recessive genetic disorder that affects most critically the lungs, and also the pancreas, liver, and intestine. It is characterized by abnormal transport of chloride and sodium across an epithelium, leading to thick, viscous secretions.
It is the most common, fatal, genetic disease in Canada. 1/25 carriers
New born screening (every baby is screened)
Adaptations to physical activity (compressor while hunting and fishing), getting a new dog,
Social Place: Hunting and fishing, gardening, walking.
Personality: Disability, takes away from motivation, withdrawn from social norms, interaction is low.

Attribute Thinking: Intelligent, knowledgeable, decay of social enthusiasm, witty and sharp

Reciprocation: Social communication is lower because lack of recreational activities.
Cognitive: lack of oxygen to the brain. Intellectual, Intuitive, sociable, humorous, witty.
Psychomotor: lack of oxygen to the brain,inhibits basic motor function and cognition, fluid in the lungs prevents vigorous physical activity.

Clubbing of fingers.
Affective: Witty and humorous but signs of depressive like symptoms (not getting outside, not walking)

Sammy, Keith’s dog had passed away and is an obvious factor inhibiting daily physical activity.
Lives in Penhold, family friend, grew up in new Brunswick, AB since 1980, 23 years old when he moved here, 56 yrs olds now, married, to long, 30 years, two kids, Clifton and Jackson, 28 and 26.

Keith nicknamed Boney. Small, hunchbacked, clubbed fingers.
But Keith participated and demonstrated the same behaviours as a healthy person.

Vernacular vs Systemic: This interview illustrates Keith’s personality. Loving wife and family. Great relationship with his doctor. (Dr. Brown)

Aesthetic anxiety: physical differences (clubbing of fingers)

Existential anxiety: empathy? Keith shows concern for others with CF. ex Melissa
“For the Birds”:
Cystic Fibrosis:
Most common, fatal, genetic disease within children in Canada.
New born screening. Salt content in mucus.
Smaller than other kids growing up, but didn't let it stop him from playing hockey.
Didn't affect him negatively; joked around about it with friends (nickname: boney-boner, but laughed it off), was very jokey.
Doesn't think he should be treated differently, seems very optimistic about cystic fibrosis, doesn't have a mental block when it comes to doing what he wants.
Case Study: Keith – Cystic Fibrosis

Who is Keith?

Social Place: Married for 30 years, 2 sons, likes to hunt & fish, gardening, stays active by walking and biking. Dr. Brown, dietician, physiotherapist.

Personality: Funny, likes to joke around, used to be quite social and outgoing as a kid, now is a bit more introverted but whenever he does go out to socialize he really enjoys it.

Attribute Thinking: Says he’s not as sharp as he used to be but that’s because he’s getting old, could be because he’s lacking the social interaction that he used to get. Doesn’t feel that the disease affects him too much.

Reciprocation: Doesn’t entertain like he used to, his doctor and other therapists/physicians are very good to him, good relationship with wife

Psychomotor: Smaller than other kids growing up, but didn’t let it stop him from playing hockey, basketball

Affective: Didn’t affect him negatively; joked around about it with friends (nickname: boney boner, but laughed it off), was very jokey

Cognitive: Doesn’t think he should be treated differently, seems very optimistic about cystic fibrosis, doesn’t have a mental block when it comes to doing what he wants.

How might you explain to the other students the inclusion of Keith? (Discuss anxiety): Keith didn’t really talk about having much anxiety throughout his life, had a very good sense of humour and didn’t feel isolated in any way.

Use the example of “For the Birds” for example:

Vernacular vs. Systemic – what examples do we see that the people in Keith's life see him in a vernacular or systemic way? Most of what Keith talked about seemed to be very vernacular. He is very close with his doctor, has a great relationship with his wife, has good friends, and therefore doesn’t see his life in a different light. Was a bit systemic when explaining what CF is, and the chances of having a child born with CF.

Who are the professionals that support Keith? What is their role? Dr. Brown (Keith’s physician: regulates Keith’s medications, keeps in touch to make sure he’s doing alright), Dietician (making sure that Keith is eating a well-balanced diet in order to suit his disorder; designs diet to suit Keith’s issues with his pancreas)

Abilities Based Approach – What is Keith capable of? Growing up he said that he was fully capable to participate in anything he wanted to. Still manages to stay active despite being 56 (14 years past life-expectancy).

What are Keith's challenges? Growing up he developed later than other boys (was always smaller, went through puberty at a higher age), the fluid build up in his longs causes infection very easily so he must check in regularly with his doctor to make sure his medications are up to date (getting antibiotics for any new infections), pancreas doesn’t produce insulin as efficiently as a normal pancreas.

How is Physical Activity helping Keith with his quality of life? He thinks that keeping active is extremely important for him to not just survive but thrive, since he stays so active he is able to do the things that he wants.

What other ways can you think of that could assist Keith to improve his quality of life? Pushing out of his comfort zone to socialize more often. He said that his wife has to drag him out to socialize, but once he gets there he enjoys it so much that she has to drag him away when it’s time to go. Socializing more often would improve his wellness by reducing stress and keeping his mind more active by carrying on conversations regularly.
Reflection Video 4:

Keith’s challenges and challenges that develop with CF:

•Clubbing of the fingers and thumbs


•Skinny/ petite




Keith believes that being physically active is very important, and that his condition does not affect how well he can perform.
Fund raising:
For people with CF it is essential to integrate and promote exercise that will increase lung function.
Aerobic interval training is an effective way to improve a patients strength, endurance, speed and agility.
Improved lung function is critical for a person living with CF.

The thick secretions of viscous solution clog the airways in the lungs, which often cause inflammation and severe lung infections.
Plan for Activity:

With direct instruction, using vocal cues, an explanation and demonstration of dynamic mobility stretching and aerobic exercise will be given.

This process will take several weeks because of differing variables based around safety, understanding, confidence, age,experience, genetics, abilities,endurance and participation.

Dynamic stretching is an effective way to introduce basic fundamental movement skills. These movements will improve strength, balance, range of motion, flexibility and safely prepares a body for exercise.

Aerobic exercise will promote cardiovascular endurance, speed, agility, strength and an overall better sense of well being.

Within a couple weeks a learner will be able to perform dynamic stretching and aerobics at a mastery level without any cues.
The use of social media is an effective way to instruct learners so that they can seek out information and different exercises to further develop skills. This is essential for visual and auditory learners. (YouTube)
Whole and Part Practice:
Skills will be taught individually and cues will be identified to ensure understanding and proper range of motion.

Once learner is able to perform basic fundamental movement skills individually the skill will progress to whole practice. Aerobic activities involves sequences and repetition of several differing movement skills.

The movements and degree of modification will be dictated by age, appropriateness, interdependence,number of participants and safety.
Performance Objective and Reinforcement
Instruction will be a progression of direct, task/practice, reciprocal, self discovery and self directed learning/teaching.

Providing constructive feedback will progress to reciprocal instruction where probing questions will be answered to ensure understanding.

Instructor feedback will eventually not be necessary once mastery has been inferred.

The purpose of the self teaching progression is to ensure that a lifelong ability and want to perform exercise is established. This will mean that there will be no practitioner or teacher involved.
Instructional Strategies:
The shaping for dynamic and aerobic activity will involve static posturing. Ensuring proper range of motion and balance are obtained.
The chaining of aerobic activity will be implementing several different movements into sequence. Ensuring full range of motion, endurance and speed are being utilized.
The fading portion of our performance outcome is based on the ability of Keith to be able to perform these activities on a daily basis and give him the knowledge and confidence to seek out new programs. These can be performed at home or at the gym to ensure social mediation.
Reinforcement will be positive by addition. Adding information, knowledge, confidence and ability to Keith's life will promote a healthier and happier lifestyle.
The safety concerns surrounding Keith are his age, ability, genetics, capacity, knowledge, environment (treadmill) and his individual want to perform these skills for life.
Skill Component:
Strength Mod Gym membership/personal trainer
Change environment

Endurance Low Treadmill. Change equipment.

Speed & Agility Low Walking dog/treadmill. Goal setting
Individual Skill
Skill Modification
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