3^rd International Conference and Expo on Physiotherapy October 13-15, 2016 Kuala Lumpur, Malaysia

Biography:

Dr. Muhammad Jamil Sabit has the honor of being first Pakistani Pain Physician who was awarded Fellow of Interventional Pain Practice (FIPP) Credentials by the World Institute of Pain (WIP) on his brilliant success in 2013 FIPP Exam. He is official mentor of WIP for the training of fellow physicians in interventional pain practice as well as FIPP Faculty & Examiner.

After completion of his MBBS, he pursued the field of Anesthesiology as Diplomat since 1992 at Mayo Hospital Lahore, a tertiary care teaching hospital, affiliated with King Edward Medical University Lahore Pakistan. His field of interest remained Chronic Pain Management Services. He did his MSc (Pain Medicine) and became pioneer of advanced pain management services in Pakistan. He is President of Pain & Physical Therapy CME Academy Lahore Pakistan & Director Pain Management Services Al Razi HealthCare Lahore Pakistan.

Abstract:

Abstract Objective: Low back pain is one of the leading causes of musculoskeletal problem. 70% to 80% patients visit health care setups having acute on chronic low back pain. The objective was to find the effects of Spinal Epiduroplasty with and without exercises rehabilitative program in patients with Low Back Pain after failed back surgery syndrome.

Method: Fifty Low Back Pain patients after failed back surgery syndrome who were rehabilitated at Pain & Physical Therapy CME Academy Lahore Pakistan from 16th November 2015 to 1st April, 2016 with variable duration of pain after failed back surgery syndrome were treated with spinal epiduroplasty and exercises rehabilitative program.

The patients were divided into two groups according to the treatment plans. Group-I was treated with spinal epiduroplasty. Group-II was rehabilitated with combination therapy (spinal epiduroplasty plus exercises regime). The effects of treatment in both groups were assessed with visual analog scale (VAS), before the treatment, at 1 day & 10th day after the treatment.

Results: VAS of all patients after spinal procedures was decreased but the results were more significant in Group II (p＜0.05).

Conclusion: Exercises Rehabilitation plus spinal epiduroplasty is one of the best treatment options for the patients suffering from low back pain due to failed back surgery syndrome.

Keywords: Exercises Rehabilitation; Low back pain; Failed back surgery syndrome; Epiduroplasty

 

Biography:

Syed Rehan Iftikhar Bukhari has completed his Masters in Orthopedic Manual Physical Therapy at the age of 25 years from Riphah International University. He is Clinical Coordinator and Lecturer at College of Physical Therapy, Government College University Faisalabad, Pakistan.

Abstract:

Cervical radiculopathy is a common neuro-musculo-skeletal disorder causing pain and disability. Traction is part of the evidence based manual physical therapy management. The objective of the study was to determine the Effects of Mechanical versus Manual Traction in Manual Physical Therapy combined with segmental mobilization and exercise therapy in the physical therapy management of Patients with Cervical Radiculopathy. This randomized control trial was conducted at department of physical therapy and rehabilitation, Rathore Hospital Faisalabad, from February to July 2015. Inclusion criteria were both male and female patients with evident symptoms of cervical spine radiculopathy and age ranged between 20-70 years. The exclusion criteria were Patients with history of trauma, neck pain without radiculopathy, aged less than 20 and more than 70. A total of 72 patients with cervical radiculopathy were screened out as per the inclusion criteria, 42 patients were randomly selected and placed into two groups by toss and trial method, and only 36 patients completed the study, while 6 dropped out. The mechanical traction was applied in group A and manual traction in group B along with common intervention of segmental mobilization and exercise therapy in both groups for 6 weeks. The patient’s outcomes were assessed by self reported NPRS and NDI at the baseline and after completion of 06 weeks exercise program at 3 days per week. The data was analyzed through SPSS version-21, and paired T test was applied at 95% level significance to determine the statistical deference between two groups. Clinically the group of patients treated with mechanical traction managed pain (mean pre 6.26, mean post 1.43), and disability (mean pre 24.43 and mean post 7.26) more effectively as compared with the group of patients treated with manual traction (Pain mean pre 6.80, mean post 3.85 and disability mean pre 21.92 and post 12.19). Statistically the results of both mechanical and manual traction techniques are equally significant in group A and B for pain and disability (p-value less than 0.05). It is oncluded that cervical radiculopathy patients treated with mechanical traction, segmental mobilization, and exercise therapy managed pain and disability more effectively than treated with manual traction, segmental mobilization, and exercise therapy.

Biography:

David is an experienced physiotherapist with long and established practice in the non-surgical management of low back pain. He has a particular interest in improving function and quality of life in patients with persistent low back pain and has established the Functional Restoration Service at the Royal Orthopaedic Hospital to address this. He qualified as a physiotherapist from Birmingham University in 1994, after previously completing a degree in Sports Science, and has worked at several orthopaedic centres including the Nuffield Orthopaedic Centre in in Oxford.

He has extensive experience of occupational rehabilitation, having worked for both public and private agencies, and uses a biopsychosocial approach to help patients maximise their function. He completed an MSc in Pain Science and Management at Keele University in 2010. He also works as an Extended Scope Practitioner within the spinal team at the Royal Orthopaedic Hospital and has close links with the spinal surgical team

 

Abstract:

Back pain is of considerable interest in society today and is a source of ongoing disability and days lost from work in the adult population (Driscoll et al., 2014).Historically, the recommended management has encompassed conservative methods, from physiotherapy and a range of other manipulative techniques to surgical interventions in various forms. There is now agreement that adults with persistent low back pain who have failed physiotherapy and have high levels of disability and psychological distress are best managed through a combined physical and psychological approach, which should be up to 100 hours in length (NICE, 2009). This combined approach has been modified by authors in several forms, of varying duration, with good results, supporting the idea that benefit can be gained from interventions of a lesser duration (Hill et al., 2011; Hunter et al., 2006; Lamb et al., 2010). The present paper reports on the results, as measured using the Oswestry Disability Index (ODI) and Pain Self-Efficacy Questionnaire (PSEQ), of a four-week functional restoration programme (FRP) treatment intervention, run in a tertiary spinal centre, which used a combined physical and psychological approach.

Biography:

Working as Associate Professor in the department of musculoskeletal physiotherapy since 2005 in a reputed college in central India. Worked as physiotherapist for New Zealand national cricket team during the cricket world cup.

 

Abstract:

Shoulder pain is one of the commonest causes for patient visiting rehabilitation clinic. The term adhesive capsulitis of shoulder has been used for the patients with shoulder pain and mobility deficits. The prevalence of shoulder pain has been reported to be 26%, with greater prevalence among females. Adhesive capsulitis will be used to describe both primary (idiopathic) and secondary adhesive capsulitis. The primary is associated with medical conditions like DM, Hyperthyroidism, IHD etc and secondary is associated with extended mobilization, Cumulative trauma or surgical trauma. Studies have demonstrated the benefits of manual therapy for improvement in mobility and pain measure. Recently new advances for the treatment of adhesive capsulitis are the use of Kinesiotape (KT), which is a safe technique that has minimal side effects that facilitates musculoskeletal rehabilitation by reducing discomfort. However minimal evidences exist to support the use of KT in the tr eatment of adhesive capsulitis.
30 subjects diagnosed with adhesive capsulitis (stage II) within the age of 45 to 65 years were randomly selected and was grouped as “A” and “B” with equal representation by random sampling using lottery method. Subjects of group B was given KT in addition to End range mobilization (Grade IV) 3 sessions per week for 6 weeks. Outcome measures were pain on VAS, Range of Motion and UCLA score.
The collected data was analyzed using one way repeated measure ANOVA and Wilcoxon Rank Sum test. Over day 1 to end of 6 weeks the average reduction of pain in group A was 2.53+1.35 and in group B was 3.33+1.11. Comparison of UCLA score shows a difference of 5.06+3.23 in group A and 5.73+3.06 in group B at the end of six weeks. There was significant improvement in global range of motion in both the groups with marked increase in group B as compared to group A at the end of 18 sessions.
The randomized controlled trial shows that Kinesiotape has an adjunct effect on pain, range of motion and function along with end range mobilization in the of adhesive capsulitis of shoulder.

Biography:

Mehreen Ashfaq has completed her DPT at the age of  25 years from The University Of Lahore and she is doing her private clinic.

Abstract:

BACKGROUND:          

RTAs are the most common cause of deaths in the world. And in RTAs fracture of long bones are the most common. Management of fracture is different depending on the type of fracture and age of the patient. Post operative rehabilitation protocols used after the operation varies in different hospitals. Few hospitals and consultants don’t emphasize on the post operative rehabilitation of the patients, which leads to different complications including knee stiffness, decreased strength, abnormal gait and pain in the operated limb. Rehabilitation protocols after the operation if used correctly makes the life of patient very stress-free in his ADLs. This study has served its purpose to inform and guide the physiotherapist, doctors and students that not only Post Operative Rehabilitation exercises are important for patients, they are a must for them.

OBJECTIVE:To see the effects of early knee bending particularly in improving the ROM, Pain and quadriceps muscle strength compared with patients who will not be given knee bending after the operation                     

METHODOLOGY:                                                                                         

A cross sectional survey was conducted. Data was collected from physical therapy department of the Ghurki Trust Teaching Hospital which is 650 bedded hospitals. Male Orthopedic ward was the main data collection ward. 36 Patients were observed in the study which non probability sampling technique, dividing pats studying in different universities offering physical therapy in Lahore. Non probability sampling technique was used dividing patients in two groups, one group having 18 patients. Range of Motion at knee was measured by Goniometer, to measure the pain level; pain level (1-10) scale was used. Manual muscle testing was performed to assess the muscle strength of Quadriceps.

RESULTS:

72 patients were studied under two groups equally divided. One group was given the rehabilitation protocol while the other wasn’t. Results shown that there was significant improvement in range of motion at knee, affected side was with less pain also. 70% shown more than 90 degree range of motion at knee. While 80% of the patients shown bad results who were not given the exercises regime. It was concluded that early range of motion exercises in interlocking nail fixation proved to be very useful for patients and for physiotherapist as well. Patients who have been given post operative exercises have shown marked sign of improvement in gaining range of motion at knee, strength of quadriceps and decreasing pain level. Range of motion was main segment studied in this research which later on was creating various problems for the patients if knee got stiffed. And patients who were not given the treatment were observed with unimproved range of motion at knee, unsettled pain in affected lower extremity and poor muscle strength of the quadriceps.                                                                     

CONCLUSION:                                                              

It was concluded that early range of motion exercises in interlocking nail fixation proved to be very useful for patients and for physiotherapist as well. Patients who have been given post operative exercises have shown marked sign of improvement in gaining range of motion at knee, strength of quadriceps and decreasing pain level. Range of motion was main segment studied in this research which later on was creating various problems for the patients if knee got stiffed.

KEY WORDS:                                                                

Interlocking Nail, Fracture, Range of Motion, Pain, Stiff Knee, Rehablitation, Operation, Quadrecips

 

Biography:

Dr. Filippo Zanella is a physical therapist graduated at University of Bologna and skilled in sports physiotherapy, in the treatment of musculoskeletal disorders and visceral pathologies. Professor of manual therapy, International K-Active Taping Instructor and adjunct professor of the degree course in physical therapy of Juba, Dr. Zanella has completed several postgraduate courses in Italy and beyond (USA, Spain, Albania, Mexico) getting increasingly skills in orthopedics and neurology. He is also the CEO of "Physio": a geolocated app that helps people to book local physiotherapists, and helps physiotherapists to manage bookings and acquire new clients.
 

Abstract:

The presentation discuss about the causes that lead to a dysfunction of the fascial tissue and about the ways in which it can evolve in time. After an overview of fascial function and dysfunction – including brief anatomy and physiology notes - the participants will be able to understand the connection between thickening, contracture, fibrosis and calcification, as well as the fundamental role of the myofascial sliding and gripping. In the end we will compare a selection of hypothetical models and therapeutic manual therapy approaches to treat fascial dysfunctions and we will talk about known methods of fascial modification.

 

Biography:

Afsaneh Nikjooy, PhD is an Assistant Professor of Physical Therapy, Department of Physical Therapy, in Iran University of Medical Sciences, Tehran, Iran. She is a member of International Continence Society (I.C.S) as well as the Iranian Continence Society (Ir.C.S). She has worked in pelvic floor physiotherapy for more than 12 years and has managed several courses of pelvic floor physiotherapy for master students in this field in the faculty of rehabilitation, Iran University of Medical Sciences.

Abstract:

We aimed to study the differences between the dynamic indices of the pelvic floor, i.e. anorectal angle and perineal descent, in dyssynergic defecation patients in comparison with healthy controls, based on MR Defecography. 22 constipated patients with dyssynergic defecation and 14 healthy asymptomatic subjects were included in the study. 4 MR Defecography dynamic indices, including paradox (abnormal anorectal angle change), perineal descent during straining, perineal ascent, and narrowing of anorectal angle at squeeze, were measured in patients and healthy subjects. Paradox Index had the highest sensitivity (95.45%) and specificity (92.86%) for detection of dyssynergic defecation, with an R² value of near 1 (0.902). The sensitivity and specificity of other indices were not high; therefore, no significant improvement could be achieved using other indices along with Paradox Index. Negative Predictive Value (92.85%) and Positive Predictive Value (95.45%) were only high in Paradox Index. Paradox Index was indicated to be the best finding of MR Defecography for identifying dyssynergic defecation patients from healthy controls. Hence, MR Defecography could be exploited as a reliable tool to show the patients the paradoxical function of their pelvic floor muscles, which could enhance their imagination of the correct defecation pattern during their therapy.

Biography:

Naveed Anwar is currently working as an eminent Faculty member at Department of Physiotherapy in University of Lahore, Pakistan. He has published numerous research papers and articles in reputed journals and has various other achievements in the related studies. He has extended his valuable service towards the scientific community with his extensive research work.

Abstract:

Background:-

Previous literature had proved the significance of Physiotherapy as an effective management in the management of Mechanical Neck Pain, still there was lack of literature seen supporting the effectiveness of different Physiotherapy interventions with their doses targeting specific group of population (adults/students only). The aim of this study was to see the Efficacy of Kaltenborn Grade III mobilizations, Muscle Energy Techniques and their combination to improve range and functional ability in adults with Mechanical Neck Pain.

Materials & Methods:-

A quasi experimental study on 72 freshly diagnosed patients with Mechanical Neck Pain was conducted in Physiotherapy Department of Fatima Memorial Hospital Shadman. Those patients were randomly divided in three groups (Mobilization group, METs group and Combination group). There was no significant difference between age, educational year, computer using hours, duration of pain and initial NDI score and its percentage .NDI scale and goniometry was used as an assessment tool to measure the outcome of treatment in different groups before and after treatment (follow up 1 week).

Results:-

According to the results there was significant improvement seen in Combination group( Mobilization and METs ) in terms of  pain , which decreased from 7.70±0.69 to 1.25±1.93 (p=0.00), gain in ROM e.g. Cervical Flexion (27.29±2.38 to 37.54±3.14 ) , Right SF (from 30.20±2.84 to 41.45±3.84), Left SF (from 32.62±4.5 to 43.25±3.75), RR( from 43.25±5.7 to 57.33±3.0 )and LR ( from 48.08±6.8 to 58.50±3.4). Whereas, marked significance (p=0.00) was seen in the NDI score and percentage of Combination group (from 33.12±3.5 to 3.29±7.7 and 67.50±6.3 to 6.67±15.5 respectively).

ANOVA tells us that difference was significant in all three groups as p=0.000 in categories of pain ( VAS) , gain in Cervical (Flexion, Right SF, Left SF, RR,LR) and NDI score and percentage as p=0.000.

Combination group had significant (p=0.00) difference within the groups then METs and Mobilization group in all categories of pain (VAS) , gain in Cervical (Flexion, Right SF, Left SF, RR,LR) and NDI score and percentage. However, METs and Mobilization difference was not significant within the group.

Conclusion:-

Combination of (Grade III Kaltenborn and METs) was seen more effective in terms of improving Mechanical Neck Pain, in smaller treatment session ( 7 days only).

Key words:-Neck ach, Cervicalgia, Cervical Pain, Chronic, Manual therapy

Recommendations:-

Further studies are also required to compare the long term effects of combination of treatment i.e. they are effective in improving quality of life on long term. Are they effective in improving endurance of the patients or what treatment combination will result in long term effective results.

Biography:

Satheeskumar Durairaj has completed his MPT at the age of 24 years from The tamilnadu Dr,MGR Medical University and persuing doctoral studies from Nitte University, Mangalore, India. He is the Associate professorr of PPG College of Physiotherapy, Coimbatore, India, a pioneer organization in paramedical profession. He has published 2 papers in reputed journals.

Abstract:

Objective: The primary objective of this study was to identify the safety and feasibility of TENS combined with task oriented training(TOT) to improve upper limb function  in children with HCP.

Design, Setting, Participants: A single-blind, multicenter, randomized placebo-controlled study included 45 HCP children, aged 6.2 ±1.9 years from P.P.G. College of Physiotherapy, Coimbatore and K.S Hegde Charitable hospital, Mangalore during Febraury 2014 to January 2015.

Interventions: Participants were randomly assigned to receive TENS, Placebo-TENS and conventional Physiotherapy (CPT). All Participants followed same task oriented training along with main intervention for 90 minutes per session for 3 days in a week for 8 weeks. 

Outcome Measures: modified Tardieu scale (mTS), Quality of upper extremity skill test (QUEST) and ABILHAND-Kids (ABK) questionnaire were measured before and after the treatment at end of first day, 4^th and 8^th week. Adverse reaction mentioned in activity log and parent rated feedback questionnaire also measured at end of 8^th week.

Results: No adverse events were found and all participants were adhered treatment protocol very well. All the parents agreed (median score – 4.6 in 5 point Likert’s scale) to safety of the treatment protocols. The HCP children showed statistically significant difference (p<0.05) in elbow spasticity (Y) level in mTS and upper limb function in QUEST. 

Conclusions: TENS appears to be safe, feasible, and well tolerated in most children with hemiparesis. But need more detailed clinical research to explore the efficacy of TENS in upper limb rehabilitation in HCP subjects