Day 1 :
Keynote Forum
Anand Shetty
University of St. Mary, USA
Keynote: Disparity in utilization of healthcare services among African Americans and Caucasians with diabetes in the United States
Time : 08:45-09:25
Biography:
Anand Shetty is a Professor in the Department of Physical Therapy at the University of St. Mary. He is also the Co-Director of Research in the department. Currently he teaches anatomy, exercise physiology, and a series of research courses. He received his Doctoral degree in Physical Education from the University of Northern Colorado. He has published and presented numerous articles on obesity and a frequent invited speaker on obesity and nutrition. He has more than 25 years of teaching and research experience
Abstract:
The purpose of this study was to identify disparity of utilization of healthcare services among African, Americans and Caucasians in the United States from 2006-2008 and 2009 and 2011. A random sample of patients with type-II Diabetes Mellitus was collected from 2006- 2011 using files derived from inpatient charts and insurance carrier data was analyzed by an independent t-test. The outcome variables are number of hospital stays, length of hospital stay, number of physician office visits, number of physical therapy visits and incidence of lower limb amputations. Health care disparities in the utilization of health care for DMII exist between African Americans and Caucasians. Caucasians are more likely to visit physicians and physical therapists while African-Americans are more likely to go to hospitals, stay longer in hospitals, and have lower limb amputations. The causes of these disparities between African Americans and Caucasians require further investigation for complete understanding.
Keynote Forum
Areerat Suputtitada
Chulalongkorn University, Thailand
Keynote: Novel of extracorporeal shockwave therapy and high-power laser therapy in musculoskeletal pain conditions
Time : 9:25 to 10:15
Biography:
Areerat Suputtitada is a Professor of Physical and Rehabilitation Medicine. She is the Chairperson of Neurorehabilitation Research Unit at Chulalongkorn University and Chairperson of Excellent Center for Gait and Motion at King Chulalongkorn Memorial Hospital in Thailand. She was invited as international speaker for more than 60 times around the world. She has received 18 international and national awards and published more than 60 international and national articles in the areas of her expertise including neurological rehabilitation, spasticity and dystonia, gait and motion and pain. She is an expert clinician in ESWT for various indications in the field of physical and rehabilitation medicine. She has been elected and appointed to important positions at ISPRM such as the Chair of Women and Health Task Force and the International Exchange Committee
Abstract:
Rehabilitation management of musculoskeletal pain conditions are challenges. Most patients developed chronic pain conditions since inadequate management during acute pain phase. Currently, extracorporeal shock wave therapy (ESWT) and Class IV lasers or high-power laser therapy are novel therapy for these conditions. Interestingly both therapies with different actions and mechanisms have same benefits on musculoskeletal pain conditions and considered as regenerative medicine therapies. The evidences of safety, efficacy and good patient compliance made both therapies to be increasing popular in the worldwide. ESWT has become one of the best investigated treatment modalities for various conditions of the musculoskeletal system such as myofascial pain syndrome, tendinopathies and osteoarthritis, etc. An optimum treatment protocol for ESWT appears to be three treatment sessions at one-week intervals, with 2000 impulses per session and the highest energy flux density that can be applied. The proposed mechanisms for the benefit of ESWT on musculoskeletal tissue include direct effects on tissue calcification, alteration of cell activity through cavitation, acoustic micro streaming, hyper vascularity and blood flow increment, alteration of cell membrane permeability and effects on nociceptors through hyper stimulation, blocking the gate control mechanism. Class IV lasers or high-power laser therapy offers better therapeutic outcome compared to Class III lasers as follows: (1) Larger dosages of therapeutic energy, (2) Deeper penetration into the body, (3) Larger treatment surface area, this is important when treating large regions, such as the lumbar spine, quadriceps or hips, (4) Greater power density, (5) Continuous power supply and (6) Superior fiber optic cables: Fiber optic cables transmit laser energy from the laser to the treatment probe (wand) at the end of the cable. The beneficial effects of ESWT and high-power laser therapy on musculoskeletal tissues are anti-Inflammation, analgesic, accelerated tissue repair and cell growth, improve vascular activity, release trigger points and desensitization and reduce fibrous tissue formation. In conclusion, ESWT has been proven for more than 20 years as effective and safe noninvasive treatment option for tendon and other pathologies of the musculoskeletal system in a multitude of high-quality RCTs. High power laser therapy is by far the most exciting new clinical treatment to advance physical medicine in the 21st century anti-inflammatory and analgesic effects. It offers better therapeutic outcome compared to Class III lasers which has been using for a long period of time with little impressive outcome. High power laser therapy is newer therapy and increasing evidences.
Keynote Forum
Dagmar Pavlu
Charles University, Czech Republic
Keynote: Elastic resistance exercises in physiotherapy
Biography:
Dagmar Pavlu is an Associate Professor on Charles University, Czech Republic and is the Head of Department of Physiotherapy of FTVS. She has received her Master’s degree in Physiotherapy and Doctor’s degree in Pedagogy and received her PhD (CSc). Further, she earned the degree of an Associate Professor in Exercise Physiology. She was the President of the professional organization of Physiotherapists of the Czech Republic. She is a Member of Accreditation Board by Ministry of Health and also a Member of EC of Association of Rehabilitation and Physical Medicine in Czech Republic. She was the Vice-Chairman of European Region of World Confederation for Physical Therapy. Her current research interests include analysis of the effect of physiotherapeutical methods and she has altogether 150 publications to her credit.
Abstract:
Recovery process after different illness or injuries to a normal life is very long and difficult process, in which participate and cooperate many professionals-physicians, physical therapists, occupational therapists, trainers, conditioning specialist etc. In different stages of recovery process many procedures are used, special treatment interventions, most popular recovery techniques like hydrotherapy and massage, stretching, also nutrition-intervention, etc. Important role in recovery procedure play strength training and conditioning. To achieve optimal recovery result, therapy and/or training must be carefully planned and functional establish. As a very beneficial procedure, functional elastic resistance training with Sanctband, which can be optimally dose in and adopt to all stages of recovery procedure. Sanctband resistance training can be used not only like typical strengthening training, but can support recovery process by different ways. Areas, which can be used for elastic resistance training with Sanctband, as one of most modern devices, will be presented and documented by examples of research. Focus will be done on demonstration of various workouts and strength training in therapy, endurance training and therapy procedures to increase muscle stretch and expand the scope of joint mobility, coordination or training exercises, speed ability or training exercises, exercises to improve stability, general exercises or specific training for sports, exercises for the handicapped, exercises for children, exercises in pairs or groups and also on water exercises.
- Neurological Rehabilitation| Physiotherapy in Treatment & Care | Womens Health & Palliative Care
Session Introduction
Jennifer Honing
Fresenius University of Applied Sciences, Germany
Title: Therapy accompanying use of VR-glasses in hemiparetic children and adolescents
Time : 11:05-11:30
Biography:
Jennifer Höning has her expertise in sportphysiotherapy and passion in improving athletes. Her pilot study based on responsive constructivists creates new pathways for improving healthcare. She has built this study after years of experience in research, evaluation, teaching both in hospital and education institutions. This approach is responsive to all stakeholders and has a different way of focusing.
Abstract:
Statement of the Problem: Hemiparetic untreated children are particularly affected by a developmental disorder, some of them never learn to walk by their own. Hemiparesis as a result of an ischemic stroke in children and adolescents under 16 years of age is reported in the literature with an incidence of approximately 3-5 and 1, 6:100.000, respectively. The theoretical basis for the study of the therapeutic use of VR in children and adolescents with hemiparesis is based on the success of mirror therapy. Similar to mirror therapy, a situation, a movement sequence is presented to the brain in the therapy-accompanying treatment with the virtual reality spectacles (VR glasses) in such a way that the patient believes that his affected limb would be actively involved, thus causing the corresponding brain area of the affected side. By the mirroring of the non-affected extremity, important motor areas are activated in the affected hemisphere, which could otherwise only be activated by voluntary movements of the affected limb itself. The purpose of this study is to describe the effect of using VR glasses for improving movements by hemiparetic children.
Methodology & Theoretical Orientation: The design of the pilot study corresponds to a 12-week prospective cohort study with simple blinded evaluation. The children and adolescents are examined with the assessments: Nine Hole Peg Test, Box and Block Test, Hand ability test Movement-ABC-2, Timed-up & go Test, Ten Meters Walking Test, Goal Attainment Scale and Six Minute Walking Test. The measurement times are before the study, after 6 weeks, after 12 weeks and after 6 months. Studies in adults have shown that it is possible to learn motor movements in the virtual reality and implement them in the real world.
References
- Holden M K (2005) Virtual Environments for Motor Rehabilitation: Review. Cyber Psychology & Behavior; 8: 187-219.
- Lewis G N, Rosie J A (2012) Virtual reality games for movement rehabilitation in neurological conditions: how do we meet the needs and expectations of the users? Disability and Rehabilitation; 34: 1880-1886.
- Michielsen M, Selles R, van der Geest J, Eckhardt M, Yavuzer G, Stam H, Smits M, Ribbers G, Bussmann J (2011) Motor Recovery and Cortical Reorganization after Mirror Therapy in Chronic Stroke Patients: A Phase II Randomized Controlled Trial. Neurorehabilitation & Neural Repair; 25: 223-233.
Albert Carrere
The Corridor Clinic, Spain
Title: Running as a lower limb injuries prevention
Time : 11:30-11:55
Biography:
Albert Carrere is an expert in the prevention and treatment of running injuries and has been trained specifically to acquire a great command of techniques to diagnose and treat runners. He currently runs his own clinic and take care of elite runners who competes internationally. He is co-responsible for La Clínica Del Corredor in Spain and provides training for health professionals in this field. He has also participated as a speaker at the XII SETRADE Congress of Orthopedic Trauma and Surgery as an expert in the choice of footwear as a tool in the prevention of running injuries.
Abstract:
Physical activity has been associated with danger, recommending that visit a doctor before starting any physical activity program. Is physical activity or is inactivity more harmful? Running is a popular sport, practiced today by millions of people and within reach of all, but this activity is related to a high number of injuries being 80% of the runners injured per year the current figures. Why humans being injured with something he has done throughout his evolution and for which it is designed? The market and the brands have tried unsuccessfully to provide a solution to this large number of injured runners. However, they have not been able to reduce the incidence of injuries and have not even managed to improve their performance, based their recommendations on marketing rather than on the science. The main cause of the injuries of runners is a wrong Mechanical Stress Quantification, to prevent overuse injuries you have to adapt the mechanical stress progressively. The body adapts, provided that the applied stress does not exceed its adaptability. Based on this postulate, a sustained running program, with the appropriate recommendations, scientifically supported and free from commercial misrepresentation, will provide the benefits to maintain and/or improve the musculoskeletal health of lower limb and prevent pathologies of the locomotor system.
Lippert-Gruner M
Charles University, Czech Republic
Title: Implementation Of Early Rehabilitation Programs For Patients After Traumatic Brain Injury In Acute Care
Time : 11:55-12:20
Biography:
M. Lippert-Grüner, Department of Rehabilitation Medicine, First Faculty of Medicine, Charles University Prague and General Teaching Hospital in Prague, Czech
Republic
Abstract:
Introduction: The incidence of brain injury is high and result often in severe neurological impairment and functional disability with associated and sometimes catastrophic socio-economic consequences. Rehabilitation medicine is now challenged by patients who survive with severe complex deficits (sensorimotor, disorders of consciousness and neurocognitive as well as neurobehavioral) confirmed the importance of immediate rehabilitation following the injury and the importance of a rehabilitation continuum of care. Early rehabilitation programs can be implemented not only in rehabilitation hospitals, but also in acute care. Especially physiotherapeutical early mobilisation including bed cycling and other specialized therapy options is one of the main points in the therapy program.
The aim of the study is to show the implementation of early rehabilitation programs for patients after traumatic brain injury in acute care and to evaluate the outcome after 12 and 24 months.
Methods and Subjects: A total of 51 survivors (age 33. 8, range 16-64 years, m:f = 4 :1) of severe brain injury (GCS
Results: Data revealed a high level of independence in activities of daily living (mean Barthel Index after one year 92.7 points, after two years 93.7 points). After one and two years, 74.5% and 80.4% of the patients, respectively, were completely independent of need for care. Nevertheless, more than half of the patients had sensorimotor, behavioural, speech, visual and/or auditory disturbances. Return to work rates improved between one and two years after trauma, as evidenced by the rate of patients being back to full time work at one year (n= 14, 28%) and two years (n=20, 40%) post-STBI. Return to work rates improved between one and two years after trauma, as evidenced by the rate of patients being back to full time work at one year (n= 14, 28%) and two years (n=20, 40%) post-STBI; although, none of these changes reached statistical significance.
Discussion and conclusions: In summary the successful implementation of early rehabilitation programs for patients after traumatic brain injury in acute care is possible. Focussed on outcome, the data revealed a high level of independence in activities of daily living. There are still changes in both impairment and disability related areas between one and two years post-STBI, but the degree of improvement is variable depending on the area being considered. Clinicians should remain aware of the fact that modulation of impairment and disability appear to continue well beyond one year post-STBI which may impact on decisions regarding the provision and intensity of further rehabilitation efforts.
Jessica Immonen
Rocky Mountain University of Health, USA
Title: Osteoarthritis of the anterior cruciate ligament and the medial tibial plateau: Public health considerations from a cadaveric model
Time : 12:20-12:45
Biography:
Jessica Immonen has completed her BS in Biology at the University of Dayton, Ohio, Master’s degree in Anatomy and PhD in Anatomy at Pennsylvania State University’s, College of Medicine. She defended her dissertation on work in translational drug therapy for diabetic wound healing and presently, she is working as a Faculty at Rocky Mountain University of Health Professions in Provo, Utah. Her work on diabetic wound healing received the 2015 Best Clinical Paper Award from the Society of Experimental Biology and Medicine. Currently, she teaches courses in gross anatomy, neuroscience and physiology and serves as the Co-Chair of the Department of Anatomy and Physiology. Her primary research includes work on osteoarthritis of the knee using cadaveric models and earned her the 2017 Young Faculty Honorarium from the American Association of Anatomists.
Abstract:
Some at-risk populations for osteoarthritis (OA) have been identified yet the literature makes little suggestion regarding precise age of disease onset or preventative strategies to reduce risk for disease onset in various groups. In 2008, the American College of Rheumatology estimated that 37.4% of 60+ years old Americans are affected by knee OA. This analysis suggests that this is largely underestimated. Morphometric analyses of the articular cartilage of the tibial plateau were performed on cadaver specimens using Image ProÒ software on three age populations: <70 years old, 70-79 years old and ³80 years old. The articular cartilage of the medial tibial plateau in ³80 years old specimens showed a 1.7-fold increase in surface area degeneration (mm2) compared to 70-79 years old specimens (P<0.05). This degradation was compared to donors’ reported histories. Data showed that by the 7th decade of life, when patients are in their 60s, articular cartilage degeneration on the tibial plateau had commenced in 100% of specimen. All donors that reported homemaker as an occupation displayed above average medial tibial plateau degeneration (32.33±24.85%) for their age group while simultaneously reporting pathologies in their clinical history that encourage a sedentary lifestyle. This assessment identifies an occupational class that should be aware of their propensity to develop disease while considering the concept that an appropriate BMI does not guarantee joint health. This assessment also identifies a more realistic time frame than previous public health advisory committees have produced regarding age of disease onset and initiation of preventative measures. It is recommended that strength training of the hip abductors and the musculature supporting the knee joint commence early in adult life to avoid valgus collapse and shearing at the knee joint, two of the most common biomechanical reasons for the initiation of pathologies such as OA.
Recent Publications
- Jessica Immonen, Chris Siefring and Luke Sanders (2017) Osteoarthritis of the Anterior Cruciate Ligament and the Medial Tibial Plateau: A Cadaveric Study. Cartilage; 1: 1947603517713817.
Juan Castellano
La Coruna University, Spain
Title: Title: L.A.F ( Location, Analysis and Facilitation): A new approach in physiotherapy in the management of mechanical dysfunctions
Time : 13:30-14:15
Biography:
Juan Castellano is an authority and leader of opinion in the prescription of exercise for health. He provide education to numerous institutions as Universities andhospitals, wellness centers and other health associations worldwide. He is a pioneer in the formal training of the prescription of exercise for health and Pilatesmethod in physiotherapy in Spain. His programs have been accredited by professional colleges of physiotherapy, universities and by the National Continued Training department of the Ministry of Health. He begun his pre-doctoral program initiating clinical trials on diabetes type II in 2009. His research focused on the exercise and life style for promoting health, specifically the biological mechanisms. Nowadays, actually he is studying how the different type of exercises promote brain health and the effects of resistance and endurance exercise in partial autophagy deficiency in mice. His current project study the mechanisms of the exerciseto promote health: circulating miRNA characterization and validation as epigenetic regulator of molecular response to exercise. (Start date: 01/01/2016; finish date: 31/12/2018)
Abstract:
Stability re-training targets both the local and global stability systems. Activation of the local stability system to increase muscle
stiffness along with functional low-load integration in the neutral joint position controls segmental or articular give.
Global muscle retraining is required to correct multisegmental or myofascial dysfunction in terms of controlling the site and
direction of load that relates to provocation.
"L.A.F method (Location, Analysis, Facilitation), a new approach in physiotherapy for the management of mechanical
dysfunctions.
L.A.F solves dysfunctions with 3 steps (3 R System):
Rebalance by global active stretch
Reeducation by proprioceptive and corrective technics
Retraining by the right patterns of movement adapted to morphology and physical condition.
L.A.F applies precise forces through manual techniques and provides accuracy to the movement being very effective in the
physical condition recovery phase, in re-education and training for a high spectrum of populations. "
L.A.F ( Location, Analysis and Facilitation ). Is a pedagogic protocol that intend to align the right steps for the management of
mechanical dysfunctions using natural patterns of movement to analyze the reasons or causes of the loss of mobility or stability.
Our pedagogic method solves dysfunctions with 3 steps (3 R System): (1) Rebalance by global active stretch, (2) Reeducation
by proprioceptive and corrective technics, and (3) Retraining by the right patterns of movement adapted to morphology and
physical condition.
The pedagogic protocol is based on palpating bone references to analyze what happens during the integrated movement and to
know if there are lacks of stability or mobility in the arthrokinetic chain.
In the corrective phase, forces are applied to facilitate certain segmental patterns of movement with sufficient stability. This
system has an application to the clinic to avoid irritating the soft tissues before past traumatic episodes.
Martina Christine Steinboeck
Vivantes Humboldt Clinic, Germany
Title: The use of combined treatment procedures during cervical dystonia
Time : 14:15-15:00
Biography:
Martina Christine Steinboeck is currently working as a Physical Therapist in the neurological rehabilitation clinic Vivantes in Berlin, Germany, focused on state-of-the-art technology of gait rehabilitation and movement disorders.
Abstract:
Dystonia is characterized by a colorful picture of symptoms. However, the different forms of manifestation, as well as their treatment possibilities, are not sufficiently known. Cervical dystonia is the most prevalent type of dystonia and many patients face a lifetime of chronic disability despite repetitive Botulinum neurotoxin A (BoNT) injections. A synergistic effect of individualized physiotherapy adapted to this disease and the injection of BoNT within outpatient and inpatient neurological rehabilitation is not sufficiently researched. In this workshop the individual therapeutic areas will be explained in the form of a short overview followed by a chase study of a patient with torticollis. It is to assess if the results of the therapy show improvement within body functions and activities, as well as the Health related Quality of Life. From the obtained results from this case study, an improvement can be demonstrated after the combination of BoNT-injection and individualized therapy. It becomes clear that a good therapy success is possible only through the implementation of several different therapeutic procedures. This combination offers the patient an extended field of interventions to minimize their symptoms and improve their quality of life.
Silverio Di Rocca
M.P.R International School, Switzerland
Title: The stomatognathic system’s role in postural and physical rehabilitation
Time : 15:00-15:25
Biography:
Silverio Di Rocca has completed his graduation degree in Dentistry and post-graduation degree in Functional Orthopedics from University of Buenos Aires, Argentina. He has also received degree in Dentistry and Prosthetic at the University of Turin, Italy and Doctorate in Dentistry and Prosthetic at University of Turin, Italy. He is the Director of the MPR International School, Vice President International Representative and Founder of API Swiss (International Association of Posturology Switzerland). He is also a Professor in Amocoac Diplomate in Mexico and COMEI, College of Dentistry in Mexico, Associate Professor in ICOM (International College of Osteopathic Medicine) Milan, Italy and an International Honorary Member of AMOCOAC.
Abstract:
When dealing with chronic pain, the holistic approach in diagnosis and treatment is very important. We live in a time where super-specialization in medicine, leads professionals to be blind and unprepared in front of patients with problems that spread beyond their sectorized specialty. We seem to have forgotten that the human body is not made up of small sectors, but is one, indivisible whole. In the specific case of postural and physical rehabilitation, specialists are too often confronted with treatments that should work but somehow do not have lasting results, due to interferences from other parts of the body. In particular the stomatognathic system is a great disturber when a balanced mandibular position is lost. With the jaw being part of the muscle chains, through the hyoid system that connects it with the rest of the body, it is extremely important to have an understanding of this complex relation to obtain balanced and functional results, that are in harmony throughout the whole body.
Harish S Krishna
Malabar Medical College, India
Title: Metabolic reason for bone and joint pain: A clinical and radiology differential diagnosis perspective for physiotherapists
Time : 15:25:15:50
Biography:
Harish S Krishna has completed Bachelor of Physiotherapy, Masters in Musculoskeletal and Sports Physiotherapy. Currently, he is pursuing PhD in the area of osteopathic manual therapy in chronic lung diseases. He has 13 research papers and his main field of interest in research is podiatry. He has designed a couple of exercising machines for the correction of foot abnormalities and is in the process of achieving patency. He is the Chairperson of ethical committee for NITTE institute of physical therapy under NITTE University, Review committee member for Indian Journal of Physical Therapy. He is the chief instructor of SHARP INSIGHT-a research center in Mangalore formed by physiotherapists, Orthopedicians, Radiologists, Mechanical and Electrical engineers. He is a consultant on ergonomics, corrective exercises to various MNCs.
Abstract:
The first line physiotherapy diagnosis is to identify/rule out reasons/conditions which mimics bone and joint pain (global differential diagnosis), e.g., hematological, oncology, metabolic, immunological, etc. once ruled out the next level of diagnosis is to identify the pain producing anatomical structures (anatomical differential diagnosis), then search for the possible causes for its dysfunction. Among the vast spectrum of global differential diagnosing conditions, metabolic reasons are common to be seen, confusing to identify. The clinical part of the talk covers the clinical tips which helps in diagnosing metabolic bone/joint pain by understanding in depth of its nature, type behavior, etc. and its comparison with mechanical pain. The radiology part will be dealing with spine and extremity changes as seen in X-ray and MRI in cold orthopedic conditions as well post-operative ones which as a physiotherapist have to look out for a safe and quality treatment. The end-note of the talk consists of the recent evidence based physiotherapy management for metabolic pain.
Erika Van Der Mescht
Lymphoedema Association of South Africa, South Africa
Title: Educating patients and health care providers about how complete decongestive therapy (CDT) can help reduce the risk of developing severe lymphoedema
Time : 16:05-16:30
Biography:
Erika van der Mescht is a Physiotherapist (BPhysT) and certified Lymphoedema Therapist. She co-presents courses with the International Lymphoedema and Wound Care Institute and does various awareness talks about lymphoedema for BSN Medical. She also submits articles to be published in the local Physiotherapy magazine about lymphoedema on a monthly basis. Her expertise is in the field of lymphoedema diagnoses, management and education. She is passionate about reducing the risk of developing lymphoedema after trauma and educating patients and health care providers about warning signs and symptoms of what can become a very debilitating condition.
Abstract:
Lymphoedema is often overlooked as a manageable condition as it is not directly life-threatening or debilitation in the early stages. Or in many cases, it is wrongly diagnosed as merely a chronic edema. But chronic edema for 3 months or longer should be diagnosed as lymphoedema secondary to a specific cause: (1) Primary lymphoedema is rare and in many cases health care providers not referring for complete decongestive therapy is because of a lack of awareness about the possible treatment options. In the past 30 years, there has been a lot of research regarding lymphoedema management, of which all added to the development of complete decongestive therapy as the gold standard for lymphoedema treatment. (2) There has also been a randomized, single blinded, clinical trials’ proving that lymphoedema risk reduction protocols are successful. (3) Surgical studies have been done recently mostly showing good promise in reducing limb volume, but most of these studies are done in combination with complete decongestive therapy before, during or after surgery is performed. (4) Some studies have investigated the negative effect of lymphoedema on quality of life. (5) And even if only that is the objective of lymphoedema management, education for early referral and interventions for lymphoedema is vitally important. There are early studies using near-infrared fluorescence imaging, proving a visible effect on contractile lymphatic function after doing manual lymph drainage to create anastomoses to non-affected areas and (6) even though this has been clinically seen for many years. The goal of the session is to emphasize the importance of educating health care providers to diagnosing primary and secondary lymphoedema in the early stages of the condition in order to prevent debilitating, deformed limbs, which has detrimental effects on a patient’s health, work, social life and activities of daily living.
References
- Keast D H, Allen J O, Despatis M and Brassard A (2014) Chronic oedema/lymphoedema: Under-recognised and under-treated. Int Wound J; 12(3): 328-33.
- Lasinski M M, Thrift K M, Squire D, Austin M K, Smith K M, Wanchai A, Green J M, Stewart B R, Cormier J N, Armer J M (2012) A Systematic Review or the Evidence for Complete Decongestive Therapy in the treatment of Lymphedema from 2004 to 2011. PM R; 4(8): 580-601.
- Torres Lacomba M, et al. (2010) Effectiveness of early physiotherapy to prevent lymphoedema after surgery for breast cancer: randomized, single blinded, clinical trial. BMJ; 340.
- B B Lee, J Laredo and R Neville (2011) Current status of lymphatic reconstructive surgery for chronic lymphedema: It is still an uphill battle! Int J Angiol; 20(2): 73-80.
- Kim S J, Kwon C H, Yi O Y (2007) Effect of complex decongestive therapy and the quality of life in breast cancer patients with unilateral lymphedema. Lymphology; 40(3): 143-51.
Maria de Lourdes Oliveira Vilela Garcia
International Halliwick Association, Brazil
Title: Aquatic physiotherapeutic intervention on the balance of healthy elderly
Time : 16:30-16:55
Biography:
Maria de Lourdes Oliveira Vilela Garcia has graduated in Physiotherapy and is a Specialist in Aquatic Physiotherapy. She has received her Post-graduate in Aquatic Physiotherapy in Vallens-Switzerland and another Post graduation in Physiotherapy Applied in Neurology in Goiania, Brazil. She is a Member of IHA Executive Committee and International Instructor of the Halliwick Concept and Bad Ragaz Ring Method. She has also written an article on aquatic physiotherapeutic intervention on the balance of healthy elderly. Presently, she has been working in the area of aquatic physiotherapy, on rehabilitation and habilitation of neurological, orthopedic, rheumatologic, geriatric and cardiopulmonary patients.
Abstract:
This presentation deals with the fear of falling, which often afflicts the elderly and is related to the reduced functioning of their balance (the visual, vestibular, somatic and sensitive systems). These systems can be influenced by specific aquatic physiotherapeutic methods and can also benefit from immersion. This study aims to identify scientific works which prove the effects of aquatic physiotherapy in improving balance in healthy older people. It concludes that certain methods of aquatic physiotherapy, when adequately applied, are important in promoting a satisfactory response in these people`s balance.
Kern Rebello
New Horizons Child Development Centre, India
Title: Multidisciplinary intervention for a child with hearing loss and vestibular concerns
Time : 16:55-17:20
Biography:
Kern Rebello has completed Bachelors in Physiotherapy from Father Muller Medical College at Mangalore, India and Post-graduation in Health and Rehabilitation Sciences from University of Pittsburgh, USA.
Abstract:
Introduction: Children with congenital hearing loss have speech and language impairments. Profound hearing loss leads to vestibular dysfunction, which results in balance and co-ordination deficits. Thus, the child has difficulties in acquiring gross motor skills, which in turn limit her interaction with the outside world and acquisition of academic and life skills. We have documented the comprehensive evaluation of a child with hearing loss and vestibular concerns, under various disciplines within the same clinical setting and the successive interventions that the child received.
Case Report: A 12 year old girl with speech and hearing concerns was evaluated at a multidisciplinary child development center. MRI-cochlea and auditory evaluation indicated Mondini dysplasia with moderate to profound hearing loss in the left and right ear respectively. Developmental evaluations revealed balance and co-ordination deficits; gross and fine motor delay and sensory concerns. Academic evaluation indicated difficulties in reading, spelling, writing and comprehension. Psychological evaluation indicated moderate sub-normality in social and intellectual functioning, associated with behavioral concerns.
Intervention: Multidisciplinary intervention was implemented over 18 months. Hearing aids enabled the child to express her needs using single words and improve receptive and expressive vocabulary. Physiotherapy and occupational therapy improved depth perception, balance and attention span. Pre-academic skills improved significantly (e.g., shape, color and number recognition; phonemic awareness). Parental counseling and behavior modification techniques reduced tantrums and stubborn behavior.
Conclusion: Multidisciplinary intervention is incumbent for optimally reducing vestibular concerns associated with hearing loss. Functional improvement across multiple developmental domains is essential to improve quality of life.
Mahboob ur Rahman
Pakistan Physiotherapy Association, Pakistan
Title: The occurrence Of Osteoarthritis among the cases presented at Habib Physiotherapy complex Peshawar
Time : 17:20-17:45
Biography:
Mahboob ur Rahman is the Founder and Chairman of Habib Physiotherapy Complex, graduated in Physiotherapy from Karachi University, Pakistan. He is also the Founder of Mahboob School of Physiotherapy and was awarded with recommendation by Government of Pakistan by Quaid-e-Azam Gold Medal and King Abdullah Gold Medal. He has also been Member of Pakistan Bait ul Mal Khyber Pakhtunkhawa Province. Currently, he is also elected as the Chairman, Board of Directors and Pakistan Physiotherapy Association. His book Chest Physio for the War Wounded has been published by National Book Foundation, Islamabad.
Abstract:
Background & Aim: Physiotherapy is multi-dimensional and can treat a vast variety of conditions, ranging from musculoskeletal aches, arthritis, joints problems, paraplegia, hemiplegic, sports injuries and frozen shoulder, etc. apart from culture competency and core medical knowledge a physiotherapist must competent enough in all a physiotherapist medical condition where physical therapy play vital role, this study aims to identify the frequency of common clinical condition among client presented at Habib Physiotherapy Complex (HPC), Hayatabad in 2010.
Methodology: This was descriptive study; the data were retrieved from record register of HPC (Indoor and Outdoor patients) recording their presenting complains and known diagnoses. Data was collected on structure grid. Data was analyzed using SPSS version 15 and presented in term of frequency and percentages.
Result: Majority of clients, 1280 (29%) were suffering from low back pain, the second common condition, 891 (20%) was osteoarthritis of knee joint and cerebrovascular accidents 824 (18.4%), while cervical pain account 734 (16.4%). Rest of clinical conditions included frozen shoulder, pelvic inflammation, cerebral palsy, polio affected and paraplegia.
Conclusion: The study reveals the occurrence of osteoarthritis (low back, cervical pain and knee joints pain) were the most common condition which deteriorated the performance of common individuals in our society.
Harsh Agarwal
Indian Association of Physiotherapist, India
Title: Gait parameters across three attentional loading conditions during timed up and go test: A comparative study between age-matched healthy individuals and stroke survivors
Biography:
Harsh Agrawal has completed his Bachelors in Physiotherapy from Institute of Technology and Science in year 2012 and Masters in Neurology from the same institute in year 2014. He has a work experience with renowned Multispeciality NABH accredited Hospitals of India like Apollo Hospital, Delhi and Medanta Hospital, Gurgaon. He is a certified Manual Therapist and has done full time course from Indian Academy of Fitness Training. Presently he is working as a Senior Consultant at Portea Medical and Healers at Home and is a life time Member of IAP, MTFI and IAFT
Abstract:
BACKGROUND: The benefits of this study is that it may improve motor functions along with cognition and activity limitation which occurs with ageing. The results of the study can be used judiciously, in the management of motor function of old adults as well as stroke survivors.
PURPOSE:To determine the effects of attentional loading conditions Timed Up and Go Test on Gait Parameters in age-matched healthy older adults and stroke patients.
METHODS: A sample of 30 subjects was recruited and randomly assigned into 2 groups- Group1-experimental group including stroke survivors and Group 2-control group including age-matched healthy individuals . Both groups received attention demanding task ( Single task condition,Dual motor task condition and Dual cognitive task condition) along with Timed Up and Go Test.
RESULTS: Repeated measures analysis of variance(ANOVA) was used to analyze gait parameters across 3 attentional loading conditions(single,dual-motor,and dualcognitive task condition) between groups.A post hoc Bonferroni comparison was performed when the repeated measure ANOVA test revealed a significant difference(P<0.05).
TUG TIME comparison between group 1 and group 2 showing MEAN±SD of TUGS,TUGDT and TUGCB as 17.21±1.31 and 13.74±3.72, 18.52±1.40 and 13.68±0.91, 18.52±1.40 and 15.74±2.03 respectively. On comparison of Mean TUGS of group 1 and group 2 , ‘t’ value was 3.40 and ’p’ value was 0.002. Hence there was significant difference in Mean TUGS between group 1 and group 2. On comparison of Mean TUGDT of group 1 and group 2 , ‘t’ value was 11.14 and ’p’ value was 0.001. Hence there was significant difference in Mean TUGDT between group 1 and group 2.On comparison of Mean TUGCB of group 1 and group 2 , ‘t’ value was 4.34 and ’p’ value was 0.001. Hence there was significant difference in Mean TUGCB between group 1 and group 2. NUMBER OF STEPS comparison between group 1 and group 2 showing MEAN±SD of NSS,NSDT and NSCB as 15.26±1.94 and 13.33±1.44 , 15.26±1.94 and 14.00±1.36 ,15.86±1.76and 14.86±1.72 respectively.On comparison of Mean NSS of group 1 and group 2 , ‘t’ value was 3.08 and ’p’ value was 0.005. Hence there was significant difference in Mean NSS between group 1 and group 2. On comparison of Mean NSDT of group 1 and group 2 , ‘t’ value was 2.066 and ’p’ value was 0.048. Hence there was significant difference in Mean NSDT between group 1 and group 2.On comparison of Mean NSCB of group 1 and group 2 , ‘t’ value was 1.56 and ’p’ value was 0.128. Hence there was no significant difference in Mean NSCB between group 1 and group 2. WALKING VELOCITY comparison between group 1 and group 2 showing MEAN±SD of WVS, WVDT and WVCB as 35.13±2.55 and 49.40±5.56, 33.53±2.13 and 43.93±2.78, 32.53±2.26 and 38.53±4.71 respectively.On comparison of Mean WVS of group 1 and group 2 , ‘t’ value was 9.02 and ’p’ value was 0.001. Hence there was significant difference in Mean WVS between group 1 and group 2. On comparison of Mean WVDT of group 1 and group 2 , ‘t’ value was 11.46 and ’p’ value was 0.001. Hence there was significant difference in Mean WVDT between group 1 and group 2.On comparison of Mean WVCB of group 1and group 2 , ‘t’ value was 4.44 and ’p’ value was 0.001. Hence there was no significant difference in Mean WVCB between group 1 and group 2. CONCLUSION: In this study, we accept that there is significant difference in gait parameter during Timed Up and Go Test across three attentional loading conditions between age-matched healthy individuals and stroke patients.