Day 2 :
- Disability and Management
Location: Texas C
- Occupational Therapy and Physical Rehabilitation
Location: Texas C
- Rehabilitation techniques
Location: Texas C
Chair
Philippines Cabahug
Kennedy Krieger Institute, USA
Co-Chair
Albert Recio
Kennedy Krieger Institute, USA
Session Introduction
Philippines Cabahug
Kennedy Krieger Institute
USA
Title: Activity-based restorative therapies: Successful innovations in neurorehabilitation
Time : 09:00-09:20
Biography:
Philippines Cabahug is a Physician in the paralysis restoration program at the International Center for Spinal Cord Injury (ICSCI) and Faculty Clinical Instructor within the Department of Physical Medicine and Rehabilitation at the Johns Hopkins University School of Medicine. Her professional honors include the Johns Hopkins Healer Award from the Johns Hopkins Department of Physical Medicine and Rehabilitation in 2010 and 2012 and the Frank L. Coulson, Jr. Award for Clinical Excellence in 2012. Her research interests include spasticity management and aging in spinal cord injury, and the use of vibration plates in spasticity management.
Abstract:
Traditional rehabilitation following spinal cord injury focuses on teaching compensatory techniques to enable the individual to perform daily activities despite significant neurologic deficits. Once thought to be irreparable, recent evidence has shown that the central nervous system is capable of plasticity, regeneration and recovery. Activity Based Restorative Therapies (ABRT) is a new fundamental approach to deficits induced following neurological paralysis. ABRT involves lifelong interventions based on the principle of activity-dependent neural plasticity. The goal is to drive changes in the nervous and muscular systems by repetitive activation of the neuromuscular system, both above and below the injury level using rehabilitation therapies. This optimizes the neurologic system and offsets the rapid aging, physical deterioration and secondary complications associated with SCI. It is characterized by high intensity practice, task specific and patterned activity above and below the level of the lesion. Key components include weight loading activities, Functional Electrical Stimulation (FES), neuromuscular electrical stimulation, locomotor training, massed practice and task-specific training. Though activity based interventions is not the cure for paralysis, it is important to note that it utilizes activity and physical exercise as tools for neurologic recovery rather than to merely achieve a compensatory function.
Albert Recio
Kennedy Krieger Institute
USA
Title: Use of a virtual reality ride-on sailing simulator as a rehabilitation tool for recreational sports and community integration
Time : 09:20-09:40
Biography:
Albert Recio is a physician in the paralysis restoration program at the International Center for Spinal Cord Injury (ICSCI), and the Medical Director for the Aquatics Medicine Program at Kennedy Krieger Institute. His research interests center on activity-based restoration therapies (ABRT). In an effort to provide patients with long-term spinal cord injuries or paralysis greater independence, his research evaluates the ability of ABRT to help patients recover neurological sensation and physical movement. His field of interest also includes electrical stimulation in the treatment of recalcitrant pressure wounds and the use of functional electrical stimulation (FES) to activate nerves innervating extremities affected by paralysis resulting from spinal cord injury (SCI).
Abstract:
This research is pilot study demonstrating use of a virtual therapeutic sailing simulator as an important part of rehabilitation. The main objective of this initial proof-of-principle trial is to develop a therapeutic sailing program for individuals with SCI using the VSail-Access system that will have measurable improvements on physical and psychological health.The subjects were asked to complete the Spinal Cord Injury Quality of Life Questionnaire (SCI QL-23) at the beginning and the end of training program. They engaged in a simulator sailing program once a week, 1-hour/session for 12 weeks.All subjects demonstrated a substantial improvement in their sailing scores and SCI QL-23 scores. Following completion of the simulator course, all subjects were able to successfully sail on the water demonstrating ability to perform sailing maneuvers (i.e. steering, gybing, etc.). Subjects reported that for the very first time they participated in a sports activity with their respective family members and experienced a sense of optimism about the future.For many individuals living with paralysis, participation in recreational sports may seem impossible or even unimportant. This study is one of the first to scientifically quantify the positive impact of therapeutic sailing following a spinal cord injury, including a significant increase in overall self-confidence and sense of accomplishment among participants. The Virtual Sailing VSail-Trainer is the first sailing simulator available for people with paralysis. Its stationary, motorized sailboat cockpit features specialized software that enables patients to navigate the boat around a virtual course in the same way as an actual sailboat in the water. Electronic sensors give the participant real-time feedback that matches their movements and allows them to control wind strength and water conditions.
Kristine M Hallisy
University of Wisconsin
USA
Title: Tai Chi- Meditative movement therapy as a biopsychosocial intervention for persistent pain: A clinical application
Time : 09:40-10:00
Biography:
Kristine M Hallisy, PT, DSc, OCS, CMPT is an Assistant Professor at the University of WI-Madison Doctor of Physical Therapy Program. Her teaching responsibilities include musculoskeletal course work, health promotion and wellness, orthotics and prosthetics. She received a Bachelor of Science degree in Physical Therapy from the University of Wisconsin-Madison (1984), a Master of Science in Kinesiology from the University of Michigan-Ann Arbor (1992) and a Doctorate of Science in Physical Therapy from Andrews University in Berrien Springs, Michigan (2011). Her clinical appointment includes patient care at University Health Services (student health) and professional staff development at UW-Health Princeton Club East Outpatient PT Clinic. She serves as a faculty member, instructor and Director of Mentoring for the Post-Professional Orthopaedic Clinical Residency Program offered at the UW-Health and Meriter hospitals. She provides service to the Wisconsin Physical Therapy Association (WPTA) as a member of the WPTA Board of Directors, Co-Chair of the Health Promotion and Wellness Committee and special liaison to the WPTA Continuing Education Committee.
Abstract:
Background: Persistent pain is a complex biopsychosocial condition that despite research efforts and innovative interventions remains a prevalent, disabling and costly challenge. It exacts a significant health burden in regards to quality of life costs (e.g. organic pathology and pain, psychological and psychosocial factors) as well as direct (medical) and indirect (economic workforce) costs. As such, management of persistent pain requires a 5-step psychologically-informed interprofessional collaborative approach to optimize management. Description: Meditative movement therapy (MMT), a new category of exercise, defined by: 1) some form of movement or body positioning, 2) a focus on breathing and 3) a calm state of mind with the goal of deep states of relaxation will be discussed as a physical therapy mind-body intervention for the management of persistent pain. Summary of Use: A clinical application of a specific form of MMT; a simplified version of Yang-style Tai Chi (Tai Chi Fundamentals Program3) will be described. Tai Chi mind-body principles and guidelines for Tai Chi practice will be outlined. Specific Tai Chi movement patterns and their therapeutic, biomechanical and functional implications for the management of persistent pain will be delineated. Importance to Audience: This medical model tai chi program was developed in collaboration with physical therapists and utilizes a neurodevelopmental progression, and as such, is accessible to clients of all ages and functional abilities. As a MMT, Tai Chi has been shown to convincingly positive evidence for fall prevention and improvement of psychological health, as well as associated health benefits for many chronic health conditions (e.g. musculoskeletal and neurologic conditions, cardiovascular health, bone density, muscle strength and pain). As a MMT, Tai Chi is one example of a broad range of self-management mindbody exercise programs that may be beneficial for persons with persistent pain.
Kischa S Reed
Florida A&M University
USA
Title: An assessment of bamboo as a potential low-cost material for exoskeleton design in normal walking
Time : 10:00-10:20
Biography:
Kischa S Reed is an Assistant Professor in the Division of Physical Therapy since 2012. She graduated with a BS degree in Physical Therapy at FAMU in 1998. She earned her Doctorate in 2011 from Utica College, NY. Prior to joining the Faculty, she held a variety of clinical and administrative positions. She served as a Leading Rehabilitation Consultant to many industry leaders in television and music. Her background is in the areas of manual therapy and spine rehabilitation. She is a Member of the Florida Physical Therapy Association‘s (FPTA) and serves as a Florida Assembly representative.
Abstract:
In spite of the great progress made in the design and implementation of exoskeleton-type walking assistive devices, there is room for further improvement, especially if the cost of these exoskeletons is to be reduced. Some of the methods that can be explored include finding alternative materials and/or addressing the issue of design. Considering that bonesetters have utilized bamboos in developing world for splinting fractures as a means of immobilization. In this study, a detailed analysis of the properties of bamboo was carried out which revealed that the material is lightweight, has good flexibility and high strength. These are requisite properties of the structural components of the exoskeleton-type walking assistive devices. Property comparison with the currently known low-cost duralumin material used in exoskeleton revealed that bamboo compares favorably well. A correlation between kinematics and kinetics of human walking as well as bamboo property is presented. An evaluation of lower extremity loading and energy expenditure was analyzed to further investigate the relationship between exoskeleton design, lower-limb loading capacity and energy expenditure encountered during dynamic ambulation.
Hikmat Hadoush
Jordan University of Sciences & Technology
Jordan
Title: Optimization of mirror therapy to excite ipsilateral primary motor cortex
Time : 13:25-13:45
Biography:
Hikmat Hadoush graduated from Jordan University of Science and Technology (JUST) with BSc degree in PT. After almost two years of being PT Therapist and Teaching Assistant in JUST, he left to Japan to start his professional and academic journey. There, he did MSc in Locomotor and Neurological Rehabilitation and PhD in Neurological Rehabilitation focusing in cortical plasticity in response to various neurological conditions and neurological rehabilitation approaches. The journey ended and he returned again to JUST as Assistant Professor, where he started his new journey in cortical stimulation therapy and in developing new approach of pediatric rehabilitation.
Abstract:
Mirror therapy is based on the experimental substrate of a visual illusion of active hand movement to excite ipsilateral primary motor cortex. This study tested whether ipsilateral primary motor cortex excitability could be modulated by enabling or disabling the vision of the active hand during mirror therapy. Motor cortical activations of healthy right-handed participants (n=10) were identified by Magnetoencephalography (MEG) system. Participants performed voluntary index finger extension of their dominant and non-dominant hands, separately, while viewing mirror reflection images of their active hand superimposed upon their hidden inactive hand. This was performed either with vision of the active hand (uncovered viewing condition) or without vision of the active hand (covered viewing condition). In the covered viewing condition, the ipsilateral primary motor cortex could be excited in all participants (n=10) and this excitation did not differ whether the active hand was the dominant or non-dominant hand. However, in the uncovered viewing condition, dominant and non-dominant hands were able to excite ipsilateral primary motor cortex only in a number of participants (n=4 and n=7, respectively). Moreover, the participants’ responses to the illusion validation questionnaire revealed that the covered viewing condition could cause greater visual illusion for the active hand than the uncovered viewing condition. In conclusion, disabling vision of the active hand during mirror therapy was more effective to excite ipsilateral primary motor cortical responses, it was better to create a greater visual illusion of the active hand, and it could ensure the same mirror therapy effectiveness between dominant and non-dominant hands.
Carolyn McMakin
Fibromyalgia and Myofascial Pain Center of Portland
USA
Title: Treatment of neuropathic pain by modulation of inflammatory mediators using specific frequencies and microamperage current
Time : 13:45-14:05
Biography:
Carolyn McMakin developed Frequency Specific Microcurrent (FSM) in 1996. She has a part-time clinical practice and does Clinical Research and Teaches FSM seminars in the US and abroad. She consults with and treats professional teams and elite athletes. She has lectured at the National Institutes of Health and at conferences on fibromyalgia and the differential diagnosis and treatment of chronic pain syndromes. She has authored seven peer-reviewed articles, four book chapters and two abstracts in the areas of chronic pain and differential diagnosis. Her textbook, “Frequency Specific Microcurrent in Pain Management” was published by Elsevier in 2010.
Abstract:
Neuropathic pain for which there is often no effective therapy is mediated by inflammatory cytokines IL-1, IL-6, TNF α and substance P. Microamperage current has been shown to increase ATP production by 500%. It is theorized that microcurrent stimulates membrane peptides and voltage gated ion channels causing them to reconfigure in the correct orientation to normalize cellular function. Treating neuropathic pain in fibromyalgia associated with spine trauma using microamperage current and one specific frequency combination reduced IL-1(330 to 80 pg/ml, p=0.004), Il-6(239 to 76 pg/ml, p=0.0008), TNF α (305 to 78, p=0.002) and substance P (180 to 54pg/ml, p=0.0001) and increased endorphins (8.2 to 71.1 pg/ml, p=0.003). Pain scores were reduced from an average of 7.3+/-1.2 to 1.3+/- 1.1 in 45 of 54 patients (P=0.0001). Studies have shown an association between induction of Cox-2 increased prostaglandin release and nociception.FSM demonstrated a reproducible, application time dependent and frequency specific 62% reduction in Lox and Cox inflammation in a mouse model controlled trial. A retrospective study of 20 neuropathic pain patients with a mean chronicity of 6.7 years showed reductions in pain from an average 6.8+/-1.8 to1.8+/-2.1(p<0.001). Frequency modulated microcurrent is low risk, cost effective and widely available making it a reasonable method for treatment of neuropathic pain.
- Pain and injury management
Location: Texas C
Chair
Philippines Cabahug
Kennedy Krieger Institute, USA
Co-Chair
Albert Recio
Kennedy Krieger Institute, USA
Session Introduction
Denise Jagroo
VA Hospital
USA
Title: Understanding and developing treatment strategies for pelvic pain syndromes
Time : 14:05-14:25
Biography:
Denise Jagroo earned her Doctoral Degree from NYU. She is also a Board Certified Clinical Specialist in Women’s Health Physical Therapy. Along with being certified in both Pelvic Physical Therapy and Manual Physical Therapy, she is the author of Your Best Pregnancy: The Ultimate Guide to Easing the Aches, Pains and Uncomfortable Side Effects DuringEach Stage of Your Pregnancy. She has lectured at several national conferences, teaches her own full day course and has her own private practice in NYC. She pioneered a pelvic clinic at the Manhattan Veterans Hospital and is a pelvic pain survivor.
Abstract:
There are many intertwined causes that may lead to pelvic pain. These causes include musculoskeletal, neural, visceral and hormonal factors among others. Common injuries often become compounded and chronic and begin to involve neighboring systems in the body. This lecture will delve into the anatomy of the pelvic structure as well as the overlapping symptoms, referred pain patterns and clinical presentations of pelvic pain syndromes. The common misdiagnoses, mistreatments and mistakes in managing these patients will be reviewed. Recommendations for clinical questioning of the patient, evidence based treatment strategies and proper management of the pelvic pain patient will be discussed. Specific conditions such as coccxydynia, pelvic floor syndromes and pudendal neuralgia will be discussed as well as influential neural processes such as central sensitization. This lecture will provide the attendees with practical application and a broader understanding of the complex pelvis.
Hilde Krans Schreuder
Bethesda Medical Center
The Netherlands
Title: Amputation for CRPS-I?
Time : 14:25-14:45
Biography:
Hilde Krans-Schreuder, MD, has completed her specialization as a physiatrist at the age of 29 years from University Medical Center Groningen and finished Medicine at the Erasmus University Rotterdam before. During her specialization, she did research on amputation for CRPS-I, which resulted in an article, published in J Bone Joint Surg Am. 2012 Dec 19;94(24):2263-8. She works as a physiatrist at Bethesda Medical Center, Hoogeveen, where a treatment program for patients with CRPS-I is implemented with good results: PEPT. This program was started due to the efforts of J.W. Ek, GP.
Abstract:
Between May 2000 and October 2008, 22 patients from the University Medical Center Groningen (The Netherlands) underwent amputation of a non-functional limb because of longstanding and therapy-resistant CRPS-Ι. A study was started to gain insight in consequences of an amputation on pain, participation in daily life activities, quality of life, use of prosthesis and risk of recurrence in patients with longstanding, therapy resistant Complex Regional Pain Syndrome type I (CRPS-Ι). All patients were interviewed through a semi-structured interview and underwent a physical examination. Main outcome measures were: Pain, perceived changes after amputation, participation in daily life activities, quality of life, use of prosthesis, recurrence of CRPS-I. Twenty patients (95%) reported an improvement of their lives. Nineteen patients (90%) reported a reduction in pain, 17 patients (81%) reported an improvement of mobility and 14 (67%) reported an improvement in sleep. Quality of life was rated as good by 14 patients. Reconsidering, 18 out of 21 patients would again choose to undergo an amputation. Ten of the 15 lower limb amputees and 1 of the 6 upper limb amputees regularly used a prosthesis. There was a recurrence of CRPS-Ι in the residual limb of 3 patients (14%) and (recurrence of) symptoms were reported in another limb for 2 patients (10%). Conclusions: Amputation may positively contribute to the lives of patients with longstanding, therapy-resistant CRPS-Ι. Use of a prosthesis is likely for lower limb amputees. Risk of recurrence of CRPS-I was 24%.
Jan-Willem Ek
Bethesda Medical Center
The Netherlands
Title: Pain exposure physical therapy may be a safe and effective treatment for longstanding complex regional pain syndrome type 1: a case series.
Time : 14:45-15:05
Biography:
J.W. Ek studied medicine at the Erasmus University of Rotterdam. In the same place he specialized as general practitioner. As well as general practitioner, he worked several years at the University of Amsterdam and Groningen as coach and teacher. After he was confronted by accident with a treatment that seemed successful for long lasting CRPS type 1, he studied this syndrome and got interested in pain, especially chronic pain, in general . This resulted in a publication (Clin Rehabil December 2009 vol. 23 no. 12 1059-1066) and a job at the rehabilitation department of the Bethesda Medical Center in Hoogeveen. Here he works with Drs Hilde Krans-Schreuder, who is also interested in CRPS type 1 and chronic pain.
Abstract:
Objective: To determine if treatment of longstanding complex regional pain syndrome type 1, focusing on functional improvement only while neglecting pain, results in clinical improvement of this syndrome. Design: Prospective description of a case series of 106 patients. Setting: Outpatient clinic for rehabilitation. Interventions: Physical therapy of the affected limb directed at a functional improvement only while neglecting the pain, was performed following an extensive explanation. Normal use of the limb between the treatments was encouraged despite pain. A maximum of five of these sessions were performed in three months. Measures: Radboud Skills Test was used to monitor functional improvement of the arms. Speed and walking distance was used as the measure of outcome for the legs. Results: The function of the affected arm or leg improved in 95 patients. Full functional recovery was experienced in 49 (46%) of them. A reduction in pain presented in 75 patients. In 23 patients functional recovery was reached despite an increase in pain. Four patients stopped early due to pain increase. Conclusions: Our results suggest that ‘pain exposure physical therapy’ is effective and safe for patients who are unresponsive to accepted standard therapies. Avoiding the use of a limb due to pain will result in loss of function. Forced usage of limbs restores the function, reverses these adaptive processes and leads to regain of control by practice with a reduction of pain in most cases. Discussion: Considering there is no evident therapy and the validity of the diagnosis is doubted , the results of this prospective case-series in combination with other results, raise some important questions about aetiology, diagnosis and treatment. (We did a follow-up study of which the results are very promising. A case study can illustrate the treatment)
Robert Weiss
Lymph Activist’s Site
USA
Title: Functional outcomes measurement in the absence of disability: The lymphedema example
Time : 15:05-15:25
Biography:
Robert Weiss is a retired aerospace systems engineer with a Master of Science degree from the University of California at Los Angeles. He has completed 80 hours of Dr. Vodder lymphedema therapy training, and is a graduate of the NLN LSAP Program, NBCC Project LEAD and Quality Care LEAD. He has co-authored a systematic review of manual therapy for breast cancer-related lymphedema for the Cochrane Collaboration. He is a member of the ALFP Steering Committee, is a PCORI Merit Reviewer and lectures at lymphedema conferences on incidence and prevalence of lymphedema, breast lymphedema, cost-efficacy of lymphedema treatment, and lymphedema insurance, reimbursement and legislation.
Abstract:
Background: Treatment of lymphedema falls mainly into the scope of practice of therapists. Unfortunately the measurement tools employed by therapists over the years have been developed to measure functional disability, and the goal of lymphedema treatment is to treat it in an early enough stage to prevent disability. Furthermore there are currently few lymphedema measures or outcome tools to measure midline lymphedema (breast, torso, genital, head and neck). Methods: We review new devices being evaluated that may be suitable for objective measurement of non-extremity lymphedema, such as lymphedema of the breast and chest, torso, head and neck and abdomen. We review status of protocols using skin thickness measurements by ultrasound and MRI, skin tissue water content using bio-impedance and dielectric constant instruments, and elasticity measurements. We discuss new questionaires that are being specifically designed for the subjective measurement of lymphedema in accordance with the ICF framework. These new instruments promise to be more sensitive to changes in lymphatic system function and severity than the currently utilized general measures of function and current specific measurement instruments. Results: We identify a number of promising new objective measurement devices for measurement of extremity and midline lymphedema severity, and we list promising new subjective measurement instruments with high sensitivity to changes in lymphedema severity even before it becomes disabling. Conclusions: With the inexorable advance of “pay for performance” replacing “pay for service” reimbursement it is of vital importance that new functional outcome measurement instruments be developed to support reimbursement for treatment of lymphedema.
Abdullah M Al-Shenqiti
Taibah University
Saudi Arabia
Title: The use of low intensity laser therapy in peripheral nerve regeneration: An updated critical review
Time : 16:00-16:20
Biography:
Dr. Abdullah Al-Shenqiti received his PhD from University of Manchester 2002, and his research had got FDA approval (2005) for the use of Low intensity laser therapy in the treatment of trigger points that are associated rotator cuff tendoinitis. He was also the director of Medical Rehabilitation Hospital in Madinah city, Saudi Arabia (2005-2012).He is currently a dean for the faculty of Medical Rehabilitation Science, and assistant professor in the School of Physical Therapy in University of Taibah, Madinah city in Saudi Arabia. He is also president of Saudi Physical Therapy Association (Western region branch).
Abstract:
Objectives: This review describes the possible factors that may have contributed to the variability of the results between studies that have assessed the effects of Low Intensity Laser Therapy (LILT) on peripheral nerve regeneration. Furthermore, it aims to make recommendations to overcome the methodological shortcomings identified. Methods: A comprehensive search of the literature using ‘peripheral nerve injury’, ‘laser therapy’, ‘phototherapy’, ‘nerve repair’ and ‘nerve regeneration’ was conducted via Medline, Embase, Cinahl and the Cochrane Controlled Trial Register followed by a hand search. In vitro, in vivo experimental studies and clinical trials were included. Results: 25 studies were critically reviewed and showed considerable variability in irradiation parameters, techniques, approaches, length of irradiation courses, experimental injury tools and procedures. Discussion: Many studies that have investigated the use of LILT in nerve regeneration produce positive results. However, the majority of these studies suffered from a number of shortcomings: No evidence of blinding and/or randomizing procedures, lack of specification of irradiation parameters, unspecified and/or inadequate tests in their experimental injury procedures, inappropriate irradiation parameters and/or poor experimental conditions. Conclusions: The results of the studies that investigated the use of LILT in nerve regeneration were variable. This was probably due to different irradiation parameters, techniques, approaches, length of irradiation courses and experimental injury procedures.
- Exercise and trauma
Location: Texas C
Chair
Ellen L Glickman
Kent State University, USA
Co-Chair
Rhonda L Haley
Wheeling Jesuit University, USA
Session Introduction
Rhonda L. Haley, Wheeling Jesuit University, USA
Wheeling Jesuit University
USA
Title: Physical therapy interventions, including student education, for individuals with chronic kidney disease receiving hemodialysis treatments
Biography:
Rhonda Haley is a Clinical Assistant Professor and Director of Clinical Education in the Doctor of Physical Therapy program at Wheeling Jesuit University in Wheeling, West Virginia, USA and a staff physical therapist for Wheeling Hospital. She is a Clinical Specialist in Geriatric Physical Therapy and a certified Athletic Trainer. Rhonda presented Cardiorespiratory Rehabilitation, an International Training Workshop, at Universidad Autonoma de Yucatan in Merida, Yucatan, Mexico, a concurrent session at the APTA Combined Sections National Conference in San Diego, California, USA, and a research paper roundtable discussion at the 5th International Symposium Service-Learning at Stellenbosch University, Stellenbosch, South Africa.
Abstract:
This educational session is designed to present the most current evidence supporting the benefits of physical therapy interventions for the individual receiving hemodialysis treatments and demonstrate a method to promote this awareness within a Doctor of Physical Therapy curriculum. It will also provide support for the provision of those physical therapy services while the individual is receiving the dialysis treatment. Current research supports physical activity for individuals with chronic kidney disease and describes the benefits of physical activity for these individuals. Physical therapists possess the skills and the tools to effectively prescribe, monitor and educate people with chronic kidney disease on safe physical activities. Diabetes mellitus, obesity, and impaired cardiovascular function are other conditions faced quite often by individuals with chronic renal disease that may result in a lowered quality of life. Physical therapists can become integral members of the medical teams caring for these individuals by providing interventions to increase the quality of life for that population. With the continued rise of this world-wide public health problem, education for current physical therapy students regarding hemodialysis and the role of physical therapists for those suffering from chronic kidney disease is imperative. This session will identify some key elements utilized by one university to educate students while providing a service during hemodialysis treatments.
Allen Marangoni
Wheeling Jesuit University
Wheeling Jesuit University
Title: Physical therapy interventions, including student education, for individuals with chronic kidney disease receiving hemodialysis treatments.
Time : 10:55-11:15
Biography:
Allen Marangoni, is a professor of physical therapy at Wheeling Jesuit University. Dr. Marangoni has been an active participant in service learning many years and has successfully coordinated programs through five different accreditation cycles using a system analysis approach. He earned an Ed.D. from Nova Southeastern University, a Master of Medical Science from Emory University School of Medicine, a B.S degree in Biology and degrees in Physical Therapy from West Virginia University and Wheeling Jesuit University.
Abstract:
This educational session is designed to present the most current evidence supporting the benefits of physical therapy interventions for the individual receiving hemodialysis treatments and demonstrate a method to promote this awareness within a Doctor of Physical Therapy curriculum. It will also provide support for the provision of those physical therapy services while the individual is receiving the dialysis treatment. Current research supports physical activity for individuals with chronic kidney disease and describes the benefits of physical activity for these individuals. Physical therapists possess the skills and the tools to effectively prescribe, monitor and educate people with chronic kidney disease on safe physical activities. Diabetes mellitus, obesity, and impaired cardiovascular function are other conditions faced quite often by individuals with chronic renal disease that may result in a lowered quality of life. Physical therapists can become integral members of the medical teams caring for these individuals by providing interventions to increase the quality of life for that population. With the continued rise of this world-wide public health problem, education for current physical therapy students regarding hemodialysis and the role of physical therapists for those suffering from chronic kidney disease is imperative. This session will identify some key elements utilized by one university to educate students while providing a service during hemodialysis treatments.
Biography:
Marie Vazquez Morgan earned a Bachelors of Science in Physical Therapy in 1993, a Masters in Health Sciences in 1997 from Louisiana State University Health Sciences Center in Shreveport, and her Doctorate in Health Studies from Texas Woman’s University in Denton, Texas in 2006. She has 19 years of clinical rehabilitation experience and has been a faculty member and Assistant Professor at Louisiana State University Health in Shreveport, School of Allied Health Professions since 1997. She has presented research both nationally, internationally, and regionally at continuing educations seminars. Her expertise is in neurological interventions as well as nutrition, wellness, lifestyle modification, and community rehabilitation and occupational health. She was recently featured in National Newsline Magazine for PT speaking on the role of cultural diversity in the physical therapy profession, and was honored in November 2006 by Maybelline NY as outstanding female educator of the year, and featured in People en Espanol December 2006 issue. She was also a recipient of the American Physical Therapy Association Minority Faculty Development National Scholarship in 2003.
Abstract:
Purpose: African Americans (AA) have higher prevalence and mortality rates of cardiovascular disease largely due to barriers in accessing health care and disease risk factors. The purpose of this pilot study was to identify risk factor status in rural AA residents of North Louisiana, who attended target churches and compare those findings with state, regional and national norms for the AA population. Setting/Participants: Sixty-three adults (16 men, 47 women) attending target churches in Northwest and Northeast Louisiana were recruited to participate in health screenings. Measures: Blood pressure, blood glucose, cholesterol, BMI, physical inactivity, smoking prevalence, and percent body fat. Analysis: Descriptive statistics were used to compare results to regional, state, and national norms. Results: The cohort displayed a higher prevalence of hypertension, diabetes, physical inactivity, and percent body fat in comparison to regional, state, and national norms. Conclusion: Results from this pilot screening demonstrate evidence of a trend of elevated health risks for development of cardiovascular disease in targeted group of AA adults. Findings indicate the need for further cultural specific wellness interventions including preventative screenings, to lower the health risks of developing chronic diseases in the AA population in Northern Louisiana. Identifying those at risk can lead to earlier diagnosis, and reduced morbidity and mortality.
Melissa K. Trovato
Kennedy Krieger Institute
USA
Title: Assistive technology to promote community integration
Time : 11:35-12:15
Biography:
Melissa Trovato, MD is board certified in Physical Medicine and Rehabilitation and Pediatric Rehabilitation Medicine. She is an Assistant Professor of Physical Medicine and Rehabilitation at the Johns Hopkins School of Medicine. She is Director of Inpatient Rehabilitation at the Kennedy Krieger Institute, where she has worked for 14 years.
Abstract:
Individuals with developmental disabilities frequently have communication needs and require the support of a Speech-Language Pathologist. A portion of these children and adults will also require use of Alternative and Augmentative Communication (AAC) devices to allow them to not only communicate their basic needs but to also improve social interaction at home and in their community setting. Furthermore, AAC devices often help support spoken speech and provide a model for speech production. Numerous devices are available ranging from low tech to cutting edge. Technological advances are yielding very few limitations to physical access of AAC devices at present and may include eye gaze, proximity switches, and use of key-guards. Selection of the appropriate device is crucial for successful use. An evaluation by a SLP familiar with AAC and devices is necessary to assess for appropriateness of use and device choice. Follow up visits for training and customization are necessary. Carryover of use in the home and school should be reinforced. Funding for devices varies by state, insurance company and school district. We will review several types of AAC including multiple modes of access. Additionally, we will discuss funding and basics for referral.
Lauren R C Tooley
Kennedy Krieger Institute
USA
Title: Assistive technology to promote community integration
Time : 11:35-12:15
Biography:
Lauren Tooley, MS, CCC-SLP is an ASHA certified Speech-Language Pathologist who has worked in the field for nine years. She is the Manager of the Assistive Technology Clinic at Kennedy Krieger Institute in Baltimore, MD. She conducts Assistive Technology Assessments for adults and children with developmental and acquired disabilities who may need assistance with environmental controls, augmentative and alternative communication devices, executive functioning, and written expression.
Abstract:
Individuals with developmental disabilities frequently have communication needs and require the support of a Speech-Language Pathologist. A portion of these children and adults will also require use of Alternative and Augmentative Communication (AAC) devices to allow them to not only communicate their basic needs but to also improve social interaction at home and in their community setting. Furthermore, AAC devices often help support spoken speech and provide a model for speech production. Numerous devices are available ranging from low tech to cutting edge. Technological advances are yielding very few limitations to physical access of AAC devices at present and may include eye gaze, proximity switches, and use of key-guards. Selection of the appropriate device is crucial for successful use. An evaluation by a SLP familiar with AAC and devices is necessary to assess for appropriateness of use and device choice. Follow up visits for training and customization are necessary. Carryover of use in the home and school should be reinforced. Funding for devices varies by state, insurance company and school district. We will review several types of AAC including multiple modes of access. Additionally, we will discuss funding and basics for referral.
Yvonne Eschke
Lymphologic med. Weiterbildung, Aschaffenburg
Germany
Title: Edemas caused by different kinds of angiological problems and their treatment
Biography:
Yvonne Eschke is staatlich geprüfte und staatlich anerkannte Physiotherapeutin since 1996. She completed the Fachschule für Physiotherapie, Wannseeschule e.V. in Berlin (Germany). In 2008 she completed the education for teacher of Manual Lymphatic Drainage/ CDT at Lymphologic med. Weiterbildung in Aschaffenburg and in Leipzig (Germany). Since 17 years she is working at Praxis Aue in Hamburg (Germany) and since seven years teaching in various cities in Germany and giving lectures and workshops in conferences in Brazil, Spain and Austria. Since November 2013 she is studying at Thim International Hogeschool voor Fysiotherapie in Utrecht (Netherlands).
Abstract:
In addition to the blood circulation the lymphatic system transports liquids from the interstitial tissue into the blood vessels and supports and backs up the veins in transporting liquids from peripheral to central regions. According to Starling's hypothesis there should be an equilibrium in microcirculation between filtration and reabsorption. But in orthostasis and in tissues like musculature and skin for example the reabsorption is entirely done by the initial lymphatic vessels. The liquids have to pass the lymphatics on their way to the veins (Schad 1996, 1998). This is another key function of the lymphatic system apart from the well known cardinal function of protein transport. The lymphatics have to compensate what the veins cannot cope (in physiologic as in pathologic situations). If this capacity is exceeded a swelling because of a high-volume insufficiency as well as a combined insufficiency appears in the tissue. In case of a combined insufficiency, stimulating the activity of the lymph vessels can therefore accelerate the healing of wounds and inflammatory processes which are accompanied by a protein rich edema. This acceleration is reached by CDT. Complex Decongestive Therapy combines manual lymphatic drainage with skin care, compression with decongestive lymphatic bandage and physical exercise. The Manual lymphatic drainage and compression is not only used to treat primary and secondary lymph edemas but also the wide spread edemas of inactivity and immobilization, the post surgery and post traumatic edemas even in sport physiotherapy, and the phlebological edemas. The possible results of therapy can be shown in several case reports. The description of the pathophysiology is followed by a demonstration of the very soft strokes of Manual lymphatic drainage (Vodder Method) and by the demonstration of the essential multi-layer
Ellen Glickman
Professor
Kent State University
Title: Effects of a long-term university exercise program on physical activity in previously sedentary individuals
Time : 17:30-17:50
Biography:
Dr. Ellen Glickman is a recognized expert in the area of environmental physiology with ~76 original, full-length papers in scientific journals, 3 technical reports and 1 Book Chapter. She is a Fellow of the American College of Sports Medicine, a reviewer for many of the top journals in her field, including Medicine in Science and Sport and Exercise, European Journal of Applied Physiology and Occupational Physiology and Aviation Space and Environmental Medicine. She has been an invited lecturer at numerous national (i.e., The American College of Sports Medicine, Wilderness Medical Society) and International Conferences (International Conference of Environmental Ergonomics (ICEE), Oxford University Roundtable, government research laboratories (i.e., Brooks AFB, US Army Research Institute Environmental Medicine USARIEM) and Universities. In 2001, The Wilderness Medical Society Awarded Dr. Glickman their Research Award for their Outstanding Scientist. Most recently, Dr. Glickman has partnered with Orbital Research Inc., (Cleveland, OH) a STEM initiative, to enhance our knowledge in the area of environmental physiology with technology to better understand human physiology. Dr. Glickman received her Ph.D. from the University of Pittsburgh from 1989 -1995. She was part of the Department of Kinesiology at Louisiana State University and had an environmental physiology laboratory at Pennington Biomedical Research Center. In 1995 Dr. Glickman joined the faculty at Kent State University and has continued her work in acute cold exposure. She started at USARIEM as a National Research Council Scientist and continues to serve as a contract employee with USARIEM as part of the Military Nutrition Division. Finally, Dr. Glickman has been Principal Investigator or Co-Investigator on numerous externally funded projects during her time at Kent State University. Dr. Glickman has served as Interim Associate Dean of Graduate Studies, at Kent State University.
Abstract:
Purpose: To explore the health-related and physical effects (via an accelerometer) of a 16-month group exercise program among previously sedentary individuals. Methods: 150 individuals were engaged in a faculty staff exercise program, however complete data is only available for the purpose of this analysis on 18 individuals. Therefore, we analyzed the data of 18 faculties and staff aged 52.9±6.2 years who participated in 16 months of supervised group exercise. These individuals participated in group exercise three times per week for 60 min. Participants self-selected into supervised exercise classes offered with an emphasis on aerobic fitness. Pre and post-testing variables measures included body weight, body fat percent, resting heart rate, curl-ups and sit-and-reach. Results: There was a significant decrease (p<0.001) in body weight from pre (89.4±19.4 kg) to post testing (87.4±1705 kg). Percent body fat revealed a significant decrease (p<0.001) from pre (37.5±6.8) to post (30.3±6.5). Resting heart rate demonstrated a significant decrease (p=0.011) from pre (76±11 bpm) to post (71±8 bpm). There was a significant improvement in the amount of curl-ups in one min (p=0.039) from pre (32.8±10.9) to post (44.8±20.5) test. There was a significant gain in flexibility measured by the sit-and-reach (p<0.001) from pre (24.0±9.8) to post (28.5±9.0) test. Of the 11 individuals that regularly wore the MOV band an average of 36.12 miles per week were recorded over the 16 month exercise program (n=11). Conclusion: Participation in the 16 month university group exercise program reduced body weight, percent body fat, and resting heart rate and improved the number of curl-ups and flexibility in previously sedentary individuals. Physical activity levels met the American College of Sports Medicine recommendations of 35 miles per week in the individuals that wore the MOV band. This investigation demonstrates that an on-site supervised exercise program among previously sedentary individuals is beneficial. Future research is needed to evaluate the long term effects of increasing the exercise duration and compliance in this population.
Caterina Abraham
Wheeling Jesuit University
USA
Title: Maternal and fetal benefits of regular exercise and physical activity during pregnancy
Time : 17:50-18:10
Biography:
Caterina Abraham is an Associate Clinical Professor in the Department of Physical Therapy at Wheeling Jesuit University. She has 20 years of physical therapy practice experience with the last 14 being in the academic setting. She earned a Bachelor’s Degree in Physical Therapy (1994) and a Master’s Degree in Public Health (2004) from West Virginia University. She earned her Doctor of Physical Therapy degree (2009) from Temple University. She has authored a chapter on pre-natal and post-partum exercise in the textbook titled: Clinical Pediatric Physical Therapy: From the NICU to Independent Living by Mark Drnach.
Abstract:
This session will present recent evidence supporting the benefits that an active lifestyle, including regular exercise and physical activity have on a woman and her child, both during gestation and after. An overview of the physiologic changes that occur in multiple systems during pregnancy will be presented along with instruction on safe exercises, parameters of exercise, body mechanics instruction and exercises to avoid during gestation and in the immediate post-partum period. Benefits such as assisting in maternal weight management, improved tolerance of the labor process, positive effects on fetal size and improved ability to recover from both vaginal and caesarian deliveries will be presented. Pelvic floor health will also be included in the discussion. The session will identify some of the common neuromusculoskeletal conditions (diastasis recti, diastasis symphysis pubis, etc.) that may occur as a result of fetal growth, a shifting uterine position during pregnancy, the delivery process and adjustments in the post-partum period. Suggested interventional strategies for these conditions will also be presented.
- Spinal Cord Injury
Location: Hilton San Antonio
- Pain and injury management
Location: Texas C
Chair
K Dean Reeves
University of Kansas, USA
Co-Chair
Kaydar M Al Chalabi
Neuro-Spinal Hospital, UAE
Session Introduction
Linqiu Zhou
Thomas Jefferson University
USA
Title: The Anatomy of Lumbar Dorsal Ramus Nerves and Its Significance in Lower Back Pain
Time : 09:00-09:20
Biography:
Dr. Zhou has received his bachelor degree of medicine and master degree in orthopaedic spinal surgery in China during the periods of 1979 to 1984 and 1987 to 1990. He completed an orthopaedic residency and spine fellowship in China before moving to the United States. He worked for several years as a visiting scholar at MCP Hahnemann University, before completing his second residency in Physical Medicine and Rehabilitation at the University of Pennsylvania. After that, he received his pain fellowship training at Thomas Jefferson University. He is board certified by the American Board of Physical Medicine and Rehabilitation, and is also board certified in Pain Management. Dr. Zhou has extensive experience in the basic and clinical research and with the diagnosis and treatment of spinal and musculoskeletal disorders, and various pain syndromes. His research has included cryoanalgesia, spinal dorsal ramus anatomy and clinical implication, cervicogenic headache, pudendal neuralgia. Dr. Zhou teaches in several medical universities as a professor, and has published more than 40 articles and chapters. He is serving as an editorial member of several journals and expert Reviewers for Journals like Neuromodulation. He also invented several medical devices and received numerous awards and honours.
Abstract:
This presentation will review the anatomy of the spinal dorsal ramus system and its implication of lower back pain, including clinical findings, pathogenesis and treatment. Each spinal dorsal ramus arises from the spinal nerve and then divides into a medial and lateral branch. The medial branch supplies the tissues from the midline to the zygapophysial joint line and innervates two to three adjacent zygapophysial joints and their related soft tissues. The lateral branch innervates the tissues lateral to the zygapophysial joint line. The clinical pain presentations follow these anatomic distributions, which can be used for localizing the involved dorsal ramus. The diagnosis can be confirmed by performing a single dorsal ramus block that results in relief of pain and muscle spasm. Etiologically, any factor that stimulates the spinal dorsal ramus can cause low back pain, which is distinct from zygapophysial joint syndrome. Clinically, L1 and L2 are the most common sites of dorsal rami involvement. Treatment includes spinal dorsal ramus injection therapy and percutaneous neurotomy. We will present our resent clinical study of lumbar vertebra compression fracture induced lower back pain and outcome of treatment. Summarily, irritation of the spinal dorsal ramus system is a potential source of low back pain. Based on the anatomy and clinical presentation, the involved spinal dorsal ramus can be localized and treated.
K Dean Reeves
University of Kansas
USA
Title: Groin pain: Structural or neurogenic? Changing treatment and research options
Time : 09:20-09:40
Biography:
K Dean Reeves, MD, is a leading Researcher in the field of regenerative injection and is currently focusing on research in chronic pain mechanisms and treatment. He is board certified in Physical Medicine and Rehabilitation and is on adjunct faculty (Clinical Associate Professor) at the University of Kansas. He is on the Board of Directors of the American Association of Orthopaedic Medicine and serves on the Institutional Review Board of the International Cellular Medicine Society.
Abstract:
Groin pain presents in several ways, one is typically sports related, also termed athletic pubalgia or misleadingly termed sports hernia. There is seldom any actual herniation, although inguinal canal asymmetries may be present. A variety of abnormalities can be seen on MRI in athletic pubalgia, and regenerative injection or surgical approaches appear to have a high degree of success in treatment. The challenging presentation of groin pain is chronic vulvar/ scrotal/ rectal/ general perineal burning pain in men or women. This complaint is common in the general population, although it is a diagnosis of exclusion after negative OB/GYN or GU evaluation for infections or chronic skin conditions. These patients commonly associate with pelvic floor dysfunction. Allodynia and/or hyperalgesia are common, indicative of neuropathic pain. Neurogenic pain symptoms are only partially remediable with medication approaches.
K M Al-Chalabi
Neuro-Spinal Hospital
UAE
Title: Spinal cord injuries in UAE: Retrospective, demographic & overview study of patients admitted & managed in Neuro-Spinal Hospital Dubai during last 12 years
Time : 14:05-14:25
Biography:
Dr.Kaydar M. Al-Chalabi is a physiatrist working in the Neuro-Spinal Hospital of Dubai, UAE. He is also a Specialist Physician In Physical Medicine ,Rheumatology And Rehabilitation in RMRC(Rheumatology, Rehabilitation Medicine And Physiotherapy Clinic) Dr. Chalabi used to be the CEO & Chairperson of JCI Accreditation Committee at Neuro-Spinal Hospital Dubai (2005 till 2011). In addition, he practiced as consultant physician and a general director of the Iraqi National Spinal Cord Injuries Center (NSCIC), 2003 till 2005. Dr. Chalabi has been actively involved in many national and international conferences both as a key speaker and an attendee.
Abstract:
Study Design: Retrospective Demographic Statistical Analysis & Overview of the Concept of Comprehensive Management & Rehabilitation in UAE. Settings: Neuro -Spinal Hospital /Dubai UAE Objectives: 1) Demographic Statistical Analysis of 232 patients (age, gender, nationality, etiology/nationality: UAE locals, Expats: Arabs & Non Arabs, levels & types of injuries, surgical & conservative managements). 2) Overview of quality, concepts, status of comprehensive care, management & rehabilitation In UAE. Patients: Spinal cord injured patients admitted in Neuro-Spinal Hospital during the period February 2003 till December 2014 was 232 patients. UAE locals were 114(49%), expats 118(51%). Males were 176(76%) and females 56(24%). Tetraplegia 66(28%), paraplegia 166(71.5%). Age: 153 (66%) are below 40 years. Etiology: RTA 135(58%), fall from heights 44 (19%), sport injuries 23 (10%), diseases 20 (8.5%). Surgical procedures (fixation, decompression laminectomy, excision, baclofen pumps, spinal cord stimulation, sacral roots stimulations, etc.) were done on 140 patients (60%) while the rest were admitted for conservative treatment. These figures are as per total number of the group, however for demographic purposes, they were subdivided into three main subgroups: UAE Locals, Arab Expats & Non Arab Expats just to show the variations between them as far as etiology, age, gender, level & types of injuries. For example RTAs among locals were 71%, while Arab expats 47 % & 44% in non Arab expats, and accordingly there are differences in the other variables. UAE is multinationality country and according to 2013 population census 88.5% are expats while locals constitute only 11.5%. On the other hand, in UAE there is huge construction works, all kinds of sport activities, high speed modern vehicles. In each kind of work, the domain is from certain countries and each of them has different interests, hobbies as per their culture, habits, religion, traditions etc. Concept & status of SCI management & Rehabilitation in UAE differs from other countries where there are holistic SCI centers, such are not available & for that reason it is very difficult to obtain national data or registry of such cases or incidence, adding to that patients usually receive their acute treatment and then disappear (return home) being unable to cover treatment costs & no insurance covers that for good. Even the local people, the government used to send them abroad to continue their treatment and rehabilitation after the initial acute management. Only we see them afterwards if there is complication or for certain procedures. Conclusions: In spite of all modern life facilities, services &high standard health care whether governmental or private which are afforded by local emirates or federal governments for all people, locals or residents, concept of SCI comprehensive care ,management & rehabilitation is still not coping with the international standards. No national data about incidence, impact & awareness of such issue can be obtained or retrieved & no SCI center per se neither in the capital/Abu Dhabi nor in the other emirates.
K Dean Reeves
University of Kansas
USA
Title: Results from multinational independent randomized controlled trials on practical, inexpensive and effective treatment of temporomandibular dysfunction
Time : 14:05-14:25
Biography:
K Dean Reeves, MD, is a leading researcher in the field of regenerative injection and is currently focusing on research in chronic pain mechanisms and treatment. He is board certified in Physical Medicine and Rehabilitation and is on adjunct faculty (Clinical Associate Professor) at the University of Kansas. He is on the Board of Directors of the American Association of Orthopaedic Medicine and serves on the Institutional Review Board of the International Cellular Medicine Society.
Abstract:
Longitudinal studies of subjects with temporomandibular dysfunction (TMD) show residual symptoms in many and nearly 25% have unabated symptoms. TMJ injection of dextrose without anesthetic had been noted empirically to have analgesic effect on local pain and to promptly reduce bruxism. A pilot study in Hong Kong demonstrated that simple intraarticular hypertonic dextrose injection using a 30 gauge needle was clinically and significantly more effective in the treatment of pain and dysfunction of TMD than intraarticular anesthetic injection. Hypertonic dextrose injection results in a brief stimulation of the inflammatory cascade, with resultant production of growth factors. However, non-inflammatory dextrose effects on growth factor production have been demonstrated, and more recently 5% dextrose has been found to treat neurogenic inflammation (pain from upregulation of the TRPV1 receptor on peptidergic nerves). The latter has the theoretical benefit of reducing pain, regardless of the status and position of the intraarticular cartilage or degree of degenerative change of the TMD. Following the pattern of the pilot study in Hong Kong, researchers in three separate countries, (China, Argentina and Canada), began adequately powered stand-alone RCTs. Each study compares one group receiving 0.2% lidocaine in hypertonic (20%) dextrose to a control group receiving 0.2% lidocaine in normal saline. Subjects are those with moderate to severe chronic facial pain and jaw dysfunction. The method is minimally uncomfortable and easily reproducible. Results from each site and their implications will be discussed.
Lisa Beck
Mayo Clinic
USA
Title: The Journey through Co-Existing Injuries: Spinal Cord and Brain Injury
Time : 14:25-14:45
Biography:
Lisa A. Beck MS, RN, CNS-BC, CRRN is an Assistant Professor of Nursing, College of Medicine Mayo Clinic. She is currently a Clinical Nurse Specialist in the Spinal Cord Injury Program at Mayo Clinic. She is a contributing author of “Mayo Clinic Guide to Living with Spinal Cord Injury”. Ms. Beck is the Past President of the Nursing Section and Secretary of the Governance Board for the Academy of Spinal Cord Injury Professionals. She is a member of the Steering Committee of the Consortium for Spinal Cord Medicine. She has presented and published a variety of topics related to SCI.
Abstract:
The co-occurrence of spinal cord injury (SCI) and traumatic brain injury (TBI) is common; however, the clinical ramifications are complex. Persons sustaining co-existing injuries are simply not the sum of two injuries, both SCI and TBI medical and psychosocial entities. Cognitive sequelae can hamper the acquisition of new knowledge and skills needed to regain functional independence and facilitate recovery. There is a paucity of specialized care for persons with co-existing injuries, thus a more robust understanding of the impact of TBI on SCI can assist the rehabilitation team, patient and family through the journey of recovery. This educational program will review the data and research on co-existing injuries regarding acute and rehabilitative care, functional outcomes and costs compared to persons sustaining SCI only. A case will be used to describe the effect of co-existing injuries on the patient/family system. Finally, a series of cases will be presented to outline the risks of secondary SCI complications. It is essential the rehabilitation team understand the implications of co-existing injuries. Program enhancement or specialized care is critically needed to improve rehabilitation outcomes and lifelong health and wellness of persons with co-existing injuries. Learning Objective 1: Identify trends and research outcomes of persons with co-existing injuries Learning Objective 2: Describe the effect of co-existing injuries on the patient/family system Learning Objective 3: Recognize additional risks for secondary complications in persons with co-existing injuries.
Oya Umit Yemisci
Baskent University
Turkey
Title: Low-level laser therapy- Does it affect hand function and quality of life in carpal tunnel syndrome?
Time : 14:45-15:05
Biography:
Oya Umit Yemisci, MD is an Associate Professor of Physical Medicine and Rehabilitation, and is currrently working at the Department of Physical Medicine and Rehabilitation, Baskent University Hospital, Ankara, Turkey. She is actively involved in education, residency training, research and clinical treatment at the inpatient rehabilitation hospital especially in the field of rehabilitation medicine including serebrovascular events and spinal cord injury. She is also currently performing electrodiagnosis and involved in research and residency training at the electroneuromyography (ENMG) laboratory.
Abstract:
Objective: To evaluate the effects of low-level laser therapy (LLLT) on clinical and electrophysiological parameters and health-related quality of life in patients with idiopathic carpal tunnel syndrome (CTS). Design: A prospective randomized, controlled clinical trial. Setting: Outpatient clinic of a university-affiliated hospital. Participants: A total of 98 hands of 52 female patients with a clinical and electrophysiological diagnosis of CTS were included in the study. Interventions: The patients were randomly assigned into two groups. Group 1 received 12 sessions of LLLT (670 nm, 4 J per session) over the carpal tunnel area for 4 weeks. Group 2 was given only neutral wrist splint. Patients in both groups were not permitted to receive any medical treatment or any other physical treatment for CTS during the study. Main Outcome Measures: Clinical assessment included the Tinel, Phalen and Buda tests, sensory evaluation, motor evaluation, hand grip and pinch grip strengths, Symptom Severity Scale, Functional Status Scale and levels of health-related quality of life were determined by using the Short Form-36. Electrophysiological test included nerve conduction studies and needle electromyography. Clinical evaluations of the patients included in the study were performed at the baseline, after the treatment and 3 months follow-up. Electrophysiological studies were performed before and 3 months after the treatment by the same physiatrist. Results: The hand-pinch grip strength, Functional Status Scale and Short Form-36 scores improved only in the LLLT group at post-treatment and at 3 months follow-up. Additionally, electrophysiological parameters showed significant improvement in the LLLT group. There was no statistically significant difference in terms of any other parameters between the two groups. Conclusions: These results suggest that LLLT may be a good conservative treatment method for CTS patients due to the improvement in clinical and electrophysiological parameters and quality of life.
Ä°lkin Mirzayev
Baskent University
Turkey
Title: Relationship between level of injury and urodynamic findings in spinal cord injury patients
Time : 15:25-15:45
Biography:
Ä°lkin Mirzayev, professor at Baskent University, Turkey. His research interests focuses on spinal cord injury.
Abstract:
Objective: To investigate the relationship between lesion level and urodynamic findings in spinal cord injury (SCI) patients. Materials and Methods: The medical records of 236 newly injured SCI patients admitted to our inpatient rehabilitation hospital were evaluated retrospectively and 131 patients who had urodynamic evaluation for neurogenic bladder were included in the study. Neurological levels of the patients were compared with the detrusor dysfunction as determined by urodynamic investigation. Results: There were 91 (69.5%) males and 40 (30.5%) females with a mean age of 39.1±15.17 years. The spinal cord lesion was cervical in 31(24%) patients, thoracal in 83 (63%) patients and lumbosacral (13%) in 17 patients. Forty-five percent (45%) of the patients with cervical cord injury, 32% of the patients with thoracal cord injury, and 29% of the patients with lumbosacral cord injury had detrusor hyperactivity. The ratios of low compliance bladders in the cervical, thoracic, and lumbosacral lesions were 58%, 54%, and 64%, respectively. There was no statistically significant relationship between detrusor hyperactivity or compliance and lesion level (p>0.05). According to the The American Spinal Injury Association Impairment Scale (AIS) classification, 83 (63%) patients had a complete lesion and 48 (37%) patients had an incomplete lesion. Hyperactive detrusor was determined in 31% of the patients with complete injury and 42% of the patients with incomplete injury. There were 45 (54%) bladders with low compliance in the complete lesion group and 29 (60%) bladders with low compliance in the incomplete lesion group. No statistically significant relationship was found between detrusor hyperactivity or compliance and AIS grade (p>0.05). Conclusion: We concluded that it not possible to determine the type of neurogenic bladder depending on the level and severity of lesion in SCI patients and urodynamic evaluations are essential for neurogenic bladder management in these patients.
Trent Jackman
Idaho State University
USA
Title: Exploratory Comparison of Students’ and Clinical Instructors’ Report of Frequency and Importance of Professional Behaviors
Time : 15:45-16:05
Biography:
Trent Jackman is a Clinical Associate Professor of Physical Therapy at Idaho State University. He is the Academic Coordinator of Clinical Education in the Physical Therapy Program.
Abstract:
Purpose: The purpose of this study was to explore the comparison of students’ and clinical instructors’ report of importance and frequency of professional behaviors during clinical education affiliations. Number of Subjects: 136 Materials/Methods: Using the clinical instructor characteristic statements developed by Emery & Wilkinson1, a survey was developed on Survey Monkey®. It contained the 43 statements about professional behaviors. The survey was sent to 142 clinical instructors (CIs) actively serving as CIs and to 118 students while on their various clinical affiliations. The CI was asked to self-report the importance of each behavior and the frequency with which she/he demonstrated the behavior using a 5 point Likkert scale. The student was also asked to report their belief of the importance of each behavior and the frequency with which the CI demonstrated the behavior on the same scale. Results: 60 CIs and 76 students completed and returned the survey resulting in a 42% and 64% return rate respectively. Characteristics rated the top in importance by the CIs included: point out student performance discrepancies, plans effective learning experiences, perceives self as extension of academic program, defines specific objectives for the experience. Characteristics rated the top in importance by the students included: CI points out performance discrepancies, CI is extension of academic program, CI demonstrates professional behavior, CI provides unique learning experiences, CI schedules regular meetings. Characteristics demonstrated with the highest frequency according to the CIs included: questioning/coaching in a way to facilitate student learning, providing a variety of patients, pointing out discrepancies in student performance, explaining the psychological basis of PT evaluation, making yourself understood. Characteristics the CI demonstrated with the highest frequency according to the students included: pointing out discrepancies in your performance, questioning/coaching in a way that facilitates learning, explaining psychological basis of PT evaluation, providing unique learning experiences, observing performance in a discreet manner. When comparing student and CI perceptions of frequency, both groups gave high frequency to pointing out discrepancies, coaching that facilitates learning, and explaining the psychological basis of PT evaluation. They differed when rating providing a variety of patients, providing unique learning experiences, observing performance in a discreet manner, CI consistent extension of PT program, CI manages time well. Conclusion: Both CIs and students report observing “pointing out discrepancies in student performance”, “coaching in a way that facilitates learning”, and “explaining the psychological basis of PT evaluation” with the highest frequency. Further research should be done to compare student and CI reports.
Tripti R A Gyan
Practice Manager NottinghamUK
Title: The evolving physiotherapist in a modern world
Time : 16:05-16:25
Biography:
Tripti R A Gyan completed her BSc (Hons) and MSc in Physiotherapy at Coventry University in the UK. She has over 19 years’ clinical experience including 13 years in Private Practice. She was a member of the Physiotherapy Team at the London 2012 Olympic Games, the 2014 Commonwealth Games in Scotland and is hoping to be part of the 2016 Medical Team at the Rio 2016 Olympics. She is committed to raising the profile of the Physiotherapy profession and enjoys collaborating with her international colleagues.
Abstract:
One of the principal responsibilities of a physiotherapist is to create the appropriate balance between managing a patient’s expectations and essential intervention. The concept of personalized care can be described as providing the right treatment for the right patient at the right time, ideally giving the best treatment for each individual patient. However, physiotherapy treatment must remain founded on the same evidence-based approach that has made effective intervention standardized. Having a flexible and open mind in our approach to treatment does not infer naivety or ignorance. It instead acknowledges that new questions regarding the efficacy of physiotherapy treatment will always be asked with new perspectives offered in light of new research continuously emerging. Assessment and treatment skills aside, if we want to support the empowerment of our patients for the rest of their lives, we need to have a genuine passion for helping people, an open but discerning mind and a commitment to self-development. We must of course stay abreast of what is being researched and observe the best of practice. Having a healthy skepticism to new research is not an excuse to be uninformed but can rather be viewed as an opportunity to rise to the challenges they present, instead of being dictated to. We must gather knowledge, synthesize it and apply it with relevance and confidence to our patients with the understanding that any new research is only a snapshot that it is part of a larger picture.
Mohamad Reza Nikoo
Hamadan university of medical science
Iran
Title: Effect of Cardiac Rehabilitation Program on Exercise Capacity in Women Undergoing Coronary Artery Bypass Graft in Hamadan-Iran
Time : 16:25-16:45
Biography:
Dr. Mohammad Reza Nikoo is currently working as an assistant professor of Physical Medicine and Rehabilitation department in the University of Social Welfare and Rehabilitation in Iran. He is an active member in Medical Council of Iran and Iranian Society of Physical Medicine and Rehabilitation. He has been an editorial board member of Iranian Rehabilitation Journal. His research interest includes electrodiagnostic medicine, cardiac rehabilitation and therapeutic exercise. He has published a number of articles and presented in a large number of International meetings.
Abstract:
Objectives: The purpose of this study was to determine the effects of cardiac rehabilitation program (CRP) on exercise capacity and rate pressure product (RPP) in Iranian female patients undergoing coronary artery bypass grafting (CABG) in Hamadan, Iran. Methods: Sixty women after CABG were assigned into an exercise group (n = 30, mean age 58.5 ± 10.8 years), who performed physical training for 12 weeks, or a control group (n = 30, mean age 59.3 ± 8.6 years) who received usual care. Functional capacity and RPP were evaluated by six minute walking test (6MWT) and exercise test. Results: In comparison to before training, significant increases of estimated exercise capacity (10.72 ± 1.30 vs. 7.72 ± 1.6 MET's,respectively) as well as 6MWT (556 ± 66.1 vs. 375.2 ± 28.1 meters, respectively) were observed in exercise group after 12 weeks training (P<0.001). Women increased their exercise duration time (464.6 ± 107.3 vs. 311.2 ± 101.7 seconds, respectively) by 49.2% and RPP (22361 ± 3206 vs. 20270 ± 2704.1, respectively) by 10.3% after training (P<0.001). However, no significant differences were found before and after CRP in the control group. Conclusions: Women referred for rehabilitation have similar levels of compliance and improvement in exercise capacity and supply of oxygen to cardiac muscles (measured by peak myocardial oxygen consumption). After CRP, women demonstrated significant improvements in exercise duration time, 6MWT, RPP and supply of oxygen to cardiac muscles. CRP can play an important role in improving functional independence in women.
Guadalupe Genis-Gonzalez
Fremont College School of Sports and Rehabilitation Therapy
USA
Title: RSM-Russian Sports Massage
Biography:
Guadalupe Genis-Gonzalez studied Massage Therapy in Ontario CA and became a Licensed Massage therapist in 2008. In 2010 she studied Russian Sports Massage therapy in San Diego CA and has completed her associate of science degree in sports and rehabilitation therapy, from Fremont College in Cerritos CA, where she was also a charter member of the Alpha Beta Kappa Honor Society. She has previous experience working with professional athletes and worked two seasons with the Los Angeles Sparks WNBA Team and where she also completed her Sports Medicine Internship. And is looking forward to making her special RSM techniques known through the world of Sports Medicine and Rehabilitation therapy.
Abstract:
Russian Sports Massage (RSM) is an advanced manual techniques for reducing pain due to Neuro-Muscular Dysfunctions and for maintaining and enhancing functional performance. It is very rare to find an MT who is certified to perform the therapy in California. Learning to work with athletes and witnessing their performance increase as a result of our educated touch is an inspiring, memorable experience. Russian sports massage is very strictly performed when using to help athletes trying to reaching Peak performance. For instance using, oil and a 14-16 inch bolster is key to this therapy. RSM can also be applied with any modality and be looked at as a therapeutic approach. Which is very unique as well, learning how to incorporate these techniques towards anyone who is suffering with Pain management and any unknown or undiagnosed pathology/ disease can be treated and get some comfort. RSM focuses on working with the Nervous System and while being performed the therapist works with the midlines of the body, the person receiving RSM should wait 2-4 hours after a meal, or 6 to 8 hours after working out to receive therapy. All Massage can be interrupt digestion and interfere with rehabilitation after a workout.