Day 3 :
- Neurological Rehabilitation
Physiotherapy in Treatment & Care
Physiotherapy methods and Instrumentation
Session Introduction
Tripti R A Gyan
TG Physiotherapy Care, UK
Title: Creating professional resilience in physiotherapy practice
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 12 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:
There is a misconception that evidence based practice stymie creativity and innovation. Whilst 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 does not infer naivety. We must stay abreast of what is being researched whilst observing the best of practice; acknowledging that our shortcomings as a profession can be viewed as an opportunity to rise to the challenges they present, and developing strategies to improve upon them. New research and innovation require knowledge to be gathered, synthesized and applied with relevance to our patients. Creativity adds professional value via ‘thinking’ differently; ‘innovation’ brings market value by ‘doing’ differently. Both involve behavioural change in practice. This shift in traditionally structured thinking requires rigour and trust in the process to achieve the desired results. Any profession that is innovative and emotionally intelligent will thrive. Innovation strategies, therefore, need to be flexible and reactive to deal with the unexpected. This is where professional resilience and agility begin to have meaning. A collaborative, resilient profession that is forward-thinking will have longevity and achieve far more. To thrive, we need to embrace possibilities, not just probabilities; be informed by research, yet not be dictated by it. We can make forecasts, but we cannot be certain what the future holds. It is inevitable that new questions regarding the efficacy of physiotherapy treatment will always be asked, with new perspectives offered in light of research continuously emerging. We need to explore whether we can make our knowledge more relevant in the modern world and increase our market value in an industry where unpredictable external imperatives exist.
Laura Smith
University of Michigan-Flint, USA
Title: The future of health and rehabilitation: Interprofessional education & collaborative practice
Biography:
Laura Smith, PT, DPT, OCS, MTC, FAAOMPT is an Assistant Professor and Coordinator of the Orthopedic Post Professional Residency and Certificate Program at the University of Michigan-Flint. She has extensive national and international teaching and clinical experience. She is a Fellow of the American Academy of Orthopedic Manual Physical Therapists. She is completing her PhD in Adult Education with research interests in interprofessional education and orthopedic manual physical therapy. She is an active member of the American Physical Therapy Association and the American Academy of Orthopaedic Manual Physical Therapists.
Abstract:
A demand exists for the educational needs of health providers to enter the workforce and confidently meet healthcare needs in today’s culturally diverse, economically challenged society. A rising number of racial and ethnic minorities in the healthcare system and providing quality cost effective patient care has created challenges for health care providers. The proposed interventions to meet this societal need are interprofessional collaboration, interprofessional education (IPE), and collaborative teaching models. The goal of IPE is to provide an education for health care providers that will prepare them for working in a collaborative team environment to address the diverse health care needs of society. Interprofessional collaboration, IPE, and collaborative teaching practice models are of growing interest as a means of providing cost effective quality patient care. The general attitudes of faculty and students in health professions programs toward IPE are positive and well established in the literature. The overriding goal of IPE is to improve clients’ health through the education of a collaborative, practice-ready workforce that is responsive to local health needs. Collaborative practice, interprofessional education, and interprofessional teamwork will be presented and ideas for collaborative practice models will be presented. The presentation will improve knowledge and provide specific suggestions to improve the educational delivery methods in health and medical learning environments and emphasize need for interprofessional collaboration and vision for collaborative practice.
Yuri Yoshida
University of Evansville, USA
Title: Is outpatient physical therapy after total knee arthroplasty clinically effective?
Biography:
Yuri Yoshida has completed her PhD degree from University of Delaware and Postdoctoral studies from University of Utah. She is an Assistant Professor at University of Evansville. She is currently investigating a new gait training with utilizing eccentric contraction of quadriceps for individuals after knee replacements. Yy25@evansville.edu
Abstract:
An NIH consensus statement identified a void in our understanding of the usefulness of outpatient physical therapy following total knee arthroplasty (TKA) surgery. Evidence does exist that intensive quadriceps strengthening following the in-patient and home health phases can successfully improve physical function. Collectively however, it is still not clear whether outpatient physical therapy focusing on strengthening exercise improves physical functioning in patients after TKA. This lecture describes the differences in physical function and mobility in TKA recipients that suggests it is clinically useful to undergo outpatient physical therapy. A descriptive analysis of previously published studies showed outcomes with employing outpatient physical therapy versus those studies where outpatient physical therapy was not employed reveals clinically important differences in physical function (SF-36pcs , Timed Up and Go, Stair Climbing Test, the six-minute Walk Test) 3, 6, and 12 months following surgery. After discuss the systematic review of TKA literature, a new innovative exercise protocols for individuals following TKA will be introduced. The new exercise is utilized characteristics of eccentric contraction for the quadriceps femoris, and it can successfully accelerate mobility level. Based on a successful clinical trial with using eccentric training equipment (i.e. eccentron), the author has investigating if the downhill walking exercise can provide the similar effect. The first results from a case study will be introduced in the lecture.
Biography:
Cristy Phillips is an Assistant Professor of Physical Therapy at Arkansas State University in Jonesboro, AR. She is also CEO of Kids and Company, LLC., a pediatric physical therapy provider. She has over 16 years of experience in working with individuals with neurological and cognitive impairment. Her main research interests pertain to how physical activity can be deployed to mitigate impairments associated with neurodevelopmental and neurodegenerative disorders, particularly Down syndrome and Alzheimer's disease. cphillips@astate.edu
Abstract:
A wealth of evidence suggests that regular physical activity (PA) promotes neural mechanisms requisite for the maintenance of cognition in aging persons at risk for Alzheimer’s disease (AD). Preclinical and clinical studies demonstrate that PA can be deployed to optimize synaptic number and function, neurogenesis, neurotrophin levels, and circadian rhythm while simultaneously mitigating processes involved in plaque and neurofibrillary tangle formation. Nevertheless, more than one-third of the world adult population fails to meet recommended activity guidelines. Given that many of the pathological features of AD precede cognitive decline by decades, ample time exists to harness these health-related benefits. In this session, we will discuss the protocols previously used to alter the progression of AD-related neuropathology before highlighting current implications for physical therapist practice.
Biography:
Abstract:
Relevance: OA knee is one of the most common conditions leading functional disabilities seen worldwide. Clinically, it is characterized by pain, tenderness, functional limitation, crepitus, occasional effusion, swelling of the joint, weakness and atrophy of the muscles. There are different methods to manage osteoarthritis, conservatively, and/or surgically. Physiotherapy treatment, as a part of conservative management, involves reduction of pain, improvement of muscle strength and improvement of functional ability by various approaches like exercise therapy, electrotherapy and manual therapy techniques. Quadriceps muscle weakness is one of the main features seen in OA knee. Russian current stimulation has been successfully used to increase muscle strength in healthy athletes but its effect on quadriceps muscle strength in OA knee has not been studied. Hence the present study was undertaken to know the effect of Russian current stimulation on quadriceps muscle strength in patients with primary OA knee. Purpose: The purpose of study was to determine the effects of Russian Current stimulation on quadriceps muscle strength and function of the knee in subjects with primary osteoarthritis (OA) of knee. Participants: 30 subjects (mean age 50.25±6.35 years) diagnosed with primary OA knee were recruited from Out-Patient Department of Physiotherapy of KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum. Method: Subjects were randomly allocated into 2 groups namely Group A (n=15) who received Short Wave Diathermy (SWD) and exercises and Group B (n=15) who received SWD, exercises and Russian current stimulation for 10 days. The outcome measures were Visual Analog Scale (VAS) for pain, muscle strength by using Hand-held dynamometer, and WOMAC osteoarthritis index for functional disability. Analysis: Within group and between groups, analysis after intervention was done to assess changes using paired t-test and unpaired t-tests. Result: The VAS scores for group A reduced from 6.8±1.49 (baseline) to1.4±0.91 (post-intervention) and for group B from 6.3±1.29 (baseline) to 1±1.14 (post-intervention). The WOMAC score of group A decreased from 59.7±11.56 (baseline) to 24.1±6.01 (post-intervention) and of group B decreased from 50.4±22.30 (baseline) to 12.5±7.54 (post-intervention). The muscle strength of group A increased from 7.9±0.94 (baseline) to 8.6±0.95 (post-intervention) and of group B it increased from 8.3±0.67 (baseline) to 10.6±0.89 (post-intervention). Group B showed better improvement in muscle strength and function than group A. The intra group and between group comparison was statistically significant with p=<0.001 for both the groups. Conclusion: Russian current stimulation is effective in increasing quadriceps muscle strength and secondarily improving the functional ability in subjects with primary OA knee. Implications: Russian current stimulation can be added in the management protocol of OA knee along with conventional therapy for reducing pain, increasing quadriceps muscle strength and improving function of the knee.
Olufunke Adewumi Ajiboye
Lagos University Teaching Hospital, Nigeria
Title: Beneficial effects of therapeutic exercise training in the management of individuals with bi-ventricular heart failure
Biography:
Olufunke Adewumi Ajiboye obtained her BSc in Physiotherapy from University of Ibadan in 1988. After a compulsory one year national youth service, she opted for a clinical job with Specialist Hospital Yola. She eventually moved to Lagos University Teaching Hospital (LUTH) as a clinician in 1997 and climbed steadily through the ranks to her present position of Deputy Director Physiotherapy Services. Though an accomplished clinician, she went back to school and obtained her MSc and PhD in Physiology from University of Lagos, Nigeria in 2002 and 2014 respectively. A clinician per excellence and a researcher, she has published more than 13 papers in peer reviewed journals of international standard and presented her research outcomes in more than 10 conferences both at national and international level. Many of her research outcomes had won awards both at national and international level. Recently she was conferred with Fellowship Award from National Postgraduate Physiotherapy College of Nigeria
Abstract:
The hallmarks of chronic heart failure are fatigue, breathlessness and exercise intolerance leading to impaired quality of life and capacity for activities of daily living. Exercise training (ET) has been recommended as an adjunctive therapy but ET role in CHF has not been explored in Nigeria. The aim of this study was therefore to investigate the role of ET in the management of Nigerians with bi-ventricular heart failure (BVF). Sixty six Nigerians with mean age 54.1±1.6 years, in New York Heart Association functional class II and III, recruited from Cardiology Unit of Lagos University Teaching Hospital Nigeria with BVF participated in the study. They were consecutively randomized into exercise group (EG) and control group (CG). They were monitored on their drug therapy and went through education /counselling sessions. Subjects in the EG, performed 12 weeks aerobic and resistance ET three times weekly. Assessment of functional walking capacity and muscle strength was carried out pre and post ET. Data was analyzed using the SPSS Package version 17 and presented using descriptive statistics of mean±SEM. Paired t test and Independent t test were used to compare pre and post test variables within and between the groups. Level of significance was set at p<0.05. A significant improvement was observed in all components of functional walking capacity and muscle strength (p<0.001) in EG while no significant improvement was observed in CG. Supervised and structured exercise training is safe and beneficial for patients with BVF.
Diana Veneri
University of Hartford,USA
Title: Does combining body weight support treadmill training with Thera-Band® improve hemiparetic gait? A case report
Biography:
Diana Veneri is an Associate Professor at the University of Hartford, teaching the adult neurologic rehabilitation content. She earned her Neurology Clinical Specialist credentials in 2008 and is currently serving as a Clinical Content Expert for the Specialization Academy of Clinical Experts (SACE). She earned her EdD from the University of Hartford. She has been a physical therapist since 1986. veneri@hartford.edu
Abstract:
The purpose of this single subject case report was to explore the use of Thera-Band® Elastic Band in combination with body weight support treadmill training during locomotor training of a person with chronic stroke. Inclusion and exclusion criteria were established and Institutional Review Board approvals were obtained. During training, the Thera-Band® was configured around the subject’s hemiparetic leg in a figure-8 fashion and attached to the harness of the body weight support; its purpose was to assist with hip, knee and ankle dorsiflexion during swing and proper foot placement during stance, avoiding excessive inversion. The protocol consisted of three, ten-minute intervals with five-minute rest periods in between, three times per week for a total of ten weeks. Outcome measures included fast gait speed, spatiotemporal variables of gait, endurance and ankle eversion strength. Data collection occurred at baseline, weeks five and ten and six weeks post intervention. All 90 training trials were completed. Mean gait speed increased from .625m/s at baseline to 1.10m/s at week sixteen. Gait distance increased from 191m at baseline to 367m at week 16; ankle eversion strength increased from 4.67±0.45 to 5.90±0.59 force/Kg. GAITRite data demonstrated a more symmetrical gait pattern, with a more equal step length and stance time when comparing left and right limbs, and an increased stride length bilaterally. The results of this case report demonstrated significant improvement in the fast walking speed, gait endurance, gait symmetry and spatiotemporal gait variables and ankle eversion strength. Several limitations and suggestions for further research were identified.
Umasankar Mohanty
Manual Therapy Foundation of India, India
Title: Manual therapy for mechanical low back pain: Unraveling the mechanical enigma
Biography:
Umasankar Mohanty, BPT (Hons), MPT (Manual Therapy), SRP (London), MISEP, MIAP, FAGE, PhD is the founder and President of Manual Therapy Foundation of India®. He is the Elected President of The Indian Association of Physiotherapists. He has completed his Bachelor’s degree in Physiotherapy from premier Institute of India SVNIRTAR, Cuttack in 1998 and completed Masters in Manipulative Therapy from Manipal College of Allied Health Sciences, Manipal in 2001. He has completed his PhD from Mangalore University from the Dept of Physical Education and Sports in 2012. He has 32 publications in international reputed journals and magazines. He has one million visitors in You tube for his manual therapy videos. He is author of the book titled “Manual Therapy of the Pelvic Complex, A compendium of illustrated manual therapy techniques”. He is an international acclaimed Manual Therapy teacher and has trained 12,536 physiotherapists across the globe. He is PhD guide at Lovely Professional University, India. umasankar_mohanty@yahoo.co.in
Abstract:
The development of bipedal plantigrade progression is a purely human accomplishment. We share two-legged locomotion with some flightless birds, such as the ostrich, and an arched plantigrade foot with the bear. However, the orthograde position is exclusively human and permits us, literally, to view the world in an upright manner, although not always acting in an upright way. It is this orthograde position primarily responsible for the enigma called Low Back Pain. Eighty per cent of the population suffers a disabling episode of low back pain at least once during their lives and at any one time 35% will be suffering from low back pain. Manual Therapy Techniques are very useful for the treatment of Disc Prolapse, Facet Syndrome, Muscular Assymetry, Sacroiliac Joint involvement and Piriformis syndrome. In Disc prolapse for effective prognosis and treatment the centralisation phenomenon is very important. The useful techniques are 1) Manipulation Extension (Cyriax) 2) Dallison Technique for Lateral Shift Correction 3) Springing Technique. In Facet syndrome manipulation therapy is believed to solve the problem by separating the apposed articular cartilages and releasing the trapped apex. The sacroiliac joint (SIJ) has been implicated as the primary pain source in 10% to 25% of the patients with low back pain. The innominate dysfunctions (up slip, anterior rotation and out flare) give rise to SIJ pain. Correcting the position of innominate helps in amelioration of pain associated with the Sacroiliac Joint.
Bonni L. Kinne
Grand Valley State University, USA
Title: An Alternative Treatment Option for Anterior Canal Benign Paroxysmal Positional Vertigo
Biography:
Bonni received a bachelor’s degree in biomedical sciences at Western Michigan University in 1984, a master’s degree in exercise science at Western Michigan University in 1985, and a master’s degree in physical therapy at Grand Valley State University in 1994. In addition, she will be receiving her doctor of health sciences degree at A. T. Still University in December. She is an assistant professor in the department of physical therapy at Grand Valley State University. She has taught vestibular rehabilitation courses across the United States since 1996, and she has recently published a book chapter and five peer-reviewed research articles.
Abstract:
The purpose of this case report is to describe the treatment of anterior canal Benign Paroxysmal Positional Vertigo (BPPV) using a “reverse” Parnes particle repositioning maneuver. The participant was a 93-year-old female who was initially diagnosed with left-sided posterior canal BPPV and was treated with the Parnes particle repositioning maneuver. This technique was unsuccessful after two attempts. After the second attempt, she demonstrated downbeating right torsional nystagmus when she rolled over onto her left side. As a result, she was subsequently diagnosed with right-sided anterior canal BPPV. After the Kim, Shin, and Chung anterior canal BPPV technique was unsuccessful, a “reverse” Parnes particle repositioning maneuver was performed. Three days after she had been treated with this repositioning technique, the participant no longer reported any vertigo or functional problems. Three months later, these positive outcomes remained. Therefore, a “reverse” Parnes particle repositioning maneuver should be considered a viable alternative in the management of anterior canal BPPV.
EmÃdio Jorge Santos Lima
Salvador University, Brazil
Title: Respiratory rate as an important predictor of weaning from mechanical ventilation
Biography:
Emidio Jorge Santos Lima is a MD, Master in Computer Modeling and PhD in Knowledge Diffusion. He has developed clinical studies, in the last 9 years, on weaning from mechanical ventilation. He is Professor at University Salvador – Laureate International Universities Network and has published Book and papers in reputed journals. Recently he started, with The University of Paris – France, an international multicenter study on lung ultrasound score as one predictor of weaning from mechanical ventilation. emidio.lima@gmail.com
Abstract:
Background: There is not an ideal predictor of weaning from mechanical ventilation (MV). In a large meta-analysis, despite methodological limitation, respiratory rate (RR) was considered a promising predictor. I have published one study that evaluates RR as a predictor of weaning failure from MV in 2012. Methods: We prospectively evaluated 166 patients scheduled for weaning from MV. RR was compared with the following outcomes: weaning success/failure or extubation failure. Results: Weaning success was present in 76.5% and weaning failure in 17.5% of patients. There were 6% of reintubations. The predictive power for RR weaning failure, RR best cut-off point > 24 breaths per minute (bpm), was: sensitivity 100%, specificity 85%, and accuracy 88% (ROC curve, p<0.0001). Of the patients with weaning failure, 100% were identified by RR during screening (RR cut-off >24 bpm). There were 15% false positives, weaning successes with RR>24 bpm. Conclusion: RR was an effective predictor of weaning failure. The best cut-off point was RR >24 bpm, which differed from those reported in the literature (35 and 38 bpm). Only 6% of patients were reintubated, but RR or other weaning criteria did not identify them.
Ali Rafaqat
Comwave Institute of Sciences and Information Technology, Pakistan
Title: Effects of pulmonary rehabilitation on dyspnea in COPD patients
Biography:
Ali Rafaqat has completed his Bachelor of Physiotherapy from Jinnah Post Graduate Medical Centre Karachi University and Post Professional Doctor of Physiotherapy from Isra University, Islamabad Campus. He is the Director of Rehabilitation Sciences COMWAVE Institute of Sciences and IT
Abstract:
The purpose of this study is to determine the effects of pulmonary rehabilitation (treadmill training, stationary cycle) dyspnea in COPD patients. This was an experimental study. Sample was drawn on the basis of purposive convenient sampling technique. A structured questionnaire was used to gather the information. Sample was further sub-divided into two groups: experimental and control group. Experimental group was provided with pulmonary rehabilitation (treadmill training, stationary cycle and other respiratory exercises) and control group was only provided with breathing exercises. The descriptive analysis through frequency tables and cross tabulation is shown through the IBM SPSS statistics V 20.0. Results show that in the control group (COPD patients), 96% patients did not show any improvement while 4% patients showed improvement in 6 min walk test on tread mill after respiratory therapy by use of incentive spirometer. In the experimental group, 52% patients showed complete improvement in dyspnea on tread mill while 36% patients showed mild improvement in dyspnea on tread mill and 12% cannot complete 6 min walk test on tread mill because of dyspnea. From the results, it is concluded that pulmonary rehabilitation (treadmill training and stationary cycle) along with respiratory exercises is beneficial for the patients, as compared to respiratory exercises alone.