Day 1 :
Keynote Forum
Anand Shetty
University of St. Mary, USA
Keynote: Understanding the movement disorder associated with Parkinson’s disease and suggestions for therapeutic intervention: A theoretical model
Time : 09:00 AM-09:30 AM
Biography:
Anand Shetty is a Professor in the Department of Physical Therapy at the University of St. Mary. He is also the Co-Director of Research in the Department. Currently, he teaches Anatomy, Exercise Physiology and a series of research courses. He has received his Doctoral degree in Physical Education from the University of Northern Colorado. He has published and presented numerous articles on obesity and a frequent invited speaker on obesity and nutrition. He has more than 25 years of teaching and research experience.rnrnanand.shetty@yahoo.comrn
Abstract:
Currently there is no sufficient information how dopamine interacts at the basal ganglia and controls refining of movements for execution by the cerebral cortex. This paper will introduce the physiological and mechanical events that may happen due to lack of dopamine release by the substantia nigra and influence of subthalamic nuclei. This model may help therapy specialists to develop appropriate physical activities for a patient with Parkinson’s disease. A summary of several therapeutic activity models will be discussed. Basic anatomy, physiological events, mechanical events, and therapeutic approaches will be discussed to control rigidity, spasticity, initiation of movements, control of postural muscles, and improve balance of patient’s with Parkinson’s disease.
Keynote Forum
Areerat Suputtitada
Chulalongkorn University,King Chulalongkorn Memorial Hospital, Thailand
Keynote: Sensitization in myofascial pain syndrome
Time : 09:30 AM-10:00 AM
Biography:
Areerat Suputtitada, MD, is Professor of Physical and Rehabilitation Medicine. She is the Chairperson of Neurorehabilitation Research Unit at Chulalongkorn University and Chairperson of Excellent Center for Gait and Motion at King Chulalongkorn Memorial Hospital in Thailand. She was invited as international speaker for more than 60 times around the world. She received 18 international and national awards, and published more than 60 international and national articles in the areas of her expertise including neurological rehabilitation, spasticity and dystonia, gait and motion, and pain. She is an expert clinician in ESWT for various indications in the field of physical and rehabilitation medicine. She has been elected and appointed to important positions at ISPRM such as the Chair of Women and Health Task Force and the International Exchange Committee.rnrnsareerat1111@gmail.comrnprof.areerat@gmail.comrn
Abstract:
Sensitization in corresponding spinal segments plays a major role in the formation of continuous pain in a given part of the body. The term called by Professor Andrew A. Fischer for this phenomenon is “spinal segmental sensitization” (SSS). Chronic pain is contributed by sensitization of spinal nociceptive neurons, regardless of the original provoking events. SSS is a hyperactive state of the spinal cord caused by irritative foci sending nociceptive impulses from a sensitized damaged tissue to dorsal horn neurons. The clinical manifestation of dorsal horn sensitization includes hyperalgesia of the dermatome, pressure pain sensitivity of the sclerotome and myofascial trigger points within the myotomes, which are supplied by the sensitized spinal segment. In Myofascial pain syndrome (MPS) first described by Professor Janet G Travell and Professor David G Simons, active myofascial trigger points present lower pressure pain threshold when compared to people with no pain or the presence of only latent trigger points. There are significant elevated levels of substance P, calcitonin gene-related peptide (CGRP), bradykinin, tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β), serotonin, and norepinephrine in the vicinity of the active myofascial trigger point. Overall, pH was significantly lower in the active trigger point. Treatment rationale and techniques may evolve from this information, and should be taken into account when dealing with chronic patients with amplified pain responses. The mechanism consists of the nociceptive stimuli generated in the sensitized areas bombarding the dorsal horn of the spinal cord. This causes central nervous system sensitization with resultant hyperalgesia of the dermatome and sclerotome and spreads from the sensory component of the spinal segment to the anterior horn cells, which control the myotome within the territory of the SSS. The importance of SSS is emphasized by the fact that it is consistently associated with musculoskeletal pain. The development or amplified activity of MTrPs is one of the clinical manifestations of SSS. The segmental desensitization treatment consists of injection of local anesthetic agents in the involved dermatome to block the posterior branch of the dorsal spinal nerve along the involved paraspinal muscles. In addition, local anesthetic injection is applied peripherally near the foci of irritation in local soft tissue, directly into taut bands and trigger points, using a needling and infiltration technique. Stretching exercises, local heat application and additional transcutaneous electrical nerve stimulation (TENS) treatment complete the muscular relaxation after the injections. Extracorporeal shockwave therapy (ESWT) can also play a role in desensitization.
Keynote Forum
Umasankar Mohanty
Manual Therapy Foundation of India, India
Keynote: Manual therapy for cervicogenic headache
Time : 09:30 AM-10:00 AM
Biography:
Umasankar Mohanty is the Founder and President of Manual Therapy Foundation of India®. He has completed his Bachelor’s degree in Physiotherapy from premier Institute of India SVNIRTAR, Cuttack in 1998 and completed Master’s in Manipulative Therapy from Manipal College of Allied Health Sciences, Manipal in 2001. He has completed his PhD from Mangalore University from the Department of Physical Education and Sports in 2012. He has 35 publications in international reputed journals and magazines. He has one million visitors in youtube for his manual therapy videos. He is the author of the books titled “Manual Therapy of the Pelvic Complex, A compendium of illustrated manual therapy techniques” and “Manual Therapy of The Shoulder Complex”. He is an international acclaimed Manual Therapy Teacher and has trained 12,956 physiotherapists across the globe. He is a PhD guide at Lovely Professional University, India.rnumasankar_mohanty@yahoo.co.inrnrn
Abstract:
Cervicogenic headache (CEH) is a unilateral headache localized in the neck or occipital region, projecting to the frontal and temporal regions. The cervicogenic headache accounts for up to 20% of all headaches. Sjaastad et al. were the first to give its current name in 1998. The diagnostic criteria for cervicogenic headache as outlined by Sjaastad et al. (1998) and the International Headache Society (2000) are principally based on subjective characteristics. The pain is triggered by active neck movement, passive neck positioning, extension or extension with rotation toward the side of pain, or on applying digital pressure to the involved facet regions or over the ipsilateral greater occipital nerve. Diagnostic imaging such as radiography, magnetic resonance imaging (MRI), and CT are normal. The structures with possibilities which give rise to the cervicogenic headaches are the upper cervical nerves (greater and lesser occipital nerves), nerve roots, cervical muscles, cervical discs and zygapophyseal (facet) joints, occipito-atlantal, atlantoaxial, middle cervical and lower cervical area. The functional convergence of upper cervical and trigeminal (trigeminal nucleus caudalis) sensory pathways allows the bidirectional referral of painful sensations between the neck and trigeminal sensory receptive fields of the face and head. Manual therapy techniques comprising of cranial base release, cervical A-P glide, lateral P-A glide, transverse glide, high velocity low amplitude thrust techniques (HVLAT) and muscle energy techniques for suboccipitals are found to be extremely useful for the treatment of cervicogenic headache.
- Physiotherapy Specializations
Sports & Physiotherapy
Advancements in Physiotherapeutic treatments
Session Introduction
Craig Smith
Club Physio Group, Southern Africa
Title: Dry needling for myofascial trigger points
Biography:
Craig qualified from the University of Cape Town with a BSc Physio and a BSc Sports Science in 1989. His first professional sports physo iposition was as physio to the touring rebel England cricket team to South Africa in 1990 (Mike Gatting was captain), He then joined the South African cricket team from 1991 - 2002 as the lead team physio. In 2003-2010 Craig worked in county cricket in the UK with Lancashire, Nottingham (2004-2009) and as a consultant physio with Hampshire in 2010. In 2003 he start Club Physio, a seminar and courses facilitating company that now runs and facilitates physio, sports medicine and manual therapy course in Southern Africa, the UK, Ireland, Europe, India, Asia and the Middle East and the USA. Craig lives in Cape Town South Africa and Nottingham also travels extensively, enjoys golf, surfing, running and yoga. craigthephysio@gmail.com
Abstract:
Myofascial Trigger Points have been one of the most commonly overlooked causes of both acute and chronic pain. Today, evidence shows that myofascial pain may often be the primary cause of pain and dysfunction. This workshop presentation highlights recent studies in MTrP including the neurophysiology and pathology and will demonstrate the technique of de-activation of trigger point areas using dry needling with acupuncture needles. The practical demonstration of superficial and deep dry needing will also focus on needle safety and cleanliness, the effects of needling muscle, fascia and connective tissue and specifies about needling different muscles and areas of the body. This workshop is mainly but not restricted to therapists for whom dry needling is in their scope of practice.
Biography:
Cristian F Reich has completed his PT studies from University of Buenos Aires and he holds a chair in the University of Buenos Aires, Medicine School. He is the main Professor of Electrotherapy since 1996. He is an expert in thermal waters, Manual Therapeutic in RPG and POLD methods like Dry Needing, Percutaneous Electrolysis and Vestibular Rehabilitator. He was the chair in Electrotherapy from 1998 to 2008 at Entre Rios University, School of Medicine. He has been a Lecturer for many years and has delivered at least 100 talks in different countries. He has published a book and has written articles, book chapters and journals.
Abstract:
Introduction: The purpose of this study is to compare at least two different ways to treat patients who suffer, on the one hand, from soft tissue pathologies such as ulcers, arteriovenous wounds and the side effects of wound healing only by nursing care. And, on the other hand, patients who suffer from hard tissue pathologies for instance, when the bone does not heal. Subjects: Twenty patients (14 wounds) and (10 no healing bones) were randomly awed to the treatment groups. Methods: All patients received standard wound care consisting of wound cleaning twice daily, application of moist dressings and continuous relief of pressure until the wounds were healed. The ultraviolet protocol consisted of two treatments weekly using a lamp, it was calculated with National Biological Corporation devices, probe with a 400-nm. Wounds were checked every 14 days and surface areas were calculated according to some elements were calculated according to the criteria used to measure ulcers by decubitus Sessing scale, WHS scale, Sussman scale, PSST scale, PUSH scale, DESIGN scale and CODED scale, RESVECH scale and LUMT scale. Weekly percentage changes in wound area were compared. Results: Results showed that UVNA1 treatment had a greater effect on wound healing than nursing care did. The PEMF’s Protocol consisted of 90 days where doses were calculated with clinical and Montoya Scales between 90 to 15 Hz and 50 Gauss. All patients who received PEMF’s demonstrate a very high treatment for bones which have not healed in certain conditions. Conclusion & Discussion: Ultraviolet narrow band A1 and PEMF’s showed decrease healing time in soft and hard tissue and it may allow for a faster return to rehabilitation programs, work and leisure time in patents with pressure ulcers and leisure activities and for those have non healing bones.
Biography:
B J Lehecka is an Assistant Professor at Wichita State University in Wichita, KS. He is the Director of Wichita Running, a clinic for runners and sports teams. His research is focused on gluteal endurance measures and their relationship to running-related injuries. He is a PhD Candidate in Orthopedic and Sports Science at Rocky Mountain University of Health Professions. In addition to university lecturing, he has been an invited speaker for 20 continuing education conference lectures. He has published multiple articles relevant to sports physical therapy. Bryan.Lehecka@wichita.edu
Abstract:
Running is a wonderfully intricate and individualistic melding of foot, ankle, knee, hip, trunk, and upper body motion. This lecture is designed to teach attendees how to examine these intricate motions, and to communicate conclusions that can be drawn by telescoping up to a 5000- foot view of running research in its entirety. The discussion will include an exploration of the neuroscience associated with running as well as the physiological and psychological benefits of this popular activity. In-depth instruction for practical running gait analysis and the evaluation of runners will be provided, in addition to a myriad of treatment techniques. A special emphasis will be placed on the function, evaluation, and treatment of runners’ glutes. These large muscles are paramount to safe and efficient running technique. Moreover, most clinicians currently neglect the evaluation and treatment of runners’ gluteal endurance. Over 50% of the glutes’ fibers are Type I endurance fibers; therefore, it would behoove clinicians to evaluate and treat this often overlooked characteristic of these important muscles in runners.
Gunnel Berry
The Christie NHS Foundation Trust Manchester, UK
Title: Pain in children – 3 case studies
Biography:
Gunnel Berry is a member of the Chartered Society of Physiotherapy in 1974 having trained at the Middlesex Hospital London. She completed her MSc degree in Advanced Physiotherapy at the University College London in 1995. Having worked in Sweden, Great Britain and Borneo, she was trained as a Reflexologist in 1989 at the Bayly School of Reflexology. After participating in an audit into the clinical role of physiotherapy within a GP practice she developed Adapted Reflextherapy (AdRx) as a method to address pain. She has presented and published papers on AdRx at Physical Therapy Congresses in Barcelona, Birmingham, Chicago and in The Journal of Complementary Therapies in Clinical Practice amongst others. Although retired from clinical practice, she is the Educational Officer of the Association of Chartered Physiotherapists in Reflex Therapy. gunnel.berry1@gmail.com
Abstract:
Children are expected to participate in physical activity without pain and with full function. Pain causes immobility, discomfort and misery. Children may complain of pain but are ignored, told it is growing, over- or under-use pains of muscles and bones. Children have no clear experience to differentiate pains. They react to an immediate situation. The mission of the NCHID (National Institute of Child Health and Human Development) is to ensure that all children have the chance to achieve their “…full potential for healthy and productive lives…” Abdominal pain affects 10 – 20% of school age children. Musculoskeletal dysfunction may be the cause for abdominal pain. how is this addressed? AdRx (Adapted Reflextherapy) is reported as a manual therapy applied on the feet in context of pain. The hypothesis is that sensory stimulus facilitates synaptic potentiation by nerve plasticity. This has been particularly beneficial in acute and chronic pain states. Anatomical and physiological plasticity are ongoing processes in tissue matrix ensuring continued replacement and regeneration of damaged tissue material ensuring synaptic interchanges. This presentation includes 3 case studies of children suffering from severe pain a) abdominal pain, b) Achilles tendon pain, c) pain during void and bowel evacuation procedures associated with severe dermatitis. Symptoms had severe inhibitory effects on the children’s lives. Application of AdRx offered good outcomes. An interactive debate on a common denominator of children’s pain and method of treatment in context of physiotherapy intervention is encouraged.
Paolo Ortelli
RMP International School Di Rocca Concept, Switzerland
Title: Description of a case treated in myofunctional postural rehabilitation Di Rocca (MPR)
Biography:
Paolo Ortelli is a Physiotherapist since 1986, and later, after several specializations in manual techniques studied Osteopathy in France, Italy and Switzerland, where he received his Doctorate in Osteopathy at the University Ludes-Oradea (2003). To complete his rehabilitation training, he has focused his interest on Acupuncture and became Doctor of Acupuncture at Beijing University (WFAS, 2011). In the same time, he was trained in Posturology (Orthopraxy) and Method MPR di Rocca. He has published several papers in some local journals and rehabilitation magazines. He works as Rehabilitator and teaches osteopathy and TCM in the RMP di Rocca Concept. paoloortelli@ticino.com
Abstract:
Dr. Paolo Ortelli, describes the case of a patient treated in rehabilitation following the concept of RMP di Rocca. The patient, who initially had to undergo a left hip arthroplasty surgery, preferred to take a conservative treatment. According to the parameters of Myofunctional Postural Rehabilitation, the treatment was scheduled as following: the placement of an orthodontic appliance named BED (Body Equilibrium Device) to neutralize tensions resulting from the teeth and the temporo-mandibular joints (expecially at night); interventions with homotoxicology treatments done by the Doctor and; osteopathic therapy combined with traditional Chinese medicine and physical therapy interventions on the muscles chains by the Rehabilitator. Even dietary advices and interventions for improving intestinal absorption and metabolism of sugars in general have been implemented to allow a good metabolic and postural functionality. The two professionals show with this clinical case as an example, that the RMP, without interfering on the various techniques used, can serve as a guideline for proper setting of the treatments, while identifying priorities and multidisciplinary intervention times, to achieve the best possible result in both qualitative and economic terms.
Biography:
Vandana Jaisingh is a Senior Consultant in Sports Physiotherapy and Chairperson and Founder of PHYWorld Physiotherapy and Osteopathy Clinics. With 20+ years of experience in this health industry, she worked across multiple organizations including Safdarjung Hospital, Holy Family Hospital, Northern Railway Central Hospital, GB Pant Hospital, L.N.J.P. Hospital (MAMC), Kalawati Saran Hospital (LHMC), Institute for Physically Handicapped, Amar Jyoti Institute, ESIC Hospital, Hindu Rao Hospital, and Dr. Bela Sethi, South Extension. She founded PHYAction in 1996. PHYAction was rebranded to PHYWorld in 2008. By education, she has specialized in Sports Physical Therapy from Amar Jyoti Institute (2008) and Bachelors’ in Physical Therapy from Delhi University (Gold Medallist 1994). drvandana10@gmail.com
Abstract:
Introduction: The breathing pattern (BP) and rib cage-abdominal movement are relevant factors in understanding and assessing pulmonary impairment. Thoracoabdominal asynchrony/paradox– refers to the asynchronous movement of the thorax and abdomen that can be seen with respiratory muscle dysfunction and increased work of breathing. This can be seen as a time lag/phase shift of thoracoabdominal motion or as pure paradox where the thorax and abdomen are moving in completely opposite directions at the same time. There are lot of recent studies showing the effect of breathing exercises and diaphragmatic breathing for improvement in paradoxical breathing pattern in obesity. The effect of electromyography (EMG) biofeedback to improve thoracoabdominal paradox has not been studied yet. Objective: To compare the two protocols and formulate a new treatment plan for correction of paradoxical breathing. Procedure: The subjects were assessed and divided into 2 groups group A and group B. All the subjects undergone an EMG assessment and cross sectional diameter at umbilicus level at the end of inspiration and expiration have been assessed. Group A received the biofeedback training to recruit the abdomen and manual training including diaphragmatic breathing with scooping for 20 sessions and again the diameter was assessed after end of every session and at the end of 10th and 20th session. EMG readings were assessed again. Group B received manual training including diaphragmatic scooping with diaphragmatic breathing to recruit the abdomen muscles for 20 sessions. And at the end of 10th and 20th session EMG assessment was done. At the end of 10th and 20th session the cross- sectional diameter was assessed and recorded. Results: For inter group analysis of results unpaired T-test was used and those results were considered who had a p-value of less than or equal to 0.05. The biofeedback training to correct paradoxical breathing [SDNN] = 4.5150 than control group [SDNN] = 2.7110 with p value<0.01 has been found to show significant results than manual diaphragmatic training. Conclusion: The biofeedback training can be an effective treatment for correcting the paradoxical breathing pattern in obese patients, but it can be more effective if patient is also under the weight loss programme. The diaphragmatic excursion will increase leading to significant change and patient can lead a better life without respiratory complications.
EmÃdio Jorge Santos Lima
General Hospital Roberto Santos, Brazil
Title: Percutaneous tracheostomy without bronchoscopy: A safe procedure
Biography:
Emídio 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 a Professor at University Salvador – Laureate International Universities Network and has published a book and some papers in reputed journals. Recently, he finished an international multicenter study on lung ultrasound score as one predictor of weaning from mechanical ventilation at the University of Paris – France. emidio.lima@gmail.com
Abstract:
Background: Tracheostomy is a common procedure in ICU, particularly as an approach for weaning from mechanical ventilation. In mid-1980s percutaneous tracheostomy (PCT) was introduced as a less invasive alternative for the standard surgical tracheostomy. A tracheostomy facilitates weaning from mechanical ventilation, in long-term ventilated patients, by improving airway cleaning, better patient comfort, and decreasing airway resistance. Prolonged mechanical ventilation has a main complication i.e., ventilator-associated pneumonia. In such cases early tracheostomy may reduce that complication. Methods: We analyzed prospectively 104 adult patients mean age of 53 years who underwent PCT at our ICU between 2012 and 2014. Inclusion criteria were: age >18 years and indication for tracheostomy. Exclusion criterion was technical contraindication for PCT. All the PCT were performed at bedside using Ciaglia technique. Results: Among 104 patients, reasons for PCT were: Weaning failures in 82 (78.85%) and airway protection in 22 (21.15%). The most frequent reasons for admission to the ICU were: Sepsis in 18 (17.31%), pneumonia in 17 (16.35%) and stroke in 7 (6.73%). The mean duration of preceding translaryngeal intubation was 9 days. The mean length of ICU stay was 14 days. We observed one complication in one patient; it was a tracheal stenosis. 66 patients (63%) died during their stay in the ICU. These deaths were unrelated to the PCT, but related to severe organ dysfunction. 38 patients (36.54%) survived and was discharged from the hospital, 37 was decannulated. Conclusion: PCT, in our series, was a safe and practical procedure for bedside management of critical patients.
Gabriel Y F Ng
The Hong Kong Polytechnic University, Hong Kong
Title: The healing effects of nanomized Chinese herbal medicine on overuse-induced Achilles tendinopathy
Biography:
Gabriel Y F Ng publishes extensively in scientific and professional journals and has received research awards from Australia and the United States as well as the President’s Teaching Award from the Hong Kong Polytechnic University. His research interests cover Sports Physiotherapy, Knee Joint Rehabilitation and the basic science of Soft Tissue Injury/Repair. He is currently the Vice President of the Hong Kong Association of Sports Medicine and Sports Science, and is on editorial boards of several international journals. rsgng@polyu.edu.hk
Abstract:
Tendinopathy is a common clinical problem causing pain, disability and mental stress. Abnormal loading on the tendon with either overuse or underuse is believed to be a major causative factor of tendinopathy. Chinese herbal medicine has long been applied in management of soft tissue injuries. It was hypothesized in the current study that externally applied nanomized herbal medication would have higher penetration power and increased bio-viability at the tendons leading to better treatment efficacy than non-nanomized medication. Achilles tendinopathy was induced in SD rats (n=24) using the forced upper body suspended downhill running model for 8 weeks. The exercised rats were divided into 3 equal groups of exercise control, nanomized or normal herbal extract treatment groups in which the herbs comprised Dipsaci Radix, Rhizoma Notoginseng, Flos Carthami and Rhizoma Rhei (ratio=1:1:1:1). Both treatment groups received topical application of the herbs on both Achilles tendons for 6 weeks after the training. Results of biomechanical testing demonstrated that Achilles tendons of the exercise control group exhibited higher load relaxation, lower stiffness and lower ultimate tensile strength (UTS) as compared to the other 2 groups. However, both nano-herb and normal herb treated tendons showed comparable results to non-exercise control group (n=8), except the nano-herb group tended to exhibit higher UTS than normal-herb group. The results suggested, the present formula improved the healing potential for degenerative Achilles tendon and nanomization of the herbal extract have a tendency to further enhance the healing effect in terms of biomechanical properties.
Wei-L Hsu
National Taiwan University, Taiwan
Title: A novel fall prevention training using a treadmill-based balance perturbation during walking in older adults with osteopenia
Biography:
Wei-L Hsu is currently an Associate Professor and the Director of Movement Science Laboratory in the School and Graduate Institute of Physical Therapy at National Taiwan University, Taiwan. She completed her PhD in Biomechanics and Movement Science at the University of Delaware, USA and Post-doctoral studies in Neuroscience at the University of Oregon, USA. Her research interests are centered on gait and posture in older persons and individuals who has movement disorders. She also continues her clinical practice as a physical therapist to bridge the gap between bench and bedside. She has extensive experience in characterizing movement patterns in patients with spinal disease, poor balance control, characterizing muscle strength, and analyzing the effect of physical therapy and surgical interventions on movement functions. She serves as an editor and reviewer for numerous scientific journals. She has been an invited speaker at national and international scientific meetings. wlhsu@ntu.edu.tw
Abstract:
Studies have shown that muscle quality and good posture alignments are critical for balance control in older adults. People are diagnosed with osteopenia often combining with muscles weakness, and increased spine kyphosis leading vertebral fractures and poor balance control, even falls. Identifying the factors related to falls occurring within this population is essential for developing effective regimes for fall prevention. The split-belt balance perturbation treadmill has recently been developed to provide postural perturbations during walking. Treadmill-based perturbation balance training utilizes repeated unpredictable external perturbation that caused postural interference. It can generate unexpected accelerations forward or backward to simulate a slip or a trip and can also generate sideway displacements at various speeds to compromise the lateral stability of participants. The aim of this study was to develop a novel fall prevention training using a treadmill-based balance perturbation during walking. We used a split-belt balance perturbation treadmill and playware tiles to improve dynamic balance in older adults with osteopenia. External perturbations during treadmill training can activate involuntary adaptive postural responses in aging adults. The results showed that this training can improve muscle strength, bone mineral content, static and dynamic balance, thereby reducing the risk of falls in aging adults. The unique contribution of the results lies in integrating an explicit physical examination and biomechanical approach to a relevant clinical problem into a translational model. The findings provide a new paradigm of treatment approaches for balance control and might reduce the risk of falling and fracture. This research can potentially be applied to persons with poor balance who are at a high risk of falling.
Silverio Di Rocca
M.P.R International School, Switzerland
Title: Inter-relation between the cranio-facial system, the tonic-postural system and body posture
Biography:
Silverio Di Rocca has completed his Graduation in Dentistry, Post-graduate degree in Functional Orthopaedics both from the University of Buenos Aires, Argentina. He has also done a degree in Dentistry and Prosthetic at the University of Turin, Italy and a Doctorate in Dentistry and Prosthetic at University of Turin, Italy. He is the Director of the M P R International School, Vice President International representative and Founder of API Swiss (International Association of Posturology Switzerland). He is also a Professor in Amocoac Diplomate in Mexico and COMEI, College of Dentistry in Mexico, Associate Professor in I.C.O.M (International College of Osteopathic Medicine) Milan, Italy and an International Honorary member of AMOCOAC. sdirocca@gmail.com
Abstract:
The negative interference of the stomatognathic system on body posture is well known. Static posture regulation is given by the Tonic Postural System: a closed cybernetic system that regulates basic muscle tone, through its receptors (proprioception), in charge of the neuromuscular balance necessary for the body's harmony. The main receptors of this system are: Oculomotor system sistema, foot support and vestibule. Their main function is that of transferring environmental information surrounding the body, information that the nervous system then elaborates a response to. Unfortunately our central computer (Central Nervous System) has no way of knowing if the information is correct or not. The C.N.S. merely reacts to any information, however when this information is incorrect these reactions lead to chronic illnesses. The stomatognathic system can be out of sync when the jaw position is incorrect, generally due to dental malocclusion. In such situation, the oculomotor system is the main one to be affected (one of the body's main receptors), along with the vestibular system, in charge of balance, and the cervical spine, creating postural problems. It is for this very reason that the stomatognathic system is considered a postural disturber; the M.P.R. (Myofunctional Postural Rehabilitation) takes these phenomenon into account, and has made it the foundation in the development of B.E.D. (Body Equilibrium Device) that allows to cancel the negative effect of the masticatory system.
Dimitra Nikoletou
Kingston University,St. George’s University of London, UK
Title: Are there differences in adherence to home-based, inspiratory muscle training programmes between athletes and non-athletes? Implications for designing community based rehabilitation programmes for respiratory patients
Biography:
Dimitra Nikoletou is a Senior Lecturer at the Faculty of Health, Social Care and Education at Kingston University & St. George’s University of London and an honorary Senior Lecturer at the Infection and Immunity Research Institute at St. George’s University of London. Her research focuses on exercise prescription and rehabilitation in different clinical populations and is currently running an NIHR funded study. She has published in peer-reviewed journals, leads the Pulmonary and Cardiac rehabilitation component of 3 different MSc programmes and is a fellow of the Higher Education Academy having trained over 1,000 physiotherapists in the last 13 years. D.Nikoletou@sgul.kingston.ac.uk
Abstract:
Home-based exercise programmes are used in a variety of clinical conditions as part of comprehensive patient management. Inspiratory muscle training (IMT) is a rehabilitation option that has been used in patients with various respiratory conditions, to improve perception of breathlessness and exercise capacity as well as in athletes to improve performance in competitive sports. However, results from research studies vary in these 2 groups, raising questions about possible differences in motivation and adherence to home-based IMT programmes and the effectiveness of this intervention in respiratory patients as opposed to healthy athletes. This presentation will examine evidence from an exploratory study investigating differences in adherence to a four-week, high intensity, home-based IMT programme in athletes and healthy non-athletes, all of whom were physiotherapy students. It was hypothesized that healthy young volunteers should have no difference in adherence to a short IMT programme at home and their experiences following this programme should be similar. This was a mixed method study, using self-report diaries to monitor adherence and focus groups to explore participants’ experience following a 4 week IMT programme. Secondary outcomes were the maximal inspiratory and expiratory pressures (PImax and PEmax respectively), meters rowed in a rowing ergometer in 4 minutes and rate of perceived exertion (RPE) before and after rowing. Adherence is an important factor for any successful rehabilitation programme and results from this study suggest variation even in knowledgeable healthy individuals. Results will be present and discussed in the context of existing literature in this field.
Biography:
Timothy Winey has been conducting independent research on non-classical field effects on water and other liquids for the last 10 years. After a series of highly anomalous results both commercial and academic interest in his work has begun accelerating rapidly, particularly in the areas of fuels, foods and health applications, more specifically, the use of structured water for the improved uptake of phyto-compounds. timothywiney@btinternet.com
Abstract:
According to a growing body of research, the structure of water is implicated directly in, and may even be the catalyst for, inflammatory response throughout the body. Structured water (water with certain cluster sizes) has been shown to be reducing, making it a functional anti-inflammatory. I will present direct experimental (in vitro and in vivo) evidence of this reducing/anti-inflammatory effect as well as improved hydration.
Garima Gedamkar
Charotar University of Science and Technology, India
Title: Effect of cervico-thoracic mobilization on shoulder pain and functional independence in paraplegics
Biography:
Garima Gedamkar completed her Master of Physiotherapy in Neurology from Swami Vivekanand National Institute of Rehabilitation Training and Research (SVNIRTAR), under Ministry of Social Justice and Empowerment, Govt. of India. She also completed her PG Diploma in Rehabilitation Physiotherapy from All India Institute of Physical Medicine and Rehabilitation (AIIPMR), under Ministry of Health and Family Welfare, Govt. of India. She was honored by All India Institute of Physical Medicine and Rehabilitation, Society for Promotion of Medical Research (Government of India, Ministry of Health and Family Welfare) for outstanding performance. Currently, she is working as a faculty member at Ashok and Rita Patel Institute of Physiotherapy, a constituent of CHARUSAT, India. Apart from being an academician and clinical therapist, she is also involved in community survey and service. garimagedamkar87@gmail.com
Abstract:
30%-50% of the individuals with spinal cord injury (SCI) have shoulder pain of such severity that it interferes with transfers, manual wheelchair propulsion, overhead reaching, and sleep; it can also limit vocational and recreational pursuits. Wheelchair propulsion and transfers (mostly studied) are among the other factors responsible for inducing shoulder pain, which is unavoidable to be functionally independent. In the presence of pain, individuals may not perform up to the optimal level or deny doing exercises. Rest may prolong rehabilitation duration, increase financial burden, depression or reduced motivation. Also, no standardized exercise protocols are available (minimum of 6 weeks and more) due to less number of studies and home exercise programs are of longer duration. 4 weeks (5 days a week, 1 session per day) of cervico-thoracic mobilization when combined with exercises (stretching and strengthening) showed statistically significant decrease in shoulder pain and improved functional independence than exercise therapy alone. Addition of cervico-thoracic mobilization sets platform to perform the exercises optimally, facilitate rehabilitation by immediate pain reduction and maintain the effect 24 hours post-intervention. It also reduces the duration of treatment for shoulder pain as compared to the available protocols. Since level of injury, level of impairment, motivation, environmental factors influence the functional independence, comprehensive approach should be considered.
Dana Badau
University of Medicine and Pharmacy of Targu Mures, Romania
Title: The impact of kinetoprophylaxy in fitness movements
Biography:
Dana Badau is working as a full Professor at the University of Medicine and Pharmacy of Tirgu Mures, Department of Human Motor Sciences and Department of Physiokinetotherapy. She completed her PhD in 2005 at Transilvania University from Brasov and her Habilitation in 2015 at Babes-Bolyai University of Cluj-Napoca. She is the President of the Romanian Federation Sport for All and member of several national and international academic and professional associations. She has published more than 80 papers in indexing journals and conference proceedings and has been serving as an Editorial Board Member of repute. danabadau.brasov@gmail.com
Abstract:
The posture and correct movements during fitness exercises are an important goal in primary kinetoprophylaxy. The effects of physical exercise are multiple and they influence the human morphological, neuropsychical and functional levels. Primary kinetoprophylaxy in fitness movements’ aim: posturing; increase of relaxation capacity; re-establishment of the correct alignment of the body; regaining of strength and muscular endurance; recovery of coordination, motor control and balance; correction of respiratory deficit; reeducation of sensitivity and; optimizing the effort capacity. An important goal of primary kinetoprophylaxy is to make the fitness instructor aware of the importance of correct posturing and movements during workout aiming to prevent muscular and joint injuries. Primary kinetoprophylaxy in fitness must focus on performing movements related to the joint structures, length of the moving segment of the body, muscular tonus, age, complexity and 3D movements. Our study on 80 fitness instructors performed in 2015, aimed to identify and correct the fitness movements. The research applied a worksheet containing 50 fitness initial positions and movements which include the most frequent errors in execution. The study highlights a medium level knowledge of correct posture and of the instructors’ capacity to identify and correct the movement errors. The impact of primary kinetoprophylaxy targets to optimize the physical fitness and health through correct physical exercises applied to the individual particularities of the subjects.
Sunday R Akinbo
University of Lagos, Nigeria
Title: Relationship between pain intensity and sleep (index) parameters in patients with chronic low back pain
Biography:
Sunday R Akinbo, his academic and professional qualifications include BSc Physiotherapy, MSc & PhD Musculoskeletal Anatomy, University of Lagos, Nigeria and FPC, Nigeria. He is a Member of several national and international academic and professional associations among which are, Nigeria Society of Physiotherapy (NSP), Society for the Study of Pain, Nigeria (SSPN), International Association for the Study of Pain (IASP), International Society of Physiotherapy Journal Editors (ISPJE). He has also served as external assessor for Physiotherapy promotion exercise in several hospitals in Nigeria, and Chairman and Member of several academic and professional accreditation panels in Nigeria and Ghana. He is a recipient of several academic, professional and community distinction awards. He has attended well over 100 conferences locally and internationally, and has presented papers in all the conferences attended, and has also served as a Guest/Keynote Speaker in over 40 meetings (Conferences and Workshops). He has published well over 80 full research studies and 100 research abstracts in peered reviewed journals and conferences proceedings. His professional areas of specialization are Musculoskeletal & Orthopedics Physiotherapy and Sports Physiotherapy. He is presently the Head (Chairman), Department of Physiotherapy, College of Medicine of the University of Lagos and also; the Head (Chairman) and Consultant Physiotherapist, Department of Physiotherapy, Lagos University Teaching Hospital both in Lagos Nigeria. sraakinbo@cmul.edu.ng
Abstract:
Background & Objective: Chronic Low back pain (CLBP) is a common problem that most people experience at some point in their lifetime. It is associated with various physical, emotional, economical and psychological dysfunctions that eventually cause deterioration in quality of life (QoL). This study investigated the relationship between pain intensity and sleep disturbance in patients with CLBP. Methods: The study is a cross-sectional survey in which 112 patients attending 3 tertiary hospitals in Lagos, Nigeria were evaluated for LBP of duration greater than 3 months. The survey employed a visual analogue scale (VAS) and the Pittsburgh Sleep Quality Index (PSQI) to determine pain intensity and explore sleep variables respectively. The results were analyzed using Pearson product-moment correlation coefficient, independent t-test and Mann-Whitney U. Level of statistical significance was set at p<0.05. Results: There was a statistically significant correlation between pain intensity and overall sleep index (r=0.22, p=0.02). Furthermore, there was a significant correlation between pain intensity and sleep latency (r=0.26, p=0.00) and sleep disturbance (r=0.27, p=0.00). Conclusion: The study significantly established the adverse effect of CLBP on quality of sleep on patients. Therefore, sleep problems should be addressed as an essential part of management in patients with CLBP
Mansour Sahebozamani
Shahid Bahonar University of Kerman, Iran
Title: Effects of functional fatigue on position sense of elbow and shoulder joints in elite female table tennis players with upper crossed syndrome
Biography:
Mansour Sahebozamani has completed his PhD in 2004 from Sport Medicine Department of Russian State University of Physical Education and Tourism. He is the Dean of the Faculty of Physical Education & Sport Scinces in SBUK and Chairman of the Department of Sport Injures and Corrective Exercises. He has published more than 50 papers in scintific journals. sahebozamani@yahoo.com
Abstract:
Muscle fatigue due to physical activity occurs in different parts of neuromuscular structures including the central nervous system, and neural control of muscle that cause reducing efficiency and increasing muscle injury. The present study aimed to assess the effects of functional fatigue as a risk factor for injury on position sense at the elbow and the shoulder girdle joints in the elite female table tennis players with upper crossed syndrome and also to compare with healthy players. This semi-experimental study was performed on 24 elite female table tennis players (age: 24.66±3.28 years) participating in the students Olympiad in 2014. The presence of upper crossed syndrome was diagnosed based on increased forward head angle and rounded shoulders angle. The group with upper crossed syndrome experienced higher increase in position sense at the elbow following fatigue protocol compared to healthy players (5.58 degrees versus 2.38 degrees, main effect of 0.67, p<0.001). The results showed no significant difference in the mean of angle reconstruction error between the two groups with and without abnormality after fatigue protocol before that (9.58 to 6.75 in group with upper crossed syndrome and 9.00 to 6.58 in healthy group, main effect of 0.01, p=0.53). Fatigue can decrease proprioception in the elbow joint, but this reduction was not seen in shoulder so the shoulder joint position sense may be increased after functional fatigue.
Ketan Bhatikar
Indian Association Of Physiotherapist , India
Title: Spastic diplegia- Effectiveness of aquatic therapy and treadmill walking, is there a role of surgery? - A single case study
Biography:
Ketan Bhatikar completed his Masters of Physiotherapy from City College of Physiotherapy Mangalore. He worked as an Consultant physiotherapist and HOD at Bits Pilani, Goa. He is Youngest and the 1St Physio of India with administrative post in BCCI; Co-opted as Member of Goa cricket Association, affiliated body of BCCI. He Had the cover page of physiotimes magzine also he published Effects of myofascial release technique in subjects with subacute trapezius spasm. He awarded as PHYSIOCON, Bangalore and Young Achiever Award at AIIMS, Delhi Physiotherapist of super six cricket matches where he been a physio for the bollywood stars. He Played Active Part of Massive Satyagraha at Delhi, jantar mantar for formation of central physiotherapy council. ketanbhatikar@gmail.com
Abstract:
In India, prevalence of cerebral palsy (CP) is estimated over 25 lakh individuals, whereas incidence is up to 3 cases per 1,000 live births and spastic diplegia accounts for 57%. Describing a single case study of 13 years old boy, diagnosed with spastic diplegia. Case ‘P’ was on regular physiotherapy at the age of 2 years 10 months, as the child was unable to sit and walk, had undergone surgical release for bilateral lower limbs. After which, child was presented with crouch gait and bilateral planovalgus. He is on regular aquatic and treadmill walking since 1 year and shows a better posture in standing as a descriptive analysis. It raises a doubt about surgical interventions at early age and remnants of the same.