Novel Physiotherapies 2018 March 19-20, 2018 Berlin, Germany

Biography:

Andrew Hague’s interest in the technology that was to become CellSonic began in 1987 with the first lithotripter in Britain. Using his own capital he developed the CellSonic VIPP machines and sold them around the world.

Abstract:

The traditional view of physiotherapy is that it teaches a few simple exercises and by pressing with fingers some pain can be alleviated. Worse than that, a physiotherapist is inferior to an orthopedic surgeon.

Whether that was ever true, it certainly is not now. Instead of pressing with fingers, the physiotherapist has a new tool in CellSonic that performs non-invasive surgery, does not use drugs and has no side effects. Patients come in bent and walk out straight.

Quite apart from the benefits to patients, the status of physiotherapy is enhanced, the business improved and earnings increased. With their knowledge of anatomy, all a physiotherapist needs to master the new technology is a few minutes training on how to operate the machine and then they are working inside the body from the outside.

Cellsonic VIPP (very intense pressure pulses) damage or provoke. This is a simplification because the complete explanation is complicated. Damage is done to infection, germs are killed, calcifications shattered and blockages released. Provocation is the stimulation of the immune system to make a repair by bringing stem cells to the site, increasing vascularization and blood cells. Muscles are enhanced and nerves repaired. Additionally and very simply, the replication of mutant cells is stopped and they then only replicate healthy cells. In other words, cancer is stopped without drugs, non-invasively and without side effects.

It takes a physiotherapist five minutes to realise that they can do more than they were trained to do. Quite apart from curing cancer, which is the easiest treatment to perform, an athlete can be given a 13% improvement in performance. A geriatric marooned in bed with a catheter and pressure sore can be restored to mobility and dignity. Half the population all of whom have lower back pain can be relieved. What cannot be done easily is to placate orthopods who sense that physios have encroached on their patch? CellSonic has no apologies.

The story of CellSonic is one of discovery. It started with breaking kidney stones with sound waves forty years ago. This is now done in all hospitals of the world and millions of patients have been treated safely. Since then the technology has changed, the machines became smaller, weaker, handheld and cost much less. New applications were reported by customers, usually doing something that was not recommended but they thought they would try it. The fact that CellSonic has no side effects made everything possible. This is unique in medicine where all drugs have side effects. Gone is the notion that the body is the sum total of its chemistry. The pharmaceutical industry still has an important role to play but it is no longer the only force in medicine.

Biography:

Jenna DeSimone is Currently working as senior staff physical therapist at Rusk Rehabilitation in New York, USA 

Abstract:

Title: GNE Myopathy: Recognizing Key Features to Optimize Physical Therapy Treatment in a Rare Myopathy

Authors/Institutions: Jenna DeSimone PT, DPT, NCS, Rusk Rehabilitation, NYU Langone Health; Stephen Fischer, PT, DPT, NCS; Program Manager, Rusk Rehabilitation, NYU Langone Health 

Abstract Body:

Background and Purpose: GNE myopathy, a rare autosomal recessive adult-onset disorder with progressive muscle atrophy and weakness, is due to a missing GNE/MNK enzyme, causing a sialic acid deficiency. Progressive distal limb weakness with a unique quadriceps sparring presentation is common. Investigational drug trials exist, but the disease currently has no cure. GNE myopathy has often been misdiagnosed, due to large exclusions in the population when histopathologic diagnostic criteria required multiple findings on muscle biopsy. Today the diagnosis relies on clinical presentation, including muscle imaging, and is confirmed by genetic studies. GNE myopathy presents with unique patterns of muscle dominance-quadriceps vs hamstrings, abductors vs adductors, hip extensors vs hip flexors, plantar flexors vs dorsiflexors, biceps vs triceps-with subjective reports of tripping, difficulty managing steps and rising from chairs. The authors have partook in data collection for a GNE myopathy IRB approved drug trial for 4 years, and are now seeing this population in the clinic. There is no literature available on GNE myopathy and physical therapy at this time. This report will identify the clinical characteristics of GNE myopathy and highlight the role of physical therapy (PT) in improving physical function, decreasing falls risk, and improving quality of life in this patient (pt) population.

Case Description: Pt is a 42-year-old female, noted a 6-year progressive decline in distal BLE weakness with increased falls. She was referred to PT for strengthening, balance and gait training, and to transition from soft over the counter AFOs to custom AFOs. She was not enrolled in a drug trial. Pt presented on evaluation with impaired strength, balance, endurance, and increased fear of falls. Pt received 30-60 min individual PT sessions 1-2 times per week for 32 sessions. Treatment emphasized strengthening dominant muscle groups to optimize function, balance training, and progressing high-level mobility with appropriate AFOs.

Outcomes: First and final outcome measures: 5 Time Sit to Stand 9 sec to 6 sec, Timed Up and Go 7.8 sec to 6.6 sec, Gait Speed (GS) self-selected 1.21 m/s to 1.49 m/s, GS fast 1.56 m/s to 1.79 m/s, Mini-BESTest 20/28 to 27/28, and Hi-MAT 27/54 to 29/54. Fall rate from x1 weekly to x1 in 3 months.

Discussion: Knowledge of GNE myopathy presentation and prognosis enabled PT to develop targeted strengthening programs to improve functional strength, decrease the risk of falls, and improve quality of life. Focused strengthening of dominant muscles with moderate intensity to prevent fatigue is essential in a population with difficulty generating new muscle fibers. Education on appropriate bracing to decrease falls risk and improve high-level mobility added to pt quality of life. More research is warranted as treatment options for pts with GNE myopathy progress.

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