Day :
Keynote Forum
Erika Cyrus Barker, Head of Physical Therapy department, University of Santa paula, Costa Rica
Head of Physical Therapy department, University of Santa paula, Costa Rica
Keynote: Evidence based physiotherapy treatment for ankylosis spondylitis
Time : 30 min
Biography:
Abstract:
Keynote Forum
Haider Darain
Khyber Medical University, Pakistan
Keynote: Effects of levels of supervision during a standardised post-surgical rehabilitation programme influence PROMs assessing function
Biography:
Abstract:
Keynote Forum
Jenna DeSimone Rusk Rehabilitation, USA
Jenna DeSimone, Rusk Rehabilitation, USA
Keynote: GNE Myopathy: recognizing key features to optimize physical therapy treatment in a rare myopathy
Biography:
Abstract:
- Poster presentation
Session Introduction
Asma Abdullatife Alderaa
King Saud University, Saudi Arabia
Title: Chronic lower limb oedema in a population of saudi arabian residents with multiple sclerosis: An evaluation of progressive resistance exercise
Biography:
Asma Alderaa is a phd student in the University of Nottingham, UK, at her last year. She earn her Master degree from St Gorges univeirty in London in 2011. She
is a Lecturer at King Saude University, KSA. Her main research interest is in multiple sclesrosis and lymphatic system.
Abstract:
Introduction: The prevalence rate of Chronic Lower Limb Oedema (CLLO) in people with MS (pwms) has been
reported to be between 45% and 62% respectively (Solaro et al., 2006; Keeley et al. 2017). Statistical significance was
found between age and Expanded Disability Status Scale (EDSS), where older patients with more disability were
more likely to have oedema (ibid). Evidence of of chronic oedema managements are mainly a specific group related
management or in A form of components treatment where the effectiveness of one component rather than the other
can Not be confirmed. Moreover, evidence related to non-pharmacological intervention in forms of Exercises to treat
CLLO with MS people has not been investigated thoroughly. Therefore, with this Lack of evidence in this area this
study is aimed to assess the effectiveness of progressive resistance Exercise (PRE) in the management of changing
chronic lower limb oedema (CLLO) in people with MS who are resident in Saudi Arabia and to determine the impact
of CLLO on MS patients’ quality Of life.
Methods: Two-hundred and fifty-five pwms and EDSS between 3 to 6.5 were screened from two Hospitals for
CLLO by using a pitting oedema test. Twenty-two were found to have CLLO, However, fifteen out of them agreed
to participate in the study. The participants performed a Biweekly 12-weeks lower limb PRE. The participants
were assessed for any changes in their lower Limb circumference pre and post intervention using a 4 cm interval
circumference which divided the Legs into 6 segments. In addition, Quality of Life (QOL) was measured by using
the Quality of Life Measure for Limb Lymphedema (LYMQOL) tool and Short form of the mcgill Pain Questionnaire
(SF-MPQ) in pre and post intervention.
Results: Fourteen participants completed the intervention with mean age of 44±7.11 years, EDSS 5.6±0.96, BMI
29.08±7.91 and disease onset 12.92±3.7 years. A part from the 5th segment in the Right leg, mean difference volume
reduction was reported in all segments and a greatest reduction Can be seen in the 1st segment -9.11 ml (SD 27.5)
followed by 6th segment -8.57 ml (SD 20.3).However, none of the segments were statistically significant. In the left
leg, again the highest mean Difference volume reduction can be seen in the 2nd segment -5.37 ml (SD 15.5) then
1st -4.51 ml (SD 12.2) and followed by 6th -1.74 ml (SD 30.4). Similar to the right leg, none of the left leg Segments
were statistically significant. In terms of pain and QOL, statistically significant reduction Was reported in the Visual
Analog Scale (VAS) domain P=0.01 and present pain intensity (PPI) Domain P=0.02, and statistically significant
increase in the overall QOL domain P=0.006.
Conclusion: This twelve-week program results demonstrate that PRE has effects on CLLO in terms Of pain and
QOL in pwms. However, no statistically significant was found in the legs volume but Mean difference reduction was
reported at different segments in both legs. More research with Bigger sample size is necessary.
Marcus Orgel
Medical School Hannover, Germany
Title: Transcutaneous Osseointegrated Prosthetic Systems (TOPS)-pain after mobilization: What kind of role does the angle of abduction play?
Biography:
Marcus Orgel was a student of human medicine at the University of Heidelberg, Germany from 10/2007 - 10/2014, he was also a resident at the clinic for trauma
surgery (Prof. Dr. med. Christian Krettek) during 06/2015 at Medical School Hannover, Germany and he is the deputy head of the section for endo-exo-prosthetic,
clinic for trauma surgery (Prof. Dr. med. Christian Krettek) from 02/2017 at Medical School Hannover, Germany.
Abstract:
Transcutaneous osseointegrated prosthetic systems (TOPS) have been used as an alternative method to the
external artificial limbs for patients with limb amputation. Patients with transfemoral amputations very often
suffer from pain in the region of their lateral hip following rehabilitation with TOPS after starting full weight
bearing. We suppose a dependency between this pain and the malposition of the residual femur bone which tends
to abduction. When socket prosthesis is used, weight bearing doesn’t have a direct effect on the bone. The energy
is spread to the soft tissue. Due to the inevitable missing at least of parts of the mm. adductoris, there often exists a
lateral deviation of the residual femur. Additionally, there is an atrophy and contraction of the muscles surrounding
the hip joint. Using TOPS, the patients perform full weight bearing direct to the bone which comes much closer to
physiological walking. At the same time, the lateral muscle groups are getting under painful tension. In our study
we are going to investigate a correlation between the development of pain enclosing the hip joint and the changed
angle of abduction comparing it to the former use of socket prosthesis. We would like to show that physiotherapy in
advance might reduce or even eliminate the pain.
Simone Paulyn
Brandes and Diesing, Germany
Title: Physiotherapy for leg- amputated patients in the physiotherapy pratice
Biography:
Simone Paulyn is a physiotherapist since 2000 with experiences in hospitals, rehabilitation clinics and private sections. She has been treating amputees since
2005. Since 2017 she is working for Brandes & Diesing in the section of orthopedical mechanics leading the prosthesis gait training section and is part of the
TOPS-Team in Hanover which is actually making studies about TOPS and She has published four books as well as many articles in various magazins.
Abstract:
Learning how to walk with the prosthesis is a very important aspect in therapy. A physiological gait should be
trained in varying situations of daily life, so that the patient is able to integrate as good as possible into social
life. Depending on the reason for an amputation there exist different restrictions for the amputee which require
diagnosis-orientated therapeutical actions. With patients of the mobility grade 1&2 the focus is on walking safely,
balance and a physiological gait. With patients of the mobility grade 3&4 the focus is more on complex situations
of daily life, outdoor and sports. A detailed diagonsis and gait analysis give information which therapy improves
the conditions for a physiological gait. A combination of contracture-prophylaxis, PNF, manual therapy, treatment
of scarfs, facial therapy, strengthening muscles, core stability, drainage of the lymphatic system, handling of the
prosthesis as well as treating phantom pain e.g. With mirror therapy. A very important aspect in rehabilitation
is interdisciplinary collaboration. An adequately built prosthesis as well as the exchange between the orthopaedic
technician and the physiotherapist lead to a better result. We practice this in our prosthetic gait training in groups in
our practice and company in Germany with success.
Ines Llamas-Ramos
University Hospital of Salamanca, Spain
Title: Dry needling in the treatment of de quervain’s tenosynovitis
Biography:
Ines Llamas-Ramos has completed her PhD at The University of Salamanca, Salamanca, Spain. Currently, she is working as a Physiotherapist at the University
Hospital of Salamanca and carrying out her clinical practice. She has been working as a Visiting Professor at The University of Salamanca, in the Department
of Nursing and Physiotherapy. She has published several articles about cancer and dry needling in reputed international journals and has been serving as an
Editorial Board Member of various medical journals.
Abstract:
The patient of this study is a female administrative, she was 57 years old. In her job she always uses the computer
and she has a lot of repetitive movements. She referred pain in the first extensor compartment of her right
wrist. She went to a physiotherapy clinic and has completed three sessions of conservative treatment (massage
therapy and stretching). Two months later she was still having pain and a slight loss of muscle strength in her right
arm. She went to another physiotherapy clinic and she received a session consisting in massage in her forearm,
wrist articular movement, deep transverse massage in tendons of her first dorsal compartment, ultrasound and
stretching. She improved but she was still having pain and inflammation. In the second session the physiotherapist
proposed dry needling and the patient accepted. After one session of dry needling, ultrasound and stretching, the
final recuperation was achieved. Continued stretching at home was recommended. Six months later the patient is
completely asymptomatic. We can conclude that dry needling in the treatment of De Quervain’s tenosynovitis has
great benefits in pain, inflammation and muscle and tendon recuperation after repetitive movements as well as its
long-term maintenance. A lot of evidence exists about the effect of dry needling in muscles but the application of
this technique in one specific tendon improves symptomatology. We thought that this line of research could give
physiotherapists great results in the treatment of their patients.
Ines Llamas-Ramos
University Hospital of Salamanca, Spain
Title: Ultrasound added to manual therapy is effective in the treatment of temporomandibular disorders
Biography:
Ines Llamas-Ramos has completed her PhD at The University of Salamanca, Salamanca, Spain. Currently, she is working as a Physiotherapist at the University
Hospital of Salamanca and carrying out her clinical practice. She has been working as a Visiting Professor at The University of Salamanca, in the Department
of Nursing and Physiotherapy. She has published several articles about cancer and dry needling in reputed international journals and has been serving as an
Editorial Board Member of various medical journals.
Abstract:
A female woman, 29 years old, physiotherapist suffering from temporomandibular disorders since, she was 17
years old. She referred pain, functional disorders of the masticatory system, temporomandibular joint and
masticatory muscles. She has completed five sessions of therapeutic treatment that includes stretching exercises,
passive and active range of motion exercises and strengthening exercises. Each type of exercise was performed for the
duration of six seconds and repeated 10 times. She improved but she was still having limitation to open her mouth in
her left temporomandibular joint. After consultation with a specialist, he recommended a magnetic resonance. This
magnetic resonance showed a temporomandibular disorder type I. She was referred again to rehabilitation service,
she performed the same treatment and her physiotherapist added a low intensity ultrasound. After 10 sessions she
felt better, her range of motion was increased, her masticatory muscles were relaxed and the pain decreased. It is
important to follow this patient, to know how long she keeps the results in order to offer her the best and more
complete treatment for her pathology. We can conclude that low intensity ultrasound with manual therapy helps to
improve the range of motion, pain and to keep free the temporomandibular joint. It is important to apply a correct
treatment to obtain long term results. More studies with more sample size are needed to confirm this hypothesis.
Ines Llamas-Ramos
University Hospital of Salamanca, Spain
Title: Ultrasound added to manual therapy is effective in the treatment of temporomandibular disorders
Biography:
Ines Llamas-Ramos has completed her PhD at The University of Salamanca, Salamanca, Spain. Currently, she is working as a Physiotherapist at the University
Hospital of Salamanca and carrying out her clinical practice. She has been working as a Visiting Professor at The University of Salamanca, in the Department
of Nursing and Physiotherapy. She has published several articles about cancer and dry needling in reputed international journals and has been serving as an
Editorial Board Member of various medical journals.
Abstract:
A female woman, 29 years old, physiotherapist suffering from temporomandibular disorders since, she was 17
years old. She referred pain, functional disorders of the masticatory system, temporomandibular joint and
masticatory muscles. She has completed five sessions of therapeutic treatment that includes stretching exercises,
passive and active range of motion exercises and strengthening exercises. Each type of exercise was performed for the
duration of six seconds and repeated 10 times. She improved but she was still having limitation to open her mouth in
her left temporomandibular joint. After consultation with a specialist, he recommended a magnetic resonance. This
magnetic resonance showed a temporomandibular disorder type I. She was referred again to rehabilitation service,
she performed the same treatment and her physiotherapist added a low intensity ultrasound. After 10 sessions she
felt better, her range of motion was increased, her masticatory muscles were relaxed and the pain decreased. It is
important to follow this patient, to know how long she keeps the results in order to offer her the best and more
complete treatment for her pathology. We can conclude that low intensity ultrasound with manual therapy helps to
improve the range of motion, pain and to keep free the temporomandibular joint. It is important to apply a correct
treatment to obtain long term results. More studies with more sample size are needed to confirm this hypothesis.
Aleksandra Szylinska
Pomeranian Medical University, Poland
Title: Respiratory capacity as an element of qualification for cardiac rehabilitation among women and men following a cardiac surgery
Biography:
Dr Aleksandra Szylinska (PhD) is a physiotherapist. She works as Assistent Profesor at Department of Medical Rehabilitation and Clinical Physiotherapy.
Practical working as a physiotherapist in Cardiac Surgery Clinic with patients early stage after surgery.
Abstract:
Introduction: The cardiac surgery is followed by severe functional depression of the respiratory system. It is caused
by many independent factors connected with the surgery itself, extracorporeal circulation and postoperative course,
especially mechanical ventilation. Studies confirm that the postoperative course and return to a normal lifestyle is
more difficult for women than men. Cardiac rehabilitation has a significant impact on the prevention of complications
and mortality after cardiac surgery.
Aim: Analysis of spirometry results depending on the sex of the patients qualified for two models of rehabilitation
(inpatient or home-based) after cardiac surgery.
Materials & Methods: In the Department of Cardiac Surgery, 104 patients admitted to a planned coronary artery
bypass grafting were prospectively examined. The patients had a spirometry examination on the day of admission to
hospital, and at 5th and 25-30th days after surgery. At the 5th day after surgery (i.e. The day of discharge), patients
were randomized into two groups of 52 patients on the basis of spirometry, sex (women and men) and age (≤65 and
>65 years). This resulted in two homogeneous groups before the separation. The first group was qualified for the
second phase inpatient cardiac rehabilitation at the Cardiac Rehabilitation Department at the Cardiac Surgery Clinic.
The second group conducted home-based exercises according to the same exercise program. The last spirometry
examination was performed 25-30 days after the surgery.
Results: Among the examined women a significantly better final result of spirometry examination was observed
in group one (inpatient rehabilitation) than in group two (home-based), considering all women (p<0.001), women
under 65 years of age (p=0.011) and those over 65 years of age (p=0.007). Among men, a decrease in the last spirometry
result compared to the pre-surgery examination was also significantly lower following inpatient rehabilitation than
home-based rehabilitation. The younger group (below 65) had better spirometry results than the older group (>65)
but the results were not statistically significant.
Conclusion: Lesser decrease in respiratory capacity in the range of forced vital capacity following a cardiac surgery
was observed in the group of women and men undergoing inpatient rehabilitation.
Iwona Rotter
Pomeranian Medical University, Poland
Title: Comparative analysis of quality of life in patients following unilateral breast cancer surgery depending on the physiotherapeutic method used to reduce swelling
Biography:
Dr Iwona Rotter (MD, PhD) is a medical doctor, specialist in Neurology and Rehabilitation Medicine. She works as Head at Department of Medical Rehabilitation
and Clinical Physiotherapy. She has published many papers in refereed journals.
Abstract:
Introduction: Breast cancer is the most common cancer in women. One of the most frequent complications of breast
cancer treatment is lymphedema of the upper limb, which significantly worsens the quality of life of patients, which
is why it is necessary to find effective methods of reducing edema.
Aim of the study: Assessment of quality of life of patients after breast cancer surgery undergoing treatment of upper
limb edema with the use of a comprehensive standard anti-edema therapy with ready-made compression products
and a therapy modified by kinesiotaping.
Material & Methods: We examined 65 patients with lymphedema of the upper limb following breast cancer surgery.
Patients were divided into two groups. In group A a complex anti-edematous therapy with kinesiotaping (n=34) was
applied, while in group B a compression sleeve was used (n=31). Patient’s quality of life before and after therapy was
assessed using the LYMQOL questionnaire. Differences in upper limb circumference before and after the therapy
were measured with a tape measure. Each patient underwent 8 complex antiedematous therapy sessions once a week
for two months.
Results: In both groups an improvement in quality of life was observed according to all domains of the LYMQOL
questionnaire before and after rehabilitation (p<0.001). In both group A (kinesiotaping) and group B (compression)
mean circumferences of the upper extremity were reduced (p<0.001). No statistically significant differences between
the groups were found, except that the patients using the kinesiotaping method were more frequently observed to
improve the quality of life in the domain of well-being than those using a compression sleeve (p=0.045).
Conclusion: Both antioedematous therapies improved the quality of life and were an effective method to reduce
lymphedema in patients following breast cancer surgery, but the well-being was much higher in patients using
kinesiotaping.
Shannon Ya-Hui Chiu
The Institute of Biomedical Engineering-National Chiao Tung University, Taiwan
Title: Quantitative evaluation of upper limb rehabilitation using an intelligent stacking cone system in a game setting
Biography:
Shannon Ya-Hui Chiu has completed her Master’s degree in the Institute of Biomedical Engineering at National Chiao Tung University. She has excellent
engineering training, and is an expert in system integration and automation. She has participated in the design and construction of various medical devices,
including an upper limb rehabilitation device, an emulated laser acupuncture system, and the development of near infrared brain activity recording device.
Abstract:
People suffering neurological deficits due to sudden onset of occlusion or rupture of cerebral vessels usually develop
multiple clinical symptoms such as hemiplegia, dysesthesia, difficulty in speech or comprehension or defect of
visual fields after the acute phase. Specifically, functional impairment of the upper extremities is most common in
these patients. It is important to design a suitable training program for individual patient to effectively restore physical
functions. However, the current training protocols often rely on manual and subjective assessment of upper extreme
functions. In this paper we present the implementation of an “Intelligent Stacking Cone System” that was designed
to quantitatively evaluate the functional status of the upper limbs during rehabilitation. The design of a video game
setting with a console emulating the famous whac-a mole game can significantly improve patient participation in the
rehabilitation program. The system is integrated with many optoelectronic position sensors. During the execution,
the system can detect five key timings including the reaction time after a picture prompts, palm grip action, upper
limb remove action, palm release action and upper limb return action. The timing differences between these five
critical activities are used to represent the dynamic status of the upper limb rehabilitation. The therapist could
compare with the past training result to assess explicitly quantified patient progress. Intelligent stacking cone upper
limb rehabilitation system is a new design and method for rehabilitation. This system aims to raise the efficacy and
fun level during diagnostic and therapeutic procedures, thus improve the outcomes.
Iwona Rotter
Pomeranian Medical University, Poland
Title: Comparative analysis of quality of life in patients following unilateral breast cancer surgery depending on the physiotherapeutic method used to reduce swelling
Biography:
Shannon Ya-Hui Chiu has completed her Master’s degree in the Institute of Biomedical Engineering at National Chiao Tung University. She has excellent
engineering training, and is an expert in system integration and automation. She has participated in the design and construction of various medical devices,
including an upper limb rehabilitation device, an emulated laser acupuncture system, and the development of near infrared brain activity recording device.
Abstract:
People suffering neurological deficits due to sudden onset of occlusion or rupture of cerebral vessels usually develop
multiple clinical symptoms such as hemiplegia, dysesthesia, difficulty in speech or comprehension or defect of
visual fields after the acute phase. Specifically, functional impairment of the upper extremities is most common in
these patients. It is important to design a suitable training program for individual patient to effectively restore physical
functions. However, the current training protocols often rely on manual and subjective assessment of upper extreme
functions. In this paper we present the implementation of an “Intelligent Stacking Cone System” that was designed
to quantitatively evaluate the functional status of the upper limbs during rehabilitation. The design of a video game
setting with a console emulating the famous whac-a mole game can significantly improve patient participation in the
rehabilitation program. The system is integrated with many optoelectronic position sensors. During the execution,
the system can detect five key timings including the reaction time after a picture prompts, palm grip action, upper
limb remove action, palm release action and upper limb return action. The timing differences between these five
critical activities are used to represent the dynamic status of the upper limb rehabilitation. The therapist could
compare with the past training result to assess explicitly quantified patient progress. Intelligent stacking cone upper
limb rehabilitation system is a new design and method for rehabilitation. This system aims to raise the efficacy and
fun level during diagnostic and therapeutic procedures, thus improve the outcomes.
Mohammad Kamali Kakhki
Tehran Healthcare Clinic, Iran
Title: The carpal-tunnel syndrome: Experimental works in diagnosis and treatment of fourty-five hands
Biography:
Mohammad Kamali Kakhki has completed his M.D at the age of 25 years from Mashhad University of Medicine and studied in the field of Trigger point therapy,
Palpitation anatomy and Massage therapy from Tehran University of Medicine. He works in Tehran Healthcare Clinic (west marzdaran, Tehran, Iran) and has 30
years experimental works on muscle, ligaman and nervous system.
Abstract:
Carpal tunnel syndrome (CTS) is the most common peripheral nerve involvement which entraps the median
nerve in a restricted space at the wrist and converts the anterior surface into the osteofacial tunnel. Carpal tunnel
is formed by flexor retinaculum and carpal bones which passes the long flexor tendons of the fingers and median
nerve through the tunnel. The clinical sign of the syndrome is defined by burning pain, nocturnal numbness and
paraesthesia to the lateral three and a half fingers. In severe cases, median nerve innervated muscles weakness can
cause numbness in hands. This syndrome may occur in both employed and non-working people even housewife
who forceful hand work with their wrists. There are several ways of treatment for CTS including splints, ultrasound,
acupuncture, exercise, laser, steroid injections, oral steroid and surgical technique. However, some of these treatments
temporarily reduce pain and are not compelling. This problem is due to the lack of knowledge about the cause of
syndrome in the body. We found that this syndrome can be created in two different ways in the body: primitive
carpal tunnel syndrome which is caused by narrowing of the canal and compression of median nerve and long
flexor tendons. Secondary carpal tunnel syndrome is caused by cervical lesions such as neck osteoarthritis, cervical
discs, compression of brachial plexus nerve and this pressure can be transmitted to the tendons of the wrists and
fingers. The purpose of the present study is to report the experimental works in CTS based on the type of entrapment
by Multi-Functional Vibrating Device (MFVD) in Tehran Healthcare Clinic. Forty patients with carpal tunnel
syndrome who complain from tingling, burning pain or weakness in one or two of their hands referred to the Tehran
Healthcare Clinic. Of these patients, thirty-two women and eight men referred and five of them had syndrome
in both hands. First, the type of syndrome was investigated based on the sort of involvement. Then, current age,
onset age, the severity of the syndrome and syndrome duration were asked. Afterwards, the treatment was done
by vibration stimulation of entrapped flexor or nerve using MFVD during five sessions. The successful treatment
of the syndrome was considered through examination of the pain and the flexion of wrist and finger during the
wrist-flexion test and gripping, which is related to the brachial plexus nerves and long flexor tendons. Fifteen out of
forty-five hands were not treated because they referred to the clinic very late and their syndrome became chronic. So,
they require the other methods like surgical technique for treatment. Of the thirty hands treated, nine had primitive
CTS and twenty-one had secondary CTS and the recovery were achieved by works on entrapped flexor and brachial
plexus nerves, respectively. The patients with primitive CTS were driver, painter, sculptor, chef or housewife who put
a lot of pressure on their wrist and the patients with secondary CTS were farmer, cleaner or the other jobs that put
a lot of pressure on their necks, shoulders, arms and wrists. The average age of referred patients was between 45 and
60. The duration of the syndrome is very important for treatment. If the duration of the syndrome is short, it can
be easily treated by MFVD, but if it is over a long period of time, the treatment is more difficult and in the chronic
form, no sign of recovery was observed by vibration stimulation. Although, there are different ranges of treatment in
patients with CTS, but the type of CTS have to be considered on the choice of treatment. This treatment method has
been an experimental works which showed very good results for both primitive and secondary CTS but non-chronic
syndrome. Thus, this method is recommended for treatment of patients with CTS.