Scientific Program

Day 1

KEYNOTE SPEAKERS
  • Physical analgesia – state-of-the-art

    Medical University of Sofia
    Bulgaria
    Biography

    Philosophy Doctor - scientific specialty “Physical Therapy and Rehabilitation”; thesis (2004): ‘Investigation of capacities of some physical modalities in the prevention, therapy and rehabilitation of diabetic polyneuropathy patients’. Doctor of Medical Sciences - scientific specialty “Physical Therapy and Rehabilitation”; thesis (2009): ‘Complex neurorehabilitation algorithms for functional recovery and amelioration of independence in activities of daily living in socially significant invalidating neurological diseases’. Philosophy Doctor - scientific specialty “Pedagogics”; thesis (2013, Sofia University): ‘Innovations in the Education in the field of Rehabilitation’. SCIENTIFIC POSITIONS: Associated Professor (2006); Professor (2010); scientific specialty “Physical Therapy and Rehabilitation”. High Attestation Commission at the Council of Ministers, Bg. She knows French, Spanish, English, Russian language .

    Abstract

    Pain management is an important part of rehabilitation algorithms in clinical practice. Pain is one of the most frequent sensations, formed in the nervous system. By definition, pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage. The Declaration of Montréal of the International Pain Summit of the International Association for the Study of Pain (IASP) identifies that chronic pain is a serious chronic health problem and access to pain management is considered as a fundamental human right. We proposed the notion physical analgesia for the application of physical factors for pain management. By our opinion the anti-pain effect of physical modalities is very important, with a high level of efficacy. Physical analgesia has not side consequences and may be applied in combination with other therapeutic factors. In physical analgesia a lot of physical modalities are applied: ? Preformed modalities: Low frequency currents and low frequency modulated middle frequency currents (sinusoidal-modulated, interferential, Kots currents); Transcutaneous electroneurostimulation (TENS); High frequency currents (diathermy, ultra-high frequency currents, decimeter and centimeter waves); Ultra-sound and phonophoresis with NSAIDs; Low frequency magnetic field; Deep Oscillation; ? Natural modalities: Kryo-factors (ice, cold packs, cold compresses); Thermo-agents (hot packs, hot compresses), Hydro- and balneo-techniques (douches, baths, piscine); hydro and balneo-physiotherapy techniques (underwater massage, under water exercises, etc.); Peloidotherapy (fango therapy, thermal mud, sea lye compresses); Physiotherapy techniques - stretching, post-isometric relaxation, manual therapy (traction, mobilization, manipulation); massages (manual and with devices; periostal, connective tissue massage, etc.); ? Reflectory methods: electrotherapy, thermotherapy and physiotherapy in reflectory points and zones; acupuncture, laserpuncture, acupressure, etc We propose our own theory for explanation of pathogenetic mechanisms of action of physical modalities on the nociceptive and neuropathic pain: By influence on the cause for irritation of pain receptors - consequence of stimulation of circulation, metabolism and trophy of tissues (by low and medium frequency electric currents, magnetic field, ultrasound, He-Ne laser; massages; manual techniques); By blocking of nociception (low frequency currents, including transcutaneous electrical nerve stimulation or TENS; lasertherapy); By inhibition of peripheral senzitization (low and middle frequency currents, TENS; magnetic field; lasertherapy); By peripheral sympaticolysis (low frequency currents like dyadinamic currents, peloids); By stopping the neural transmission (by ? and ?? delta - fibers) to the body of the first neuron of the general sensibility (iontophoresis with Novocain in the receptive zone – the region of neuro-terminals); By input of the gate-control mechanism (TENS with frequency 90-130 Hz and interferential currents with high resulting frequency - 90-150 Hz); By activation of the reflectory connections: cutaneous – visceral, subcutaneous-connective tissue-visceral, proprio-visceral, periostal-visceral and motor-visceral (classic manual, connective tissue and periostal massage, post-isometric relaxation and stretching-techniques); By influence on the pain-translation in the level of posterior horn of the spinal medulla – using the root of activation of encephalic blocking system in the central nervous system (increasing the peripheral afferentation) and influence on the descending systems for pain – control (TENS with frequency 2-5 Hz and interferential currents with low resulting frequency 1-5 Hz, acupuncture and laserpuncture; reflectory and periostal massage, zonotherapy, acupressure, su-dgok massage; preformed factors in reflectory zones /palms of hands, plants of feet, paravertebral points; zones of Head, of Mackenzie, of Leube-Dicke, of Vogler-Krauss/); By inhibition of central sensitization (lasertherapy; peloidotherapy; physiotherapy); By influence on the psychic state of the patient – the drug «doctor» and the drug «procedure». The influence of physical modalities on the interstitium (‘milieu interieur’ of Claude Bernard) is the theoretical base for a combined pain management programme. We present our own experience and results in patients with conditions of the nervous and motor systems.

  • Effects of an Educational Program for Self-management, on Functional Independence of Adolescents with Spina Bifida

    Lisbon University
    Portugal
    Biography

    Assistant Professor at the Nursing College of Lisbon, Child and Adolescent Department. Doctorate in Nursing at the Lisbon University . Master's in Special Education, Faculty of Human Motricity. Graduate Nurse, Specialist in Child and Pediatric Health Nursing. Started to work in the hospital since 1988, Neonatology, Pediatrics, Child Development Center. Member of the Spina Bifida Center at Garcia de Orta Hospital until 2002. Since 2002 has joined the academic career at Nursing College of Lisbon as an assistant professor. Collaborates with the Spina Bifida and Hydrocephalus Portuguese Association since 2002, was vice-president from 2005 to 2013. Coordinator of the project “Training Camp - Educational Program for Self-Management on Adolescents with Spina Bifida / Spinal Cord Injury " 2011, 2012, 2013, 2014, 2015 and 2016 .

    Abstract

    Background The number of children with Spina Bifida (SB) who survived reaching adulthood increased significantly and their adolescence transition is a major concern. The purpose of this study is to develop and evaluate an educational program that promotes self-management competencies and facilitate their transition to adulthood. Methods An intervention based on psychoeducational strategies was embedded within a summer camp experience (7 Sessions). Fifty-six adolescents with SB, aged between 10 to 18 years preformed the program and assess their effect on functional independence, self-concept and self-esteem. With a before (T1) and after (T2 and follow-up T3) design, the analysis was performed using the program IBM SPSS Statistics 20, ANOVA repeated measures. Results The adolescents made a significant gains on functionality, cognitive and motor domains with moderate to high effect sizes observed. In the Motor domain we emphasize the improvement on self-care and emptying dimension (bowel and bladder). Conclusions The program had greatest impact in the motor domain of the functionality (self-care, elimination, transfers), which remains six months later. This program produces better effects on young people aged between 10 and 12 years without previous experience on camps, regardless the gender, level of injury, presence of hydrocephalus or the type of auxiliary gait devices they use. In general, the results support that the experience improves the self-management competences and the functionality of youth with SB and, suggest that the program was highly effective.

  • Correlation between the Functional Walking Capacity and Domains of Health Related Quality of Life in Individuals with Bi-Ventricular Heart Failure

    Lagos University Teaching Hospital, Lagos Nigeria
    Nigeria
    Abstract

    BACKGROUND: Individuals with heart failure present with progressive reduction in their functional capacity, their activity of daily living, thus result in poor quality of life. OBJECTIVE: The objective of this study was to correlate the functional walking capacity of individuals with bi-ventricular heart failure (BVF) as measured by Six Minute Walk Test (6MWT) with the disease specific health related quality of life domains using Kansas City Cardiomyopathy Questionnaire (KCCQ). METHODS: Sixty Six (66) Subjects (female = 37, 56% ) with Chronic BVF in Class II and III of New York Heart Association with mean age 54.0 ± 1.6 years recruited from a Nigerian Tertiary Hospital participated in the study. The Functional Walking Capacity of this patients was estimated using 6MWT to determine the 6MWD while the health related quality of life was assessed using KCCQ. Data was analysed using SPSS [IBM] Version 21 and the significant level was set at p < 0.05. RESULTS: There was significant negative correlation between the 6MWD and 6 domains of QoL but only 2, Fatigue and dyspnoea were statistically significant. (r = - 0.430, p = 0.002 and r = - 0.285, p = 0.045) respectively. Positive correlation was also observed between 6MWD and overall QoL, knowledge and perception domains though the correlation were not significant. CONCLUSION: This study showed that functional walking capacity is negatively correlated with some of the symptoms being experienced by individuals with Bi-ventricular heart failure

Physiotherapy Techniques and Exercises
Chair
Co-Chair
Rehabilitation Methods
Speaker
  • REHABILITATION OF OBSTRUCTED DEFECATION: TECHNIQUES AND TREATMENT OUTCOMES
    Speaker
    prof.Filippo pucciani
    university of florence
    Italy
    Abstract

    Obstructed defecation is broadly defined as the inability to evacuate contents from the rectum, with symptoms of a subjective sensation of anal blockage during defecation. It is a subset of constipation, in that it differs from slow-transit constipation in terms of pathophysiology, due to outlet pelvic obstruction with anorectal dysmotility. Outlet obstruction may be caused by organic or functional diseases: disorders of rectal sensation and pelvic floor dyssynergia are the main etiologic functional factors. The treatment of functional diseases is rehabilitative and multimodal rehabilitation guided by anorectal manometry is a useful method for managing the pathophysiology of obstructed defecation. The mean length of the rehabilitation cycle is about 5 months. The overall mean Obstructed Defecation Syndrome score shows significant improvement after rehabilitative treatment, using two, three or four rehabilitative techniques (pelviperineal kinesitherapy, biofeedback, anal electrostimulation, rectal sensory retraining). Therefore, multimodal rehabilitation of obstructed defecation provides the opportunity to improve the severity of symptoms in many patients. Moreover, multimodal rehabilitation identifies those ‘nonresponders’ who should be next in line for more expensive and invasive therapeutic procedures (sacral neuromodulation or surgery).

  • Immune responses following McKenzie lumbar spine exercise in individuals with acute low back pain : A preliminary study
    Speaker
    Prof. Saud Alobaidi
    Kuwait University
    Kuwait
    Biography

    Prof. Saud received his Ph.D. in physical therapy from New York University 1991. Prof. Saud have 32 years of clinical experience, in the management of pain and musculoskeletal dysfunction. Currently he is working as professor of and Dean of Faculty of Allied Health Sciences, at Kuwait university. His research area included management of acute and chronic pain and dysfunction, focusing on the consequences of selected biopsychosocial factors including; anticipation and fear of pain, exaggerated pain perception, pain avoidance behavior, life stress, coping strategies, self-efficacy on human performances

    Abstract

    Background; The pathophysiology of low back pain (LBP) and disk-related sciatica is not limited to mechanical compression of the neural tissue. Inflammation and inflammatory mediators, has been implicated in the production of acute or chronic pain. Objectives; This study explores the immune responses following 4 weeks of McKenzie lumbar spine exercise in individuals with acute low back pain (ALBP). Methods; Participants were 15 volunteered patients with ALBP. Ten ml of peripheral blood were obtained from each patient before and after 4 weeks of McKenzie exercise intervention. All patients underwent subjective and objective assessment. Intervention was custom designed following McKenzie assessment and treatment protocol. For a reference purpose similar blood samples was obtained from 15 healthy individuals. Flow cytometric analysis was used to evaluate the frequencies of CD4+ T lymphocyte sub-populations and the intracellular cytokine expression within this cell population. Pain perceptions were obtained at baseline and following each week of exercise sessions. Results; There was no significant difference in the frequency of T lymphocyte sub-populations; memory (CD4+CD45RO+) T cells, helper inducer (CD4+CD29+) T cells, CD3+CD16+CD56+ T cells and naive/suppressor (CD4+CD45RA+) T cells at base line relative to these cell populations after exercise sessions. Pain was significantly reduced after 4 weeks of McKenzie exercise interventions (p<0.05). The percentage of T cells expressing pro inflammatory cytokines IL-8 and TNF-? and anti-inflammatory cytokine IL-4 increased significantly (p<0.05) following intervention. Interestingly, the reduction in pain scores did not correlate with elevated anti-inflammatory cytokines. Conclusion; McKenzie exercise induced an immune activation state and simultaneously up regulated anti-inflammatory IL-4 cytokines that boost pain relief.

  • Effects of an Educational Program for Self-management, on Functional Independence of Adolescents with Spina Bifida
    Speaker
    Maria Isabel Dias da Costa Malheiro
    Lisbon University
    Portugal
    Biography

    Assistant Professor at the Nursing College of Lisbon, Child and Adolescent Department. Doctorate in Nursing at the Lisbon University . Master's in Special Education, Faculty of Human Motricity. Graduate Nurse, Specialist in Child and Pediatric Health Nursing. Started to work in the hospital since 1988, Neonatology, Pediatrics, Child Development Center. Member of the Spina Bifida Center at Garcia de Orta Hospital until 2002. Since 2002 has joined the academic career at Nursing College of Lisbon as an assistant professor. Collaborates with the Spina Bifida and Hydrocephalus Portuguese Association since 2002, was vice-president from 2005 to 2013. Coordinator of the project “Training Camp - Educational Program for Self-Management on Adolescents with Spina Bifida / Spinal Cord Injury " 2011, 2012, 2013, 2014, 2015 and 2016 .

    Abstract

    Background The number of children with Spina Bifida (SB) who survived reaching adulthood increased significantly and their adolescence transition is a major concern. The purpose of this study is to develop and evaluate an educational program that promotes self-management competencies and facilitate their transition to adulthood. Methods An intervention based on psychoeducational strategies was embedded within a summer camp experience (7 Sessions). Fifty-six adolescents with SB, aged between 10 to 18 years preformed the program and assess their effect on functional independence, self-concept and self-esteem. With a before (T1) and after (T2 and follow-up T3) design, the analysis was performed using the program IBM SPSS Statistics 20, ANOVA repeated measures. Results The adolescents made a significant gains on functionality, cognitive and motor domains with moderate to high effect sizes observed. In the Motor domain we emphasize the improvement on self-care and emptying dimension (bowel and bladder). Conclusions The program had greatest impact in the motor domain of the functionality (self-care, elimination, transfers), which remains six months later. This program produces better effects on young people aged between 10 and 12 years without previous experience on camps, regardless the gender, level of injury, presence of hydrocephalus or the type of auxiliary gait devices they use. In general, the results support that the experience improves the self-management competences and the functionality of youth with SB and, suggest that the program was highly effective.

  • Correlation between the Functional Walking Capacity and Domains of Health Related Quality of Life in Individuals with Bi-Ventricular Heart Failure
    Speaker
    Dr Olufunke Adewumi Ajiboye
    Lagos University Teaching Hospital, Lagos Nigeria
    Nigeria
    Abstract

    BACKGROUND: Individuals with heart failure present with progressive reduction in their functional capacity, their activity of daily living, thus result in poor quality of life. OBJECTIVE: The objective of this study was to correlate the functional walking capacity of individuals with bi-ventricular heart failure (BVF) as measured by Six Minute Walk Test (6MWT) with the disease specific health related quality of life domains using Kansas City Cardiomyopathy Questionnaire (KCCQ). METHODS: Sixty Six (66) Subjects (female = 37, 56% ) with Chronic BVF in Class II and III of New York Heart Association with mean age 54.0 ± 1.6 years recruited from a Nigerian Tertiary Hospital participated in the study. The Functional Walking Capacity of this patients was estimated using 6MWT to determine the 6MWD while the health related quality of life was assessed using KCCQ. Data was analysed using SPSS [IBM] Version 21 and the significant level was set at p < 0.05. RESULTS: There was significant negative correlation between the 6MWD and 6 domains of QoL but only 2, Fatigue and dyspnoea were statistically significant. (r = - 0.430, p = 0.002 and r = - 0.285, p = 0.045) respectively. Positive correlation was also observed between 6MWD and overall QoL, knowledge and perception domains though the correlation were not significant. CONCLUSION: This study showed that functional walking capacity is negatively correlated with some of the symptoms being experienced by individuals with Bi-ventricular heart failure

  • Thermobalancing therapy® and Dr Allen's Devices are an excellent physiotherapy tool for treating chronic conditions that cause pain and other troubling symptoms
    Speaker
    Dr Simon Allen
    Fine Treatment
    United Kingdom
    Biography

    Dr. Allen obtained a PhD in Medicine in 1978. For over 14 years, he worked at and subsequently headed a hospital’s cardio-vascular department, and treated patients with renal diseases. He had authored many scientific articles on metabolic disorders, including those linked to obesity, kidneys, arthritis, cardio-vascular and gastroenterological diseases. He lectured medical doctors pursuing higher medical qualifications. He then devoted nearly two decades to further medical research into various chronic internal diseases. Dr Allen established Fine Treatment, UK, is the author of The Origin of Diseases Theory and the inventor of effective physiotherapeutic devices which enable the Thermo balancing therapy.

    Abstract

    Thermobalancing therapy and Dr Allen’s Devices provide a side effects free treatment for common chronic internal disorders, such as back pain, chronic prostatitis/chronic pelvic pain syndrome (CPPS), benign prostatic hyperplasia (BPH) and kidney stones. The therapy and Dr Allen’s Device received a US patent, as “Therapeutic device and method”. Thermobalancing therapy is based on a new understanding of the origin of diseases that states that all chronic internal diseases have the same root, the pathological activity of capillaries. As a result of changes in small blood vessels, the focus of hypothermia becomes a continuous trigger in the affected tissue, which slowly increases the pressure in the affected organ that gradually leads to its malfunction. Dr Allen’s Device applies thermoelement(s), which accumulates the body heat and becomes the source of energy itself, tightly to the skin in the projection of the affected area eliminating the focus of hypothermia and, consequently, pain and other troubling symptoms. Two clinical trials on thermobalancing therapy in men with BPH and chronic prostatitis confirmed its effectiveness. After 6 months of use of DATD: in men with BPH, there was a decrease in the prostate volume (mL) from 45.1 to 31.8 and urinary symptoms score from 14.3 to 4.7; in men with chronic prostatitis, pain reduction ranges from 10.3 to 3.5, and prostate volume (mL) from 31.7 to 27.0. There were no changes in the control groups.

Advancements in Physiotherapy
Speaker
  • The Effect of a 5-Week Group-Based Exercise Program on Strength, Balance, Mobility, and Gait in the Older Adult Population: A Pilot Study
    Speaker
    Carol Maritz
    University of Sciences
    USA
    Abstract

    Background: Falls are also the fifth leading cause of death among adults aged 65 years and older. Lower extremity weakness and decreased balance are two important risk factors associated with falls in the older population. Current research suggests that in order to produce effective outcomes, an exercise program for older adults needs to be at least 10 weeks in length Methods: 18 of 23 participants over the age of 60 years (17 female, 1 male; mean age 74 years) completed this pre-test-post-test design. The participants tested on the following outcome measures: 30-second Chair Stand test for lower extremity strength, Four Square Step test (FSST) for dynamic balance, Timed up and go (TUG) test for mobility, Activity-Specific Balance Confidence Scale (ABC) for balance confidence and GAITRite® for forward and backward walking velocity. Participants attended a 45-minute group-based exercise program twice a week for 5 weeks at a local church. The program included a 5 minute warm up, 10 minutes of stretching, 20 minutes of strengthening for both upper and lower extremities with resistance as well as core work, 5 minutes of balance training and 5 minutes of cool down exercises. Results: A significant difference was found in the pre- and post-test measures of backward gait velocity (p=.034), forward gait velocity (p=.016), 30-second Chair Stand Test (p=.001), TUG (p=.022), and the FSST (p=.001). Although there was no statistically significant differences found in the ABC scale, the overall scores increased. Conclusion: This 5-week group-based exercise program was effective at improving forward and backward gait velocity as well as decreasing the clinical risk for falls in older adults. It is recommended that elements of this program be incorporated into physical therapy practice. Additionally, upon conclusion of physical therapy treatment, older adults should be encouraged to participate in community-based group exercise programs to maintain overall health and wellness and prevent future falls.

Manual Physiotherapies
Sports & Physiotherapy
Chair
Co-Chair
Physiotherapy in Treatment & Care
Physiotherapy methods and Instrumentation

Day 2

KEYNOTE SPEAKERS
  • Permanent ankle left joint distortion by drivers and right joint by passengers in countries with “right rules of traffic”. New syndrome. Case report

    Vincent Pol University
    Poland
    Biography

    Prof. Tomasz Karski MD PhD – I was born on 2nd January 1939. In the years 1956 – 1961 I studied at Medical University in Lublin. I received medical doctor certificate in 1961. From 1961 to 1963 - practicum in Medical Departments. During the studies I was active for 3 years in Students Scientific Orthopaedic Association and later after graduation I was the assistant - teacher for young students generation. In 1967 and next in 1971 I passed specializations degrees - first and second degree - in orthopaedic surgery and traumatology of movement apparatus. In 1972 I received the title “doctor degree” and in 1982 after habilitation (colloquium before Medical University Council) I passed consecutive degrees to receive PhD degree and later assistant professor title. In 1993 I was awarded by full professor degree and title by President of Poland. Since 1st October 1995 (till - I be retired in 2009) I was the Head of Chair and Department of Paediatric Orthopaedics and Rehabilitation of Medical University in Lublin/Poland, in the biggest Paediatric Hospital in Eastern Poland Region (in Polish: Uniwersytecki Szpital Dzieci?cy in Lublin). I was a member of Polish Orthopaedic and Traumatology Association (PTOiTr) since 1963. For 12 consecutive years I was Secretary of Lublin Section of the Polish Orthopaedic and Traumatology Association, for 4 years I was Vice-President of the Section of POTA and for 4 years I was a President of the Lublin Section of this Association. I worked in Editorial Board of Polish Hand Surgery, of Journal of Paediatric Orthopaedics part-B, of Biblioteka Ortopedii Dzieci?cej (Pediatric Orthopaedics Library) and of Journal Locomotor System - „Pohybové ústrojí“ (Czech Republic). I was a member of EPOS since 1985 and of Société Internationale de Chirurgie Orthopédique et de Traumatologie (SICOT) since 2002. I was 36 times awarded by the Rector of Medial University of Lublin for my scientific and educational achievements. I received three times awards from the Ministry of Health of Poland (1975, 1986, 1993). I was awarded with medals: "Przyjaciel Dziecka" (1978r.), "Medal Pami?tkowy Sze??dziesi?ciolecia TPD” and „Mi?dzynarodowego Roku Dziecka" (1979r.), Z?ot? Odznak? TWK (1984r.), Z?oty Krzy? Zas?ugi (1987r.), Medal im. dr Henryka Jordana (2000r.) and Krzy? Kawalerski Polonia Restituta (2000r.) and Medal Komisji Edukacji Narodowej (2003r.). Since 1996 I am a Honorary Member of Hungarian Orthopaedic and Traumatology Association, since 2003 of Slovak Orthopaedic and Traumatology Association and since 2009 of Czech Republic Purkynie Society. I described the aetiology of the so-called idiopathic scoliosis (1995-2007) and I described a new rehabilitation treatment of this spine deformity. In the year 2001 I described in new classification of two groups of scoliosis – “S” deformity in I epg and “C” II/A & “S” II/B epg group. In 2004 I described “I” scoliosis (only stiff spine) in III epg group. In new (Karski’s 2001-2004) classification there are 3 groups and 4 types of scoliosis: – “S” I epg (etio-patho-genetical) scoliosis, influencing factor walking and permanent standing ‘at ease’ on the right leg. Two curves. Rip gibbous on the right side. 3D. Stiff spine. Progression. – “C” II/A epg and “S” II/B epg scoliosis, influencing factor permanent standing ‘at ease’ on the right leg. General flexibility in “S” II/B epg. 2D. Spine is not stiff but flexible. No progression or slight. – “I” III epg scoliosis. 2D. Stiff spine, minimal or not curves. No progression. This type of scoliosis was not admitted to the group of scoliosis till 2004 (T. Karski). I have published many articles in numerous polish and foreign journals and also in four books about scoliosis (2000, 2002, 2003, 2011). My observations about scoliosis has been published by International Research Society for Spinal Deformities (IRSSD), after Congresses in Athens - 2002, in Gent (Belgium) - 2006 in Liverpool – 2008 and in Pozna? (Poland) in 2012 and during SICOT Congresses in Egypt (2002), in Cuba (2004), in Istanbul (2005), in Morocco (2007). I had to publish my articles in Pan Arab Journal of Orthopaedics and Trauma (two articles), next in China. In the years 2009 – 2017 I published many articles (36) in USA, Canada, Spain, Czech Republic, two in Poland. My scientific interest is paediatric orthopaedic surgery and specially: dysplasia of the hips - DDH, congenital feet deformities, torticollis (wry neck) , cerebral palsy (CP), genua valga, crura vara – Blount disease, since 1984 (after the scholarship stay in Invalid Foundation Hospital in Helsinki – Finland) – spine deformities (scoliosis) and more others. I am author of 7 original orthopedic devices. I am author or co-author of 450 + 36 publications in medical literature Polish and in abroad (in English, in German and in Spanish) and I am the author of 5 books. I am retired from 2009. In the time 2009 - 2016 I have publish 36 article in USA, Spain, Canada, Germany, Czech Republic, China, Egypt.

    Abstract

    Typical deformations and pain syndromes of feet. Deformations of feet in children and feet pain syndromes in adults are very common in many people, mostly in women in many countries. There are: 1/ “static valgus or plano – valgus” feet deformity in children and youth, 2/ insufficiency and pain by adults in frontal part of feet as result of limited plantar flexion of the toes, 3/ valgus deformity of the big toes (hallux valgus), 4/ Köhler’s disease among girls wearing not proper shoes, 5/ congenital deformation of feet, needed special orthopedic program, often surgery, 6/ deformations of feet, knee, pelvis and spine in children with Minimal Brain Dysfunction (MBD) Material presented in lecture - together: 28 patients. 24 cases with left ankle joint pain syndrome and 4 cases with right ankle joint pain syndrome. Material is from the years 2012 – 2016. Instability and secondary pain syndrome of ankle joint. The article describe this special type of foot insufficiency – “instability of ankle joint” and pain syndrome because of “permanent distortion of this joint” – the left ankle joint in drivers and right ankle joint in passenger in countries with “right traffic rules”. Till now never was described the “insufficiency of ankle joint” because of instability of this joint as result of causes described by authors – its mean – getting out from the car on one leg. The symptoms of such illness can be not only in left or right foot but also in left or right knee. In our patients we observe: swollen foot, limited dorsal flexion of foot, painful region of Achilles and sinus tarsi. The gait was with limping or some patients were even not able to walk longer distance. Such instability, because of permanent distortion of ankle joint and can occur also among people doing some jobs – when exist permanent rotation movement of the whole body on full stabilized feet longer time, for example among the women working in kitchen. Treatment. In our material we noticed, that the treatment in this group of patients, before contact with us, was mostly not proper and not leading to full recovery. This improper treatment was among presented patients even 4 – 5 years ! In lecture we present cases of the feet problems and we discuss method of therapy and rules of prophylaxis. The article about this problem and proper therapy was publish in USA in June 2017 (see literature). Discussion and Conclusions. 1/ We described the pathology syndrome of the ankle joint, the chronic distortion caused by rotation movement made during getting out the car. 2/ This is the new “Syndrome of Distortion and Following Instability of Ankle Joint”. 3/ Unfortunately in all our patient the previous diagnosis was not proper and the therapy not leading to recovery. 4/ The illness can be the long time lasting problem - 4 or even 5 years. 5/ It is important - the proper diagnosis and proper treatment with the information about the prophylaxis – getting out the car on both legs, without rotation movement of the body on stabilized feet.

  • Extended perspective of sensorimotor training - do we train functionally enough?

    Academy for integrative physiotherapy and training education
    Germany
    Biography

    Slavko Rogan (PhD, MSc PT, MSc Osteopathy, MA adult education, cand. MA school management) is a lecturer and research scientist. He has a background in physiotherapy, osteopathy and further adult education. He works in the fields of geriatrics, musculoskeletal disorders and sport science. His research interests focus on the development of exercise and training programs in elderly persons, investigation of manual therapy effectiveness and sensorimotor training and in the field of adult education he focusses on mentoring and (attended) self-study. In this field, he has authored more than 35 peer-reviewed articles in peer-reviewed journals in the field of gerontology, sport science and physiotherapy.

    Abstract

    The movement control and movement coordination are subject to the functional capability of the sensorimotor system. This includes the recording, its forwarding and the signal transmission. In everyday life, a muscle response must occur within a certain time frame, with the aim to stabilizing a joint or to keep the body in balance. For example, the quadriceps muscle must contract during walking within 125 to 200 ms or during stairs climbing within 100 to 150 ms. Implemented to treatment modalities, a frequency range between 3 and 6 Hz should be used. Sensorimotor training (SMT) is used in rehabilitation and prevention to improve the slowed muscle reflexes. This is usually done with the aid of active devices, such as whole-body vibration devices (WBV), as well as passive therapy devices, such as foam mats, balance boards, etc. However, studies show that passive therapy devices produce primary weak stimuli below 3 Hz. The question that arises is if these devices could produce the necessary stimuli for the sensorimotor system in order to obtain the desired motor response. On the one hand, the presentation takes up this question, examines various movements from everyday life and sports from the side of biomechanics and demonstrates which movement patterns are produced by active and passive training devices. On the other hand, the meaningful use and the requirements of such training devices in rehabilitation and prevention should be critically examined, analyzed and discussed.

Sports & Physiotherapy
Speaker
  • effects on the improvement of non-specific low back pain and postures adopted in adolescents
    Speaker
    Dr. Beatriz Minghelli
    Piaget Institute, Research in Education and Community Intervention
    Portugal
    Biography

    Beatriz Minghelli, Adjunct Professor in the School of Health Jean Piaget / Algarve, Piaget Institute of Study Cycles in Physiotherapy and Nursing since 2006. Member of Research in Education and Community Intervention (RECI) –Piaget Institute PhD in Public Health, Epidemiology specialty, in the National School of Public Health, NOVA University Lisbon, Portugal, Master of Science in Physical Therapy from the School of Human Kinetics, University of Lisbon, Portugal, Physiotherapist by Education School Helena Antipoff - Rio de Janeiro, Brazil. With regard to research, has 27 publications in national and international journals and several participations in scientific events through work in the form of poster and oral presentations. Reviewer of scientific article for several journals (Journal of Public Health, BMC Musculoskeletal Disorders, International Journal of General Medicine, ClinicoEconomics and Outcomes Research, Journal of Spine & Neurosurgery, Adolescent Health, Medicine and Therapeutics, Archives of Physiotherapy, Journal of Pain Research). Member of the Editorial Board of the Journal Austin Spine, EC Orthopaedics journal, Research and Reviews. Most investigations are related to epidemiology studies, including obesity, low back pain, scoliosis, postural changes, injuries in different sports (soccer, surf, cycling, martial arts).

    Abstract

    Low back pain (LBP) has become a growing public health problem in adolescents, presenting a relatively high prevalence during school age. In southern Portugal, 966 adolescents were evaluated, aged between 10 and 16 years and the results revealed that 15.7% of students had LPB at the present time, 47.2% had experienced it in the last year and 62.1% had lifetime prevalence of LBP. Several factors may be involved in the pathogenesis of LBP, such as genetic, psychosocial, physiological, anthropometric and environmental, among them ethnicity, age, sex, smoking, obesity, physical activity practice, sedentary activities such as television watching and computer use, adoption of wrong postures and incorrect transportation and excess weight in school backpacks. Minghelli et al. study found that students who sit with the spine incorrectly positioned presented 2.49 (95% CI: 1.91-3.2, p<0.001) greater probability of having LBP, and students using improper positions for watching TV or playing games have 2.01 (95% CI: 1.55-2.61, p<0.001) greater probabilities compared to those who adopted correct postures. Physiotherapy in the school health field emerges with the objective of promoting knowledge and health conditions in this specific area of LBP and postural changes, optimizing the technical and personal skills of teachers and students, and developing individual and collective health potential. The performance of the Physiotherapist in schools should involve a salutogenic approach in order to create in schools a stimulating environment of creativity and a critical sense, and not just an intervention aiming at changes in risk factors. Empowerment, capacity and motivation must be given so that adolescents and the entire school community are responsible for their own health choices. Several studies have verified the effectiveness of a school health program in improving students' posture and knowledge about ergonomic issues, however, there are still no guidelines and little is known about the effectiveness of such a program. The objective of this oral presentation will be to disseminate the guidelines of scientific studies that were used in school health programs and their effectiveness and to present a school health project developed in schools in the south of Portugal. References • Cardon G, De Clercq D, De Bourdeaudhuij I. Effects of back care education in elementary schoolchildren. ACTA PÆDIATR 89 (2000) 1010-17 • Cardon GM, De Clercq DLR, Geldhof EJA et al (2007) Back education in elementary schoolchildren: the effects of adding a physical activity promotion program to a back care program. Eur Spine J 16:125–133 • Cardon GM, De Clercq DLR, de Bourdeaudhuij IMM (2002) Back education efficacy in elementary schoolchildren—a 1-year follow-up study. Spine 27:299–305 • Cardon G, De Bourdeaudhuij I, de Clercq D (2002) Knowledge and perceptions about back education among elementary school students, teachers, and parents in Belgium. J School Health 72:100–106 • Geldhof E, Cardon G, de Bourdeaudhuij I et al (2007) Back posture education in elementary schoolchildren: a 2-year follow up study. Eur Spine J 16:841–850 • Geldhof E, Cardon G, De Bourdeaudhuij I, De Clercq D. Back posture education in elementar schoolchildren: stability of two-year intervention effects. Europa Medicophysica 2007; 43 (3): 369-379 • Jones G, Macfarlane G. Epidemiology of low back pain in children and adolescents. Arch Dis Child 2005; 90: 312-316 • Jones M, Stratton G, Reilly T, Unnithan V. A school-based survey of recurrent non-specific low-back pain prevalence and consequences in children. Health Education Research 2004; 19 (3): 284-289 • Leboeuf-Yde C. Back pain - individual and genetic factors. Journal of Electromyography and Kinesiology 2004; 14: 129-133 • Minghelli B, Oliveira R, Nunes C. Non-specific low back pain in adolescents from South of Portugal: prevalence and associated factors. Journal of Orthopaedic Science August 2014; 19 (6): 883-892 • Williams F, Sambrook P. Neck and back pain and intervertebral disc degeneration: Role of occupational factors. Best Practice & Research Clinical Rheumatology 2001; 25: 69-79

Rehabilitation Methods
Speaker
  • Skeletal muscle atrophy and hypertrophy after Spinal Cord Injury
    Speaker
    Ashraf S. Gorgey
    Virginia Commonwealth University
    USA
    Biography

    Ashraf S. Gorgey, MPT, PhD, FACSM  is currently the Director of Spinal Cord Injury Research at Hunter Holmes McGuire at VA Medical Center and Associate Professor at Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University. He has a bachelor and master degrees in physical therapy. He acquired his PhD in exercise physiology in 2005 with special emphasis on electrical stimulation, muscle activation and fatigue from the University of Georgia. He completed a postdoctoral fellowship at the University of Michigan with special focus on studying the adaptations in body composition and metabolic profile after SCI. His research background is in Rehabilitation and Exercise Physiology with special interest in individuals with SCI. His research work has focused on investigating rehabilitation strategies that could improve the quality of life in individuals with SCI and minimize the SCI health related secondary complications. Dr. Gorgey is primarily interested in applications of electrical stimualtion and the capability of utilizing exercise intervention to evoke skeletal muscle hypertrophy, favorable body composition and metabolic profiles in persons with chronic SCI.  He is also interested in understanding the cellular and molecular adaptations to unloading and hypertrophy. Dr. Gorgey is currently studying the effects of resistance training and testosterone replacement therapy interventions on parameters of physical activity in persons with SCI including body composition, metabolic and mitochondrial health. His research has received a national recognition by different organizations, including the Department of Veteran Affairs and Department of Defense. Dr. Gorgey has published close to 85 peer-reviewed articles and presented nationally as well as internationally in different scientific meetings. 

    Abstract

    Skeletal muscle atrophy is one of the most prominent changes to occur post spinal cord injury (SCI), with thigh muscle cross-sectional area being up to 30–50% smaller than that of able-bodied controls few weeks after injury. Skeletal muscle atrophy has dramatic effects, especially after motor complete SCI (i.e. no voluntary movement below the level of injury) on several health parameters. These parameters may include bone, metabolic and cardiovascular health and may lead to secondary health complications similar to obesity, type II diabetes and cardiovascular disease. Therefore, an effective rehabilitation approach is essential to attenuate the process of skeletal muscle atrophy and the rapid decline in lean mass after SCI. Neuromuscular electrical stimulation (NMES)-resistance training (RT) has been shown to be an effective rehabilitation strategy for producing muscle hypertrophy and decreasing fat in individuals with SCI. The training process involves progressively loading the trained muscle in a gradual fashion to carry on weights for 12-16 weeks. We have demonstrated that person with motor complete SCI can lift ~26 lbs. without any noticeable adverse events. Enhancing the development of metabolically active lean muscle mass has the potential to enhance, basal metabolic rate, glucose homeostasis and improve lipid profile following SCI. We will demonstrate recent evidence that highlights the significance of restoring and maintaining lean mass on mitochondrial health, visceral fat as well as metabolic health after SCI. We believe that a multi-disciplinary approach of combining NMES-RT and dietary interventions can optimize cardiometabolic outcomes after SCI.

Physiotherapy Techniques and Exercises
Advancements in Physiotherapy
Manual Physiotherapies
Physiotherapy in Treatment & Care
Physiotherapy Lymphedema

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