Day 1 :
Deborah Hilton Statistics Online, Australia
Keynote: A summary of the research evidence that reports on the benefits of exercise and physical activity programs mostly from a population health perspective including details from the ABS on physical activity participation rates?
Time : 09:00-09:30
Deborah Hilton has qualifications of BPhty, and an MPH. Her dissertation was an analysis of the Australian Diabetes Screening Study, and this was published in the Medical Journal of Australia. Her research gate profile is https://www.researchgate.net/profile/Deborah_Hilton, listing 14 research items [publications], which have been read over 1500 times and there have been approximately 250 citations. Her website is Deborah Hilton Statistics Online (http://sites.google.com/site/deborahhilton/). Her CV lists 11 peer reviewed publications, 1 manuscript acknowledgement, I grant successfully applied for, 22 poster presentations, 1 book acknowledgement, 7 paper conference presentations, and other adhoc work including 18 short articles written.
Physical activity [PA] is important for general health and wellbeing. Inadequate exercise is a risk factor for a number of health conditions, while engaging in PA is beneficial for various medical conditions. Hilton and colleagues publication in 2002, analysed data retrospectively from the general-practice based Australian Diabetes Screening Study. Prevalence estimates for undiagnosed diabetes using the American (ADA), Australian (ADS) and WHO criteria were 9.4%, 16.0%, and 18.1% respectively. A publication by Koye et al  that analysed data from the Australian Diabetes, Obesity and Lifestyle [AusDiab] study reported that in older Australians, diabetes more than doubled the odds of reporting disability at 12 years with body mass index and cardiometabolic factors accounting for much of the relationship. Hence interventions that target weight control, may prevent disability and promote health as people age. A systematic review on the PEDro website by Richardson et al  that reviewed pedometer based walking programs and weight loss found that these programs result in a modest amount of weight loss with longer programs being more effective. Hilton assessed knowledge, usage and acceptability of fitness trackers in 2016 when she conducted a survey. Eight different trackers, pedometers, apps or websites were included and 100 surveys were sent out with seventy returned. The fitbit was the most known about and utilised fitness tracker. Systematic reviews on the PEDro website report that PA and exercise are beneficial for low back pain prevention [Steffens et al 2016], for improving pain and functional status in people with knee or hip osteoarthritis [Regnaux et al 2015] and for chronic pain in adults [Geneen et al 2017]. This presentation will also highlight Australian Health Survey findings reporting that approximately one in four children, less than one in ten teenagers, and only one in five adults reach the required number of steps/day.
- Hilton DJ. 2016. The global children’s challenge program; pedometer step count in an Australian school. International Journal of Social, Behavioral, Educational, Economic, Business and Industrial Engineering. 10: 588-591.
- Hilton DJ. 2014 Computational Methods in Official Statistics with an Example on Calculating and Predicting Diabetes Mellitus [DM] Prevalence in Different Age Groups within Australia in Future Years, in Light of the Aging Population. International Journal of Mathematical, Computational, Physical and Quantum Engineering 8: 1208-1212.
- Kabra SK, Lodha R, Hilton DJ. 2008 Antibiotics for preventing complications in children with measles. Cochrane Database of Systematic Reviews Issue 3. Art. No.: CD001477. DOI: 10.1002/14651858.CD001477.pub3.
- Hilton D, Reid C, Paratz J. 2006 An under-used yet easily understood statistic: the number needed to treat. Physiotherapy 92: 239-245.
- Rosenfeldt F, Hilton D, Pepe S, Krum H. 2003 Systematic review of effect of coenzyme Q10 in physical exercise, hypertension and heart failure. Biofactors 18: 91-100.
Chartered Physiotherapist, Fellow of Association of Reflexologists,
Gunnel Berry is a member of the Chartered Society of Physiotherapy in the UK and has completed her Master’s degree in Advanced Physiotherapy from the UCL London. She then qualified as a Reflexologist. As a Clinical Specialist in pain, she developed adapted reflextherapy as a concept and treatment for patients in pain. She has presented and published papers on the same subject in Europe, USA and China. Although retired from clinical practice, she maintains a role as an Educational Officer of the Association of Chartered Physiotherapists in Reflex Therapy, and has recently published a book, “Adapted Reflextherapy: An Approach to Pain”.
A whiplash injury commonly occurs at a high or low velocity motor-vehicle accident with an un-expectant occupant subjected to acceleration and deceleration G-forces with physiological, neuroplastic and pathological consequences. Victims of whiplash injury complain of multisite and variable pain during or after an accident. Although the cervical spine is most commonly affected thoracic and lumbar spines should be included as sources of pain. Biopsychosocial therapy has been found to reduce central nervous system hyperexcitability in chronic pain patients. Extensive investigations to understand pain has been carried out. Attempt to apply modern neuroscience in clinical practice and Worsfold offers interventions to rehabilitate whiplash injury patients. Founded on the principle of ‘counter-irritability’ of neuroplastic activity adapted reflextherapy has been found to alter subjective and objective whiplash symptoms. This presentation introduces a hypothesis supporting a practical application which may offer clinical value in treatment of whiplash injury patients.
- Physical Therapy Diet and Physical Health Sports Injury and Rehabilitation
Santa Paula University, Costa Rica
Erika Cyrus Barker is the Chair Director of Physical Therapy Program, Santa Paula University, Costa Rica, a Physical Therapist with studies in Rehab Sciences. He holds a PhD degree in Medical Sciences Research. He is also a Researcher in the field of Functional Limitations caused by Chronic Degenerative Diseases.
Patients with ankylosing spondylitis, have an increased risk of functional limitation if adequate treatment of all functional alterations is not performed. Pain is not the only symptom to be treated in patients with this condition, there are functional alterations characteristic of the disease, as well as alterations of the environment and the role of life that directly influence the well-being and functionability of patients. The main alterations presented by ankylosing spondylitis are, pain and stiffness caused by inflammation of the sacroiliac joints, which progressively extends to other joints of the spine, producing numerous changes in the patient's posture. Physiotherapy treatment in ankylosing spondylitis plays a very important role both in the prevention of the evolutionary process of the disease and in the treatment of the disease once the symptoms have appeared. Thus, one of the tools that the physiotherapist has for the treatment of AS in the long term is the Therapeutic Exercise. A study by Viitanen et al., provides a very important data for our investigation, the results showed that the duration of the disease does not affect the results; or in other words, that the effects of physical exercise on these patients are independent of the progress of the disease, or of the stage of the pathology in which the patient is found, so that age would not be an inconvenience for the inclusion of these patients in a physical exercise program. It should be noted that all the exercises of the program must be related to the alterations that patients of ankylosing spondylitis suffer as a result of it. Not all exercises are beneficial for this affectation. The present bibliographic review is accompanied by a proposal based on a series of case studies, the results of which have allowed patients in this condition to maintain an active life and with minimal limitations in function.
Mohamed sathak A J College of Physiotherapy, India
P. Senthil working has a Professor in faculty of Physiotherapy, Mohamed Sathak A J College of Physiotherapy with a total experience for 15 years in both academic as well as hospital sector. I am Pursuing as a part-time Research scholar of Physiotherapy (PhD) in Vel’s University, India. Interested in the musculoskeletal evaluation and its intervention part which is the common issues in the community. The above mentioned oral presentation topic on this Physician’s 2017 conference will be newer method of evaluation that reveals the primary kinematic causes for the musculoskeletal problems and thereby effective intervention can be decided and implemented in the Physiotherapy field.
E mail ID: [email protected]
Background: Neck and shoulder pain can be a disabling and recurrent disorders characterized by periods of remission and exacerbation, so too does the prevalence of musculoskeletal dysfunction (MSD). Even the overactive and underactive muscles in the neck region lead to poor performance of upper extremity function also. The upper body dysfunction (UBD) screening chart was developed to assist in the detection of MSD. Although varying musculoskeletal assessment has been used, components of UBD screening chart had combined kinematic analysis and muscular imbalance due to the recurrent problems. Expanding the UBD screening chart use in health care system may improve the detection of MSD allowing for earlier treatment. The primary goal of this study was to evaluate the use of the UBD screening chart in health care by comparing the results of assessments of orthopaedic surgeon with those of physiotherapist.
Methods: Patients from 25-45 years old recruited from an orthopaedic health centre were examined by an orthopaedician and a physiotherapist who recorded the appearance of each participant's posture and the appearance and movement of the shoulder, neck and thoracic spine by deeming them normal or abnormal. UBD scores were compared between the investigators with the proportion of observed (Pobs), positive (Ppos) and negative (Pneg) agreement being the primary outcomes. Kappa statistics were also calculated.
Results: A total of 100 patients consented to participate who were previously diagnosed has MSD. Results showed reasonable agreement between the orthopaedician and physiotherapist; Pobs=0.698, Ppos=0.614 and Pneg=0.752. The coefficient of agreement (estimated Kappa) was 0.3675 for the composite UBD score. For individual components of the UBD exam, the highest agreement between orthopaedician and physiotherapist was in the assessment of posture and muscle imbalance.
Conclusion: Previously reported recurrent increase in signs and symptoms of musculoskeletal conditions has highlighted the need for a simple yet sensitive screening exam for the identification of musculoskeletal abnormalities. Results of this study suggest that health care practitioners can efficiently use the UBD chart examination in the assessment of populations with a high proportion of musculoskeletal issues.
P Senthil, et al. (2015) Effectiveness of global posture re-education on pain and improving quality of life in women with chronic neck pain. International journal of physical education, sports and health 1(4): 07-09.
Senthil P, Sudhakar S, R Radhakrishnan (2016) Isolated activation of deep cervical flexors in chronic neck pain. Indian Journal of Physiotherapy and Occupational Therapy 10(2): 121-124.
- P Senthil, R Radhakrishnan (2016) Normative data and intra-reliability of push-pull dynamometer on normal healthy college students. IJHSR ISSN: 2249-9571
- P Senthil, S Sudhakar, R Radhakrishnan (2016) Effect of thoracic correction exercises in upper body dysfunction of 94-year-old male participant: A case report. Journal of Clinical and Diagnostic Research. 10(12): YD01-YD02.
Armed Forces Centre for Health Rehabilitation, Saudi Arabia
Abulkhair M Beatti, PhD, is the Director of Armed Forces Centre for Health Rehabilitation and Consultant Physiotherapy, Taif, Saudi Arabia. He is also a Collaborate Lecturer at Dammam University, Saudi Arabia. He completed BSc and MSc at King Saud University, Saudi Arabia and a PhD in Physiotherapy at University of Queensland, Australia. His research focuses on the study of various aspects of interferential therapy in the management of pain. Current investigations also relate to elucidating the effect of interferential therapy on pain while using different arrangement of electrodes in relation to the pain spot. In his spare time, he enjoys attending sporting events and traveling.
Statement of the Problem: Interferential therapy (IFT) has been applied in a quadripolar way so that the two currents intersect in the painful area. Clinically, no clear reduction effect of pain has been confirmed with this application method of IFT. Experimentally, the highest voltage of IFT is being induced outside the intersection area of the two used currents. Thus, it is probably true that placing the painful area outside the intersection spot of the two currents would reveal a significant pain reduction which was investigated in this study.
Methodology & Theoretical Orientation: A double-blind placebo-controlled clinical investigation on 168 subjects with subacute low back pain subjects was carried out. Participants were randomly assigned to: 1. External IFT (painful spot was at 2 cm outside of the outer borders of the electrodes), 2. Placebo external IFT, 3. Traditional IFT (painful spot was at the crossing area of the two currents), 4. Placebo traditional IFT. Groups 1 and 3 received 20 min of IFT at 100 Hz and comfortable stimulation intensity. Groups 2 and 4 received sham IFT for 20 min. Before and immediately after IFT session, pain severity, pressure threshold (PPT) and distribution were assessed using visual analogue scale (VAS), algometer, and distance from pain source, respectively. Distance from the tip of middle finger to the ground during forward trunk flexion determined range of motion (ROM).
Findings: VAS and ROM improved with all groups, P˂0.001 and P=0.04 respectively. No statistical differences appeared between groups, for VAS P=0.15-0.95 and for ROM P=0.10-0.83. True IFTs improved VAS and ROM to same extent. There was a trend of better VAS reduction with true IFTs compared to placebos. Oppositely, PPT and pain distribution did not significantly change with any of the groups, P=0.11 and P=0.48 respectively. Significant statistical difference between groups was in favour of placebo groups; for PPT (P=0.01) and for pain distribution (P=0.04). True IFTs changed PPT and pain distribution closely.
Conclusion & Significance: This study failed to show neither real pain reduction effect of IFT nor difference between traditional and external applications. None of the pain outcome measures assessed here, nor the ROM, were affected by IFT. That is because, both true and placebo applications reduced pain and improved the ROM to same extent. However, there was a trend of superiority of true applications to both placebos for reducing pain severity
- Beatti A, Tucker K, Chipchase L (2012) A double-blind placebo-controlled investigation into the effects of interferential therapy on experimentally induced pain. Int. Musculoskelet Med. 34: 115-122.
- Beatti A, Rayner A, Souvlis T, Chipchase L (2010) A systematic review of the analgesic effect of interferential therapy on clinical and experimentally induced pain. Phys. Ther. Rev. 15: 243-52.
- Beatti A, Rayner A, Chipchase L, Souvlis T (2011) Penetration and spread of interferential current in cutaneous, subcutaneous and muscle tissues. Physiotherapy 97: 319-26.
Irfan Tifeku was born in Kacanik, Kosovo. He has taken the first lessons in his country and the university studies he has finished in Albania. He has completed his Master of Science in Physiotherapy at the age of 25 years from University of Medicine in Tirana. He is the director of the clinic Fizioterapia, a private clinic of the physiotherapy in Prishtina, Kosovo. He has published more than 12 papers in reputed journals and has been part of different conferences and congresses in Kosovo, Albania and abroad in Europe. He has been for two years assistant professor of Kinesiology in the University of Tetovo, in Macedonia. He is specialized in the branch of osteopathy and ultrasound.
Low-back pain (often referred to as “lower back pain”) is a common condition that usually improves with self-care. However, it is occasionally difficult to treat. Some health care professionals are trained to use a technique called spinal manipulation to relieve low-back pain and improve physical function (the ability to walk and move). Spinal manipulation is one of several options—including exercise, massage, and physical therapy—that can provide mild-to-moderate relief from low-back pain. Spinal manipulation appears to work as well as conventional treatments such as applying heat, using a firm mattress, and taking pain-relieving medications (amp. Artrosilen 160 mg 4x ; Galvanic currents). Spinal manipulation—sometimes called “spinal manipulative therapy”—is practiced by health care professionals such as chiropractors, osteopathic physicians, naturopathic physicians, physical therapists, and some medical doctors. Practitioners perform spinal manipulation by using their hands or a device to apply a controlled force to a joint of the spine. The amount of force applied depends on the form of manipulation used. The goal of the treatment is to relieve pain and improve physical functioning.
Overall, studies have shown that spinal manipulation is one of several options—including exercise, massage, and physical therapy—that can provide mild-to-moderate relief from low-back pain. Spinal manipulation also appears to work as well as conventional treatments such as applying heat, using a firm mattress, and taking pain-relieving medications.
In 2007 guidelines, the American College of Physicians and the American Pain Society included spinal manipulation as one of several treatment options for practitioners to consider when low-back pain does not improve with self-care. More recently, a 2010 Agency for Healthcare Research and Quality (AHRQ) report noted that complementary health therapies, including spinal manipulation, offer additional options to conventional treatments, which often have limited benefit in managing back and neck pain. The AHRQ analysis also found that spinal manipulation was more effective than placebo and as effective as medication in reducing low-back pain intensity. However, the researchers noted inconsistent results when they compared spinal manipulation with massage or physical therapy to reduce low-back pain intensity or disability.
Researchers continue to study spinal manipulation for low-back pain.
- A 2011 review of 26 clinical trials looked at the effectiveness of different treatments, including spinal manipulation, for chronic low-back pain. The authors concluded that spinal manipulation is as effective as other interventions for reducing pain and improving function.
- A 2010 review that looked at various manual therapies, such as spinal manipulation and massage, for a range of conditions found strong evidence that spinal manipulation is effective for chronic low-back pain and moderate evidence of its effectiveness for acute low-back pain.
- A 2009 analysis looked at the evidence from 76 trials that studied the effects of several conventional and complementary health practices for low-back pain. The researchers found that the pain-relieving effects of many treatments, including spinal manipulation, were small and were similar in people with acute or chronic pain.
- A 2008 review that focused on spinal manipulation for chronic low-back pain found strong evidence that spinal manipulation works as well as a combination of medical care and exercise instruction, moderate evidence that spinal manipulation combined with strengthening exercises works as well as prescription nonsteroidal anti-inflammatory drugs combined with exercises, and limited-to-moderate evidence that spinal manipulation works better than physical therapy and home exercise.
Researchers are investigating whether the effects of spinal manipulation depend on the length and frequency of treatment. In one study funded by NCCIH that examined long-term effects in more than 600 people with low-back pain, results suggested that chiropractic care involving spinal manipulation was at least as effective as conventional medical care for up to 18 months. However, less than 20 percent of participants in this study were pain free at 18 months, regardless of the type of treatment used.
Researchers are also exploring how spinal manipulation affects the body. In an NCCIH-funded study of a small group of people with low-back pain, spinal manipulation affected pain
Nitish Mathew completed his Bachelors degree at the age of 23 years from MGM Institute of Health sciences, India and Masters in Clinical Exercise Physiology from Waikato Institute, New Zealand. Over these years he has worked in India, New Zealand and Australia as a Physiotherapist and Clinical Exercise Physiologist, and received various awards for his contribution in sectors of rehabilitation, fitness training and social work. He has published 3papers and serving as an Aged care Physiotherapist in Sydney presently.
Australians have shown a great increase in life span when comparing the statistics of mortality rates since 1890. Credit goes to the higher medical and social standards practised in the country which prevents number of deaths as a result of motor vehicle accidents or heart diseases. But Australia like all other places is facing the challenge to eradicate long term health issues in geriatric population such as stroke, chronic obstructive pulmonary disease, heart diseases,osteoarthritis and osteoporosis. Physiotherapy has proved to restore normal health and fitness to individuals with such conditions even when recent advances in medicine and surgery have failed.On the contrary, the Australian aged populations in the residential or aged care facilities, rural and remote areas are unable to receive regular physiotherapy treatments due to various reasons.Physiotherapy in aged care nursing homes focus on pain management by massage or heat packs,because Government does not fund for other important goals of rehabilitation like, Balancetraining, gait training, manipulations or strengthening. On the other hand, an average aged carephysiotherapist earns from $60K- $101K annually, yet the number of physiotherapists workingin aged care is less than other streams. The reasons behind less physiotherapists opting for Agedcare are numerous, which causes the undertrained nursing staff to provide pain management to residents in aged care facilities. The purpose of this study is to understand the barriers faced by aged population in Australia to take physiotherapy treatment. The researcher points out thecurrent status of funding for aged care in nursing home and private health centers. The study is a
helpful resource for Physiotherapists in aged care facilities, or those interested to join this field,