Day 1 :
Keynote Forum
James Stoxen
Team Doctors, USA
Keynote: The integrated spring-mass model approach to treating thoracic outlet syndrome
Time : 09:30-10:30
Biography:
James Stoxen, D.C. (Video Bio), owns and operates Team Doctors Chiropractic Treatment and Training Center. Team Doctors is one of the first care centers in the world to combine chiropractic care, therapy, active rehabilitation and strength training for world class athletes in a private rehab training center for competitions. Dr. Stoxen also provides “on-site” chiropractic care and anti-aging consultation and care to numerous top celebrity entertainers all over the world.
Abstract:
The use of Hand-Held Devices (HHD) such as mobile phones, game controls, tablets, portable media players and personal digital assistants have increased dramatically in past decade. This drastic change has led to new batch of difficult to treat, musculoskeletal disorders of the upper extremities such as myofascial pain syndrome of neck and upper back and thoracic outlet syndrome. The thoracic outlet anatomy and how the bundle passes through the passageway is complex for even musculoskeletal experts. So, for doctors trained in other specialties there can be an inadequate understanding about nature and cause of thoracic outlet syndrome. A syndrome rather than a disease, the Mayo Clinic, Cleveland Clinic and the National Institute of Neurological Disorders and Stroke, plus top 10 ranked hospitals for neurology and neurosurgery agree persistent compression of nerves, arteries and veins traveling through the thoracic outlet is what leads to thoracic outlet syndrome. Three models of human movement, the inverted pendulum model, the spring-mass model and the integrated spring-mass model (ISMM) were discussed. The ISMM model, which integrates the spring suspension systems of the foot and shoulder region as well as the torsion spring of the spine and the mass, the head. I will discuss my clinical findings show compressive disorders like TOS and herniated discs are merely an over control of tension on the human spring mechanism leading to these syndromes. I will give brief review of the symptoms and their patterns, the common orthopedic tests and diagnostic tests, the 16 different common conservative therapies and the 10 reasons for when surgery is medically necessary. I will discuss an alternative treatment for this disorder based on the integrated spring mass model.
Keynote Forum
Paolo Flocco
MAIT ®, Italy
Keynote: The organic effects of stress and the links with inflammation: New proposals in rehabilitation, the MAIT® method
Time : 11:00-12:00
Biography:
Paolo Flocco has graduated in Physiotherapy from the University of Rome "La Sapienza". After various work experiences and different courses, he enrolled at CERDO, one of the most prestigious schools of Osteopathy in Italy and after six years of training he became Osteopath. For several years he has been working as a professional and dealing with study and research. He writes in national journals and blogs of scientific popularization. He is also an International Lecturer and Member of the scientific committee of the most important post-graduate training company for physiotherapists in Italy. He is the founder of MAIT®, a new approach to manual medicine.
Abstract:
Life expectancy has progressively increased in the industrial world, but in recent years another indicator has been being considered: Healthy life expectancy. The worrying fact is that this indicator is gradually decreasing. This leads to a number of societal challenges: Increased days off from work, increased expenditure on health care, increased consumption of drugs, increased per capita expenditure and increased risk of side effects. It is clear that the money spent on medicines has increased steadily over the last 25 years and NSAIDs play a major role in this. Please note that at least 15% of people taking NSAIDs exceed the maximum permissible dose and are at risk of serious side effects. Analyzing ISTAT statistics on Italian health, 39% of those interviewed had recourse to drugs in the last two days before the interviews. The overweight population is steadily increasing, including the pediatric age. The prevalence of diabetes, osteoporosis, chronic and autoimmune diseases is also increasing. Population is more sedentary. Unfortunately, this is a European trend. Parallel to worsen health condition, 16% of European employees feel stressed every day, according to data from a recent study by ADP, "The workforce view in Europe 2018". The situation becomes even worse if we consider female workers or workers in the health sector, reaching peaks of 20%. Could there be a correlation between these data? We believe so, because stress, physical, behavioral or psychic, produces inflammation, giving rise to possible symptoms, even structural. For this reason, we believe that it is useful to propose complementary approaches to intervention.
- Physical Medicine | Spinal Cord Injury | Neurological Rehabilitation | Brain Injury | Physical Health Management | Sports Medicine
Chair
Pedro Orlando Mena Quinones
University Hospital of Torrevieja, Spain
Co-Chair
Khader A. Almhdawi
Jordan University of Science and Technology, Jordan
Session Introduction
Pedro Orlando Mena Quiñones
University Hospital of Torrevieja, Spain
Title: Defining future scope of physical medicine and rehabilitation
Biography:
Pedro Orlando Mena Quiñones has completed his MD from Instituto Superior de Ciencia Medicas de la Habana, Cuba and completed his Residency Training Program on Physical Medicine and Rehabilitation in 1985 at the National Center of Rehabilitation Julio Diaz in Cuba. He is the Former Chairman of Spinal Cord Injury Service and Chairman of Miscellaneous Service at National Center of Rehabilitation Juilio Diaz. He is the Lecturer and Teaching Staff of National Rehabilitation Center Julio Diaz Hospital and Former Member of Physical Medicine and Rehabilitation Examiners Board. He is the Former Senior Specialist at Hamad Medical Corporation. He has participated in 47 congresses, conferences, nationals and international meetings with more 60 papers presented (lectures, oral communications and posters) 11 articles published in different journals.
Abstract:
As a result of the developments during the last decades, there has been a dramatic change in the demographic constituency and the health of general citizenry with an increase of aging population and disabling conditions. This put a permanent progressive stress not only in the present but also in the future on health system having the responsibility to respond to emerging demands. People expect now and will expect then to live longer and better as specialty physical medicine and rehabilitation currently have and will keep in the future a paramount role to ensure a better quality of live by improving functioning, quality of life and proper social integration. To exactly predict how will be medicine in the future and particularly physical medicine and rehabilitation is a difficult task and it is like predicting what is going to happen in the market, we simply don’t know it. There are many factors influencing next generation’s future: economic growth, political stability, natural catastrophes, environment contamination, climatic changes, the presence of wars either localized or globalized, emerging diseases, epidemics etc. Any way there is a permanent discovery and development of new technologies and therapies that will have an impact on the practice of physical medicine and rehabilitation in the future: The next generation of physical medicine and rehabilitation specialists will need to be familiar on robotic medicine, neural implant, nano medicine, artificial intelligence, DNA manipulation etc. But the essence of physical medicine and rehabilitation will remain. The key aspects of future scope of physical medicine and rehabilitation are defined.
Alberto Cliquet Junior
Universidade de Campinas, Brazil
Title: Clinical improvements for spinal cord injured subjects going through innovative rehabilitation techniques and paralympic sports
Biography:
Alberto Cliquet Junior has graduated from Universidade de São Paulo (USP) and PhD (1988) from the University of Strathclyde. He is a full Professor at the Department of Orthopedics, Universidade de Campinas-UNICAMP (from 2003) and full Professor at USP (since 1998). Currently he is the Deputy Coordinator of the Surgery Postgraduate course and the Coordinator for the Orthopedics undergraduate course.
Abstract:
The work presented here displays comprehensive neurologic and orthopedic rehabilitation strategies based upon neuromuscular stimulation, including basic concepts and clinical implications, being twofold: (1) Medical sciences towards functional diagnoses, therapy, cardiovascular health and paralympic sports performance; (2) engineering sciences on innovative technology for rehabilitation of Spinal Cord Injured (SCI) subjects. Artificial and voluntary gait recovery are shown to be feasible, being assessed through motion analysis, electromyography, evoked potential, magnetic resonance imaging, radiography, oxygen consumption, bone densitometry, etc. Comorbidities such as post-traumatic syringomyelia (due to upper limb effort), disuse osteoporosis, cardiovascular disease and autonomic dysreflexia (yielded by pain stimuli and lack of sympathetic nervous system) are addressed. Loss of bone mass is known to be higher in tetraplegia than paraplegia and the same applies to carotid intima-media thickness of SCI subjects which is larger in tetraplegics. SCI physiotherapy focuses mostly on cardiovascular exercises, not on the mechanical loads applied to the lower limbs which are required to preserve bone quality. Shoulder, hip and knee joints are also looked at, in particular for the athletes. Technology innovation is presented for spasticity evaluation, upper limb movement as well as thermal stimulation towards the lesion completeness diagnoses. Rehabilitation techniques, technology and sports can yield a longer life to such patients and minimize their clinical complications.
Mohd Rami Al-Ahmar
Jordanian Spinal Cord Injury Charitable Society, Jordan
Title: Challenges and outcome following spinal cord injury
Biography:
Moh'd Rami Al-Ahmar, MD JB (Physical Medicine & Rehabilitation), Spinal Injury Senior Specialist. Spinal Cord Injury (SCI) Fellowship, Robert Jones & Agnes Hunt Orthopedic Hospital, Oswestry, UK. He is the Vice President of the Jordanian Spinal Cord Injury Charitable Society (JoSCIS). He is Educational Committee Member of International Spinal Cord Injury Society (ISCoS). He is Executive Board member of Jordanian PM&R Society, (ISPRM Society Member). (SCI) Unit, Royal Rehab Centre, King Hussein Medical City.
Abstract:
Spinal Cord Injury (SCI) is one of the most devastating injuries which necessitate considerable changes and life-altering of an individual and their families. Acute SCI is a complicated, multi organ failure; proper and early management may make the difference between recovery and lifelong disability. Although there is contemporary advances in spinal cord medicine, considerable challenges remain, particularly recovery of lost neurologic function following injury. Prevention is the cure in SCI management and motor function is the primary determinant of overall function following SCI. Accurate documentation of the neurological level and completeness of SCI is paramount for diagnostic and prognostic aspects. A detailed neurological examination performed at least 72 hours following traumatic SCI is important prognostic value; significant neurological recovery will be expected over later weeks and months, following an incomplete injury. This talk will present a series of SCI patients evaluated according to the International Standards using the American Spinal Injury Association (ASIA) scoring and were admitted and managed at the spinal unit-King Hussein Medical Center. Accurate neurological assessment and comprehensive surgical vs. conservative management is needed to improve the final functional outcome and prevent lifelong disability.
Suad Trebinjac
Al Garhoud Private Hospital, UAE
Title: Mesenchymal stem cells in treatment of musculoskeletal disorders: Current evidence and future perspective
Biography:
Suad Trebinjac graduated from Medical Faculty University of Sarajevo on 3/25/82 with entrance date 9/1/74. The school is in Sarajev. Dr. Suad Trebinjac's specialty is Physical Medicine and Rehabilitation and currently works as a Physician. He is working as Associate professor in Dubai Medical College for Girls. The first Prolotherapy’s in Middle East (training in the University of Wisconsin-USA).
Abstract:
Musculoskeletal disorders are chronic, painful and followed by significant morbidity. Furthermore, the cost of treatment produces economic burden. Variety of therapeutic options are mainly symptom oriented, often providing only temporary therapeutic effect. Stem cells become an attractive scientific subject due to their potential to differentiate into other types of cells and eventually regenerate or repair damaged tissue. Mesenchymal Stem Cells (MSCs) are commonly used, because of their potential to differentiate into musculoskeletal lineage, eventually generating new cartilage, bones, muscles and fat. Preclinical and some clinical studies show promising results. Better insight into the paracrine effect and favorable joint environment, (which are the most important for successful outcome), opened a new perspective for more efficient outcome in the future. In this oral presentation, I will try to highlight three key points;
(1) What is the current clinical evidence for the application of MSCs in the treatment of chronic knee cartilage damages, ligaments and tendons?
(2) What is the possible mechanism of action of MSCs?
(3) Who are the best candidates for this type of treatment?
Also, the future perspective in this medical field will be specified.
Khader A. Almhdawi
Jordan University of Science and Technology, Jordan
Title: Task-oriented rehabilitation for upper extremity post-stroke: A case study
Biography:
Khader A Almhdawi is the Chairman of Rehabilitation Sciences Department (PT, OT and Speech/Audiology) at Jordan University of Science & Technology (JUST), Irbid, Jordan. He has obtained his OT BSc from JUST in 2003 and his MSc from Colorado State University, USA and PhD in Rehabilitation Sciences (Stroke Rehabilitation) from the University of Minnesota, USA in 2011. He is currently researching in the field of adults' physical dysfunctions particularly of neurological challenges, assistive technology, occupational stress, education and accommodating individuals with disabilities and integrating them in community.
Abstract:
Background: Effective and feasible approaches for Upper Extremity (UE) rehabilitation are needed.
Aims: This case study demonstrated the conduction and efficacy of occupational therapy Task-Oriented approach (TO) for improving UE motor and the functional abilities post-stroke.
Methods: A case study of a 60 years old male (Mr. J) who had ischemic right cerebral vascular accident with resultant left hemiparesis with a chronicity of 12 years. Mr. J got 6 weeks of 3 hours/week TO treatment. TO consisted of client-centered functional activities consistent with Mr. J client-centered treatment goals. Measurements included Canadian Occupational Performance Measure (COPM), Motor Activity Log (MAL), Wolf Motor Function Test (WMFT), active range of motion and handheld dynamometry strength of the paretic UE.
Results: TO treatment followed large functional and motor improvements. COPM performance and satisfaction were 1.8 and 2.2 units greater respectively, MAL amount of use and quality of use were 2.1 and 1.39 units greater, WMFT time was 4.63 second faster and grip strength increased 14.33 lb. Furthermore, paretic UE range of motion, tone status and grasp abilities were improved.
Conclusion: TO approach appears an effective and feasible UE post-stroke rehabilitation approach inducing clinically meaningful UE functional improvements. More studies are needed to provide more evidence for this approach.
Ali Serhan
Physicians accross Continents, Turkey
Title: Outcome of program designed to evaluate the extent of benefit of the amputee from his prostheses in PAC-prosthetic center in Turkey
Biography:
Ali Serhan has completed his master’s degree from Damascus University. He is the Director of Prosthetic Department in PAC-Turkey.
Abstract:
In order to follow up our patients in PAC-prosthetic center in Turkey, whose most of them were living in Syria and there getting back to the center to evaluate their prosthesis is difficult, so we designed a form to obtain that.
The form in of 1 page, it has some questions, by which we can evaluate the benefit of the patient from the prosthesis.
Also, we designed a computer program to inter this information and analyze the data.
I wanted to share you the results.
Sedigheh Sadat Tavafian
Tarbiat Modares University, Iran
Title: Prediction of stretching exercise behaviour among office employees using Pender Model
Biography:
Sedigheh Sadat Tavafian is a Professor of Health Education, Department of Health Education and Health Promotion. She is the Faculty Member of Medical Sciences, Tarbiat Modares University, Iran. She has published more than 55 published paper indexed in SCOPUS.
Abstract:
Purpose: Office employees of all ages are at risk for developing physical inactivity. In many countries, physical inactivity is one of the main causes of non-communicable diseases such as Musculoskeletal Diseases (MSDs) that are increasing in Iran.
Aim: This study aimed to predict the influencing factors on Stretching Exercise (SE) among office employees using Health Promotion Model (HPM) in Shahid Beheshti University of Medical Sciences (SBUMS) of Iran.
Method: Data were collected by researcher-made and standard questionnaires from eligible office employees working in comprehensive service centers for urban-rural health affiliated to SBUMS from May to Sep 2016.
Results: Totally 420 office workers with mean age of 37.1±8.03 years old took part in the study. This study showed that perceived barriers to action could prevent the studied participants from doing stretching exercise. [OR (%95CI): 0.875(0.815-0.939), P<0.001)], However, perceived self-efficacy [OR (%95CI): 1.126(1.0411-1.2171), P=0.003)], commitment to plan of action [OR (%95CI): 1.118(1.033-1.367), P=0.003)] and interpersonal influences [OR (%95CI): 1.248(1.1371-1.3701), P<0.001)] were significant predictors for stretching exercise behavior.
Conclusion: This study showed that the office workers who were more confident and commitment to plan of action and perceived less barrio were more likely to do stretching exercise.
Sherif Azmy Rizkalla
Nasser Institute for Research and Treatment, Egypt
Title: Nutrition for optimal sports performance
Biography:
Sherif Azmy Rizkalla had the honor to start Nutrition & Pain Management Clinics in more than 5 hospitals – of which NASSER HEALTH INSTITUTE was the greatest. He used to be the Sports Nutrition Consultant of the Egyptian Modern Pentathlon Team (from 2004 -2012 and made New Swimming Olympic records in Bejing 2008 & UK 2012 with C.Amr Elgezairy ). He used to be the Sports Nutrition Consultant of All Egyptian Olympic Teams Qualified for UK 2012 (from 2010 – 2012 Olympic Silver Medal in Fencing with C.Alaa A.Kassem). Now he is a Board member in UAMS (Union Affricane de Medicine du Sport ), also World Society of Sports, Exercise Medicine (WSSEM) Board Member, UKAD – Accredited Advisor, USADA- HealthPro Certified, WADA- Sport Physician’s tool kit Certified and FIFA Diploma in Football Medicine which gives me a great opportunity to serve my country & many other countries giving awareness educational lectures about the importance of healthy nutrition & the hazards of doping for athletes.
Abstract:
Choosing the right foods, fluids and supplements can help athletes perform at their best. To help an athlete reach peak performance, dietitians work with athletes to plan for: 1. Adequate energy from food 2. Enough fluids to keep the body hydrated 3. The right balance of nutrients. Meeting energy needs during activity will help athletes: 1. Replenish glycogen stores 2. Provide protein to build and repair tissue 3. Provide essential fatty acids.
Registered dietitians, particularly those with an expertise in sports nutrition, are uniquely equipped to provide nutrition advice to athletes. Dietitians are the only regulated health care professionals in Canada in the field of nutrition. They can work with athletes to help them achieve peak performance by learning: 1. What to eat and drink before, during, and after exercise 2. How to use nutrition to help with performance and improve recovery time 3. When to use sports drinks instead of water 4. How to prevent dehydration 5. If certain vitamin or mineral supplements are needed 6. That ergogenic [performance enhancing] aids should be used with caution only after careful screening for safety 7. How to reduce their risk of contracting illnesses such as gastroenteritis or upper respiratory tract infections from the foods they eat (and the utensils used to cook them).