Rehabilitation Medicine

310 Pages·2016·3.89 MB·English

Journal of Supplement 55
August 2016
REHABILITATION
MEDICINE
The International Non-profit Journal
International official journal of the
– International Society of Physical and Rehabilitation Medicine (ISPRM)
Official journal of the
– UEMS European Board and Section of Physical and Rehabilitation Medicine (EBPRM)
– European Academy of Rehabilitation Medicine (EARM)
Published in association with the
– European Society of Physical and Rehabilitation Medicine (ESPRM)
– Canadian Association of Physical Medicine and Rehabilitation (CAPM&R)
– Asia Oceania Society of Physical and Rehabilitation Medicine (AOSPRM)
– Baltic and North Sea Forum for Physical and Rehabilitation Medicine (BNFPRM)
ABSTRACTS
The 10th World Congress of International
Society of Physical and Rehabilitation
Medicine
May 29–June 2, 2016, Kuala Lumpur, Malaysia
P
ublished by the non-profit
Foundation for Rehabilitation Information
www.medicaljournals.se/jrm ISSN 1650-1977

J Rehabil Med 2016; Suppl 55: 1–306
ABSTRACTS
THE 10TH WORLD CONGRESS OF
INTERNATIONAL SOCIETY OF
PHYSICAL AND REHABILITATION MEDICINE
MAY 29–JUNE 2, 2016, KUALA LUMPUR, MALAYSIA
© 2016 Foundation of Rehabilitation Information. ISSN 1650-1977
doi: 10.2340/16501977-2139 J Rehabil Med Suppl 55
2 ISPRM – May 29–June 2, 2016, Kuala Lumpur (Malaysia)
J Rehabil Med Suppl 55
Oral Abstracts 3
ORAL PRESENTATIONS (MAY 29–JUNE 2, 2016)
PAEDIATRIC REHABILITATION I rimental by worsening the cerebral ischemia. The AVERT study
(Bernhardt 2015) showed negative effect of high dose of very early
mobilisation. Material and Methods: Patients have been recruited
1 in this multicentre randomized controlled trial (9 stroke units with
FUNCTIONAL MOVEMENT-POWER TRAINING PRM teams) to compare “soft” (20 mn/day apart from respiratory
needs) versus “intensive” PT (idem + 45 minutes of intensive exer-
FOR CHILDREN WITH DEVELOPMENTAL CO-
cises/day), initiated within the 72 first hours after a first hemispheric
ORDINATION DISORDER: A RANDOMIZED CON- stroke. Blind assessment has been made. The primary criterion was
TROLLED TRIAL the motor control assessed by the Fugl Meyer score at D90. Sec-
ondary criteria were: Fugl Meyer at D15, D30, D45, postural bal-
S.S.M. Fong1, X. Guo2, Y.T.Y. Cheng1, T.T.T. Yam1, K.P.Y.
ance (PASS), autonomy (Rankin and FIM) at D15, D30, D45, D90,
Liu3, D.J. Macfarlane1
unexpected medical events, length of hospital stay, quality of life
1The University of Hong Kong, Institute of Human Performance, (SIS) at D90. The study has been approved by the local ethics com-
Hong Kong, Hong Kong- China, The Hong Kong Polytechnic Uni- mittee n°2011/37, registered on clinical trial.gov NCT01520636.
versity, Department of Rehabilitation Sciences, Hong Kong, Hong Results: 103 of the 104 included patients could be analysed, 64
Kong- China, University of Western Sydney, School of Science and males, 67 right hemispheric lesions, 80 ischemic lesions, NIHSS
Health Occupational Therapy, NSW, Australia <8 in 19 patients, 8–15 in 42, >15 in 42; age 66.2±13/67.2±11. No
significant difference between groups was observed for the primary
Introduction/Background: Children with developmental coordina- criterion (median 41.5 [14;76] versus 54 [22;80] p=0.32), neither
tion disorder (DCD) demonstrate both central nervous system and for any of the secondary criteria. The number of unexpected medi-
peripheral neuromuscular deficits that may affect their balance cal events was the same in the two groups. Conclusion: The conclu-
ability. This study compared the effectiveness of a novel func- sion of this study is congruent to that of previous studies. Very early
tional movement–power training (FMPT) program, a traditional intensive exercises after stroke do not seem to be more effective
functional movement training (FMT) program and no training in on motor recovery than a soft PT preventing immobility related
the improvement of postural control strategies and neuromuscular complications.
performance in this population. Material and Methods: This was
a single-blinded randomized controlled intervention trial. One
hundred sixty-one children with DCD (age: 6–10 years) were ran- 3
domly assigned to the FMPT, FMT, or control groups. The two
KNEE HYPEREXTENSION ORTHOSIS ON LOWER
intervention groups received FMPT or FMT twice a week for 3
months continuously. Physical measurements were taken before, EXTREMITY MOTOR FUNCTIONS IN INDI-
after and 3 months after the end of the intervention period. The VIDUALS WITH STROKE: A RANDOMIZED CON-
primary outcomes were the composite score and strategy scores on TROLLED TRIAL
the sensory organisation test as measured by a computerised dy-
namic posturography machine. Secondary outcomes included the L.R. Liao1, H.B. Liu2, X.Q. Deng3, M.X. Liao2
knee muscle peak force and the time taken to reach the peak force 1Guangdong Provincial Work Injury Rehabilitation Hospital, De-
which were evaluated using hand-held dynamometer. Results: The partment of Physical Thearapy, Guangzhou, China, 2Guangdong
balance strategies adopted in sensory challenging environments of Provincial Work Injury Rehabilitation Hospital, Department of
the FMPT participants showed greater improvement from base- Physical Therapy, Guangzhou, China,3Guangdong Provincial
line to post-test than those of the FMT participants (7.10 points; Work Injury Rehabilitation Hospital, Department of Prothesis &
p=0.008) and the control participants (7.59 points; p=0.005). The Orthotics, Guangzhou, China
FMPT group also exhibited greater improvement from baseline
to the post-test in the knee extensor peak force and time to peak Introduction/Background: Knee hyperextension is common in indi-
force in the knee flexors. Conclusion: The novel FMPT program viduals with stroke and known to cause secondary gait deviations.
was more effective than the conventional FMT program in the en- However, their impact on the knee joint is not fully understood.
hancement of balance strategies and neuromuscular performance in The aims of this study are to investigate the effects of knee hy-
children with DCD. perextension orthosis on lower limb functions in individuals with
stroke. Material and Methods: Sixty people with stroke (mean age:
61.2 years, SD: 9.2) were randomly assigned to the experimental
group (n=8) and control groups (n=8), from Jun 2015 to Dec 2015.
STROKE I All stroke patients were given conventional rehabilitation therapy
(physical therapy, occupational therapy and traditional Chinese
medicine treatment, 180 minutes/day in total, 6 days/week); in ad-
2
dition, the experimental group was used of functional knee hyper-
ACTIVE MOBILITY EARLY AFTER STROKE extension orthosis in indoor ground walking training for 30 min-
(AMOBES). A RANDOMISED CONTROLED TRIAL utes, while the control group without used of the functional knee
hyperextension orthosis in indoor ground walking training for 30
A. Yelnik1, F. Colle2, C. Lamy3, C. Monchaud2, M. Brondel4, minutes. Outcome measurements included the Fugl-Meyer Assess-
C. Kemlin4, A. Leger5 ment of Lower Extremity (FMA-LE), Berg Balance Scale (BBS),
1GH Lariboisière F.Widal, PRM, Paris, France, 2Sainte Anne hos- Time-Up and Go test (TUG), 10 Meters Walking Test (10MWT)
pital, PRM, Paris, France, 3Sainte Anne Hospital, Neurology, Par- and 6 Minutes Walk Test (6MWT) assessment of the lower extrem-
is, France, Pitié-Salpétrière Hospital, PRM, Paris, France, 5Pitié- ity motor function of all stroke patients. The assessments were
Salpétrière Hospital, Neurology, Paris, France performed at baseline, 4-week and 8-week treatment. Results: Af-
ter 4-week and 8-week of treatment, intention-to-treat analysis re-
Introduction/Background: Active and intensive physical therapy vealed a significant time effect for FMA-LE, BBS, TUG, 10MWT
(PT) facilitates motor recovery when provided at a subacute stage and 6MWT (p<0.05). After 4-week of treatment, the time by group
after stroke. The efficiency of very early intensive PT (within the interactions effects were significant for the TUG (22.62±5.45),
2 first weeks) has been much less investigated. Early intensive re- 10MWT (17.21±4.45) and 6MWT (150.97±3.438), respectively;
habilitation might be beneficial for neural plasticity but also det- after 8-week of treatment, the FMA-LE (19.92±4.87) and BBS
J Rehabil Med Suppl 55
4 ISPRM – May 29–June 2, 2016, Kuala Lumpur (Malaysia)
(40.74±797), TUG(19.11±4.42), 10MWT (15.13±3.98) and 6MWT mean age of subjects was 38.6±1.3 years old. The whole subject
(172.21±28.64), respectively, the differences were statistically sig- had one side Ischialgia. The mean of pain intensity using a VAS
nificant (p<0.05). Conclusion: Using the functional knee hyperex- scale was 7.2±0.5. The mean of pain onset was 4.3±1.5 months. All
tension orthosis on walking training, can significantly improve the of subjects admitted can not walk for more than 100 m because of
recovery of stroke patients with lower extremity motor function, it pain. Four subjects had right ischialgia, while the rest was on left
is recommended further application in clinic. side. All subject had Ischialgia on the higher side of the pelvic. All
subjects received laser therapy by 2,500 Hz of frequency, and 125
mW of intensity for 15 minutes daily during 5 days on a Piiriformis
4 muscle area, Used of footwear which had a medial arch support and
ROLE OF CIMT IN STROKE a supported on heel by a 0.5 cm lifter on the shorter leg. The pain
intensity reduced to 2.3±0.3 (p=0.02) after treatment, and all of
E.H. Khan1, D.N.A. Dina1 subjects claimed to be able to walk more than 100 m without pain.
1Shaheed Suhrawardy Medical College, Physical Medicine and Re- Conclusion: Biomechanical abnormalities associated with ischial-
habilitation, Dhaka, Bangladesh gia.Treatment on the piriformis muscle, as well as correction on the
pronation foot and FLLD will reduce pain and improve function.
Introduction/Background: Stroke is the common and disabling
global health-care problem. In most cases, it is accompanied by
considerable motor functional loss. Retraining motor functions 6
especially for upper limbs are necessary as it plays an important
RANDOMISED CONTROLLED TRIAL OF CERVI-
role in performing activities of the daily living (ADL). Constraint
induced movement therapy (CIMT) is one of the rehabilitative CAL NERVE ROOT PULSED RADIOFREQUENCY
interventions for motor recovery. Material and Methods: To ob- VIA POSTERIOR APPROACH FOR THE CERVICAL
serve the impact of constraint induced movement therapy (CIMT) RADICULOPATHY
on upper limb motor functions of post stroke survivors. A Quasi
experimental study was conducted at the Department of Physical L. Xiao1, Q. Zhou2, D. Xong3, J. Yang3
Medicine and Rehabilitation in Shaheed Suhrawardy Medical Col- 1Shenzhen Nanshan Hospital of Guangdong Medical College, Pain
lege Hospital (ShSMCH) for six months. The patients eligible for Management, Shenzhen, China, 2Guangdong Medical College,
CIMT were evaluated clinically and by standardized assessment Pain Mangement Center, Shenzhen, China, 3Shenzhen Nanshan
tools at enrollment and followed up at 2 and 4 weeks after giving Hospital of Guangdong Medical College, Pain Mangement Center,
conventional rehabilitation and CIMT. Motor functional abilities of Shenzhen, China
hemiparetic upper limb were assessed by Fugl-Meyer assessment.
Main Outcome measures: Motor functional abilities of hemiparetic Introduction/Background: The procedures of pulsed radiofrequen-
upper limb after giving CIMT were assessed at 2 weeks and at 4 cy (PRF) and/or cervical nerve root block (CNRB) via the poste-
weeks using Fugl-Meyer assessment. Results: A total 60 patients rior approach for cervical radioculopathy (CR) were done for many
were interviewed, among them mean age was 52.77±10.30. Most years. The purpose of this study was to compare the efficacy of
of the patients (60%) were found in 46–60 years age group Most CNRB, PRF versus the combination via the posterior approach. Ma-
of them (72%) were male. Mean of onset of stroke duration. were terial and Methods: We used a prospective, randomized, controlled
34.62±48.66 and most of the patients 78.3% in 1–30 days group study. 62 Patients were randomized into three parallel groups A, B
Ischemic stroke was in 77% patients Among patients right sided and C. Group A included patients receiving CNRB alone, Group
hemiparesis was 75% and HTN was 51.7%.. Mean of FM base- B PRF alone, and Group C the combination. The patients received
line status was 45.57±7.56. Among them Moderate impairment Electric Acupuncture Therapy if there was no good effect at the
was found 86.7%. Follow-up after two and four weeks, FM score time of 1month. The VAS of 0 to 10 was used to measure pain in-
status was found (p=0.000) statistically significant. Conclusion: tensity. Global perceived effect (GPE) was scored by the patient on
Constraint- induced movement therapy (CIMT) along with con- a 7-point scale. The outcomes were evaluated at 1 week, 1 month,
ventional therapy has a fruitful impact on post stroke hemiparetic 3 months and 6 months. Results: All the patients experienced the
upper limb survivors who were eligible for CIMT. procedure successfully. The VAS scales dropped significantly in
three groups at any time follow up (p<0.001). There was no signifi-
cant difference between group A and B (p>0.05). However, there
was a significant improvement in group C when compared with
PAIN I either group A or group B at times of one more months follow up
(p<0.001). There was no difference in success rate of GPE with
5 positive result in all three groups at 1week follow up, but, there
was significant difference amongst group A, B and C at one more
PRELIMINARY STUDY: MANAGEMENT OF ISCHI-
months follow up (p<0.001). The necessity of electric acupuncture
ALGIA ON BIOMECHANICAL ABNORMALITIES therapy (EAT) was significantly decreased in group C as compared
M.R. Rachmawati1, N. Sidarta1 to group A or B (p<0.05). No serious complications were observed
in any of the patients. Conclusion: The posterior approach of com-
1Faculty of Medicine- Trisakti University, Anatomy/Physical Medi-
bined CNRB and PRF done via posterior approach appears to be
cine and Rehabilitation, Jakarta, Indonesia
safe and efficacious for CCR. The combination therapy yielded bet-
Introduction/Background: Ischialgia is a common problem found ter outcomes than either CNRB or PRF alone.
in daily practice. There was still few practitioners who has real-
ized that the biomechanical abnormalities can associated with an
Ischialgia. The prevalence of Biomechanical abnormalities i.e MUSCULOSKELETAL CONDITION I
functional leg length disparity (FLLD) accompanied by foot prona-
tion was 60–90% among population. External hip rotation will be
7
occurred in the longer leg, which caused excessive contraction and
inflammation of the Piriformis muscle and will be produced a Piri- BLOCK RANDOMISED EXERCISE CLASSES FOR
formis syndrome, as a result from pressure of an Ischiadical nerve PEOPLE WITH SHOULDER PAIN: EFFECTIVENESS
passed on it. Treatment on the piriformis muscle an correction of OF TWO DIFFERENT EXERCISE CLASSES AND AN
the Biomechanical abnormalities expectedly will reduce the pain
INVESTIGATION OF PROGNOSTIC CORRELATES
and increase the function. Material and Methods: A preliminary
study on 7 subjects by convinient random sampling. Results: The E. Barrett1, K. McCreesh1, K. O’ Sullivan1, J. Lewis2
J Rehabil Med Suppl 55
Oral Abstracts 5
1University of Limerick, Department of Clinical Therapies, Lim- mean initial Abd from 46.30 to 1350 FL from 87.60 to 172.70; ER
erick, Ireland, 2University of Hertfordshire, Department of Allied from 30.50 to 85.60 and IR from 15.70 to 80.60. Further, there
Health Professions and Midwifery, Hertfordshire, United Kingdom was also improvement in CMS 27.6 to 89.3. Statistical tool used
for comparison was paired t-test. Conclusion: Conclusion: Combi-
Introduction/Background: Shoulder pain is a common musculo- nation of pressure controlled intrarticular hydraulic distention and
skeletal condition. Patients are traditionally treated with one-to-one community based stretching exercise method of treatment of adhe-
physiotherapy. There are no outcome studies of exercise classes sive capsulitis of shoulder was one of the most cost-effective and
for people with non-specific shoulder pain. It is unclear if postural functionally effective methods of treatment.
exercise improves the outcomes of shoulder treatment. The corre-
lation of somatic (non-musculoskeletal) symptoms to outcomes in
shoulder pain has not been studied. The aims are: 1.To determine
the effectiveness of an exercise class in people with non-specific PRM INTERVENTION I
shoulder pain. 2.To compare the outcomes of a shoulder exercise
class with and without a postural exercise component. 3.To inves- 9
tigate if Subjective Health Complaints (SHC), Nordic Assessment
EFFICACY OF RADIAL EXTRACORPOREAL
Score (NAS) or baseline pain intensity are associated with treat-
ment outcomes? Material and Methods: Eligible participants were SHOCK WAVE THERAPY FOR DISABLING PAIN
recruited after referral to physiotherapy. Block randomisation was DUE TO SEVERE PRIMARY KNEE OSTEOARTHRI-
used to allocate participants to a shoulder exercise class or a shoul- TIS: A RANDOMIZED CONTROLLED TRIAL WITH
der and thoracic exercise class, once a week for 6 weeks. Primary
SUBJECTIVE AND OBJECTIVE ENDPOINTS
outcomes were the Disabilities of the Arm, Shoulder and Hand
(DASH) and Numeric Rating Scale (NRS) and were measured at C. Schmitz1, M. Imamura2, S. Alamino Felix de Moraes2,
baseline, 6 weeks and 6 months by the primary investigator (blind- W.T. Hsing2, F.M. Alfieri2, L. Battistella2
ed to treatment allocation). SHC and NAS were measured at base- 1Ludwig-Maximilians-University of Munich, Department of Neu-
line. Results: 32 participants were included. Mean NRS and DASH roanatomy, Munich, Germany, 2University of São Paulo School of
improved significantly at both follow ups (6 week change NRS=2.6 Medicine, Institute of Physical Medicine and Rehabilitation, São
(±1.6), DASH=30.2 (±23.7), 6 months change NRS=3.1(±2.1),
Paulo, Brazil
DASH=27.6 (±24.9), p<0.05). There was no significant between-
group difference in NRS and DASH (p>0.05). SHC was strongly Introduction/Background: Radial extracorporeal shock wave ther-
correlated with baseline pain (rs=0.58) and disability (rs=0.52). apy (rESWT) with high energy flux density (EFD) of 0.25 mJ/
SHC, NAS and pain at baseline were strongly correlated with dis- mm2 was demonstrated in the literature to be effective and safe
ability at 6 months (rs=0.51, rs=0.47, rs=0.48 respectively). Con- in the treatment of disabling pain due to severe primary knee os-
clusion: A 6 week exercise class was effective in improving pain teoarthritis. However, such high-energy rESWT devices are not in
and disability in people with shoulder pain, which was improved widespread use, and it is unknown whether this condition could
further at 6 month follow-up. Posture may not be an important as- also effectively be treated with a conventional rESWT device
pect of shoulder pain treatment. SHC, NAS and pain intensity have with EFD not exceeding 0.16 mJ/mm2. Material and Methods:
strong prognostic value in shoulder pain. 105 female patients suffering from disabling pain due to severe
primary knee osteoarthritis between 3 and 480 months (median,
72 months) were randomized into two groups. Patients in the
8 rESWT group received three sessions of rESWT (2,000 impulses
CONSERVATIVE TREATMENT OF ADHESIVE OF per session applied around the entire knee with EFD between 0.10
and 0.16 mJ/mm2). Patients in the placebo group received three
SHOULDER: EFFECTIVENESS OF COMBINATION
sessions of sham rESWT using a placebo handpiece. Outcome
OF INTRAARTICULAR DISTENSION AND COMMU-
measures included assessment of pain on movement and physi-
NITY BASED STRETCHING EXERCISE PROGRAM cal function at one week (W1) and three months (M3) after the
last treatment session. Results: Both rESWT and sham treatment
K. Wangjam1
reduced the mean VAS score by approximately 25% at W1 and
1J N Institute of Medical Sciences, Physical Medicine and Rehabili-
M3, with no statistically significant differences between groups.
tation, Imphal, India
The rESWT group showed a statistically significantly better mean
Introduction/Background: Different methods of conservative treat- WOMAC score for pain at the treated side than the placebo group
ment are used for treatment of adhesive capsulitis/frozen shoulder. at W1 and M3, whereas differences in mean WOMAC scores for
Of these, pressure controlled athrographic distension’, followed stiffness and limitations in physical function at the treated side
by ‘care-giver operated home based stretching’ exercise program and mean WOMAC scores for pain, stiffness, and limitations in
was evaluated for treatment of stage II frozen shoulder. Objective physical function at the untreated side were not statistically sig-
was to assess its effectiveness by prospective cohort study. Ma- nificantly different between the groups at W1 and M3. Conclusion:
terial and Methods: Materials and Methods: sixty eight patients rESWT as performed in the present study is not sufficient to treat
diagnosed as adhesive capsulitis shoulder, 30 males and 38 females disabling pain due to severe primary knee osteoarthritis. For this
were included. Mean age of these patients was 51.5 ± 15.6 years condition a much higher energy flux density must be applied in
and mean duration of disease was 4.2 ± 4.8 months; studied from order to achieve treatment success.
Nov 2014 to Dec, 2015. Intervention: supra-spinatus nerve block,
followed by intra-articular instillation of 15 to 20 ml of saline
10
mixed with 5 ml of 2% xylocaine and 2 ml of methyl-prednisolone
acetate; so that intra-articular pressure was around 100 mm of Hg. CORRELATION OF SONOGRAPHIC LONGITUDI-
This was followed by demonstration of home-based stretching ex- NAL-SAGITTAL TECHNIQUE AND TRANSVERSE-
ercise program to designated care-givers to be started immediately
AXIAL TECHNIQUE OF ARTICULAR CARTILAGE
after injection. The same was to be done at home and continue three
MEASUREMENT IN PATIENTS WITH KNEE OS-
times daily; to be repeated 15 to 20 times per session. Out-come
measures: change in range of motion of abduction (Abd), flexion TEOARTHRITIS
(Fl), external rotation (ER), internal rotation (IR) and Constant-
A.K. Malvar1, C. Gonzalez-Suarez1,2, M.M. Bernardo1, B.G.
Murley Score (CMS) for functional assessment of shoulder. Mini-
Tan-Sales1,2, S. Aycardo2, R. Chan2, M. Tan-Ong2, D.D.
mum follow-up was 12 weeks and maximum 24 weeks; mean being
Feliciano1, F. de los Reyes3
15.8. Results: There was significant change of ROM shoulder from
J Rehabil Med Suppl 55
6 ISPRM – May 29–June 2, 2016, Kuala Lumpur (Malaysia)
1University of Santo Tomas Hospital, Department of Physical PAEDIATRIC REHABILITATION II
Medicine and Rehabilitation, Manila, Philippines, 2University of
Santo Tomas, Faculty of Medicine and Surgery, Manila, Philip-
12
pines, 3University of the Philippines - Diliman, School of Statistics,
Quezon City, Philippines DELAYED AMPUTATION AND PROSTHETIC FIT-
TING IN PATIENTS WITH CONGENITAL TIBIAL
Introduction/Background: Musculoskeletal ultrasound has been
used in the diagnosis of osteoarthritis which includes the meas- DEFICIENCY
urement of the anteroposterior diameter of the articular cartilage. N. Haga1, S. Fujiwara1, K. Okada2, H. Mano1, T. Shibata3,
There are two methods of assessing the articular cartilage thick- H. Tanaka4, K. Takikawa5
ness. The first method measures it at the femoral trochlear area with
1Graduate School of Medicine - The University of Tokyo, Depart-
the ultrasound transducer placed immediately above the patellar
ment of Rehabilitation Medicine, Tokyo, Japan, 2Graduate School
and perpendicular to the long axis of the extremity (Yoon, 2008).
of Medicine - The University of Tokyo, Department of Orthopedic
The second method assesses the articular cartilage in the longitudi-
naI plane where the transducer head was placed along the midline Surgery, Tokyo, Japan, 3Tazawa MFG Co., Department of Pros-
of the lateral and medial condyles. The primary objective of this thetic, Tokyo, Japan, 4National Rehabilitation Center for Disabled
study is to compare articular cartilage thickness using longitudi- Children, Department of Orthopedics, Tokyo, Japan, 5Shizuoka
nal and transverse techniques in patients with knee osteoarthritis. Children’s Hospital, Department of Pediatric Orthopedics, Shi-
Material and Methods: A systematic knee sonographic examina- zuoka, Japan
tion was performed in patients with knee osteoarthritis by Altman’s
Introduction/Background: Treatment for congenital tibial deficien-
classification of idiopathic osteoarthritis. Longitudinal-sagittal
cy has not been established. In complete deficiency (Jones type 1a),
scanning in the medial and lateral knee joint space was performed
Brown procedure (BP) and knee disarticulation (KD) are options,
with the patient’s knee positioned in 90 degrees flexion, while su-
while in distal malformation (type 2 and 4), reconstruction of the
prapatellar transverse-axial scan was done in a maximally flexed
foot and Syme amputation (SA) both with tibiofibular synostosis
knee of a supine patient. Articular cartilage was evaluated as thick-
are options. Though KD and SA are preferably performed before
ness (narrowing), severity of focal cartilaginous lesions (abrasion),
two years of age, the surgery is delayed in some patients because
and loss or maintenance of clarity of the cartilaginous layer (clar-
of the parents’ hesitation to accept amputation or because the initial
ity). Results: Eighty-seven participants (mean age=65±7.9) were
reconstruction surgery lead to poor functional outcome. The objec-
recruited, 73 of which were female and 14 were male (female to
tive of this study is to report the course of patients with delayed
male ratio 5:1). Mean body mass index was 26.43±4.0 kg/m2. 86%
amputation. Material and Methods: Among the 16 patients with
(75 out of 87) had bilateral knee pain and mean visual analog score
23 affected limbs who visited our Limb Malformation Clinic, five
for knee pain was 4.6/10 on left and 4.1/10 on right. There is a
with seven limbs underwent amputation after five years of age, for
significant correlation in the cartilage thickness between both scan-
whom we retrospectively examined Jones classification, course of
ning techniques at the lateral left (r=0.596), medial left (r=0.575)
treatments and the functional outcome. Results: One patient (uni-
and medial right articular cartilage (r=0.249) knee except for the
lateral type 1a) underwent KD at age five without any preceding
left lateral articular cartilage. Conclusion: Sonographic scanning
surgery. Two patients (unilateral and bilateral type 1a) who expe-
of the articular cartilage could be either measured in the transverse
rienced BP at age one underwent KD at age six and nine due to
suprapatellar or longitudinal planes.
contracture or instability of the knee joint. One (unilateral type
1a) experienced BP at age eight months, femoral lengthening at
11 age 11, and transfemoral amputation at age 18 due to fixed knee
joint and limb length discrepancy. These five limbs were fitted with
ULTRASOUND THERAPY VERSUS SHOCK WAVE
endoskeletal prosthesis with polycentric knee joint. Two patients
THERAPY IN TREATMENT OF PLANTAR FASCIITIS (unilateral type 2 and 4), who experienced foot reconstruction with
tibiofibular synostosis around age one, underwent SA at age six and
S. Alrawaili1
seven due to recurrent foot deformities. They were fitted with en-
1King Saud Medical City, Medical Rehabilitation Administration,
doskeletal and exoskeletal prostheses. All five patients developed
Riyadh, Kingdom of Saudi Arabia
no phantom pain after amputation surgery, and obtained ambula-
Introduction/Background: The purpose of this study is to com- tion without walking aids. Conclusion: When necessary, delayed
pare the effects of ultrasound therapy combined with stretching amputation is a safe and effective procedure for patients with con-
and strengthening exercises versus shock wave therapy combined genital tibial deficiency.
with the same exercises on pain severity, functional disability of
the foot, foot pressure and ankle dorsi and plantar flexion ROM in
13
patients with plantar fasciitis. Material and Methods: Thirty male
and female patients with chronic unilateral plantar fasciitis includ- IMPROVED PASSIVE RANGE OF MOTION AND
ed in this study. Their age ranged from 35–45 years with body mass MODIFIED ASHWORTH SCALE SCORES AFTER
index less than 30 kg/m2. The patients were assigned randomly
RADIAL EXTRACORPOREAL SHOCK WAVE THER-
into two groups. Group (A) consisted of 15 patients who received
APY IN VERY YOUNG SPASTIC CHILDREN WITH
ultrasound therapy combined with stretching and strengthening
exercises, and Group (B) consisted of 15 patients who received CEREBRAL PALSY
shock wave therapy and the same exercises of group (A). Results: C. Schmitz1, T. Wang2, L. Du2, M.C. Kiessling1, L. Shan2,
The results of this study showed significant improvements in both
W. Wang2, J. Feng2, F. Jia2
groups. There was a statistically significant differences between
1Ludwig-Maximilians-University of Munich, Department of Neu-
groups in pain severity, functional disability of the foot and foot
plantar pressure in favour of group (B), and there was a statisti- roanatomy, Munich, Germany, 2First Hospital of Jilin University,
cally non-significant differences between groups in ankle range of Department of Pediatric Neurological Rehabilitation, Changchun,
motion. Conclusion: This study showed that treatment of plantar China
fasciitis with shock wave therapy combined with therapeutic exer-
Introduction/Background: Radial extracorporeal shock wave ther-
cises is more effective than ultrasound therapy combined with the
apy (rESWT) has been demonstrated to be effective and safe in
same exercises.
J Rehabil Med Suppl 55
Oral Abstracts 7
the treatment of spasticity. However, it is unknown whether this 15
could also be an option for treating very young children with cer-
BOTULINUM TOXIN-A IN POSTOPERATIVE PEDI-
ebral palsy suffering from spasticity with the aim to improve motor
ATRIC STIFF HIPS
function development. Material and Methods: 66 children (mean
age 27.0±13.6 months; mean±SD) with diagnosed cerebral palsy R. Tamer1, Y. awaad2
were divided into two groups according to their patents’ decision.
1Al-Takhassusi Hospital, Riyadh, Kingdom of Saudi Arabia, 2Oak
Children in the rESWT group (n=34) received conventional physi-
Wood Health System, Pediatric Neurology, MI, USA
otherapy and one session of rESWT per week for three months
(1500 impulses at energy flux density of 0.03 mJ/mm2 per session; Introduction/Background: The aim of the study is to show the func-
shock waves applied to the gastrocnemius and soleus muscles of tional contribution of botulinum toxin-A in the treatment of post-
the affected leg). Children in the control group (n=32) received operative pediatric stiff hips. Material and Methods: Four pediatric
conventional physical therapy for three months. Passive range of patients with postoperative stiff hips were included. Three patients
motion (pROM) and Modified Ashworth Scale (MAS) scores of with complicated developmental Dysplasia of the hip after multiple
spastic muscles were examined at baseline (BL), after the first revision surgeries, and a case of cerebral palsy after hip surgery
rESWT session, and at one month (M1), three months (M3) and were given botulinum toxin injections. In selected muscles as an
six months (M6) after BL. Gross motor function measure (GMFM) adjunctive therapy to the standard orthopedic and rehabilitation
was performed at BL, M3 and M6, and the Gesell developmental management. Results: All patients experienced a significant reduc-
schedule (GDS) was assessed at BL and M6. Results: Children in tion in pain with a significant improvement in posture, range of
the rESWT group showed statistically significant improvements motion and mobility. Conclusion: The preliminary results of botu-
in mean pROM and mean MAS scores immediately after the first linum toxin-A injection when given to selected muscles seem to be
rESWT session as well as at M1 and M3, but not at M6, compared promising in relieving pain and improving range of motion in pedi-
to children in the control group. No statistically significant differ- atric patients with postoperative stiff hips. It may be considered as
ences between the rESWT group and the control group were found an option in the treatment of difficult cases of postoperative stiff
in mean GMFM and mean GDS data. Conclusion: The combination hips refractory to physiotherapy.
of physiotherapy and rESWT is more effective than physiotherapy
alone in the treatment of spasticity in very young children with cer-
ebral palsy. However, more rESWT sessions and/or higher energy 16
flux density are needed to further improve treatment success. STOP TAKING ON POUNDS (STOP): A PEDIATRIC
WEIGHT MANAGEMENT PROGRAM FOR UNDER-
14 SERVED, AT-RISK MINORITY CHILDREN
TASK-SPECIFIC BALANCE TRAINING FOR CHIL- F. Kuo1, L.A. Goebel2, C. Mushi-Brunt1
DREN WITH DEVELOPMENTAL COORDINATION 1Indiana University, School of Health and Rehabilitation Sciences,
DISORDER: A RANDOMIZED CONTROLLED TRIAL Indianapolis, USA, 2Indiana University, School of Medicine, Indi-
anapolis, USA
S.S.M. Fong1, X. Guo2, K.P.Y. Liu3, W.Y. Ki4, L.H.T. Louie5,
R.C.K. Chung2, D.J. Macfarlane1 Introduction/Background: Overweight and obesity have tremen-
1The University of Hong Kong, Institute of Human Performance, dous consequences on health and worldwide economy (Cawley,
Hong Kong, Hong Kong- China, 2The Hong Kong Polytechnic 2010). Both are linked to a number of chronic diseases and long-
term psychosocial impact, including cardiovascular risk, hyper-
University, Department of Rehabilitation Sciences, Hong Kong,
lipidemia, hypertension, diabetes, sleep apnea, lack of body image,
Hong Kong- China, 3University of Western Sydney, School of Sci-
and bullying (Freeman et al., 2007; Dietz, 1998). Most communi-
ence and Health Occupational Therapy, NSW, Australia, 4Empo-
ties are characterized by unhealthy lifestyles when it comes to diet
ria State University, Health- Physical Education and Recreation
and physical activity. Healthy lifestyles, including healthy eating
Department, Emporia State, USA, 5Hong Kong Baptist University,
and physical activity, can lower the risk of becoming obese and
Department of Physical Education, Hong Kong, Hong Kong, China
developing related diseases (CDC, 2012). Material and Methods:
Introduction/Background: The sensory organisation of balance Since 2008, an inter-professional team has adapted and implement-
control is compromised in children with developmental coordi- ed a culturally sensitive pediatric weight management program
nation disorder (DCD). This study was conducted to evaluate the called the S.T.O.P. (Stop Taking on Pounds) Program. The program
efficacy of a task-specific balance training (functional-movement is a six-month culturally sensitive weight management program for
training, FMT) programme in improving sensory organization and children between the ages of 8 and 15 years old that uses a fam-
postural control in a DCD population. Material and Methods: A ily approach for obesity prevention and intervention. The program
single-blinded, randomised controlled trial involving more than includes an inter-professional team of physicians, dietitians, occu-
88 children with DCD was carried out. The participants were ran- pational and physical therapists, mental health clinicians, and nurs-
domly assigned to either a FMT group or a control group. The FMT es. The health care professionals work with youth participants in
group received two task-specific training sessions per week for 3 adopting a healthier lifestyle by developing a nutrition plan, mak-
months and the control group received no training during the study ing healthier food choices and finding fun ways to be more physi-
period. Measurements of the participants’ sensory organisation cally active. Graduate occupational therapy students (OTS) work
(somatosensory, vestibular and visual ratios), balance and motor closely with the Program leaders to assist delivery of interactive
proficiency (Movement Assessment Battery for Children, MABC activities. Results: These activities include: taste healthy food and
scores) and center of pressure sway velocity (Unilateral Stance drink choices, playing the Wii or other interactive games, learn-
Test, UST scores) were taken at baseline, immediately after FMT ing healthy recipes, group fitness activities, and strategies to ad-
and 3 months after FMT. Results: The FMT group (n=47) showed dress bullying, etc. The Program is offered in two culturally diverse
greater improvements than the control group (n=41) in somatosen- Centers. Both Centers provide opportunities for OTS to collaborate
sory ratio at 3 months (p<0.001) and 6 months (p<0.001), but the inter-professionally while working with community members from
within-group changes were not significant (p>0.05). The results diverse cultures, and to apply cultural competencies & professional
of both the MABC and the UST also suggested that the balance communications. Conclusion: This presentation will: (1) discuss
performance of the FMT group was significantly better than that facts about childhood obesity, its contributing factors, physical &
of the control group at 3 and 6 months (all p<0.05). Conclusion: psychosocial impacts in development; (2) describe an inter-profes-
Task-specific balance training was effective in improving the sen- sional collaboration in a community-based pediatric weight man-
sory organisation and balance performance of children with DCD. agement program for underserved, at-risk minority children.
J Rehabil Med Suppl 55
8 ISPRM – May 29–June 2, 2016, Kuala Lumpur (Malaysia)
PHYSICAL AND REHABILITATION MEDICINE spondylolisthesis. Results: Magnetic resonance imaging (MRI)
DIAGNOSTICS is widely used in evaluation of patients with LBP; however, high
costs, limited availability and contraindications for its use have re-
stricted MRI utilization. In a quest for a less expensive and readily
17
available tool to investigate LBP, clinicians and researchers found
A DEVICE WITH USING MAGNETIC SENSOR CAN ultrasonography (US) as an alternative. In this review we discuss
DETECT DIFFERENCE OF FINGER DEXTERITY the US application in diagnosis of some common causes of non-
BETWEEN PEOPLE WITH COGNITIVE DISORDER specific chronic LBP. Discussed topics include evaluation of spinal
canal diameter, paraspinal and transabdominal muscles, sacroiliac
AND AGE MATCHED HEALTHY PEERS
joint laxity, pregnancy related LBP, sacroiliitis, and spondylolis-
I. Kondo1, S. Suzumura1, A. Ohsawa1, T. Nagahama1, A. thesis using US in patients with LBP. Conclusion: While the first
Kandori2, Y. Sano2 researches on employing ultrasound in diagnosis of patients with
1National Center for Geriatrics and Gerontology, Rehabilitation LBP had been focused on spinal canal diameter, recent studies have
been mostly performed to evaluate the role of transabdominal and
medicine, Obu, Japan, 2Hitachi Ltd-. Research and Development
paraspinal muscles on core stability and thereby LBP occurrence.
Group, Healthcare inovation center, Kokubunji, Japan
On the other side, Doppler ultrasonography has recently played an
Introduction/Background: Deterioration of dexterity has been important role in objective measurement of joint laxity as a com-
reported in the population of dementia. Skillful using of hand is mon etiology for LBP. Doppler imaging also in pregnant patients
closely related to keeping the ability of daily living in this popula- with LBP has been recommended as a safe and sensitive method.
tion. Finger tapping was used as an indicator to know the extent of As conclusion, according to recent and most prestigious studies, fo-
decay in hand dexterity for the patients with dementia but there was cusing more on transabdominal muscle thickness can be considered
the controversy whether the ability of finger tapping could detect as future approach in investigations.
the difference between people with cognitive disorder and healthy
peers. Recently, we invented a new device to measure the finger tap-
ping movement with using magnetic sensor. (UB-1®)The purpose
CANCER REHABILITATION
of this study was to define parameters of finger tapping measured
with using UB-1 to detect the difference of finger tapping between
people with cognitive disorder and age matched control. Material
19
and Methods: Subjects were six men and eight women diagnosed
Alzheimer disease or mild cognitive disorder (AD/MCI group: av- FUNCTIONAL STATUS AND ASSOCIATED FACTORS
erage age 72.5 SD 6.1) and age matched peers (6 men and 7 wom- IN TURKISH PATIENTS WITH COLON CANCER:
en) without cognitive disorder (Control group: average age 71.7 SD PRELIMINARY RESULTS
7.9). The parameters of finger taping were total moving distance,
energy balance, standard deviation (SD) of contact duration, SD of B. Kara1, G. Kaya2
tapping interval, and SD of phase difference between taps of both 1Gulhane Military Medical Academy, School of Nursing, Ankara,
hands. Results: There were statistically significant differences be- Turkey, 2Gulhane Military Medical Academy, Department of On-
tween AD/MCI group and Control group in total moving distance cology Clinic, Ankara, Turkey
(p=0.03), SD of contact duration (p=0.02), SD of tapping interval,
(p=0.03). Conclusion: It was dependent on the parameter of finger Introduction/Background: Patients with colon cancer are at risk for
tapping whether we could detect the difference between patients developing functional impairment. However, studies on functional
with cognitive disorder and healthy peers.We are going to use these status in this population are limited. The aim of this study was to
parameters to define the difference of hand dexterity for the extent evaluate functional status and to determine its associations with
of cognitive disorder and also to monitor the deterioration of hand demographic/disease-related characteristics and perceived family
function in the course of progression of dementia. support in Turkish patients with colon cancer. Material and Meth-
ods: This cross-sectional study included 30 patients (53.3% male)
with colon cancer who were followed up by an oncology outpatient
18 clinic in a training hospital in Turkey. Inclusion criteria were age 18
years or older, colon cancer diagnosis for at least one month, aware
THE ROLE OF ULTRASOUND IN DIAGNOSIS OF
of diagnosis, having received at least one chemotherapy regimen,
THE CAUSES OF LOW BACK PAIN: A REVIEW OF
ability to communicate in Turkish and agreeing to participate in
THE LITERATURE the study. Exclusion criteria were cognitive impairment, history of
major psychiatric disorder, the presence of substantial physical dis-
P. Noormohammadpour1, R. Kordi1, P. Heidari2, M. Ros-
ability and unstable clinical status. Data were collected by using
tami3, F. Farahbakhsh1
an information form, the Functional Living Index-Cancer (FLIC),
1Sports Medicine Research Center - Neuroscience Institute, Tehran and the Cancer Patient Social Support Scale (CPSS). Descriptive
University of Medical Sciences, Tehran, Iran, 2Nuclear Medicine statistics, the Mann-Whitney U test and Spearman’s correlation co-
and Molecular Imaging - Massachusetts General Hospital, Har- efficient were used for the analysis of data. A p value of <0.05 was
vard Medical School, Boston, USA, 3Department of Neurosurgery regarded as statistically significant. Results: The mean age of the
- Shariati hospital, Tehran University of Medical Sciences, Tehran, patients was 60.0±11.8 years (range =22–75) and the median dura-
Iran tion of disease was 12 months. The majority of the patients (90%)
had metastases, and 36.7% had comorbidity. The mean FLIC score
Introduction/Background: Low back pain (LBP) is among the most
of the patients was 112.9±22.4, and the mean CPSS total score was
prevalent musculoskeletal conditions in the developed countries.
147.4±12.7. The FLIC scores were lower in females than males
It is a common problem causing disability and imposing a huge
(z=–2.163, p=0.031). The FLIC scores were also positively cor-
economic burden to individuals and state organizations. Imaging
related with the CPSS total (r=0.55, p=0.002) and subscale scores
plays an important role in diagnosis of the etiology of LBP. Ma-
(emotional support: r=0.54, p=0.002, and information support:
terial and Methods: The electronic databases included: PubMed,
r=0.56, p=0.001; respectively). Conclusion: The functional status
Ovid SP Medline and ISI and Google Scholar. In every search
of the patients was higher than moderate level. Better understand-
engine another search was performed using various permutations
ing of factors associated with functional status may provide more
of the following keywords: ultrasonography, ultrasound imaging,
effective interventions to improve health and well-being in patients
low back pain, back muscles, paraspinal muscles, multifidus, trans-
with colon cancer.
verse abdominis, muscle size, spinal canal, sacroiliac joint and
J Rehabil Med Suppl 55