Future of Rehab Focus of International Rehabilitation Conference

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From: http://www.ptproductsonline.com/2014/06/future-rehab-focus-international-rehabilitation-conference/

 

Future of Rehab Focus of International Rehabilitation Conference

Published on June 23, 2014

The OMICS Group is hosting the 2^nd International Conference and Exhibition on Physical Medicine & Rehabilitation (Physical Medicine-2014) on July 14 to 16 in Baltimore. The international event aims to share the global knowledge in understanding the recent medical aspects of rehabilitation and treatment methods for the related disorders, according to a news release from the OMICS Group. Dr. George S. Everly, from Johns Hopkins University School of Medicine, USA; Dr. Carol A. Maritz, University of the sciences, USA; and Dr. Chin-Moi Chow, Australia will be the Keynote speakers during the opening ceremony of Physical Medicine-2014.
The conference and exhibition will discuss the recent advancements in the rehabilitation field comprised of: physical therapy; rehabilitation techniques; neurologic disorders; diet and physical health; physical health and chronic health condition; sports injury and rehabilitation; pain and injury management; exercise and trauma; industrial health and management; and population and human health. The theme for the 2014 conference is “Facing the Future of Health and Rehab Solution.”
The OMICS Group news release notes that international event will also see the presence of renown speakers of this field, includeing Adriaan Louw, International Spine and Pain Institute, USA; William Hanlon, Saint Francis University, USA; Meri Goehringis, Grand Valley State University, USA; Terry Haines, Monash University, Australia. In addition, Jaya Shanker Tedla, MPT, PhD, from King Khalid University, Saudi Arabia will host a workshop on the Strengths of training in spastic diplegia the past, present and future.
Sunday R.A Akinbo from University of Lagos (CMUL), Nigeria will host another international workshop on ‘Clinical Decision Making in Sports Injury: Assessment and Management’.
The OMICS Group is an Open Access Publisher that publishes 300 open access online science journals with 30,000 editorial board members drawn from academics, research, and industries, as indicated on the OMICS Group news release. The group hosts more than 150 international conferences worldwide that explore different streams of research.
For more information about the 2^nd International Conference and Exhibition on Physical Medicine & Rehabilitation, visit http://omicsgroup.com.
Source: OMICS Group

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Pharmacology update: 2014 drug trends

NASHVILLE -- More orphan drugs approved in recent years are filling the need for treating rare disease and medical conditions, according to a presenter at the the American Association of Nurse Practitioners 2014 meeting.

Alan Agins, PhD, who gave a pharmacologic overview of drug approvals since 2012, noted a growing trend among pharmaceutical companies.

“I think what we're going to see for the next [two decades] is more specialty drugs,” Agins told Clinical Advisor. “Overall for the last 15 years, the number of drugs approved has gone down, partly because we've pretty much filled out our dance cards on chronic diseases.”
There were 27 first-of-a-kind drugs approved by the FDA in 2013 compared to 39 approvals just the year before. About a third of those approvals were indicated for the treatment of rare conditions and diseases.
Of note, afflicted patients with several conditions would benefit the most from recent approvals, Agins said.
Patients with chronic obstructive pulmonary disease (COPD) can now benefit from once-daily inhalers such as fluticasone and vilanterol (Breo Ellipta). Ease of use and convenience allow for better adherence in the patient population.
Patients with type 2 diabetes can take once-weekly GLP-1 agonists, enabling patients to avoid the hassle of maintaining the pharmacokinetics of the drug with once- or twice-daily dosing. Drugs such as exenatide, although expensive, have better efficacy and fewer side effects.
Newer oral anticoagulants such as dabigitran give patients more flexibility when it comes to diet and lifestyle modifications compared to warfarin. In studies, these medications were associated with lower rates of hemorrhage compared to warfarin, showed no interactions with diet/lifestyle, and did not need to be monitored.
Agins also warned about several unmet needs in drug development, most damagingly from growing drug resistance in antibiotics and the lack of new antibiotic classes.
“The newest class of antibiotics for primary care providers is now 32 years old,” he said about fluoroquinolones. “It's so much so [a problem] that the government actually spent about $200 million last year to hire one of the pharmaceutical companies to develop new antibiotics.”
Alzheimer disease is another condition with an increasing lack of drug treatment options. “Since 1998, over 104 drugs have entered clinical trials and have all failed in terms of AD,” Agins said. “We have an idea of what causes the disease but we're still not definitive, and we certainly don't have any drugs out there on the near horizon.”
Agins is hopeful that in the next 20 years, we will be making the switch from simply managing diseases with drugs to curing them outright.
“But it's going to take some biotechnology and microbiology,” he said. “We're treating symptoms of hypertension and cholesterol and all those other things now, eventually we're going to cure those diseases or prevent them totally.”

Reference

1. Agins AP. #14.3.039. “New Drugs in the Arsenal in Primary Care.” Presented at: AANP 2014. June 17-22; Nashville, Tenn.

Physical disability doesn’t have to be fate

from: http://www.jpost.com/Health-and-Science/Physical-disability-doesnt-have-to-be-fate-361611

          

By JUDY SIEGEL-ITZKOVICH

07/06/2014 01:59

 

Jerusalem’s Alyn Hospital has for 80 years treated and rehabilitated infants, children and teens suffering from a wide variety of injuries and congenital diseases.

Prosthetic limbs Photo: JUDY SIEGEL-ITZKOVICH

Staffers at Jerusalem’s Alyn Hospital used to be satisfied if the children they cared for managed to move from point A to point B in a wheelchair or with a walker.

Today, said Dr. Maurit Beeri, director- general of the country’s national center for pediatric and adolescent rehabilitation of physical disabilities, they aim much higher.

“We believe that it is the right of every child – including those suffering from physical challenges – to have the best quality of life possible. Therefore, Alyn provides the tools to all patients and their families so they can learn how to cope with their condition and reach their full potential, helped by their family and the Alyn staff.”

One of the world’s leading specialists in pediatric rehabilitation and the only facility of its kind in Israel, the hospital diagnoses and rehabilitates infants, children and adolescents suffering from physical disabilities, both congenital and acquired (such as from road accidents, falls and terror attacks). Alyn, founded 80 years ago, has 120 inpatient beds and 600 inpatients a year, along with 20,000 outpatient visits to its clinics.

Patients come to the center in the capital’s Kiryat Hayovel quarter from all over the country and from abroad for its multidisciplinary care and are rehabilitated there regardless of their religion, ethnic origin or language.

Its outpatient clinics focus on everything from spina bifida and spinal cord injury to leg braces and spasticity. To raise a child’s motivation so that they make progress in their rehabilitation process, Alyn adds animal-assisted therapy, computer technology therapy, virtual reality games, medical clowns, hydrotherapy and exercising in the hospital’s therapeutic sports center. Throughout the rehabilitation process, patients and their families are closely assisted by nursing staff, social workers and psychologists.

A few weeks ago, it held at the capital’s Crowne Plaza Hotel a second conference on child rehabilitation, with the discussions including the use of robotics technology to enhance outcomes for children with cerebral palsy; social networks; metronome training for children with brain damage; and diaphragmatic pacing as a respiratory rehabilitation tool.

Prof. Arnon Afek, a medical administrator who only a few weeks ago became director-general of the Health Ministry, spoke briefly to the conference participants.

“I originally come from Sheba Medical Center at Tel Hashomer that regards rehabilitation as a major task,” he said. “We save people’s lives, but that’s only the beginning. The patient should leave the system with maximal function. So rehabilitation is the correct model – but it’s not good enough. There are very few rehabilitation beds around the country.

We are going to expand them. Alyn Hosptial’s work to help children reach their maximum potential is not trivial in my eyes. At Alyn and other rehabilitation facilities, the patients are among the weakest in society, but the staff people really care,” said Afek.

"WE AT the hospital are older and more experienced; we don’t really know the language of the kids who use What’s App and other cellular phone applications and social networks,” said Beeri. “There is definitely a gap between Generation Z and us. Other changes are that, fortunately, we have fewer trauma patients, including victims of terror attacks, than we used to. The last patient we received who had been severely wounded in a terror attack... was wounded at the Central Bus Station three years ago. But we now get children and teens with more complex problems who need intensive care, chronic pain syndromes and somatoform disorders [mental illnesses that cause bodily symptoms that can’t be traced back to any physical cause].”

The World Health Organization’s model for child rehabilitation is comprehensive.

“Health,” continues the Alyn director, involves all functions. It is determined by activity, the functioning and structure of the body, the environment and personal characteristics.

Even at three months of age, a baby has a temperament and personality.”

The doctors and nurses don’t just tell the parents and children what they must do. “We all have to work together. Everyone in the multidisciplinary team has his own expertise. How well the patient will do also depends on how the family members’ functioning. One can see two children with the same disability, but one will remain severely disabled and the other will be able to function well depending on how much the family can help,” Beeri continues.

There are five F’s of child rehabilitation.

These are fitness, function, family factors, friendship and fun. They need to have fun to develop physically and emotionally. This is a more holistic approach, said Beeri. “We now look at the children’s future in a more positive way.”

Children everywhere, and at Alyn, hardly play ping-pong anymore; they do it on a digital console. They have a lower level of patience. Their motivations and interests are different, said Beeri.

“The borders are fuzzy. Kids send smartphone messages in abbreviations, much of it in English. There’s a gap between the kids and their parents and between the kids and our medical staff. There is a difference depending on whether the medical staffer is younger or more veteran. It has gone from the hi-fi of my generation to the wi-fi of today.”

All of this can affect rehabilitation of children with cerebral palsy, brain injuries, spina bifida, neuromuscular disorders and others. Children used to die from these conditions, but technology keeps them alive, so they have to be assisted in functioning as much as possible.

Among the latest devices invented for the disabled is the ReWalk, an Israeli-developed “exoskeleton” system that enables people paralyzed in the lower parts of their bodies to stand and walk. Just approved by the US Food and Drug Administration, ReWalk was developed Dr. Amit Goffer, who was inspired to develop the ReWalk exoskeleton unit because he himself is quadriplegic. He founded Argo Medical Technologies in 2001 to create a patented product that would enable persons with spinal cord injuries to walk again. Over the past decade, Argo has grown from a small research and development start-up based in Israel to an international company with headquarters in the US, Germany and Israel.

The paralyzed person wears the device, which is an “external robot” that moves the hips and knees so they can walk even though their nerves were damaged or destroyed. Paralysis victims can thus get up from their wheelchairs and move about on their legs, looking at others from normal height. They need to wear a backpack to bear the ReWalk’s computer and battery, and a control with buttons is worn on the wrist.

Based on natural walking movements of the legs, ReWalk can improve patients’ cardiovascular health, halt the loss of fat tissue and boost their muscle and gastrointestinal performance. They also suffer less pain, need to be hospitalized less frequently and need to take less medication.

Although prices are $65,000 and up, the exoskeleton technology will probably become cheaper and would surely be a boon to paralyzed children and teens at Alyn.

“The exoskeleton will help the disabled function much better, not only to overcome disability but to help them be faster and stronger than a healthy person. In the future,” predicts Beeri, these devices will interface with our brains and be operated directly by the brain.

Already today, Alyn uses special pillows to measure pressure on parts of the body to prevent the development of pressure sores, which can develop into serious infections.

Google Glass, a small wearable computer with an optical head-mounted display that displays information in a hands-free format, will also be a boon to the physically disabled. Smartphones can be used instead of joysticks, simply by changing the angle at which you hold them.

“This is a new world that we ourselves don’t really understand.”

Other changes with which the medical profession must cope include protecting the privacy of patients despite the sending of email and SMS messages and being part of forums. In addition, medical students don’t have to learn everything by heart any more. Information is available at the tips of their fingers by smartphone.

“I must admit that it’s an important advance from trying to decipher the bad handwriting of doctors. Now it’s all digital,” said the Alyn pediatrician.

There is plenty of information available, she continues, “But there is a downside – such as the lack of differentiation between real experts and laymen [who think they are experts]. There are many people who provide information but have a personal agenda. We are exposed to an oversupply of data. A doctor will give a diagnosis, and the parents say they just read an article on the Internet that the physician himself has not yet read. This can lead to a lack of faith in the doctor.”

Parents read reports of “new” treatments that haven’t even been studied and are not available to the patients. There are complementary medicine and commercial interests. Everybody is selling something. Families want a cure to their children’s problems, but we can almost never supply it,” said Beeri.

ALYN BROUGHT over for the conference a guest speaker from the Rehabilitation Institute of Chicago, Prof. Deborah Gaebler-Spiro. Affiliated with the Northwestern University Feinberg School of Medicine and Children’s Memorial Hospital, the facility had 150 beds. Gaebler-Spiro, who specializes in pediatric rehabilitation, works only with children.

“I toured Alyn and found there is brilliant interaction with the parents and children. This is a very good social-medical integration model. We in the US are more medically driven. Our catchment area in Chicago and even outside our state of Illinois is so broad that it’s harder to get the family involved,” she said.

An exhibition of mostly imported equipment for disabled children – held outside the Crowne Plaza ballroom equipment – had items similar to what is available in Chicago, said the American pediatrician. “But in the US, not everything that is available meets the patient’s needs. A child may get a power wheelchair, but there is no elevator leading to his or her apartment.”

In addition, “children hold a special place in our hearts, but as they grow older, there is less of a tradition of supporting them. It is much harder to get funds when they reach 18 or 21.”

The biggest change between now and when Gaebler-Spiro studied medicine at the University of Chicago is that “we know [now that] we can improve neuroplasticity with certain techniques. What they start with is not their inevitable fate. Their abilities can be improved. Children with cerebral palsy who are given robotic technology will do much better.”

Her rehabilitation institute, which was founded in the 1950s to cope with children stricken by polio who needed to be in iron lungs, is now involved with regenerative medicine, including stem cells. “There’s an explosion in technology. Equipment is lighter, faster and cheaper.”

Cerebral palsy affects 100,000 US kids up to the age of 18. Including those who survived into adulthood, CP affects 800,000 Americans. Working closely and constantly with engineers, her medical staff improve strength, tone, balance and motor control.

“We developed a passive stretching device to help the foot below the ankle. The children move virtual food around on the screen. By moving a foot, a helicopter seems to crash through a wall, thus strengthening their muscles. Stiffness of their joints and spasticity of their muscles are alleviated. The child can even do this at home through tele-rehabilitation,” explained Gaebler-Spiro. “We trick them into doing rehabilitation. A child with one functional toe can get a drink by himself. Even babies can drive robotic cars. The earlier they can do this, the better. Robots can be fun, perfect for practice, provide feedback during treatment and provide reinforcement.”

Courage Kenny Rehabilitation Institute opens in Forest Lake

from: http://forestlaketimes.com/2014/06/18/courage-kenny-rehabilitation-institute-opens-in-forest-lake/

By The Forest Lake Times

June 18, 2014 at 11:01 am

Two therapy businesses merge

Courage Kenny Rehabilitation Institute opened March 26 at 1467 S. Lake St. in Forest Lake. (Photos by Kailey Hanson)

Kailey HansonTimes Intern

This spring, 1467 S. Lake St. became the physical juncture of the Courage Center and the Sister Kenny Rehabilitation Institute in Forest Lake.

In June 2013 the two organizations merged under Allina Health to become Courage Kenny Rehabilitation Institute, the first collaboration of the new company. The Courage Center had been located at 146 N. Lake St., while the Sister Kenny Rehabilitation Institute held residency at 555 W. Broadway Ave.

“When Allina Health, Sister Kenny and Courage Center merged together, that was able to give us that opportunity to join two separate physical locations into one,” said regional manager Steven Scherger. “The merger really brought them together organizationally, operationally, and this is the first physical merger, per se, of the organization.”

Courage Kenny’s specialties cover physical therapy, occupational therapy and speech therapy.

Physical therapy involves muscles, bones, ambulation and mobility. Occupational therapy focuses on functional mobility, cognition, thoughts and sensory integration. Speech therapy targets communication and oral motor skills.

“The spectrum of services that we offer is entirely comprehensive,” Scherger said.

At the new facility, Courage Kenny employs nine therapists, two provider coordinators and one rehabilitation aide. No layoffs were made in the transition.

With the compilation of the two businesses, the number of patients has increased significantly, averaging between 70-80 patients in a day.

The new location has rooms that provide therapeutic equipment targeted for patients’ specific therapies. The new Courage Kenny facility, at 5,000 square feet, holds six adult treatment rooms, four pediatric treatment rooms, an adult speech room, a pelvic pain and incontinence room, a kitchen, an adult gym and a pediatric gym.

The pediatric gym includes a ball pit, swings and a climbing wall for young patients as a reward for finishing therapy.

Dale Olson works on a squatting exercise with a therapist at the new Courage Kenny Rehabilitation Institute.

The adult occupational therapy, physical therapy and speech pathology areas are separated.

“The speech and pediatric rooms utilize extra drywall and sound mitigation ‘green glue’ to reduce noise transfer between rooms,” Scherger said. “This helps the patient focus more on their treatment.”

Being across the street from the Allina Medical Clinic allows patients there to have easy access to therapy.

“It really highlights Allina’s commitment to Forest Lake and the patients that are out here and the population that we serve out here,” Scherger said. “I’m really excited to see the collaboration that’s occurred and manifests in this site, and it highlights the good work we can do here in Forest Lake.”

The facility is open Monday through Thursday from 7 a.m. to 6 p.m. and Friday from 7 a.m. to 4:30 p.m. 

Brain Injury Rehabilitation Program

No rest for rehab: Physiotherapy must begin right after an injury

From: http://www.thestar.com.my/Lifestyle/Health/2014/06/08/No-rest-for-rehab/

by revathi murugappan

Unlike generic physiotherapy methods, DBC’s programmes, which use various devices, work on the concept of active muscle reconditioning. –LOW BOON TAT/The Star

For faster and better recovery, physiotherapy must start immediately after you get injured, regardless of whether you are an athlete or not.

In the past, if you sustained an injury, the medical practitioner would prescribe you a dose of painkillers and muscle relaxants, and ask you to rest the injured area.
Although some doctors continue with this practice, this treatment modality has been shown to be ineffective.

Now, evidence shows that rehabilitation through physiotherapy and exercise machines produce the best results.
“Rest is disastrous! You’ve got to work on the injured site immediately or it’s going to be difficult to rehabilitate.
“Complications can arise if you don’t start the programme early enough,” says Finnish physiotherapist Peter Halén, who specialises in orthopaedic manual therapy (OMT) and sports physiotherapy.
Surgery is always the last option, unless you’re a professional athlete who needs to get back to the field quickly.
“Rehabilitation may start a little later with surgery, but it is important in pre- and post-surgery, or the athlete might need to end his career.”
With 34 years of clinical experience in rehabilitation of musculoskeletal disorders, Halén is a much sought-after lecturer in university physiotherapy departments, both in Finland and around the world.
He was recently in Kuala Lumpur to conduct a two-day workshop on Overuse Injuries in Sports, organised by Document Based Centre (DBC) Physiotherapy Centre Malaysia.

Peter Halén correcting a client doing his rehabilitation exercises.

Unlike generic physiotherapy methods (ultrasound, electrotherapy, massage, heat or cold, etc), DBC’s programmes, which use various devices, work on the concept of active muscle reconditioning.
It addresses other clinical elements like endurance, core stability, co-ordination and balance control.
This is essential for achieving the ultimate goal of freedom from pain and improved function.
Developed in Finland almost 15 years ago, the pre- and post-assessment in DBC includes measuring the affected joint’s range of motion.
Electromyography (EMG) is also used to read and monitor muscle activity. In addition, psychological profiling is carried out.
Studies have shown that more than two years after the completion of the programme, 80% of individuals who remained active after the programme, were not limited by pain in their daily activities or at work.
DBC is also the official supplier to the Liverpool Football Club.
Less manipulation
Halén was formerly the regional trainer for DBC International Ltd in South-East Asia.
The Finn’s credentials are impressive, having worked during two Olympic Games (Sydney 2000 and Athens 2004) with the Finnish Olympic team.
He was also the physiotherapist for the Singapore Paralympic team during the Beijing 2008 Games; and since 2010, has held the position of senior physiotherapist with all the Finnish Youth Olympic teams.
At the moment, Halén, 57, is also the physiotherapist for the Finnish national artistic gymnastic team.
“In the early years, physiotherapy was very hands on.
“We used manual manipulation, ultrasound and electrotherapy. Or, we might also do 15 minutes of hot pack, 15 minutes of massage and 15 minutes of electrotherapy.
“But, the field has progressed so much and we’ve discovered that warming up on the treadmill and working on strengthening the joint, together with increasing flexibility, are the best methods to overcome injuries.
“I hardly do any manipulation nowadays because we’re more interested in the function rather than the structure.”
More kids affected
In a survey carried out in Finland recently, outcomes show that those in the 11-19 age group were moving 25% less than those in the same age group 25 years ago.
“We’re not created to sit and do nothing. Since the invention of gadgets, we have gone downhill.
“Do you know there is even a touch screen overuse injury?
“People get injured when they try to do exercises without the touch screen!” cringes Halén, rolling his eyes in mock disbelief.
“Before, I used to treat a lot of elderly patients, but now, it’s mostly youngsters, even from primary schools.
“Kids at 12 are getting degenerative discs, which is shocking.”
Very often, our structures are overloaded and result in pain.
As the load transfer is wrong, the spine is overloaded and injuries occur. Or, the locomotive system could be incorrectly applied.
He says, “The majority of spine problems are to do with inadequate lifting.
“We can’t do anything if it is a degenerative joint, but we can give you exercises and tools to handle the problem and lessen the pain.
“Today, we know how the brain functions, so we can coach and update the ‘software’ to rewire the nerves.”
Rewiring their minds
Of course, there are patients who, despite rehabilitation, experience no pain reduction, so Halén tries to condition them into believing that pain is really no big deal.
His method involves telling the patient to tolerate the pain and continue to work on the function.
Something in the brain changes when pain becomes chronic, which explains why some people have a lower threshold of pain.
“My job is to motivate and understand what patients need to do.
“I ask them, ‘Can you change your job?’ No. ‘Can you change yourself?’ Yes. Then, I proceed to tell them how to do it.
“It takes time, but it can be done. In fact, I talk so much that I’m exhausted at the end of the day, even though I don’t use my hands!” says Halén, chuckling.
Finish the course!
He shares that tendinopathy is the most common sports overuse injury, especially in the ankle, knee and shoulder areas.
Tendinopathy is actually a broad term encompassing painful conditions occurring in and around tendons in response to overuse. There may be little or no inflammation present in these conditions, but it can be painful.
He also adds that sportsmen and laymen suffer the same injuries; the only difference is that among the latter, it’s a result of underuse.
“As you get older, the tendency is to sustain injuries faster but, recovery is slower, so it’s important to follow through with the rehabilitation,”
Having worked in Singapore for a few years, Halén says he notices a vast difference in patient attitude among the different nationalities.
In Finland, patients are more likely to perform the exercises, but here, people want to be “treated”.
“They want a quick fix because they’re too busy and have no time for physiotherapy.
“With some patients who come for physiotherapy, they don’t return once the pain level decreases. They don’t understand that they have to continue doing the exercises with lesser frequency to maintain the function.
“That’s why it’s so important for the correct information to be relayed. Rest and doing nothing when you’re injured is going to get you nowhere.”

Your time is limited, so don't waste it livine someone else's life.  ---by Steve Jobs

https://www.youtube.com/watch?v=bAkxg9_6WR8

Lazy husband as I do dare not organize grand wedding as this video.  The video is nevertheless a good example for wheelchair users.  :)

https://www.youtube.com/watch?v=kh09Rn2JsJM