A question of balance

Why do older people fall? Graham Clews explores this and other neurology-related questions under discussion at Congress

The focus of this year’s Congress is the benefit that physiotherapy can provide for all. There will also be sessions relevant to physios in their own practice and to service provision at a time of flux in the NHS.  Neurology is no exception.

Sessions in this year’s neurology strand will look at physiotherapists’ one-to-one work with patients, provide information useful in service design, and hear of ongoing work to increase activity and exercise among older people and those with long-term conditions.

One of the major sessions to focus on increasing activity will be presented by Dr David Lowery, a clinical psychologist, who will set out results from a project examining exercise as a therapy for the psychological symptoms of dementia.

Dr Lowery is the research programme manager for EVIDEM-E, which is studying whether regular safe exercise can help both the person with dementia, and their carer, by affecting the behavioural and psychological symptoms of dementia.

Dr Michael Trenell, director of the MoveLab physical activity and exercise research group at Newcastle University, will complement Dr Lowery’s presentation by discussing strategies to measure and increase activity in people with long-term conditions.

Increasing activity

Chris Manning, course director of the foundation degree in long-term conditions at the School of Rehabilitation Sciences, St George’s University of London, who developed this year’s neurology theme at Congress, says that while some sections of the programme will focus on increasing activity and exercise, he stuck closely to Congress 2011’s overall ethos of ‘for you, for us and for all’, when designing the schedule.

‘There will be sessions on increasing activity for whole populations, as well as one-to-one care, such as Mark Rogers’ presentation,’ he says.

‘We also have sessions looking at telemedicine, and how service user involvement can help build capacity in neurological services, which will be useful from a service redesign point of view, particularly in demonstrating quality from a patient experience.’

Bernie Porter, a nurse consultant at the National Hospital for Neurology and Neurosurgery in London, will deliver the presentation on telemedicine, explaining how ‘videoclinics’ can be used by physiotherapists to treat patients with multiple sclerosis, who may otherwise have to travel long distances to reach specialist centres.

Tom Penman, head of stroke services at Tower Hamlets Community Health Services, will consider service user involvement in service design.

Balancing act

The neurology thread will kick off on the Friday morning with keynote speaker Professor Mark Rogers discussing how balance strategies and training can help patients with Parkinson’s disease and older people.

Professor Rogers, who is professor of physical therapy and rehabilitation science at the University of Maryland School of Medicine, is currently investigating the neuro-mechanical basis of impaired balance that leads to falls in older people.

In his research he uses a robotic device to pull patients into a controlled fall. Professor Rogers will explore whether clinical interventions that aim to reduce falls by either balance or gait training are conceptually accurate, or whether intervention strategies that emphasise the interactive nature of posture and movement functions are needed.

Dr Pip Logan, associate professor in community rehabilitation at the University of Nottingham, will speak on community-based falls rehabilitation, which is an area of interest to the CSP.

The CSP has supported the charity Age UK’s ‘Stop falling, start saving money’ campaign, which aims to improve access to evidence-based exercise programmes for older people and support multi-disciplinary falls-prevention services. The society is also producing a briefing for members on fragility fractures and falls, which will help physios make the case for cost- and clinical effectiveness of physiotherapy in falls prevention.

Stroke rehab

On Congress’s second day, Dr Sara Demain, a lecturer in physiotherapy at the University of Southampton’s School of Health Sciences, will introduce work on the use of three tactile devices in stroke rehabilitation. Developed with Dr Geoff Merrett, a lecturer in electronic systems at the same university, the devices generate a realistic ‘sense of touch’.

Stroke rehab often ignores sensation, and instead focuses on repetitive movement, says Dr Demain.

‘Our aim is to develop technology that provides people with a sense of holding something or of feeling something, like holding a hot cup of tea, and we want to integrate this with improving motor function,’ she says.

Dr Demain will tell Congress of the three devices the Southampton team have developed, including a ‘shape memory alloy’ device, which has thermal properties, and can replicate the ‘cup of tea’ sensation.

This follows Professor John Rothwell’s update on neuroplasticity and its relevance for rehabilitation practice following stroke, and Dr David Butler’s presentations on adaptations in the brain as a consequence of pain.

John Rothwell is professor of human neurophysiology at the Institute of Neurology, University College London, and although he’s not a physiotherapist, Chris Manning says his presentation will be highly relevant to physios.

The session on the biopsychosocial approach to assessment and management of pain by Dr Butler, director of the Neuro Orthopaedic Institute at the University of South Australia, will be relevant to both musculoskeletal and neurological physios. fl

Congress Dates

  • CSP Congress 2011 is being held at the BT Convention Centre, Liverpool, Friday 7 – Saturday 8 October 2011

In addition to neurology, there are four other programme themes this year.

They are:

  • musculoskeletal;
  • cardio-respiratory;
  • management, clinical leadership and public health;
  • and (on Friday only) a theme aimed specifically at associates.
  • In our next issue of Frontline we’ll be looking at what you can expect from the cardio-respiratory theme.

For more details or to book online see:  www.cspcongress.co.uk or go to the booking form on page 50

See also pages 18-19 in this issue of Frontline.

Associate members and Congress

Our article ‘You’ll never walk alone’ (18 May) about reasons for coming to Congress, may have suggested that associates did not have dedicated sessions at CSP Congress. We would like to confirm that there will be a full associates theme at Congress, on Friday 7 October. Details can be seen online at www.cspcongress.co.uk

Graham Clews

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