74 F I S I O T E R A P I E SEPTEMBER 1979 5. T h e caring aspect o f m assage was em phasised. 6. U ltraso u n d was th o u g h t co ntro versial in pregnancy. 7. ‘Sam -B row n’ su p p o rtiv e belt could be w orn to su p ­ p o r t the sacro-iliac jo in ts and stab ilise the pelvic ring. 8. M a n ip u la tio n was also th o u g h t to be co ntro versial in pregnancy. 9. E d u ca tio n plays a vital p a rt in the treatm ent routine. P atients m ust be tau g h t ho w to c a rry over co rrect p o stu ral p o sitio n s o f the bod y in everyday activities. T h ey m ust un d erstan d th e an ato m y an d m ovem ents o f th e spinal colum n an d pelvis in o rd er to m inim ise unnecessary stresses an d strains. P atients should be tau g h t how to m ove fro m sitting to standin g, o r fro m lying to sitting; the co rrect sitting p osture, standing p o sition s and m a n n er o f lifting. E d u c a tio n m ust also p re p a re the p a tie n t fo r the p o st-n ata l period. In conclusion positio n s o f op tim al co m fo rt fo r exer­ cise, sleep, relax atio n , first stage la b o u r an d delivery w ere discussed. A th o ro u g h know ledge o f each p a tie n t’s co ndition is essential before exercises are com m enced and the p h y sio th erap ist m ust m ake a d ap tatio n s w here necessary fo r each indiv idual p atien t, alw ays bearing in m ind th a t injud icious exercise will do m ore h a rm than good. V A L U E O F Q U A L I T Y O F M O V E M E N T F O R P R E G N A N C Y M ost people are ig n o ra n t a b o u t th e ir bodies and how they w o rk . M an y peo p le are starved o f m ovem ent as they do n o t p a rtic ip a te in sp o rt o r organ ised exercise a fte r leaving school. V a rio u s occupations, careers and n a tu re en courage laziness o r exercise inactivity. M a r­ riage leaves even less tim e fo r sport. T h u s m ost w om en a re unfit a t th e b eginning o f pregnancy. A dvancing pregnancy leads to in creasing stiffness and unw illingness o r in ab ility to m ove. E xercise classes a re p u t off, es­ pecially if p eo p le co ntinu e w o rk ing. L a b o u r comes as a surprise as it is physically h a rd e r than expected. T h us the m o th er is faced w ith post-natal recovery an d a d ju st­ m ent, flabby muscles, an aching back an d very little tim e. T h is vicious cycle can be preven ted b y organised, co rrect and reg u la r m ovem ent. T o achieve fitness f o r lab o u r, a t least twelve weeks o f an te-natal tra in in g is recom m en ded, usually fro m 24 - 36 weeks, w hich leaves an o th er 4 weeks fo r m ore exercise o r rest, w h ichever is ap p ro p ria te . Once preg ­ n a n t w om en start exercising, they co ntinu e into labour. T h ey feel b e tter as aches and pains d isapp ear, they relax an d look b e tter as they m aster co rrect m ovem ent, becom e co -ordin ate and feel in co ntro l o f th e ir bodies. It is too late to w ait un til la b o u r starts, w hen they feel stiff and in co -o rd in ate an d have difficulty in p er­ fo rm ing the task. A b d o m in a l muscles w o rk at an increasing m echanical disadv antag e in pregnancy, thus exercises are perform ed^ in lying and po sture co ntro l is stressed. One aim s at!| no rm a l m ovem ent checking ab n o rm al o r excessive m o vem ent an d suggesting a su ita b le hom e ro utin e. A ny m ovem ent w hich is painfu l o r un c o m fo rtab le is dis­ co ntinued an d possibly a different startin g p o sitio n is all th a t is required. T h e ex ercise ro u tin e is follow ed by relax atio n tra in ­ ing, norm al b rea th in g changes expected in labour, pushing techniques, advice on b r a ’s an d breast care an d problem s en coun tered on taking th e baby home. P atients are fam iliarised w ith h o sp ita l ro u tin e on ad m ission an d taken on a to u r o f the la b o u r and post­ n a tal w ards. T im e fo r discussion and questio ns con­ trib u tes to relax ation. E xercises to m usic follow ed the sh o rt dissertation. H . B. Kastell R EPO RT ON TH E THIRTEENTH G E N E R A L MEETING O F THE NATIONAL COUNCIL T h e T h irte e n th G en eral M eetin g o f th e S ou th A frican S ociety o f P h y sio th e ra p y was held in th e B eattie com ­ plex o f th e U n iv ersity o f C ape T ow n on \2 6 an d 27 A p ril 1979. F o rty delegates attend ed , the full voting strength being fifty-five. Several observers also attended. T h e C hairm an , M rs. K. M. Levy, w elcom ed delegates an d observers an d gave a special w o rd o f w elcom e to P rofesso r A. J. B rin k, P resid en t o f th e S outh A frican M edical R esearch C ouncil and D ean o f th e F a c u lty o f M edicine at the U n iv ersity o f Stellenbosch, an d to M r. J. J. C raig, P resid en t o f the South A frican Society of P hy sioth erapy. P ro fesso r B rin k gave th e opening address, in w h ich he o utlin ed th e activities o f the M edical R esearch C ouncil an d challenged p hy sio therapists to involve them selves in research projects, p a rtic u la rly in the clinical sphere. In delivering his P resid en tial address, M r. C raig discussed th e im p lic atio n s o f first-con tact p hy sio th erap y p ractice and the im p o rta n ce o f establishin g the p rin cip le o f first-contact practice. M r. C ra ig ’s speech was p u b ­ lished in the Ju n e issue o f th e Jo urn al. In h e r co m prehensive C h a irm a n ’s r e p o rt M rs. Levy com m ented first on the ro le w hich the N a tio n a l C om ­ m ittee of R epresen tatives, w hich m et fo r th e first tim e in J a n u a ry 1976, had played in th e affairs o f the S ociety since its inception. T h e N a tio n a l C om m ittee o f R ep resentatives, as a tru ly representative body, had n o t only acted in an ad viso ry capacity to the N atio n al E xecutive C om m ittee but had been the o rig in a to r of several m otio ns su bm itted to this C ouncil M eeting f o r a final decision. One m a tte r alrea d y passed by p o s ta l v o te h a d enabled th e Special G ro u p s/A sso c iatio n s to' elect represen tatives to an d subm it resolutio n s to C oun­ cil, an d at th is p o in t th e C h airm an w elcom ed the first official representativ es o f the Special G rou ps/A ssocia­ tions. M rs. L evy also stressed the n a tio n a l interest and concern o f the N a tio n a l E xecutive C om m ittee and wel­ com ed the fact that n o m in atio n s fo r th is Com m ittee fo r th e first tim e included the nam es of fo u r nom inees fro m ou tside the T ran sv aal. T h e C h airm an also o u tlin ed th e w o rk o f the P ro ­ fessional B oard over the last two years. E very effort is being m ade to have the p rescrip tio n o f the whole co u n try in respect o f the profession o f p h y sio therapy re-gazetted. T h e list o f acceptable registrab le overseas q u alification s has been com pletely revised and criteria f o r th e acceptance f o r reg istratio n o f ad d itio n a l qualifi­ cations h ave been laid dow n. T h ere is also a m ove to establish a fu rth e r set o f crite ria fo r post-basic courses o f a s h o rter d u ra tio n than one y e ar w hich m ight con­ trib u te tow ards a cred it system recognised by the Public Service C om m ission fo r salary purposes. A lth ough salary scales an d cond itions o f service for p h y sio th erap ists in p ro v in cial em ploy w ere still far fro m satisfactory , th e C h airm an than ked th e D e p a rt­ R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 3. ) SEPTEMBER 1979 P H Y S I O T H E R A P Y 75 m ent o f H e alth , an d in p a rtic u la r the S ecretary for H e a lth , fo r th e ir in te re st in ou r profession. I t was con­ sidered essential th a t th e rem ain in g two d ip lo m a courses in p h y sio therapy b e changed to degree courses, both fro m the p o in t o f salary stru ctu re an d fro m the p o in t o f increasing the academ ic co n ten t o f the un d erg rad u a te syllabus. It seems likely th a t a degree course w ill be im plem en ted soon a t th e M edical U n iv ersity o f S outhern A frica, b u t problem s are still being en co u n tered w ith the change to degree status at P reto ria. T h e N a tio n a l E x ecutive C om m ittee was keen to co ntinue th e policy o f invitin g an overseas guest an n u ally to conduct courses a ro u n d the co u ntry , b o th to encourage stim u latin g exchange o f ideas an d to in­ crease the revenue to the F u n d fo r the P ro p a g a tio n of P ro fessio n al K now ledge. Should m em bers be assisted by this fund to study overseas it was felt th a t they should be req u ire d to dissem inate th e ir know ledge by holding sim ilar courses on b e h alf o f th e Society. In her re p o rt on th e affairs o f the W o rld C on­ fed e ra tio n fo r Physical T h e ra p y th e C h airm an dis­ cussed the am endm ent to th e ethical p rin cip les o f the C onfederation w h ich allow ed first-con tact p ractice p ro ­ vided th a t this did n o t conflict w ith th e eth ical p r in ­ ciples o f the ind iv id u al m em ber-organisatio ns. A rising o u t o f this rep o rt, C ouncil passed an am endm ent to o u r ow n ethical princip les stating th a t m em bers w ould no t u n d ertak e treatm en t o f an y p a tie n t except w hen referred by a registered m edical p ra c titio n e r o r registered dentist, except in an em ergency or in case o f som e o th e r ex ceptio nal reason or unless he has d irec t access to the p a tie n t’s doctor. A fter rep o rtin g on the m em bership o f the Society, now standing at 1173, M rs. Levy concluded h e r re p o rt by th a n k in g th e ou tg o ing P residen t, M r. C raig, th e out-going N ational E xecutive C o m m ittee m em bers and, in p a rtic u la r, the Office Secretary, M rs. Jean W ells. Other reports T h e G eneral T re asu rer, M iss H . B aines, gave a very co m prehensive r e p o rt as well as p resentin g th e Incom e an d E x p en d itu re A ccounts, B alance Sheets and E s ti­ m ates fo r the period July 1978 to Ju n e 1979. T h e financial statem ents fo r bo th the G en eral F u n d and the F u n d fo r the P ro p a g a tio n o f P ro fessio n al K now ledge were adopted . .C om prehensive reports w ere given by th e Jo u rn al E d ito r (including th e financial re p o rt an d estim ates Jrepared by the Jo u rn al T reasu rer), the A p p o in tm en ts In fo rm atio n Secretary, the Special G rou ps/A sso ciation s, the representatives o f th e Society on n a tio n al o rg an isa­ tions and the B ranches o f the Society. A ll these reports ap p eared in th e A genda f o r th e C ouncil M eetin g and m ay be read by contactin g y o u r B ranch S ecretary or an y of y o u r B ranch delegates to C ouncil. Amendments to the Constitution Several m otio ns concerning p ro ced u re a t C ouncil and th e expenses of C ouncil M em bers w ere carried at a Special C ouncil M eeting held at the sam e venue im m e­ diately b e fo re the o p enin g of the G e n eral M eetin g. N o less th an 13 fu rth e r A m endm ents to th e C o n stitu tio n or Bye-Laws w ere passed a t the G eneral M eeting. T h is concern o f th e m em bers in th e affairs o f th e ir Society is heartening , rep resen tin g as it does^ a new sense of resp o n sib ility on th e p a rt o f the o rd in a ry m em ber in all parts of the R ep u b lic. I t is hop ed th a t th e C o n ­ stitu tio n in its new fo rm w ill pro ve an effective w orking docum ent fo r som e years to com e; th e C o n stitu tio n a l S ub-C om m ittee are. n o t av erse to the w o rk involved in im plem enting the am endm ents passed but are concerned a t the cost of fre q u e n t rep rin tin g o f the C onstitution. Resolutions N in e te e n R esolutions, A m ended R e so lu tio n s o r A d d i­ tional R eso lution s w ere carried , f o u r w ere n o t carried, one fell aw ay w h en n o t seconded and tw o were w ith ­ draw n. I t is n o t possible to o u tlin e all these R eso lu ­ tions in this rep o rt. T h ey a p p e a r in th e M inutes of the T h irteen th G eneral M eeting o f the N a tio n a l C ouncil and m em bers w ere asked, th ro u g h their B ranches, to indicate if they w ished to receive a copy of th e M inutes, w hich will be circu lated shortly. T he B ranch delegates w ill also have rep o rte d back to th e ir B ranch m em bers.T he new N a tio n a l E xecutive C om m ittee is now en ­ gaged in im plem enting the R eso lu tio n s passed, eith er directly o r th ro u g h the P rofessio nal B oard and the South A frican M ed ical an d D e n tal C ouncil. M inutes of N a tio n a l E x ecutive C om m ittee M eetings are sent to all B ranch S ecretaries an d re p o rt on the progress m ade in this respect. One develop m ent has been the fo rm a ­ tion o f a new sub-com m ittee — th e Investigating C om ­ m ittee fo r salaries, con dition s o f service and reg istra­ tion o f post-gradu ate courses. T h is sub-com m ittee has alrea d y m et tw ice u n d er the C h airm an sh ip of M iss P. B ow erbank. .A n A d d itio n al R eso lu tio n passed by C ouncil ap pro ved the S ociety’s affiliation to th e South A fric a n N euro- developm ental T h e ra p y A ssociation; this req u ire s ratifi­ cation a t the n ex t C ouncil M eetin g b e fo re an official representative can be a p p o in te d as it i n v o l v e s an A m endm ent to the Bye-Laws. N o less th a n ten A d d i­ tional R e so lu tio n s w ere discussed by C ouncil. Since delegates hold no m a n d ate fo r R eso lu tio n s not d is­ cussed a t B ranch level, an y A d d itio n a l R esolutions passed have to be ratified a t a subsequent C ouncil M eeting It is o bv iously p referab le n o t to introdu ce A d d itio n a l R esolutions unless an urgen t need has arisen. E lection o f Office Bearers and Executive Committee T h e follow ing w ere elected to Office: P resid en t: M rs. K. M . LevyV ice-P residents: P rofesso r J. C. A llen, P rofesso r J. C. de V illiers, P ro fesso r H . F . P om pe van M eerd ev o o rt, P ro fesso r F . P. R e tie f, P rofesso r T. L. S ark in .1st V ice-C h airm an: M iss S. Irw in -C a rru th ers 2nd V ice-C h airm an: M rs. F. G la u b er G eneral T re a su re r: M iss H . B ainesJo u rn a l E d ito r: M rs. J. A. C. G ild er C om m ittee M em bers: M iss P. B ow erbank, M rs. V . F o g a rty , M rs. L. H a ck , M rs. N . L ennard, M r. C. L iggins, M iss L. P re to riu s and M iss E. Sm ith. F o r th e first tim e in th e h is to ry o f th e Society we have a ph y sio th erap ist as o u r P resident, and no-one is m o re w o rth y of this h o n o u r th an M rs. M olly Levy, who has served th e Society over several decades as G eneral Secretary, as C h airm an and as m em ber o f num erous sub-com m ittees and w ho is th e presen t C h airm an ot the P ro fessio n al B oard.Also fo r the first tim e in the h isto ry o f the Society, two m em bers, including th e 1st V ice-C h airm an, w ere elected to th e N atio n al E x ecutive C om m ittee fro m branches outside th e borders o f the T ransvaal, viz. fro m th e W estern Pro vin ce B ranch an d fro m the N a tal C oastal B ranch. T his is a w elcom e first step in m a k in g the N a tio n a l E xecutive C om m ittee m ore truly natio nal. S. Irw in -C a rru th ers R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 3. )