JUNIE 1974 F I S I O T E R A P I E 7 II to try p re lim in a ry p la s te rs to see w h e th e r th e aS- T will h e a b le to c o p e w ith th e in c re a s e d flexion, bility is a p a r tic u la r p ro b le m fo llo w in g o p e ra - * a r o u n d th e h ip jo in t. P e lv ic in sta b ility is a p ro b - ti°nS a m n io n to a lm o s t a ll c e re b ra l-p a ls ie d c h ild re n , lem cfgW 0 f th e m c a n tilt o r r o ta te th e ir pelvis or very . ex tend th e ir h ip s. H o w m u c h g re a te r th e p ro b - act tnen fo llo w in g tra n s fe r o r re le a s e o f m uscles 'cring u p o n th e h ip jo in t a n d pelvis. aCTh so iu tion w o u ld seem to be to p re v e n t th e need ex te n siv e su rg e ry , a n d th e o n ly in d ic a tio n f o r su r- f°r would seem to be e sta b lish e d d e fo rm itie s in the gfjp r u n tre a te d c h ild . C e rta in ly su rg e ry sh o u ld be ded in a y o u n g ch ild w h e re th e re is so m u c h p o te n - 3-V| for influencing th e p o s tu ra l to n e a n d m o v e m e n t tterns by m e a n s o f n e u ro d e v e lo p m e n ta l th e ra p y — A there a re c e rta in ly f a r b e tte r w ay s o f in h ib itin g a [V(oro re action th a n by le n g th e n in g th e h a m strin g s! S U M M A R Y : This article a tte m p ts a r e a p p ra is a l o f th e c o n c e p t o f A r o d e v e l o p m e n t a l th e ra p y in c e re b ra l p a ls y in th e Tope th a t th is a p p r o a c h to tre a tm e n t w ill be m o re c o n ­ sistently ap p lie d . R E F E R E N C E S : 1 B obath, K . a n d B.: T h e T r e a tm e n t o f M o to r D is­ orders o f P y ra m id a l a n d E x tr a p y r a m id a l O rig in by Reflex I n h ib itio n a n d F a c ilita tio n o f M o v e m en t, P h y sio th e r. (C .S.P .) 41, 5, M a y 1955. 2 . B obath, K. a n d B.: T h e N e u r o p a th o lo g y o f C e re ­ bral P a lsy a n d its Im p o rta n c e f o r T r e a tm e n t a n d D iagnosis, C e re b . P a lsy B ull., 1, 8 A u g u s t 1959. 3. B obath, K . a n d B.: A n A n a ly sis o f th e d e v e lo p ­ m en t o f s ta n d in g a n d w a lk in g p a tte rn s in p a tie n ts with c e re b ra l p a ls y , P h y s io th e r. (C .S .P .) 48, 6 , Ju n e 1962. 4. B obath, B.: M o to r d e v e lo p m e n t, its effect on g eneral d e v e lo p m e n t, a n d a p p lic a tio n to th e tr e a t­ m ent o f c e re b ra l p a lsy , Ib id . 5. B obath, K . a n d B.: T h e f a c ilita tio n o f n o r m a l p o s ­ tu ra l re a c tio n s a n d m o v e m e n ts in th e tre a tm e n t o f c e re b ra l p a lsy , P h y s io th e r. (C .S .P .), 50, 8 , A ugust 1964. 6 . B o b a th , B.: A b n o rm a l P o s tu r a l R eflex A c tiv ity c a u se d by B ra in L esions; L o n d o n , H e in e m a n n , 1965. 7. B o b a th , B.: T h e v e ry e a rly tre a tm e n t o f c e re b ra l p a ls y , D evel. m ed . c h ild n e u ro l., 9, 4, A u g u s t 1967. 8 . B o b a th , B.: T h e T r e a tm e n t o f N e u ro m u s c u la r D is ­ o rd e rs b y Im p ro v in g P a tte r n s o f C o -o rd in a tio n , P h y s io th e r. (C .S.P .), 55, 1, J a n u a r y 1969. 9. B o b a th , K .: T h e n o rm a l p o s tu r a l reflex m e c h a n ­ ism a n d its d e v ia tio n in c h ild re n w ith c e re b ra l p a ls y , P h y s io th e r. (C .S.P .), 57, 11, N o v e m b e r 1971. 10. B o b a th , K .: T h e M o to r D e fic it in P a tie n ts w ith C e re b ra l P a lsy , C lin ic s in D e v e l. M e d . N o . 23, L o n d o n , H e in e m a n n , 1972. 11. F in n ie , N ., H a n d lin g th e Y o u n g C e re b ra l P a lsie d C h ild a t H o m e , L o n d o n , H e in e m a n n , 1968. 12. M a g n u s, R .: C a m e ro n P riz e lec tu re s o n so m e r e ­ su lts o f stu d ies in th e p h y sio lo g y o f p o s tu re , L a n c e t, ii, 531 (p. 585) 1926. 13. R o o d , M . S.: T h e use o f S e n so ry R e c e p to r to A c tiv a te , F a c ilita te a n d In h ib it M o to r R e sp o n se , A u to n o m ic a n d S o m a tic , in D e v e lo p m e n ta l se q u e n c e ; in ; A p p ro a c h e s to th e T r e a tm e n t o f P a tie n ts w ith N e u ro m u s c u la r D y s fu n c tio n , S tu d y C o u rs e V I, 3rd O c cu p . T h e r. C o n fe re n c e , D u b u q u e , Io w a , W m . C. B ro w n & C o . 1964. 14. S c h a lte n b ra n d , G .: S o m e O b s e rv a tio n s o n D e v e lo p ­ m e n t o f H u m a n M o tility a n d on M o to r D is tu r b ­ a n c e s, B ull. N e w Y o r k A c a d . M ed ., 3, 534, 1927. 15. S to c k m e y e r, S. A .: A n In te r p r e ta tio n o f th e a p ­ p ro a c h o f R o o d to th e T re a tm e n t o f N e u ro m u s c u ­ la r D y s fu n c tio n , A m . J. P h y s. M e d ., 46, 1, F e b r u a ry 1967. 16. W eisz, S.: S tu d ie s in E q u ilib ru im R e a c tio n , J. N e rv . M e n t. D is., 8 8 , 150, 1938. A C K N O W L E D G E M E N T S : D r. a n d M rs. K . B o b a th , M rs. J. B ryce, P ro f. M . R o o d a n d M rs. E. R ic h a rd s o n — f o r p o s t-g ra d u a te c o u rs e n o te s a n d p e rs o n a l d iscussion. R ep o rt o f S ym p o siu m o f th e O b s te tric G ro u p o f S.A. S o c ie ty o f P h y s io th e ra p y PHYSIOTHERAPY and the PELVIS* P H I L L I P V . T O B IA S F.R.S.(S.A f.), F .L .S .(L o n d .), D .Sc., P h .D ., M .B .B .C h. H o n o r a r y V ic e -P re sid e n t, S o u th A fric a n S ociety o f P h y s io th e ra p y This S y m p o siu m a n d F irs t A n n u a l G e n e ra l M e eting of the S o u th A fric a n S o c iety o f P h y s io th e ra p y O b s te tric G roup re p re se n t a n im p o r ta n t ste p fo rw a rd in th e life and w ork o f y o u r S ociety. B nef a d d ress a t th e Official L u n c h e o n m a rk in g th e First S y m p o siu m o f th e F irs t S p e c ia liz ed G r o u p — the O bstetrics G r o u p — o f th e S o u th A fric a n S o ciety o f P h y s io th e ra p y , 2 3 rd M a rc h 1974. I n th e a b se n c e o f y o u r P re sid e n t, P ro fe s s o r B. B ro m ilo w -D o w n in g , le t m e e x p re ss m y p ra is e a n d c o n ­ g ra tu la tio n s to th e S o c iety on th e e sta b lis h m e n t o f this, t h e first o f its S pe c ia lised G ro u p s . T h e in c e p tio n o f th e O b s te tric G r o u p a y e a r a g o w as a n o th e r la n d m a rk — a n d th is m e e tin g is a n o th e r m ile ­ sto n e — in th e a d v a n c e o f P h y s io th e ra p y in S o u th e rn A fric a . In fa c t, sig n ific a n t d e v e lo p m e n ts in P h y s io ­ th e r a p y a re o c c u rrin g a t such a te m p o th e s e d a y s t h a t o n e sc a rc e ly h as tim e to c a tc h o n e ’s b re a th . O n ly la s t y e a r, th e P ro fe s s o ria l B o a rd f o r P h y s io th e ra p y c am e in to b e in g a n d o ne fo u n d o n e s e lf c o n g ra tu la tin g P r o ­ fe sso r J e a n B la ir on h e r e le c tio n as its first C h a irm a n . O n ly a y e a r o r tw o h a v e p a sse d since th e W itw a te rs- r a n d U n iv e rsity in a u g u ra te d a n e w degree, th e M a s te r o f S cience in P h y s io th e ra p y , a n d a lre a d y o u r first c a n ­ d id a te s a re c o m p le tin g th e ir d isse rta tio n s. I w o n d e r h o w lo n g it w ill be b e fo re w e find o u rse lv e s c o n sid erin g th e e s ta b lis h m e n t o f a S o u th A fric a n C o lle g e o f P h y s io th e ra p y ! 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. ) 8 P H Y S I O T H E R A P Y JUNE, 1974 .1 s h o u ld b e fa ilin g in m y d u ty if I w e re n o t to c o n ­ v e y m y w a rm fe lic ita tio n s to M rs . A u d re y M c F a r la n e a n d h e r C o m m itte e o n c o n c e iv in g a n d g iving b ir th to th e O b s te tric A s s o c ia tio n — a p p r o p ri a te ly a h a p p y b irth d a y . I s h o u ld e sp e c ia lly lik e to e x p re ss a p p r e c ia ­ tio n to M iss R o s e m a ry H a r te o n c o n v e n in g w h a t h a s u n d o u b te d ly b e e n a m o s t su c c e ss fu l S y m p o siu m . I k n o w I sp e a k f o r a ll o f y o u w h e n I e x te n d th a n k s a n d g r a ti­ tu d e to th e s p e a k e rs — so m e o f w h o m h a v e c o m e a ll th e w ay f r o m P r e t o r ia a n d C a p e T o w n , as w e ll a s so m e o f o u r lo c a l lu m in a rie s , fo r th e ir c o n tr ib u tio n s la s t e v e n in g ; a n d to P ro f e s s o r J a c k A lla n f o r c o n d u c tin g th e L e c tu r e /D e m o n s tr a tio n th is m o rn in g . . O b s te tric s — w h a t a c ru c ia l a r e a w ith w h ic h t o b e g in y o u r sp e c ia lis e d g ro u p s ; f o r e v e ry th in g b e g in s w ith it. A n d , a f te r a ll, a s a g re a t m e d ic a l m a n o n c e s a id , is n o t th is p e lv is th e tr iu m p h a l a rc h th r o u g h w h ic h p a sse s ev e ry y o u th f u l c a n d id a te f o r im m o rta lity ? T h is p e lv ic tr iu m p h a l a rc h is o n e o f t h e su p re m e p r o d u c ts o f e v o lu tio n a r y g e n iu s : f o r it h a s a tta in e d its h u m a n fo rm a n d fu n c tio n w h ile o v e rc o m in g tw o o r th re e m a jo r a n d s o m e tim e s c o n flictin g c h a lle n g e s. O ne w a s th e tr e n d in a n c ie n t tim e s to w a rd s a n in c re a s e in th e b ra in size o f th e n e w b o rn b a b y ; w ith th is w e n t th e n e e d f o r a c o n c o m ita n t e n la rg e m e n t o f th e b irth -c a n a l; a n d th e th ir d w a s th e a tta in m e n t b y o u r a n c e s to rs o f u p rig h tn e s s . T h e w a y in w h ic h th e s e a p p a r e n tly irre c o n c ila b le b io lo g ic a l g o a ls w e re a c h ie v e d w i th o u t th e p e lv ic m e c h a n ism fa llin g in to a h e a p o f ru in s, o r o u r species giv in g u p th e se e m in g ly u n e q u a l stru g g le a n d becoming e x tin c t, is o n e o f th e g r e a t sa g a s o f h u m a n development. E n d is s n a a k s d a t, n ie te e n s ta a n d e d ie fe it d a t hierdie e w o lu sie v a n v e rn a a m s te b e la n g is, n a v o rs in g in hierdie a r e a ’n b a ie jo n g e n n u w e o n tw ik k e lin g is. Eenvoudig is d ie kw e ssie so o s v o lg : H o e k o n d it g e b e u r h e t d a t die fe tu s ’n d rie v o u d ig e v e rg ro tin g v a n sy b re in versoen m e t d ie v e reistes v a n ’n n o rm a le g e b o o rte ; e n teixelf- te rty d v e rs o e n m e t d ie v e ra n d e rin g s in d ie bekkenbeen. sy g e w rig te e n sy sp ie re — w a t d ie b e re ik v a n opregt- h e id v e rg ese l h e t? T h e m in d b o g g les a t th e th o u g h t t h a t we ever sur­ v iv ed th is th r e e f o ld c h a lle n g e o f th e bigger-brained n e w b o rn b a b y , d e m a n d in g a m o re c a p a c io u s birth- c a n a l; th e m a in te n a n c e , n e v e rth e le ss, o f n o r m a l parturi­ tio n ; a n d th e m a jo r p e lv ic re a d ju s tm e n ts t h a t accom­ p a n ie d th e a tta in m e n t o f th e u p r ig h t sta n c e a n d bipedal g a it. Y e t su rv iv e w e d id ; a n d o n ly b y th e developm ent of a s u p e rb m e c h a n ism w h o se n u a n c e s h a v e b e e n occupy­ ing y o u r a tte n tio n la s t e v e n in g a n d th is m o rn in g . n Y e t e v en th e m o s t p e r fe c t o f N a tu r e ’s m e c h a n is ^ n e ed s th e g u id in g h a n d o f th e th e r a p e u tic tea m from tim e to tim e . S o it is fitting t h a t y o u r Society has o rg a n is e d th is S y m p o s iu m o n th e ro le o f th e physio­ th e ra p is t in h e lp in g to e ase th o s e musculo-ligamentous p ro b le m s w h ic h o u r m o s t s p e c ta c u la r a n d all-too-recent e v o lu tio n a ry re v o lu tio n h a s le ft in its w a k e. REPORT OF FIRST A.G.M. OF OBSTETRIC GROUP OF S.A.S.P. b y M iss R . H a u te , C hairm an T h is d e lig h tfu l a n d s u ita b le “ c o m m e n t” b y P ro fe s s o r T o b ia s a t th e lu n c h e o n w h ic h b r o u g h t to a n e n d th e p r o ­ c ee d in g s o f th e S y m p o siu m , g a v e e v e ry o n e f o o d fo r th o u g h t, p r io r to th e F ir s t N a t io n a l A n n u a l G e n e ra l M e e tin g o f th e O b s te tric G r o u p o f th e S .A .S .P ., w h ic h fo llo w e d o n th e S a tu r d a y a f te r n o o n . By a ll a c c o u n ts th e S y m p o siu m o n “ T h e M a jo r M u s c le G r o u p s In v o lv e d in P re g n a n c y , P a r tu r iti o n a n d P o s t- n a ta l R e c o v e ry ” w a s a g r e a t success, a n d a w ide in te re s t w as sh o w n w h ic h w a s m o s t e n c o u ra g in g . O n th e F r id a y e v e n in g , P r o fe s s o r J e a n B la ir, first c h a ir m a n o f th e P h y s io th e r a p y B o a rd , o p e n e d th e p r o ­ c ee d in g s w ith a s h o r t b u t p e r tin e n t sp e e ch . T h e th r e e p r e s e n ta tio n s by th e P a n e l d e a lin g w ith th e th e m e o f th e S y m p o siu m w e re b r ie f in o r d e r to m e e t p r o g r a m m e r e q u ire m e n ts . D r . v a n R o o y e n , P r o ­ fe s s o r v a n D o n g e n a n d D r. d u T o it p re s e n te d “m u ltu m in p a r v o ” , a b ly c o n d e n s in g th e ir sp e c ia lis e d su b je c ts. M a n y in te re s tin g p o in ts w ere ra is e d w h ic h p re c ip ita te d lively d isc u ssio n , r e g re tfu lly c u t s h o r t b y th e o ld e n e m y — T im e . T h e p ro c e e d in g s w ere, sk ilfu lly h a n d le d b y th e C h a ir m a n , D r . E . A . S tra s h e im w ith a d e lig h tfu lly lig h t to u c h a n d a n a b ility to d ra w a n d h o ld id e a s to ­ g e th e r. C a p e T o w n ’s D r. P e te r B a illie fo llo w e d w ith a ta lk o u tlin in g m e th o d s o f c o n tro llin g “ m u lti- f o e ta l” p r e g ­ n a n c ie s a n d so m e o f th e d ifficu lties e n c o u n te re d en ro u te . C le a rly w o rk in th is field h a s o p e n e d n ew h o riz o n s in o b s te tric s w h ic h w ill n e e d th e c a r e f u l a tte n tio n o f o b s te tric p h y s io th e ra p is ts . P e r h a p s th e m o s t re m a r k a b le e v e n t o f th e S y m p o siu m w a s th e “ h a p p e n in g ” a t th e S a tu r d a y m o rn in g W o r k ­ s h o p , in w h ic h P ro f e s s o r A lla n o f th e A n a to m y d e p a r t­ m e n t o f W its. U n iv e rsity h a d u n d e r ta k e n to prepare sp e c ia lly d isse c te d sp e c im e n s re le v a n t to th e theme of th e S y m p o siu m . N o less th a n 91 m e m b e rs of the S .A .S .P . e n ro lle d ! T h is slo w e d d o w n th e demonstra­ tio n s , a n d it w a s d e c id e d to s c ra p th e E x erc ise Work­ s h o p in fa v o u r o f c a rry in g th e A n a to m y discussion to a c o n c lu s io n (w h ic h o f c o u rs e it d id n ’t!) T h e most p ro m is in g a s p e c t p e r h a p s w as P ro f. A l la n ’s willingness to c o n tin u e th e w o rk in th e f u tu r e in th e f o r m of pro­ p e rly c o n tr o lle d p ro je c ts , a n d th e n e w c om m ittee will b e in v e s tig a tin g th e p o ss ib ility o f th is offer in the neat fu tu re . A c o n tin u a n c e o f th is b a sic ty p e o f revisii a n d d isc u ssio n w o u ld e n s u re a m o re p o sitiv e result fn th e p r o p o s e d E x e rc is e W o rk s h o p , a n d therefore, th o u g h it re m a in s a p rin c ip a l o b je c tiv e o f th e Associa­ tio n , th is w o rk m ig h t, o f n e ce ssity , b e set a sid e for the tim e b e in g . A t th e A .G .M . M rs. A u d re y M c F a r la n e announced t h a t sh e w o u ld b e u n a b le to c o n tin u e a s C hairm an of th e O b s te tric G r o u p a s she is g u id in g th e n ew school o f p h y s io th e ra p y a t G a -R a n k u w a t h r o u g h its initial sta g e s. I n th is w e w ish h e r e v e ry success. T h e n a m e “ G r o u p ” w a s c h a n g e d to “ A sso c ia tio n ”, and th e n e w ly e le c te d c o m m itte e is as fo llo w s; C h a ir m a n : M iss R o s e m a ry H a r te , Johannesburg V ic e -c h a ir: M rs. L o u is e H a c k , P r e to r ia S e c re ta ry : M rs . B re n d a K a s te ll, Johannesburg T re a s u r e r : M rs. P ie tr o u v a n R o o y e n , Pretoria C o m m itte e : M rs . B e ry l C h a n tle r, P re to ria M rs . F ra n c e s G la u b e r , Johannesburg M rs . A u d re y M c F a rla n e , Pretoria M rs . G illia n O o s th u iz e n , Pretoria 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. )