October, 1954. P H Y S I O T H E R A P Y Page Three SIT-WALKING By AL F RE D R O T H B E R G S u p e r i n t e n d e n t P h y s i o t h e r a p i s t , R e h a b i l i t a t i o n C e n t r e , W . N . L . . A . - H o s p i t a l , J o h a n n e s b u r g . P A T I E N T S o n a l o n g - t e r m w a l k i n g r e - e d u c a t i o n p r o g r a m m e o f t e n g o t h r o u g h a f r u s t r a t i n g w a i t i n g p e r i o d t e f o r e t h e y a t e a l l o w e d t o s t a r t w a l k i n g p r o p e r . A m o n g t h e m a r e t h o s e m a n y c a s e s w h o h a v e d o n e w e l l w i t h c o n s e r v a t i v e p r e p a r a t o r y e x e r c i s e s o n t h e b e d a n d w i t h a p p a r a t u s , b u t s t i l l l a c k s u f f i c i e n t s t r e n g t h — g e n e r a l l y o r a t t h e s i t e o f t h e l e s i o n — t o b e u p w i t h c r u t c h e s o r e v e n in t h e w a l k i n g m a c h i n e . T h i s a p p l i e s t o p a t i e n t s r e c o v e r i n g f r o m P a r t i a l P a r a p l e g i a o f v a r i o u s o r i g i n , H e m i p l e g i a , A n t e r i o r P o l i o m y e l i t i s , P e r i ­ p h e r a l N e u r i t i s , A r t h r i t i c c o n d i t i o n s , a n d m a n y o t h e r c a u s e s , t r a u m a t i c o r o t h e r , t o o n u m e r o u s t o s p e c i f y in d e t a i l . S i t - w a l k i n g p r o v e d a v a l u a b l e a d j u n c t in t h e t r a i n i n g p r o g r a m m e a n d h e l p e d t o t i e p a t i e n t s o v e r t h i s w a i t i n g p e r i o d . It w a s a n i m m e d i a t e s u c c e s s w i t h p a t i e n t s i n a r m y h o s p i t a l s d u r i n g t h e w a r . I t h a s b e c o m e a n e s t a b l i s h e d r o u t i n e in o u r R e h a b i ­ l i t a t i o n C e n t r e . Apparatus : T h e e q u i p m e n t r e q u i r e d is s i m p l e . I t is t h e f a m i l i a r w a l k i n g m a c h i n e , w i t h t h e a d d i t i o n o f a s e a t i n g a r r a n g e m e n t a t a s u i t a b l e h e i g h t f r o m t h e g r o u n d . S o m e o f t h e o l d e r a n d v e r y s u b s t a n t i a l t y p e s o f w a l k i n g m a c h i n e s a r e a l r e a d y s u p p l i e d w i t h a s e a t o r p l a t f o r m , f o r r e s t i n g . T h e n e w e r p a t t e r n s ____ a ■. a n d e s p e c i a l l y a t y p e m a n u f a c t u r e d i n t h i s c o u n t r y a r e w i t h o u t it. S u c h a s e a t c a n b e a t t a c h e d in v a r i o u s w a y s , e . g . s u s p e n d e d f r o m t h e t o p r a i l s , o r r e s t i n g o n t h e l o w e r f r a m e w o r k . A v e r y s i m p l e s t r u c t u r e w a s p r o d u c e d b y o u r w o r k s d e p a r t m e n t . It c o n s i s t s o f a w o o d e n b o a r d , 9 " > l 8 " > ' 3 / 4 " , s c r e w e d t o 3 / 4 " s t e e l f l a n g e s w h i c h h o o k e a s i l y o v e r t h e t o p r a i l s , g i v i n g a r e l i a b l e f o u r - p o i n t s u s p e n s i o n ( F i g . 1 . 1. T h e s e a t is e a s i l y d e t a c h a b l e a n d c a n t e i n s e r t e d c l o s e t o t h e b a c k l a i l o r a t a n y d e s i r e d d i s t a n c e f r o m it. T h i s is i m p o r t a n t s i n c e s o m e p a t i e n t s m a y h a v e d e f o r m i t i e s o r d i s a b i l i t i e s w h i c h p r e v e n t t h e m f r o m s i t t i n g w e l l u p r i g h t . T h e s e a t c a n t h e n b e h u n g u p s o a s t o a l l o w t h e p a t i e n t t o r e c l i n e s o m e w h a t . A f o l d e d b l a n k e t , a p i l l o w o r o t h e r c u s h i o n i n g c a n t e p l a c e d b > o v e r t h e b a c k r a i l f o r c o m f o r t . I P O bject: i T h e o b j e c t o f s i t - w a l k i n g i s t o t e a c h t h e p a t i e n t w a l k i n g m o v e m e n t s . £ • w h i c h s i m u l a t e v e r y n e a r l y a c t u a l w a l k i n g . It h e l p s h i m t o w a r d s c a r e f u l « t i m i n g a n d p r o p e r c o - o r d i n a t i o n . It c a n b e g r a d e d f r o m s m a l l f o r w a r d a n d b a c k w a r d m o v e m e n t s t o a f a i r l y l o n g s t r i d e , t h u s b u i l d i n g u p m u s c l e ^ ‘9- '■ s t r e n g t h a n d i n c r e a s i n g r a n g e o f m o v e m e n t . It e n a b l e s h i m t o t r a n s l a t e p r e v i o u s e x e r c i s e s o n t h e b e d a n d w i t h e q u i p m e n t f r o m t h e p u r e l y a c a d e m i c t o s o m e t h i n g w h i c h a p p e a r s t o h i m s u b s t a n t i a l l y d i f f e r e n t , n a m e l y s e l f - p r o p u l s i o n . T h e r e is h a r d l y a p a t i e n t w h o d o e s n o t i n s t a n t a n e o u s l y feel t h a t w a l k i n g in t h e s i t t i n g p o s i t i o n is a d v a n c i n g h i m t o w a r d s a c t u a l w a l k i n g . Y e t a l l t h e t i m e h e c a n c o n c e n t r a t e o n t h e s t a g e s o f w a l k i n g w i t h o u t t h e a p p r e h e n s i o n w h i c h a c c o m p a n i e s e a r l y w a l k i n g in t h e u p r i g h t p o s i t i o n , b e it w i t h a p p a r a t u s , c r u t c h e s , o r s t i c k s . T h e f e a r o f f a l l i n g is e l i m i n a t e d . Preparation : C a s e s s h o w i n g m a r k e d w e a k n e s s i n o n e o r b o t h l i m b s o r l a c k o f c o - o r d i n a t i o n a r e a s a r o u t i n e p u t first o n t h e b e d - b i c y c l e . T h i s is a s i m p l e t u b u l a r f r a m e w o r k s u p p o r t i n g t w o p e d a l - l i k e f o o t b o a r d s , t o w h i c h t h e p a t i e n t ' s fe e t a r e s t r a p p e d . It i s f i x e d t o t h e b e d w i t h l e a t h e r s t r a p s a n d b u c k l e s . D e p e n d i n g o n t h e w e a k n e s s o f t h e p a t i e n t h e m i g h t f ir s t b e g i v e n a d d i t i o n a l s u p p o r t b y s p r i n g s o r r u b b e r s l i n g s ( e . g . B i c y c l e t u b e s 2 6 / 2 ) . A s h e g a i n s s t r e n g t h , t h e t e n d e n c y o f h i s k n e e s t o f l o p o u t w a r d s will d i s a p p e a r a n d t h e s l i n g s c a n b e d i s c a r d e d . Progression : T h e p a t i e n t is t h e n t r a n s f e r r e d t o t h e s i t - w a l k i n g m a c h i n e . T h e s e a t is a d j u s t e d t o t h e p a t i e n t ' s i n d i v i d u a l r e q u i r e m e n t s . B o t h f e e t a r e p l a c e d o n t h e g r o u n d w i t h t h e k n e e s a p p r o x i m a t e l y a t r i g h t a n g l e s . A s a p r e l i m i n a r y t e s t h e is i n s t r u c t e d t o lift f ir st t h e o n e a n d t h e n t h e o t h e r f o o t j u s t o f f t h e g r o u n d a n d r e s t it a g a i n . S o m e t i m e s n o t e n o u g h s t r e n g t h o r c o n t r o l is p r e s e n t in o n e o r b o t h h i p s t o c a r r y t h i s o u t s a t i s f a c t o r i l y . T h e b e g i n n e r m a y t h e n b e g i v e n a d d i t i o n a l a s s i s t a n c e . H i s t h i g h c a n b e s u p ­ p o r t e d b y a n e l a s t i c s l i n g w h i c h h a n g s f r o m a c r o s s Fig. 2. 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. ) Page Four P H Y S I O T H E R A P Y October, 1954. b a r , p l a c e d o v e r t h e t o p r a i l s o f t h e m a c h i n e . F i g u r e 3 s h o w s t h e s l i n g a d j u s t e d t o g i v e t h e p a t i e n t ' s r i g h t l e g j u s t e n o u g h a s s i s ­ t a n c e t o lift h i s h e e l w i t h h i s o w n e f f o r t a b o u t o n e i n c h o f f t h e g r o u n d . A s h e r e l a x e s h i s l i f t i n g e f f o r t h i s f o o t w il l t o u c h t h e g r o u n d a g a i n . M o s t p a t i e n t s , h o w - e v e r , w i l l n o t r e q u i r e t h e a s s i s t a n c e o f e l a s t i c t h i g h s u p p o r t s . T h e y c a n p r o c e e d i m m e d i a t e l y t o t h e n e x t s t e p , a k i n d o f " m a r k i n g t i m e " e x e r c i s e w h i l e t h e s i t - w a l k i n g m a c h i n e is k e p t s t a t i o n a r y . I n t h i s e x e r c i s e , f e e t a r e a g a i n o n t h e g r o u n d , a n d k n e e s f l e x e d t o a b o u t 9 0 d e g r e e s . T h e p a t i e n t is t a u g h t t o e x t e n d o n e k n e e a n d p l a c e t h e h e e l f i r m l y o n t h e g r o u n d . T h e n f l e x i n g t h e k n e e h e r e t u r n s t h e f o o t t o i ts i n i t i a l p o s i t i o n . T h i s s e q u e n c e i s r e ­ p e a t e d w i t h t h e o t h e r le g, a n d s o o n . P r o g r e s s i o n f r o m h e r e l e a d s t o t h e f i r s t s t a g e in s e l f - p r o p u l s i o n : T h e p a t i e n t e x t e n d s f i r st t h e o n e l e g , t h e n t h e o t h e r , p l a c i n g b o t h f e e t f a i r l y c l o s e t o g e t h e r . H e t h e n d i g s b o t h h e e l s f i r m l y i n t o t h e g r o u n d a n d f l e x e s b o t h k n e e s s i m u l a t n e o u s l y . T h i s r e s u l t s in a p u l l i n g f o r w a r d o f t h e w h e e l - m a c h i n e . T h e p a t i e n t p a u s e s w h e n t h e k n e e s a r e j u s t b e y o n d t h e r i g h t a n g l e . H e b r e a t h e s , a n d r e p e a t s t h e m o v e m e n t . A t t h e v e r y b e g i n n i n g it m a y b e n e c e s s a r y f o r t h e p h y s i o t h e r a p i s t t o a s s i s t w i t h i C F y f a g e n t l e p u s h f r o m b e h i n d t h e m a c h i n e , b u t o n c e t h e p a t i e n t is r h y t h m i c a l l y in h i s f L j f J T 1^ / s t r i d e , h e wi ll i n m o s t i n s t a n c e s n o t r e q u i r e f u r t h e r a s s i s t a n c e . ■ C A I x T h e n e x t s t e p f r o m h e r e p r o d u c e s s i t - w a l k i n g p r o p e r I t c o n s i s t s o f e x t e n s i o n f o f o n e l e g , f o l l o w e d b y f l e x i o n o f t h e s a m e k n e e w i t h a s h a r p p u l l f o r w a r d o f t h e m a c h i n e t ill t h e k n e e is f l e x e d t o a b o u t 9 0 d e g r e e s . T h e n t h e o t h e r l e g is e x t e n d e d , t h e h e e l d u g i n f i r m l y , a n d t h e k n e e f l e x e d w i t h a n o t h e r f o r w a r d p u l l . S l o w l y t h e p a t i e n t d e v e l o p s h i s o w n r h y t h m , a n d w i t h a c o r r e s o p n d i n g s w i n g o f t h e t r u n k , f o r w a r d a n d i b a c k w a r d , h e a c q u i r e s a n e a s y F' 3 - 3- " g a i t , ” e v e n t u a l l y g e t t i n g a l o n g e r s t r i d e , w i t h k n e e - f l e x i o n a p p r e c i a b l y ̂ ‘ 1 b e y o n d t h e r i g h t a n g l e . T h i s is s h o w n in F i g u r e 4 ; t h e p a t i e n t , o n l y v e r y s l o w l y r e c o v e r i n g f r o m t h e a f t e r - e f f e c t s o f a T B . - M e n i n g i t i s , is m o v i n g a r o u o d a l m o s t a t s p e e d f H | # g f f a n d w i t h g r e a t d e x t e r i t y . ( H e h a s p r o g r e s s e d f r o m t h e r e t o w a l k i n g w i t h » e l b o w c r u t c h e s w i t h i n a b o u t t w o w e e k s , e v e n t u a l l y u s i n g o n e w a l k i n g s t i c k o n l y ) . Special Cases: N o t a l l p a t i e n t s w i ll b e a b l e t o f o l l o w t h e a b o v e d e s c r i b e d r o u t i n e . D e a l i h g w i t h a l a r g e v a r i e t y o f c o n d i t i o n s a n d a f f l i c t i o n s o f v a r y i n g d e g r e e s , it is, o f c o u r s e , n o t p o s s i b l e t o d e s c r i b e in d e t a i l t h e d i f f i c u l t i e s w h i c h m a y b e e n c o u n t e r e d in e a c h i n d i v i d u a l c a s e . B u t s o m e g r o u p s c a n b e t r e a t e d b y r o u t i n e s o f t h e i r o w n . H e m i p l e g i c s , f o r e x a m p l e , o n a c c o u n t o f s p a s t i c i t y , p r e s e n t t h e i r o w n p r o b l e m s . T h e n o t t o o b a d l y a f f e c t e d , h o w e v e r , c a n o f t e n b e t a u g h t r e l a x a t i o n a n d c o n t r o l o f s p a s m s i n t h e s i t - w a l k e r . F i g u r e 5 s h o w s a p a t i e n t , a b o u t t h r e e m o n t h s a f t e r h i s c e r e b r a l a c c i ­ d e n t . H i s r e - e d u c a t i o n p r o g r a m m e f o l l o w e d t h e u s u a l p a t t e r n w h i c h h a s y i e l d e d g o o d r e s u l t s w i t h t h i s t y p e o f c a s e . W e l l n u r s e d b y h i s o w n m i n e h o s p i t a l , i n t e l l i g e n t , a n d c o - o p e r a t i v e , h e w a s s e n t t o o u r R e h a b i l i t a t i o n C e n t r e w i t h e n o u g h r e s i d u a l I 3 s p a s t i c i t y , i n c o - o r d i n a t i o n , a n d I ^ f l a c k o f b a l a n c e t o m a k e s t a n d i n g _ - j p o r w a l k i n g w i t h a s s i s t a n c e s t il l I ■ J r i * i m p o s s i b l e . H e t o o k i m m e d i a t e l y m , t o g e n e r a l s t r e n g h t e n i n g e x e r c i s e s » a n d t r a i n i n g o f c o - o r d i n a t i o n in t h e b e d - b i c y c l e a n d w i t h s u s ­ p e n s i o n s l i n g s . Pig 4 A t t h e b e g i n n i n g o f s i t - w a l k ­ i n g h e , l i k e m o s t h e m i p l e g i c s , u s e d t o s h o o t t h e e x t e n d e d r i g h t l e g s h a r p l y u p , s i m u l t a n e o u s l y l i f t i n g t h e r i g h t a r m i n a s p a s m f r o m its r e s t p o s i t i o n o n t h e r a i l . ( F i g . 5). It s o o n b e c a m e p o s s i b l e t o t e a c h h i m t o p l a c e t h e a f f e c t e d l eg, w i t h t h e a s s i s ­ t a n c e o f t h e a f f e c t e d a r m . in a m o r e a d v a n t a g e o u s p o s i t i o n . C o u p l i n g t h i s w i t h c o n t r o l l e d b r e a t h i n g a n d a s l o w f o r w a r d b e n d i n g o f t h e t r u n k , h e b e c a m e w e l l r e l a x e d a t t h i s s t a g e o f h i s e x e r c i s e s ( F i g . 6 .). N o w s l o w l y e x t e n d i n g t h e u n a f f e c t e d l e g a n d p l a c i n g h i s a f f e c t e d h a n d o n t h e r a i l , h e w a s r e a d y f o r t h e n e x t p r o g r e s s i o n . W i t h t h e le ft f o o t f i r m l y o n t h e g r o u n d h e w a s s h o w n t o fl ex a n d e x t e n d t h e le ft k n e e s l o w l y , t h u s g r a d u a l l y p u l l i n g a n d p u s h i n g t h e m a c h i n e f o r w a r d a n d b a c k . T h r o u g h t h i s r o c k i n g m o v e m e n t h e t a u g h t h i m s e l f t o e a s e h i s r i g h t k n e e t o w a r d s c o m p l e t e r e l a x a t i o n in a n y i n t e r ­ m e d i a r y p o s i t i o n . ( F i g . 7. ). N e x t t h e m a c h i n e w a s s l o w l y p u s h e d f o r w a r d b y t h e a t t e n d i n g p h y s i o t h e r a p i s t , w h i l e t h e p a t i e n t c a r r i e d o u t w a l k i n g m o v e m e n t s in s i t t i n g , s l o w l y e x t e n d i n g a n d f l e x i n g f i r s t t h e l e ft a n d t h e n t h e a f f e c t e d r i g h t l eg, u n t i l e v e n t u a l l y h e p r o p e l l e d h i m s e l f q u i t e r h y t h m i c a l l y in t h e w a l k e r . H e p r a c t i s e d f o r a b o u t t w o w e e k s in t h e m a c h i n e w h e n h e m a n a g e d t o s t a n d u p , s w i v e l t h e m a c h i n e a r o u n d a n d s t a r t e d Fig. 5 . t o p u s h it i n f r o n t o f h i m s e l f . ( F i g . 8 .). H e p r o g r e s s e d f r o m t h e r e t o w a l k i n g o n h i s 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. ) October, 1954. P H Y S I O T H E R A P Y Page Five o w n w i l h o n e c r u t c h a n d l a t e r w i t h o n e w a l k i n g s t i c k . P s y c h o l o g i c a l A s p e c t s . S i t - w a l k i n g s e e m s t o b o o s t m o r a l e c o n s i d e r a b l y . O f t e n it is i n s t i t u t e d a t a t i m e w h e n t h e p a t i e n t is d o u b t f u l a b o u t h i s c h a n c e s o f e v e r w a l k i n g a g a i n . H e h a s f r e q u e n t l y l o s t c o n f i d e n c e in h i s s t r e n g t h a n d h i s a b i l i t y t o b a l a n c e . M a n y o f t h e s e p a t i e n t s a r e in a s t a t e o f d e p r e s s i o n , e i t h e r o n a c c o u n t o f l o n g b e d - r e s t . o r t h r o u g h t h e n a t u r e o f t h e i r a f f l i c t i o n . F x e i c i s e s o n t h e b e d o r w i t h a p p a r a t u s a r e n o l o n g e r w i l l i n g l y a c c e p t e d , m a k i n g t h e t a s k o f t h e p- g p h y s i o t h e r a p i s t a l m o s t i m p o s s i b l e . A t t h a t s t a g e s i t - w a l k i n g o f t e n p r o v i d e s a n a p p r o a c h c o m p l e t e l y n e w t o t h e p a t i e n t . H e is q u i c k t o l e a l i z e t h a t t h e p r e c e d i n g e x e r c i s e s n o w m a k e it p o s s i b l e f o r h i m t o m o v e a r o u n d . C o n f i d e n c e in t h e s o u n d n e s s o f h i s r e h a b i l i t a t i o n p r o ­ g r a m m e is r e n e w e d . H e f e e ls t h a t w a l k i n g is c o m i n g w i t h i n h i s g r a s p , a n d d o u b l e s h i s e f f o r t s t o a c h i e v e it. A l t h o u g h n o t a g u a r a n t e e o f s u c c e s s in e v e r y c a s e , s i t - w a l k i n g s e e m s w o r t h a t r i a l . The largest organ in the body U l t r a - v i o l e t i r r a d i a t i o n is a m e t h o d o f a d m i n i s t e r i n g m e d i c i n e t h r o u g h t h e s k i n — t h e l a r g e s t o r g a n in t h e b o d y — in a f o r m w h i c h is r e a d i l y a b s o r b e d b y t h e o r g a n i s m . T h e h i g h - e n e r g y r a d i a t i o n e v o k e s t o n i c r e a c t i o n s w h i c h s t i m u l a t e a l l t h e p r o c e s s e s o f m e t a b o l i s m . T h e v i t a m i n s a n d a n t i - b o d i e s p r o d u c e d in t h e s k i n a n d its v a s c u l a r s y s t e m a r e t r a n s ­ m i t t e d b y t h e b l o o d t o t h e r e m o t e s t c e l l s o f t h e o r g a n i s m . T h i s a c c o u n t s f o r t h e b e n e f i t s o f u l t r a - v i o l e t i r r a d i a t i o n in s u c h a v a r i e t y o f c o n d i t i o n s — s k i n d i s e a s e s , b l o o d a n d g l a n d u l a r d e f i c i e n c i e s , s u b - n o r m a l n u t r i ­ t i o n , d e f e c t s o f c a l c i u m m e t a b o l i s m , t u b e r c u l a r a n d o t h e r i n f e c t i o n s , e t c . T h e n a m e " H a n o v i a " h a s b e c o m e s y n o n y m o u s w i t h c l i n i c a l e q u i p m e n t f o r u l t r a - v i o l e t r a y t r e a t m e n t . W h y n o t i n v e s t i g a t e i ts b e n e f i t s f o r y o u r o w n p r a c t i c e " 1 I l l u s t r a t e d c a t a l o g u e f r e e o n r e q u e s t . F o r f u l l d e t a i l s c o n t a c t : — TH E BRITISH G E N E R A L EL EC TRIC C O . LTD. Magnet House: Loveday and An d er so n Sts., J O H A N N E S B U R G Branches: C A P E T O W N , D U R B A N , P O R T E L IZ A B E T H , S A L I S B U R Y , B U L A W A Y O . A g e n ts fo r: H A N O V I A LTD., S L O U G H , E N G L A N D . 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. ) Page Six P H Y S I O T H E R A P Y October, 1954. THE COLONIAL MUTUAL LIFE ASSURANCE SOCIETY LIMITED. SOUTH AFRICAN SOCIETY OF PHYSIOTHERAPISTS GROUP ENDOWMENT FUND. We have pleasure in announcing th a t a G roup Endow ­ m ent F und has been inaugurated for members o f the South African Society o f Physiotherapists and will be underwritten by The Colonial M utual Life Assurance Society Limited (hereinafter referred to as the Underwriters). T he F und will enable members o f the Society to obtain assurance at a lower cost than is possible with individual contracts and will enable them n o t only to insure their lives for the benefit o f their dependents but to save for their retirement by deduction o f regular monthly contributions from salary. The Trustees o f the F und will hold at th e Society’s headquarters a 'm aster policy on the schedules of which will be entered full particulars o f each mem ber’s assurance. The benefits consist o f guaranteed am ounts payable at the age selected by the member, o r on prior death, and are subject to increase by annual bonus additions. A ddi­ tional benefits in the form o f Cash Payments subject to increase by bonus additions as declared in the U nderw riter’s Accident D epartm ent and waiver o f future contributions are payable upon disablement due to certain contingencies prior to the selected age as set out on the m aster policy. Members of the Society who wish to insure under this scheme m ust complete a short proposal form together with a stop order fo r the deduction o f contributions m onthly from salary. Benefits will depend upon: (1) the mem ber’s age on entry into the scheme; (2) the monthly contribution to be paid; (3) the selected age at which the sum assured is •payable. All members will receive a certificate of enrolm ent giving full details o f contributions and benefits. In the event o f a member leaving the Society, the en­ rolment will be converted into an ordinary policy with the underwriters. Benefits and contributions will remain unchanged but future contributions will require to be paid direct to the underwriters. Such a policy on the life o f a female m em ber may, in certain circumstances, be con­ verted into a policy on the life o f her husband if he is in­ surable and n o t m ore than 10 years her senior. T he F und is similar to th a t which has operated for the benefit o f members of the South African Nursing Association for many years and the Executive o f your Society hope th a t all members will give the F und their full support. C U T HERE To the TRUSTEES GROUP ENDOWMENT FUND, S.A. SOCIETY OF PHYSIOTHERAPISTS, P.O. BOX 1106, PRETORIA. Please supply me with details. N a m e ................................................................................. A d d re ss ............................................................................ D ate of B irth.................................................................... O ccu p atio n ....................................................................... Where employed.............................................................. How much can you afford to pay each m onth : CHANGES OF ADDRESS (Notifications to be made to the Secretary, P.O. Box 11151, Johannesburg). Mrs. C. Levy (nee Sack) to 19, Buffalo R oad, Emmar- entia, Johannesburg. Mrs. L. A. Berson (nee Todes) to 25, Bowood G ardens, Bowood R oad, C larem ont, Cape. Mrs. I. M oore to 5, Fox R oad, Vincent, E ast London. Mrs. H. Judge to 24, Davyson R oad, East London. Mrs. Peggy Beukes (nee M ynhardt) to P.O. Nggelini, Cape Province. Miss K . D. Francis to Governm ent H ospital, Lobatsi, Bechuanaland. Mrs. von Levetzow to Robbehoek, P.O. Witelsbos, District H um ansdorp, Cape. Miss P. M oore to c /o N urses Q uarters, European H ospital, Chingola, N . Rhodesia. Miss M. Rehfeld to 61, High Level R oad, Green Point, Cape Town. Miss Sandra Saber to S.A. Office, P.O. Box 3060, Tel Aviv, Israel. Mrs. H. Barnes to 1, Sunnyside M aisonettes, G rafton R oad, Yeoville, Johannesburg. Miss P. C hatterton to 24, St. James R oad, East London. THE SOUTH AFRICAN SOCIETY OF PHYSIOTHERAPISTS - CONFERENCE PROGRAMME KIMBERLEY, NORTHERN CAPE, October 9th— 11th, 1954. Saturday, 9th October, 1954: 9.00—a.m.— 10.45 a.m. BUSINESS. 10.45 a.m .— T A LK by D r. COLLlN S. W ELCO M E TO D ELEGA TES. L EC T U R E to “ Outline Practical Scheme for R ehabilitation, with particular reference to part to be played by Physiotherapy.” 11.15 a.m ................... TEA. 11.45 a .m ................... L E C T U R E by Miss J. Blair on recent advances in methods o f muscle stim ulation. 12.45 p .m ................... L U N C H . 2.15 p ’m ................... BUSINESS. 4.00 p .m ................... TEA. 4.15 p.m.— 5.15 p.m. BUSINESS. 6.00 p .m ................... CIV IC C O C K TA IL PA RTY 8.30 p .m ................... BRAAIVLEIS. Sunday, 10th October, 1954: 9.00 a.m .— 10 a.m. D E M O N ST R A T IO N o f Machines by Mr. H. Kretschm er of Medical D istributors. - 10.30 a.m ................... SightSeeing—D E BEERS DOGS. 11.30 a.m ................... TEA. 12.00 p .m ................... Sight Seeing—T H E BIG HOLE. 1.00 p.m ................... LU N C H . 2.00 p.m. BUSINESS. 4.00 p.m ................... TEA. 4.15 p.m.— 6.00 p.m. BUSINESS. Monday, 11th October, 1954: 9.00 a.m ................School for Physically H andi­ capped. 11.00 a.m ................... Helen Bishop O rthopaedic After C are Home. 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. )