DECEMBER 1981 P H Y S I O T H E R A P Y 107 EXCERPTS FROM THE ANNUAL CSP CONGRESS IN LONDON HELD AT THE ROYAL FR E E HOSPITAL IN HAMPSTEAD A lecture by D r G re? G rieve on lum b ar instability was perhaps the highlight of the congress. A pr&cis of it could never do justice to the inform ation and re­ searched facts presented, but the essential them e was that lum bar instability and hyperm obility are factors often overlooked by physiotherapists in the assessm ent and treatm en t of lum bar pain. T he causes, briefly, are: • G eneralised disc degeneration (kissing spine). • Ia tro g e n ic (c o n se q u e n c e o f su rg ic al fu sio n ). • P o s tp a rtu m a b n o rm a lity . • Single localised m echanical strain. • C hronic localised degenerative changes. • N a tu ra lly h y p e rm o b ile sp in e (h e re d ity ). • N e o p lasm s. T he conservative treatm ent, according to G rieve, is to teach stabilisation exercises, viz. gentle lu m b ar flexion such as: • C rook lying; dynam ic abdom inal bracing. • C rook lying; flex head and neck; holding as long as it takes to say your nam e and address. • C rook lying; hands behind head; contraction of oblique abdom inals. • P ro n e ly; 2 leg extension; progress by placing small pillow across the ankles. • P ro n e ly; static contractio n of back extensors a t a segm ental level, e.g. L4 - 5 instability, ph y sio th era­ pist places thum b over level and p atient practises localised static contraction. • P ro n e lying; progress above exercise by placing pillow under abdom en, legs over edge of bed; lo­ calised h o ld /re la x at required level. • Sitting, p a tie n t’s thum b over required level; localised h o ld /relax . An unstable jo in t should never be m anipulated, but the hypom obile jo in t above o r below the level should be m obilised. If a lu m b ar support is required, never supply it w ithout a plan to eventually elim inate it, and at all costs restore confidence to the p a tie n t and give him a positive outlook. In B ritain, 24 m illion w orking days are lost each year due to back injury, costing the country £1 000 m il­ lion a year. P revention o f back disorders is the func­ tion of the m aterials handling research unit. T he lecture by D r D. A. Stubbs on Back P roblem s in W ork and Leisure was based on a recen t research on nurses and adolescent w ater-ski jum pers. I t was found th at the injuries were caused by the accum ulation o f re­ peated traum a. In the case of nurses, the intra-abdom inal pressure (IAP) was m easured during the activities of lifting patients in bed, and it was found that if the spinous stress was exceeded often enough during the day, a back problem resulted. I t was fo u n d th a t the A ustralian o r shoulder lift placed m uch less stress on the back whereas the orthodox lift caused excessive IA P. Of the adolescent water-ski jum pers, 4 7 % had lum bar and thoracic pain. By using m easuring devices attached to the head of fem ur, iliac crest and lateral m alleoli, he found th a t the force of pressure a t ram p site was 16G (1G force is required to keep us o n the ground) and because skiers practise frequently, the accum ulation of G shocks leads to jo in t trau m a, and the research u n it advised the appropriate authorities to ban ski jum ping fo r u n d er 16-year-olds. T he A ssociation o f Sports M edicine held a m eeting in w hich they appealed to physiotherapists in general, and younger ones in particular, to tak e a voluntary interest in the sports injuries o f th eir local clubs, th ere­ by no t only propagating the role of physiotherapy in sport, bu t also aiding the athletes and gaining useful on-site experience. If physiotherapists do not do this, fa r less qualified people will step into the breach. Basically, the on-site physiotherapist w ould have to learn to observe the injury as it occurs, to assess the serious­ ness o f the dam age and to advise as to rest, strapping, ice, etc., or to call fo r fu rth e r m edical advice. T he sportsm an receives an unbelievable barrage of repeated traum a to the skeletal system, b u t his courage and de­ term ination to continue m akes physiotherapy involve­ m ent in sports m edicine so gratifying. T he lecturer cited the exam ple of the blind physiotherapist, who recently clim bed M t. E verest, and blind am putees in B ritain who go w ater-skiing. P atricia Swilling C A N A D IA N PHY SIOTH ER APY ASSOCIATION In Ju n e 1981, the Board of D irectors o f the C anadian Physiotherapy A ssociation approved revisions to the policies and procedures governing eligibility for m em bership in the A ssociation for physiotherapists educated outside C anada. T h e revisions are designed to provide a process which is equitable to all physio­ therapists educated outside C anada and to ensure th at educational requirem ents and ethical standards required fo r m em bership in the A ssociation are m aintained at a level at least equivalent to th a t of a C anadian grad­ uate who holds a baccalaureate degree in physiotherapy. T he procedures set forth below describe the m echan ­ ism fo r physiotherapists who are eligible to practise in any country o th er than C anada to becom e eligible for m em bership in the C anadian P hysiotherapy Association. On and afte r Septem ber 30, 1982, fo r physiothera­ pists applying fo r m em bership in th e C anadian P h y ­ siotherapy A ssociation who have received th e ir ph y ­ siotherapy education outside C anada, the follow ing will be required: (1) graduation from a school of physiotherapy, and eligibility fo r m em bership in the professional association of the country of graduation; (2) dem onstration of proficiency in eith er English o r F rench, if n either language is the ap p lican t’s m other tongue; (3) successful com pletion of w ritten screening exam i­ nation; (4) successful com pletion of a clinical residency in an accredited facility in C anada. A pplicants m u st successfully com plete each step in the o rd er set o u t above before they are perm itted to proceed to the next step. T o perm it a sm ooth transition from th e present to the new regulations, th e follow ing interim arran g e­ m ents have been adopted fo r applicants from South A frica: P hysiotherapists who received their physiotherapy education in South A frica will be adm itted to m em ­ bership in the C anadian Physiotherapy Association 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. ) 108 F I S I O T E R A P I E DESEMBER 1981 w ithout exam ination o r clinical resid en cy provided: (1) they are m em bers o f th e natio n al association o r eligible fo r such m em bership; (2) the application fo r m em bership is postm arked prior to Septem ber 30, 1982; (3) registration is com pleted by M arch 31, 1983. PRIVATE PRA CTITIO NER S’ ASSOC IATIO N Change o f Secretary Please note th a t the A cting S ecretary is: M rs. P. Pilkington, 59 A lm a R oad, R O S E B A N K 7700. T ele­ phone: (021) 69-2419. E X C H A N G E SYSTEM Physiotherapists w ho wish to w ork or stu d y in G e r­ m any have to m ake individual a rra n g e m e n ts as no ex­ change system exists at present. O f course the physio­ therapist who w ants to w ork in G erm an y should know the G erm an language. T hey are advised to contact the hospitals and schools in: Heidelberg R ehabilitationsklinik H e rr Prof. D r. m ed. Schimpf, B onhoefferstr. 1, D -6900 H eidelberg 1 Staatl. anerk. Schule fu r K ran k en g y m n astik a.d. O rthop. K linik u n d P oliklinik d e r U niversitat H eidelberg H e rr P rof. D r. m ed. H . C otta Schlierbacher Landstra/3e 200a, D -6900 H eidelberg 1 Karlsbad R eh ab ilitatio n sk ran k en h au s H e rr P rof. D r. m ed. B ister G u ttm an n str. 1, D -7516 K arlsb ad 1 Staatl. anerk. Schule fu r K ran k en g y m n astik am R eh ab ilitatio n sk ran k en h au s K arlsbad-L angensteinbach H e rr D r. m ed. K . B rinkm ann G u ttm an n str. 1, D -7516 K arlsb ad 1 t D eutscher V erband fu r P h y sio th erap ie — Z entralver- ban d der K ran k en g y m n asten (ZVK) e.V . — L andes- verband B aden-W urttem berg e.V. — H e rr J. G rete, 1. V orsitzend er W iederhaoldstr. 25, D -7000 S tu ttg art 1 Bischofswiesen R eh ab ilitatio n szen tru m und K u rk lin ik L oipl H e rr H eliek D-8242 B ischofsw iesen Murnau B erufsgenossenschaftliche (Jnfallklinik H e rr P rof. D r. m ed. J. P ro b st Professor-K iintscher-Str. 8, D -8110 M u rn a u D eutscher V erband fu r P h y sio th erap ie — Z entralver- ban d der K ran k en g y m n asten (ZV K) e.V . — L andes- verband Bayern e.V. — Frau J. von Busekist Barer-St. 86a, D -8000 M u n ch en 40 Damp Ostseeklinik D am p 2000 D -2335 D am p Staatl. anerk. L eh ran stalt fu r K rankengym nastik an der O stseeklinik D am p H e rr Prof. D r. med. H . Schoberth D-2335 D am p 2 Kiel Staatl. anerk. L e h ran stalt fu r K rankengym nastik Dr. L ubinus K iel H e rr D r. m ed. H. Lubinus D ahlm annstr. 1-3, D-2300 K iel 1 D eutscher V erband fu r Physiotherapie — Z entralver- band der K rankengym nasten (ZKV) e.V. — Landes- verband H am burg und Schleswig-H olstein e.V. — F rau L.-Ch. H adank, 1. V orsitzende Innocentia-S tr. 42, D -2000 H am b u rg 13 Please contact the chairm en of the physical th e ra p y ^ , branches which are regionally in contact w ith those* centres. So far an exchange system does not exist be­ cause of language problem s and the d ifferen t standards in physical therapy. SUB-COMMITTEE ON RESEARCH It was suggested at C ouncil th at the feasibility of establishing a co-ordinating com m ittee on Research should be investigated. I t was felt th a t this could be of value to individual m em bers o f the Society and to th e profession as a whole. A sub-com m ittee has been convened to establish w hether there is a need to co-ordinate research. If a need is found, the objec­ tives o f the sub-com m ittee will be: 1. T o set up a register of all research th a t is being done by physiotherapists in this country. 2. T o direct m em bers who are interested in research to persons who are working in the sam e field. 3. T o publish twice yearly a list of researchers w ith a b rief description of their research. If you are involved in research or clinical trials or are interested in doing research, please send the fol­ lowing inform ation to the C hairm an of Research, S.A.S.P., P.O . Box 11151, Johannesburg, 2000. N am e, address and research interest; w hether registered fo r ;u higher degree; interested in receiving a copy o f th e l i s ^ of research w orkers; prepared to assist o th e r research w orkers in your specialised field. THE SOUTH A FRICAN PSORIASIS ASSOCIATION Registered w ith th e D ep artm en t o f H ealth , W elfare and Pensions W.O. 02200490007 A im s are: (1) T o collect m oney fo r m ore research projects into the causes, treatm en t and cure of psoriasis. (2) T o educate the general public ab o u t th e disease. (3) T o provide support and m utual aid fo r th e suf­ ferers by setting up branches and, groups in order to discuss com m on problem s related to this disease. It is hoped th at this A ssociation will receive your support. F o r fu rth e r inform ation contact: M rs. A. Weiner, M C SP, 106 H e rb e rt Baker Street, G roenkloof, P retoria. 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. ) D E C E M B E R 1981 P H Y S I O T H E R A P Y 109 VII COM M ONW EALTH A N D IN T E R N A T IO N A L CONFERENCE IN SPORT, PH Y SIC AL E DU CA TIO N A N D D A N C E Brisbane, Queensland, Australia. September 23 - 28th, 1982 “PHYSIOTHERAPY IN SPORT” CALL FOR PAPERS ‘C o n fe re n c e 82/ is b e in g h e ld a t th e U N IV E R SIT Y OF Q U EEN SL A N D in th e w eek p r io r to th e 1982 COMMONWEALTH GAMES. T here are several areas of interest w ithin the C on­ ference, including a section relating to P hysiotherapy in Sport. This has three m ajo r streams: Subsections Principal speaker M a n a g e m e n t of Sporting D r. D. R eid (C anada) In ju rie s Injury P revention P ro fesso r V. Ja n d a (Czechoslovakia) hysiotherapy c are o f D r. R. Q uirk (A ustralia) the ballet dancer Abstracts Any person offering to give a paper relating to one of these them es should send an ab stract o f 300 w ords by January 1st, 1982, to the Sectional C hairm an of ‘Physiotherapy in S port’: Professor M arg aret I. Bullock, D epartm ent o f P hysiotherapy, U niversity o f Q ueensland, ST. LU C IA , Brisbane, Q ueensland 4067, A ustralia. A bstracts will be subm itted fo r consideration o f ac­ ceptance to an In tern atio n al Review B oard. T o be considered fo r publication in C onference P ro ­ ceedings, final papers m ust be subm itted by Ju n e 1st, 1982. Information: O th er inform ation m ay be obtained from ‘P hysiotherapy in S port’ Sectional C hairm an, P ro ­ fessor M. I. Bullock. BOAT TRIP TO SC A N D IN A V IA A N D RUSSIA 1 6 - 2 9 May 1982, to include IX W.C.P.T. World Congress F u rth er details o f this trip to C openhagen, H elsinki, L eningrad an d Stockholm on Ms Ilm a ta r can be ob­ tained from G enootschap voor Fysiotherapie, Postbus 248, 3800 A E A m ersfoort, H olland, m entioning “ Stu- dicreis Scandinavie” , BOOK REVIEW Joubert, Z. F . (1981): A unique writing tablet fo r the disabled. R ehabilitation in S .A ., 25, 51 - 56. The article describes a finger w riting tablet developed by the a u th o r fo r use b j' disabled persons who cannot write with a pen and also experience problem s when using typew riters. By w riting large letters on the writing tablet with a finger (or toe), a m essage can be set up by an electronic read-out unit, corrected if neces­ sary and then printed by electronic printers. T he w riting tablet is very adaptable in size and assembly, whilst it can be used fo r a variety o f com m unicators, w riting m achines and telecom m unicators. It can also be ad ap ted fo r use by visually handicapped, blind and m ultihandicapped persons. T ranslation of a u th o r’s sum m ary. CLASSIFIED SALE OF PRIVATE PRACTICE F or Sale — Busy P riv ate P ractice in E ast L ondon. Apply: Mrs. A. Larsen, 6 St Jam es R oad, E ast L on­ don. Telephone: (0431) 2-1754 O ffice H ours. PHYSIOTH ERAPIST REQ UIRED Experienced Physiotherapist required fo r private practice in Sea P oint, Cape, from 1st M arch, 1982. K nowledge o f M aitland techniques a recom m endation. P hone (021) 44-8795 after 19h00. F ISIO TERAPEUT B EN O D IG V A C A N C Y — PHYSIOTH ERAPIST Fisioterapeut benodig vir p riv aat prak ty k in V ir­ ginia. U itstekende salaris. V yfdag week. Skakel (017) Full-tim e Physiotherapist w ith M aitlan d and Sport 3-4688 (werksure) of (017) 3 -2 5 11 (na-ure). Injury experience required fo r P rivate P ractice. Salary and A ccom m odation negotiable. T elephone __________ ___________________________________________(024) 2-2764. B L U E G U M T R A IN IN G CENTRE Physiotherapist required fo r C erebral P alsied A d o ­ lescents. W orking hours: 08h30 - 14h00 + school holidays. Salary: D ep artm en t of Internal A ffairs scale. A p p l y : Mrs. F ourie. P . O . B o x 3, B O N T E H E U W E L C A P E T O W N , 7763. T elephone (021) 67-5101. LOCUM REQ UIRED Locum required fo r P rivate P ractice in L A D Y ­ S M IT H N atal fo r + six weeks M a rc h /A p ril 1982. For fu rth er details phone (0361) 2619 or w rite to P.O. Box 1014 L A D Y S M IT H , N atal 3370. 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. )