Baby boomers may recall the days of being screened for scoliosis in elementary or middle school. While this practice was common in states across the US for a number of years, it has stopped in many communities.

Some may also remember when kids diagnosed with scoliosis wore heavy-looking metal braces. This full-torso brace extended from the pelvis to the base of the skull. Designed by Milwaukee-area physicians and commonly referred to as “The Milwaukee Brace,” it was the most popular bracing approach in past decades.

Today, screenings and treatment approaches are varied.

Screen early, screen often

Wisconsin is one of more than 25 states where school screenings are not currently mandated. Yet many organizations recognize the benefits of screening programs including the American Academy of Orthopedic Surgeons (AAOS), Scoliosis Research Society, and American Academy of Pediatrics.

Most physicians perform screenings during annual check-ups. Yet, a challenge exists because many adolescents do not have routine wellness doctor visits.

Screenings take as little as 30 seconds and are commonly performed on children between 10 and 15. A trained health care professional views the spine in both standing and bending positions. Children with suspicious findings should see a physician who often orders an x-ray. Parents may also want to have a child examined by a physical therapist (PT) to discuss exercise-based approaches to treatment.

Most children with scoliosis have mild curves and won’t need aggressive treatment. When a curve is suspected or confirmed, routine screenings are critically important. Some parents opt for screenings every three months rather than semi-annually or yearly, especially during times of rapid adolescent growth. Information about a curve’s progression is important in determining the best treatment approach.

Treatment options: Physical therapy can play an important role

Medical organizations publish treatment guidelines. The decision to treat scoliosis is based on many factors, including age, maturity, sex, family history, curve size and how much the child is likely to grow.

Traditionally in the US, treatment involved a “wait and see” approach. Physicians have most commonly monitored curve progression and initiated treatment if the curve passed a certain threshold. Typically, physicians recommend bracing or surgery, or both. Scoliosis surgery involves techniques to fuse or join the vertebrae along the curve

Bracing options have expanded. The most commonly used brace is a thoraco-lumbo-sacral orthosis (TLSO), or underarm brace. It is more easily concealed under clothing than the Milwaukee Brace. Additional bracing approaches have emerged in recent years with some options including (insert list).

In the US, PT has also recently emerged as a valuable treatment. In past decades, while PT has played a minor role in scoliosis treatment in America, it is now becoming more popular among a growing number of patients.

One PT-based approach has seen increased popularity in the US within the past five years. The Schroth method is a conservative, non-surgical, exercise-based approach developed in Germany in the 1960s. In Europe, more than 3,000 patients are treated with Scroth annually. Today, fewer than 20 therapists in the US are Schroth-certified; three are on staff at our Milwaukee area clinic which draws patients from across the US.

Schroth involves an attempt to reduce curve progression and provides additional benefits such as improved breathing. Patients work intensively with a physical therapist, learning how to expertly perform exercises specific to their scoliosis curve pattern. In many patients, Schroth is combined with the Rigo-System Cheneau (RSC) brace. Until recently, this brace was available only in Europe. The US has fewer than 10 orthotists who are trained to fit RSC braces; one offers services at our Milwaukee-area clinic.

Many US physicians say research is inconclusive for bracing or physical therapy. With Schroth, most patients report a benefit of being empowered to take action in addressing scoliosis, and many report improved postural deformity. Physical therapists at Spinal Dynamics of Wisconsin have successfully prevented surgery for some patients who believed it was their only option, including those who travel to the clinic from out of state. In some patients, curve reduction has been achieved.

Decision about screening for and treating scoliosis are always individual choices of families. Parents and children should be aware of the importance of screening and explore various treatment options if scoliosis is diagnosed.

Cindy Marti is a physical therapist and president of Spinal Dynamics of Wisconsin. She has traveled to Europe to study the Schroth method, a non-surgical approach to scoliosis treatment used wiedly across Europe for decades. She and two of her clinic’s colleagues are among fewer than 20 US-based physical therapists now certified in Schroth.

Sidebar: What is Scoliosis?

Scoliosis is the medical term for an abnormal curvature of the spine. It occurs in approximately 2-3% of people in the US, most commonly children. Idiopathic scoliosis means that the spinal curve develops for unknown reasons. Scoliosis curves are at highest risk for worsening during adolescent growth spurts. At onset, scoliosis rarely involves pain; thus, it is often not diagnosed early. Once progressed, scoliosis can seriously impact a person’s quality of life. Early detection is important to ensure optimal management of scoliosis. For additional information, visit the National Scoliosis Foundation website at scoliosis.

Spinal Dynamics of Wisconsin believes early and frequent scoliosis screenings are important. We offer the following on the first Saturday of each month.
8:00 to 8:30 a.m.: free screenings for children ages 10-15; physician follow-up is recommended if a potential problem is identified
10:30 to noon: free lecture about scoliosis and the Schroth treatment, an exercise-based approach to treatment
Sessions are at 2300 N. Mayfair Rd, Suite 555, in the Mayfair Bank Tower. Registration is required. Visit www.sdwpt. We also encourage schools and community groups to contact us to discuss scoliosis screenings at their locations.

National Scoliosis Foundation

Hundreds of patients in Nottingham are benefitting from an almost unlimited supply of free tennis balls to help with exercises to control the often debilitating symptoms of Parkinson’s disease. The tennis balls are being donated by the Nottingham Tennis Centre after they were approached and asked to help by Nottingham University Hospitals NHS Trust’s physiotherapist, Sandy Gill.

Sandy, who is a member of the gym at the Nottingham Tennis Centre, noticed that tennis balls that were no longer ‘bouncy’ enough for tennis were being donated through a ‘ball bin scheme’. She approached the Tennis Centre to see if they would consider donating them to NUH where they would be put to excellent use to help Parkinson’s disease sufferers control the symptoms of their disease.

Patients suffering from Parkinson’s disease often experience a stiffening of the fingers or a debilitating and uncontrollable tremor which makes simple everyday tasks – which most of us take for granted – such as dressing, eating and writing very difficult.

Physiotherapists at NUH use tennis balls in a series of exercises to help reduce hands stiffening and aid tremor reduction. Patients are encouraged to roll the tennis balls in the palm of their hands to keep fingers supple and to roll them along the table to stretch out their fingers and help increase manual dexterity and hand-eye co-ordination.

Sandy Gill said: “These simple exercises can play a beneficial role in helping Parkinson’s patients retain their hand mobility, making every day tasks easier to perform.

“Having a guaranteed, regular supply of free tennis balls has enabled us to give our patients balls to take home with them so that they can practice their exercises at home. It means we can use and distribute them as needed rather than having to be prescriptive over their use.

“It is terrific that something so small can have such huge benefits for our patients.”

Richard Joyner, manager at the Nottingham Tennis Centre, said: “At the Tennis Centre we get through a huge amount of tennis balls. Balls get to a point where they are no longer of good enough quality to use for the programme, so we set up a ‘ball bin scheme’ to donate to appropriate organisations.

“We are delighted that the physiotherapists have found a beneficial use for them with Parkinsons’s disease sufferers, and look forward to continuing this partnership.”

Nottingham University Hospitals NHS Trust was named as a top-ranking teaching Trust in the UK in the 2008 ‘Good Hospital Guide’ by health information specialist Dr Foster. The guide says that among the reasons for the Trust’s success are that patients recover better than the national average after operations to replace previous hip and knee replacements and that the dedicated isolation facilities available at the Trust provide a good environment for patients with infectious diseases.

For the second year running, the Trust has also been highlighted as having one of the lowest ‘standardised mortality rates’ in the country. This means that patients in our hospitals are more likely to survive serious illness than in many other hospitals in the UK.

The full guide can be read here.

NUH is one of the largest Trusts in the UK, with an annual budget of more than ВЈ550 million. It was formed on 1 April 2006, when two top-rated trusts – Queen’s Medical Centre and Nottingham City Hospital – merged in order to develop a range of high-quality, sustainable patient services across the two campuses.

As a major teaching Trust, NUH enjoys close links with the city’s universities and attracts and develops the highest calibre of staff. It continues to be the hospital of choice for patients, encourage investment and remain at the forefront of research.

It has one of the busiest emergency departments in the UK and has a total of 1,664 hospital beds across both campuses.

www.nuh.nhs

The American Physical Therapy Association (APTA) is urging patients with musculoskeletal pain to consider treatment by a physical therapist, in light of a new federal survey showing that more than one-third of American adults and nearly 12 percent of children use alternative medicine – with back and neck pain being the top reasons for treatment. Results of the 2007 survey of more than 32,000 Americans were released Dec. 11 by the National Institutes of Health’s National Center for Complementary and Alternative Medicine.

According to APTA, physical therapy offers an evidence-based, time-tested solution to these common conditions in comparison to alternative treatments.

For neck pain, for example, a recent study published in the medical journal Spine found that when patients received up to six treatments of manual physical therapy and exercise, they not only experienced pain relief, but were also less likely to seek additional medical care up to one year following treatment.

“This study, demonstrating the efficacy of physical therapy for a condition as widespread as neck pain, is particularly relevant in today’s challenging economic environment,” according to the study’s lead researcher and APTA spokesman Michael Walker, PT, DSc, OCS, CSCS, FAAOMPT. “The Kaiser Foundation, for instance, recently found that more than half of all Americans are not taking prescribed medication and postponing needed medical care in an effort to save money. It is important for consumers to know that there are effective, conservative solutions such as physical therapy available.[1]”

Walker’s study compared the effectiveness of a three-week program of manual physical therapy and exercise to a minimal intervention treatment approach for patients with neck pain.

Study participants consisted of 94 patients with a primary complaint of neck pain, 58 (62%) of whom also had radiating arm pain. Patients randomized to the manual
physical therapy and exercise group received joint and soft-tissue mobilizations and manipulations to restore motion and decrease pain, followed by a standard home exercise program of chin tucks, neck strengthening, and range-of-motion exercises. Patients in the minimal intervention group received treatment consistent with the current guidelines of advice, range-of-motion exercise, and any medication use prescribed by their general practitioner. Patients did not have to complete all six visits if their symptoms were fully resolved.

Sample exercises to relieve neck pain can be found on the APTA Web site, apta/consumer.

Results show that manual physical therapy and exercise was significantly more effective in reducing mechanical neck pain and disability and increasing patient-perceived improvements during short- and long-term follow-ups. These results are comparable with previous studies that found manual physical therapy and exercise provided greater treatment effectiveness (Hoving et al, 2002)[2] and cost effectiveness (Kothals-de Bos et al, 2003)[3] than general practitioner care.

“Physical therapist intervention can be an effective, high-value, conservative solution for treatment of musculoskeletal pain,” said Walker. “Physical therapists can help individuals improve mobility and quality of life without expensive surgery or the side effects of pain medication. We give patients the tools they need, such as the home program we used in the study, to help them prevent or manage a condition in order to achieve long-term health benefits.”

Physical therapists are highly-educated, licensed health care professionals who can help patients reduce pain and improve or restore mobility — without expensive surgery or the side effects of medications. APTA represents more than 70,000 physical therapists, physical therapist assistants, and students of physical therapy nationwide. Its purpose is to improve the health and quality of life of individuals through the advancement of physical therapist practice. Learn more about conditions physical therapists can treat at apta/consumer, and find a physical therapist in your area at findapt.us.

References

1. kff/kaiserpolls/h08_posr102108pkg.cfm

2. Hoving JL, Koes BW, de Vet HC, van der Windt DA, et al. Manual Therapy, Physical Therapy, Or Continued Care by a General Practitioner for Patients with Neck Pain. Ann Intern Med 2002;136 (10):713-722

3. Korthals-de Bos IB, Hoving JL, van Tulder MW, et al. Cost effectiveness of physiotherapy, manual therapy, and general practitioner care for neck pain: economic evaluation alongside a randomised controlled trial. BMJ 2003;326 (7395):911

American Physical Therapy Association

Rush University Medical Center and 10 other healthcare facilities in the U.S. and Canada have been awarded a $4.3 million grant from the National Institutes of Health to identify which rehabilitation therapies, or combination of therapies, can best help victims of traumatic brain injuries. Rush is the only center in Illinois participating in the study.

“Our aim in this study is to isolate individual components of the range of therapies we use to treat our patients and determine how, and to what degree, each is associated with improved function,” said Dr. James Young, chairman of the department of physical medicine and rehabilitation at Rush and an internationally recognized expert in the treatment of brain injuries.

The five-year study will collect the records of more than 2,300 patients who have suffered moderate to severe traumatic brain injuries, including detailed demographic, diagnostic and clinical profiles of each patient. Daily logs will be kept of the individually tailored treatment programs the patients undergo in physical therapy, occupational therapy, speech/language therapy, physiatry (physical medicine), psychology/psychiatry, and social support. Outcomes will be catalogued and correlated with both the patients’ characteristics and therapeutic interventions.

The researchers will then analyze the data to determine which therapies were the most successful in improving outcomes for patients with different types and severities of traumatic brain injuries.

Patients will also be followed for a full year after being discharged to assess their quality of life, including whether they were able to live independently, drive a vehicle, and participate in daily activities.

The analysis will involve an unusual research methodology called practice-based evidence for clinical practice improvement, which relies on data from routine clinical practice to determine what works for whom, when, and at what cost. The methodology has been used successfully to improve treatment for stroke.

Traumatic brain injury occurs when the head suddenly and violently hits an object, as in a fall or car crash, or when an object, such as a bullet, pierces the skull and enters brain tissue. Symptoms of a traumatic brain injury can be mild, moderate, or severe, and vary depending on the extent and location of the brain damage. For patients with moderate or severe injuries, symptoms range from headaches and lethargy to convulsions, loss of coordination, confusion, cognitive deficits, and behavior and mood changes.

Research to date has done little to help identify the best treatments for the range of symptoms. Randomized clinical trials of rehabilitation therapies, for example, typically evaluate only specific treatments for a select group of patients. Results are not general enough to apply to the whole population of traumatic brain injury patients.

By isolating individual components of therapy as applied to patients with different degrees of traumatic brain injuries, the researchers expect to be able to prescribe best practices for rehabilitation, raising the standard of treatment in facilities all across the country.

“From the extraordinary wealth of data we’ll collect in this five-year analysis, we will be able to offer clinicians the information that can help them evaluate their current treatment practices and select therapies that are most likely to help their patients,” Young said. “This is medicine at its best: treatment based on the results of years of clinical practice.”

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Rush University Medical Center is an academic medical center that encompasses the more than 600 staffed-bed hospital (including Rush Children’s Hospital), the Johnston R. Bowman Health Center and Rush University. Rush University, with more than 1,730 students, is home to one of the first medical schools in the Midwest, and one of the nation’s top-ranked nursing colleges. Rush University also offers graduate programs in allied health and the basic sciences. Rush is noted for bringing together clinical care and research to address major health problems, including arthritis and orthopedic disorders, cancer, heart disease, mental illness, neurological disorders and diseases associated with aging.

Source: Sharon Butler

Rush University Medical Center

For parents, “it may be [a] natural, god-given right to freak out about the sex lives of adolescents,” but national statistics on teenage sex behaviors show that “young people today really aren’t any more promiscuous than we were,” the Washington Post’s Carolyn Butler writes in an opinion piece.

Butler cites a recent survey from the Centers for Disease Control and Prevention’s National Center for Health Statistics. The survey, which covered 2006 through 2008 found that 42% of girls and 43% of boys ages 15 through 19 reported having had sex, a rate virtually unchanged since 2002. In 1988, 51% of girls and 55% of boys in that age range said they had had sex.

Bill Albert, chief program officer at the National Campaign To Prevent Teen and Unplanned Pregnancy, said teen pregnancy rates are 39% lower than they were in 1990, despite a small uptick in 2005.

Kathy Woodward, medical director of the Adolescent Health Center at Children’s National Medical Center, said the overall news on teen sex today “is really a mixed bag,” adding, “The good news is that we’ve been able to at least hold the line on the number of kids still deciding to wait on becoming sexually active.”

Butler continues that the CDC survey found that contraceptive use also has “remained steady” in recent years, with 79% of girls and 87% of boys saying they used contraception the first time they had sex. However, she adds that Woodward expressed concern about a significant increase in the number of teens using the “spectacularly ineffective” rhythm method — 17% of girls in the most recent survey, compared with 11% in 2002.

Woodward also noted that other CDC statistics show that 25% of adolescent girls have a sexually transmitted infection, such as chlamydia or human papillomavirus. The uptick in STI rates mirrors increases in HIV rates among young women, Woodward added (Butler, Washington Post, 6/15).

Reprinted with kind permission from nationalpartnership. You can view the entire Daily Women’s Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women’s Health Policy Report is a free service of the National Partnership for Women & Families.

© 2010 National Partnership for Women & Families. All rights reserved.

Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death in Canada. Although it is an incurable chronic disease, effective treatments exist to relieve symptoms and improve the course of the illness.

The latest study by Dr. François Maltais of the Hôpital Laval, institut universitaire de cardiologie et de pneumologie de Québec and Dr. Jean Bourbeau, of the Research Institute of the McGill University Health Centre (MUHC) proves the effectiveness of home-based pulmonary rehabilitation and provides new insight into improving care services. The study was published in the journal Annals of Internal Medicine on December 16th.

Home-based pulmonary rehabilitation: an effective and safe alternative

Pulmonary rehabilitation is currently the most effective treatment available to improve shortness of breath, effort tolerance and the quality of life of patients suffering from COPD. “Our results prove that home-based rehabilitation is just as effective and safe as that provided in hospitals,” states Dr. Maltais. “What’s more, it is a real benefit to patients in comparison to a strictly pharmacological treatment.”

In spite of its obvious benefit, only two per cent of COPD patients in Canada are offered this treatment because health care facilities do not have the means to offer it in-house. In half of the regions of QuГ©bec, pulmonary rehabilitation is not even offered to patients.

The home-based program designed by the Canadian researchers is based on aerobic exercises and can easily be performed alone. This helps to ease the burden on hospitals, while continuing to provide optimum care. This major study involved more than 250 patients in 10 Canadian centres.

Towards a new health care system organisation?

“We hope that this study will lead to the reorganization of the system so that as many patients as possible will be able to benefit from the program,” Dr. Bourbeau explains. “Its widespread implementation could have a major positive impact both on the public’s health and on the health care system.”

In addition to the economic beneficial interest of home-based treatment, the physical condition of patients improves to the point where they no longer require as many hospital visits. This program could therefore help to reduce expenses.

This program reflects the current trend of involving patients in the management of their chronic illnesses. Education, accountability and making healthier lifestyle choices have a positive impact on most chronic illnesses, including COPD.

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This release is available in French.

This study was funded by the Canadian Institutes of Health Research (CIHR) and the Fonds de la recherche en santГ© du QuГ©bec (FRSQ).

Dr. Jean Bourbeau is Director of the Respiratory Epidemiology & Clinical Research Unit of the Montreal Chest Institute of the MUHC, and a researcher in the axes of “respiratory health” and “health outcomes” at the Research Institute of the MUHC. He is also assistant professor at McGill University’s departments of Medicine and Epidemiology, Biostatistics and Occupational Health. Dr. Bourbeau is the Director of the COPD axes of the FRSQ’s Respiratory Health Network.

Dr. FranГ§ois Maltais is a pneumologist at HГґpital Laval, Institut Universitaire de Cardiologie et de Pneumologie de l’UniversitГ© Laval and a full professor at that university’s department of medicine. He is the Medical Director of the respiratory rehabilitation program at his institute and Director of the respiratory health care research team at UniversitГ© Laval.

The Research Institute of the McGill University Health Centre (RI MUHC) is a world-renowned biomedical and health-care hospital research centre. Located in Montreal, Quebec, the institute is the research arm of the MUHC, the university health center affiliated with the Faculty of Medicine at McGill University. The institute supports over 600 researchers, nearly 1200 graduate and post-doctoral students and operates more than 300 laboratories devoted to a broad spectrum of fundamental and clinical research. The Research Institute operates at the forefront of knowledge, innovation and technology and is inextricably linked to the clinical programs of the MUHC, ensuring that patients benefit directly from the latest research-based knowledge.

The Research Institute of the MUHC is supported in part by the Fonds de la recherche en santГ© du QuГ©bec.

For further details visit: muhc/research.

About HГґpital Laval, Institut universitaire de cardiologie et de pneumologie de QuГ©bec

Founded in 1918, HГґpital Laval, Institut universitaire de cardiologie et de pneumologie de QuГ©bec, is the heart and lung institute of UniversitГ© Laval. It provides the population of Central and Eastern QuГ©bec with subspecialized care and services in cardiology, pneumology, and the surgical management of obesity. The Hospital also has an in-house research center that is renowned worldwide and supported by Fonds de recherche en santГ© du QuГ©bec (QuГ©bec Health Research Council). The main goal of the Laval Hospital Research Center is to slow the obesity epidemic and the progression of cardiovascular and pulmonary disease through research and prevention. The Laval Hospital Research Center has focused its development around this vision and aims to become the leading North American research center in cardiology, pneumology, and obesity. The HГґpital Laval Research Center is one of the 38 affiliated research centers of UniversitГ© Laval. Located in QuГ©bec City, UniversitГ© Laval was the first francophone university created in North America. Its 17 faculties offer comprehensive programs to 38,000 students including 10,000 graduate students.

Find this press release, with the original article and a short audio document by following this link: muhc/media/news/ or hopitallaval.qc/communiques.asp

Source: Isabelle Kling

McGill University Health Centre

Family Members Want Straight Talk from Physicians Regarding Poor Patient Prognosis

When a patient is incapacitated by serious illness, family members become surrogate decision makers. However, physicians may feel reluctant to discuss a particularly poor prognosis with surrogates for fear that it could extinguish all sense of hope. Researchers conducted face-to-face interviews with 179 family members of seriously ill patients to determine their opinions about balancing hope and telling the truth about a poor prognosis. Nearly all of the surrogates said that withholding bad news was not acceptable. They felt that knowing the truth was important because it gave them an opportunity to prepare emotionally and practically for a loved one’s death.

Home Rehabilitation is a Safe, Viable Option for COPD Patients

COPD is a progressive disease that causes debilitating shortness of breath. Exercise training can reduce shortness of breath, even in severe COPD. While hospitals have programs that provide closely supervised exercise training, access to these programs is limited. Researchers conducted a study of 252 COPD patients to find out if a home-based, largely unsupervised exercise program could be as effective as a hospital-based program. All patients had four weeks of education about living with COPD before being randomly assigned to either hospital or home rehabilitation. In both programs, patients were instructed to perform three exercise sessions per week for eight weeks. During the eight weeks, trainers called home exercisers weekly to provide encouragement. After eight weeks, trainers called once every two months. At one year, patients in both groups reaped equal benefits, with both reporting less shortness of breath than before. Researchers conclude that tailoring pulmonary rehabilitation to meet individual needs could improve accessibility to this effective intervention.

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About the American College of Physicians and Annals of Internal Medicine

Annals of Internal Medicine (annals) is one of the five most widely cited peer-reviewed medical journals in the world. The journal has been published for 81 years and accepts only 7 percent of the original research studies submitted for publication. Annals of Internal Medicine is published by the American College of Physicians (acponline/), the largest medical specialty organization and the second-largest physician group in the United States. ACP members include 126,000 internal medicine physicians (internists), related subspecialists, and medical students. Internists specialize in the prevention, detection, and treatment of illness in adults.

Source: Angela Collom

American College of Physicians

A new study by researchers at The George Institute for International Health has found that back pain is a reoccurring problem for five million Australians.

According to lead author, Professor Chris Maher, Director of Musculoskeletal Research at The George Institute, “After an episode of back pain resolves, one in four people will experience a recurrence within one year. This explains why around 25% of the Australian population suffers from back pain at any one time.”

Low back pain is the most prevalent and costly musculoskeletal condition in Australia(1), estimated to cost up to $1billion per annum with indirect costs exceeding $8billion(2). It is also the most common health condition causing older Australians to be absent from the labour force.(3)

According to Professor Maher, patients and clinicians need to shift their focus to prevention. “We tend to treat the pain when it’s there, but when you recover, patients rarely take steps to prevent the problem from returning. People understand the message about lifting correctly but heavy lifting is only one of the risk factors for developing back pain. What many people do not understand is that some of the risk factors for back pain are also the risk factors for other chronic diseases like heart disease. My advice is that people should take a similar approach to back health, as they do for heart health – eating right, exercise and a healthy lifestyle is definitely good for your heart, and also your spine,” he added.

“Good, previous research has shown participation in an exercise program after the original episode of low back pain is highly effective in preventing recurrence. Those in the exercise group had half the rate of recurrence of the control group. Other studies have indicated that strengthening muscles and developing fitness show some benefit in avoiding recurring back pain. Mental stress also increases the risk of back pain so including stress management in a health promotion approach would be a sensible way to reduce your chances of back pain. Just paying attention to lifting correctly is probably not enough, a holistic approach is really best.”

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Researchers reviewed patients who had recovered from their initial back pain within six weeks. Patients saw a range of treatments from general practitioners, physiotherapists and chiropractors in Australia. 353 patients were followed over one year and contacted at six weeks, three months and 12 months.
Australian Institute of Health and Welfare. Australia’s health 2000: the seventh biennial health report of the Australian Institute of Health and Welfare. 7th ed. Canberra: AIHW, 2000.

Walker B, Muller R, Grant W. Low back pain in Australian adults: the economic burden. Asia Pacific Journal of Public Health 2003;15(2):79-87.

Schofield DJ, Shrestha RN, Passey ME, Earnest A, Fletcher SL. Chronic disease and labour force participation among older Australians. MJA 2008; 189 (8): 447-450

Source: Emma Orpilla

Research Australia

A system that can recognize human gestures could provide a new way for people with physical disabilities to interact with computers. A related system for the able bodied could also be used to make virtual worlds more realistic. The system is described in detail in a forthcoming issue of the International Journal of Arts and Technology.

Manolya Kavakli of the Virtual and Interactive Simulations of Reality Research Group, at Macquarie University, Sydney, Australia, explains how standard input devices – keyboard and computer mouse, do not closely mimic natural hand motions such as drawing and sketching. Moreover, these devices have not been developed for ergonomic use nor for people with disabilities.

She and her colleagues have developed a computer system architecture that can carry out “gesture recognition”. In this system, the person wears “datagloves” which have illuminated LEDs that are tracked by two pairs of computer webcams working to produce an all-round binocular view. This allows the computer to monitor the person’s hand or shoulder movements. This input can then be fed to a program, a game, or simulator, or to control a character, an avatar, in a 3D virtual environment.

“We developed two gesture recognition systems: DESigning In virtual Reality (DesIRe) and DRiving for disabled (DRive). DesIRe allows any user to control dynamically in real-time simulators or other programs. DRive allows a quadriplegic person to control a car interface using input from just two LEDs on an over-shoulder garment. For more precise gestures, a DataGlove user can gesture using their fingers.

The system architecture include the following components: Vizard Virtual Reality Toolkit, an immersive projection system (VISOR), an optical tracking system (specifically the Precision Position Tracker (PPT) system) and a data input system, Kavakli explains. The DataGlove input is quite simplistic at the moment, but future work will lead to an increase in sensitivity to specific gestures, such as grasping, strumming, stroking, and other hand movements.

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“Gesture recognition in virtual reality” by Manolya Kavakli in Int. J. Arts and Technology, 2008, 1, 215-229

Source: Manolya Kavakli

Inderscience Publishers

The editors of Archives of Physical Medicine and Rehabilitation are pleased to announce a special supplement to the December issue, highlighting traumatic brain injury (TBI). Archives of Physical Medicine and Rehabilitation (archives-pmr/) is the official journal of the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation, and is published by Elsevier.

The supplemental issue is entitled, “Special Issue on Traumatic Brain Injury from the Toronto Rehabilitation Institute TBI Recovery Study: Patterns, Predictors, and Mechanisms for Recovery, Plus New Directions for Treatment Research,” and the Guest Editor is Robin E.A. Green, PhD, CPsych. Dr. Green is a scientist in neurorehabilitation and a clinical neuropsychologist at the Toronto Rehabilitation Institute, where she heads the Cognitive Neurorehabilitation Sciences Lab.

According to Guest Editor Robin Green, ‘”This peer-reviewed supplement of Archives of Physical Medicine and Rehabilitation comprises a series of studies on traumatic brain injury conducted in the Cognitive Neurorehabilitation Sciences Lab at the Toronto Rehabilitation Institute and the Department of Medical Imaging at the Toronto Western Hospital. These papers are intended to offer novel insights into the clinical impact of brain injury and into mechanisms of recovery, with the aim of encouraging new directions for treatment research based on the root causes of behavioral and brain dysfunction.”

According to Dr. Green, the supplement issue is particularly pertinent in light of the increased awareness of and concern about TBI due to the large number of brain injuries being sustained by soldiers in Iraq and Afghanistan.

Ian H. Robertson, PhD, MRIA adds that, “This special supplemental issue is outstanding in a number of ways – in giving the clinician a sense of what can be said to the worried family of TBI patients and what cannot, and in offering researchers important insights from imaging and neuropsychology into the possible mechanisms for the postacute recovery process. Most importantly, this issue yields real pointers as to how the course of recovery from TBI may be influenced.”

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Subscribers can access the full content of this supplemental issue and all issues of Archives of Physical Medicine and Rehabilitation at the journal web site, www.archives-pmr. Institutional subscribers can access the journal through ScienceDirect, www.sciencedirect.

About Archives of Physical Medicine and Rehabilitation

Archives of Physical Medicine and Rehabilitation, the official publication of the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation, provides timely clinical papers, cutting-edge research, and comprehensive reviews in the fields of physical medicine and rehabilitation. The Editor in Chief is Jeffrey R. Basford, MD, PhD. More information about the journal can be found online at archives-pmr/.

About Elsevier

Elsevier is a world-leading publisher of scientific, technical and medical information products and services. Working in partnership with the global science and health communities, Elsevier’s 7,000 employees in over 70 offices worldwide publish more than 2,000 journals and 1,900 new books per year, in addition to offering a suite of innovative electronic products, such as ScienceDirect (sciencedirect/), MD Consult (mdconsult/), Scopus (info.scopus/), bibliographic databases, and online reference works.

Elsevier (elsevier/) is a global business headquartered in Amsterdam, The Netherlands and has offices worldwide. Elsevier is part of Reed Elsevier Group plc (reedelsevier/), a world-leading publisher and information provider. Operating in the science and medical, legal, education and business-to-business sectors, Reed Elsevier provides high-quality and flexible information solutions to users, with increasing emphasis on the Internet as a means of delivery. Reed Elsevier’s ticker symbols are REN (Euronext Amsterdam), REL (London Stock Exchange), RUK and ENL (New York Stock Exchange).

Source: Caroline Foote

Elsevier