euro-physiotherapy-2017-scientifictracks-abstracts

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Journal of Physical Therapy and Sports Medicine

Volume 1, Issue 1

Euro Physiotherapy 2017

Page 32

December 07-08, 2017 Rome, Italy

Euro-Global Physiotherapy Congress 2017

Gait rehabilitation – contemporary methods

Ivet Koleva

, Taina Avramescu

, Borislav Yoshinov

, Radoslav

Yoshinov

, Rodica Traistaru

, Diana Kamal

, Konstantin Kamal

Medical University of Sofia, Bulgaria

University of Craiova - Romania

Bulgarian Academy of Sciences, Sofia

Clinical Hospital Filantropia - Craiova, Romania

he World Report on Disability defines the

goals of

rehabilitation:

prevention of the loss of function;

slowing the rate of loss of function;

improvement or

restoration of function

; compensation for lost function;

maintenance of current function.

Gait

is an important

element of the everyday life functionality of our patients in

rehabilitation practice, and is crucial for their independence

in activities of daily living, respectively for their autonomy.

Our purpose is to emphasize the potential of some

contemporary physical modalities for

balance training

and

gait recovery

, based on best practices and evidence-

based research. Principal clinical and instrumental

assessment and treatment methods are stated. Special

attention is paid to:

functional electrical stimulations

(with low and middle frequency electric currents);

deep oscillation; manual therapy techniques

(tractions,

mobilizations and manipulations);

proprioceptive

neuro-muscular facilitation

(PNF) methods;

analytic

exercises, device-assisted mechano-therapy

(passive,

active or combined), etc. We insist on the importance

technical aids

(wheelchair, canes, or walking sticks)

and weight bearing (restricted, fractional or total) during

the rehabilitation process. Future possibilities are cited,

including potential of

internet-based educational courses

We explain some

principles of balance and gait

rehabilitation

, dues to our modest clinical experience (of

30 years) and our own results in patients with conditions of

the nervous and motor systems. Special attention is paid to

neurological and neuro-surgical rehabilitation algorithms

–

in patients with: post stroke hemiparesis, multiple

sclerosis, Parkinsonism, traumatic brain injury (TBI),

brain tumors, spinal cord injuries (SCI) with paraplegia;

lumbo-sacral radiculopathy and diabetic polyneuropathy

(DPNP) with femoral, peroneal or / and tibial paresis; or

radiculopathies and peripheral paresis after neurosurgical

intervention (for spinal trauma and discal hernia).

Authors suggest

‘Guidelines of operational standard

procedures in

rehabilitation after lower limb orthopedic

surgery’

:inpatients

withacetabular,inter/transtrochanteric

or distal femoral fractures, with gamma nail or vis – plaque

endoprosthesis; joint replacement of lower extremities

(hip and knee arthroplasty); ACL and PCL (anterior and

posterior cruciate ligament) alloplasty; total and partial

meniscectomy

. Rehabilitation protocols for patients with

trans-femoral and trans-tibial amputations

are proposed.

Our rehabilitation algorithms and guidelines are not

intended to be construed or to serve as a standard of

care. Standards of care are determined on the basis

of all clinical data available for an individual case and

are subject to change as scientific knowledge and

technology advance and patterns of care evolve.

Typical and atypical clinical cases

will be presented,

including patients with comorbidities, complex or multiple

fractures, common or rare complications.

For effective gait rehabilitation the inclusion of a multi-

professional therapeutic and

rehabilitation team

is obligatory.

Different models of organization of the

teamwork

of the staff are applied:

interdisciplinary

(complex care of the patient from different scientific and

professional disciplines);

multi-disciplinary

(role of every

professional is completely independent from the others);

transdisciplinary

(everyone helps the work of the others;

role and functions are distributed). We consider that the

clinical practice imposes the necessity of transition from

a multi-disciplinary to a transdisciplinary model of team

work, with a clear definition of the fields of competence

and the responsibility of the team members. In Bulgarian

rehabilitation practice traditionally a lot of specialists are

included:

medical doctors – specialists

in Neurology,

Neurosurgery;

Rheumatology;

Orthopedics

and

Traumatology and in Physical and Rehabilitation Medicine

(PRM);

bachelors and masters

in Physical Therapy and in

Occupational therapy (Kinesio-therapy and Ergo-therapy

– according nomenclature of some countries, e.g. Bulgaria

and Romania).

Biography

Philosophy Doctor - scientific specialty “Physical Therapy and Rehabilitation”;

thesis (2004): ‘Investigation of capacities of some physical modalities in the

prevention, therapy and rehabilitation of diabetic polyneuropathy patients’.

Doctor of Medical Sciences - scientific specialty “Physical Therapy and

Rehabilitation”; thesis (2009): ‘Complex neurorehabilitation algorithms for

functional recovery and amelioration of independence in activities of daily living

in socially significant invalidating neurological diseases’. Philosophy Doctor -

scientific specialty “Pedagogics”; thesis (2013, Sofia University): ‘Innovations

in the Education in the field of Rehabilitation’. SCIENTIFIC POSITIONS:

Associated Professor (2006); Professor (2010); scientific specialty “Physical

Therapy and Rehabilitation”. High Attestation Commission at the Council of

Ministers, Bg. She knows French, Spanish, English, Russian language .

yvette@cc.bas.bg

Ivet Koleva et al., J Phys Ther Sports Med 2017