ApiFix is an innovative method to treat Adolescent Idiopathic Scoliosis. A minimal invasive surgery, with a short peri-apical fixation, is followed by Scoliosis Specific Exercises
The New CA Vantage™ Storage Resource Manager Storage Management Like You’ve N...CA Technologies
Take an in-depth look at the new features in CA Vantage™ Storage Resource Manager r14, including modern single pane of glass dashboards that provide a holistic view and make it easier than ever to track your storage utilization and resolve storage issues more quickly. Join us for a technical deep dive to learn best practices and techniques to make sure you are leveraging the over 1200 objects that can be viewed in CA Vantage to optimize your storage infrastructure. Take a closer look at the new dashboards, summaries and alerts and learn how to use the new automatic topology discovery feature to quickly analyze, identify, prevent or correct storage issues. Also hear about new performance features that help you exploit zIIP engines and memory functions to reduce your mainframe costs. For more information, please visit http://cainc.to/Nv2VOe
The Social Practice of Showering: Consideration of a HabitAznie Rahim
The social practice of showering has evolved over time from public bathing to a private routine. Key factors that influenced this change include the Black Death, the Industrial Revolution, and the rise of ideals around personal hygiene and cleanliness in the Victorian era. Now showering has become an ingrained daily habit for many that uses more water and resources than realized. Recommendations to reduce its environmental impact include adopting more efficient showering behaviors and technologies.
ApiFix treatment for Adolescent Idiopathic Scoliosis (AIS): The importance of...Nikos Karavidas
The document discusses the ApiFix treatment for adolescent idiopathic scoliosis and the importance of Schroth method exercises after the minimal invasive operation. It summarizes that ApiFix offers an internal brace option for some scoliosis cases as an alternative to bracing or spinal fusion. It also finds that using Schroth method exercises after the ApiFix operation helped improve scoliosis parameters like Cobb angle and trunk rotation in patients. The document concludes that proper patient selection for ApiFix and use of post-operative Schroth exercises can lead to good treatment outcomes.
Corrective exercises in the treatment of scoliosisNikos Karavidas
Physiotherapeutic Scoliosis Specific Exercises (PSSE) can be used as an exclusive treatment for mild scoliosis and in combination with bracing for greater curves. There are 3 RCT's and 1 Systematic review with meta-analysis, which prove the effectiveness of the PSSE (Level of Evidence I)
The New CA Vantage™ Storage Resource Manager Storage Management Like You’ve N...CA Technologies
Take an in-depth look at the new features in CA Vantage™ Storage Resource Manager r14, including modern single pane of glass dashboards that provide a holistic view and make it easier than ever to track your storage utilization and resolve storage issues more quickly. Join us for a technical deep dive to learn best practices and techniques to make sure you are leveraging the over 1200 objects that can be viewed in CA Vantage to optimize your storage infrastructure. Take a closer look at the new dashboards, summaries and alerts and learn how to use the new automatic topology discovery feature to quickly analyze, identify, prevent or correct storage issues. Also hear about new performance features that help you exploit zIIP engines and memory functions to reduce your mainframe costs. For more information, please visit http://cainc.to/Nv2VOe
The Social Practice of Showering: Consideration of a HabitAznie Rahim
The social practice of showering has evolved over time from public bathing to a private routine. Key factors that influenced this change include the Black Death, the Industrial Revolution, and the rise of ideals around personal hygiene and cleanliness in the Victorian era. Now showering has become an ingrained daily habit for many that uses more water and resources than realized. Recommendations to reduce its environmental impact include adopting more efficient showering behaviors and technologies.
ApiFix treatment for Adolescent Idiopathic Scoliosis (AIS): The importance of...Nikos Karavidas
The document discusses the ApiFix treatment for adolescent idiopathic scoliosis and the importance of Schroth method exercises after the minimal invasive operation. It summarizes that ApiFix offers an internal brace option for some scoliosis cases as an alternative to bracing or spinal fusion. It also finds that using Schroth method exercises after the ApiFix operation helped improve scoliosis parameters like Cobb angle and trunk rotation in patients. The document concludes that proper patient selection for ApiFix and use of post-operative Schroth exercises can lead to good treatment outcomes.
Corrective exercises in the treatment of scoliosisNikos Karavidas
Physiotherapeutic Scoliosis Specific Exercises (PSSE) can be used as an exclusive treatment for mild scoliosis and in combination with bracing for greater curves. There are 3 RCT's and 1 Systematic review with meta-analysis, which prove the effectiveness of the PSSE (Level of Evidence I)
Evidence Based Medicine on the Physiotherapeutic Scoliosis Specific ExercisesSanja Schreiber
This presentation provides evidence on the effect of physiotherapeutic scoliosis specific exercises on scoliosis outcomes that is coming from methodologically stronger studies.
SEAS is an individualized exercise program adapted for conservative scoliosis treatment. It is based on a specific active self-correction technique performed without aids to primarily improve spinal stability in active self-correction. The SEAS exercises train neuromotor function to stimulate reflexive self-corrected posture during daily life activities.
http://bestscoliosisexercises.com/
best scoliosis exercises
Scoliosis exercises are designed to correct or improve the lateral or rotary curvature of the spine. Opinion is still divided in the medical world as to the cause of
the condition. Some theories state nutrition or environmental issues, more recently some consider the cause to be a defective gene.
O documento descreve vários desvios posturais e exercícios corretivos para cada um. Inclui lombalgia, cifose, escoliose, joelhos geno valgo e varo, pés plano, cavo, valgo e varo, e condições como pé equino e calcâneo.
Scoliosis management by yoga therapy dr.shirishdshirishingmail
The document outlines a yoga programme for managing scoliosis. It describes a series of asanas (yoga poses) to address muscle imbalances and strengthen the weaker side of the body. The poses include twists, asymmetrical poses, and supported forward bends. The goal is to train the musculoskeletal system and stimulate neural memory of balanced alignment. Counter poses are used to stretch tight muscles on the contracted side. Applying the lessons to daily life can help maintain benefits outside of practice.
Emotional Design by Joely Gardner - pcSC Session 18Mack McCoy
This document discusses emotional design and how to create products that evoke emotions. It explains that emotions play an important role in customer decisions and satisfaction. Emotional design is about making products enjoyable and pleasurable to use. The document provides various models of emotions and discusses how to use language, questions, and research to understand customer emotions. Examples are given of emotionally-designed products and websites that were successful because they made customers feel certain positive emotions like trust and satisfaction. Tools and resources for emotional design are also listed.
1. Scoliosis correction protocols involve static and stress x-rays to assess correction, restoring the lordotic curves, cross crawl exercises, stabilizing the pelvis, adjusting using drop techniques, and correcting calf biomechanics.
2. Key elements for scoliosis correction include restoring the lordotic curves, using a rolled towel or other exercises on the convexity for 18 minutes, and performing leg drop or other exercises to stabilize the pelvis.
3. Stress x-rays laterally flexed into the convexity can show the minimal amount of correction that is possible, helping to set correction goals.
O documento discute a reabilitação de pacientes amputados. Ele descreve as causas comuns de amputação, incluindo problemas vasculares, traumatismos, diabetes e tumores. Ele também discute a biomecânica dos pacientes amputados e as etapas da reabilitação, como alívio da dor, fortalecimento muscular, alongamento e uso de próteses ou cadeiras de rodas. Casos de estudo de cães e gatos amputados ilustram o processo de reabilitação.
Programas do Centro de Fisioterapia e Reabilitação de Itatiba (vinculado ao F...inclusao.eficiente
O documento descreve a inauguração de um Centro de Fisioterapia e Reabilitação em Itatiba, Brasil em 10 de dezembro de 2010. Ele detalha a equipe multidisciplinar, as instalações e serviços oferecidos, incluindo atendimento adulto e infantil, fisioterapia, terapia ocupacional, fonoaudiologia e atendimento domiciliar.
O documento descreve sete exercícios do Método Klapp para tratamento de escoliose, incluindo "engatinhar perto do chão", "deslizamento horizontal" e "grande curva". Um estudo testou a eficácia do método e observou que foi eficaz para tratar assimetrias de tronco, mas não demonstrou bons resultados para outras curvaturas ou alinhamento de joelhos. Cada postura foi mantida por 8 minutos em sessões de 70 minutos, duas vezes por semana, por 20 sessões.
O documento discute tipos de deformidades vertebrais como escoliose, classificação etiológica da escoliose, características radiográficas, patomecânica, história clínica, exames e objetivos do tratamento da escoliose. Aborda tratamento conservador incluindo órtese, fisioterapia, RPG e suas críticas, bem como histórico do tratamento ortótico.
A escoliose é uma curva anormal na coluna vertebral no plano frontal, podendo ser idiopática (75% dos casos, hereditária), congênita (10% dos casos, associada a outras má-formações) ou por miopatia (risco aumentado em crianças acamadas). Sua avaliação inclui exames físicos, radiografias para medir a curva e classificá-la, e o índice de Risser para avaliar o potencial de crescimento. O tratamento é conservador para curvas leves com fisioterapia, coletes ou ges
O documento discute como os exercícios podem modificar a postura, mencionando que vícios posturais podem ser corrigidos com reeducação psicomotora, desvios posturais com exercícios de mobilização e força, e desvios estruturais podem ser contidos ou reduzidos. Também apresenta diversos exercícios corretivos para diferentes problemas de postura como escoliose, cifose, lordose e hipercifose.
Scoliosis 101 describes the condition of scoliosis, how it is evaluated, traditional treatment recommendations,andt he most recent developments in non-invasive
rehabilitation based treatment. For more information visit http://www.treatingscoliosis.com or call
Scoliosis is a lateral curvature of the spine visible from the front or side with an accompanying abnormal twisting. It is classified by degree of curvature as mild, moderate, or severe. The main types are congenital, neuromuscular, degenerative, and idiopathic scoliosis. Idiopathic scoliosis is the most common and has no known cause. Treatment depends on the type and severity, and may include bracing, exercise, or surgery. Schroth exercises are a conservative treatment that aim to correct posture and reduce the curve through stretching and strengthening techniques. A case study found Schroth therapy combined with bracing successfully reduced scoliosis curves in an adolescent patient.
Hip-Physiocure in collaboration with The Yorkshire Hip Clinic and Fitcure have produced their new evidence based 2021 Hip Arthroscopy Rehabilitation guide
This document discusses sacroiliac (SI) joint dysfunction, including:
1. It is a degenerative condition of the SI joint that results in lower back pain and accounts for 15-30% of outpatient lower back pain cases.
2. Risk factors include previous lumbar fusion, pregnancy, pelvic trauma, and iliac crest bone graft harvesting. Pathophysiology can involve intraarticular, extraarticular, or idiopathic mechanisms.
3. Diagnosis is based on history, physical exam including provocative tests, and SI joint infiltration. Differential diagnosis includes lumbar spinal stenosis, disc disease, and hip issues.
Physiotherapy in Reconstructive Surgery .pptxAhmedMufleh1
The document discusses physiotherapy for reconstructive hand surgery. It covers:
1. Pre-operative physiotherapy assessment and treatment including range of motion, strength, mobility and respiratory assessment.
2. Common hand surgeries like tendon repairs, amputations, and arthritis conditions. Flexor tendon injuries are classified into zones.
3. Post-operative rehabilitation protocols including immobilization, early passive motion, and early active motion. Exercises and progression of motion and strength over time are described for each protocol.
Physiotherapy in Reconstructive Surgery .pptxAhmedMufleh1
The document summarizes physiotherapy principles for reconstructive hand surgery. It discusses pre-operative assessment and mobility training. Post-operatively, it describes protocols for immobilization, early passive mobilization, and early active mobilization of flexor tendon injuries. Flexor tendon zones and factors affecting rehabilitation are also outlined. Treatment of post-surgical adhesions includes blocking exercises, gliding exercises, and myofascial release.
The document discusses rehabilitation after ACL reconstruction surgery. It begins with an introduction noting that ACL tears are a common sports injury. It then covers knee anatomy, the anatomy and biomechanics of the ACL, surgical treatment, and post-operative rehabilitation phases and techniques. The rehabilitation process involves regaining range of motion and quadriceps strength in early phases, advancing to sport-specific drills, with a focus on gradually increasing loads on the knee through strengthening and proprioceptive exercises.
Evidence Based Medicine on the Physiotherapeutic Scoliosis Specific ExercisesSanja Schreiber
This presentation provides evidence on the effect of physiotherapeutic scoliosis specific exercises on scoliosis outcomes that is coming from methodologically stronger studies.
SEAS is an individualized exercise program adapted for conservative scoliosis treatment. It is based on a specific active self-correction technique performed without aids to primarily improve spinal stability in active self-correction. The SEAS exercises train neuromotor function to stimulate reflexive self-corrected posture during daily life activities.
http://bestscoliosisexercises.com/
best scoliosis exercises
Scoliosis exercises are designed to correct or improve the lateral or rotary curvature of the spine. Opinion is still divided in the medical world as to the cause of
the condition. Some theories state nutrition or environmental issues, more recently some consider the cause to be a defective gene.
O documento descreve vários desvios posturais e exercícios corretivos para cada um. Inclui lombalgia, cifose, escoliose, joelhos geno valgo e varo, pés plano, cavo, valgo e varo, e condições como pé equino e calcâneo.
Scoliosis management by yoga therapy dr.shirishdshirishingmail
The document outlines a yoga programme for managing scoliosis. It describes a series of asanas (yoga poses) to address muscle imbalances and strengthen the weaker side of the body. The poses include twists, asymmetrical poses, and supported forward bends. The goal is to train the musculoskeletal system and stimulate neural memory of balanced alignment. Counter poses are used to stretch tight muscles on the contracted side. Applying the lessons to daily life can help maintain benefits outside of practice.
Emotional Design by Joely Gardner - pcSC Session 18Mack McCoy
This document discusses emotional design and how to create products that evoke emotions. It explains that emotions play an important role in customer decisions and satisfaction. Emotional design is about making products enjoyable and pleasurable to use. The document provides various models of emotions and discusses how to use language, questions, and research to understand customer emotions. Examples are given of emotionally-designed products and websites that were successful because they made customers feel certain positive emotions like trust and satisfaction. Tools and resources for emotional design are also listed.
1. Scoliosis correction protocols involve static and stress x-rays to assess correction, restoring the lordotic curves, cross crawl exercises, stabilizing the pelvis, adjusting using drop techniques, and correcting calf biomechanics.
2. Key elements for scoliosis correction include restoring the lordotic curves, using a rolled towel or other exercises on the convexity for 18 minutes, and performing leg drop or other exercises to stabilize the pelvis.
3. Stress x-rays laterally flexed into the convexity can show the minimal amount of correction that is possible, helping to set correction goals.
O documento discute a reabilitação de pacientes amputados. Ele descreve as causas comuns de amputação, incluindo problemas vasculares, traumatismos, diabetes e tumores. Ele também discute a biomecânica dos pacientes amputados e as etapas da reabilitação, como alívio da dor, fortalecimento muscular, alongamento e uso de próteses ou cadeiras de rodas. Casos de estudo de cães e gatos amputados ilustram o processo de reabilitação.
Programas do Centro de Fisioterapia e Reabilitação de Itatiba (vinculado ao F...inclusao.eficiente
O documento descreve a inauguração de um Centro de Fisioterapia e Reabilitação em Itatiba, Brasil em 10 de dezembro de 2010. Ele detalha a equipe multidisciplinar, as instalações e serviços oferecidos, incluindo atendimento adulto e infantil, fisioterapia, terapia ocupacional, fonoaudiologia e atendimento domiciliar.
O documento descreve sete exercícios do Método Klapp para tratamento de escoliose, incluindo "engatinhar perto do chão", "deslizamento horizontal" e "grande curva". Um estudo testou a eficácia do método e observou que foi eficaz para tratar assimetrias de tronco, mas não demonstrou bons resultados para outras curvaturas ou alinhamento de joelhos. Cada postura foi mantida por 8 minutos em sessões de 70 minutos, duas vezes por semana, por 20 sessões.
O documento discute tipos de deformidades vertebrais como escoliose, classificação etiológica da escoliose, características radiográficas, patomecânica, história clínica, exames e objetivos do tratamento da escoliose. Aborda tratamento conservador incluindo órtese, fisioterapia, RPG e suas críticas, bem como histórico do tratamento ortótico.
A escoliose é uma curva anormal na coluna vertebral no plano frontal, podendo ser idiopática (75% dos casos, hereditária), congênita (10% dos casos, associada a outras má-formações) ou por miopatia (risco aumentado em crianças acamadas). Sua avaliação inclui exames físicos, radiografias para medir a curva e classificá-la, e o índice de Risser para avaliar o potencial de crescimento. O tratamento é conservador para curvas leves com fisioterapia, coletes ou ges
O documento discute como os exercícios podem modificar a postura, mencionando que vícios posturais podem ser corrigidos com reeducação psicomotora, desvios posturais com exercícios de mobilização e força, e desvios estruturais podem ser contidos ou reduzidos. Também apresenta diversos exercícios corretivos para diferentes problemas de postura como escoliose, cifose, lordose e hipercifose.
Scoliosis 101 describes the condition of scoliosis, how it is evaluated, traditional treatment recommendations,andt he most recent developments in non-invasive
rehabilitation based treatment. For more information visit http://www.treatingscoliosis.com or call
Scoliosis is a lateral curvature of the spine visible from the front or side with an accompanying abnormal twisting. It is classified by degree of curvature as mild, moderate, or severe. The main types are congenital, neuromuscular, degenerative, and idiopathic scoliosis. Idiopathic scoliosis is the most common and has no known cause. Treatment depends on the type and severity, and may include bracing, exercise, or surgery. Schroth exercises are a conservative treatment that aim to correct posture and reduce the curve through stretching and strengthening techniques. A case study found Schroth therapy combined with bracing successfully reduced scoliosis curves in an adolescent patient.
Hip-Physiocure in collaboration with The Yorkshire Hip Clinic and Fitcure have produced their new evidence based 2021 Hip Arthroscopy Rehabilitation guide
This document discusses sacroiliac (SI) joint dysfunction, including:
1. It is a degenerative condition of the SI joint that results in lower back pain and accounts for 15-30% of outpatient lower back pain cases.
2. Risk factors include previous lumbar fusion, pregnancy, pelvic trauma, and iliac crest bone graft harvesting. Pathophysiology can involve intraarticular, extraarticular, or idiopathic mechanisms.
3. Diagnosis is based on history, physical exam including provocative tests, and SI joint infiltration. Differential diagnosis includes lumbar spinal stenosis, disc disease, and hip issues.
Physiotherapy in Reconstructive Surgery .pptxAhmedMufleh1
The document discusses physiotherapy for reconstructive hand surgery. It covers:
1. Pre-operative physiotherapy assessment and treatment including range of motion, strength, mobility and respiratory assessment.
2. Common hand surgeries like tendon repairs, amputations, and arthritis conditions. Flexor tendon injuries are classified into zones.
3. Post-operative rehabilitation protocols including immobilization, early passive motion, and early active motion. Exercises and progression of motion and strength over time are described for each protocol.
Physiotherapy in Reconstructive Surgery .pptxAhmedMufleh1
The document summarizes physiotherapy principles for reconstructive hand surgery. It discusses pre-operative assessment and mobility training. Post-operatively, it describes protocols for immobilization, early passive mobilization, and early active mobilization of flexor tendon injuries. Flexor tendon zones and factors affecting rehabilitation are also outlined. Treatment of post-surgical adhesions includes blocking exercises, gliding exercises, and myofascial release.
The document discusses rehabilitation after ACL reconstruction surgery. It begins with an introduction noting that ACL tears are a common sports injury. It then covers knee anatomy, the anatomy and biomechanics of the ACL, surgical treatment, and post-operative rehabilitation phases and techniques. The rehabilitation process involves regaining range of motion and quadriceps strength in early phases, advancing to sport-specific drills, with a focus on gradually increasing loads on the knee through strengthening and proprioceptive exercises.
The document discusses the rotator cuff, which is made up of four muscles and tendons that hold the humerus in the shoulder joint. Rotator cuff tears are a common cause of shoulder pain and disability. Tears can be classified based on timing (acute or chronic) and depth (partial or complete). Treatment for acute tears is usually surgical repair, while chronic tears may be treated with rest, physical therapy, and surgery if conservative treatment fails. Rehabilitation after repair focuses on protecting the repair while regaining range of motion and strength over 3 phases lasting 3-6 months.
Meniscus injuries are common in young adults, often caused by twisting or heavy lifting. Symptoms include knee pain, swelling, stiffness, tenderness, pain with squatting, popping or clicking in the knee, and limited motion. Meniscus tears are classified as longitudinal, horizontal, radial, or flap tears. Exams like McMurray's test and Apley's test are used to diagnose tears. Treatment involves medications, surgery if the meniscus cannot be repaired, physiotherapy including exercises and bracing, and rehabilitation protocols after arthroscopic surgery or meniscal repair surgery. Isokinetic training after arthroscopy can help improve knee function and muscle strength recovery.
Shoulder arthroscopy is an increasingly popular minimally invasive surgical technique for treating various shoulder conditions. It provides improved visualization of the shoulder anatomy compared to open surgery and results in less post-operative morbidity. The document outlines the indications, contraindications, preoperative evaluation and preparation, operative technique including portal placement and diagnostic arthroscopy steps, as well as postoperative rehabilitation. Arthroscopy has enhanced understanding of shoulder pathologies and allowed treatment that previously could only be addressed via open surgery.
La hernie du sportif : diagnostic et traitement, technique mini-ainvasive -Dr...VitamineB
La hernie du sportif : diagnostic et traitement, technique mini-invasive
Par le Docteur Ulrike MUSCHAWECK
Lors de la 1ère Journée Européenne de la pubalgie
Clinique du Sport Bordeaux Mérignac
radical mastectomy is a disabling condition, the side effects and post surgical complications of the conditions affect the patient both physically, psychologically and socially. in this presentation, an attempt to cover problem list, do's and don'ts, assessment, management is explained in detail.
The ACL provides primary stability to the knee by limiting anterior tibial translation. It has an average tensile strength of 2160 N. An ACL tear is commonly seen in sports involving sudden stops and changes in direction. Clinical exams like the Lachman and anterior drawer tests can indicate an ACL tear. MRI is the gold standard for diagnosis. Treatment options include conservative management or arthroscopic reconstruction using grafts like hamstring tendons. Post-op rehabilitation is crucial and athletes may return to sports around 6-9 months following surgery.
The ACL provides primary stability to the knee by limiting anterior tibial translation. It has an average tensile strength of 2160 N. An ACL tear is commonly seen in sports involving sudden stops and changes in direction. Clinical exams like the Lachman and anterior drawer tests can indicate an ACL tear. MRI is the gold standard for diagnosis. While conservative treatment is possible, surgery is often pursued to reconstruct the torn ligament using grafts like the patellar tendon. Post-operative rehabilitation and physiotherapy are important for a successful recovery.
This talk looks a few common knee disorders including ACL tears, patellar tendinopathy,and Osteoarthrits and meniscal tears, and looks at Physiotherapy management and some of the associated evidence. The talk was a 30 minute for Doctors unfamiliar with management options and was semi-technical in nature. It provides several patient handouts for practitioners to use. Videos describing exercises were also included in the talk but not available in Slideshare.
This document discusses early onset scoliosis (EOS) and various treatment options. EOS is defined as scoliosis beginning before age 5 or 10. Treatment options include observation, bracing, casting, growing rods, VEPTER, and fusion surgery. Growing rods and VEPTER involve periodic lengthening to allow continued spine and lung growth while correcting the curvature. Magenetically controlled growing rods are a newer option that can be lengthened in the office without surgery. Both have benefits but also risks like infection and premature fusion. The goals are to improve spine and lung development while avoiding early fusion when possible for EOS patients.
manipulations for the cervical and lumbar spineamj20008
The document summarizes research on spinal manipulation for low back pain. It finds that manipulation is more effective than sham therapy or therapies deemed ineffective/harmful for acute low back pain. However, manipulation provides no significant advantage over other treatments like general practitioner care, analgesics, physical therapy, exercises, or back school. The document also outlines potential side effects of manipulation and clinical prediction rules to determine which patients are most likely to benefit from manipulation.
Total knee replacement surgery aims to relieve pain and restore mobility and function. It involves replacing damaged cartilage and bone in the knee joint with prosthetic components. Pre-operative evaluation assesses a patient's medical history, physical exam, labs, and risk factors. Post-operatively, patients undergo physical therapy including range of motion exercises to regain mobility while avoiding high-impact activities. Nursing care focuses on wound monitoring, pain management, and early ambulation to aid recovery.
Rotator Cuff Injuries present at Chirayu Medical College.pptxNamanSharda2
The document discusses rotator cuff injuries, including the anatomy of the rotator cuff, classification of tears, symptoms, physical examinations, investigations like X-rays and MRI, and treatment options like conservative management, open repair, arthroscopic repair, and rehabilitation protocols. It also covers irreparable rotator cuff tears and treatment options for those, which can include conservative care, decompression, tendon transfers, graft interposition, balloon spacers, capsular reconstruction, or reverse shoulder arthroplasty.
Beverland D. Surgical Factors Influencing RomStruijs
The document discusses several factors that can influence range of motion (ROM) after knee arthroplasty surgery:
1) Surgical technique factors like thoroughly removing osteophytes, restoring proper joint alignment and posterior condylar offset, avoiding excess release of the medial collateral ligament, and closing the surgical wound in extension rather than flexion.
2) Rehabilitation protocols, including early use of continuous passive motion and adherence to post-operative physical therapy.
3) Patient factors such as pre-operative ROM, obesity, and underlying diagnosis of rheumatoid arthritis or osteoarthritis.
4) Potential treatments for stiff knees after surgery include manipulation under anesthesia and revision procedures to address issues like internal rotation of the femoral component
Diatesis Pubic Symphysis - Case PresentationAkeem Bakare
This document discusses the management of diastasis pubic symphysis, beginning with an introduction to the condition, epidemiology, etiology, assessment, management, prognosis, and a case study. Diastasis pubic symphysis is defined as the separation of normally joined pubic bones without fracture. It is most commonly caused by pregnancy and delivery. Assessment involves pelvic x-rays and pain/functional scales. Conservative management includes pelvic support, physical therapy, and medications. Prognosis is typically good if addressed promptly with proper management. A case study demonstrates successful treatment of a woman's severe diastasis pubic symphysis over 5 weeks using these conservative approaches.
Similar to Apifix presentation english version (20)
Physiotherapeutic Scoliosis Specific Exercises (PSSE): Recent evidence for th...Nikos Karavidas
The recent high methodological quality studies (RCT's) have proved the effectiveness of the PSSE for the scoliosis treatment (Level of Evidence I). The international scientific societies SRS, SOSORT, AAP, AAOS, POSNA recognize that the PSSE can halt the progression of scoliosis and must be the first step of treatment in curves below 25 degrees
Ο ρόλος του Φυσικοθεραπευτή στην Αντιμετώπιση της Παιδικής και Εφηβικής Σκολί...Nikos Karavidas
Διάλεξη στο 25ο Ετήσιο Συνέδριο του Πανελληνίου Συλλόγου Φυσικοθεραπευτών: Διαδικασία Λήψης Κλινικών Αποφάσεων αναφορικά με την Φυσικοθεραπευτική Αξιολόγηση της Παιδικής και Εφηβικής Σκολίωσης
The preliminary results from the first trials of Gensingen brace (by Dr. Weis...Nikos Karavidas
The Gensingen brace is a new Cheneau type brace, which seems to be the most effective and comfortable brace. This study presents the first preliminary results in Greece.
Η μέθοδος Schroth και η σημασία της στην θεραπεία της Εφηβικής Ιδιοπαθούς Σκο...Nikos Karavidas
Υπάρχουν οι κατάλληλες επιστημονικές αποδείξεις (Level of Evidence I) πως η μέθοδος Schroth αντιμετωπίζει αποτελεσματικά την σκολίωση. Οι ασκήσεις βασίζονται στην τρισδιάστατη αυτοδιόρθωση της σκολιωτικής στάσης, στην στροφική αναπνοή και στην εκπαίδευση διατήρησης των διορθώσεων κατά τις καθημερινές δραστηριότητες.
Ο ρόλος των Ειδικών Φυσικοθεραπευτικών Ασκήσεων για την Σκολίωση (Physiothera...Nikos Karavidas
Πλέον υπάρχουν επιστημονικές αποδείξεις [Randomized Controlled Trials (RCT) - Level of Evidence I ] που πιστοποιούν την αποτελεσματικότητα των Ειδικών Ασκήσεων για την Σκολίωση (PSSE) είτε σαν αποκλειστική αντιμετώπιση σε μικρές σκολιώσεις μέχρι 25 μοίρες, είτε σε συνδυασμό με κηδεμόνα σε μεσαίες και μεγάλες σκολιώσεις
Η θεραπεία με κηδεμόνα σε άτομα με Εφηβική Ιδιοπαθή Σκολίωση και κύφωση Scheu...Nikos Karavidas
Η SRS δίνει ξεκάθαρες οδηγίες για τις ενδείξεις εφαρμογής του κηδεμόνα στην θεραπεία της κύφωσης και της σκολίωσης. Δυστυχώς, στην Ελλάδα οι ενδείξεις αγνοούνται και αυτό έχει ως συνέπεια να παρατηρείται πολύ υψηλό ποσοστό μη αναγκαίας θεραπείας (overtreatment)
ApiFix is an innovative method to treat Adolescent Idiopathic Scoliosis. A minimal invasive surgery, with a short peri-apical fixation, is followed by Scoliosis Specific Exercises
Brace treatment for Adolescent Idiopathic Scoliosis (AIS) and Scheuermann Kyp...Nikos Karavidas
I. SRS and SOSORT guidelines for treating AIS and Scheuermann kyphosis with braces based on Cobb angle and Risser sign.
II. A cross-sectional study of 167 patients treated with braces for AIS or kyphosis found an overtreatment rate of 42.5%, with 43.2% of AIS patients and 40.8% of kyphosis patients overtreated.
III. Possible reasons for high overtreatment rates include ignorance of treatment guidelines, overreliance on bracing without exercise, and lack of physician education in treating spinal deformities. Overtreatment can cause psychological, social, and financial problems for children.
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1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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Apifix presentation english version
1. Short fixation followed by
Specific Physiotherapy Program
ApiFix®
New minimal invasive method to treat
Adolescent Idiopathic Scoliosis
Nikos Karavidas, MSc, PT
2. Nowadays, there is a missing step
between conservative treatment and
spinal fusion. This gap can be covered by
Apifix, which offers the “internal brace”
option.
25°- 40°≤25° ≥50°
ApiFix – The “internal brace”
ApiFix®
3. Treatment process
Scoliotic deformity
ApiFix Implant attaches to the pedicle
with 2 screws – peri apical and a relative
correction of the deformity is achieved
A miniature ratchet mechanism allows
the elongation of an expandable rod
The implant gradually elongates by specific
Physiotherapeutic exercises, enlarging the
distance between the two screws. This
gradual correction targets to bring the
curvature into the “safe zone” , below 35ο
4. Spinal fusion Vs ApiFix
Spinal fusion
• Surgical incision approx. 30- 45 cm
• Duration of operation 6-8 hours
• Hospitalization 6-7 days
• Blood loss 800-1500cc
Apifix
• Surgical incision approx. 10 cm
• Duration of operation 45-60 min
• Hospitalization 1-2 days
• Blood loss 50 cc
• No fusion, no effect on growth
plates, does not affect growth
• Normal range of motion of spine
after surgery
• Potential option to remove the
device after maturity
• Option for spinal fusion in the
future
• Statistically significant lower rate
of surgical complications
5. ApiFix
Typical Long Fusion Case
ApiFix Concept
Apifix acts like an “internal brace”, which combines a minimal invasive surgical
procedure with Physiotherapeutic Scoliosis Specific Exercises (PSSE) with
Schroth method
6. Fatigue Test per ASTM F 1717
Testing Jig Test Sample
- Test performed by EndoLab GMBH (Germany)
- ApiFix Run-out load at 5,000,000 cycles was 1000N
- Standard fusion systems of good quality holds around 300N*
* Multiaxial Pedicle Screw Designs: Static and Dynamic Mechanical Testing. Ralph E. Stanford et al, Spine Vol. 29, No. 4 , 2004
Run out load [N] of standard fusion systems* and
the ApiFix system
Fatigue test
7. Spherical joint between the
Implant and the Screw.
No moments can be transferred,
only pure axial loads.
The Nut firmly holds the
spherical ring but the joint
is still free to move 3D.
Risk reduction
8. Risk Analysis
OutcomeRisk MitigationMain Risks Identified
Proper safety factor identifiedFinite Elements AnalysisImproper design leading to
early failure
System was able to withstand
1,000N loading for 5MC
Fatigue test per ASTM F1717Fracture of system under long
term fatigue loading
Low wear of 0.01 mg/MCWear test of 10 MCWear of ratchet mechanism
Low steady state wear of 0.02
mg/MC per joint
Wear test of 10 MCWear of poly-axial joint
For properly indicated patients,
the system was able to reduce
the curve to below 35 degrees
Clinical trial in EuropeFailure of system to reduce
scoliotic curve below 35
degrees
No device related adverse event
in 37 patients with up to 2.5
years follow up (438 patient-
months)
Clinical trial in EuropeUnexpected adverse events
9. Indications for ApiFix
• Apifix is not applied to
every type of scoliosis
• Lenke type 1 (Main
Thoracic), Lenke type 5
(Thoracolumbar)
• Cobb angle 40ο – 60ο
• Moderate rotation
• Flexible curve
( significant correction
in side-bending x-rays)
10. The most suitable patients for the program are aged 11-12 with 90%
risk of progression and aged 13-14 with 70% risk of progression, to
bring them to the age of 16 with only 10% risk of progression
Age °≤19 20°-29° 30°-59° ≥60°
≤10 45% 100% 100% 100%
11-12 23% 61% 90% 95%
13-14 8% 37% 70% 90%
≥16 0% 10% 30% 70%
Risk of curve progression ˃5 °, by age
Indications for ApiFix
11. Pre-operation
• Scoliosis classification by Lenke
• X-ray evaluation and estimation
of Cobb angle
• Evaluation of flexibility by lateral
bending x-rays
• Radiological and clinical
assessment also by the Certified
Physiotherapist
• Commencement of the exercises
1 month prior to the operation
• Detailed information to the
patient and their family,
expectation management
Post-operation
• Exit of the hospital 1-2 days after
the operation
• Commencement of exercises 2
weeks after the operation
• Radiological assessment at 1,3
and 6 months
• Continuation of the exercises for
at least 6 months
• Detailed information to the
patient and their family about the
results of the treatment
• Long follow-up
Treatment protocol
12. Pre-operation
• Commencement 1 month prior to the
operation, (3-4 sessions)
• Expectation management, body
awareness, principles of correction,
main goals of treatment
• Improvement of spinal mobility and
flexibility by manual therapy
techniques, massage and exercises
• Teaching of the 5 basic ApiFix
exercises
Post-operation
• 2 weeks - 8 weeks, (6 sessions) :
- Relief of post-operative pain and
stiffness
- ApiFix exercises
• 8 weeks – 6 months, (6 sessions) :
- ApiFix exercises
- Auto-correction exercises based on
Schroth method and Barcelona
Scoliosis Physical Therapy School
(BSPTS) principles, which consist a
holistic approach to treat the whole
spine in AIS, and stabilize the result
Physiotherapeutic Scoliosis Specific Exercises (PSSE)
13. 5 basic ApiFix exercises
1 2 3
4 5
These 5 exercises are applied only for the purpose to expand the device, they are designed
only for thoracic curves and do not consist a holistic approach to treat scoliosis.
The ApiFix exercises developed by Dror Levi and Lior Neuhaus Sulam.
14. Schroth method
Goals of treatment by Schroth method:
• Personalized exercises based on the curvature
type (Physiotherapeutic Scoliosis Specific
Exercises-PSSE)
• 3D auto-correction of scoliosis and active self
elongation
• Angle Trunk Rotation (ATR) improvement and
prevention of flatback
• Activities of Daily Living (ADL ) training
• Improvement of Vital Capacity (VC) and
breathing function
• Improvement of posture and clinical
appearance
• Reduction or elimination of pain
• Improvement of spinal mobility and flexibility
• Reduction of mechanical forces that promote
progression
The exercises are prescribed only by
Schroth Certified Therapists
15. 6m post op1m post oppre op
Case study 1
Cobb 45ο Cobb 23ο Cobb 19ο
19. Follow up Pre-Op Post-Op 12 weeks
Cobb
angle
47 33 30
Case study 4
Age 15
Risser 2
Sex F
20. Case study 4
Spinal flexibility is maintained
after the operation
Gradual expansion of the ApiFix
mechanism after exercises
21. Pre-op
Th (R) 54ο – Lu (L) 44ο
Immediately after operation
Th (R) 30ο – Lu (L) 33ο
1 month after
operation (before
starting exercises)
Th (R) 37ο – Lu (L) 39ο
3 months after Schroth
exercises
Th (R) 35ο – Lu (L) 39ο
Case study 5
Age 14
Risser 0
Sex F
23. Before exercises 3 months after exercises
Case study 5
Sagittal plane improvement 3 months after Schroth exercises
24. Before exercises 3 months after exercises
Case study 5
Improvement of clinical appearance, ATR, shoulder and pelvic asymmetries 3
months after Schroth exercises
25. • Benefits from Schroth method after the ApiFix operation:
- Halt progression of scoliosis, even after the marked progression the first month
after operation and before starting the exercises
- Further opening of the device
- Thoracic Cobb angle improvement from 37ο to 35ο
- Halt progression of the lumbar curvature
- Remarkable improvement of posture, with better symmetry for shoulders and
pelvis
- Slight improvement of ATR, 14ο to 13ο for the thoracic curve, and 9ο to 7ο for the
lumbar curve
- Sagittal plane improvement, with more harmonic kyphosis and lordosis
- Pain elimination
- Psychological improvement
- Improved breathing function and VC
- ADL training
Case study 5
26. • Difficulties faced during treatment with Schroth method:
- No indication for treatment, double major scoliosis, Lenke type 3
- No slight or moderate rotation (ATR 14ο – 9ο )
- Delayed commencement of exercises (4 weeks after operation)
- Not flexible curvature
- Progression of both curves, thoracic and lumbar, 1 month after
operation
- Risser 0, pre-menarche when starting exercises, so the risk for
proggression was higher
- Lack of trust for the result of the treatment by the family
environment
Case study 5
27. Pre-operation
Lu (L) 36ο
After operation
Lu (L) 22ο
Case study 6
6 months after Schroth exercises
Lu (L) 18ο
Age 19
Risser 5
Sex F
Cobb angle improvement and better balance for
shoulders and pelvis 6 months after Schroth exercises
29. • Benefits from Schroth method after ApiFix operation:
- Cobb angle improvement from 22ο to 18ο
- Further opening of the device
- Significant improvement of posture and better balance for shoulders and pelvis
- Significant improvement of Kyphotic angle from 57ο to 49ο
- Better clinical appearance and psychological support
- Activities of Daily Living (ADL) training
- Pain elimination
• Difficulties faced :
- No indication for ApiFix, Lumbar Scoliosis
- Delayed commencement of exercises, 4 weeks post-operation
- Low compliance with exercises for the first 3 months
- No chance to perform side-bending exercises to open the device
Case study 6
30. Conclusions- Recommendations
• The main goal of treatment with ApiFix is to bring the scoliosis into
the “safe zone”, below 35ο ,and avoid progression in adult life
• The treatment targets to ensure a good quality of life for the
patient, without movement restrictions and pain, and posture
improvement
• It is crucial to follow the indications for ApiFix treatment, because it
is not applied for every type of scoliosis
• The exercise program must be designed exclusively by a Certified
Schroth Therapist, who is a specialist in scoliosis treatment
• Exercises must start before the operation according with the clinical
assessment, in order to improve the final result of treatment
• A long follow-up is required to state the long-term results and there
is an imperative need for good quality research to present the
effect of ApiFix treatment
31. THANK YOU
NIKOS KARAVIDAS, MSc, PT
Physiotherapist
Certified Schroth Therapist
Certified SEAS Therapist
McKenzie Therapist