2009 APA Conference Week Abstracts - Australian Physiotherapy ...

Aquatic Physiotherapy Group
2
What’s different about my sport:
swimming?
Blanch P
Australian Institute of Sport
Swimming fast has come under intense public scrutiny in
the last few months. There seems to be a public feeling that
if we could all put on the ‘super suits’ we would all be able
to move like a dolphin. Certainly the reduction of drag is an
important concept in swimming fast but there is more to it
than putting on a suit. The concepts of moving fast through
water, the musculoskeletal requirements and costs will be
discussed.
Measuring the outcome of aquatic physiotherapy
interventions with persistent pain patients
Daly AE
Persistent Pain Service, Austin Health, Melbourne.
Aquatic physiotherapists and their persistent pain patients
know that the aquatic environment impacts positively on
pain, stiffness, function and exercise ability. Yet many studies
fail to find a significant effect from aquatic interventions.
This presentation will touch briefly on some of the possible
reasons for this lack of demonstrated effect and suggest
possible solutions. Various forms of outcome measurement
will be presented and the benefits and drawbacks of each
will be discussed. Delegates will gain knowledge about
combining different types of outcome measurement and
be able to access and utilise the majority in their clinical
practice immediately.
Successful management of the persistent pain patient
in the aquatic environment
Daly AE
Persistent Pain Service, Austin Health, Melbourne.
Persistent pain is a common problem encountered by
aquatic physiotherapists. Many clinicians question their own
abilities to manage this challenging condition optimally.
This presentation will discuss the model of care within the
interdisciplinary pain service at Austin Health, Melbourne,
with particular consideration of our utilisation of the aquatic
environment. The consequences of persistent pain for the
patient will be discussed and an alternative to the common
paradigm of acute pain management will be presented.
The challenges faced by the aquatic physiotherapist will
be presented as will solutions and management strategies.
Delegates will gain knowledge about the management of
persistent pain that can be put into practice immediately.
Greater trochanteric pain syndrome: fat, female and
over forty. Fact or fiction?
Fearon AM, 1,2 Scarvell JM, 1,2 Cook JL, 3 Smith PN 1,2
1
The Australian National University, Canberra. 2 The Trauma
and Orthopaedics Research Unit, Canberra. 3 Deakin University,
Melbourne.
The aim of this research was to clarify the demographic and
body type profile, and the signs and symptoms of people with
Greater Trochanteric Pain Syndrome (gluteal tendinopathy,
Trochanteric bursitis). Thirty-two participants who fitted the
inclusion criteria and 20 age and sex matched asymptomatic
control participants were recruited. GTPS was diagnosed
clinically and confirmed by imaging. Participants were
assessed using the Oswestry Disability Index, the Harris
Hip Score and a purpose built questionnaire. A battery of
clinical tests including BMI, hip joint range of movement,
hip muscle strength using a hand held dynamometer,
Trendelenburg’s sign, step up and hip hitch tests, timed
up and go, and ten metre walk test were undertaken. The
demographic and body type results will be presented in the
light of existing research. The sensitivity and specificity of
the clinical tests will be presented. This presentation will
provide clarification for clinical and differential diagnosis
in complex cases.
Hydrotherapy for osteoarthritis of the hip or knee:
review of randomised clinical trials
Fransen M
The University of Sydney, Sydney
Osteoarthritis of the hips or knees is associated with poor
lower limb muscle strength and function. In addition,
many older people with osteoarthritis of the hips or knees
are overweight and sedentary, greatly increasing the risk
of various serious co-morbidities. However, participating
in regular land-based physical activity programs is often
experienced as exacerbating joint pain, leading to poor
adherence and therefore non-responsiveness in terms of
symptomatic benefits. While there is a high level of evidence
for the symptomatic effectiveness of land-based exercise
programs for most people with osteoarthritis of the knee,
there is very limited evidence for the benefits for people with
osteoarthritis of the hips. The results of a recently conducted
systematic review of randomised clinical trials evaluating
hydrotherapy programs for people with osteoarthritis of
the hips or knees will be presented. These results will be
compared with results from systematic reviews evaluating
land-based programs. The possible rationale for conflicting
or contrasting findings will be discussed.
Higher intensity aquatic physiotherapy for
compensable patients with musculoskeletal injury and
chronic pain: a study of two comparative cases
Geytenbeek JM
Roberts Physiotherapy, Adelaide
Water-based exercise is intuitively regarded as a treatment
of gentle intensity with low likelihood of aggravating
patient pain for application in the management of chronic
musculoskeletal injury. However, the greater volume
of research evidence supporting the use of water-based
exercise has investigated arthritic populations undergoing
group-prescribed exercise. More recently, researchers
have documented exercise intensity, aiding clinicians
in transferring the measured results of researchers into
repeatable clinical practice. The complexity of compensable
injury with several issues potentially mitigating measurable
outcome-effectiveness attributable to a discrete therapeutic
approach among a multitude of co-interventions, has
probably posed a disincentive to the investigation of this
relevant, highly prevalent and costly, therapeutic population.
Two clinical cases of patients with chronic musculoskeletal
compensable injury are presented to demonstrate the
reasoning behind and application of higher intensity
aquatic physiotherapy in an environment of kinesiophobia
The e-AJP Vol 55: 4, Supplement