Synapse SPRING 2000 - acpin

SYNAPSE ● SPRING 2000ADVERTISEMENTdeliver what the title promised.I am sure that all the delegateswould join me in a bigthank you to all the committeemembers of ACPIN for all theirhard work and planning – itcertainly paid off! Of course,the standard is set now –you’ve got a lot to live up toACPIN!ABSTRACTS &LECTURE NOTES■C PLASTICITY OF THENERVOUS SYSTEM ANDTHE FUTURE OF NEURO-PHYSIOTHERAPYProfessor Raymond TallisThere is increasing evidencethat rehabilitation is effectivefollowing stroke. Manypatients, however, still remainsignificantly disabled. The artof stroke rehabilitation is,therefore, relatively undevelopedas a science. We have noclear idea of the elements ofthe rehabilitation package thatbring about the benefits thatare seen and even less evidenceabout the respectivemerits of the particular techniquesof remedial therapy.Many of these have anywaygrown up as a result of customand practice rather than beingfully grounded in what isknown about the damagedbrain and ways in whichrecovery might be promoted.The talk will focus on waysin which stroke rehabilitationin future may be made moreeffective. Several strategieswill be considered but the mainemphasis will be on reversingimpairments, either by buildingon elements of current techniquesidentified by rigorousstudies as effective or, andmore importantly, by developingnew techniques designedto drive neuroplasticity.Current understanding aboutthe ability of the brain to reorganisein response to damageand, more widely, the ability ofexcitable tissue (brain, nerve,muscle) to respond to externalstimuli in ways that may beuseful for neurological rehabilitationwill be discussed. Thecentral role of appropriateafferent information inenhancing desirable plasticchanges and inhibiting maladaptiveones will be discussedand their application illustratedwith examples. Thevalue of using simpler modelssuch as the reversal of musclewasting will be emphasisedand examples will also be givenof the process of driving plasticityin the cerebral cortex.The huge effort that will berequired to bring neurotherapyclose to neuroscience hasimplications for the organisationof research. These, too,will be discussed. As stroketherapy becomes more scientific,other elements of humanecare will not become lessimportant. Just as an appeal to‘holism’ should not be used tojustify an unscientific,approach to therapy, theadvent of scientific treatmentsshould not excuse forgettingholistic care.Professor Tallis is Professor ofGeriatric Medicine at theUniversity of Manchester andan Honorary ConsultantPhysician in Geriatric Medicinewith Salford Royal HospitalsNHS Trust. He is the author ofover 150 medical publications,but has also published andbroadcast extensively on nonmedicaltopics. He wasawarded an Honorary Doctorateof Letters for his contributionsto literature and philosophy in1997.■C THE ROLE OFCENTRAL PATTERNGENERATORS INWALKINGDr Pam Evans BA, MCSP, Dip TPThe presence of spinal centrescapable of independently generatinglocomotion was firstdemonstrated in cats in 1947.Much of the early work whichfollowed was concerned withexamining the autonomy andthe flexibility of these ‘centralpattern generators’ (CPGs) indifferent species.With the growth in understandingof the cellularmechanisms underlying biologicalfunction came furtheropportunities to investigatehow the generators mightwork. It became possible tostudy the circuitry of CPGs ofsimple animals and to identifythe behaviour of individualcells within them. Currentlyevidence indicates that thecyclical patterns of locomotionare usually produced byintrinsic characteristics ofpacemaker cells, but that thispattern is reinforced by the circuitryof the network. Suchlayers of reinforcement ensurethe remarkable functional reliabilityof CPGs.Efforts to understand thecomplex networks which makeup mammalian CPGs have concentratedupon theinteractions between the generatornetworks and signalsboth from sensory receptorsand from the locomotor centresin the brain. In recent yearssuch studies have revealed thatCPGs have close, two-way relationshipswith the braincentres and also with thespinal pathways which mediatesensory input and motoractivity. The first reports ofisolated CPG activity in humansfollowing the success of our programme at the 1999 Congress,ACPIN have put together another exciting programme to expandour knowledge both of the CNS and treatment concepts inneurophysiotherapy. We are delighted to have the support of such awide variety of speakers, covering such a range of topics.The conference will again combine concurrent SIG programmes,discussion times and social events. Sir Ranulph Fiennes is the keynotespeaker for the congress and there will again be a large tradeexhibition.ACPIN have organised a buffet supper at the Novotel Hotel, and atonly £10 per head (including a glass of wine) come along, relax anddiscuss the major points of the day!Friday 20th October14.00WelcomeLinzie BassettChair of ACPIN14.05Adaptation of nerve, muscleand soft tissue toImmobilisationProfessor Goldspink15.00Tea15.30The Application of FunctionalElectrical Stimulation (FES)Dr Jane Burridge MCSP16.15-17.00 Neurodynamics-Effect in the NeurologicallyImpaired PatientAnita Wade MCSPSaturday 21st October10.30Coffee11.00The Holistic Approach toAlignmentPatty Shelley MCSPSenior Bobath Tutor11.45-12.30Mulligan Concept: Stability orMobilityAnnette Bishop MCSP16.15-17.30Acupuncture in NeurologicalConditionsVal Hopwood MSc, MCSPThis lecture is jointly supportedby AACP & ACPIN19.30ACPIN Buffet Supper at theNovotel HotelSunday 22nd October9.30Muscle Imbalance in Relationto the Neurologically ImpairedPatient.Dave Fitzgerald Dip Eng,MISCP, MCSP, Grad Dip ManipTher.10.15The Forgotten AutonomicNervous SystemPatty Shelley MCSPSenior Bobath Tutor11.00Coffee11.30The Bobath Concept TodayDr Margaret Mayston, PhD,MCSPDirector of the Bobath Centre12.30CloseLinzie BassettChair ACPIN24