© 2008 Foundation of Rehabilitation Information. ISSN 1650-1977 J Rehabil Med 2010; Suppl 48: 1–204
ABStrActS
Second
Asia–Oceanian conference of
Physical and rehabilitation Medicine
APril 29–MAy 2, 2010, tAiPei
WELCOME TO TAIPEI
Dear Colleagues,
On behalf of the Organizing Committee, it is our greatest honor to have you here in Taipei to attend the 2
ndAsia-Oceanian Conference of Physical and Rehabilitation Medicine (2
ndAOCPRM). The conference will be held from April
29
thto May 2
ndof 2010 in the Taipei International Convention Center.
The theme of our conference is “Rehabilitation: “From Cell to Society”. We have invited reputable speakers from
all over the globe to cover the hottest topics in modern physical and rehabilitation medicine. Numerous workshops
will be organized to offer hands on practice in soft tissue ultrasound examinations, shockwave therapy, and in the
fabrication of ankle-foot-orthosis.
As you may know, Taipei is famous for its inexpensive but high quality electronic products, and the adventurous
night markets. Taipei is also well known for its 101 building, one of the world’s renowned skyscrapers. Therefore, I
strongly advise you to take the opportunity to tour around Taipei and experience the unique fusion of Chinese - Western
cultural lifestyle that Taipei has to offer.
If you need any further assistance from us, please do not hesitate to let us know. It is our obligation to ensure that
your stay in Taipei will be an enjoyable one. Thank you very much!
Sincerely yours,
Simon FT Tang
Chairman of the Organizing Committee
ThurSday, april 29, 2010
09.00–17.00ESPRM-AOSPRM Collaborative Program of ICF – International Classification of Functioning, Disability and Health
Implementation of ICF in Rehabilitation Medicine from the ISPRM Perspective Gerold Stucki
Measurement Tools Alarcos Cieza
Overview and Updates on ICF Core Set Development Alarcos Cieza
ICF-based Strategy for Return-to-work after Medical Rehabilitation Christoph Gutenbrunner The Study of ICF Core-set Validation in Twelve Diseases in China Tao Xu ICF and the Evaluation of Persons with Walking Abnormalities in Clinical Settings Alain Delarque
The European Experience of Using ICF in Research Alarcos Cieza
Asian-European Interaction: ICF and AOCPRM-ESPRM Cooperation Alessandro Giustini
Friday, april 30, 2010
08.30–10.00
Keynote Speech
The Philosophy of Rehabilitation, from Cell to Society Gerold Stucki KS 01-01
Complex Regional Pain Syndrome (CRPS): Evaluation and Treatment Martin Grabois KS 01-02
10.30–17.00
Musculoskeletal Disoders: Musculoskeletal Ultrasonography
Role of Elastography in Neuromusculoskeletal Ultrasound Gi-Young Park 0430A1
Elastography of Plantar Soft Tissue Properties Chih-Chin Hsu 0430A2
Application of Ultrasound in Sports Injuries Yi-Pin Chiang 0430A3
Non-invasive Measurement of Vessels Mechanical Properties Yio-Wha Shau 0430A4
Rehabilitation Potentials Following Foot Drop Among Leprosy Cured Patients Ajit Kumar Varma 0430E1FP
The Prevalence of Musculoskeletal Disorders in the Textile Occupation, Thailand Petcharat Keawduangdee 0430E2FP Functional Outcomes of Major Lower Limb Amputation 1994–2006: A Modern Series Jane Wu 0430E3FP
Effects of Disc Degeneration and Muscle Dysfunction on the Cervical Spine Stability: From in
Vitro Study Using Porcine Model Chih-Hsiu Cheng 0430E4FP
Nitric Oxide Concentrations in CSF are Possible Predictors of Postoperative ADL Improvement in
Lumbar Canal Stenosis Shinji Kimura 0430E5FP
Paradigm Shift in the Management of Back Pain M. Taslim Uddin 0430E6FP
Effect of Taping for Patients with Lateral Epicondylitis and Motion Tracking on Elbow Tissue
from Ultrasonic Image Sequence Pei-Chun Hsieh 0430E7FP
Ultrasound-guided Injection Therapy for Frozen Shoulder Sheng Bi 0430E8FP
Comparison of Elastography and Gray-scale Ultrasonography in Diagnosing Small
Full-thick-ness Supraspinatus Tendon Tear Giyoung Park 0430E9FP
15.30–17.00
Interventional Rehabilitation
An interventional PM&R Approach to Spinal Pain: Evidence-based Approach and Beyond David Cifu 0430J1
Ultrasound Diagnosis and New Treatment in Adhesive Capsulitis (Frozen Shoulder) Gi-Young Park 0430J2
Ultrasound Guided Injection Treatments in Rehabilitation Medicine Carl PC Chen 0430J3
New Advances in Therapeutic Ultrasound Wen-Shiang Chen 0430J4
Extracorpal Shock Wave Therapy on Rehabilitation of Tendinopathy Mao-Hsiung Huang 0430J5
The Science of Intravascular Laser Irradiation of Blood (ILIB) and Its Applications Tien-Yow Chuang 0430J6
10.30–12.00
Brain Disoders: Traumatic Brain Injury
Event-related Potentials and Dual Sensory Impairment (DSI) in TBI Henry Lew 0430B1
3
Neuroprotection Strategies in Experimental Traumatic Brain Injury Szu-Fu Chen 0430B3
Effect of Noise on Retention and Transfer of a Spatial Memory Task in Unequal Context in
Male Rats: A Behavioral Review Mohammad Ali Gheraat 0430B4FP
Effect of Hyperbaric Oxygenation (HBO) on Unilateral Spatial Neglect (USN) Induced by
Traumatic Brain Injury Jinglong Liu 0430B5FP
Analysis of Influence Factors of Cognitive Impairment Following First Onset of Stroke Xiquan Hu 0430B6FP
13.30–15.00
Brain Disorders: Neural Plasticity & Cognition
Cognitive Component of Tai Chi Chuan: A fMRI Study Chetwyn Chan 0430F1
How Valid is the Broken Mirror Theory of Autism Ya-Wei Cheng 0430F2
Cognitive and Neuroimage Assessment and Human Cognitive Rehabilitation Yuejia Luo 0430F3
Representation of Tactile Motion in the Primary Somatosensory Cortex: A Psychophysical and
Neurophysiological Study Yu-Cheng Pei 0430F4
Reveal the Neural Mechanism and the Property of Pure Alexia for Chinese Characters by
Us-ing NeuroimagUs-ing Techniques and Cognitive Neuropsychological Tests Chunlei Shan 0430F5FP
The Effects of Basal Ganglia Stroke on Implicit Learning Zhongli Jiang 0430F6FP
Cognitive Flexibility in Children with Learning Disability H.S. Somashekara 0430F7FP
15.30–16.00
Development of Physical and Rehabilitation Medicine in Aisan and Oceanian Region
Development of Physical and Rehabilitation Medicine in Taiwan Simon Fuk-Tan Tang 0430K1
The Development of Rehabilitation Medicine in the Philippines: Our Work, Mission and Vision Reynaldo Rey Matias 0430K2
Development of Physical and Rehabilitation Medicine in Mongolia Baljinnyam Avirmed 0430K3
History of Development of ISPRM: Review of the Challenges John Melvin 0430K4
10.30–17.00
Brain Disorders: Stroke
Depression and Anxiety in the Hemiplegic Jorge Lains 0430C1
Mirror Neuron System in the Pre-motor Cortical Area: A RCT in the Post-acute Stroke Arm
Rehabilitation. Preliminary Report Marco Franceschini 0430C2
Effectiveness of Ultrasound Guided Botox Injection on Balance in Post-stroke Patients with
Lower Extremities Spasticity Zulin Dou 0430C3
Massage Therapy in Depressed People: A Meta-Analysis of Clinical Trials Wen-Hsuan Hou 0430C4
Power Rehabilitation, Principle and Method Tkahito Takeuchi 0430G1
Functional Electrical Stimulation Improves Functional Recovery of the Upper Extremity of
Subjects with Acute Stroke: A 6 Months Follow-up Study Tiebin Yan 0430G2
Evidence-based Stroke Rehabilitation? Keh-Chung Lin 0430G3
Facilitating Motor Performance Through External Cueing for People with Parkinson’s Disease Hui-Ing Ma 0430G4
Physical Findings, Sonography and Shoulder Pain of Hemiplegic Shoulders in Acute Stroke
Patients during Rehabilitation Yu-Chi Huang 0430G5
Effects of Motion Control Shoe on the Kinematic, Kinetic and Motor Control of the Leg During
Running Gabriel Y.F. Ng 0430L1
The Role of Imagery in Constraint-induced Movement Therapy Karen Liu 0430L2
Use of Proprioceptive Stimulation in Stroke Rehabilitation Sang-I Lin 0430L3
Cortical Reorganization Induced by Body Weight-supported Treadmill Training in Individuals
with Stroke Ray-Yau Wang 0430L4
Integrity of the Corticospinal Tract Predicts Motor Recovery in Stroke: Diffusion Spectrum
Imaging Studies Pei-Fang Tang 0430L5
Telerehabilitation in Subjects with Subacute Stroke Kwan-Hwa Lin 0430L6
Effects of Sit-Stand-Sit Strategies on Postural Stability in Stroke Patients Ta-Sen Wei 0430D1
Robotic-assisted Therapy of Paretic Upper Limb for Chronic Stroke Pai-Yin Chen 0430D2FP
Correlation Factors of the Health-related Quality of Life in Patients with Chronic Aphasia Due
to Stroke Lochia Chang 0430D3FP
Correlation of Stroke-onset Severity with Health Status, Quality of Life and Family Impact in
Patients with Ischemic Stroke Ru-Lan Hsieh 0430D4FP
Comparison of Intramuscular Botulinum Toxin Type A Injection and Percutaneous Muscular Branch Block of the Tibial Nerve for Reducing Ankle Plantarflexor Spastcitiy: A Randomized Clinical Trial
That Using Computer Exercise Upper Limb of the Ischemic Stroke Patients Observe the
Changes of Brain Functional Magnetic Resonance Imaging Jin Chen 0430D6FP
The Effect of Rehabilitative Training on Brain Functional Reorganization in Patients with
Cerebral Infarction by fMrI: A Longitudinal Study Xiquan Hu 0430D7FP
13.30–17.00
Cardiopulmonary Rehabilitation and Obesity
Schedule of Cardiac Rehabilitation Farzaneh Torkan 0430H1
Exercise Prescription and Thrombogenesis Jong Shyan Wang 0430H2
Benefits of Phase 2 Cardiac Rehabilitation in Patients with Myocardial Infarction Ssu-Yuan Chen 0430H3
CARES THAI Actions: Preventive and Rehabilitative Program for Cardiac and High Risk
Factors Patients Piyanuj Ruckpanich 0430H4
To Facilitate Return to Work Through Cardiac Rehabilitation Leonard S.W. Li 0430H5
Phase 2 Cardiac Rehabilitation Improves Aerobic Capacity of Heart Transplantation
Recipi-ents at One Year After Surgery Ssu-Yuan Chen 0430M1FP
Study of Physiological Ischemic Exercise Training on Circulating Epcs and Neovasculation in
Pathological Myocardial Ischemia Animals in Vivo Chun-Xiao Wan 0430M2FP
Electrical Stimulation in Patients with Severe Chronic Heart Failure. Masahiro Kohzuki 0430M3FP
The Effects of Phase 2 Cardiac Rehabilitation Program on Health-related Quality of Life
Among Heart Transplantation Recipients Chen-Jung Hsu 0430M4FP
The Effect of Isometric Exercise on Human Coronary Collateral Function During Acute
Coro-nary Occlusions Xiao Lu 0430M5FP
Is Horseback Riding More Effecitve Than Horse Riding Robot for Physical Exercise?: Heart
Rate Monitoring, Caloric Consumption, 2D Motion Analysis and Surface EMG Monitoring Naohisa Kikuchi 0430M6FP Effectiveness of Breathemax Breathing Device on Airway Secretion Clearance in Patients
Dependent on Mechanical Ventilation Sujittra Kluayhomthong 0430M7FP
Effect of Phase Ii Cardiac Rehabilitation After Coronary Artery Bypass Graft: A Comparison
of Quality of Life, Peak V 2 and Functional Aerobic Impairment. Po-Chin Strong 0430M8FP Nos-3 Effected on the Pulmonary Arterial Pressure and Alleviated the Pulmonary Small
Arte-rial Remodeling in Chronic Hypoxic Hypercapnic Rats by Kallikrein Xiaotong Wang 0430M9FP
13.30–17.00
Cross-Strait Session
Development of Rehabilitation Services for Child Cerebral Palsy in China Xiaojie Li 0430I1
Neural Function Information Detection and Rehabilitation Engineering Jue Wang 0430I2
The Theory and Approach of Disability Classification and Evaluation Based on ICF model Zhuoying Qiu 0430I3
Analyses of Clinical Assessment of Unilateral Neglect after Stroke Weiqun Song 0430I4
Applied Research of Exercise Therapy in Complications of Diabetes Zhongli Jiang 0430I5
The Effects of Angelica Sinensis Injection on the Neuronal Metabolites and Blood Flow Speed
within Reperfusion Following the Ischemic Cerebral Injury in Rats Wei-Jing Liao 0430I6 Mental Health Status of the Parents of Cerebral Palsy Children and its Relationship with
Personality Traits Zhihai Lu 0430N1FP
CCK-8 Prevents Glutamate-Induced Apoptosis in Cultured Cortical Neurons Via
Up-regula-tion of Bcl-2/Bax Ratio and Down-RegulaUp-regula-tion of Caspase-3 Jiangbao Zhou 0430N2FP
Protective Effect of BDNF to Newborn Rats with Hypoxie-ischemic Brain Damage Jiangbao Zhou 0430N3FP
Morphine Preconditioning Induces Delayed Neuroprotection Against Glutamate-Induced
Excitotoxicity Qing Shang 0430N4FP
Clinical Comparative Study on Acupuncture and Swallowing Trainning for Treating
Dysphag-ic Patients with Stroke Pande Zhang 0430N5FP
Application of Network Thinking and Network Analysis on Meridian Researches Feng Lin 0430N6FP
Postischemic Wheel Running Increased Neurogenesis in the Subventricular Zone of Adult
Rats With Local Cerebral Infarction Xiquan Hu 0430N7FP
Study on Auditory Semantic Priming Effects in Aphasia Patients Zhongli Jiang 0430N8FP
Dysfunction of the Mitochondria in the Cerebrum of Mice Induced by Chronic Hypoxic
Hy-percapnia Xiaotong Wang 0430N9FP
Study on the Therapeutic Effects of Chinese Traditional Manipulation Combined with
5
SaTurday, may 1, 2010
08.30–10.00
Keynote Speech
Postural Motor Control: What We Learned from Animal Model and Its Relevance for Human Tatian Deliagina KS 02-01
Application of rTMS and tDCS in Rehabilitation after Brain Damage Yung-Zu Huang
John Rothwell KS 02-02
10.30–17.00
Brain Disorders: Sensory-Motor Control
Biophysics of Assessment of Human Motor Control by Surface Polyelectromyography Art Sherwood 0501A1
Motor Control Modification in Humans after SCI Barry McKay 0501A2
Correlation of Motor Control in the Supine Position and Assistive Device Used for
Ambula-tion in Chronic Incomplete Spinal Cord-injured Persons Simon Fuk-Tan Tang 0501A3
Neurophysiology of the Human Spinal Cord Tested by Lumbosacral Evoked Potentials, the
H reflex and Posterior Root-muscle Reflexes Karen Minassian 0501A4
Human Neural Control of Posture: Modifications of Lumbar Posterior Root-muscle Reflexes Ursula Hofstoetter 0501D1
Neuroimaging Assessment of Human Spinal Cord White and Grey Matter Spyros Kolias 0501D2
Transitory Human Paraplegia Vedran Deletis 0501D3
The Neurophysiology of Human Locomotor Training Keith E Tansey 0501D4
The Effect of Peripheral Nerve Lesion upon Postural Control Justin Bown 0501H1
Novel Access to the Human and Animal Locomotor Circuitry Yury Gerasimenko 0501H2
Transformation of Nonfunctional Spinal Circuits Into Functional and Adaptive States in
Para-lyzed Rats Gregoir Courtine 0501H3
Human Motor Control and Recovery of the Motor Functions after CNS Lesions Milan Dimitrijevic 0501H4
10.30–15.00
Spinal Cord Disorders
Acute Spinal Cord Injury: Advancements in Basic Science Research and Clinical Care Chi-Tsou Huang 0501B1
What We Learnt from Management of Spinal Cord Injury Post Sichuan Earthquake – 2 year
Experience Jianan Li 0501B2
Bowel Management in SCI patient: From Research to Real World. Apichana Kovindha 0501B3
Brindley’s Technique for the Treatment of Bladder Dysfunction Post Spinal Injury Injure Mou-Wang Zhou 0501B4
Neurogenic Bowel Dysfunction in Patients with Spinal Cord Injury Chin-Wei Liu 0501B5
The High-sensitivity C-reactive Protein in Patients with Chronic Spinal Cord Injury Chun-Chiang Huang 0501E1
International Perspectives of Spinal Cord Injury – Clinical Care Xianghu Xiong 0501E2
PET in Assessing Brain Plasticity among People with Spinal Cord Injury Yen-Ho Wang 0501E3
Effects of Electrical Stimulation of Pudendal Nerves on Bladder Voiding Function in the
Spinal Cord Injured Rat Yin-Tsong Lin 0501E4FP
Changes of Physical Abilities, Quality of Life, Incidences of Complications and Falls in
Pa-tients with Chronic Spinal Cord Injury 6 Months After Discharge: A Preliminary Study Jiraporn Wannapakhe 0501E5FP An Overview of the Stem Cells in the Management of Spinal Cord Injury Farooq Rathore 0501E6FP
A Initial Study on Brain fMRI of Spinal Cord Injury Patients Lijuan Ao 0501E7FP
The International Spinal Cord Injury Core Data Set: Experience of a Non-model System
Hospital Julia Patrick Engkasan 0501E8FP
Quantitative Analysis of Bladder Compliance in Subjects with Neurogenic Bladder Voiding
Dysfunction after Spinal Cord Injury Su-Ju Tsai 0501E9FP
15.30–17.00
Assessment, Evaluation and Diagnosis
Innovation in Assessing Balance Function in Patients with Stroke: A Set of
Functional-hierar-chy Short Forms and Computerized Adaptive Test Wen-Hsuan Hou 0501I1FP
Does Marathon Running Cause Chronic Degenerative Lesions of the Knee?: An
Influence of Chin-tuck Maneuver on Temporal and Kinematic Characteristics in Normal
Swal-lowing Ja-Ho Leigh 0501I3FP
New Portable System for Comprehensive Measurement of Spasticity Encompassing
Electro-physiologic, Kinematic and Biomechanical Aspects in Stroke Patients Jeong Hwan Seo 0501I4FP Technical Validity and Reliability of Objective Measurement in Swallowing Kinematic Analysis Seongmin Chun 0501I5FP
Functional Assessment of Balance in Early Stages of Multiple Sclerosis Raabeae Aryan 0501I6FP
Developing Who ICF Core Sets for Subacute Stage of Spinal Cord Injury in Taiwan Chin-Wen Wu 0501I7FP
The Prognostic Role of the Modified Rankin Scale on Survival in Patients with Stroke Hsi-Ting Chiu 0501I8FP
Early Changes of Knee Joint Movement in People with Knee Osteoarthritis During Gait; A
Motion Analytic Study with Point Cluster Technique Masami Akai 0501I9FP
10z30–12.00
Pain Management: Part 1
Rehabilitation of Muscle Injuries in Sports Walter Frontera 0501C1
Current Concepts in Musculoskeltal Pain, Mobility and Gender Mark Young 0501C2
Phantom Pain in Amputees Parviz Mojgani 0501C3
Acupuncture and Myofascial Trigger Points-human Study Li-Wei Chou 0501C4
Effect of Neuromuscular Blocking Agent on the Spontaneous Electrical Activity in a
Myofas-cial Trigger Spot of Rabbit Skeletal Muscle Shu-Min Chen 0501C5
13.30–15.00
Musculoskeletal: Osteoarthritis & Osteoporosis
Physical Exercise and the Osteocyte Osteogenic Response Jorge Lains 0501F1
The Role of Exercise in Osteoarthritis (OA) of the Knee Angela B.M.Tulaar 0501F2
Exercise to Maximize Peak Bone Mass and Minimize Bone Loss Sukajan Pongprapai 0501F3
Headache Due to C2 Sensory Radiculopathy Juan Mauel Guzman
Gonzalez 0501F4
Cercvical Radiculophy Induced Neck Pain Kamyar Akrami 0501F5
Management of Cericalgia in the Middle Aged Chih-Wei Chou 0501F6
15.30–17.00
Pain Management: Part 2
Current Advance in Myofascial Pain Chang-Zern Hong 0501J1
Diagnosis and Treatment for Myofascial Pain Syndrome of the Upper Back Muscles Baljinnyam Avirmed 0501J2
The Link Between Immobility and Microgravity Low Back Pain Reynaldo Rey Matias 0501J3
Approach to Mechanical Low Back Pain Ahmad Raeissadat 0501J4
Local Treatment of Myofasicl Pain: NSAID Patches Lin-Fen Hsieh 0501J5
Laser Treatment for Myofasicl Trigger Points Kai-Hua Chen 0501J6
13.30–15.00
Rehabilitation Technology and Engineering
Application of a Cycling Wheelchair to the Patients with Gait Disturbance Yasunobu Handa 0501G1
Functional Electrical Stimulation Cycling Exercise Shih-Ching Chen 0501G2
The Development of New Intelligent Comprehensive Interactive Care (ICIC) System for
Elderly Care Alice M.K. Wong 0501G3
Cortical Activation During Robot-aided Rehabilitation Futoshi Wada 0501G4
15.30–17.00
Prosthetic and Orthotics
Influence of the Level of Amputation on Survival Advantage and Functional Performance in
Elderly Amputees Takaaki Chin 0501K1
Lower-limb Prosthetics: Previous Research and Future Development Winson Lee 0501K2
The Effect of Rigid vs. Flexible Spinal Orthosis on the Clinical Efficacy and Acceptance of
the Patients with Adolescent Idiopathic Scoliosis Man Sang Wong 0501K3
Application of Ankle-foot Orthoses Following Stroke: Update and Future Chih-Kuang Chen 0501K4
Orthotic Management of Myelodysplasia Moon Suk Bang 0501K5
7
Sunday, may 2, 2010
08.30–10.00
Keynote Speech
Rehabilitation of Combat-Injured Polytrauma (TBI, Amputation and SCI): The U.S. Veterans
Health Administration Experience David Cifu KS 03-01
Recent Advancement and Management of Spasticity Anthony Ward KS 03-02
10.30–15.00
Brain Disorders: Spasticity
Severe Spasticity (ITB therapy) Zampolini Mauro 0502A1
Evaluating Functional Outcomes after the use of Botulinum Toxin for Spasticity Post Acquired
Brain Injury: An Australian Experience John Olver 0502A2
Botulinum Toxin and Intrathecal Baclofen: Concurrent or Sequential Therapies? Gerard Francisco 0502A3
The Application of Motor Control Assessment in Patients with Spasticity Simon Fuk-Tan Tang 0502A4
Treatment of Early Post-stroke Upper Limb Spasticity in Asian Patients: Results of a Prospective,
Multicentre, Randomized, Double-blind, Placebo-controlled Trial of Botulinum Toxin A Injection Kong Keng He 0502E1
Comprehensive Management of Spasticity in Cerebral Palsy Moon Suk Bang 0502E2
Neurophysiological Monitoring of Intrathecal Baclofen Delivery for Control of Spasticity Dobrivoje Stokic 0502E3
EMG Patterns Induced by Different Angular Velocity in Stroke Patients with Ankle Spasticity Ta-Sen Wei 0502E4
15.30–17.00
Rehabilitation Technology and Engineering,Geriatric Rebabilitation, Complementaray and Alternative Medicine
Application of Surface Eeg-Based Brain-Machine Interface (BMI) to Rehabilitation Practice Meigen Liu 0502I1FP Can Transcranial Direct Current Stimulation (TDCS) Modify the Resting-state Functional
Connectivity of the Motor Cortex?: A Proof of Concept FMRI Study Gad Alon 0502I2FP
Efficacy of a Computerized Assessment and Training System for Chronically Dizzy Patients Chung-Lan Kao 0502I3FP
Functional Electrical Stimulation to Dorsiflexors and Plantar Flexors During Gait to Improve
Walking in Adults with Chronic Hemiplegia Gad Alon 0502I4FP
The Effect of Newly-Designed Dynamic Cushion System on Deep Tissue of Human Buttock:
A 3D Finite Element Analysis Shih-Cherng Lin 0502I5FP
Intensive Training of Chronic Stroke on a Motorized Cycle Combined with Functional
Electri-cal Stimulation (FES): Effect on Locomotion Gad Alon 0502I6FP
Malnutrition and Rehabilitation Outcome of Disuse Syndrome: A Retrospective Cohort Study Hidetaka Wakabayashi 0502I7FP
Performance on Hornsby Disc Test Predicts Rehabilitation Potential in Cognitively Impaired
Elders Jan Yueh-Chen Hong 0502I8FP
Walking and Balance Performance in Exercise, Lifestyle Active and Inactive Elderly Thiwaporn
Thawee-wannakij 0502I9FP
10.30–12.00
Brain Disorders: Speech & Swallowing
New development in Dysphagia Evaluation Tai Ryoon Han 0502B1
Effects of Pneumatic Dilation on Cricopharyngeal Function in Patients with Achalasia Zulin Dou 0502B2
Evaluation and Management in Irradiated NPC Patients with Dysphagia Tyng-Guey Wang 0502B3
Speech and Language Problems in Preschool Children in Taiwan Pao-Chuan Torng 0502B4
Recent Trends and Tools in the Assessment of Aphasia in Taiwan Lu Lu 0502B5
Lingual Kinematics When Speaking at a Fast Rate in Dysarthric and Nondysarthric
Individu-als Post Stroke Yea-Tzy Chen 0502B6
13.30–15.00
Molecules Biology
The Effects of Ultrasound on Tendon Cells Wen-Chung Tsai 0502F1
Proteomic Research in Ageing and Rehabilitation Medicine Carl P.C. Chen 0502F2
The Effects of Physical Agents on Musculoskeletal Cells Chia-Hsin Chen 0502F3
Caveolin-1 Deficiency Reduces Early Brain Injury After Experimental Intracerebral
The Cross-talk Between Transforming Growth Factor-beta1 and Ultrasound-induced Matrix
Catabolism During Mechanotransduction of Rat Tenocytes Yuan-Hung Chao 0502F5FP
Living Muscle Tissues Imaging with Autofluorescence by Using Two Photon Laser Excitation
Microscopy (TPEM) Chien-Cheng Chen 0502F6FP
15.30–17.00
Education and Ethics in Rehabilitation
Evolving Medical Board Certification in the United States Joel A. DeLisa 0502J1
Strategies for Undergraduate Education in PRM John Melvin 0502J2
Submission and Publication of Scientific Articles in Rehabilitation Medicine Gunnar Grimby 0502J3
Title Missing Marta Imamura 0502J4
Education and Training of PM & R Professionals in Mainland China Dahong Zhuo 0502J5
Resident Training of PM & R in Taiwan Alice MK Wong 0502J6
Older People’s Acceptance of Falls Prevention Education Moreena Kwa 0502J7FP
Rehabilitation Doctors’ Attitudes Towards Ethics Issues Julia Patrick Engkasan 0502J8FP
10.30–12.00
Electrodiagnosis
Pitfalls and Pearls in Nerve Conduction Study and Needle EMG Shin J. Oh 0502C1
Peripheral Nervous System Electrophysiology: Reporting Procedures, and Pitfalls Gulseren Akyuz 0502C2
Post Polio: Etiology, Diagnosis and Treatment Gunnar Grimby 0502C3
Peripheral Nerve Electrodiagnosis in Rehabilitation Medicine Zongyao Wu 0502C4
On-nerve Needle Nerve Conduction Study: Histological Basis of NCS, Conversion Factor, and
Its Clinical Relevance Shin J. Oh 0502C5
13.30–15.00
Pain Management: Part 3
Pain Management Marta Imamura 0502G1
The Application of Surface Electromyography on Treating Lumbar Disc Herniation Jingsong Mu 0502G2FP
Effect of Sitting Postures on Lumbar Multifidus and Internal Oblique Fatigue Pattanasin
Areeudomwong 0502G3FP
Increased Both Contractile Subunit Protein Phosphorylation Signaling and Endplate Noise
Prevalence in Myofascial Trigger Spots of Rabbit Skeletal Muscle Ta-Shen Kuan 0502G4FP
Comparison of Mire and Traditional Physical Therapy for the Inhibition of the Irritability of
Myofascial Trigger Spot of Rabbit Skeletal Muscle Wei-Chih Lien 0502G5FP
The Characteristics of Polysomnographic Findings Among the Patients with Chronic Neck–
shoulder Pain Hung-Shen Chen 0502G6FP
The Immediate Effects of A Single Thoracic Manipulation on Cervical Range of Motion and
Pain in Patients with Chronic Mechanical Neck Pain: A Randomized Controlled Trial Thavatchai Suvarnnato 0502G7FP Intra-Articular Botulinum Neurotoxin Type a for Advanced Knee Osteoarthritis Chen-Liang Chou 0502G8FP
Occipital Nerve Stimulator Therapy for a Refractory Cervicogenic Headache Linqiu Zhou 0502G9FP
15.30–17.00
Pain Managemen: Part 4
Pictorial Guides to Myofascial Pain Yoon Kyoo Kang 0502K1
Various Interventions in Myofascial Pain Angela B.M.Tulaar 0502K2
Pathophysiology of Myofascial Trigger Point Ta-Shen Kuan 0502K3
Diagnostic Ultrasound to Myofascial Trigger Point and Taut Band Hsin-Shui Chen 0502K4
Three-dimensional Real Time Sonographic Morphologic Assessment of Human Myofascial
Pain During Needling: Demonstration of a Pilot Study Hung-Jih Hsu 0502K5
9
10.30–17.00
Pediatric Rehabilitation
GABAA Receptor Expression in Patients with Spastic Cerebral Palsy Chang-Il Park 0502D1
Longitudinal Studies on the Developmental Functions and Clinical Variables in Children Born
with Prematurity Suh-Fang Jeng 0502D2
Advances in Measurement Methods for Children with Developmental Delay in Taiwan Hua-Fang Liao 0502D3
Advances in the Application of Botulinum Toxin in Pediatric Rehabilitation Jeng-Yi Shieh 0502D4
Advances in Current Intervention for Children with Cerebral Palsy Chia-Ling Chen 0502D5
Footprint Measurements Analysis of the Flatfoot in Preschool Children Kun-Chung Chen 0502H1FP
A Clinical Research on Frontal Lobe Development During Infants and Young Children Period
with Quantitative Assessment of Cranial Mri and Early Detection of Cognitive Function Xiang Chen 0502H2FP Establishing Hypothetic Models Based on “International Classification of Functioning,
Dis-ability, and Health – Children and Youth Version“ (ICF-CY) In Infants and Toddlers with Motor Delays – with Maintaining a Body Position (D415) as the Motor Outcome
Ai-Wen Hwang 0502H3FP
Gene Expression Profiling in Congenital Muscular Torticollis Shin-Young Yim 0502H4FP
Characteristics of Children with Cerebral Palsy in South Korea In-Young Sung 0502H5FP
A Study of the Protection of Bdnf on Cortical Neurons Jiang-Bao Zhou 0502H6FP
The Effect of Therapeutic Exercise on Behavioral Performance in Children with Attention
Deficit Hyperactivity Disorder: A Systematic Review Chao-Chi Hong 0502H7FP
A Review on the Effect of Botulinum Toxin a Injection for Children with Cerebral Palsy Using
ICF for Goal Setting and Outcome Measure Nar-Chi Chan 0502H8FP
Functional Outcome of Acute Phase Rehabilitation by GMFCS And Disease Pattern
Classifi-cation for Pediatric Acute Encephalopathy Patients Kaoruko Takada 0502H9FP
Mirror Neurons, Empathy and Autism Ya-Wei Cheng 0502L1
Advances of Intraoperative Neurophysiologic Monitoring During Spinal Cord and Spinal
Surgery in Children Tsui-Fen Yang 0502L2
Speech and Language Intervention Program for Preschool Children in Taiwan Pao-Chuan Torng 0502L3
Development of Rehabilitation and Services of Child Cerebral Palsy in China Xiao-jie Li 0502L4FP
Prevalence and Associated Factors for Functional Articulation Disorders in
Mandarin-speak-ing Children of Taiwan Isabel Tou 0502L5FP
Practice Pattern Groups in the Pediatric Inpatient Physical Therapy Programs: Preliminary
Study Hsu-Fan Chang-Chien 0502L6FP
Systematic Review and Meta-analysis Of Horseback Riding Intervention on Gross Motor
Change in Children with Cerebral Palsy Hung-Chou Chen 0502L7FP
Group-based Physical Therapy Early Intervention for Infants with Developmental Delay: Two
0429WS4
IMPLEMENTATION OF ICF IN REHABILITATION MEDICINE FROM THE ISPRM PERSPECTIVE
Gerold Stucki1,2,3,4
1Department of Health Sciences and Health Policy, University of
Lucerne and SPF, 2Swiss Paraplegic Research (SPF),3ICF Research
Branch, WHO FIC CC Germany (DIMDI) at SPF (Switzerland) and
4IHRS, Ludwig Maximilian University (Germany)
The health sector employs four strategies: prevention, cure, support and rehabilitation. The International Classification of Functioning, Disability and Health (ICF) is the basis for the conceptualization of the rehabilitation strategy and is of relevance for curative, preven-tive and supporpreven-tive health strategies. The ICF and the ICF-based conceptualization of the rehabilitation strategy are again the basis for the organization of human functioning and rehabilitation re-search in distinct scientific fields and the development of rere-search capacity with respect to academic training programs, interdisci-plinary university centres and national/international collaboration networks. Along with these conceptual developments, there is a wide range of activities in the development of practice tools and applications of the ICF throughout the rehabilitation world. First of all, the ICF can serve as reference for the comparison, selection and further development of existing measures of human function-ing. The mapping of measures can now rely on established linkage rules. The development of minimal standards for the assessment and reporting of functioning based on the ICF as a reference has made progress over the last years in cooperation between ISPRM, the ICF Research Branch WHO CC FIC (DIMDI), and WHO. The Brief ICF Core Sets are the standards for reporting and planning of studies as well as for clinical encounters. The Comprehensive ICF Core Sets are the standards for multi-disciplinary assessments for example in the context of rehabilitation medicine. Another important development is the operationalization of ICF qualifiers as a means to directly applying the ICF in clinical practice and research. Under the leadership of the Functioning and Disability Reference Group (FDRG) of the WHO Family of International Classification (WHO-FIC) network, a task force is coordinating the further development of coding rules and specific measurements related to one ICF or more ICF categories.
0429WS4
GETTING TO KNOW ICF, MEASUREMENT TOOLS, OVERVIEW AND UPDATES ON ICF CORE SET DEVELOPMENT
alarcos Cieza
Institute for Health and Rehabilitation Sciences, Research Unit for Biopsychosocial Health (Germany)
Functioning and disability are key concepts in the practice of reha-bilitation medicine [8]. Thus, the implementation of approaches that describe, assess and evaluate functioning and disability of persons with health conditions in rehabilitation appears to be a priority and presumably will remain so for years to come.The International Clas-sification of Functioning, Disability and Health (ICF) [21], approved by all member states of the World Health Assembly in 2001, is the current agreed-on classification that contains the whole universe of meaningful units necessary to describe the experiences of people in relation to functioning, disability and health. These meaningful units contained in the ICF are called ICF categories and are the units of the classification.There are different challenges when applying the ICF in rehabilitation. One of them is the development of inter-national standards and methodological approaches to facilitate its implementation.The objective of the talks “Overview and updates
on ICF Core Set development” and “Measurement tools” is to present different approaches to address that challenge.The current state of the development of ICF Core Sets as well as their areas of use will be presented. The ICF Core Sets are international standards based on a sound, evidence-based and consensus-driven process involving experts from all over the world. ICF Core Sets have been developed for a number of specific health conditions. In addition, a Generic ICF Core Set that allows the comparison of functioning and disability across health conditions and health-care contexts and that can be applied in the general population is under development. It is also possible to develop measurement standards based on the ICF Core Sets. The corresponding methodological approach will be introduced. It has been developed based on Rasch analyses to identify those ICF categories of a determined ICF Core Set which differentiate among patients with different levels of functioning and disability and that, on the basis of which, a summary score can be created. Based on this methodology clinicians will not only rely on profiles of functioning, which are the starting point for planning treatment, but also on summary scores, which will allow them to estimate the overall level of functioning of patients, to monitor disease and rehabilitation management, and to follow patients along the continuum of care and over a life span. A new methodology developed to construct interval scales for specified ICF categories by integrating items from a variety of patient-oriented instruments will also be shown. This methodology allows the estimation of the value on the ICF qualifier, which is the reference rating scale proposed by WHO to rate the level of a problem in a determined ICF category. It represents a new development in how to measure single ICF categories in a sound way and provides the principles to use the ICF qualifier as a reference metric for instruments that are already used in clinical practice.
0429WS4
ICF-BASED STRATEGY FOR RETURN-TO-WORK AFTER MEDICAL REHABILITATION
Christoph Gutenbrunner
Department for Rehabilitation Medicine, Hannover Medical School (Germany)
purpose: Return-to-work rates after medical rehabilitation still are
unsatisfactory. Studies show, that they amount only around 55 and 75%. In order to increase return-to-work rates after rehabilitation model for appropriate measures has been developed based on the ICF-model and driven by results of the literature. Two of such strategies are evaluated in pilot studies. materials and methods: The literature has been reviewed in order to identify barriers for return-to-work after acute disease and in chronic conditions. Ad-ditionally studies aiming at an improvement of return-to-work after rehabilitation have been included. In a second step the identified factors were classified according to the dimensions of the ICF. Using the ICF-models strategies for new elements for rehabilitation inter-ventions were identified. Two of the strategies were implemented and evaluated in pilot studies. results: The most relevant barriers for return-to-work identified were psychosomatic comorbidities, lack of motivation and empowerment, insufficient coping strategies, payment of pensions during rehabilitation, lack of communication between rehabilitation an vocational doctors, and insufficient fo-cussing of rehabilitation measures on the requirements of the work place. They can be classified according to the ICF-model mainly as personal and environmental factors. Most important strategies have to overcome the gap between these contextual factors and rehabilitation measures. Two strategies result: the first one aiming at strengthening personal resources of the individual, the second on aiming at focussing all rehabilitation measures to the requirements at the work place including the linking of rehabilitation and occupa-tional activities. After implementing the first strategy in a German
11
Pre-conference workshop
rehabilitation centre, the motivation has been improve significantly compared to a control group. The second approach led to a signifi-cant reduction of sick-leaf days compared to a historical control.
Conclusion: Using a systematic approach based on results of the
literature and the ICF-model relevant strategies to increase return-to-work rates could be identified. The implementation of two of theses strategies already improved the situation. Based on the conceptual work further strategies should be derived and evaluated.
0429WS4
VALIDITY STUDY OF THE ICF CORE SET IN CHINA
Tao Xu1, Xiaolin huang1, Tiecheng Guo1, Tiebin yan2,
Guangxu Xu3, Tong Wang3, Xiquan hu4
1Tongji Hospital, Tongji Medical College, Huazhong University of
Science and Technology, 2Sun Yat-sen University, The Second
Af-filiated Hospital ,3The First Affiliated Hospital of Nanjin Medical
University and 4The Third Affilated Hospital of Sun YatSen
Uni-versity (China)
purpose: To study the validity of the ICF Core Set for 10 of 12
different health conditions in Chinese patients and to identify candidate categories for brief ICF Core Set to be used in China.
materials and methods: This study was a part of the ICF Core
Sets multicenter international validation study. It was conducted in 39 different countries and coordinated by the ICF research branch of the WHO collaborating centre for the Family of International Classifications at the Ludwig-Maximilians-University in Munich. This cross-sectional multicenter study involving 10 study centers in China with patients under 10 different health conditions includ-ing breast cancer, depression,diabetes mellitus, chronic ischaemic heart disease, low back pain, osteoarthritis, obesity, obstructive pulmonary diseases, stroke and osteoporosis. The comprehensive ICF Core Set of 10 different health conditions were filled in by health professionals. The patients reported their health- related qual-ity of life in the Medical Outcome Study Short Form 36 (SF-36), the Self-administered Comorbidity Questionnaire (SCQ, Sangha, 2003) and condition specific health-status measures such as heart disease health-related quality of life questionnaire (MACNEW) for CIHD patients. Descriptive statistics was used to describe the study population as well as to examine the frequency of patients’ problems in each specific health condition and to examine the fre-quency of patients problems in subsets including socio-economic factors (age, gender and other variables), disease characteristics (disease severity and activity), disease duration, comorbidities etc. Factor analysis and Spearman correlation were performed to test the validity of comprehensive ICF Core Set. The brief ICF Core Set for Chinese patients with CIHD and stroke were developed by using patients interview combined expert’s questionnaire investigation. Cronbach, Kendall’s W and Spearman correlation were used to test the reliability and validity of the brief ICF Core Set. All analysis was performed with SPSS 11.0 for Windows. results: 913 partici-pating Chinese patients under 10 different health conditions were recruited including 175 breast cancer, 48 depression , 215 diabetes mellitus, 74 chronic ischaemic heart disease, 31 low back pain, 56 osteoarthritis, 83 obesity, 72 obstructive pulmonary diseases, 129 stroke, 30 osteoporosis patients. Those health conditions with sam-ple size over 50 patients were selected for further statistics analysis. Thus the validity of the ICF Core Set for 7 health condition such as osteoarthritis were examined finally. The brief ICF Core Set for Chinese patients with CIHD and stroke have good reliability and validity, the categories of them showed considerable similarity to the previously proposed brief ICF core set. Some discriminatory categories could be elucidated socio-economic factors ( age , gender and other variables), disease characteristics (disease severity and activity), disease duration, and comorbidities, etc. Conclusion: The present study served as a contribution to the ongoing development of the Brief ICF Core Set for several health condition developed by the ICF research branch of WHO. An ultimate aim is to provide tools that can be applied to describe patients from all over world and that
can be used to compare the level of functioning and disability of the study populations across the studies. The present result should be compared to the results from other countries.
0429WS4
EVALUATION OF PATIENTS WITH GAIT
ABNORMALITIES IN PRM SETTINGS BASED ON ICF
alain delarque1, laurent Bensoussan1, Jean-michel
Viton1
1University Hospital of Marseille (France)
purpose: Assessment of patients with gait abnormalities in physical
and rehabilitation medicine settings. materials and methods: Clinical examination based on the International Classification of Functioning, Disabilities and Health. Body structure, activities and participation, and environmental factors (physical and human factors) must all be assessed. Qualitative and quantified assessments of gait are part of the activity and participation evaluation. Scales are also used to as-sess gait activities. results: Our programme leads to understand the underlying mechanisms and the aetiology of the disorders, to obtain quantified gait parameters, to define suitable therapeutic methods, and to follow the course of the disease. Conclusion: Clinical evaluation based on ICF leads to improving quality of life.
0429WS4
ICF AND AOCPRM–ESPRM COOPERATION
alessandro Giustini
Scientific Director Rehabilitation Hospital San Pancrazio (Italy)
To support and develop a truly international cooperation between Europe and Asia-Oceania in rehabilitation, agreeing on a common language and education are essential. Of course the individual socio-political cultural and financial circumstances in each region and country also play a role in developing such international cooperation, especially when national and international health policymakers are involved. The World Health Organisation’s ICF is an effective tool for representing various health conditions and disability. The ICF takes into account not only the bio-medical aspects of a health condition, but also the functioning of the individual and other factors. The ICF can also serve as the framework for policy and interventions. The international exchange of scientific information and experience about ICF application as well as a common ICF educational platform (not only for PMR doctors, but also for all rehabilitation professionals) are essential to facilitating the use ICF in rehabilitation. National and international societies (AOSPRM and ESPRM) and scientific events could be used as a vehicle for supporting international cooperation by providing the opportunity to exchange knowledge and experience. The ICF Workshop at the AOCPRM meeting in Taipei takes a big step toward achieving this endeavour.
0429WS4
GETTING TO KNOW ICF
melissa Selb
Swiss Paraplegic Research (Switzerland)
purpose: 1. To get to know the ICF model hands-on (with
exer-cises); 2. To acquire basic knowledge of ICF for applying in various settings. materials and methods: PowerPoint presentation and exercises (paper hand-outs) incl. paper copies of the ICF book.
Con-clusion: The ICF provides an effective framework for evaluating
patients in the rehab setting as well as for determining appropriate interventions. The ICF Training will address the following points: 1. Structure and framework of the ICF; 2. ICF categories and how to use them in describing patients (with exercise); 3. ICF qualifiers and how to use them in describing the extent/severity of functioning (with exercise); 4. Creating a categorical profile.
KS01-01
THE PHILOSOPHY OF REHABILITATION, FROM CELL TO SOCIETY
Gerold Stucki1,2,3,4
1Department of Health Sciences and Health Policy, University of
Lucerne and SPF, 2Swiss Paraplegic Research (SPF), 3ICF Research
Branch, WHO FIC CC Germany (DIMDI) at SPF (Switzerland) and 4Switzerland and at IHRS, Ludwig Maximilian University
(Germany)
With the International Classification of Functioning, Disability and Health (ICF) the World Health Organization (WHO) has prepared the ground for a comprehensive understanding of Human Func-tioning and Rehabilitation Research integrating the biomedical perspective on impairment with the social model of disability. This poses a number of old and new challenges regarding the enhancement of adequate research capacity. The approaches will be summarized to address these challenges with respect to three areas: the organization of Human Functioning and Rehabilitation Research into distinct scientific fields, the development of suitable academic training programs and the building of university centres and collaboration networks.
KS01-02
COMPLEX REGIONAL PAIN SYNDROME (CRPS): EVALUATION AND TREATMENT
martin Grabois
Physical Medicine and Rehabilitation, University of Texas Health Science Center, Houston (United States)
This topic is widely discussed and diagnosed. It is vital to un-derstand the pathophysiology of CRPS if one is to unun-derstand its evaluation and treatment. This will address in detail with multiple possible theories addressed. The evaluation and its classification have recently been updated. A more comprehensive and specific classification will be presented based on recent research for utiliza-tion in the clinical and research diagnosis of CRPS. The treatment of CRPS is in evolution with new proposed treatments which have questionable effectiveness and cost efficacy. This program will address the evidence basis studies on treatment especially based on the proposed pathophysiology of CRPS. New treat-ments will be explored and critiqued. The educational objectives of this symposium are that on the completion of this activity, the participants will be able to: 1) understand the recent research in the area of CRPS; 2) understand how recent research is changing clinical practice of CRPS; 3) understand the current etiology of CRPS; and 4) understand the current concepts of evaluation and treatment of CRPS.
13
Musculoskeletal Disorders: Musculoskeletal Ultasonography
musculoskeletal disorders: musculoskeletal
ultrasonography
0430A1
ROLE OF ELASTOGRAPHY IN
NEUROMUSCULOSKELETAL ULTRASOUND
Gi-young park
Department of Rehabilitation Medicine, Catholic University of Daegu School of Medicine (Republic of Korea)
Tissue hardness, the elasticity of the tissue identified on palpation, that is, deformability of the tissue, is determined by the structure and composition of the tissue. Tissue elasticity imaging consists of either an image of estimated elastic modulus or an image of strain in response to external force. The principles of tissue elasticity imaging are as follows. First, tissue compression produces strain and displacement within the tissue. Secondly, Strain is smaller in harder tissue than in softer tissue. Thirdly, we can estimate tissue hardness by measuring the tissue strain induced by compression. Many methods for tissue elasticity imaging are based on static tissue compression, which measure the strain distribution inside a body produced by relaxing or compressing a tissue. Therefore, tissue elasticity imaging does not directly represent tissue elastic-ity but, rather, tissue displacement and strain. Diverse modalities may be used for tissue elasticity imaging, the most powerful being magnetic resonance elastography. Ultrasound elastography imaging is possible for the evaluation of nearly every tissue and is one of the useful methods to quantify the strain of soft tissue. As conventional ultrasonographic examination, freehand manipula-tion of the transducer and real-time visualizamanipula-tion are required for a practical system of ultrasound elastography. Commercial ultra-sound scanners already offered real-time elastography and more to follow. Ultrasound elastography provides information of tissue hardness, in addition to shape or vascularity, which is obtained with conventional ultrasonography. In clinical practice, ultrasound elastography is not used independently but as a supplementary role for conventional ultrasonography. In the technical aspects of ultrasound elastographic examination, high quality of ultrasound elastographic imaging is obtained with the transducer and lesion perpendicular to gravity and light contact using transducer that does not distort the lesion. When excessive compression is ap-plied, a false-negative finding may be observed because relations of nonlinear properties of tissue elasticity are changed. When us-ing ultrasound elastography, it is necessary to include a sufficient area of surrounding normal tissue in the region of interest (ROI) correctly to determine the difference in hardness of the lesion compared with the normal area. In color-scale elasticity images, the scale ranged from purple for tissue with greatest strain (soft-est tissue) to red for those with no strain (hard(soft-est tissue). Green indicated average strain in the ROI. These color-scale elasticity images are superimposed on the corresponding B-mode images so that the ultrasonographer can easily recognize the relationship between strain distribution and the lesion on B-mode images. Ul-trasound elastography has potential for enhancing the specificity of ultrasound and mammography for breast cancer detection. Lesions in the prostate, thyroid, pancreas, and lymph nodes have been effectively imaged using ultrasound elastography. The technique may also be possible in the evaluation of diffuse liver disease including cirrhosis and transplant rejection. Tissue elasticity not only varies among different tissues, such as muscle, tendon, and nerve, but seems to reflect disease-induced changes in tissue prop-erties. Therefore, ultrasound elastography is expected as means for providing novel diagnostic information for musculoskeletal disease since the tissue hardness is closely related to its pathology.
Tendons are particularly suitable for ultrasonographic examination. The dynamic imaging of ultrasonography can be used to assess the level of tendon subluxation, and determine the severity of a tendon injury, either partial or complete. We compared ultrasound elastographic findings with gray-scale ultrasonographic findings and evaluated the diagnostic value of ultrasound elastography for detecting small full-thickness supraspinatus tendon tear. Ultra-sound elastography was obtained using free hand manipulation. For color-scale elastography, the diagnostic criterion indicative of the full-thickness tendon tear included a lesion with even elastic pattern (diffuse purple or mixed purple, blue or green) involving the full-thickness of supraspinatus tendon. Single-contrast shoul-der arthrography was performed by the physiatrist and used as the reference standard for the full-thickness tendon tear. Our results indicate that ultrasound elastography showed higher accuracy than gray-scale ultrasonography in the diagnosis of small full-thickness supraspinatus tendon tear. Therefore, ultrasound elastography should be considered as an additional ultrasonographic method for evaluating small full-thickness supraspinatus tendon tear. Myofascial pain syndrome is a common type of musculoskeletal pain and characterized by trigger points, which are defined as hyperirritable spots within taut bands of skeletal muscle fibers. Myofascial taut band is considered a shortened or contracted mus-cle fiber band with increased musmus-cle tone. Therefore, myofascial taut band have its higher stiffness compared to the surrounding muscle fiber. Magnetic resonance elastography is a non-invasive MR-based phase contrast imaging technique to image difference in tissue stiffness. Its findings suggest that the stiffness of the taut bands in patients with upper trapezius myofascial pain may be 50–100% greater than that of the nearby surrounding involved muscle or the controls. It may have a potential for objectively characterizing myofascial taut bands that have been detectable only by the clinician’s palpation. Ultrasound elastography also showed increase of stiffness in the taut band region of the affected upper trapezius muscle relative to that of the unaffected side in patients with myofacial pain syndrome. In the evaluation of peripheral nerve injury, ultrasound elastography is important not only to ap-preciate the lesions but also to give more information about the entire nerve structure involved in trauma. In a case with median sensory neuropathy after carpal tunnel steroid injection, focal hyperechoic area in the damaged median nerve was revealed on gray-scale ultrasonography. Ultrasound elastography showed that the stiffness of focal hyperechoic area in the median nerve (red on color-scale elastography) was greater than that of the surrounding nerve tissue (green on color-scale elastography). At 6 months after injection, pervious focal hyperechoic area in the median nerve disappeared and showed normal nerve echogenicity on follow-up ultrasonography. In addition, even stiffness of the median nerve (green on color-scale elastography) was noted on follow-up ultra-sound elastography. This means that it changed from hard abnormal tissue to soft normal nerve tissue. Therefore, ultrasound elastog-raphy can provide the precise information about serial structural changes of the injured peripheral nerve. Ultrasound elastography may have potential for assessing the nature and consistency of lesions including hemorrhage, infection, edema, cyst, lipoma, and tumor. Recent study suggests that ultrasound elastography may be useful in monitoring the severity of lymphedema. I consider that ultrasound elastography can provide us with more information in order to get a precise diagnosis of neuromusculoskeletal disorders. However, ultrasound elastography is recommended as a mean of assessment to complement the conventional ultrasonographic method. It is expected to be a new ultrasonographic technique for the diagnosis of neuromusculoskeletal disease such as tendon tear, nerve injury, myofascial pain syndrome, and lyphedema etc. It may be widely used in the field of neuromusculoskeletal disease for the near future.
0430A2
ELASTOGRAPHY OF PLANTAR SOFT TISSUE PROPERTIES
Chih-Chin hsu1, Wen-Chung Tsai2, Simon Fuk-Tan Tang2
1Department of Physical Medicine and Rehabilitation, Chang Gung
Memorial Hospital and 2Department of Physical Medicine and
Rehabilitation, Chang Gung Memorial Hospital (Taiwan)
The plantar soft tissue, located beneath the calcaneus and metatar-sals, is subject to repeated load bearing and functions as an efficient shock absorber during walking and running. It contains organized fibrous compartments that retain the adipose tissue. The fibrous septa extending from the skin to the perichondrium is organized into superficial small chambers, the microchamber, and greater chambers, the macrochamber, situated deep in the small chamber stratum. There is increasing interest in measuring the plantar soft tissue mechanical properties, which provide not only information regarding the mate-rial itself but also indicate the presence of a disease. Elastic modulus (E), representing tissue stiffness, and energy dissipation ratio (EDR), representing tissue energy absorption, are parameters frequently used in describing linear and non-linear tissue properties, respectively. In our previous observations, the plantar soft tissue thickness, E and EDR increased in the aging process. The tissue properties are also velocity dependent, which character is not seen in elderly individuals. The above tissue properties changes may be responsible for easy feet pain in aging persons. The diabetic plantar soft tissue has absorbed higher energy than healthy subjects. This phenomenon may contribute to the development of foot ulcers in diabetic patients. Elastography is a non-invasive method to detect stiffness or strain images of soft tissues in response to external disturbance. It is, therefore, considered to be an ideal examination to detect inhomogeneous plantar soft tis-sue properties. Microchambers tistis-sue properties and physiological functions are thought to be different from those of macrochambers owing to the different structures. The stiffness of the two different layers in heels in healthy young subjects has been quantified. The tissue stiffness of the microchamber is nearly 10 times of that in the macrochamber. The macrochamber plays a major role in the heel-pad tissue resiliency, i.e., the ability of the tissue to recover its shape after deformation caused by compression. This layer may be responsible for the cushioning effect in the heel pad during walking. The micro-chamber seems to function as an inherent heel cup that maintains most of the macrochamber layer beneath the calcaneus and prevents excessive macrochamber layer deformation. Heel pad tissue proper-ties are altered heterogeneously in people with diabetes. Increased macrochambers but decreased microchambers stiffness may cause diminished cushioning capacities in diabetic heels.
0430A3
APPLICATION OF ULTRASOUND IN SPORTS INJURIES
yi-pin Chiang
Department of Rehabilitation Medicine, Mackay Memorial Hospital (Taiwan)
High-frequency high-resolution ultrasound has been widely used in the past decade for the musculoskeletal injury. With higher frequency of the transducers and advanced processing speed of the machines, superficial structures could be clearly seen under the real-time ultrasound scanning. The A4 size or pocket-sized portable ultrasound machine are available now. It is very convenient to bring the machine to the filed to scan for the sports injury. Application of ultrasound to sports injury may include detection and localization of the lesions, clarify the staging and severity of the injury, and help in setting the program for treatment and rehabilitation. Superficial muscles, tendons, ligaments, bursae and superficial bony structures are easily depicted in the ultrasound. Panoramic view yields wider vision of the lesions and facilitates the understanding of ultrasound images. A dynamic study of ultrasound to the lesions is very im-portant in sports medicine. With dynamic scanning, interaction of
lesion to the surrounding structures could be demonstrated so that the function of the lesion could be understood. Ultrasound-guided aspi-ration for the hematoma in the injured muscles can be immediately applied in the field to get better outcome. Conclusion: Ultrasound is a very convenient and useful tool for sports injury.
0430A4
NON-INVASIVE MEASUREMENT OF VASCULAR MECHANICAL PROPERTIES
yio-Wha Shau, Sun-hua pao
Industrial Technology Research Institute (Taiwan)
Dynamic imaging of ultrasonography provides a convenient real-time diagnostic tool for clinical research. A novel interactive image analysis technique has been developed to quantify the biomechanical proper-ties of blood vessels in-vivo. Automatic edge-detection techniques of vascular walls and the depth compensation of ultrasound image were implemented. The M-mode images were used to evaluate the vascular energy dissipation ratio (EDR) with a higher spatial resolution. Also, the sequential B-mode images offer the vascular stiffness in differ-ent radial direction. We also developed a non-invasive technique to detect the change of intima-media thickness (IMT) at common carotid artery (CCA). With the lumen pressure measured at brachial artery (BA), the CCA relative stiffness between the intima-media and the adventitia could be calculated. Our present method discloses a non-invasive method to evaluate the arterial stiffness index of normalized thickness from its longitudinal scanning. Both the arterial strain and intima-media thickness (IMT) can be detected quickly with high repeatability and reproducibility. The IMT on common carotid artery of DM (diabetes mellitus) patients (n=28) was 0.52±0.18 mm and slightly larger than that of the normal control (n=36) (p<0.0001). The stiffness of normalized thickness in DM patients was also higher than that of the normal group (p<0.001). The stiffness of normalized thickness can distinguish the DM patients from CAD patients even if their artery had the similar stiffness β or incremental stiffness. The present invention is suitable for screening the coronary artery disease (CAD) or the disorder of metabolism.
0430E1FP
REHABILITATION POTENTIALS FOLLOWING FOOT DROP AMONG LEPROSY CURED PATIENTS
ajit Kumar Varma1, akshay Kumar Sinha2, arun
Kumar3, naresh prasad
1Patna Medical College (India)
purpose: Foot problems in leprosy subjects are of major concern.
Leprosy neuritis affects nerves where they are close to the skin and pass through a narrow fibro-osseous canal. In the leg this involves the lateral popliteal nerve at the neck of the fibula which leads to foot drop, and the posterior tibial nerve in the tarsal tunnel which produces anaesthesia of the sole. Resultant effect is a high stepping gait. The purpose is to achieve heel to toe gait and thereby improving the walking pattern among the leprosy cured patients. materials and
methods: 20 cases of Foot drop were selected for the
recopnstruc-tive surgery procedure who fulfilled the selection criteria. Muscle charting and other routine envestigations were done besides the sensory evaluation. Routine pre-operative vigorous exercise therapy was given for a minimum of two weeks to strengthen the Tibialis Posterior tendon. The Post operative tendon training exercise therapy was started after the third week of operation. A four week schedule rehabilitation module was vigorously applied to all patients. MCR foot orthoses was supplied to them to protect their feet while their walking after the completion of tendon training exercises. results: All patients reported for their follow up at the end of 3rd and 6th
months. Foot pressure image pattern in preoperative and postopera-tive were compared over different time duration. The heel to toe gait pattern was achieved in 80% of the cases. Recurrent inversion was evident in one case only. Mean active dorsiflexion was more
