EL-2-04-01
NEW METHODS IN THE REHABILITATION OF HEMIPLEGIC GAIT
Karl H. Mauritz (Klinik Berlin and Free University Berlin, Berlin)
Restoration of mobility is a major goal in neurological rehabilitation preventing long-term disability and handicap. The spectrum of available therapies in gait training was recently widened by treadmill training with partial body-weight support, by functional electrical stimulation (FES), locomotor pharmacotherapy, selective reduction of spasticity by botulinum-toxin injections, by acustic and visual cuing and biofeedback.
The treadmill training with partial body weight support has been compared with conventional physical therapy and proofed to be more effective. It offers the advantage of task-oriented training with numerous repetitions of a more physiological gait pattern. It can be started earlier, even in non-amulatory patients without trunc control. Functional electrical stimulation (FES) of leg muscles could be successfully combined with the treadmill training with additional improvement of walking ability.
Recent studies have also shown the positive effects of botulinum toxin A in the treatment of lower limb spasticity. For the lower limb spasticity a correlation was observed between the clinical reduction of muscle tone, functional gait parameters and a more normal emg pattern.
S-2-02-01
International cooperation in rehabilitation medicine education and training in Western Europe
Harry M.Ch. Verstappen-1, MD, Daniel Wever, MD-2 (1-Pijnsweg 26, Heerlen, the Netherlands; 2-Roessingh Rehabilitation Center, Enschede, the Netherlands)
In spite of obstacles such as differences in language, culture, social structure and economics quite a few developments have been going on within the field of education and training in Physical and Rehabilitation Medicine in the last five years.
Actual international cooperation in this field has started since the establishment of the European Board of Physical Medicine and Rehabilitation (PMR), an organization of representatives of 20 Western European countries, all members of or associated with the European Union.
The requirements for training have been specified, an European logbook for training has been introduced and the curriculum of studies and the theoretical knowledge for the diploma of the European Board PMR has been described.
Since 1993 European examinations have been held. This lecture will deal with the current state of affairs concerning education for undergraduate medical students in Western Europe - as far as is known. Some attention will be paid to post-graduate courses in Physical medicine and Rehabilitation.
