EL-3-01-01
REHABILITATION OF PEOPLE WITH VISUAL IMPAIRMENT
Stanley F. Wainapel, M.D., M.P.H. (Montefiore Medical Center/Albert Einstein College of Med.)
Visual impairment or blindness is a major cause of worldwide functional disability but it has rarely received an appropriate degree of attention or study by rehabilitation professionals. The vision rehabilitation and medical rehabilitation paradigms have many parallels which mirror their shared origins in the post-World War II period. This presentation highlights such parallels, reviews the more common causes and consequences of vision loss, and highlights the most useful techniques of vision enhancement or vision substitution. Vision impairment can often be a comorbidity in Rehabilitation Medicine inpatients or in elderly individuals. A familiarity with the vision rehabilitation system and its treatment strategies should become a standard part of the curriculum of all medical rehabilitation practitioners.
EL-3-02-01
ORTHOPAEDIC REHABILITATION
Clinical and basic approaches to early mobilization
Yasusuke Hirasawa, Hitoshi Hase, Shinro Takai, Yasuhiko Hatanaka, Yasuhiro Uchiza.
(Kyoto Prefectural University of Medicine, Kyoto, 602 Japan)
Restoration of maximum musculoskeletal function is a main purpose of the orthopaedic rehabilitation. Physical therapy should be effectively combined with occupational therapy, using appropriate orthotics, prosthetics and other devices. Therapeutic exercise is aimed to improve musculoskeltetal function, to maintain a state of well-being and to obtain eventual good quality of life.
The adverse and deleterious effects of prolonged immobilization, however, are frequently encountered in the musculoskeletal system. It is also known that immobilization reduces the functional reserve of the musculoskeletal system and results in muscle weakness, atrophy and joint contracture.
After the accurate evaluation of the patient's condition, the following programs including early mobilization are mainly done, in order to approach to the goal of the orthopaedic rehabilitation.
1) Control of pain: After the adequate period of immobilization and the protection of the injured site, therapy for pain tolerance is started with combination of TENS.
2) Improvement of muscle weakness: In addition to the muscle exercise, low frequency therapy is combined with EMG biofeedback therapy, which also provokes a willingness of the patient.
3) Prevention of the joint contracture: Early ROM exercise including passive, active assistive, and active programs is done with gradual stretching of the soft tissue. CPM is also important indication to restore range of motion.
Basic principle proved by basic research is also necessary to prescribe and supervise a program of early mobilization.
