Seminar-4-01-02
SEATING IN DUCHENNE MUSCULAR DYSTROPHY (DMD) PATIENTS
Meigen Liu (Saitama Prefecture General Rehabilitation Center, Saitama, Japan)
[Objective] In DMD patients, seating becomes very important with disease progression as a means of slowing deformities, maintaining mobility and enhancing QOL. In this session, I will introduce our study results of the seating problems in DMD patients and discuss appropriate seating approach.
[Methods] The study subjects were 97 DMD patients (Swinyard stages 4 to 8) aged 8 to 33 years. In our seating clinic, we analyzed their seating problems from the view point of spinal deformities, sitting ability, pain and discomfort, ADL and care problems.
[Results] 1) The number of patients needing support for seating increased with the progression of stage (4: 0%, 5: 26%, 6: 46%, 7: 74%), and was significantly higher in patients with spinal deformities. 2) The mean stages of manual and electrical wheelchair users were 5.8 and 7.5. 3) Pain and pressure problems were observed in 41%, and the sites of pain were related to the type of spinal deformities. 4) The ADL was related to sitting ability, spinal deformities and the seating system. Too much support for seating interfered with ADL by limiting compensatory trunk motion. 5) 58% of the care-givers experienced some kind of trauma related to the seating system while caring the patients.
[Conclusion] For appropriate seating, the following factors must be considered; 1) prevention of deformities, 2) comfort of the patients, 3) facilitation of ADL, 4) ease of care, 5) adjustability to growth and disease progression. Examples of our seating approaches will be presented.
S-4-03-01
HISTORY OF REHABILITATION MEDICINE
Henry B. Betts (Rehabilitation Institute of Chicago, Chicago, Illinois USA)
This presentation will demonstrate that the history of rehabilitation has evolved as a reaction, medical, social, and psychological, to the attitude toward formerly called "crippled" people. It has been developed not just by science and medicine but by an enhanced awareness that equality is worth achieving. It will point out the significance of the presence of "heroic cripples" at the end of the 2nd World War; the few doctors who "invented" rehabilitation; and the insistence upon powerful "community" interests that rehabilitation techniques be enhanced and promulgated. The independent living movement will be discussed as will the rise of "disabled activism."
