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Monday 4th May 2015

NEWS

WCPT Congress, 1st-4th May 2015, Suntec Singapore Convention and Exhibition Centre

Physical therapists should consider advocacy a key skill

Dining under the stars: last night’s Party Night dinner and dance at the Flower Field Hall in the Gardens by the Bay gets underway

Exercise adherence: knowing isn’t doing Why is long-term exercise adherence so difficult to achieve? The question has long eluded easy answers – but physical therapists may need to pay more attention to patient perceptions of why adherence breaks down, a focused symposium heard on Sunday. Sarah Dean from the United Kingdom, chairing the session, said there was a big gap between people knowing what to do and actually doing it. “Please don’t go away thinking that the only answer is education. We know

Inside this issue 2 News from sessions 3 The WCPT Awards 4 Thanks for the memory 6 PEDro celebrates 7 Disaster management 8 Art and health

there are people who want to do their exercises but still don’t do them,” she said. “Adherence typically requires health behaviour change.” Helen Frawley from Australia explored women’s adherence to pelvic floor exercise programmes. Her research examined perceived barriers to adherence among both patients and professionals. “Don’t assume you think the barriers are the same,” she said. Both groups agreed that patient-related factors – not the therapy itself – were the most important factors in nonadherence. But whereas clinicians tended to see the biggest problem as being patients forgetting to do their exercises, patients themselves thought the main problem was not seeing any benefit to what they were doing. “Perception of significant benefit is a really important driver for long-term adherence,” she said. “As health professionals, we need to address patient perceptions of minimal benefit.”

Advocacy is a key issue for physical therapists around the world. “The better we do it, the better we serve the communities who need us.” That was the view of Emma Stokes, associate professor in physiotherapy and a fellow of Trinity College, Ireland, chairing a session on advocacy strategies for individuals and organisations. The session centred around a model of advocacy proposed by physiotherapist Jonathon Kruger, General Manager at the Australian and New Zealand College of Anaesthetists. Advocacy, he explained, was a planned process for influencing people, to achieve a specific outcome – most obviously, the process of getting decision-makers to make a policy or practice change. But advocacy might also be about changing individuals’ knowledge, attitudes and behaviours. There are a variety of strategies that can be pursued to achieve that outcome, he said. However, achieving this influence is unlikely to work unless desired outcomes are decided from the start. “It doesn’t work if you’re not quite clear what you want,” he said. His model revolves around three

components: deciding on a desired outcome, scanning the environment to see what factors might influence a strategy, and devising the strategy. “One size doesn’t fit all,” he said. “Different countries with different problems might require different strategies. What works in Australia might not work elsewhere. But anyone can do it, and it’s a key skill for physical therapists.” An advocacy strategy might involve meetings, media releases, social media, posters or demonstrations. “Unfortunately decision-makers are unlikely to be swayed on the basis of evidence alone.” “Successful advocacy requires clarity of purpose, imagination and a spot of luck,” he concluded. Zola Dantile from the University of Pretoria, described how physical therapists in South Africa had adopted advocacy strategies, and had had to learn the importance of starting with an objective. “That really challenged me, because the outcome is right at the beginning and the strategy is at the end,” she said. “As physical therapists, I think we’re used to doing it the other way round.”

The symposium on the podium (from left): Kenneth Harwood (United States), Emma Stokes (Ireland), Zola Dantile (South Africa), Jon Warren (New Zealand)

WCPT Congress News

Pain: the brain train The benefits of exercise to combat chronic pain was the focus of a symposium session on Saturday, where Niamh Moloney from Australia explored the relationship between physical activity and mood, anxiety and stress.

Niamh Moloney

“It may be that some of us really need physical activity to maintain mood and a healthy response to stressors,” said Niamh, a lecturer in physiotherapy at the University of Sydney. She said studies on workplace physical activity and mood indicated that yoga had the greatest effect on countering anxiety, depression and stress – although the findings had to be viewed cautiously because of small study samples. So which exercise for your patient? She suggested being guided by a biopsychosocial assessments. Each person should help decide which exercise was most appropriate for them. “We need to think about exercise in a broader way than we traditionally do in physical therapy,” she said.

The exercise debate A packed auditorium at the WCPT Congress 2015 debate on Saturday afternoon considered the question: is “Exercise is Medicine” a friend or foe of physical therapy? The debate revolved around the Exercise is Medicine global health initiative from the American College of Sports Medicine (ACSM). The initiative aims to encourage primary care physicians and other health providers to include physical activity in plans for patients. Delegates were asked to consider whether Exercise is Medicine was supportive of physical therapy practice. Paul Hodges from Australia said that Exercise is Medicine (EIM) was a friend of physical therapy. He pointed out that although everyone agrees that changing physical activity behaviours would be the most effective way of tackling lifestyle-related diseases, the problem was that changing behaviour was very difficult. “We need to find another way. And an aim of EIM is to increase the uptake of physical activity – to change the attitudes of physicians and the public.

It’s a society-wide initiative to change attitudes because change is difficult.” Phil Page from the United States said that Exercise is Medicine was a foe. He said that the initiative was detrimental to physical therapy because it excluded them from their global programme. And health systems were not set up to accommodate exercise prescription as EIM propose – at least not effectively. Other speakers included Ann Moore from the United Kingdom and Linda Steyn from South Africa.

Nishchal Ratna Shakya pictured at Sunday’s disaster management seminar

Nepal physiotherapists at heart of relief efforts Nepal physiotherapists have managed to attend the WCPT Congress despite the devastation that hit their country just days before the meeting began. Nishchal Ratna Shakya, a physiotherapist and lecturer at Kathmandu University School of Medical Sciences, says he was still trembling when he arrived in Singapore. “It’s been important for me to come to get as much support as possible,” he said. There are 900 physical therapists in Nepal, and many are volunteering throughout the affected areas, travelling to the hospitals where injured people are being taken. Nishchal was at home in Kathmandu with his family when the

Your quick guide to day three of the WCPT Congress Phil Page

CongressNews2015_header_3.pdf 1 07/04/2015 15:04:06

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Just in case you haven’t already planned your final day at the WCPT Congress 2015, here’s an outline of what’s on offer today. Remember that there are other types of session too – such as platform and poster sessons. You can find full details in the congress programme and in the online iplanner. www.wcpt.org/congress/iplanner

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Editor and writer: Simon Crompton (www.simoncrompton.com) Printed by: HO Printing, Singapore Produced specially for the WCPT Congress 2015 This is the second of two congress newspapers, published on Monday 4th May and distributed to all delegates. News, pictures and videos from the WCPT Congress are published every day of the congress at www.wcpt.org/congress/articles News alerts will be sent out on social media #wcpt2015 and via the WCPT Congress app. Articles are compiled at the end of each day as WCPT Congress e-News and sent out to WCPT’s mailing list. If you have any news or suggestions for articles please contact Simon Crompton at [email protected]

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earthquake struck on Saturday, and he and his father rushed to his four-month old baby’s room to protect her. “We felt we were being thrown room to room, vertically and horizontally, and this terrible sound made you immediately feel very fearful.” Since that moment Nishchal, who is President of the Nepal Physiotherapy Association, has been trying to co-ordinate the physical therapy response in Nepal. “I was trying to channel the physiotherapy team on Facebook as the building was trembling,” he said. You can still donate money to the Handicap International Nepal appeal at the WCPT stand.

Monday: networking sessions Networking sessions offer an informal opportunity to meet and talk with colleagues who share a common interest. Today’s sessions cover Women’s health, ICF, intellectual and developmental disability, meet the researchers, animal practice, educators, spinal cord injury, private practice, amputee rehabilitation, health promotion

Today’s sessions cover Chronic pain, exercise strength training, amputee rehabilitation, ICU, paediatrics, Parkinson’s disease, shoulder impingement.

Monday: discussion panels Constructive debate and controversy are welcome at discussion panel sessions, where delegates have the opportunity to explore hot topics with experts. Today’s sessions cover Health workforce, direct access, evidence based practice, planning a WCPT Congress

Monday: seminars

Monday: focused symposia

Today’s sessions cover Neurology, developmental disabilities, mental health, talking to the media, advocacy, meet the WCPT Executive Committee

Focused symposia provide a forum where cutting edge topics can be explored and debated by experts in their fields, drawing together different research and practice perspectives.

Look in the congress programme for details of these sessions, and for information about the dozens of platform presentations and seminars also being held.

Monday 4th May 2015

Leaders honoured in WCPT Awards Norwegian physical therapist Kari Bø has been awarded the World Confederation for Physical Therapy’s highest honour for her highly influential work in women’s health. She officially received her recognition at the Congress opening ceremony, although it had earlier been announced at the WCPT Awards ceremony in Singapore. Twelve other awards have also been presented. Kari Bø is an internationally recognised researcher in the area of pelvic floor dysfunction and pelvic floor muscle training. A Professor at the Norwegian School of Sports Sciences since 1997, she has delivered key note lectures around the world, and has raised awareness of women’s health issues through her media work. According to the WCPT citation: “Her contribution to evidence based practice has had a major impact on the scientific community and thousands of women with problems related to the pelvic floor, such as urinary incontinence.” Receiving the award at the WCPT Congress, Kari Bø said: “I’m deeply humbled and proud to receive this award from our fantastic international organisation.” “I am proud of what our profession has achieved since I began my career in physical therapy. If I have one

in Rehabilitation Award. She was one of the initiators of the World Health Organization’s CBR strategy and help guide the development of the programme over three decades. WCPT International Service Awards have also been awarded to: Hua-Fang Liao – Taiwan Jill McClintock – UK Michel Landry – Canada Donald Neumann – United States Celia Tan – Singapore Archbold Hinchcliffe – United Kingdom Mary Martin – Canada (awarded posthumously) Toshihiro Morinaga – Japan Dina Brooks – Canada Alan Jette – United States

The winners of the awards gathered, with WCPT President Marilyn Moffat (left) and Doreen Moore-Wheelwright, who was WCPT President from 1970 to 1974 message for the profession it would be to work in close collaboration with, and equal partnership to, the medical profession.” The Mildred Elson Award was just one of a range of honours being presented at the awards ceremony to physical therapists who have made an outstanding contribution to their profession on an international level. Diana Hiscock, a physical therapist from the UK, was presented with the

WCPT Humanitarian Service Award 2015. For over 30 years she has worked with NGOs as a project manager in marginalised communities and in areas affected by disaster and war. Most recently she has worked with people injured and displaced by conflict in Syria and refugees in Jordan. The work of Padmani Mendis from Sri Lanka in the field of community based rehabilitation (CBR) has been recognised with the WCPT Leadership

WATCH THE VIDEOS

You can view videos of the WCPT Awards presentation on WCPT’s YouTube Channel along with other features from the WCPT Congress. Just search for WCPT YouTube

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WCPT Congress News

Thanks for the memories... And so it’s nearly over. From the flags,drumming and dragons of the opening ceremony to your last hug of farewell... we hope the WCPT Congress 2015 has been fun, fulfilling and professionally valuable. Here are some images to take home with you: the registration where it all began; the long walks down marble corridors; the trawls through the congress programme; the fun to be had in exercise and equipment demonstrations; the unforgettable sight of the WCPT President in a tri-shaw; the amazing volunteers; and most of all, the friendships.

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Monday 4th May 2015

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WCPT Congress News

PEDro celebrates birthday at congress PEDro, the internationally acclaimed physical therapy evidence database, is exhibiting at the WCPT Congress as it celebrates its 15th birthday. It is the largest physical therapyspecific evidence resource, containing more than 30,000 reports of guidelines, reviews and trials. In 2013 it became a professional partner of the World Confederation for Physical Therapy – in recognition of the fact that the two organisations share similar objectives and values. PEDro Manager Anne Moseley of the George Institute for Global Health and the University of Sydney said: “The Congress is a great way to share PEDro with physical therapists worldwide. “We are proud to say that PEDro is used in over 200 countries and has answered 13-million clinical questions in the last 15 years. One of the best things about PEDro is that is it a free online resource that helps the global physical therapy community stay informed about the latest physical therapy evidence.” PEDro is used in physical therapy practice, education and research. It only indexes research reports which use the best methods for evaluating intervention, specifically evidence-

based clinical practice guidelines, systematic reviews and randomised controlled trials. Its home page is published in 11 different languages. Search results are ranked by method (guidelines are displayed first and trials last). Trials are ranked by quality. “This helps to direct users to evidence which is most likely to be valid and contain sufficient information to guide clinical practice,” Anne Moseley said. She paid tribute to the generosity of 40 WCPT member organisations, whose support helps keep PEDro up-todate. PEDro can be found at stand D16 in the exhibition hall. The organisation is: • launching a new YouTube video on how to ask a clinical question in PICO format • launching a Turkish version of the PEDro web-site • conducting guided tours of the database in different languages • helping delegates search for highquality research evidence to answer clinical questions • recording endorsement videos • obtaining feedback from delegates. http://www.pedro.org.au/

Emma Stokes (right) was presented with a recogntion of WCPT service certificate by outgoing President Marilyn Moffat at the WCPT General Meeting

WCPT’s new President Emma Stokes was elected the new President of the World Confederation for Physical Therapy at the WCPT General Meeting in Singapore. Previously Vice President, she stood unopposed and will serve as President for the next four years. Her term as President begins when the congress ends. A new WCPT Executive Committee was also elected.

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“It’s a great privilege,” she said. “We are starting on a four-year journey building on the amazing commitment of the previous Executive Committee, President and Vice President.” Emma Stokes is Associate Professor at the Department of Physiotherapy in Trinity College, Dublin, Ireland. Her involvement with WCPT began in 1998.

Monday 4th May 2015

Why physical therapist input is essential in disaster management Yesterday morning’s WCPT seminar on disaster management had an immediate relevance, following the earthquake in Nepal which has killed 6,900 and left more than 15,000 injured according to latest figures. Several physical therapists who had planned to attend or speak at the session are instead working with emergency teams in Nepal, attempting to prevent long-term disabilities. Among them are Peter Skelton, a Project Manager with the organisation Handicap International, who has worked as part of emergency teams in Gaza, Iraq, the Philippines, Libya, Jordan and Haiti. He spoke to WCPT about the significance of the seminar before he flew out to Nepal. “It’s important because it’s about making physical therapists aware of how they can contribute. But it’s also about pulling together a strong message about what WCPT and the physical therapy community as a whole are doing in disaster management.” At the seminar’s heart was a forthcoming briefing paper from WCPT on the role of physical therapists in emergency response teams. The paper, due out later this year, examines the role of physical therapists in

emergencies – both those already working in countries where disasters are likely to happen, and those involved in an international response. “There’s been an enormous amount of interest in volunteering to work with relief and response organisations,” said Peter, who compiled the paper with Catherine Sykes, WCPT’s Professional Policy Consultant, along with panels of contributors and advisors. “What we’re trying to do is set out for people the best ways of doing that, and providing information that will support them.” “We’re also looking at what’s known as the ‘disaster continuum’. There tends to be a very heavy focus on the response phase in the first few weeks after a disaster. But in the document we’re looking at all the phases of the disaster, from the preparedness phase – what you should do in advance of disaster – through to the response, and then after that the recovery phase which is critical as well.” “What we know is that it’s far better to prepare for disasters than it is to just invest in the response stage because you can reduce a lot of the risks inherent in disaster.”

Devastation after the Haiti earthquake in 2010. Picture copyright William Daniels/ Handicap International Rehabilitation, and in particular physical therapy, he said, is of huge importance in disaster management – and there is growing international recognition of this. “I think has been a huge change in attitude recently. The Haiti earthquake in 2010 was a bit of a watershed. I think that it really emphasised to the humanitarian community as a whole

just how significant the role of rehabilitation was.” “Since then, there’s been incredibly positive steps, both in new cross-cutting humanitarian guidelines and in the World Health Organization’s foreign medical team guidance. Both of these documents set out to the humanitarian community how important rehabilitation is within a response.”

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WCPT Congress News

WCPT art and health exhibition: winners on show at congress Some of the winners of WCPT’s 2015 art and health exhibition assembled in the hall with their entries yesterday and received winners’ certificates. Among them was Rob Grieve, a senior lecturer in musculoskeletal physiotherapy from Bristol, the UK. His drypoint etching, entitled “Freedom of movement”, won the drawing category. “The movement in the picture is in opposite directions, yet united in its similarity and independence,” he said. “It took a while to come up with the idea but the execution didn’t take long.” He embarked on the work specifically for the WCPT art and health competition, which invited pieces of artwork relevant to physical therapy, including representations of human movement, fulfilling potential, physical

Fereshteh Pourkazemi’s painting

IT DOESN’T END HERE

What you’ve started at the WCPT Congress can go on Keep in touch with the contacts you’ve made, and keep networking Follow @wcpt1951 on Twitter, and like our Facebook page Rob Grieve with his winning etching “Freedom of movement” therapy encouraging independence, and physical therapy across the lifespan. There were categories for photography, painting, drawing and sculpture. The winner in the painting category was Fereshteh Pourkazemi, a lecturer at the University of Western Sydney. She is a self-taught artist who has painted all her life. Last year she started painting portraits for the first time when she was completing her PhD – “I had to release the pent up energy through portraits. It was a good way of channelling stress.”

The inspiration for her art and health competition entry was Aimee Mullins – an amputee athlete model and actress. “She showeed that adversity isn’t an obstacle that we need to get around in order to resume our living,” said Fereshteh. “It’s part of our life. I think of it like my shadow.” The vivid colours in her picture represent both the challenge and potential of change. Her painting is being used in early publicity for this year’s World Physical Therapy Day. The theme is “Fulfilling Potential”

Keep referring to the WCPT website www.wcpt.org for news, resources and lots of ways to network Look out for announcements about the forthcoming archive of presentations from the WCPT Congress – Powerpoints, abstracts and audio will be available Look at the congress videos on WCPT’s YouTube channel Come to the next WCPT Congress in 2017! It’s not that long to wait...

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