APCP Conference report

Posted on 10th November 2011

Catherine Jenkins' presentation, as well as a link to the MHRA guidelines can be found at http://www.jenx.com/apcp/.

This last weekend, 4 & 5th November Catherine and Johann attended the 38th Annual meeting of the APCP which was held at the Radisson Blu Hotel at Stanstead Airport. This was a large and attractive venue with ample space for a good exhibition and lecture space. The sheer numbers of delegates made break times somewhat of a challenge but the staff worked well to ensure everyone was refreshed prior to returning to the lecture rooms.

The venue and lecture space were excellent, and well prepared
 
Day one of Conference had parallel sessions along Neuromuscular and Musculo Skeletal themes. We only attended the Neuro Muscular Forums. Friday began with an introductory talk by Dr Eva Bower covering updated definitions of regular topics of study and conversation such as deformity and Cerebral Palsy. The regular conclusion that more evidence needed was repeated regularly throughout the two days of conference. Two different schemes for classification of evidence were discussed; Sackett (1986) and the AACPDM levels of evidence. Throughout the conference much of the evidence gained from literature review was felt by several speakers to fall into the lower grades of evidence.

In conclusion, Dr Bower encouraged those present to be rigorous in their research and to aim for the highest level of evidence possible.

The rest of the morning session was devoted to looking at differing methods of treatment currently in use in the UK for children with Cerebral Palsy and other developmental disorders. Chris Barber spoke on the Bobath Approach, Gabrella Czifra spoke on the Conductive Education Approach, Dianne Rickard spoke on the MOVE Approach and Terry Pountney spoke on Strength Training. After each speaker had given a background and overview of their approach, they all returned to the stage and entered into lively discussion, chaired by Eva Bower answering questions put into a box and taken from the floor.

After lunch, Sue Coombe reported the findings of the Survey undertaken to assess how much clinical time in the UK is spent actually treating children. The full findings will be published in the APCP Journal. The amount of truly clinical time spent by Chartered Physiotherapists who took part in the survey is very small. The survey will assist service managers, expert witnesses and department heads amongst others.

Di Coggins spoke next on Topical Management Issues. Di is a member of PPIMS (Paediatric Physiotherapists in Management) and spoke on the issues that affect managers in these turbulent times with budget cuts being requested alongside increase in input. She urged those who have a management responsibility in clinical, strategic or service implementation to consider joining the group.

Helen Chamberlain spoke next on the use of the Thera-suit Method. The background of the method was the work done with returning cosmonauts who suffered osteoporosis after prolonged exposure to weightlessness. This eventually triggered the thought that this might also aid children with disabilities and the Thera-suit began life in 2002. Specific indications and contraindications were discussed.

A very informative day ended with an update on Aquatic Therapy (formerly hydrotherapy) by Heather Epps. Heather talked on the different uses and possibilities for aquatic therapy but also of the need to assess properly the level of education in the technique that practitioners possess.

The evening was passed very pleasantly in the company of other delegates at the Conference Dinner. Between courses diners were involved in a lively quiz and the evening speakers were parents of a boy with Cerebral Palsy who gave a moving yet amusing account of their early years as parents of a child with special needs. Their talk was beautifully delivered and also gave gentle but heartfelt suggestions for improvements to aspects of the professional care they had experienced. We also watched an inspirational film about a young girl who had multiple limb amputations as a result of meningitis. Rather than sit at home and mourn her lost limbs, she took up competitive swimming and is hoping to enter the 2016 Paralympic Games. For those with energy left, there was post-dinner dancing.

Saturday morning saw Catherine Jenkins deliver the first talk which gave an overview of the Physiotherapist’s role in the prescription, acquisition, care and disposal of Medical Devices (the presentation is available at http://www.jenx.com/apcp/). All the postural support furniture that therapists use, including sleep systems and mobility products, will fall into the category of Medical Devices so almost all practicing therapists will be involved at some point in this process. The MHRA (Medicines and Healthcare Regulatory Authority) Guidelines were chosen as they have a bearing throughout the whole lifecycle of medical Devices including; design and manufacture along with prescription, acquisition, care and disposal.

Catherine Jenkins speaks for Jenx on MHRA guidelines for handling and caring for Medical Devices

Rachael Hutchinson spoke next on the evidence for the use of orthotics in Cerebral Palsy from a surgical perspective. As with many of the speakers she bemoaned the lack of really robust evidence and talked through her rationales for orthotics including separating her patients into walkers and non-walkers urging the fact that strength and control should be given more consideration than simply increasing range of movement.

Elaine Owen spoke next, again taking orthotics as her subject but this time from a physiotherapist’s perspective. Elaine gave a fast paced explanation of the importance of segment kinematics which are not always drawn off from the information gathered by gait lab and of really observing every phase of a child’s gait using either gait lab or a video camera and playing back using the pause button.

Laura Wiggins then chaired a lively “questions from the floor” session with both Rachael and Elaine taking questions.

The next session included two free papers; “Psychometric evaluation of the functional walking test for children with Cerebral Palsy” presented by Aoife Quinn and “Wee Glasgow Gait Index – a mini gait scale & neuro-biomechanics screening tool: a Pilot Study” presented by Nicola Tennant.

The AGM followed and then lunch.

After lunch, Martin Matthews of DM Orthotics, main sponsors of this year’s Confereence, spoke on the “Use of dynamic elastomeric fabric orthoses in the management of childhood scoliosis: a review of the evidence”. Martin started with explaining some of the aims of using elastomeric orthoses in childhood scoliosis including improved posture, improved body awareness and function adding that prevention is always better than cure.

“What is Apophysitis? An evidence based approach” was the next session, delivered by Luke Watson. Luke gave a tour of some of the more common conditions such as Osgood Schlatters and also the pitfalls of poor diagnosis and treatment. He also pointed out that not all evidence is truly to be relied upon giving the example of a study on the pain relieving qualities of knee strapping. In this study, pain was found to reduce with the use of strapping in those whose lives involved a high sport content but the study failed to report how this conclusion was reached since the cohort was taken from cadavers! Good reason to look very carefully at research papers and not assume that all you read will be helpful!

Sadly the Conference finished here for me due to other commitments. The final sessions were two free papers and a presentation on Music Therapy. The free papers; “Optimum physiotherapy management of pre-term infants on discharge from the inpatient setting: a Delphi Study” and “An audit to identify the frequency and factors influencing sleep disturbance in ambulant and non-ambulant children using the Dubowitz NM Service” were presented by Laura Eldridge and Katherine Finnegan respectively.

A number of the presentations from this year’s conference can be found on the APCP website: www.apcp.org.uk

Catherine Jenkins' presentation, as well as a link to the MHRA guidelines can be found at http://www.jenx.com/apcp/.

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Tags: Exhibitions