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Teamwork Acknowledged at Exhibit ion 0 pen i ng

Detective Sergeant Robin Window opened the Centenary exhibition at the CSP offices on May 23. In October 1992 his arm had been severed by an assailant with a Samurai sword. After surgery to replace it, physiotherapists at Mount Vernon Hospital had played a crucial role in enabling him to use it again. Two of them, Sue Boardman and Elaine Juzl, were present at the ceremony and Sergeant Window stressed that patience, trust and teamwork had helped him towards recovery, so that he was able to return to work at the beginning of May.

Left: Dt Sgt Window (centre) with Pennie Roberts, vice- chairman of the CSP Council and Cllr Sada Deshmukh, deputy mayor of Camden

Postgraduate Progress for the Physiotherapy Profession Alan Walker talks to Bernadette Friend

The new CSP postgraduate strategy must be seen as an educational framework to enhance physiotherapy and as a way of enabling practitioners to develop professionally and be more effective.

This is the message from Alan Walker, CSP director of education, who says everyone, including individual physio- therapists and employers, has to be made aware of the advantages of postgraduate education.

To achieve this, he urges educational establishments to ‘take education to physiotherapists’. There are now substantial opportunities for physio- therapists to study at Masters’ level. He believes that employers are more likely to support staff in further study if they can see the ‘payback’.

‘It is very important that postgraduate education is seen as enhancing physio- therapists and their capacity to work effectively. But it is also important that there is a benefit for the employer and for the patient’. How postgraduate education is perceived is ‘all important’, he says.

Last month saw the launch of the CSP postgraduate strategy for continuing education at Masters or M-level, leading to postgraduate certificates, diplomas and Masters’ degrees. This new educational development will work within the aims set out in PACE.

The strategy urges the use of ‘innovative techniques’ in postgraduate education, including practicecentred and work-based learning, distance and open learning, and accreditation of prior learning. Likewise, it suggests that assessment can also take a variety of forms, from single case studies and the use of reflective diaries, to research projects, and peer and self- assessment.

Considerable interest in postgraduate study has come from clinical course teams outside higher education and the feeling

is that many will be able to upgrade their courses from levels 3 to M.

The CSP is now able to increase ‘substantially’ the funds available for continuing education by means of external sponsorship, and an announcement on this is made this month (see page 401).

Two further strategies - one on con- tinuing professional development and one on research -are due out in the autumn.

Promotion of Physiotherapy at Boots

Chartered physiotherapists from BUPA Hospital Bushey spent a day in Boots (The Chemist) Ltd at the Harlequin Shopping Centre, Watford, Hertfordshire to promote physiotherapy, on April 29.

The physiotherapists all answered questions on a wide variety of subjects and provided information on many aspects of physiotherapy.

Following a promotional stand by a chiropractor in Boots two weeks previously, the physiotherapists felt the

Anna Anders MCSP advises a customer in Boots

public should see the orthodox alternative and be aware of the wide range of physiotherapy treatment available locally.

GD

Paediatric Master’s Unit at Birmingham

The Certificate in Paediatric Physio- therapy (Advanced), which has run successfully over the past three years at the University of Central England, Birmingham, has just gained accreditation as a unit at master’s level. The new unit will be entitled ‘Certificate in Paediatric Studies’, running over two semesters and due to start in October 1994. The unit is open to professionals working with child- ren, eg physiotherapists, occupational therapists, nurses, speech and language therapists and social workers.

The unit at present can be linked to other units within the various master’s

programmes available at the school of postgraduate studies, Faculty of Health and Social Sciences at the University of Central England, and also stands alone as a postgraduate certificate.

There are plans to develop a postgraduate diploma and full MSc in paediatric studies in the future.

CSP Credit Card Apply for

yours now.

Physiotherapy, June 1994, vol80, no6

408

Her Majesty the Queen has officially named and opened the PrincessChristian Unit at Mount Vernon Hospital, Northwood, Middlesex. Princess Christian, the fifth daughter of Queen Victoria, donated f5.000 to the new Mount Vernon HosDital

Queen Opens Unit Named after her

for patients with chest diseases in the early 1900s and on May 13, 1902, laid the

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Shown here: The Queen - apparently not unduly distressed by an injury to the royal arm - jokes with Gary Kiff, an orthopaedic patient, and Sue Boardman

foundation stone. The Queen's visit took place on February 8 this year.

The new unit consists of a 56-bed orthopaedic and oral surgery unit: the Paula Walker rehabilitation department, named after a Fellow of the CSP and housing occupational therapy, physio- therapy and speech therapy; and an X-ray department.

On her arrival the Queen was welcomed by Councillor George Booth and Mrs Booth, Mayor and Mayoress of Hillingdon, and Mr David Swarbrick, chairman of Mount Vernon Hospital NHS Trust.

A bouquet was presented by Miss Samantha Hynes MCSP, the youngest staff member working in the unit. Her Majesty then spent half an hour in the rehabilitation unit accompanied by Miss Sue Boardman, the superintendent physiotherapist. Mrs Annette Leveridge, head occupational therapist; and Mrs Sally Rodgers, speech therapist, were presented to her as were past heads of all the departments, including Miss Walker.

During her visit the Queen chatted to many of the patients and staff, particularly in hand therapy, and the main opt-patient physiotherapy, occupational therapy and speech therapy departments and gym- nasium, as well as those neurological patients receiving treatment in the neuro-gymnasium.

At the end of her visit she unveiled a commemorative plaque.

It was certainly a day to be remembered and a memorable beginning to the Centenary year.

SB

Acupuncture in Africa

AACP and IAAPT at the WCPT Africa Region Conference

The public relations department of the Acupuncture Association of Chartered Physiotherapists had a good opportunity to promote acupuncture and the AACP at the conference in Nairobi, Kenya, held in April. Papers were presented on the topic of 'Physiotherapy and acupuncture' by Maureen Lovesey, who is also chairperson of the International Association of Acupuncture Physical Therapists. There was a special interest group meeting which was facilitated for the IAAPT by Sara Mokone. It was attended by 20 people from seven countries - Cameroon, England, Kenya, Oman, South Africa, Uganda, Zimbabwe.

There was great interest and desire for education, both basic training for those countries which are thinking of joining IAAPT, as well as the request for more advanced courses to extend the use of acupuncture into other fields of physio- therapy besides pain management. This request was from Zimbabwe and South Africa, who are IAAPT members.

There were a number of proposals put forward by the meeting. One was to try to find a means of opening membership to IAAPT for countries in a way which would reflect the different resources and pay scales. Also, IAAPT will be contacted to look into promoting training programmes for the extension of the use of acupuncture

into physiotherapy practice in Africa. The AACP representatives were treated

very warmly and it was good to recontact old friends, especially from Zimbabwe - and to find that we were following similar pathways with the use of acupuncture. Perhaps this is a sign of how central acupuncture is becoming to basic core skills for many physiotherapists. SM NB. SE & London AACP Branch: A day course on treatment of RSI stress, etc, will be held on July 9 at Guy's Hospital, Contact SE rep Kim Ong, 16 Alpine Close, Parkhill CRO 5UN (tel 081-680 4964) for application form.

Far right: Maureen Lovesey lecturing, and (below) participants at the conference

Physiotherapy, June 1994, vol80, no 6

Ordination for a Physiotherapist

Janice Scott MCSP DipTP (n6e Whyman) was among the first 20 women to be ordained priest at Norwich Cathedral on Saturday, April 30.

Janice trained at King’s College Hospital, and later as a teacher at The Middlesex Hospital. After teaching for a while at The London Hospital, Janice and her husband Ian moved into private practice at Fakenham in Norfolk, where they have since remained. Mr Scott is a former CSP Council member.

Janice, who is 49 years old, works half- time in the practice, spending the rest of her time working as a non-stipendiary

CALLS FOR ABSTRACTS

Measurement Meeting The Physiotherapy Research Society

will hold a workshop meeting on ‘Measure- ment in Physiotherapy’ at Manchester School of Physiotherapy on November 10, 1994.

Abstracts of not more than 300 words should be sent to: Dr Tracey Howe, School of Human Sciences, Liverpool John Moores University, Mountford Building, Byrom Street, Liverpool L3 3AF (telO51-231 2376. fax 051-298 1261).

The final date for submission of abstracts is August 8.

Continence Conference curate in the parish. She says: ‘Physiotherapy and parish

work have a lot in common. They both demand sensitivity in relationships, but toughness in working through problems. Both types of work are at the sharp end, one physically, the other spiritually. But the physiotherapy ensures my work as a curate is earthed in good healthy realism. And that’s essential!’

By next month, one woman in 17,255 in England and Wales is expected to be a Church of England priest. So one or two more members should be ordained soon. Janice Scott

g The Association for Continence Advice g will hold its annual conference on April 8 25-27, 1995, at Weston super Mare. E The programme will include sessions on W research, the NHS market place, bladder g and bowel function, hormone replacement

therapy, urinary drainage and free papers. 2 Abstract awards will be made in the n following categories: W Scientific Abstract: Clinical and scientific 8 research carried out for communication to

specialists in an oral presentation.

Scientific Poster Abstract: Clinical and scientific research carried out for com-

W

[r

munication to specialists by the written word in a poster format,

Graphic Poster.’ Based on graphics and working with the aim of communication with the public affected with continence problems, and to encourage prevention of

The closing date for abstracts is February 18, 1995. Further information is available from the Conference Secretariat, 15th Annual Conference of the Association for Continence Advice, Index COmmUn-

Riding Honour Miss Stella Saywell F c s p has recently

been made an honorary vice-president of the Riding for the Disabled hsociation. This is in recognition of all her hard work over many years and for giving physio- this field, incontinence. therapy such a high profile within the Association.

Stella was instrumental in setting up the Riding for the Disabled Clinical Interest Group in 1970 and was chairman for many years.

Miss Saywell also served on the council of the RDA.

She started using riding as a form of rehabilitation at Winford Orthopaedic Hospital in 1948 and formed close links with physiotherapists from Holland, N~~~~~ and Denmark in the early 1950s which led to worldwide recognition in

0 The address of the National Back Pain Association is now 16 Elmtree Road, Teddington, Middlesex TW11 8ST (tel 081-977 5474, fax 081-943 5318).

ications Meeting Services, Top Floor, 19 The Hundred, Romsey, Hampshire SO51 8GD.

Ruby Reunion in Centenary Year

Twenty-three physiotherapists, who trained at the Leeds School of Physio- therapy, travelled from all parts of England to meet at Weetwood Hall, Leeds, on April 23, in order to celebrate the 40th anniversary of their first meeting.

The event was organised by four members of the group, between the months of June and December 1993. Major detective work was involved in which the CSP membership officer played a part.

Members of the group were able to circulate freely while enjoying a buffet lunch together with Centenary wine. At 4.30 pm all reluctantly departed for home after a truly memorable day.

The investigation and planning were well rewarded with the renewal of friendships which had lapsed over the years. The over- whelming feeling at the end of the day was that the event should be repeated in the future.

Left: The reunited ruby revellers

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RSI - Physiotherapy Management and Recognition As figures reveal that repetitive strain injury is approaching epidemic proportions, two physiotherapists who have been running courses on the condition talk to Bernadette Friend about its management. The TUC has estimated that 200,000 people a year take time off work because of injury through repetitive work and RSI is calculated to be costing over a €1 billion annually in lost income, benefits, treatment and lost production.

Peter Wells FCSP, a London practitioner with a special interest in the condition, says physiotherapists need to push the idea of early identification of RSI in their contacts with the public, doctors and employers.

Early referral and management are essential. He says physiotherapists need to be involved at the sharp end of the referral system and they should not have to wait until patients are eventually referred with chronic symptoms.

At the outset, patients with RSI must be believed, says Mr Wells. The distress of being thought to be a malingerer merely aggravates the chronic pain being experienced. People with upper limb disorders are often extremely distressed and worried and they should be reassured that if caught early enough, much can be done.

Physiotherapists should then carry out a detailed examination and assessment of the patient’s signs and symptoms, including specialist tests for soft tissue mobility like the upper limb tension test (ULlT) and the spinal canal SLUMP test. Despite the fact that the use of ULTT has been written about as a means of assessing whiplash injury, Mr Wells believes that the vast majority of doctors do not know about it.

Treatment has to be aimed at the relevant tissues. If a core tissue can be identified, for example, if nervous tissue mobility is found to be restricted and the signs of restriction are comparable with the symptoms, then these signs must be tackled. Treatment should take into account investigation of mobility of the thoracic and cervical spine, restoration of spinal and spinal neural tissue mobility, restoration of peripheral neural tissue mobility, mobilisationl manipulation of

related joint problems particularly in the mid thoracic spine and lower cervical spine, and attention to posture.

Many keyboard operators end up with a stooped posture, and while they will not all get RSI, if they do develop symptoms, the slumped posture will increase tension in the nervous system including, very importantly, the sympathetic nervous system. The classic posture is of rounded shoulders and a poking chin and this over- flexed position produces local spinal stress and strain, including referral into the arms. Muscle imbalance problems which develop alongside these postures also need correction.

However, attention to the clinical signs and symptoms of RSI is not enough in itself. Consideration has to be given to the workplace, which invoives more than just checking whether the chair is adjustable. If caught early, Mr Wells said patients can return to work, provided they introduce and maintain modifications. The work pattern has to be changed to prevent the occurrence of concentrated periods of unbroken stress, by incorporating frequent, regular pause gymnastics (simple stretch exercises each half hour for two minutes). These short breaks interrupt the ‘ongoing stress’ and give the tissues time to recover.

Mr Wells says he thinks that the publicity over the ruling in the High Court by Judge Prosser that RSI had ‘no place in the medical books’ had brought the condition out in the open. Since this decision, two claims for compensation have been successfully won in the courts and many more cases are in the pipeline. (See also Forum by Elizabeth Grieve in this issue).

A number of courses have been held on RSI. Mr Wells says the aim is to introduce the concept of ‘widening’ the physiotherapists’ approacb. Very often physiotherapists have the skills already - what they need is to be shown how to put everything together as a management programme.

Bury the Rumours Physiotherapist and ergonomist Jeff

Boyling says there are many myths and rumours that need to be aired, then buried. RSI-type problems have been around for a long time, particularly in manufacturing industries. Similar problems in office workers began to emerge with the intro- duction of new technology. Mr Boyling explains that while some employers can see the benefits that physiotherapy offers, others are more sceptical, fearing they may be opening a ‘can of worms’.

But one development that could bring about a change of attitude and approach, is the interest in the condition being shown by insurance companies. Insurers, with their eye on possible future claims, are now beginning to ask employers what they are doing to minimise risk.

Correct diagnosis is crucial. One patient who had been diagnosed as having RSI, has been told to stop using her keyboard. But the problem was not work-related and after she changed her sleeping position, her symptoms disappeared.

Mr Boyling believes a ‘back to basics’ approach is needed and suggests that undergraduate teaching should pay closer attention to detail in the teaching of musculoskeletal conditions.

He lists some key principles to remember: Adopt a balanced joint position.

*Avoid static muscle work. Avoid nerve compression. Reverse the posture regularly.

At least one health authority is said to be refusing treatment for RSI. While those already suffering symptoms - including many who have not disclosed that they have a problem - need help from physio- therapists now, the real key to RSI is to try to prevent the problem occurring in the first place.

Mr Boyling says: ‘We need to do a lot more in terms of prevention if we are going to minimise the risks. We are still going to have problems but they will be of a lower intensity and severity.’

research and information

Physiotherapy Research Foundation

The Physiotherapy Research Found- ation provides funding for research projects for members of the Chartered Society of Physiotherapy. For this round of applications it is hoped to provide a limited number of awards of up to €10.000, though applications for smaller amounts will continue to be considered.

Application forms and further details are available from Samantha Pym, Education Department, The Chartered Society of Physiotherapy, 14 Bedford Row, London W C l R 4ED. The closing date for applications is October 1, 1994.

Introduction to Research Pack A revised edition of the Introduction to Research Pack is now available at a cost of €5. It contains sections on:

How to write a research proposal Literature searching: what to look for and where to go Ethical and legal considerations Collaboration in research Sources of funding and how to apply Research presentations skills: How to present your project Bibliography of research books and articles Information Resource Centre: Journal holdings, request for a

General information on the IRC Projects from the research database Postgraduate programmes of relevance to physiotherapists.

literature search

For further information please contact Samantha Pym in the Education Department.

Physiotherapy, June 1994, vol80, no 6