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5 th BIENNIAL EMIRATES

PHYSIOTHERAPY CONFERENCE 19 - 20 May 2016 | Jumeirah Emirates Towers

2016

D U B A I - U N I T E D A R A B E M I R AT E S

CONFERENCE BOOK

9 CME hrs Accredited by

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Congress Secretariat: MCI Middle East, UAE, Tel: +971 4 311 6300, Fax: +971 4 311 6301, E-mail: physiodubai@mci-group.com 1


‫�صاحب ال�سمو ال�شيخ خليفة بن زايد �آل نهيان‬

His Highness Sheikh Khalifa Bin Zayed Al Nahyan

‫رئي�س دولة الإمارات العربية املتحدة‬ President of the U.A.E

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‫�صاحب ال�سمو ال�شيخ حممد بن را�شد �آل مكتوم‬

His Highness Sheikh Mohammed Bin Rashid Al Maktoum

‫ حاكم دبي‬,‫ رئي�س جمل�س الوزراء‬,‫نائب رئي�س الدولة‬

Vice President, Prime Minister and Ruler of Dubai

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‫�صاحب ال�سمو ال�شيخ حمدان بن را�شد �آل مكتوم‬

His Highness Sheikh Hamdan Bin Rashid Al Maktoum

‫ الإمارات العربية املتحدة‬,‫ وزير املالية‬,‫نائب حاكم دبي‬

Deputy Ruler of Dubai, Minister of Finance, UAE

‫رئي�س هيئة ال�صحة يف دبي‬

President of Dubai Health Authority

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TABLE OF CONTENTS

WELCOME MESSAGE

Welcome Message ............................................... 09 General Information ............................................. 10 Floor Plan .............................................................12 Organizing Committee...........................................14 Scientific Committee .............................................15 Program at a Glance.............................................. 17 Scientific Program ................................................ 18 Faculty Profile........................................................ 21 Keynote & Oral Abstracts....................................... 27 Poster Abstracts.................................................... 72

Dear Colleagues, On behalf of the local organizing committee I would like to invite you to the Fifth Biennial Emirates Physiotherapy Conference: Physio Dubai 2016, which is going to take place at the Emirates Towers / Dubai on 19th - 20th May 2016. It’s been 3 years since our last conference in 2013. Since 2006 Emirates Physiotherapy Society has taken the responsibility to continue organizing Physio Dubai Conference and gather all of you for two days to learn and interact with each other. Physio Dubai 2016 will bring world-class researchers and clinicians to disseminate their knowledge and experience in the field of musculoskeletal physiotherapy. Physio Dubai 2016 is a platform aiming at bridging the gap between practice and research by providing the latest in the growing body of knowledge and research in the field of physiotherapy and rehabilitation. The workshops that will be organized along the scientific program of the conference shall complement the knowledge gained by learning new skills and clinical applications. We would like to encourage you all to support and participate in Physio Dubai 2016 and become part of its ultimate aim of successful learning and networking. Thank you very much and we look forward to welcoming you to Dubai.

Sponsors Profiles.................................................. 88 About Dubai .......................................................... 92

Amal Alshamlan, MS, PT President of the Emirates Physiotherapy Society Chairman of the Conference

Acknowledgement................................................. 94

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GENERAL INFORMATION REGISTRATION: Registration desks for name badge collection and on-site registration will be open from 07:00am on both days of the conference. BADGES: Name badges must be visible and used at all times while attending the conference. COLORS: DESCRIPTION: Committee (All Access) Delegate (All Access, Except Speaker Preview Room) Exhibitor (No Access to Scientific Sessions) Faculty (All Access) Staff (All Access) Media (All Access)

GENERAL INFORMATION CME CERTIFICATION: 5th Biennial Emirates Physiotherapy Conference 19th & 20th May 2016 Central Sensitization in Clinical Practice: Physiotherapy as Brain Therapy for Patients with Chronic Pain Dr. Jo Nijs - 17th & 18th May 2016 Management of Neck and Arm Pain including Radiculopathy Dr. Annalie Basson - 18th May 2016

9Hrs 4.5 Hrs

Fascial Manipulation Dr. Antonio Stecco - 21st May 2016 The Shoulder: Theory and Practice (10th edition) Dr. Jeremy Lewis - 21st & 22nd May 2016

SPEAKER REGISTRATION:

9Hrs

4.5 Hrs 9Hrs

Faculty name badges and congress bags can be picked up from the Speaker Preview Room which is located Foyer 5 at the ground floor. The room will be available for presentation uploading and final checks of presentation(s). Opening hours are as follows: 19 May 07:00 – 17:00 | 20 May 07:00 – 17:00

Fast and Frugal Assessment and Treatment of Low Back Pain Dr. Chad Cook - 21st & 22nd May 2016

FOOD & BEVERAGE:

Online CME certification will be available from 27th May 2016 onwards. Please visit www.physiodubai.com to avail of your CME certificate upon completion of the online evaluation form.

Lunch & coffee breaks will be provided in Godolphin Ballroom Foyer.

9Hrs

CONFERENCE SECRETARIAT:

PRAYER ROOM: Male Prayer Room is located in the Godolphin Ballroom Foyer. Female Prayer Room is located in the Congress Room 2 - 2nd Floor.

MCI - Dubai Office, P.O. Box 124752 Dubai, United Arab Emirates Phone: +971 (0) 4 311 6300 Fax: +971 (0) 4 311 6301 | physiodubai@mci-group.com

SMOKING POLICY: Smoking within the building premises is prohibited, but designated smoking areas are provided outside of the building.

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exhibition floor plan

FIRE EXIT

FIRE EXIT

FIRE EXIT

FIRE EXIT

Godolphin Ballroom Hotel Lobby 15

Al Zaharawi

MCI

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MPC

19 Technogym

Prince

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Male Prayer Area

BTL

Entrance Coffee Area 2

Coffee Area 1

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4

Sabaa F

irst

Fire Cab

inet

6

5

City Phar

ma

Physiomart

Registration Desk

1

Registration Desk

Media

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9 Atlas

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Posters

s

Lunatu

Trinity

Fire Cabinet

Main Entrance

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ORGANIZING COMMITTEE

SCIENTIFIC COMMITTEE

Naima Saleh

Wasim Labban

Chairperson - Organizing Committee Senior Physiotherapist Board Member Emirates Physiotherapy Society UAE

Fatima Al Lingawi

Hamda AlKetbi

Chairperson - Scientific Committee Emirates Physiotherapy Society Senior Physiotherapist, Mirdif Center for Physiotherapy and Rehabilitation UAE

Bronwen Peacock

Physiotherapist Dubai Police Health Center UAE

Physiotherapist Rashid Hospital Dubai Health Authority UAE

Manipulative Physiotherapist Dubai Physiotherapy and Family Medicine Clinic Dubai, UAE

Charlotte Dibo

Beverley Strathearn

Shadin Bassas

Physiotherapist Dubai Police Health Center UAE

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Physiotherapist Orthosports Medical Centre UAE

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Physiotherapist Dubai Health Authority UAE

Meer Ibrahim

Thanooja Naushad

Jennifer Crabbe

Robyn Stanford

Physiotherapist Dubai Police Health Center UAE

Head of Rehabilitation Mediclinic City Hospital UAE

Senior Physiotherapist Latifa Hospital UAE

Physiotherapist optimalTHERAPY UAE

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2016

EMIRATES PHYSIOTHERAPY CONFERENCE 19 - 20 May 2016 | Jumeirah Emirates Towers

PROGRAM AT A GLANCE D U B A I

-

U N I T E D

A R A B

E M I R AT E S

PROGRAMME AT A GLANCE Thursday 19 May 2016

Friday 20 May 2016

DAY1

DAY2

07:00

07:00

08:00

Registration & Welcome Coffee

Registration & Welcome Coffee

08:00

09:00

Opening

Session I

09:00

Session I WCPT Keynote - Emma Stokes, Ireland Oral Abstract Presentations

Keynote - Annalie Basson, South Africa Oral Abstract Presentation

Morning Coffee & Exhibition Viewing

Morning Coffee & Exhibition Viewing

10:00

11:00

Keynote - Antonio Stecco, Italy

Keynote - Chad Cook, USA

Keynote - Einas Al Eisa, KSA Oral Abstract Presentations

Lunch and Poster & Exhibition Viewing

14:00

15:00

Keynote - Jeremy Lewis, UK

Registration

13:00

Registration

Keynote - Chad Cook, USA

12:00

17:00

12:00

Oral Abstract Presentation Technogym Symposium

13:00 Lunch and Poster & Exhibition Viewing

Session III

Session III

Keynote - Annalie Basson, South Africa

Keynote - Einas Al Eisa, KSA

Keynote - Jo Nijs, Belgium

Keynote - Jo Nijs, Belgium

Oral Abstract Presentations

Oral Abstract Presentation

Coffee Break

16:00

11:00

Session II

Session II

10:00

14:00

15:00

Coffee Break

Session IV

16:00

Session IV

Keynote - Antonio Stecco, Italy Keynote - Jeremy Lewis, UK

Oral Abstract Presentation Multidisciplinary Forum

Oral Abstract Presentations

17:00

Closing Remarks and Award Ceremony

18:00

18:00

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5 th BIENNIAL EMIRATES

5 th BIENNIAL EMIRATES

PHYSIOTHERAPY CONFERENCE

PHYSIOTHERAPY CONFERENCE

19 - 20 May 2016 | Jumeirah Emirates Towers

19 - 20 May 2016 | Jumeirah Emirates Towers

2016

D U B A I - U N I T E D A R A B E M I R AT E S

2016

SCIENTIFIC PROGRAM

*SCIENTIFIC PROGRAM

Godolphin Ballroom

07:30 - 16:00

Registration

09:00 - 09:30

Opening

09:30 -10:30

Session I Chairperson: Meer Ibrahim, UAE

09:30 - 10:00

WCPT KEYNOTE: An update on WCPT and the Global PT Community and a Focus on Emerging Areas.

Emma Stokes President, WCPT, Ireland

10:00 – 10:30

Clinical Perspective: Immediate Effect of Acupuncture on Post-Operative Pain After Lumbar Surgery

Ana Alexandra Anjos Portugal

10:30 – 11:00

Morning Coffee & Exhibition Viewing

Godolphin Ballroom Foyer

11:00 – 13:00

Session II Chairperson: Isam Al Mikhi, UAE

11:00 – 11:30

KEYNOTE LECTURE: Pros and Cons of Clinical Prediction Rules

Chad Cook, USA

11:30 - 12:00

KEYNOTE LECTURE: Fear Avoidance Beliefs and Health Literacy Among Women with Low Back Pain

Einas Al Eisa, KSA

12:00 - 12:15

Clinical Perspective: Ghanaian Physiotherapists’ Attitudes and Beliefs on Low Back Pain and How They Influence its Management

Bertha Oppong-Yeboah, Ghana

12:15 – 12:30

Clinical Perspective: Physiotherapist Perception of Self-Management of Patients’ Low-Back pain

Zalak Sanaf, UAE

12:30 - 12:45

Clinical Perspective: Low Back Pain in Law Enforcement Sector: Study of Dubai Police Meer Ibrahim, UAE

12:45 - 13:00

Discussion

13:00 - 14:00

Lunch and Poster & Exhibition Viewing

14:00 – 15:30

Session III Chairperson: Robyn Stanford, UAE

14:00 – 14:30

KEYNOTE LECTURE: The Effect of Neural Mobilization on Neuro-Musculoskeletal Conditions

Annalie Basson, South Africa

14:30 – 15:00

KEYNOTE LECTURE: Central Sensitization in Patients with Chronic Pain: Past, Present & Future

Jo Nijs, Belgium

15:00 – 15:15

Clinical Perspective: Is Physiotherapy Effective for Referred Leg Pain Arising from the Lumbar Spine? A Systematic Review

Othman Alkassabi, KSA

15:15 – 15:30

Discussion

15:30 – 16:00

Coffee Break

16:00 – 17:30

Session IV Chairperson: Veena Raigangar, UAE

Godolphin Ballroom Foyer

Godolphin Ballroom Foyer

16:00 – 16:30

KEYNOTE LECTURE: Para Tendon and Tendinopathy

Antonio Stecco, Italy

16:30 – 17:00

KEYNOTE LECTURE: Don’t Want to Be Left Out in The Cold: Non-surgical Management Of Frozen Shoulder

Jeremy Lewis, UK

17:00 – 17:15

Clinical Perspective: Effectiveness on Scapula Stabilization Exercises on Scapular Dyskisesis Type2

Pradeep Shankar, UAE

17:15 – 17:30

Discussion

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D U B A I - U N I T E D A R A B E M I R AT E S

SCIENTIFIC PROGRAM

*SCIENTIFIC PROGRAM

Day 1 - 19 May 2016

www.physiodubai.com

Day 2 - 20 May 2016

Godolphin Ballroom

07:30 - 16:00

Registration

09:00 - 10:30

Session I Chairperson: Thanooja Naushad, UAE

09:00 - 09:30

KEYNOTE LECTURE: Mechanical Behavior of Deep Fascia.

Antonio Stecco, Italy

09:30 – 10:00

KEYNOTE LECTURE: Management of Nerve-related Neck And Arm Pain

Annalie Basson, South Africa

10:00 - 10:15

Clinical Perspective: Is There any Difference in Effectiveness of Dry Needling Manual Therapy, and Kinesio Taping Methods for the Management of Patients with Myofascial Chronic Neck Pain: A Single-Blind Clinical Trial

Vahid Mazloum, Iran

10:15 - 10:30

Discussion

10:30 - 11:00

Morning Coffee

11:00 - 12:30

Session II Chairperson: Ana Alexandra Anjos, Portugal

11:00 - 11:30

KEYNOTE LECTURE: Differential Diagnosis of Musculoskeletal Disorders

Chad Cook, USA

11:30 - 12:00

KEYNOTE LECTURE: Subacromial Impingement Syndrome. A Musculoskeletal Condition Or A Clinical Illusion? The Case For Non-surgical Management

Jeremy Lewis, UK

12:00 - 12:15

Clinical Perspective: Acromioplasty for Shoulder Impingement Syndrome

Youssef Fallaha, UAE

12:15 - 12:30

Discussion

12:30 - 13:00

Scientifically based training equipment and big data management for a successful rehabilitation Sponsored by Technogym

Silvano Zanuso, Italy

13:00 - 14:00

Lunch and Poster & Exhibition Viewing

Godolphin Ballroom Foyer

14:00 - 15:30

Session III Chairperson: Stoyanka Slavova, UAE

14:00 - 14:30

KEYNOTE LECTURE: Correlates of Physical Activity Among Women (Psychological Status, Lifestyle, Interventional Strategies)

Einas Al Eisa, KSA

14:30 - 15:00

KEYNOTE LECTURE: Exercise Therapy For Patients With Chronic Pain: Retraining Pain Memories

Jo Nijs, Belgium

15:00 - 15:15

Clinical Perspective: The Effects of Viscoelastic Insole on Peak Ground Reaction Ramprasad M, UAE Forces (GRF) During Gait in Patients with Acute and Chronic Low Back Pain

15:15 - 15:30

Discussion

15:30 - 16:00

Coffee Break

16:00 - 16:30

Session IV Chairperson: Anil Prasad, UAE

16:00 - 16:30

Clinical Perspective: Principles of Cognitive Behavioural Therapy for Healthcare Practitioners

16:30 - 17:30

Multidisciplinary Forum Moderator: Wasim Labban

17:30 - 18:00

Closing Remarks and Award Ceremony.

Godolphin Ballroom Foyer

Godolphin Ballroom Foyer

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Naif Al Mutawa, Kuwait

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FACULTY PROFILE Emma Stokes President, World Confederation of Physical Therapy Ireland Dr. Emma Stokes qualified as a physical therapist in 1990 [BSc Physiotherapy, Trinity College Dublin] and as a professional coach [Leadership & Executive coaching] in 2015. While working as a clinical physical therapist at St. James’s Hospital, Dublin (1990-1996), she completed a post-graduate Diploma in Statistics (1993) and MSc (Research) in 1995 both at Trinity College Dublin. She took up an academic position at Trinity College in 1996, completed a PhD in 2005 and a graduate degree in management science (MSc Mgmt.) in the School of Business in 2008. She is an associate professor at the Department of Physiotherapy, Trinity College Dublin. In May 2015 Dr. Stokes was elected to the position of President of the World Confederation of Physical Therapy, the sole international organization representing over 350,000 physical therapists worldwide. She has 16 years of international experience representing the profession of physical therapy. Dr. Stokes has played a number of leadership roles over the course of her career. She has played a leading role in the Irish Society of Chartered Physiotherapists (ISCP) as a professional adviser as well as Chair of the Society’s Standing Committees in International Affairs and Finance. She is currently the director of the ISCP Board with responsibility for Professional Development [2012-2014] and is leading a transformation initiative of this function within the Society in preparation for the opening of the Physiotherapists Registration Board of the national regulatory authority - the Health & Social Care Professions Council (CORU) - which will require a significant re-focus of the ISCP’s role and activities. She has been a member/director of Boards in both the health [Peamount Hospital, ISCP, and European Region-WCPT] and university sector in Ireland [Trinity College Dublin. She is currently the Minister for Health’s nominee to represent the physiotherapy profession on the Health & Social Care Professions Council and the Physiotherapists Registration Board. As President of WCPT, she is the chair of the board. She previously chaired the Board of a charity for people with Parkinson’s disease.

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FACULTY PROFILE

FACULTY PROFILE

Annalie Basson President, International Federation of Orthopaedic Manipulative Physical Therapists South Africa

Chad E. Cook Interim Program Director, Professor and Vice Chief of Research Doctor of Physical Therapy Division, Duke University USA

Annalie Basson (M.Phys.T (research), B.Sc. Physiotherapy, OMT certificate) is a physiotherapist in private practice in Pretoria, South Africa. She is a clinician and has been working in private practice for the past 33

Dr. Chad Cook, PT, PhD, MBA, FAAOMPT is professor at Duke University, clinical researcher, physical therapist, and profession advocate with a long-term history of clinical care excellence and service. His passions

years. She has been involved is post-graduate teaching since 1998. She has presented courses and papers nationally and internationally. Her special interests are neck pain, headaches and low back pain. She feels strongly about promoting evidence based practice to improve patient outcomes. She has a passion for physiotherapy and in particular manual therapy. She completed her masters on in 2004. She is currently busy with her PhD at the University of the Witwatersrand. The title of her thesis is “The effect of neural mobilisation on cervico-brachial pain”. She has been involved in the South African Orthopaedic Manipulative Physiotherapy group since 1988 and was the national chair for this group from 1998 – 2004. She has served on PainSA and the Physiotherapy Pain Management Group as committee member. She has served on the IFOMPT executive committee since 2004, first as treasurer and since 2008 as president.

include refining and improving the patient examination process and validating tools used in day-today physical therapist practice. He received his BS in Physical Therapy from Maryville University in 1990 and his MBA (1999) and PhD (2003) from Texas Tech University. Dr. Cook was certified as an orthopaedic manual therapist in 2001, achieved APTA board certified orthopaedic specialization in 2002, and received fellowship status at the American Academy of Orthopaedic Manual Therapy in 2006. Dr. Cook has published over 195 peer reviewed papers and has two textbooks in their 2nd edition and a third textbook in its first edition. He is the senior associate editor for the British Journal of Sports Medicine and is a special topics editor for JOSPT. He is currently treasurer of AAOMPT. Dr. Cook has won numerous awards locally at Duke for teaching, is a recent winner of the top educator award for the American Physical Therapy Association, is the 2017 Pauline Cerasoli lecturer, is the 2008 recipient of the Helen Bradley career achievement award, and is the 2005 winner of the J Warren Perry Distinguished Authorship Award. In addition, Dr. Cook is also the 2011 winner and was the 2012 and 2013 co-winner of the AAOMPT Excellence in Research Award.

Antonio Stecco Medical Doctor, (Specialization in Physical Medicine and Rehabilitation) President of the Fascial Manipulation Association Italy Dr. Antonio Stecco is an active athlete with recurrent minor traumas. He has the luck to have a father who performed a particular manual therapy focused in the fascia. The success of the results had stimulated Antonio, at the end of Medical Doctor’s degree, to continuing the study in Physical Medicine and Rehabilitation and then, in a fellow, in ultrasonography for musculoskeletal dysfunctions and, in a PhD, in Sport Medicine. With the collaboration of his sister, who is Professor of Anatomy at the University of Padova, he performed different anatomical and histological studies to prove the real anatomy and physiology of the fascial tissue. Those studies confirmed the anisotropic characteristics and non-linear elastic behavior of the deep fascia that is composed by different layers of parallel collagen fibers. This constitutive modeling represents a useful tool to rationally interpret the correlation between functional behavior and structural conformation of the deep fascia. His major contribution was the description of the increase of the fascial stiffness due to the modification of the viscosity of the hyaluronic that is presented between the different layers of collagen fibers that compose the deep fascia. Antonio Stecco is now the President of a non-profit association who is teaching this method, invented by his father, in more than 40 countries at more than 1000 students a year. Antonio Stecco continues to progress his passion for writing and his enthusiasm for getting a research well done.

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Einas Al-Eisa Associate Professor & Consultant of Rehabilitation, Department of Rehabilitation Sciences, College of Applied Medical Sciences King Saud University KSA Dr. Einas Al-Eisa is an Associate Professor and Consultant of Rehabilitation at the Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University. She holds a M.Sc. in Physical Therapy, and a Ph.D. in Anatomy and Neurobiology from Faculty of Medicine, Dalhousie University, Canada. Dr. Al-Eisa served at several administrative positions, and is currently the Vice Rector of King Saud University for Female Affairs. She was awarded during her career with several awards, most notably: “Healthcare Professional Award” in 2007 from Harvard University. Dr. Al-Eisa published a number of research papers in International Journals such as “Spine” and the “Archives of Physical Medicine and Rehabilitation”. She participated in number of international conferences as a speaker and\or organizer. She is an alumni of the “Women & Power Leadership Program” at Harvard University. Her research interest lies in the areas of low back pain; sociocultural factors contributing to adherence; motivational interventions to promote physical activity; and women’s health. Her research activities are sponsored by grants from the Ministry of Higher Education and King Abdulaziz City for Science & Technology. www.physiodubai.com

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FACULTY PROFILE

FACULTY PROFILE

Jeremy Lewis Consultant Physiaotherapist, Professor of Musculoskeletal Research Sonographer, Independent Prescriber, London Shoulder Clinic UK Dr Jeremy Lewis (PhD FCSP) is a Consultant Physiotherapist and Professor of Musculoskeletal Research. He was born in New Zealand and trained in Australian. He works in the UK National Health Service as well as working privately in central London (www.CHHP.com). He has been awarded a Fellowship of the Chartered Society of Physiotherapy, which is the highest award the Society can bestow on one of its members. He has been acknowledged as one of the 5 most eminent clinicians in his profession (UK DoH [Department of Health] National AHP Clinical Expert Database). He assesses and treats patients with complex shoulder problems. Jeremy has also trained as a sonographer and performs ultrasound guided shoulder injections, (including intra-articular hydro-distension procedures for Stage III frozen shoulder) as part of the rehabilitation process if required and appropriate. He has also completed an MSc (Musculoskeletal Physiotherapy), and Postgraduate Diplomas in Sports Physiotherapy, and in Biomechanics, as well as MSc modules in injection therapy for soft tissues and joints. He also has a Postgraduate Certificate in Diagnostic Imaging (Ultrasound) (University of Leeds, UK). He has recently qualified as an Independent Prescriber. Since 1992, Jeremy has taught over 300 shoulder workshops internationally in the USA, Canada, Australia, New Zealand, the Cayman Islands, Brazil, Chile, Argentina, Peru, The Azores, Norway, Denmark, Switzerland, Sweden, Iceland, the Middle East, Ireland, South Africa, India, and Japan, extensively throughout Europe and throughout the UK. He has also lectured on the shoulder at many international conferences. His main areas of research interest are rotator cuff tendinopathy, shoulder pain syndromes and lateral epicondylopathy. In addition to his own research he supervises PhD and MSc students. Jeremy is an associate editor for the journals; Shoulder & Elbow and, Physiotherapy. He was a co-editor and author for Grieve’s Modern Musculoskeletal Physiotherapy (4th ed).

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Jo Nijs Professor, Department of Physiotherapy, Human physiology and anatomy, Faculty of physical education and physiotherapy Vrije Universiteit Brussel Belgium Dr. Jo Nijs holds a PhD in rehabilitation science and physiotherapy. He is professor at the VrijeUniversiteit Brussel (Brussels, Belgium) and physiotherapist/manual therapist at the University Hospital Brussels. His research and clinical interests are patients with chronic unexplained pain / fatigue and pain-movement interactions. He has (co-) authored more than 150 peer reviewed publications, obtained over €4.7 million of grant income, supervised 6 PhD projects to completion and served more than 150 times as an invited speaker at national and international meetings in 19 different countries. His work has been cited >1800 times (ISI Web of Knowledge).

Silvano Zanuso, MSc, PhD Director, Technogym Medical & Scientific Visiting Professor Faculty of Science at the University of Greenwhich(London) Italy Dr. Silvano Zanuso is the director of the Technogym Medical & Scientific Department and visiting professor at the Faculty of Science at the University of Greenwhich in London. He received his Bachelor Degree in Exercise Science at the ‘University of Padua’, his Master of Science at the ‘Manchester Metropolitan University’ and his Ph.D. in Clinical Exercise Physiology at the ‘Universidad Europea de Madrid’. Dr. Zanuso’s primary scientific and research interest is on the effects of physical activity and exercise in those with metabolic disorders, and he publishes regularly on this and other topics in recognized scientific and clinical journals. Dr. Zanuso has been a consultant for health promotion for different governments and public institutions, and he has held conferences and educational programs in more than twenty countries.

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KEYNOTE ABSTRACT An update on WCPT and the Global PT Community and a Focus on Emerging Areas. Emma Stokes, President, WCPT, Ireland Abstract: This presentation will give an overview of the WCPT, its recent consultation ‘WCPT Look Forward Together’ and its new strategic plan. It will also consider areas where PT practice is developing and emerging in new and advanced practice.

Notes

MPC has Wide range of Physiotherapy & Rehabilitation products such as

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ORAL ABSTRACTS

Notes

Immediate Effect of Acupuncture on Post-Operative Pain After Lumbar Surgery Ana Alexandra Anjo, Portugal Author: Fatine Hamza, Ana Anjos, Jorge Machado, Manuel Laranjeira, Henry Johannes Greten Background: Acupuncture has a wide range of possible applications and may be able to contribute to the management of post-operative pain. Moreover, in general, side effects from acupuncture are low. It therefore represents a useful therapeutic option to consider within the overall pain management of individuals. General Objective: To evaluate the therapeutic effect of acupuncture in relieving post-operative pain after lumbar surgery Specific Objectives: To develop a clinical protocol for the treatment of post-operative pain after lumbar surgery and to create a study design for the objective assessment of acupuncture effects in this condition Methods: We designed a randomized single-blinded controlled clinical trial to investigate if acupuncture can be a useful therapeutic option in post-operative pain after lumbar surgery. 30 patients with post-operative pain after lumbar surgery were randomly assigned to two groups. Group one: Verum group received acupuncture in three points R10(KI10), V40(BL40) and L6(SP6). Group two: received Sham acupuncture in three points that does not belong to any meridian. Leopard spot technique was the chosen acupuncture technique for both groups. Pain was evaluated by subjective measurement using the VAS and objectively by measuring the angle of the hip in the straight leg raise test (Modified Lasegue Test) to the painful point of the active movement, before and after the acupuncture. Results: Our results showed a significant decrease in the pain on VAS by almost half comparing to before the acupuncture in both groups. A significant increase in angle measurement was noted as well between before and after acupuncture in both groups. By comparing data in both groups we found out that the verum group showed better results than the sham group. However, this difference was not statistically significant at p> 0.005. Our data suggests that acupuncture can be used as a post-operative pain analgesic. It also proved the efficiency of the selected points. However, the therapeutic effect found in the control group is not unusual. Sham acupuncture appeared to have an analgesic effect in 40% to 50% of patients compared to 60% to 75% for real acupuncture. Conclusion: Acupuncture showed to be an effective way of treatment in post-operative pain after lumbar surgery for LDD and LSS. No side effects for acupuncture were found in our study. A significant difference was found before and after the acupuncture in patients who were consuming regularly their conventional analgesic medication. The subjective and objective methods of measurements were both improved after acupuncture. Finally, acupuncture can be used effectively as an adjunct to conventional analgesia in surgery departments.

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KEYNOTE ABSTRACT

Notes

Pros and Cons of Clinical Prediction Rules Chad Cook, USA Abstract: Clinical prediction rules (CPRs) have been increasingly used in physiotherapy practice and have been adopted to selected clinical practice guidelines. These rules use baseline criteria called treatment effect modifiers1, which are gathered from an a physical examination to inform the type of treatment that a patient should preferentially receive. Many CPRs have been created and have been enthusiastically incorporated in clinical practice. For example, CPRs exist to help identify which patients with back pain should receive spinal manipulation and stabilization exercises. Their purpose is to better match patients to treatments, based on their predicted responsiveness to that treatment, independent of a diagnosis. Prescriptive CPRs are mentioned in clinical practice guidelines2 for patients with spinal pain and the premise behind them is arguably sound - they are a form of ‘personalised medicine’ that help translate research findings into clinical decisions at the level of the individual patient. Recent studies have outlined limitations of these rules that deserve discussion. This presentation identifies the pros and cons of CPRs.

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KEYNOTE ABSTRACT

Notes

Fear Avoidance Beliefs and Health Literacy Among Women with Low Back Pain Einas Al Eisa, KSA Background: Low back pain is a very common health problem worldwide and affects people of all ages. It is a major cause of disability affecting general well-being and performance at work. Pain related attitudes and beliefs can actually lead to avoidance of movements and activities which in turn, contributes to disability. People with limited health literacy often lack knowledge or have misinformation about the spine as well as the nature and causes of low back pain. Without this knowledge, they may not understand the relationship between spine impairment and psychosocial dysfunction. Purpose/Aim: The aim of the study was to assess the relationship between level of disability, fear avoidance beliefs and health literacy among Saudi females with chronic low back pain. Materials and Methods: We conducted a cross sectional survey of females with chronic low back pain. Two hundred and twenty seven women, of mean age 38.5±12.2 years, comprising 152 with minimal disability, 57 with moderate disability, 15 with severe disability and 3 with crippled disability (as determined by Oswestry disability index scores) participated. Data regarding fear avoidance beliefs about LBP and health literacy were collected using the Fear avoidance beliefs questionnaire (FAB) and the Newest Vital Sign (NVS), respectively. Results: The moderate, severe and crippled disability groups reported significantly greater fear avoidance beliefs compared with the minimal disability group. Greater disability (ODI) was associated with higher levels of fear avoidance beliefs related to physical activity (FAB-PA) (r= .39, p<0.01) and high likelihood of limited literacy (r= -.38, p<0.01), although a weak association was seen between disability and fear avoidance beliefs related to work (FAB-W) (r= .26, p<0.01). Similarly, a weak negative correlation was observed between fear avoidance beliefs (PA) and health literacy (r= -.16, p<0.05). There was no significant association between fear avoidance beliefs related to work (FAB-W) and health literacy (r= -.05, p<0.05). Conclusion(s): Chronic low back pain individuals with high disability had limited health literacy and increased fear avoidance behaviours relating to physical activity. Knowing the fear avoidance behaviours and the level of patient’s health literacy may help physicians and rehabilitation health providers deliver low back pain information and apply clear communication methods that may enhance patient’s knowledge about their condition.

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ORAL ABSTRACTS Ghanaian Physiotherapists’ Attitudes and Beliefs on Low Back Pain and How They Influence its Management. Bertha Oppong-Yeboah, Ghana Author: Bertha Oppong-Yeboah, Ghana Background: Physiotherapists’ attitudes and beliefs have been reported in some countries to influence their management of low back pain including the advice they give to their patients. It has also being reported that these negative pain attitudes and beliefs of physiotherapists additionally influence the attitudes and beliefs of their patients leading to a slow recovery and consequently increased direct and indirect costs. The two main practice orientations have being identified as biomedical and biopsychosocial. The management style of Ghanaian physiotherapists in low back pain is not known although the condition is highly prevalent in Ghana. Purpose: To evaluate the attitudes and beliefs of physiotherapists with regards to low back pain and to determine how these influence their management advice. Participants: Registered physiotherapists nationwide who have been managing low back pain for at least 2 years participated in this study. They were recruited by using purposive sampling. Methodology: The Physiotherapists’ attitudes and beliefs scale (PABS-PT) was used to assess the attitudes and beliefs of participants to determine their practice orientation. A clinical vignette was used to determine the management advice given by participants concerning work, activity and rest. Information on demographics was obtained using a data capturing questionnaire. The three questionnaires were mailed to participants with a postage paid return envelope included. Analysis: Descriptive statistics of means, percentages and range were used to interpret data. Chi square analysis was used to investigate the association of demographic features of participants and their practice orientation and management advice. Results: Majority of the participants (85%) had a biomedical orientation. The mean score (SD, range) for all participants on the Biomedical subscale was 54.66 (8.29, 36–70) and on the Biopsychosocial subscale was 17.94 (2.86, 11–25). For their management advice; with regards to activity and bed rest majority of participants were broadly in line with guideline recommendations irrespective of their practice orientation. Concerning work, the proportion of recommendations that were not in line with guideline recommendations was higher (44.3%) amongst biomedical practitioners than in the biopsychosocial ones (20%); this difference was however not statistically significant. No demographic feature was found to be associated with practice orientation or management advice. Conclusion: Majority of the participants are oriented to the Biomedical Model of managing Low Back Pain and their advices concerning the management of low back pain are broadly in line with guideline recommendations. Practice orientation therefore does not appear to influence management advice in low back pain management.

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Physiotherapist Perception of Self-Management of Patients’ Low-Back Pain. Zalak Sanaf, UAE Author: Zalak Sanaf Objectives: The aim of this study was to investigate the physiotherapists perceptions of self-management of patients’ low-back pain. An approach of qualitative research methodology was used to explore physiotherapists opinion on self management and what strategies they use to in cooperate it in patients management plan. Subjects and Methods: A focused group interview was conducted with 7 physiotherapists who each had more than 3 years of experience. A focused group interview facilitated open discussion around the topic. Data analysis was done by using 6 steps thematic analysis suggested by Braun and Clarke. It involved reading and transcribing data to get meaningful themes which were based on thoughts and belief of the participants. These themes would further help therapists to structure exercise programme by in cooperating self management more efficiently in patients with low back pain. Findings: Two main themes were identified from data analysis. 1. Physiotherapists’ perception of self-management programme. 2. Physiotherapists’ perception of patient adherence. The findings of this study concluded that self management was essential approach in patients management and this should be in cooperated as a part of exercise programme. It also identified that physiotherapists should take into consideration some internal and external factors like patients perceptions and belief, their psychosocial state, their job and their pain management when designing a care plan. Physiotherapists in this study reported that in order to improve patients quality of care it is important that health care professionals should work as a multidisciplinary team. Conclusion and Discussion: All Participant physiotherapists had positive approach towards self management for management of low back pain patients but however they felt that there were few aspects of this programme that need further development. They felt that it is essential for patients to understand self management as a part of their exercise programme and they should be responsible for their quality of life with support of their physiotherapists.

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Low Back Pain in Law Enforcement: A Dubai Police Study Meer Ibrahim, UAE Author: Meer Ibrahim, Ahmed Khalil, Omar Alzadjali Context: low back pain is very common among office workers and drivers in police force. Identifying these factors that causing low back pain and what are best practice guideline for rehabilitation and prevention of these problems are helpful tools for healthcare providers and patients. Objective: To determine what are these factors that contribute to low back pain and design a rehab program that help address both factors, its correction and exercise rehabilitation. Our Sources: data base from patient physiotherapy files were searched in Dubai Police MEDCUS medical electronic filing system from 2010 and 2012 new patient files only. The key words were: bad posture 58% of patients, 16% due to prolonged sitting, and 10% due to obesity and overweight. Our focus was demining the factor and create recommended exercise program to be used as core to be provided to most of those who suffer from low back pain in Dubai police force. Outcome: Sitting, bad posture and obesity or being overweight are common contributing factors to low back pain in Police Force. A recommended postural correction and exercise program is an acceptable approach to help in reducing low back pain among Dubai Police staff from both rehab and prevention area alike. Conclusion: Bad posture, prolonged sitting and being over weight are contributing factors to cause low back pain in Dubai police staff. Proper assessment and providing best practice rehab and prevention program is crucial in reducing low back and return to work.

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The Effect of Neural Mobilization on Neuro-Musculoskeletal Conditions: A Systematic Review and Meta-Analysis Annalie Basson, South Africa Study Design: Systematic review with meta-analysis. Objectives: To determine the effectiveness of neural mobilisation (NM) for musculoskeletal conditions with a neuropathic component. Background: NM or neurodynamics is a movement-based intervention aimed at restoring the homeostasis in and around the nervous system. Two non-updated systematic reviews exist, but the current level of evidence for NM is unknown. Methods: Relevant databases were searched for randomised trials investigating the effect of NM for various neuro-musculoskeletal conditions. Standard methods to identify and select studies were used. Eligible trials were appraised for quality (JBI-MAStARI) and risk of bias (GRADE). When possible, studies were pooled for meta-analysis. Main outcomes of interest were pain, disability and function. Results: Thirty-eight studies were included in this review, of which 19 had low risk of bias. For low back pain, pain and disability improved following NM (both p<0.001). For neck-arm pain, pain improved (p<0.001). For lateral epicondylalgia, the effect of NM on pain remains uncertain (conflicting evidence). For carpal tunnel syndrome, NM was not effective for most clinical outcomes (p>0.1), but showed positive neurophysiological effects (improved intraneural oedema, temporal summation and latency). NM improved plantar heel pain. Due to the scarcity and low quality of studies, the effect of NM remains uncertain for various conditions such as post-operative low back pain and cubital syndrome. Conclusion: Pain and disability improve following NM in low back and neck-arm pain. The effect of NM in other conditions remains unclear. Due to the limited evidence and varying methodological quality,conclusions may change over time.

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Central Sensitization in Patients with Chronic Pain: Past, Present & Future Jo Nijs, Belgium Some patients with persistent low back pain have predominant central sensitization pain rather than nociceptive or neuropathic pain1-3. Central sensitization encompasses various related dysfunctions of the central nervous system, all contributing to an increased responsiveness to a variety of stimuli like mechanical pressure, chemical substances, light, sound, cold, heat, stress and electrical stimuli 4. Such dysfunctions of the central nervous system include altered sensory processing in the brain 5, malfunctioning of descending anti-nociceptive mechanisms 6,7, increased activity of pain facilitatory pathways, and enhanced temporal summation of second pain or wind-up 8,9. In addition, the pain (neuro)matrix is overactive in patients with predominant central sensitization pain. An overview of the evidence regarding central sensitization in patients with low back pain will be presented, together with guidelines on how to recognize predominant central sensitization pain in low back pain patients. Also the implications for clinical reasoning and the treatment of persistent low back pain will be addressed. A variety of treatment strategies specifically target pathophysiological mechanisms known to be involved in central sensitization pain; i.e. they hold – at least theoretically – the capacity to desensitize the central nervous system. Such treatments include pharmacological options 10, electrotherapy targeting the brain (i.e. transcranial magnetic stimulation) 10, manual therapy 10, virtual reality 10, stress management / neurofeedback training 10, transcutaneous electrical nerve stimulation 10, pain neuroscience education11, exercise therapy 12, and cognitive behavioural therapy11. Most of these treatment options, when used for treating central sensitization in patients with low back pain, have their effects through central nervous system modulation, that is, by targeting the brain (top-down approach) rather than peripheral nociceptive input (bottom-up).

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Is Physiotherapy Effective For Referred Leg Pain Arising From The Lumbar Spine? A Systematic Review Othman Alkassabi, KSA Author: Othman Alkassabi, Hana Alsobayel, Mark Perry, Toby Hall Objective: Referred leg pain arising from the lumbar spine can be disabling and has a poorer prognosis than localized low back pain. This systematic review aims to review the effectiveness of physiotherapy in managing referred leg pain arising from the lumbar spine. Data Extraction: MEDLINE, EMBASE, The Cochrane Library, PEDro, PsychINFO and AMED were searched for studies published between from inception up to 2013. Only randomized controlled trials and systematic reviews were included. Data Synthesis: The search yielded 2062 abstracts from which 13 randomized controlled trials and one systematic review were included in this review. Meta-analysis was not possible as none of the treatment comparisons were covered by more than one RCT. The risk of bias in most clinical trials was very high. In those trials where methodological rigour was acceptable, there were indications that transcutaneous electrical nerve stimulation and spinal manipulation may have some place in the management of lumbar spine referred leg pain. Conclusion: The only physiotherapy modalities that have evidence of efficacy for managing lumbar spine referred leg pain are transcutaneous electrical nerve stimulation and spinal manipulation. Further randomized controlled trials are required, with adequate sample sizes and sound methodology.

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Para Tendon and Tendinopathy Antonio Stecco, Italy The Achilles tendon analysis represents one of the most frequent request of ultrasonography evaluation, due to the highest incidence of algic symptoms, in the tendinitis events. Different authors have revealed how the inflammatory manifestations occur in the paratenon structure (Van Dijk 2011). We recruited 22 subjects with painful symptoms at the level of the Achilles tendon and 22 healthy subjects. Both groups were subjected to ultrasonography examination and Victorian Institute of Sport Assessment-Achilles questionnaire. The instrument has detected a statistically significant difference of the paratenon (p = 0.0005) as well as tendon (p<0.0001) thickness. Our results show how Achilles symptoms could also be related to an increase of the paratenon thickness. We suggested a careful analysis of the thickness of the paratenon because if thickened, that can justify the painful symptoms of the patient and represents a harbinger of a tendinophaty process

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Don’t Want To Be Left Out In The Cold’: Non-Surgical Management of Frozen Shoulder Jeremy Lewis, UK Background: Frozen shoulder is characterised by (frequently severe) pain and a substantial loss of movement and as such is associated with considerable morbidity and frustration for patients and clinicians. It is considered to be a self-limiting condition of 1 to 3 years duration. However, studies that have purported to follow sufferers, report that loss of movement and pain may still be present at 7 years. Although the term ‘frozen shoulder’ was first coined by Codman in the 1930’s, the research underpinning our understanding of the patho-aetiology and best management remains equivocal. Objectives: The aim of this presentation is to describe an evidence based care pathway for the nonsurgical management of Frozen Shoulder. The care pathway was developed after being awarded a competitive grant from Shine - The Health Foundation (www.health.org.uk). The remit was to develop a care pathway that would reduce the need for people with frozen shoulder to be referred to secondary care. In addition to the development and analysis of the clinical pathway, an independent health economist evaluated the cost of the new service in comparison to comparable care pathways being provided in secondary care. A psychologist led focus group reported on the participants’ experiences. Methods: The entire pathway was developed and run by community based specialist physiotherapists, and involved: (i) Diagnosis and health screening (ii) Ultrasound guided intra-articular glenohumeral injections (steroid and lidocaine) performed by physiotherapists (iii) Ultrasound guided intra-articular glenohumeral hydrodistension procedures (lidocaine and NaCl) performed by physiotherapists, The injection therapy was embedded within a physiotherapy rehabilitation programme. Conclusions: All stages of the pathway are supported by research evidence. Clinical outcomes were good to excellent. During the project no patient required a referral to secondary care. An independently run focus group reported that participants were very satisfied with the care received. The health economic analysis demonstrated substantial savings when the care was delivered in the community compared with secondary care. The project has highlighted areas for potential future research.

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Effectivness On Scapula Stabilization Exercises On Scapual Dyskinesis Type2 Pradeep Shankar, UAE Author: Pradeep Shankar, UAE Background: Abnormal altered scapular position during rest or motion have been termed as Scapular Dyskinesia. Scapula Dyskinesia Type-2 is one type of dyskinesia in which there is a visual prominence of entire medial border of scapula that occurs due to weakness of the serratus anterior and tightness of posterior shoulder joint capsule that results in reduction in glenohumeral flexion and abduction, resulting in decreased acromial elevation. This type of dyskinesia is commonly seen in Secondary impingement of shoulder. Rehabilitation generally begins and focused on axio-humeral and scapula- humeral than axio-scapular muscle. Early application of closed kinetic exercises on scapular stabilization and its effect of application on scapular dyskinesia type 2 is unknown. The study was proposed to find the effect of scapular stabilization exercise for type 2 Scapular Dyskinesia in subjects with shoulder impingement. Methods: An experimental study design, 7 male patients with mean age 37 years diagnosed with Shoulder impingement associated with Type 2 scapular dyskinesia were included in the study. The protocol includes closed kinematic chain exercises (scapula clock), Black burn exercises, Sleepers stretch, and thera band exercises aimed to balance force couple of upper, lower trapezius and serratus anterior. Duration of intervention was 3 sessions per week for 2 weeks. Outcome measurements such as Lateral scapular slide test and SPADI were measured pre and post interventions. Results: Analysis using Paired ‘t’ test as a parametric test found that there is statistically significant difference p<0.000 when pre to post interventions means were compared within the groups showing significant improvement in post SPADI and lateral scapular slide test. Conclusion: It is concluded that Scapula stabilization exercise protocol found to be effective in Scapular type-2 Dyskinesia.

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Mechanical Behavior of Deep Fascia. Antonio Stecco, Italy The mechanical properties of deep fasciae strongly affect muscular actions, development of pathologies, such as acute and chronic compartment syndromes, and the choice of the various fascial flaps. Actually, a clear knowledge of the mechanical characterization of these tissues still lacks. This study focuses attention on experimental tests of different regions of human crural fascia taken from an adult frozen donor. Tensile tests along proximal–distal and medial–lateral direction at a strain rate of 120 %/s were performed at the purpose of evaluating elastic properties. Viscous phenomena were investigated by applying incremental relaxation tests at total strain of 7, 9 and 11 % and observing stress decay for a time interval of 240 s. The elastic response showed that the fascia in the anterior compartment is stiffer than in the posterior compartment, both along the proximal–distal and medial–lateral directions. This result can explain why the compartment syndromes are more frequent in this compartmentwith respect to posterior one. Furthermore, the fascia is stiffer along the proximal–distal than along medial–lateral direction. This means that the crural fascia can adapt to the muscular variation of volume in a transversal direction, while along the main axis it could be considered as a structure that contributes to transmitting the muscular forces at a distance and connecting the different segments of the limb. The stress relaxation tests showed that the crural fascia needs 120 s to decrease stress of 40 %, suggesting a similar time also in the living so that the static stretching could have an effect on the fascia.

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Management of Nerve-related Neck And Arm Pain Annalie Basson, South Africa Neck pain is one of the most common debilitating musculoskeletal complaints seen in physiotherapy practice. Neck pain is often associated with headache, upper back and shoulder/arm pain. Patients with neck and arm pain are more disabled than patients with only neck pain. There is limited evidence for the optimum management strategies for nerve related neck and arm pain. Furthermore, neuropathic pain is a problem associated with and prevalent in many musculoskeletal conditions and is consistently linked to high levels of pain, disability, poor quality of life and poor response to treatment. The Lecture will discuss the different presentations of nerve-related neck and arm pain to enable differentiation.

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ORAL ABSTRACTS Is There any Difference in Effectiveness of Dry Needling, Manual Therapy, and Kinesio Taping Methods for the Management of Patients with Myofascial Chronic Neck Pain? A Single-Blind Clinical Trial Vahid Mazloum, Iran Authors: Vahid Mazloum, Vahid Sobhani Background: Chronic neck pain (CNP) is a common disorder associated with substantial morbidity. The aim of study was to investigate the effects of three various interventions in males with Myofascial CNP. Methods: Thirty-nine individuals (Mean±SD: Age 35±10.1 years; Height 178.6±7.5 cm; Body mass 86.9±7.7 kg) from 57 patients (Age range: 18-55 years) included in this blinded-clinical randomized trial. The subjects were assigned into three groups (N=13 for each group) including dry needling (DN), manual therapy (MT), and Kinesio Taping® (KT). Pain intensity, Pain Catastrophizing Scale, and Neck Disability Index and cervical spine range of motion (CROM) in different directions were evaluated by self reported questionnaires and cervical goniometer at baseline and following 5 treatment sessions. Following evaluation of the normal distribution of variables by Shapiro-Wilk test, Paired-Samples T test and One-Way ANOVA were used to analyze the data. Results: Pain intensity and catasrophizing, neck disability, and CROM in all directions were significantly improved following the three interventions (P < 0.05). The score changes in CROM for rotation to right and left in MT group was significantly greater than the other two groups (P < 0.001). Comparisons of changes in scores of other variables between the three groups revealed no significant differences (P > 0.05). Conclusions: It is assumed that DN, MT, and KT can improve pain and neck disability and increase CROM in patients with Myofascial CNP. The MT techniques are more effective in increasing CROM for rotation compared to the other two methods.

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Differential Diagnosis of Musculoskeletal Disorders Chad Cook, USA In clinical practice, physiotherapists use tests and measures for a probabilistic approach to clinical decision making. This decision making approach requires that the tests and measures provide tangible value and can alter the post-test probability of diagnosis or prognosis. Recent evidence also dictates that selected tests should be used either early in the examination process to rule out contenders or late in the examination process to confirm hypotheses. Use of diagnostic accuracy values such as sensitivity, specificity, and positive likelihood ratios has improved our ability to discriminate tests’ strengths.

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Sub-Acromial Impingement Syndrome. A Musculoskeletal Condition or A Clinical Illusion? The Case for Non-Surgical Management Jeremy Lewis, UK Neer1,2 published a clinical commentary describing a condition known as subacromial impingement syndrome where abrasion from the overlying acromion onto the rotator cuff results in 95% of all rotator cuff pathology. Subacromial impingement syndrome has become one of the most commonly diagnosed musculoskeletal conditions involving the shoulder and subacromial decompression (SAD), a procedure to remove the abrasion, one of the most common orthopaedic surgical procedures. Between 2001 to 2010 the number of SADs increased by 746% in England, United Kingdom3. Many physiotherapists and other health professional have embraced the SIS model describing how poor upper body posture, colloquially termed a forward head posture, is associated with an increase in the thoracic kyphosis with an imbalance of the shoulder girdle muscles. This results in an abnormal scapular posture (anterior tilt and downward rotation) resulting in impingement and RC pathology. In addition there has been a substantial increase in surgery to repair partial and full thickness tears involving the RC. The cost of these surgical procedures to healthcare providers and the individual is substantial. In addition, the increase is of concern, as research has repeatedly demonstrated no additional benefit from surgery when compared to a graduated exercise program for; subacromial impingement syndrome, as well as atraumatic partial and full thickness rotator cuff tears. Although there is a belief that the symptoms (pain and loss of shoulder function) relate to the shape of the acromion, size of the rotator cuff tear; research evidence does not support these contentions, and symptoms appear to be related more to psycho-social factors, such as level of education, as well as concomitant co-morbidities. These and other issues such as; the relationship to posture and symptoms, as well as our ability to make a definitive diagnosis on which to base management have also been substantially challenged4-8. History has demonstrated that bloodletting for pneumonia, prolonged bed rest for low back pain are clinical illusions and current evidence supports the contention that this may also be the case for subacromial decompressions and repairs of atraumatic rotator cuff tears. It is essential for healthcare professionals to be mindful not to over emphasis the relationship between structural failure and symptoms. These issues will be presented in the lecture.

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ORAL ABSTRACTS Acrominoplasty for Shoulder Impingement Syndrome Youssef Fallaha, UAE Impingement syndrome is one of the common problems in the shoulder where the pathology is in the rotator cuff. The diagnosis and treatment went through massive changes in the last century and Neer revolutionized the treatment of the impingement syndrome and for the last two decades there was fast improvement in the diagnosis and the treatment of the impingement syndrome. The talk will shed some lights on the impingement syndrome management and it’s history.

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Correlates of Physical Activity Among Women (Psychological Status, Lifestyle, Interventional Strategies) Einas Al Eisa, KSA Background: Physical inactivity is common among Saudi females. Many variables are associated with different levels of mental health, including physical activity. This study was designed to determine the correlation between 3 weeks of improved physical activity and psychological factors such as insomnia, depression and attention span. Methods: Seventy-six female students, of mean age 20.9 ± 1.4 years, were analyzed. Insomnia, depression and attention were subjectively assessed using the Insomnia Severity Index (ISI), the Beck Depression Inventory (BDI), and the Attention Span Test (AST), respectively. Each subject was given a pedometers and advised to walk at least 6000 steps per day for 3 weeks. Psychological status was assessed before and after the 3 weeks and compared using paired sample t-tests. Pearson correlation was used to determine the association between physical health and psychological factors. Results: Improvements in scores on the ISI (from 7.22 ± 3.06 to 4.09 ± 2.80), BDI (from 8.88 ± 3.13 to 3.98 ± 2.74) and AST (from 63.86 ± 3.06 to 77.27 ± 11.33) were observed after 3 weeks. Physical activity was negatively correlated with ISI (r = −0.74) and BDI (r = −0. 78) and positively correlated with AST (r = 0.69). Conclusion: Improved physical activity can be useful in managing insomnia, depression and attention. In female Saudi students, higher levels of physical activity were associated with improved mental health.

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Exercise Therapy For Patients With Chronic Pain: Retraining Pain Memories Jo Nijs, Belgium Even though nociceptive pathology has often long subsided, the brain of patients with chronic low back pain has typically acquired a protective (movement-related) pain memory 1,2. Exercise therapy for patients with chronic pain is often hampered by such pain memories. Musculoskeletal therapists can alter pain memories 3 in patients with chronic pain by integrating pain neuroscience education with exercise interventions 4. The latter includes applying graded exposure in vivo principles during exercise therapy, for targeting the brain circuitries orchestrated by the amygdala (the memory of fear centre in the brain). Before initiating exercise therapy, a preparatory phase of intensive pain neuroscience education is required. Next, exercise therapy can address movement-related pain memories by applying the ‘exposure without danger’ principle. By addressing patients’ perceptions about exercises, therapists should try to decrease the anticipated danger (threat level) of the exercises by challenging the nature of, and reasoning behind their fears, assuring the safety of the exercises, and increasing confidence in a successful accomplishment of the exercise. This way, exercise therapy accounts for the current understanding of pain neuroscience, including the mechanisms of central sensitization

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The Effects Of Viscoelastic Insole on Peak Ground Reaction Forces (GRF) During Gait in Patients with Acute and Chronic Low Back Pain. Ramprasad.M, UAE Author: Ramprasad.M., Ratish Manickam Purpose: To study the influence of viscoelastic insoles on peak GRF in acute and chronic low back pain patients during different walking speeds and to compare with healthy controls. Relevance: This exploratory study was aimed to find out the biomechanical rationale of viscoelastic insoles prescribed for low back pain patients that were aimed to reduce the pain levels and improve gait parameters. Methods: Study settings: Research Laboratory of Srinivas College of Physiotherapy and Research Center.Mangalore, India. Participants: Sixty participants among which 20 normal healthy individuals, twenty acute & twenty chronic low back pain patients with age of 18 to 60 years were given consent and participated the study. The peak Vertical GRF was measured during gait using the (BERTEC) Forceplate mounted in the midpoint of the walkway. The patients walked on the platform at two different walking speed velocities i.e.,preferred and fastest. They were walked on the platform under three conditions 1) Bare foot walking 2) Shod walking 3) Shoe with Insole walking. Under each condition at two different walking speeds, 3 trials were taken and the Peak Vertical GRF was measured by using Acquired Digital Software system of forceplate. Results: Intra group analysis using ANOVA with repeated measures showed that there was a reduction in Peak vertical GRF among all the three groups while using Viscoelastic Insoles (p<0.05). Intergroup analysis of showed that there was no significant difference in Peak Vertical GRF in barefoot preferred & fastest, shod preferred & fastest speed walking conditions between three groups. There was a significant difference found only in shod with insole fastest walking speed condition between groups (F = 3.58, p<0.05). There was a reduction of 5.2% in Peak Vertical GRF in chronic low back pain patients during shod with insole at fastest walking speed condition. Conclusion: Viscoelastic insoles helps to attenuate the vertical ground reaction forces during heel strike transients (a shock force of waves produced during the initial contact of heel on ground 10 to 20 ms of heel strike) and to promote cushioning effect on the spine among patients having acute and chronic back pain.

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Principles of Cognitive Behavioural Therapy for Healthcare Practitioners Naif Al Mutawa, Kuwait Half of all behavioral health conditions are treated in the primary care setting, and four out of five patients with a mental health condition will visit a primary care physician within a year. Further, most healthcare professional are stressed. Teaching principles of CBT at the physiotherapy conference kills several birds with one stone. It will give physiotherapists tools in which to talk themselves down when feeling stress and will give them basic tools to give primary advice to their future patients. This elective lecture covers the theory and practice of cognitive-behavioral therapy and training. Some of the topics included are agenda setting, thinking errors, the importance of homework assignments, and the use of daily thought records/dysfunctional thought forms. These issues and techniques and their application to the treatment of pain, stress, depression, phobias and anxiety are also covered

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Ten-Year Probability of Fragility Fractures in Peri and Postmenopausal Saudi Women of Al Ahsa Region According to Who Fracture Risk Assessment Tool (FRAXTM).

Effect of Kinesio Taping of the Gluteus Medius Muscle on Treatment of Iliotibial Band Friction Syndrome.

Authors: Ahmed Essa Al-Fayaa, Mohammed Khalid AL-Khalifah, Abdullah Saleh Al-Thani Mohja Dhafer Alshehri, Dr. Utkarsh Shahi, Assistant Professor (Orthopedic Surgery) Dr. Mohammed Farhan Al Farhan

Authors: Tamer M. Shousha, Alaadin A. Balbaa, Khaled E. Ayad, Ahmed G. Al-Saied4

Introduction: Osteoporosis is a major global public health problem, associated with significant morbidity, mortality and socioeconomic burden. It’s defined as a skeletal disorder characterized by low bone strength, leading to an increased risk of fragility fractures. The greatest bone loss occurs in women during peri-menopause, associating with estrogen insufficiency, a condition of menopause. The FRAX tool is developed by WHO to evaluate fracture risk of patients. It’s based on individual patient models that integrate the risks associated with clinical risk factors as well as bone mineral density (BMD) at the femoral neck (if available). Materials & Methods: A prospective cross sectional study, conducted in one year recruiting 400 cases. They were asked to fill FRAX questionnaire. The fracture risk assessment was done with the help of online tool for FRAX calculation. Patients were explained about fracture risk in next ten years and preventive measures were advised in terms of dietary supplementation, Lifestyle modification and pharmacological interventions. Follow up is planned after every one year assessing efficacy of treatment and disease progression. Results: The average major osteoporotic fracture risk probability in next 10 years among Saudi females of Al Ahsa region (Average age 48.3 ± 1.2 Years) was found to be 3.0% (±0.2%) and average hip fracture risk probability in next 10 years was around 0.7% (±0.08%). The ten-year probability of fragility fractures according to FRAX is higher in Saudi peri and postmenopausal women as compared to that of other Asian countries including India and China but relatively lower than those in western population. Conclusion: Fragility fractures in postmenopausal Saudi women are one of the leading causes of disability and socioeconomic loss. The extent of problem is quite prevalent in Saudi population. With the help of FRAX we can estimate the probability of such fractures and can take preventive measures to avoid them.

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Background: Iliotibial Band Friction Syndrome (ITBFS) is the primary cause of lateral knee pain in runners and accounts for nearly 22% of all running injuries. Although kinesio tape (KT) has been theorized to be an effective treatment to restore muscle function and decrease pain and despite of being widely used in the athletic field‫ و‬the efficacy and scientific evidence to support its use and effects is still being established. Still, there remains a need for clinical trials, in order to provide empirical evidence to support its reported clinical efficacy. Purposes of the study: This study was conducted to determine the efficacy of KT in treatment of ITBFS and to identify a definite relationship between hip abductor weakness and ITBFS. Subjects: Fifty patients participated in this study, age ranged from 18 to 30 years with a mean (21.74 ± 2.24) year free from hip and ankle injuries. Methods: Subjects were assigned randomly into two groups; Group (I): KT group, Group (II): Exercise group. Pain, lower limb functional performance and isokinetic hip concentric, eccentric, peak torques of the hip abductors and adductors at 30°/s were measured pre-treatment and 6weeks post treatment, using the visual analogue scale (VAS), single leg-hopping tests {single hop for distance (SHD), triple hop for distance (THD), cross over hop (CHD) and timed hop (TH)}, and the Biodex system 3 isokinetic dynamometer. Results: Post treatment, the KT group significantly increased the SLH, decreased the TH and VAS, while the exercise group significantly increased the SHD, CHD, THD, concentric and eccentric abductor/adductor ratios meanwhile, significantly decreased the TH and VAS. Comparing both groups revealed significant improvement in all variables in favor of the exercise group. Conclusion: Management strategies including hip abductor strengthening appeared to be beneficial in the treatment of ITBFS when compared to KT in decreasing pain intensity, improving lower limb functional performance and hip abductor /adductor ratios during hip concentric and eccentric contraction.

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POSTER ABSTRACTS Mckenzi Method complemented with exercises program for long-term cervicogenic headache management - A case study Authors: Adel Ali Al-Khamis Abstract: The objective of my study was to determine the effectiveness of the combination between Mckenzie techniques and therapeutic exercises, targeting the cervical regions, for treatment of cervicogenic headache. The Mckenzie techniques were series of retraction exercises done every two hours and progressed as needed. The combination between Mckenzie techniques and the therapeutic exercises has initiated from the first treatment session starting by activation of deep cervical flexors and extensors, increasing their endurance capacity, passing through stretching exercises for several muscles and mobility exercises for the upper cervical segments especially the atlanto-occipital joint, and ending by higher level strength and endurance. A 27-year-old male with a primary complaint of left-side sub occipital and occipital, severe intermittent pain. The patient met the criteria for cervicogenic headache as by Sjaastad and Fredriksen. He was functionally limited in drivin g, watching TV, and moving-around for prolonged period, and participating in gymnasium exercises. Two more scales were used; Numeric Pain Scales to measure the episodes prior to each session, and neck disability index. The first and third scales were completed in the first and last sessions to show the difference in the functional activities. The patient reported a significant decrease in his headache episodes and intensity, and demonstrated an increase in the functional activities. A solid treatment program deals with the mechanical deformities and muscle impairments in the cervical region, may results in long-term relief of CGH.

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POSTER ABSTRACTS Efficacy of Hyperbaric Oxygen Therapy on Cerebral Palsy Children Authors: Fatma A. Hegazy, Emad A. AboElnasr Objectives and Aim: This study was aimed to investigate the effect of hyperbaric oxygen therapy in modulation of muscle tone and promotion of motor development in spastic cerebral palsied children. Methods: Twenty spastic cerebral palsy ranged in age from 2 to 5 years participated in this study. The study sample was divided into two groups of equal number (control and study groups). The control group was treated by the selected designed physical therapy program. The study group received hyperbaric oxygen therapy in addition to the same selected designed physical therapy program. Evaluation was carried out for each child of both study and control groups before, after one month and three months of treatment. It included measuring of degree of spasticity by using EMG apparatus for H/M ratio, and measuring gross motor skills by using Denver developmental screen test. Results: The results of this study revealed significant reduction of spasticity and improvement of gross motor skills for both study and control groups (p<0.05), however a non-significant (p>0.05), differences was found between them. Conclusion: As with any new therapy determination of the appropriate amount of time and number of hyperbaric oxygen therapy sessions to cause a significant changes on cerebral palsy requires further researches on large sample and increase number of sessions and controlled randomization .

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POSTER ABSTRACTS An Investigation of the Factors that Influence the Attrition of Physiotherapists in Khartoum State – Sudan Authors: Khalil M., Ali, T. Salih

Developing a Five Years Strategic Plan for a Community Based Education (CBE) Program Implemented by the Physiotherapy Department at Ahfad University for Women Authors: Khalil M., Ali, T. Salih

Relevance: The issue of physiotherapists’ retention is a problem that is faced by many countries in the world. This study was to explore the pull away factors that influence physiotherapists in Khartoum state to drop out or move away. Human resources for health are identified as one of the core building blocks of a health system. WHO has identified 57 countries having a severe shortage of health-workers worldwide from which 36 countries are in Africa. Purpose: To explore the factors that influences the drop-out and attrition of physiotherapists in Khartoum state. Method: This is an exploratory qualitative approach which used semi structured interviews with eight physiotherapists and one representative from a physiotherapy committee at the Federal Ministry of Health. The data were analyzed by thematic analysis. Result: The results showed that job description, financial factors, physiotherapy association, community and other professions’ recognition were the main contributing on the physiotherapist’s attrition and draining away from Khartoum State. Conclusion: The research explored the causes of physiotherapists’ dissatisfaction from the job to the community served. Implications: This research raises the concerns and challenges of physiotherapists to decision makers to implement wider survey and review job description beside work environment policies. The ethical approval was from Ahfad University for Women

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Relevance: The physiotherapy department at the School of Health Sciences (SHS) in Ahfad University for Women (AUW) is currently implementing a community based education (CBE) rotation within the students’ placements’ period. CBE provides students with opportunities to become increasingly involved in health issues and, as their competency grows, to plan and provide care. The purpose of the project was to develop a Five Years Strategic Plan for a Community Based Education Program Implemented by the Physiotherapy Department that could fulfill its vision. Method: Situational analysis which includes; Document review, focus group discussion and interview and thematic SWOT analysis Result: A vision for CBE program, the CBE values, and the strategic goal towards 2020 were articulated. Strategic plan (July 2015 – April 2020) was structured. Conclusion: A strategic plan was developed covering the different types of physiotherapy placements at AUW. This will guide the leaders of SHS through the educational needs for CBE implementation. It is recommended that an outline of both the theoretical and practical parts of CBE should be developed by the department staff. Implications: The batch of students who were admitted to the physiotherapy major has a strategic plan for the implementation and achievement of the CBE learning outcomes. The ethical approval was from Ahfad University for Women

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POSTER ABSTRACTS Prediction of Falls Among Older People in KSA Authors: Taibah Shankiti Abstract: Falling is a serious public health problem among elderly people because of its frequency, the morbidity associated with falls, and the cost of the necessary health care. Approximately 30 percent of people over 65 years of age who live in the community fall each year. Unintentional injury, which most often results from a fall, ranks as the sixth leading cause of death among people over 65 years of age. Falls and fall-induced injuries are a common problem in older people worldwide, and the current ageing population will further increase the burden and cost associated with this type of injury. Purpose of the study: was to provide statistical data on the prediction of falls among older people in Saudi Arabia, and to examine which factors make the greatest contribution to the prediction of falls among this population. Twenty one older adults (age range between 59 and 80) participated in the study. Methods: All subjects were asked to complete two experimental tasks involving answering questionnaires and performing tasks that assessed their specific balance and motor skills. Firstly, subjects were asked to complete a questionnaire, which consisted of fall history and health status. Secondly, the subjects were asked to complete the Berg Balance Scale (BBS. Results indicated that osteoporosis was a significant predictor of Berg Balance Score (R2 = .94, p < .001), approximately ninety five percent of the variability in the Berg Balance Score was explained by its relationship to the osteoporosis. Results: Showed that diabetic is strongly correlated with the Berg Balance Score (r = 88, p <.001), approximately ninety percent of the variability in the Berg Balance Score was explained by its relationship to diabetic. Conclusion There are a lot of major risk factors for falling, even after controlling for poor balance. Taking more medications, poorer walking performance and reduced cognitive functioning. Tailored preventive programs including systematic medication reviews, specific balance exercises and cognitive training might be beneficial in reducing fall risk in older adults in Saudi Arabia.

POSTER ABSTRACTS Effectiveness of Core Muscle Strengthening for Improving Pain, Function and Balance among Females with Patello Femoral Pain Syndrome. Authors: Yasameen Musaad Al-Harbi, Manal Jaber Al-Fahmi Abstract: Relevance: Patellofemoral Pain Syndrome (PFPS) is a frequent condition which can result from core muscles instability that affects dynamic balance with females affected more than males at a ratio of 2:1. Purpose: To assess the effect of core strengthening on pain, function and dynamic balance in women with PFPS. Materials and Methods: Participants: 20 women with age ranging from 19-37 years with PFPS have been separated into experimental (Exp; n = 10) and control (Con; n = 10) groups. Both groups were given 4 weeks of conventional physical therapy program with an additional core strengthening for the experimental group. The outcome tools used were Visual Analogue Scale, Anterior Knee Pain Scale, Isokinetic Quadriceps strength and Star Excursion Balance Test. Analysis: The data was statistically analyzed by using the statistical package SPSS for Windows version 19.0. The level of statistical significance have been set at p <0.05. Paired t test was used to compare the dependent variables for strength and balance variables between pre rehabilitation and post rehabilitation testing. The 2 subjective outcome variables (VAS and AKPS scores) was compared using the non-parametric Wilcoxon signed rank test. Results: The results show a significant improvement in the intensity of pain and balance in the experimental group compared with the control group. But there was no significant improvement in the AKPS score and the quadriceps strength amongst the experimental group compared to the control group, even though all these were improved in both the groups. Conclusion: The addition of core strengthening to the conventional PFPS physical therapy program improves pain and dynamic balance in women with PFPS. The abstract has won the 2nd place for best presentation in the 7th Scientific Annual Meeting in King Abdulaziz University

This study recommends that reducing the incidence of falls must continue to be one of the highest priorities in health policy among Saudi care institutions for older people and more research is needed to better understand the prediction of fall among older patients in Saudi Arabia.

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A Systematic Review of the Effects of the Electrotherapy Alone And Therapeutic Exercises On Functional Range Of Motion For Patient With Idiopathic Frozen Shoulder

Innovative “RK Walker”

Authors: Saad Al-Omar, Faisal Al-Qarni,Mousa Al-Juweyr Background and Objective: Idiopathic frozen shoulder, also known as adhesive capsulitis, is one of the most common causes of shoulder pain and disability. The prevalence of idiopathic frozen shoulder is 2 to 3% of the general population. Idiopathic frozen shoulder will start silently and has 3 phases; First phase is known as ‘Painful Phase’, the second phase is known as ‘Freezing (Adhesive) Phase’, Third phase named ‘Throwing (Resolution) Phase’. There are a varieties of treatment options for idiopathic frozen shoulder both surgical and nonsurgical 8 such as low power laser therapy, (TENS), massage, stretching exercises, ultrasound, shortwave diathermy (SWD), Hot pack (HP). Therefore, the objective of this systematic review was to describe the effects of the electrotherapy alone and therapeutic exercises on functional range of motion for patient with idiopathic frozen shoulder. Method:The literature search will restricted to English language publications from 1990 through 2011. Several databases will search to find relevant studies, including Medline, Embase, CINHAL Centre for Reviews and Dissemination, OAIster, Physiotherapy Evidence Database (PEDro), and The Cochrane Database of Systematic Reviews. Papers were selected a participants consisted of Men and Women had symptoms of idiopathic frozen shoulder such as pain or disability. The therapists used electro therapy will compare to no treatment, placebo, or other therapy, such as Hot-Pack, Interferential Electrotherapy, and Low-Level Laser Therapy physical modalities. Result: Search of databases with selected keywords revealed 9 articles on the use of Electrotherapy for the treatment of Idiopathic Frozen Shoulder. Two studies were descriptive clinical reports and the remaining seven articles met in all inclusion criteria and were included. We discussed all the studies on which there was agreement in determining Sackett’s level of evidence, and consensus decision was achieved for all studies. Studies according to the PEDro scale: All the studies with scores ranging from 4 to 9 were classified. All studies will provide sufficient details to allow repetition of the intervention protocol. Conclusion: The treatment average was from 4- 6 weeks in most on articles. We excluded seven articles two used electrotherapy alone, and five used electrotherapy with other modalities. The articles with electrotherapy alone have no significant or limited significant, and the other five articles witch is electrotherapy with others has seen significantly improvement in ROM, relief pain and Quality of life, but in modified constant score was have limited improvement

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Authors: Priyanshu V. Rathod, Kartik Kothari, Rima M. Jani Background: Activities of Daily Living (ADLs) involves several physical and functional activities, such as standing, walking, squatting, climbing, bathing, grooming, etc.… walking is one of the most common functional requirement which gets involved in fulfilling relevant ADLs in all age groups from Pediatric to Geriatric. However such ADL may get compromised due to various disease and disorders, where assistive devices play a key role to meet the functional requirement in ADLs. Though such assistive devices has its own limitation / delimitation in functional fulfilment. However, walker is one of the common device routinely practiced by people with lower limb locomotor disabilities and compromise with its function of stair climbing up & down. There is certain need to focus on development or modification in available design of traditional standard walker to be used for climbing staircase up & down. The process of designing such assistive device will be add-on a guideline for researchers. Objectives: To understand the process of making / designing an innovative walker to be used for stair climbing up and down. To identify the challenges and troubleshooting in making / designing a cost-effective walker to be used for stair climbing up and down. To dedicate the outcome of the research work to society to add on quality of care and quality of life of needy people. Review of Literature: Modification in Walker: 1) MM Martins et al (2012) worked on “Assistive Mobility Devices focusing on Smart Walkers: Classification and Review” and observed that in the last years development of walkers has witnessed a huge increase due to their enormous potential for rehabilitation and functional compensation. Modification in walker for stair climbing up and down: 1) Boomer, was designed by Daniel Molloy, Australia, and has a futuristic aesthetic. It allows the user to climb stairs: by pushing a button the front wheels can move along to near the back wheels so that it becomes a kind of cane that helps in the up and down of the stairs. Electronic device hence costs more than traditional walker: 1) Great lakes Innovations Inc. holds patent for the Stair Climber which is a walker, designed to make a regular walker adapt seamlessly to become a stairclimbing walker. Once at the stairs, the individual can use a release mechanism to either extend or shorten the front legs, which will then make the walker level for stable use on any kind of stair surface. Testing such instruments in AutoCAD: 1) A.N.NITHYAA et al (2014) did a project of “Design and Development of Powered Lower Limb Exoskeleton for Hemiplegic Patients” in which AutoCAD 2014 software was used for the 2D drafting and 3D model creation. The wheelchair design was created using the AutoCAD Software in 2D and 3D. The project simulation of human model wearing the lower limb exoskeleton in wheel chair was designed using the CATIA software. 2) K. K. Mankala et al (2009) developed “Novel swing-assist un-motorized exoskeletons for gait training” whereby an AutoCAD drawing of an exoskeleton was built before fabricating the actual model. This AutoCAD drawing lists the various components.

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POSTER ABSTRACTS

POSTER ABSTRACTS Patient Satisfaction with Outpatient Physical Therapy in Saudi Arabia

Materials: Innovative “RK Walker”, Traditional Walker, Computer and internet, AutoCAD Software, Metal rods, hardware parts, Measure tape and stopwatch, SF-36 Questionnaire, QUEST version 2.0 Quebec User Evaluation of Satisfaction with Assistive Technology, Timed Up and GO (TUG) Test, Stair Climbing Test (SCT). Experts and collaboration: 1) Mechanical Engineers, Faculties from School of Engineering, RK University, 2) Mr. Bharat Kakadiya, Proprietor, Kelco Industries, Rajkot Methodology: Multiphasic Observational Experimental Trial, Phase I: Identify the need of change in traditional walker from physiotherapists by online survey, Phase II: Confine the NEED for facilitating standard walker for staircase climbing up and down- Designing Walker model in AutoCAD software by Mechanical Engineers to develop “RK Walker”, Phase III: Evaluation of efficacy of “RK Walker” by AutoCAD, controlled environmental lab. And testing with Healthy Adults. Both, Traditional standard Walker and “RK Walker” will be given for walking and Stair Climbing. Primary Outcome measures for both the groups are: 1). Timed UP and GO (TUG) Test, 2). Stair Climbing Test (SCT) 3).QUEST 2.0 The Quebec User Evaluation of Satisfaction with Assistive Technology. Secondary Outcome measure: 1). Pulse Rate at rest and after using Innovative “RK Walker” and Traditional standard Walker for TUG Test & SCT. Phase IV: Draw suggestive guidelines for designing a walker which can be used for stair climbing up and down. Result: Outcomes measures (TUG, SCT, QUEST 2.0, physical markers) and Feedback report score of “RK Walker” observes significant impact as compared to traditional standard walker especially in climbing staircase up & down. Discussion: As per the need of users and innovative design - a model with adjustment for stair climbing up and down requires quality training to its users. However, the quality of material and testing tools must be validated for higher research and quality purpose. Interdisciplinary approach from patients, physiotherapists, mechanical engineers, industrial experts, and software designers remain the integral part of the designing innovative RK Walker. Conclusion: This multiphasic observational experimental trial and novel concept suggest kind of modification in traditional standard walker to meet the functional needs of the users. Outcome of our study and guidelines to develop walker must be taken into consideration for researchers interested to develop walking aids for climbing staircase up and down.

Authors: Ghadah Gudairi, Einas El-Essa Purpose: To assess overall patient satisfaction with outpatient physical therapy (PT) in Saudi Arabia (SA) and to identify associated patient characteristics. Relevance: Patient satisfaction is generally recognized as a key measure of quality of care. Satisfaction in the healthcare sector is defined as the perception developed by a patient in reference to a service after its delivery. Evidence suggests that satisfied patients are more likely to benefit from PT, and are more compliant with their treatment regimes. To attain patient-centered care, the multidimensional nature of patient satisfaction needs to be addressed and analyzed in order to improve the efficacy of PT services. Participants: Eligibility to participate was defined as Arabic speakers who received PT care in the identified large government hospitals in Riyadh in the last year. A total 358 patients completed the survey. The average age was 38.1±12.7 years, (76.8%) were females. Referrals diagnoses varied, but were limited to musculoskeletal conditions (66.9%), followed by neurological (16.9%), and pain management (16.2%). The affected body regions were mainly the back (30.5%), lower limb (26.6%), neck and shoulder (15.3%), upper limb (15.3%), and multiple areas (12.5%). Methods: A cross-sectional survey study with data collected using online structured questionnaire. In addition to demographic and clinical characteristics, patient satisfaction was assessed using MedRisk Instrument for Measuring Patient Satisfaction with Physical Therapy Care (MRPS). The validity and psychometric properties of the assessment tool were found satisfactory. King Saud University Ethics Institutional Review Board granted ethical approval. Data collection was anonymous, and it has been clearly explained that the completion of electronic survey will be considered as tacit consent. Analysis: The responses to the items, components, and overall of MRPS were coded on a Likerttype scale with 5 indicates “complete satisfaction” and 1 “complete non-satisfaction”. Data were presented as frequencies and percentages for categorical variables and mean and standard deviation (SD) for continuous variables. Comparisons of overall MRPS scores by patient characteristics were evaluated using on-parametric tests; Mann-Whitney test for two-group variables and Kruskal Wallis test for more than two-group variables. All P-values were two-tailed. P-value <0.05 was considered as significant. SPSS software (release 23.0, Armonk, NY: IBM Corp) was used for all statistical analyses. Results: The overall satisfaction of patients with the PT care they received was 70.9%. Components’ satisfactions were 76.1% for communication and respect, 65.3% for convenience, 66.6% for quality time, and 68.7% for focused care. Overall satisfaction was positively associated with longer time spent in the clinic, post-treatment clinical improvement, and appropriate staff attitude. Conclusion: The finding indicates a “moderate” patient satisfaction with outpatient PT care in SA, which is slightly lower than seen in similar reports internationally. Areas of potential improvement

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include the clinic convenience and quality time. Therapists’ attitude, rather than clinical competence, appears to be the leading factor in patient satisfaction. Such finding warrants special attention to improving therapist-patient interaction and positive communication. The study offers recommendations for policy change in the delivery of PT in the Kingdom.

Investigation of Hip Kinematics In Adult Sports Participants During Single Leg Drop Landing With Chronic Groin Pain Michael Robert Dare Introduction: Groin injuries are among the top six most cited injuries in soccer and account for 1018 percent of all injuries reported in contact sport. Groin pain can result from a variety of pathologies, but according to literature, 63 per cent of groin pain is due to adductor pathology.

Effect of Yoga Poses in the Management of Dysmenorrhea in University of Sharjah Students Authors: Raigangar V, Abdalla M, Zaid F, Mohammed B, Saad F, Ifthikar K Introduction: Dysmenorrhea is defined as cyclic pain directly related to menstruation and is experienced by 80% of women each month. Sun Salutation (Surya Namaskar) exercises consists of a sequence of ten yoga poses, each pose opposite to the one before producing a balance between flexion and extension; these poses are coordinated with breathing. Objective: The aim of this study was to explore the effectiveness of yoga poses (sun salutation exercises) in the management of dysmenorrhea in University of Sharjah students and the effect of sun salutation practiced regularly on balance, flexibility, stress and absenteeism from University. Subjects: 30 single females aged between 18-24 years selected by convenient sampling were supervised to do sun salutation exercises 12 times once daily for eight weeks. Initially the exercises were done at self-selected speed, which was gradually increased over the 8 weeks training period to reach at least 12 repetitions in 4 minutes. Outcome Measures: A semi structured questionnaire and Perceived Stress Scale (PSS) was given at baseline and end of 8 weeks, Balance and flexibility were measured using One Leg Stance and Sit and Reach Test respectively, at baseline and after 8 weeks. Results: No significant difference was observed in BMI following the intervention (p = 0.655). Significant differences (p 0.001) were seen in pain, PSS, balance, flexibility following the intervention. A 20% decrease in absenteeism was also noted. Conclusion: Eight weeks of supervised sun salutation exercise practiced once daily decreases pain and perceived stress while improving flexibility and balance. This is a preliminary study which needs to be replicated in larger samples, with more duration of sun salutation practice with the addition of advanced breathing techniques to enhance relaxation.

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Objective: The objective of this study was to explore if there are kinematic differences in the hip joint in sports participants with groin pain compared to matched healthy controls. Study Design & Setting: A cross sectional, descriptive study was conducted. The study was conducted at the FNB -3D motion analysis laboratory at the University of Stellenbosch, South Africa. Outcome Variables: The dependent variables included hip kinematics in the sagittal, frontal and transverse planes at foot strike, lowest vertical point of the pelvis and total range of hip motion during a single leg drop landing. Methodology: The study sample comprised 20 male club level soccer-and, rugby players, running and cycling participants between the ages of 18-55 years of age. Ten of the subjects had chronic groin pain and the other ten were healthy matched controls. An eight-camera Vicon system was used to analyse the kinematics of the hip joint during single leg drop landing. For the purpose of comparison, the data was analysed for participants with unilateral groin pain and matched controls (n=14) and participants with bilateral groin pain and controls (n=6). The full set of data was subdivided for analysis into three distinct sub-groups. Unilaterally injured groin cases (n=7) were matched with seven healthy controls for analysis. Bilaterally injured groin cases (n=3) were matched with three healthy controls. Results: Cases with unilateral groin pain at initial contact had significantly more abduction of the hip joint when compared to controls (p<0.05). The effect size of this difference was large (0.94). Cases with unilateral groin pain also demonstrated greater hip internal rotation while the controls had external rotation (p<0.05) during a drop landing activity. Bilaterally injured groin cases landed with significantly (p=?) greater ranges of hip flexion as well as in significantly (p=?) more hip abduction during a drop landing activity. They also demonstrated greater total range of motion in the frontal plan when compared to controls. Groin pain cases overall demonstrated greater ranges of motion and tended to land in more abduction compared to controls. Conclusion: This study found that during a single leg drop landing, sports participants with unilateral chronic groin pain landed with significantly greater hip abduction and exhibited larger total range of motion in the transverse plane, which may indicate impaired stability of the hip complex when compared to controls. www.physiodubai.com

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POSTER ABSTRACTS Self Application of Patellar Taping Produce Similar Effects to Clinically Applied Patellar Taping: A Pilot Randomized Study

POSTER ABSTRACTS Can Physical Exercises Reduce the Risk of Fall for Elderly living in Nursing Homes? A Systematic Review of Randomized Controlled Trials. Authors: Alfadhel SA, Alotaibi A.D , Algarni AM, Bindawas SM

Authors: Ameer Abdullah M. Almubarak Abstract: Objectives to test the hypotheses that self-application of therapeutic taping of the knee improves pain and function in patients with osteoarthritis of the knee in a similar way to therapist application of patellar taping. Design: Randomized single blind controlled trial with two intervention arms (therapeutic tape and self-tape) six weeks duration. Setting Outcome assessment was performed in physiotherapy department in a public hospital in Northeast of Saudi Arabia. Taping interventions were applied by patients (first group) and by two experienced physiotherapists (second group). Participants 20 male patients with symptoms of knee osteoarthritis as defined by the American College of Rheumatology were randomly allocated to either group one or two (10 patients in each group). Main outcome measures: Primary outcome measure was pain as measured by visual analogue scale. Secondary measures of pain and function sub scores of Knee Objective Outcome Score (KOOS). Results The self-application of patellar tape (group 1) reported similar results in terms of reduction in pain on primary outcome, Pain and function sub scores of KOOS on secondary outcomes. Conclusions Self application of knee tape can produce similar effect to Therapeutic knee taping for the management of pain and function in patients with knee osteoarthritis.

Background: Fall in elderly is a significant health problem; nursing home residents are at high risk of falling. Physical exercises could reduce risk of fall for elderly living in nursing homes. Clear conclusive evidence for the effects of physical exercises on risk of fall for elderly living in nursing homes have not established yet. Objective: The purpose of this systematic review is to investigate the effect of physical exercises on risk of fall for elderly living in nursing homes. Setting: Nursing homes. Data Sources: Electronic databases search were performed in five databases: PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Physiotherapy Evidence Database (PEDro), and institute for scientific information (ISI). Searching was limited in English language and for clinical trials. Study Selection: Randomized controlled trials (RCTs) studies that used exercise as intervention, and measured risk of fall outcomes in elderly living in nursing homes were included. Methodological quality of selected studies evaluated by using the PEDro scale. Trials that scored ≤ 4 on the scale were excluded. Data extracted from included studies by two independent authors. Results: Ninety-four studies were identified by searching in databases. Seven studies met inclusion criteria of this review. Total number of participants in the included studies was (307) participants living in nursing homes. Effects of different types of exercises for vary durations on risk of fall investigated by the included studies. Five studies investigated the effect of multi-components exercises intervention while two studies investigated the effect of single exercises intervention. Studies that investigated multi-components exercises showed significant reduction in the risk of fall in elderly living in nursing homes. Conclusion: Findings of this review suggest that multi-component exercises programs for adequate duration are effective to minimize risk of fall for elderly living in nursing homes.

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K-Active / Germany TOGU / Germany Schwa Medico / Germany Fabrication Enterprises / USA 66fit / UK Redcord / Norway Fitter First / Canada

With the widest array of comprehensive products ranging from Therapy Equipment, Exercise Therapy products, Physio & Rehab Supplies, Pediatric Therapy products, Massage Therapy products, Sports Medicine products, Yoga & Pilates products, Therapy Education tools and much more Physiomart stands at the top for quality products.

Gold Sponsors In 1970, the Modern Pharmaceutical Company (MPC) was founded with the goal of becoming the leading healthcare distributor in the UAE, investing in the best infrastructure, systems and people so that its partners and customers were guaranteed the most ‘modern’ facilities possible. For four decades, MPC has been an active partner in the advancement of healthcare in the UAE. It has remained in the forefront by having a single objective: Excellence in the products and services it provides in order to satisfy the needs of customers and principals. MPC believes in creating lasting relationships with its staff, partners and customers, building symbiotic relationships based on honesty and trust, relationships that prosper and flourish. Partners: Enraf- Nonius (for Physiotherapy & Rehabilitation Products ): www.enraf-nonius.com RECK-MOTOMED:( Active & Passive cyclic Trainer for Upper and Lower limbs) www.motomed.com HOCOMA AG (global market leader for the development, manufacturing and marketing of robotic and sensor based devices for functional movement therapy): www.hocoma.com Zahrawi Medical is a leading provider of surgical, medical, lab, nuclear medicine, radiotherapy, Physiotherapy & Rehabilitation solutions in UAE and Qatar. Zahrawi Medical represents more than 70 international manufacturers in the healthcare field, including but not limited to HUR, TUR, Biodex, Tenscare, Medtronic, Sysmex, Mallinckrodt, Dako, Shimadzu, Sakura, Laborie and Hitachi-Aloka. Zahrawi is dedicated to provide high quality healthcare solutions in an accurate and timely manner to healthcare professionals guaranteeing great customer experience and after sales service. Zahrawi’s customers include hospitals, diagnostic and clinical labs, clinics, universities, research centers and much more. Technogym, the Wellness Company, is a world leader in the design and manufacture of fitness equipment and solutions for private homes, fitness clubs, hotels, spas, rehabilitation centers, corporate gyms, universities, professional sports facilities and more. Technogym embodies the philosophy of Wellness, which calls for a balanced lifestyle through regular exercise, healthy eating and a positive mental attitude. Technogym is equipped to meet the specific needs and requirements of the medical sector thanks to the Total Wellness Solution which deals with all issues relating to the provision of wellness solutions: interior design, equipment, apps & contents, programmes & education, marketing support & branding and after sales. Technogym’s wide range of certified products, the experience it has gained during the development of its programmes and solutions and its leadership in the field of exercise-therapy make the company an ideal partner for medical sector. In particular Technogym is able to support the work of operators at every phase, from prevention to rehabilitation, assessment and the creation of protocols.

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SPONSOR PROFILES Trinity Healthtech is the leader in Integrated Health Solutions across Middle East and India. With a focus on medical rehabilitation technologies and commercial fitness, Trinity leads the way as the exclusive sales partner in the region for the big Giants in the field of Physical Rehabilitation like; HP Cosmos, Cosmed, Vibrogym, Vaccusport, David and Core health and fitness Trinity Healthtech with its wide portfolio from market leading firms offers the most cutting edge and innovative technologies for Sports Medicine, Physiotherapy, Neurology, Orthopedics, Cardiovascular, Strength Training and Medical Rehabilitation. Trinity Healthtech is a part of the Arenja Group, a diversified business house with interests across healthcare, real estate, jewellery and industrial automation.

McDavid Inc. designs and markets sports medicine, sports protection, and performance apparel for active people and athletes. We are relentless in our pursuit of preventing injuries and enhancing performance.

SPONSOR PROFILES Welcome in the World of BTL Founded in 1993, BTL has grown to become one of the world’s major manufacturers of medical equipment. Committed to Perfection With state-of-the-art products across 3 medical areas: cardiology, physiotherapy, and aesthetics. With direct offices in more than 51 countries covering 4 continents. With over 900 employees, 120 R&D engineers and growing. BTL offers you ….. • Complete line of physiotherapy products • Possibility to attract all segments of markets • Competitive ratio QUALITY/PRICE/PARAMETERS • Eye-catching and functional design • Permanent innovation and development in the field. • The biggest company on the physiotherapy market BTL. Growing to Meet Your Needs.

For more info please visit: http://www.mcdavidusa.com/about/

Since its inception in 1967, City Pharmacy has dedicated itself to the advancement of pharmaceutical and medical service in the UAE. Covers the UAE from its corporate office in Abu Dhabi and branch offices in Dubai, Sharjah & Al Ain. We at City Pharmacy

EXHIBITORS

Co. It is our immense pleasure to introduce you to our Physiotherapy and Rehabilitation Products: 1. DJO - Chattanooga: Venaflow Elite , Intelect Neo Ultrasound Module, Intelect Neo Laser Therapy,Intelect Neo Laser Therapy Module 2. DJO - Aircast : Splints, Walkers & Braces 3. Capenergy : Low Pack Pain 4. BTS Bioengineering : GaitLab, P-Walk , G-Walk For any further information please contact: Engineer Samer Chaaban Sales Supervisor Tel: 00971 6 5553922 | Mob: 00971 50 8707555 | samir@citypharmacy.biz

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ABOUT DUBAI

ABOUT DUBAI

Dubai - the exotic jewel of the United Arab Emirates; Bordered by deserts and beaches, Dubai provides stark contrasts,from intriguing Islamic culture to the ultramodern, high-tech metropolis of the 21st century. The city is a magnificent expression of an incredible vision and an uncompromising statement of success and opportunity.

CURRENCY

Dubai has something for everyone, from vacationers seeking a relaxing break away from the pressures of work, to business travellers looking for a new exciting experience. The emirate is an international conference, exhibition and leisure destination. Lying on the calm, blue waters of the southern Gulf and flanked by the majestic desert, Dubai offers year-round sunshine and five-star luxury along with the adventure of a unique Arabian experience. Dubai is a class destination with all the modern amenities of the western world. It is a fascinating emirate with beautiful buildings, excellent restaurants andnightlife as well as white sandy beaches, culture and history that you can feel as you visit the souks, shopping malls, museums and historic buildings and sites. Lightweight summer clothing is suitable for most of the year, but sweaters or jackets may be needed for the winter months, especially in the evenings. Compared with certain parts of the Middle East, Dubai has a very relaxed dress code. However,care should be taken not to give offence by wearing clothing which may be considered revealing, for example low-cut dresses, very short skirts, or tight shirt or top in public. At the pool or on the beaches, trunks, swimsuits and bikinis are quite acceptable. Good quality sunglasses are advised, and photo chromatic lenses for those who wear spectacles. Hats, or some protection for the head, are advisable when in direct sunlight.

The monetary unit is the dirham which is divided into 100 fils. The dirham is linked to the Special Drawing Right of the International Monetary Fund. It has been held constant against the US dollar since the end of 1980 at a mid-rate of approximately US$1=Dh3.67.

ABOUT DUBAI CULTURE & LIFESTYLE LANGUAGE & RELIGION Dubai’s culture is firmly rooted in the Islamic traditions of Arabia. Courtesy and hospitality are among the most highly prized of virtues, and the visitor is sure to be charmed by the genuine warmth and friendliness of the people. Dubai society is marked by a high degree of tolerance for different lifestyles. Foreigners are free to practice their own religion, alcohol is served in hotels and, provided reasonable discretion is shown, the dress code is liberal. Women face no discrimination and may drive and walk around unescorted. Despite rapid economic development in recent years, Dubai remains close to its heritage. The official language is Arabic but English is widely spoken and understood. Both languagesare commonly used in business and commerce. Islam is the official religion of the UAEand there are a large number of mosques throughout the city. Other religions are respected and Dubai has two Christian churches, St Mary’s (Roman Catholic) and Holy Trinity (inter-denominational).

CLOTHING CLIMATE Local citizens dress in traditional robes and headdress. Arab culture and folklore find expression in poetry, dancing, songs and traditional art. Weddings and other celebrations are colourful occasions of feasting and music. Traditional sports such as falconry, camel racing and dhow racing at sea continue to thrive.

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Dubai has a sub-tropical, arid climate. Sunny, blue skies can be expected most of the year. Rainfall is infrequent and irregular, falling mainly in winter. Temperatures range from a low of about 10.5°C /50 °F to a high of 48°C/118.4°F. The mean daily maximum is 24 °C/75.2 °F in January rising to 41°C/105.8 °F in July.

PHOTOGRAPHY Normal tourist photography is allowed, however it is considered offensive to photograph Muslim women. It is also courteous to request permission before photographing men. www.physiodubai.com

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ACKNOWLEDGEMENT Platinum Sponsor

Gold Sponsors

Silver Sponsors

Official Partner Airline

Official Destination Partner

Media Partners

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