During Tuesday and Wednesday you can choose from four seminars on various topics. Seminars, which are led by world re-nowned experts, aim to further discover the depth of the issue and open up new horizons to listeners.
Changing paradigm in cerebral palsy
Seminar leader: Adam Shortland & Martin Gough, Guy's & St Thomas' Hospital Trust, One Small Step Gait Laboratory, London, United Kingdom
Adam Shortland is a Consultant Clinical Scientist in the Department of Paediatric Neuroscience, at the Evelina Children's Hospital, London, and a Senior Lecturer in the School of Biomedical Engineering and Imaging Sciences at King's College, London. Adam has managed the Gait Laboratory at his hospital for nearly 20 years and assessed thousands of children with cerebral palsy. He also directs a Master's course in clinical engineering aimed at graduates with a physical science or engineering background wishing to pursue a career as a registered clinician in rehabilitation, medical device management and design and clinical measurement. His main research interest is in gross muscle structure and function in cerebral palsy.
Martin Gough is a paediatric orthopaedic surgeon with a special interest in the management of children with disability due to neuromuscular problems. He trained in Ireland, and following fellowship experience in Toronto took up his present post working with the team in the One Small Step Gait Laboratory and the Evelina Children’s Hospital in Guy’s and St Thomas’ NHS Foundation Trust, London, in 1998. His research interests include the causes and treatment of deformity in children with cerebral palsy.
"Ms Jennifer Pierce is a senior orthopaedic surgeon who has a full paediatric outpatient list this orning. Amongst the children with rotational problems, flat feet and growing pains there are children with cerebral palsy who have significant neurological as well as orthopaedic problems. Ms Pierce doesn't enjoy seeing these complex children. She is aware that the evidence-base for surgical intervention in this group is meagre. The children present with mild muscle contractures and Ms Pierce knows that she could perform surgeries that would correct the joint positions. While she is confident that she could improve their mobility in the short-term, she is less sure that she will improve the long-term function of these children."
We invite all the professionals taking care of children with cerebral palsy (clinical scientists, physiotherapists, neurologists, rehabilitation doctors as well as orthopaedic surgeons) to take part in this seminar. We will reflect on the clinical management of children with cerebral palsy in five parts. Firstly, we will consider how clinical scientific thought evolves and how it underpins our practices.
Then, we will investigate the uses and abuses of evidence-based medicine in clinical decision making with particular reference to cerebral palsy. In the third part, we will describe the development of the normal musculoskeletal system. In the fourth part, we will review the mal-development of muscles and bones in cerebral palsy. In the final section, we will suggest ways in which musculoskeletal function may be improved to maintain mobility of individuals with cerebral palsy into adulthood.
Seminar leader: Pam Thomason, Senior Research Physiotherapist, The Royal Children's Hospital, Melbourne, Australia - Hugh Williamson Gait Analysis Laboratory
In cerebral palsy (CP) the effect of the upper motor neurone lesion on the musculoskeletal system are two-fold. Both positive and negative features. Positive features include spasticity and hyperreflexia while the negative features include impaired selective motor control and coordination and muscle weakness.
In this seminar we will discuss the morphology and architecture of skeletal muscle in children with CP in the context of muscle weakness and spasticity.
The influence of spasticity on muscle strength and how the relationship between spasticity and muscle strength changes as the child develops will be explored.
We will discuss how to assess muscle strength in a clinical and research setting.
The current state of the evidence for interventions to improve muscle weakness will be presented.
The use of strength training to improve muscle weakness in the context of multilevel orthopaedic surgery (MLS) will be presented. Recent latest long-term outcome study results will be presented. Clinical protocols from two leading centres, Melbourne and Leuven, will be compared and contrasted.
Interactive cases will be presented using the ICF framework to illustrate the management of muscle weakness. Each case will be presented with time to discuss management strategies and outcomes.
Dr. Lynn Bar-On graduated in 2010 as a Master in Rehabilitation Sciences and Physiotherapy, specialized in Pediatrics, at the Katholieke Universiteit (KU) Leuven. In May 2014 she obtained her doctoral degree, with a thesis entitled ‘Exploration of the nature of spasticity in children with cerebral palsy, based on biomechanical and electrophysiological measurements’. Lynn is now a postdoctoral researcher with affiliations at the Clinical Motion Analysis Laboratory of the University Hospitals Leuven, the Department of Rehabilitation sciences of the KU Leuven, and the department of Rehabilitation Medicine at VU medical center, Amsterdam, and is funded by individual research scholarships. Lynn is involved in several international academic programs and research collabor ations. She had a leading role in the organizational team of the European Consortium on the Concepts and Measurement of Spasticity and is since 2015, a board member of ESMAC.
Lynn’s general research interest is to unravel the pathological mechanisms that contribute towards impaired locomotion in children with cerebral palsy in order to critically analyze and improve treatment outcome. During her PhD, she worked closely with the department of mechanical engineering and the orthopedics department at the University Hospitals Leuven to develop an instrumented spasticity assessment based on electrophysiological and biomechanical signal collection and processing. She then validated the clinical use of the assessment on a large number of children with cerebral palsy and was the first to quantify heterogeneous patterns of muscle activation in different lower-limb muscles. Triggered by this unique finding, in her current post-doctoral research project, she tries to establish the relationship between alterations in muscle properties (e.g. architecture and passive stiffness), muscle activation patterns, and motor control in children with cerebral palsy. To investigate whether the heterogeneity in activation can be explained by alterations in the underlying macroscopic muscle-tendon properties, she incorporated the instrumented spasticity assessment with dynamic ultrasound imaging. She thereby combines a variety of techniques such as electromyography, dynamometry, and motion capture established by her PhD with new developments in ultrasound imaging and musculoskeletal modelling.
Marije Goudriaan studied physical therapy at the Hogeschool Brabant in Breda the Netherlands (now Avans Hogeschool) between 1998 – 2002 after which she started working as a physical therapist for approximately nine years. During her work as a physical therapist, she obtained a degree in sports rehabilitation in 2007 and a master’s degree in Human Movement Sciences (VU Amsterdam) in 2012. During her internship at the KU Leuven in 2012, she came in contact with research, which turned out to be something she really enjoys doing. From 2013 to 2018, she has been a PhD student with prof. Kaat Desloovere, studying the effect of muscle weakness on gait in children with a cerebral palsy and children with Duchenne muscular dystrophy. Her main focus is on the biomechanics of gait and its underlying components, both neural (motor control) as well as non-neural (muscle morphology). The public defense of her PhD thesis titled ‘The underlying neuromuscular mechanisms contributing to muscle weakness and their interaction with gait’ is scheduled on September 14th 2018 at the KU Leuven, Belgium.
Besides trying to finalize her PhD, Marije is a teacher at the University of Antwerp at the department of Rehabilitation Sciences and Physiotherapy.
Anja Van Campenhout, MD, PhD, is a pediatric orthopaedic surgeon at the University Hospital Leuven, and professor at the Catolic University Leuven, Belgium. Her main focus is the care for children with neuromuscular disorders. She is the medical coordinator of the Cerebral Palsy Reference Center Leuven.
Knee injury prevention and return to sport testing
Seminar leader: Richard Jones, University of Salford, Manchester, United Kingdom
Professor Richard Jones is a Professor of Clinical Biomechanics and Director of the Salford Gait Laboratory at the University of Salford. He is also Salford’s clinical biomechanics lead at the Manchester Institute of Health and Performance. Richard leads the Knee Biomechanics and Injury Research Programme in the School of Health Sciences investigating the typical and abnormal function and treatment of the knee joint. Richard has vast experience of biomechanical movement analysis in a wide range of neurological and orthopaedic conditions but his research focuses primarily on lower limb osteoarthritis, anterior cruciate ligament injury prevention and rehabilitation and conservative management of knee injuries.
Dr Andy Franklyn-Miller completed his medical training at Imperial College, London in 1998 before joining the Royal Navy and serving with the Royal Marines. He specialized in Sports Medicine and trained in the UK and Australia as the Royal Navy’s Consultant in Sport And Exercise Medicine. His final post before leaving the Military was as Head of Research and Director of the Centre for Human Performance, Sports Medicine and Rehabilitation at The Defence Medical Rehabilitation Centre Headley Court.
Dr Franklyn-Miller has worked as Team doctor to British Olympic Rowing, England Rugby, Melbourne Storm Rugby League and the New Zealand Black Ferns. He has appeared on the BBC Breakfast sofa and Radio 5 live on numerous occasions discussing athlete preparation, injury prevention and injuries to leading athletes and a regular contributor to the BJSM podcast program.
As Associate Editor of the British Journal of Sports Medicine and author of Clinical Sports Anatomy, and contributing author to the IOC Handbook of Sports Injuries and over 25 per reviewed publications on running re-education, groin pain, fascial injury, injury prevention and sports medicine anatomy.
Andy currently is Director of SSC Sports Medicine, Dublin and working on Global development and expansion of the clinic. Current research interests include: the biomechanics of groin pain, the expedited return to sport following groin injury, ACL rehabilitation biomechanics and exertional lower limb pain and Running re-education and lower limb biomechanics. He also writes an online research review with over 20,000 subscribers and weekly podcast on iTunes. He is @afranklynmiller on twitter.
It is important that an individual returning to sport after an injury is in the best possible condition from a psychological, physiological and biomechanical perspective. This involves both ensuring that the individual can perform at the required standard but also ensuring they are not at risk for an injury or follow-on injury after the initial occurrence. The return to play concept is an important element which is attracting a lot of attention worldwide and utilising this in a clinical biomechanics setting has been established in many centres.
The objective of this seminar is to give a broad overview of the research underpinning knee injury prevention and return to sport testing. The seminar will start by introducing the concepts of prevention and whether this can be achieved and also introduce the field tests that can be utilised to gain enhanced information on the individual alongside the 3D clinical biomechanics approaches that have been utilised and investigated to aid clinicians and athletes in the return to play.
Advanced MoCap data processing
Seminar leaders: Pavel Zezula & Jan Sedmidubsky , Faculty of Informatics, Masaryk University, Brno, Czech Republic
Pavel Zezula is a professor of computer science at Masaryk University (Czech Republic). His professional interests mainly focus on content-based retrieval, large-scale similarity search, and big data analysis. He is a co-author of a famous metric-based similarity search structure "M-Tree" and book "Similarity Search: The Metric Space Approach". He is also a co-author of more than 150 research publications.
Jan Sedmidubsky is a researcher of computer science at Masaryk University (Czech Republic) where he received the Ph.D. degree in 2011 along with the dean's and rector's prize for a distinguished dissertation thesis. His research activities are primarily concentrated on computer-aided similarity processing of 3D motion capture data. He is a co-author of about 30 research publications.
Motion capture technologies have already been utilized in a broad range of application fields, such as sports, computer animation, smart-homes, or medicine. However, with the fast increasing volume of collected data the manual analysis is becoming practically impossible. The objective of this seminar is to present the state-of-the-art approaches, techniques, and advanced prototypes able to automatically analyze the motion data, as needed for numerous clinical scenarios.
The seminar will introduce fundamental computerized operations, such as motion comparison, clustering, classification, searching, and annotation. As any specific motion is in the real world unique, the special emphasis will be given to the notion of similarity able to express the degree of accordance between pairs of motion sequences. In addition to traditional similarity-based comparisons, the seminar will discuss the state-of-the-art machine-learning approaches that learn descriptive movement features automatically from classified training data. The seminar will also focus on operations recognizing a given type of movement activity and searching for similar occurrences of the specific activity in very large motion archives. An efficient approach to annotate or label long sequences of motion data in real time will also be discussed.
The applicability and quality of presented operations will be demonstrated by interactive web applications, developed by the authors of this seminar. The topics of the seminar should be of interest to a broad audience – ranging from clinical researchers to medical specialists – focusing on automatic motion data manipulation.