Squatting with optimal determine the efﬁcacy of primal movements as a func- form is the start point for good seated posture generic zithromax 250 mg on-line antibiotic resistance grants. This starts ofﬁce simple key assessments to look out for order 100mg zithromax mastercard antibiotic resistance statistics, and which are workers in an inappropriate and detrimental spinal applicable as foundation observations in any given posture before they even begin their multiple hours movement pattern discount 250 mg zithromax amex antibiotic resistance originates by. These key assessment features are at their desk (see ‘Neutral spine philosophy’ above) purchase 250mg zithromax antibiotics for face cyst. The ability to be able to bend with appropriate and It is noted that handedness, footedness or ‘laterality’ effective biomechanics is a critical skill for a parent patterns contribute to postural imbalances – particu- who has to pick up the children and lift other loads larly in the frontal plane. Striations observed under No hip-back dissociation in lifting dynamic load – especially in frontal and Ability to adopt hip-back dissociation on demand transverse plane, e. Instead, laterality patterns are a dysfunctional the critic may question how motivated the workers result of imbalanced use and therefore a consequence were, this study does demonstrate that there is a likely that must be corrected for if the patient is to biome- beneﬁt in terms of productivity by ‘framing’ work chanically optimize (or ‘survive’) their environment. The whole concept of biomechanical attractors – and in particular instinctive sleep postures and archetypal Barriers to rehabilitation success rest postures – suggests that, if such postures were utilized in the work or home environment, corrective There are two major barriers to rehabilitation success: stretching may not be needed at all. In addi- Strides in this direction have been achieved in some tion, many patients attending naturopathic clinics do workplaces in Germany (Cranz 2000) where ﬂoor- so because they are in pain – not because they want based, seated and standing workstations are utilized. This means that a part, or parts, It is the ﬂoor-based workstation that speciﬁcally offers of their body have reached the point where the rate its own secondary range of working postures – the of cumulative stress has outpaced their rate of healing. As has been discussed above, it To add extra load to such a system through corrective is not that sitting should be made more comfortable exercise may further compromise an already compro- – quite the opposite. To ignore this warning system is akin to taking a painkiller in order Time to play sport. To try to ‘cushion’ or dampen this In this day and age, many patients attend health system (as is the objective of most modern ergonomics clinics with pain conditions or health complaints that approaches) is the equivalent of bandaging an ankle are largely caused by a sedentary lifestyle and the in order to play sport. The problem is being acknowl- inability to express a perceived stress, such as a dead- edged, but not really addressed. With the rapid evolu- line or monthly target, with physical reaction, such as tion of the communications age, with connectivity and running or ﬁghting. Making time for exercise and wireless gadgetry, multiple workstations are becom- stretching is a major challenge for many patients. As soon as the patient is symptom-free, ticular the gait patterns, health of most synovial joints they most commonly ‘forget’ to do their stretches or can be maintained, ranges of motion, proprioception, exercises, until something else goes wrong some coordination and many of the body’s natural pumping months down the line. Neither are we designed to exercise for exercise’s sake (see functional exercise above). Physiological load refers to the cumulative total of Historically, exercise has had a signiﬁcant purpose, stressors on the individual’s system. Such physiological played out by many a sports person and is exactly load results in increased adrenal stress and commonly why people will usually work themselves several reaches a point where adding further load to the ﬁgu- times harder chasing after (hunting) a ball, than they rative ‘camel’s back’ is literally enough to break it. Exercise as a stressor Studies have shown that working a longer day does Before advising patients to exercise, in whatever form not always pay dividends in terms of productivity. Anyone who • Poor digestion/↓ salivation has chronic pain has a corresponding limbic-emo- • Constipation tional load – as pain is stressful and disrupts function. As a result, • Night sweats the patient will most likely have visceral symptoms – • Orgasm/genital inhibition as adrenaline shuts down digestive and assimilative processes, sending the body into a catabolic state. Parasympathetic indicators: literature on training and adaptation to training is • Strong or excessive digestion taken from young elite sportsmen and women who: • Hyperactive bowel; colicky • have higher levels of growth hormone than • Incontinence your average middle-aged patient • Orthostatic failure upon rising • have a greater training age8 than the average • ↓ Respiratory rate patient • Poor sleep quality; hibernation • may be eating more healthily than the average • ↑ Mucus secretions patient • Nervousness; depression; somnolence • have a greater genetic propensity for • Hands warm and dry adaptation (hence the reason they are elite • ↑ Gag reﬂex athletes). To many, the way that they relax is drive is so exhausted, they have drifted into increased by going for a run, playing a game of squash, or doing parasympathetic tone (Wolcott & Fahey 2000). This is an ‘adrenaline sport’ such as rock-climbing, parachute commonly a sign of signiﬁcant adrenal fatigue (Wilson jumps or bungee jumping. In physics this may be seen to result in an apparent decreased stress level, but the Stress and breath underlying dysfunction has not been effectively dealt with. Stressors come in many guises: from work stress to relationship stress, ﬁnancial stress to postural stress, chemical stress to electromagnetic stress. All of these 8Training age equates to the number of years that the patient stressors will result in an elevated respiratory rate has been training with that methodology. A soccer player, for and, potentially, a subsequent breathing pattern dis- example, may have ‘soccer age’ of 20 years, but may have only just started training his lunge pattern with a barbell for one order. Such breathing pattern disorders may have a season – therefore his training age for lunging with a barbell profound effect on the physiology of the body is 1. Respiratory inﬂuences on health are Chapter 9 • Rehabilitation and Re-education (Movement) Approaches 387 discussed more fully in Chapter 10. Mouth breathing Nose breathing Reﬂexively mouth breathing and accessory breath- ing are associated, while nose breathing and dia- Accessory breathing Diaphragmatic breathing phragmatic breathing are associated (Chek 1994). In the lower lobes there ↓ Neck stability ↑ Neck stability is a greater preponderance of parasympathetic affer- • Tongue on ﬂoor of mouth • Tongue in physiological ent receptors, while reciprocally in the upper lobes rest position there are more sympathetic afferent receptors. When mouth breathing, cold unﬁltered air enters the lungs ↑ Left brain activity ↑ Right brain activity and will only service the upper lobes (Douillard 2001), Fight, ﬂight, fright, tight Rest, digest, decongest, presumably due to bronchoconstriction. The deeper, tension-less longer inhalation with nose breathing (and, inciden- tally, humans are the only animal in which obligate Catabolic Anabolic nose breathing is no longer ‘obligatory’) allows for Compromised visceral Facilitated visceral health greater stretching of the alveoli, which results in health increased production of endogenous nitric oxide. Nitric oxide is a potent sympathetic inhibitor (as well Compromised venous/ Facilitated venous/ as a stimulator of immune function) – so this is a sec- lymphatic return lymphatic return ondary way that deep breathing will decrease sympa- thetic and reciprocally increase parasympathetic tone (Douillard 2001). This results in the myriad bene- to switch the patient from a sympathetically charged ﬁts described in Table 9. Since parasympa- facilitated by running barefoot, as this means signiﬁ- thetic stimulation is associated with rest, digestion, cant attention must be paid to the upcoming ground tissue repair and anabolic processes, most patients beneath the feet. Such attention with the eyes results beneﬁt from parasympathetic-enhancing exercises. For further discussion manipulating the respiratory environment to breathe of barefoot running, see ‘Primal patterns, Gait’, using the nasal airway only, helps to enhance perfor- above. Indeed, maintaining a higher level of parasympathetic activity during running and other sports performance Muscular system as expression makes good sense, when one considers that many of psychological state sports involve right-brained creative expression as much – if not more – than left-brained logical, strate- Since the muscles are an innervated continuation of gic expression. It is being in the right brain that is nervous system expression, Keleman (1989) suggests equated with being ‘in the zone’. This is breathing stimulates sympathetic activity and there- consistent with Schleip’s (2003a) observation that the fore left brain function, meaning that ‘thinking outside myofascial system provides more afferent feedback to the box’ becomes a challenge (Chek 2006). This may the central nervous system than any of the special pose a real problem for anyone requiring a creative senses. As well as their afferent feedback, they are also capacity in their work or home life. Water may well be the connection between breath and while a common observation of Westerners made by chi (or prana). Water is one of the most diamagnetic Traditional Chinese Medicine is that they are often yin substances known to science, while oxygen is one of (water) deﬁcient. Just like an If we place on this foundation the fact that all of the electrical circuit, the polar opposite properties of water traditional breath-based disciplines (e. Westerner attending a tai chi class may come away It is well established that, historically, towns and cities unmoved by their experience. In open-minded Westerner is likely to actually perceive the the West, such water supplies were most commonly beneﬁt of the cultivation of chi as a result of the sanitized through distillation. In the East, water supplies interaction between increased oxygen and well-hydrated were most commonly sanitized through boiling the water cellular machinery (for further discussion of cellular and adding leaves with high antioxidant levels. Paramagnetic materials biochemical environment and is a classic example of attract and repel like normal magnets when subject to metabolic typing, or biochemical individuality in action. It is interesting to note that many natural health • Diamagnetism is a form of magnetism that is only authorities suggest that because Western social drinks exhibited in the presence of an external magnetic ﬁeld. Though to some this may seem a disadvantage, it also means that people with this proﬁle have very low risk of alcoholism.
The emphasis on particular impairments when selecting an embryo or fetus as worth preserving suggests that any policy diVerence between preserving an embryo or a person with purchase 100 mg zithromax visa antibiotics and sun, say 250mg zithromax sale antimicrobial yoga pant, thalassaemia is not one of principle but of practicality generic 100mg zithromax fast delivery bacteria kit. Social exclusion generic 250mg zithromax otc antibiotics for uti pain, school exclusion and family exclusion (in numbers of teenagers living on the streets) are increasing rapidly, as are expectations that children should conform to ever more speciWc milestones, school tests and behaviour standards with an unjust ‘zero-tolerance’ which does not allow for contingencies and disadvantages. Prenatal programmes are not responsible for these changes, but they are part of them, and are powerful medical and oYcial indirect endorsements of them. Another theme of injustice is when public rejection, expressed through national prenatal programmes, is made to appear to be a matter of private grief and responsibility, as when each individual woman faces the ‘choice’ of termination of pregnancy, a choice constrained by social and economic circumstances. Tests which screen ‘negatively’ for one or a few speciWc impairments are soon likely to become multi-package tests to screen simultaneously for numerous impair- ments, and then tests to select ‘positively’ for growing numbers of preferred features such as intelligence or height. When the embryo and fetus, and implicitly the baby and child, are presented to women by health professionals as a means of fulWlling adults’ dreams of perfection, rather than as ordinarily imperfect mortals to love as ends in themselves, then maternal– child as well as maternal–fetal relationships are likely to become ever more tentative and conditional. I am grateful to everyone who took part in the research,and to my co-researchers,although I am responsible for any shortcomings and opinions in this chapter. Over time, the initial way a problem is deWned then crystallizes policy debates, producing what can then become a very rigid framework, all but impossible to expand or modify (Rochefort and Cobb, 1994: vii, pp. Constitutionally, in the course of nearly 30 years of Supreme Court reasoning, abortion rights have become rigidly deWned as a problem of decisional autonomy, that is, as a problem of privacy and choice. Politically, during that same time period, the problem of abortion has been deWned by pro-life activists (as we would expect), but also by pro-choice advocates (as we might not expect) on the basis of a very traditional model of motherhood, one invoking cultural and ethical depictions of women as maternal, self-sacriWcing nurturers. The combination of deWning the problem of abortion rights constitu- tionally in terms of the privacy of choice and politically in terms of a traditional view of motherhood has produced a rigid, serious policy conse- quence – namely, failure to obtain access to abortion services for women in the form of public funding of abortions. Correction of this policy conse- quence requires a redeWnition of the problem of abortion rights from both constitutional and political perspectives, which entails, as part of that re- deWnition, a transformation of the traditional model of motherhood to include nontraditional elements. To understand more clearly what is in- volved in this transformative process, let us review the current status of how a traditional model of motherhood underlies the current way the problem of abortion is deWned. McDonagh Problem definition: constitutionalism and politics In the United States, the Due Process Clause of the Fourteenth Amendment of the Constitution prohibits the state from depriving ‘any person of life, liberty, or property without due process of law’. This Due Process right of privacy has been interpreted by the Supreme Court to mean that a state may not interfere with a person’s choice about whom to marry, how to educate and raise one’s children, or the choice to use contraceptives. When the Supreme Court established the constitutional right to an abortion in Roe v Wade in 1973, it did so by ruling that the Due Process right to privacy was ‘broad enough to encompass a woman’s decision whether or not to terminate her pregnancy’ without interference from the state. This decision was a breakthrough for women’s rights because it immediately struck down nu- merous state laws that had severely limited procurement of an abortion (Ginsburg, 1985; Klarman, 1996). The Court reasoned that because a pregnant woman ‘carries [potential life] within her’, she ‘cannot be isolated in her privacy’ and her ‘privacy is no longer sole’. Thus, in Roe, the Court established that it is constitutional for the state to protect the fetus from the moment of conception and that a pregnant woman’s right of privacy to make a choice to terminate pregnancy can be limited by, or balanced against, the state’s interest in protecting the fetus as a separate entity from the consequences of that choice. Prior to viability, although the state may not prohibit an abortion per se, the state may protect the fetus by requiring restrictive regulations, such as 24-hour waiting periods and informed consent decrees, and by prohibiting the distribution of any information about abortion in publicly funded family planning clinics. What is more, law scholars concur that the Due Process foundation for abortion rights, as interpreted by the Court, means that it would be constitutional for a state to prohibit the use of public resources to assist a woman in obtaining an abortion, even if her pregnancy is subsequent to rape or incest, and even if her pregnancy threatens her with death. After the stage subsequent to viability, the state in promoting its interest in the potentiality of human life may not only prohibit state assistance in obtaining an abortion, but may also prohibit a woman from choosing an Models of motherhood in the abortion debate 215 abortion, ‘except where it is necessary. Thus, although Roe has proved resilient in the ensuing decades for retaining the constitutional right to choose an abortion, deWning the problem of abortion rights in terms of privacy has proved completely inadequate for establishing a constitutional right to state assistance for obtaining one. This is consistent – the Due Process right of privacy to be free of government interference when making choices about one’s own life or reproductive options does not usually include a constitutional right to government assistance in exercising one’s choice. Hence, the constitutional right to choose to use contraceptives, as established in 1965 in Griswold, does not include the constitutional right to government funding to purchase contraceptives. Thus, the constitutional problem with using privacy and the Due Process Clause for deWning abortion rights is that a Due Process depiction of the abortion issue reinforces the Court’s disconnection between the constitu- tional right to an abortion and abortion funding. Since the right to make a choice without government interference – such as the right to choose an abortion or whom to marry – does not include the right to government assistance in exercising that choice, there is little, if any, constitutional leverage to apply to the abortion access issue. When we turn to the political arena, we run into a similar dead-end to procuring access to an abortion, as a result of the problem deWnition of abortion. Based on his experience, he draws attention to the conservative political message developed not only by pro-life activists, but also by the pro-choice community over the last decade. Starting at least in the mid-80s, around the time of the Thornburgh decision, pro-choice activists became so fearful that the right to an abortion would be overturned in court that they began to develop powerful conservative strategies with which to reach out to the American public. The conservative message, as Saleten analyses it, was premised on convey- ing a persuasive view of abortion rights that would be suitable for the mass media and for electoral campaigns. As a result, the right to an abortion came to be politically framed as the right to get the govern- ment out of your life; that is, the government should have nothing to do with your right to have an abortion. Thus, rather than getting the state out of a woman’s uterus, access to public funds, public facilities, and public personnel for abortion services involves getting the state into a woman’s uterus, so to speak. The pro-choice strategy of politically deWning the abortion message to be getting the government out of women’s lives, therefore, is counterproductive as a claim for public funding of abortion services. The traditional model of motherhood and abortion rights Underlying the problem deWnition of abortion rights is a traditional view of motherhood – one that rests upon a relational view of women, deWned in terms of an ethic of care, inclusive of a nurturing, if not a sacriWcial, relationship between mother and fetus. Relying on the traditional model of motherhood to deWne the problem of abortion, however, does not give us the necessary arguments to justify public funding of abortions. To gain for women state assistance in procuring abortion services, therefore, requires a redeWnition of the problem of abortion, one that draws upon a model of motherhood that incorporates non-traditional elements into the way women are envisioned when seeking an abortion. To reframe the abortion debate to make it possible to secure a constitu- tional right to abortion funding, we must reconsider the central ethical and legal issue that haunts abortion policies – what justiWes killing the fetus? When we look more closely at the way pro-choice advocates answer that question when explaining why they support abortion rights or why they themselves procured an abortion, we Wnd that their justiWcation for abortion rights, far from carrying a non-traditional message about women’s rights, relies upon and reinforces some of the most traditional components of motherhood by invoking the principles of ‘lifeboat’ ethics. In order to fulWll her role as nurturer, a woman is forced to choose how to provide the greatest good for the greatest Models of motherhood in the abortion debate 217 number; to do so, she must make a calculation of whom or what to sacriWce. Presumably, she would gladly sacriWce herself, if this would be most beneW- cial to all concerned, which, in the case of an abortion, could include the decision to continue a pregnancy. However, when using the traditional model of motherhood to justify the non-traditional goal of obtaining an abortion, it turns out that the pro-choice utility calculation can indicate that the best way to help the most people is to sacriWce the fetus by aborting it. From a political vantage point, this is a strategic way to ‘have your cake and eat it too’, since such a justiWcation leaves in place traditional cultural assumptions about women as care-givers, even while expanding the non- traditional options open to women in the form of the right to an abortion as an instrument of care-giving not to the fetus, of course, but to others. What is signiWcant about Kate Michelman, therefore, is that when she tells her story about why she obtained an abortion, that story reveals a premise that the best way to present the abortion issue is to embed it within a traditional model of motherhood. To put it another way, Michelman’s justiWcation for abortion exempliWes the political power of obtaining non- traditional goals for women by infusing those goals with the most traditional imagery associated with women. Michelman’s story employs a traditional view of a woman whose identity is deWned in terms of her childbearing goals, child care responsibilities and economic dependency on a husband. The killing of the fetus by means of an abortion, therefore, is justiWed as a sacriWce necessary for the survival, if not the good, of the greater whole. Lifeboat ethics and justification for killing Michelman’s story not only illustrates a traditional view of motherhood in the context of obtaining a non-traditional goal for women – abortion rights – it also corresponds to a speciWc ethical model that justiWes killing – lifeboat ethics. The Model Penal Code (Philadelphia: American Law Institute), pre- pared and published by the highly respected American Law Institute, analyses the lifeboat model in terms of a justiWed choice of evils. The context of the lifeboat model involves a situation in which the homicidal actions of an individual that ordinarily would be criminal are nevertheless defensible because these acts are the only way to save other lives. As stated in the Code, ‘conduct that results in taking life may promote the very value [life] sought to be protected by the law of homicide’ in the Wrst place. The example provided by the Model Penal Code is: [Suppose someone] makes a breach in a dike, knowing that this will inundate a farm, but taking the only course available to save a whole town. If he is charged with homicide of the inhabitants of the farm house, he can rightly point out that the object of the law of homicide is to save life, and that by his conduct he has eVected a net saving of innocent lives. The life of every individual must be taken in such a case to be of equal value and the numerical preponderance in the lives saved compared to those sacriWced surely should establish legal justiWcation. As Dame Mary Warnock asserts, when faced with a choice of two people dying, or one person dying at the expense of another, the decision is easy – though it is the lesser of two evils, the latter is preferable to the former. As the journalist Polly Toynbee (2000) notes, the ethicist Professor Bernard Williams oVers these hypotheticals in support of the view that it is preferable to sacriWce the lives of a few if necessary to save the lives of many. For example, if ice cave explorers Wnd themselves trapped and the only way to escape is to kill one of their members so that the rest may live, then it is ethical to do so because this is a situation that is ‘an unavoidable emergency.
Participants were assigned (not ran- between these variables and walking ability at discharge generic 250 mg zithromax with mastercard antibiotics qt interval. Assessments were conducted at The walking ability at discharge were signifcantly related the exist- baseline trusted zithromax 250 mg bacteria horizontal gene transfer, post treatment (fve months) and follow-up (six months) ence of dementia and days from the date of surgery until frst start and included self-reports and ratings by clinician and client on ill- of walking cheap zithromax 250 mg on line antimicrobial shampoo human. Results: Results: in illness management discount 100mg zithromax mastercard antibiotic allergic reaction, psychiat- days from the date of surgery until frst start of walking was 0. Wang 1Universiti Sains Malaysia, Neurosciences department- School of 1 Mackay Memorial Hospital, Physical Therapy, Taipei, Taiwan, Medical Sciences, Kota Bharu, Malaysia 2National Yang-Ming University, Physical Therapy and Assistive Introduction/Background: Occipital lobe main function is as a vis- Technology, Taipei, Taiwan ual processing centre for most visual related stimulation. Amanta- Introduction/Background: Increased mechanosensitivity of me- dine is a water-soluble drug that can penetrate most cell membranes dian nerve caused by persistent pressure is suggested clinically to including the central nervous system. The effect of amantidine to occipital lobe is for evaluating the extensibility of median nerve and related sur- still under investigation. Purpose: To assess the of a 35-year old gentleman who develop a bilateral occipital lobe intra-rater and inter-rater reliabilities of a new test for measuring tumor. His tumor had to be removed to reduce the intracranial pres- the extensibility of median nerve and myofasciae in subjects with sure and its complications. Conclusion: Amantidine might help scapular depression, shoulder external rotation, elbow extension in the neuroplasticity of vision after the removal of occipital brain and wrist extension were examined by a custom-made large semi- tumour. Three (15%) patients have severe erectile dysfunction, 7 (35%) 1 have a moderate or medium dysfunction and 5 (25%) have little or Monastir University, Department of Physical Medicine and Func- no erectile dysfunction. The main purpose of this study 600 was to identify QoL of subjects presenting with residual neurologi- cal defcits from a spinal cord injury and living at home. Boudouk- cal examination was conducted and questionnaires were flled out by the subjects. The traumatic etiology Introduction/Background: The concept of QoL, proposed by the account for 45%. Objective: To identify the factors the highest score was the energy and the lowest score was sleep. Conclusion: In recent years, the focus of rehabilitation The most important factors affecting QoL were age, evolution time outcomes has shifted from the illness itself to a broader picture of after lesion, vocational status, functional inability, level of injury, well-being; QoL is an important measure of the success of reha- bladder complications and depression. By increasing age, signifcant bilitations programmers for individuals with disabilities. After informed consent 2 ami was obtained, a clinical and functional examination was conducted 1 and questionnaires were flled out by the subjects. Results: Only nine manage to lead a sexual relationship with variable level of satisfac- Japan tion caused by several toubles. Among Introduction/Background: The virtual image was furthermore troubles cities; an erectile dysfunction in 9 cases, a problem of drawn with the computer, and whether a quantitative evaluation ejaculation (slobbery ejaculation in one case, psychogenic ejacu- was able to be done was examined. The the image of a healthy hand, and doing making to binary and the study of correlations showed a signifcant relationship between the difference is generated. Material and Methods: A 32-year-old Filipino seaman displayed on the screen differs from past mirror therapy, and can presented with 9 days of fever and delirium at a Singapore tertiary confrm the state of own paralyzed hand. The blue graph shown in fgure shows ly treated with intravenous artesunate, antibiotics and fuid resusci- the number of pixels when the image of a healthy hand is made two tation. On hospital day 3, he was orientated and could follow one- values, a red graph shows the number of pixels when the image of step commands. Despite clearance of parasitemia on hospital day the paralyzed hand is made two values, and the graph of the pea 4, he developed expressive aphasia, intentional tremors and could green is a number of pixels when the difference between a healthy only intermittently obey commands. Electroen- an index that was quantitatively appreciable of the passage of the cephalogram showed mild diffuse encephalopathy without epilepti- therapeutic gain and the improvement was suggested. On hospital day 7, his verbal output improved but he was noted to have cerebellar speech. Improvements were seen in his behaviour, mood and Functional Independence Measure. As there is no “gold standard” to guide rehabilitation in strate disruption of neurocognition, particularly those mediated by survivors of severe malaria, it remains a challenge to rehabilitate subcortical and frontal regions. All this results pointed on high patient`s awareness about their sleeping problems. Material Rehabilitation Institute of Neuromuscular Disease in Gangnam Sev- and Methods: Ten subjects with hemiparesis participated in this erance Hospital were studied from Jan 1 , 1999 to Mar 31 2015. Pulmonary function and respiratory muscle strength quantitative comparisons assessing gait parameters, including the were measured in sitting position. This deformity is character- ized by fexion of the methacarphophalangeal joints, extension of the Introduction/Background: Dystrophic myopathy is a big subtype proximal interphalangeal joints, fexion of the distal interphalangeal of myopathic disorders which leads to weakness and disability. It is also called ‘rheumatoid-like’ deformity main pathogenesis is the mutation of encoding gene responsible for due to typical image. It causes hand posture abnormality and impairs producing cell membrane stabilizing proteins. According to high the life quality of patients by reduction in dexterity, pain and deform- prevalence of muscle dystrophies in whole word and our country ity. Patients were engaged in a stepwise progres- the ideal approach for prevention, early diagnosis, treatment and sion of interventions focused on restoration of normal function, rehabilitation of patients so helping them and their families to have with copious positive reinforcement on mastering each step in the a higher quality of life. Concurrently, patients were engaged in psychologic evaluation, assessing life stressors and potential symptom reinforc- ers, with subsequent interventions as appropriate. Symptom duration and chiatry, Physical Rehabilitation, Kodaira, Japan, 2National Center treatment duration were moderately correlated (r=0. Hospital- National Center of Neurology and Psychiatry, Neurol- Conclusion: Inpatient behavioral treatment of motor conversion ogy, Kodaira, Japan disorder symptoms appears effective in a rehabilitation setting, with lasting treatment effects. We suggest using lower leg orthoses for patients which can be provided walking stability. Results: 1University of Malaya, Medicine, Kuala Lumpur, Malaysia Eighty-two patients were identifed. Contralateral neglect is common showed abnormal gait and frequent falls due to knee instability, in cortical strokes. Healthy young people have slight leftward at- drop foot and ankle sprain injuries. All the patients were able to tentional bias due to right hemispheric dominance (pseudoneglect). The The main reasons for ceasing the use of orthosis were pain, did not objective of the study was to evaluate whether the elderly people feel the necessity to use orthosis, increased walking instability and exhibit a rightward attentional bias in line bisection, as compared to beginning of use wheelchair. The results of this audit indicated and did not have history of stroke and transient ischaemic attack. A consider- All participants performed line bisection test and star cancellation able reason is their personality trait and cognitive function. In line bisection test, participants were instructed to place a er, we could not fnd suffcient cognitive data of the patients. A deviation of we couldn’t reveal any factors for showing usefulness of orthoses more than 6 mm from the midpoint indicates unilateral spatial ne- treatment. In star cancellation test, the stimuli were large 52 large stars, 13 letters and 10 short words interspersed with 56 smaller stars. Introduction/Background: Conversion Disorder is a clinically chal- lenging entity in which neurologic symptoms such as motor weak- 612 ness are not found to have an organic cause. Kikuhara , disorder symptoms involving gait (eg hemiparesis, paraparesis, 1 4 1 2 5 tetraparesis). Asato 1National Tama-zenshoen Sanatorium, Department of Rehabilita- cal, neurologic, or psychiatric disease – no patients met exclusion criteria. All patients were treated in an inpatient rehabilitation unit tion, Higashi-Murayama, Japan, 2Keio University School of Medi- setting.