Space in Special Educational Activities sessions will be limited and registration will be possible on-site at the registration desk on a first-come first-served basis.

PRINCIPLES AND PITFALLS OF NERVE STIMULATION METHOD
Tuesday, May 20
14:00 - 16:00
Jun Kimura, M.D.
Professor Emeritus, Kyoto University, Japan
Professor of Neurology, University of Iowa, Iowa City, USA

Type of SEA: Workshop
Level: Basic and Advanced

Aim:
Demonstration of Common and Unusual Electrodiagnostic Techniques

Description:

1. Motar nerve conduction studies including collision technique and repetitive stimulation
2. Sensory nerve conduction studies including the techniques for sural, superficial peroneal, dorsal ulnar and antibrachial cutaneous
3. Studies of late responses including F wave, H reflex, blink reflex, long loop reflex and silent periods
4. Description of facts, fallacies and fancies of nerve conduction studies and related methods
5. Informal question and answer session

CLINICAL AND ELECTROPHYSIOLOGICAL EVALUATION OF RESPONSE TO CONTINUOUS INTRATHECAL BACLOFEN DELIVERY
Tuesday, May 20, 2003
08:00-10:00
Stuart A. Yablon, MD, Director of Brain Injury Program, and Dobrivoje S. Stokic, MD, Director of Center for Neuroscience and Neurological Recovery,
Methodist Rehabilitation Center,
Jackson, MS, USA

Type of SEA: Mini Course
Level: Basic/Intermediate

Background:
The continuous intrathecal baclofen (CITB) delivery represents an important modality for treatment of dysfunctional spastic hypertonia. In the event of suspected or apparent change in drug effect, rapid and objective evaluation is mandatory to expedite appropriate treatments.

Goal:
The goal of this course is to review clinical and neurophysiological techniques for the evaluation of dysfunctional spastic hypertonia, with emphasis on their relevance to patients with the ITB pump. Using illustrative examples, we will discuss the utility of serial H-reflex recordings as an objective method for monitoring a patient response to CITB delivery. After this course, the participants should be able to understand how combined clinical and electrophysiological evaluation techniques may facilitate (1) determination of optimal CITB dose and selection of pump settings, and (2) evaluation and detection of suspected CITB system malfunction.

SENSORY RE-EDUCATION AFTER STROKE
Thursday, May 22, 2003
13:30-15:30
Margaret Yekutiel, Ph.D, PT.
Recanati School for Community Health Professions,
Ben-Gurion University, Be'er Sheva, Israel.

Type of SEA: Workshop
Level: Basic

Abstract
Many stroke patients have sensory perceptual disturbances that add to the disabling effects of loss of motor control. The sensory loss tends to go undetected and is seldom treated systematically, even though it may be a crucial cause of poor function. Sensory re-education (SRE) is a novel therapeutic approach with proven beneficial effects.
The workshop will open with a brief review of the following subjects: the frequency and disabling effects of sensory loss in stroke and other neurological conditions, the neurophysiological underpinnings of SRE, the concepts and principles of SRE, and the evidence from clinical trials of its efficacy.
The main part of the workshop will be devoted to giving participants the opportunity to learn and experience the methods of SRE therapy.

References:
Carey LM (1995) Somatosensory loss after stroke. Critical Reviews in Physical and Rehabilitation Medicine 7: 51-91.
Kim JS, Choi-Kwon S (1996) Discriminative sensory dysfunction after unilateral stroke. Stroke 27: 677-682.
Yekutiel M, Guttman E (1993) A controlled trial of the retraining of the sensory function of the hand in stroke patients. Journal of Neurology, Neurosurgery, and Psychiatry 56: 241-244.
Yekutiel M (2000) Sensory re-education of the hand after stroke. London: Whurr.

VOCATIONAL REHABILITATION & NEUROLOGICAL DISABILITY: THE ROLE OF ASSISTIVE TECHNOLOGY IN COMPUTER USE OPTIMIZATION
Sunday, May 18, 2003
14:00 - 15:30
Mark A. Young MD, FACP, MBA
Chair, Physical Medicine and Rehabilitation
The Maryland Rehabilitation Center

Panelists:
Bryan J. O’Young MD, Marta Imamura MD, PH.D, David Cassius MD

Type of SEA: Workshop
Level: Basic

Background:
Sensory and motor impairments related to neurological illness often represent a significant barrier to vocation. Functional impairments interfering with job performance among employable computer users include: visual, hearing ,co-ordination and movement disorders. The advent of assistive technology (AT) and computer operating system software adaptations (COSA) have enabled employable persons with neurological disease to surmount these challenges. Recent research has demonstrated, for example that persons with Parkinson's disease tremor can achieve optimization of keyboarding skill and accuracy through activation of a COSA change. (Reference: Young MA 1992: Mediterranean Meeting of PMR ""Parkinson's disease, Vocational Rehabilitation and Tremor: The Role of Technology in Workplace Accommodation"). Rehabilitation professionals can benefit from an expanded knowledge of the important role of AT and COSA to improve the vocational quality of life of their patients.

Aims:

1. Review the spectrum of neurological illnesses impacting on vocational use of computers.
2. Evaluate specific impairments which adversely effect fulfillment of work related computer tasks
3. Present & demonstrate AT & COSA techniques & tools

Methods:

1. PowerPoint presentation focusing on neurological illness and impairments impacting on computer use in an employment setting
2. Review the literature on novel assistive technology strategies to compensate for specific impairments
3. Provide a "hands on" demonstration of the above techniques and tools which clinicians and patients can deploy for successful vocational rehabilitation

Results:
Overview of recent research studies.

Summary/Conclusions:
A new generation of AT and COSA has enabled employable persons with neurological disabilities to achieve vocational success. This interactive hands on session will enable participants to expand their knowledge and skill relating to assistive technology and computer use optimization.

PRINCIPLES OF FUNCTIONAL COGNITIVE REHABILITATION: ASSESSMENT AND TREATMENT IN OCCUPATIONAL THERAPY
Tuesday, May 20, 2003
16:00-18:30
Noomi Katz, PhD, OTR1, and Sarah Averbuch, MA, OTR2,
School of Occupational Therapy, Hebrew University Jerusalem1,
Loewenstein Hospital and Department of Occupational Therapy, Tel Aviv University2

Type of SEA: Workshop
Level: Basic

Abstract
The purpose of the workshop is to present the principles of functional cognitive rehabilitation as they are applied at the occupational therapy department of the Loewenstein Rehabilitation Hospital to people that have cognitive deficits due to brain damage (vascular, traumatic or any other reason). A retraining model of cognitive rehabilitation is the basis of the intervention (Averbuch & Katz, 1998).

The workshop will include:

1. Presentation of cognitive assessment instruments. The instruments that will be presented are: the Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) and LOTCA-G (a geriatric version). These are basic batteries that provide an initial profile of the cognitive abilities and disabilities of the client as a starting point for intervention. We will also present formal cognitive and functional measures for the assessment of memory (RBMT and CMT), neglect (BIT and ADL checklist) and executive functions (BADS and EFPT).
2. Presentation of research data of the instruments' reliability and validity and their relevance to function in different populations.
3. Presentation of treatment principles with methods used in intervention. The aim of the treatment is to enhance the cognitive functional abilities of the patient providing the needed tools and reinforcing the patient's abilities to cope with everyday tasks of daily life. Short case examples will illustrate the intervention principles discussed.

The workshop is appropriate for physiatrists and therapists at all levels working with adults who suffer from cognitive deficits.
At the end of the workshop participants will know about major cognitive assessments used in rehabilitation, but particularly will be familiar with the use of the LOTCA and LOTCA-G. They will also have a better understanding of how to apply treatment principles of functional cognitive rehabilitation.

References:
Averbuch, S. & Katz, N. (1998). Cognitive rehabilitation: A retraining approach for brain-injured adults. (Ch. 3. pp.99-123), In N. Katz, (Ed.), Cognition and Occupation in Rehabilitation: Cognitive models for intervention in occupational therapy. Bethesda MD: American Occupational Therapy Association.

CONSTRAINT INDUCED MOVEMENT THERAPY IN THE TREATMENT OF UPPER EXTREMITY IMPAIRMENT AMONG PATIENTS WITH STROKE: A CRITICAL ASSESSMENT
Thursday, May 22, 2003
08:00-10:30
Steven L. Wolf, Ph.D., PT, FAPTA
Department of Rehabilitation Medicine,
Emory University School of Medicine, Atlanta, Georgia (USA)

Type of SEA: Workshop
Level: Basic

Abstract:
The purpose of the workshop is to review the foundations for constraint induced movement therapy, beginning with the work of Ogden and Franz (1917) through the development of learned non-use in the deafferented monkey model. (Taub et al, 1975, 1977, 1980). These early studies and formulations led to the concept of first, forced use, and, more recently constraint induced (CI) therapy.
This workshop is relevant to rehabilitation researcher scientists and clinicians, with little to comprehensive experience using CI therapy. During this workshop the participant will: (1) briefly learn about the basis for CI therapy; (2) gain exposure to the on-going national randomized clinical trial called EXCITE (EXcite Constraint Induced Therapy Evaluation), funded by the National Institutes of Health; (3) learn about relevant outcome measures that link impairment to ability; (4) become familiarized with ways in which mechanism of recovery (neuroplasticity) are being assessed; and (4) gain a perspective on potential inclusion and exclusion criteria for application of this intervention. The information provided in this workshop will be evidence based and examine the validity and reliability of this treatment approach.

References:
Wolf SL, Blanton S, Baer H, Breshears J, Butler AJ: The emergence of repetitive task practice in upper extremity neurorehabilitation of patients with stroke: A critical review of constraint induced movement therapy and mechanisms related to TMS, The Neurologist, 2002 (November).
Liepert J, Bauder H, Miltner WHR, Dettmers C, Taub, Weiller C: Treatment-induced cortical reorganization after stroke in humans. Stroke, 2000, 31:1210-16.

THE IMPACT OF THE AGING PROCESS ON REHABILITATION
Sunday, May 18
14:00 - 16:30
Yitshal N. Berner M.D., MPH
Head, Geriatric Medicine, Meir Hospital Kfar Saba
Affiliated to Sackler School of Medicine,
Tel Aviv Unicversity, Israel

SEA Type: Mini Course
Level: Basic

Aim: Evaluation of the effects of the aging process on rehabilitation

Description:
Evaluation of the effects of the aging process on metabolism, muscles, nervous system central and peripheral including sensory systems, cardiovascular, respiratory, renal and gastrointestinal systems.
Discussion of deconditioning in the aged as a consequence of acute medical conditions of different types.
Principles in the assessment of elderly patients undergoing rehabilitation: parameters of special importance in the aged; assessment tools and standardized validated questionnaires for the evaluation of elderly patients undergoing rehabilitation.
Case discussion and evaluation - three representative cases.

NEW APPROACHES IN DIAGNOSIS AND TREATMENT OF PAIN, BASED ON SPINAL SEGMENTAL SENSITIZATION.
Monday, May 19, 2003
14:00-18:00
Course Director: Andrew A. Fischer, M.D., Ph.D. Assoc. Clin. Professor of PM&R, Mt. Sinai School of Med. CUNY. USA
Faculty: Marta Imamura, M.D.,Ph.D., Prof. PM&R , Med. School of Sao Paolo, Brazil; Hy Dubo, M.D., Prof. of PM&R, Faculty of Med. U.Manitoba,Winnipeg, Canada; David Cassius, M.D., Seattle WA.USA; Linamara Batistella, M.D., Prof. PM&R, Sao Paolo, Brazil

Type of SEA: Workshop
Level: Basic

Background:
Spinal segmental sensitization (SSS) is a recently described syndrome, consistently present in all painful conditions, which can be diagnosed clinically by new and improved examination methods (4,5,6). Paraspinous Block (PSB) is a simple, new office procedure that alleviates pain instantaneously by reversing SSS to normal sensitivity (3,4,6).
This is a hands-on, practice oriented WS, with active participation of the audience, for training in improved diagnostic and treatment techniques. The program is suitable for physiatrists, pain specialists as well as physical and occupational therapists. New injection procedures can be practiced on live pain patients who have failed with other treatments. New tests, such as electric skin conductance and pinch and roll for objective and quantitative diagnosis of sensory dysfunction will also be practiced. The sensitivity and precision of these new tests far surpasses the conventional methods of examination (4,6).

Objectives:
Upon completion of the WS, the participants will be able to:

1. Diagnose the treatable causes of musculoskeletal pain and their associated levels of SSS.
2. Employ pain diagnostic instruments (1,2,5) (Algometer, tissue compliance meter and electric skin conductance) in their daily practice.
3. Perform new injection techniques such as: paraspinous blocks for desensitization of spinal segments; needling and infiltration to eliminate taut bands associated with trigger points and other abnormal tissues; pre-injection blocks to pre-empt the pain and irritation caused by injections of trigger points and tender areas (3,4,6).
4. Prescribe specific corrective exercises based on functional testing and postural deficiencies, and be able to instruct those exercises to the patients (1,3,5,6). All procedures have been successfully employed in private practices. Several studies have proven the efficacy of the described treatments (3,6).

Selected References:

1. Fischer AA (ed): Myofascial Pain - Update in Diagnosis and Treatment. Phys Med Rehabil Clin North Am. Philadelphia: W.B. Saunders. 1997. pp.153-169.
2. Fischer AA (ed): Muscle Pain Syndromes and Fibromyalgia. New York: The Haworth Press. 1998; 5-32.
3. Fischer AA: Treatment of Myofascial pain. J. Musculoske Pain. 1999; 7:131-142.
4. Fischer AA, Imamura M: New concepts in the Diagnosis and Management of Musculoskeletal pain: In Lennard TA (ed): Pain Procedures in Clinical Practice, Second Edition. Philadelphia, Henley & Belfus, Inc. 2000; pp. 213-229.
5. Fischer AA: Functional Diagnosis of Musculoskeletal Pain by Quantitative and objective methods. In Rachlin E (ed.): Myofascial pain and Fibromyalgia, 2nd edition. Mosby, 2002.
6. Fischer AA.: New injection techniques for treatment of Musculoskeletal pain. Ibid.

CLINICAL AND POSTUROGRAPHIC EVALUATION OF BALANCE DISORDERS
Faculty: O. Keren, M.D., R. Brown, M.Sc , A. Burstin, B.Ac., Israel, and L. Tesio, M.D., Italy.
Wednesday, May 21, 2003
08:30-11:00

Type of SEA: Mini Course
Level: Basic/ intermediate

Background:
Balance is a human-whole person activity ("I" am unbalanced, "I" fall), and thus it is well nested within the WHO model of disability. As such, balance functional assessment (whole-person, not: ENT) and rehabilitation are for sure a transversal topic in rehabilitation, which is often mistaken for one of its sub-domains, i.e., "vestibular" rehabilitation, treatment of dizziness, or so.

This is a Mini Course including active demonstration and videotaped examinations, for training and improving diagnostic techniques. The program is suitable for physiatrists, physical therapists and occupational therapists. Different tests and equipment will be presented and discussed. The last section will be devoted to a panel discussion and establishing a special group of interest (SIG).

Objectives:
Upon completion of the MC, the participants will be able to:

1. Fully comprehend basic concepts of postural control as related to balance disorders.
2. Present updated methods to assess balance disorders in the context of rehabilitation.
3. Understand the principles of posturographic examination.
4. Participate in a special group of interest (SIG) for "balance functional assessment and rehabilitation".

Content:
Overview of the following topics:

• Basic concepts of human postural mechanisms and balance..
• Description and demonstration of widely used clinical tests.
• Demonstration of a posturographic examination in the TETRAX System.
• Clinical interpretation of videotaped examinations carried out with the TETRAX and the EQUITEST Systems.
• Panel discussion.

Selected References:

1. Brauer S, Bruns Y, Gally P. Lateral Reach: A clinical measure of medio-lateral postural stability. Physiotherapy Research International: 1999:4:2:11-17.
2. Hill KD, Dwyer JM, Schwarg JA, Helme RD. A falls and balance clinic for the elderly. Physiotherapy Cand: 1994:45:20-27.
3. Kohen-Raz R. Application of Tetra-ataxia-metric posturography in clinical and developmental diagnosis. Percept Motor Skills: 1991:73:635-656.
4. Podsiadlo D, Richardson S. The timed "up & go": a test of basic functional mobility for frail elderly persons. JAGS: 1991:39:142-148.
5. Tesio L, Franchignoni FP, Battaglia MA, Peruccal L. A short measure of balance in Multiple sclerosis: validation through Rasch analysis. Funct Neurol 1997; 12,5:255-265.
6. Tesio L, Alpini D, Perucca L, Cesarani A. The short-form of the Dizziness Handicap Inventory: construction and validation through Rasch analysis. Am J Phys Med Rehabil; 1999;78:1-10.
7. Weiner BK, Duncan PW, Chandler J, Studenki SA. Functional Reach: A marker of Physical Frailty. JAGS: 1992:40:203-207.
8. Nashner LM,Peters MF
   Posturography in the diagnosis and management of dizziness and balance disorders.
   Neurol Clin. 1990 May;8(2):331-49. Review.
9. Horak FB, Nashner LM.
   Central programming of postural movements: adaptation to altered support-surface configurations.
   J Neurophysiol. 1986 Jun;55(6):1369-81.

THE USE OF BRAIN SELF-REGULATION AND BRAIN-COMPUTER INTERFACES IN NEUROLOGICAL DISEASES (epilepsy, attention deficit disorder, complete paralysis, parkinson's disease and stroke)
Wednesday, May 21
15:30 - 18:30
Prof. Dr. Niels Birbaumer
Institute of Medical Psychology and Behavioral Neurobiology, University of T?bingen, Germany, and Center for Cognitive Neurosciences, University of Trento, Italy

Type of SEA: Workshop
Level: Basic to Advanced

The workshop is relevant to Psychologists, Neurologists, Specialists in P&RM and Nurses, researchers and clinicians.

Objectives:
The course will provide participants with:

1. Basic neurophysiology of slow cortical potentials and mu-rhythm and principles of EEG- operant self-regulation.
2. Animal work on brain-computer-interfaces (BCI) and "thought-reading".
3. Equipment and Behavior Analysis for intractable epilepsies and amyotrophic lateral sclerosis (ALS).
4. Course of neurofeedback-treatment in epilepsy and ALS.
5. Ethical issues and quality of life in end-stage ALS and complete paralysis.
6. Principles of cortical reorganization in stroke and chronic pain (if time is available).

Description:
The course describes practical steps and equipment necessary for the application of neurofeedback in the above mentioned disorders. Particularly, treatment of epilepsy and verbal communication with locked-in and vegetative-state patients using operant training of slow cortical potentials is illustrated with slides and videos. Emerging applications for neurofeedback are attention deficit disorders (ADD) and post-stroke deficits. The combination with operant treatment and neurofeedback results in optimal outcome in disorders with systemic or local brain damage such as chronic pain, parkinson and stroke.
Supported by the Deutsche Forschungsgemeinschaft (DFG) & NIH.

Selected References:

1. Birbaumer, N., Ghanayim, N., Hinterberger, T., Iversen, I., Kotchoubey, B., K?bler, A., Perelmouter, J., Taub, E. & Flor, H. (1999). A spelling device for the paralysed. Nature, 398, 297-298.
2. Birbaumer, N., Lutzenberger, W., Montoya, P., Larbig, W., Unertl, K., T?pfner, S., Grodd, W., Taub, E. & Flor, H. (1997). Effects of regional anesthesia on phantom limb pain are mirrored in changes in cortical reorganizati

SURFACE ELECTROMYOGRAPHY FOR DIAGNOSTICS AND EVALUATION OF TREATMENT IN REHABILITATION
Wednesday, May 21
13:00 - 15:15
Hermie J. Hermens, Ph.D.,
Miriam Hutten-Vollenbroek Ph.D
Jaap Buurke R.PT
Roessingh Research and Development, Enschede, The Netherlands

Type of SEA: Mini Course
Level: Basic/Intermediate

Surface ElectroMyography (SEMG) is a powerful tool to assess the neuromuscular function(ing). In fact, it is at present the only tool to study how (ab)normal movements are generated.
During the past years, both the technology to record the SEMG, as well as our understanding of the interpretation of the SEMG has increased considerably. This has enabled the development of recommendations for recording and analysis of the SEMG at a European level (E.C. project SENIAM) that is gaining now worldwide acceptance. This allows reproducible measurements, a useful exchange of data and a common interpretation.
The objective of this course is to provide a good understanding of how the SEMG should be recorded, analyzed and interpreted.

Topics that will be addressed during this course are:

1. Recommendations and pitfalls for recording the SEMG
2. Relevant backgrounds for a proper interpretation of the SEMG signal and its parameters
3. Using the SEMG in the analysis of abnormal gait
4. Muscle activation in chronic pain and the use of myofeedback in neck/shoulder pain (with demonstration)
5. Using SEMG to assess spasticity
6. New emerging SEMG techniques

SCIENTIFIC APPROACHES TO THE MEASUREMENT OF SPASTICITY
Thursday, May 22, 2003
11:00-13:00
Course Director: Garth R Johnson PhD, FREng, Newcastle, UK
Faculty: Hermie Hermens PhD, Het Roessingh, Netherlands; Kevin McCarthy, European Commission, Brussels, Belgium; David Pandyan PhD, University of Keele, UK; Thomas Platz MD, Klinik Berlin, Germany; Ian Swain PhD, University of Bournemouth, UK; Frederike van Wijk, Queen Margaret University College, Edinburgh, UK;

Type of SEA: Workshop/Symposium

Background:
The ever increasing need to measure the outcomes of treatment and the frequent use interventions such as Botulinum toxin make it essential to have reliable measurement techniques. However, the measurement of spasticity has relied, for a long time, on poorly validated clinical scales.

This Workshop will present the results of in depth reviews of clinical scales, neurophysiological and biomechanical techniques for the measurement of spasticity. There will be an introductory presentation on the basic neurophysiology of spasticity and a discussion on the possible therapy approaches to rehabilitation in conjunction with antispasticity treatment.
The Symposium will be conducted by members of the EU SPASM Thematic Network - a consortium of partners drawn from 7 EU member states. A special feature of the Symposium will be a presentation by Kevin McCarthy on the opportunities for involvement in EU Framework 6 programmes of research in rehabilitation and the opportunity to establish an international spasticity group in association with the SPASM Consortium.

Objectives
Upon completion of the Workshop, the participants will have an understanding of the following:

1. the underlying neurophysiology of spasticity,
2. the features and limitations of clinical scales for the measurement of spasticity,
3. the available neurophysiological and biomechanical techniques for the measurement of spasticity
4. how to tailor therapy programmes in conjunction with antispasticity treatment.

APPLICATION OF THE ICF IN REHABILITATION MEDICINE
Wednesday, May 21
11:15-12:45
Gerold Stucki, M.D., M.S., Professor and Chair, Department of Physical Medicine and Rehabilitation, University of Munich; Director, ICF-Research Branch, WHO Collaborating Center for the Family of International Classification, Germany
Thomas Ewert, Department of Physical Medicine and Rehabilitation, University of Munich, Germany, Unit for Rehabilitation Sciences and Rehabilitation Economics

Type of SEA: Workshop
Level: Basic / Intermediate

Background:
Rehabilitation medicine defines itself with respect to concepts of functioning, disability and health. The current framework of disability - the WHO International Classification of Functioning, Disability and Health (ICF) -provides a coherent view of health from a biological, individual and social perspective. However, ICF success will depend on its compatibility with measures used in rehabilitation and on the improvement of its practicability.

Goal:
The goal of this workshop is to familiarize the participants with the ICF Core Set project, an international initiative in collaboration with WHO and the ICF Research Branch in Munich, Germany to apply the ICF for rehabilitation medicine. When applying the ICF in medicine, ICF Core Sets are an intuitive and practical approach. ICF Core Sets link the ICF to the condition perspective and make it feasible for clinical practice, research and health reporting.

Content:
The workshop will address the following topics:

• Scientific methods used in the development of the ICF Core Sets
• Organization of the International Collaboration with involvement of experts and international and national associations and societies
• How to associate your national society with the ICF Core Set project
• Results from the first two ICF Core Set conferences on Osteoarthritis, Osteoporosis,
• Rheumatoid Arthritis, Stroke, Obesity, Depression and Chronic Pain
• Information about the 3rd ICF Core Set conference from May 30 to June 2 covering Diabetes Mellitus, COPD/Asthma, Heart Disease and Asthma (Info: agarza@phys.med.uni-muenchen.de)
• How to become a partner in the testing of the ICF Core Sets in a variety of clinical settings and regions
• Software and internet based solutions to facilitate the use of the ICF and ICF Core Sets in clinical practice and research