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2023 Rehabilitation Medicine Society of Australia and New Zealand

2023 Rehabilitation Medicine Society of Australia and New Zealand6th Annual Scientific MeetingSunday 10 - Wednesday 13 September 2023 | Hotel Grand Chancellor Hobart, TAS

Concurrent Sessions

Please click below for session outlines and confirmed speakers

Concurrent Sessions 1 - Monday 11 September 2023, 1.30 pm - 3.00 pm

Concurrent Sessions 2 - Tuesday 12 September 2023, 1.30 pm - 3.00 pm

Concurrent Sessions 3 - Wednesday 13 September 2023, 10.30 am - 11.45 pm

Concurrent Sessions 1
Monday 11 September 2023, 1.30 pm - 3.00 pm
 

1.1 Rehabilitation needs in natural disaster and austere environments

Chair: Dr Yuriko WatanabeSt Vincent's Hospital Sydney, NSW 

In natural disasters, rehabilitative needs have often been neglected, with emphasis on acute response plans focused on saving lives and treating acute injuries. There is a lack of, or inadequate rehabilitation-inclusive disaster response plans and rehabilitation services in many natural disasters.  The World Health Organization (WHO) Emergency Medical Team (EMT) initiative recognises rehabilitation as an integral part of medical response and patient-centred care in disaster settings.

Disaster Rehabilitation (DR) Special Interest Group (SIG) was established in 2017. It aims to support emergency disaster rehabilitation response, provide educational resources and share knowledge. DRSIG members will present (1) patient experience in natural disasters (floods in NSW), (2) challenges faced by homeless people during pandemic, (3) up to date from ISPRM Disaster Rehabilitation Committee, and (4) international telehealth experience in rural India.

Speakers
Dr  Sumitha Gounden, Orange Health Service, NSW
Dr Yuriko WatanabeSt Vincent's Hospital Sydney, NSW
Dr  Stephen  Wilson, Royal North Shore Hospital, NSW
Dr Edwin Luk, Royal Melbourne Hospital, VIC

1.2 Tips, tricks and troubleshooting Intrathecal Baclofen therapy; the paediatric experience
Chair: Dr Lisa Copeland, Queensland Paediatric Rehabilitation Service, QLD 

Intrathecal baclofen (ITB) therapy involves the continuous infusion of Baclofen via an  implanted pump and catheter. Baclofen acts at spinal GABA receptors to improve hypertonicity. When given intrathecally, baclofen is reported to have fewer systemic medication related side effects when compared with oral Baclofen with greater efficacy.

However, the adverse event rate is reported as high as 50%. As such, ITB therapy tends to be reserved for cases of refractory spasticity or dystonia where less invasive treatments have failed.

The Australian Paediatric ITB research group (APIRG) has been tracking safety and efficacy of ITB for Australian Children for more than 10 years. This workshop will outline APIRG’s works and then use a series of cases to discuss patient selection, dosing as well as assessment and management of adverse events. 

Speakers
Dr Kirsty Stewart,  The Children's Hospital At Westmead, NSW
Dr Louise Tyack, Queensland Paediatric Rehabilitation Service, QLD
Dr Emma Richardson, Perth Children's Hospital, WA
A/Professor Ray Russo,  Women's and Children's Hospital, SA 

1.3 Approaches to Cognitive Rehabilitation  and Behavioural Management in TBI and Stroke patients

Chair: Dr Roslyn Avery, Neuro Rehabilitation SIG, NSW 

This session presents discussion and suggests some solutions to management of difficult or challenging behaviours following acquired head injuries.

1. Behaviour support group and its utility in the management of challenging behaviour.
Dr Maria Paul , MRCP (UK), FAFRM (Australia), is a Senior Rehabilitation Physician working for the South Australian Brain Injury Rehabilitation Service (SABIRS) , currently based at the Brain Injury Rehabilitation Unit at Repatriation Health Precinct Adelaide and is Hon Senior Lecturer Adelaide University , South Australia.  Dr Paul will present  the Principles of PBS and evaluation of effectiveness in managing challenging behaviour. 

2. Neuropsychiatric Formulation in Lesional TBI: A systematic Clinical Approach
Jennie Ponsford, AO is Professor of Neuropsychology and Director of Clinical Programs in the School of Psychological Sciences at Monash University and Director of the Monash-Epworth Rehabilitation Research Centre at Epworth Hospital in Melbourne, Australia. She has spent 38 years engaged in clinical work and research with adults and children with brain injury.

Her research has investigated outcomes following mild, moderate and severe Traumatic Brain Injury (TBI) and factors predicting outcome. She has also evaluated the efficacy of numerous rehabilitative interventions to improve outcome. She has published over 320 journal articles and book chapters, and two books on rehabilitation following TBI. Professor Ponsford is Past-President of the International Neuropsychological Society, Past-President of the International Association for the Study of Traumatic Brain Injury and the Australasian Society for the Study of Brain Impairment (ASSBI), and serves on the Executive of the International Brain Injury Association and ASSBI.

Speakers
Dr Maria Paul, South Australia Brain Injury Rehabilitation Service, SA
Professor Jennie Ponsford, Epworth Healthcare, VIC

1.4 Tackling hidden disability: It’s everyone’s business
Chair: Professor James Middleton, John Walsh Centre for Rehabilitation Research, NSW 

Hidden disabilities can substantially affect the well-being of people with spinal cord injury (SCI) or other causes of disability, even if they appear to be functioning well and independently. The potential for and implications of hidden disability are key considerations for the broader community of health practitioners who manage people with SCI, and for the design and implementation of disability support systems. Opportunities exist to improve management of hidden disability in SCI by improving networking between specialist and non-specialist rehabilitation and community services to improve access to expertise and equity of care.

This workshop highlights the issue of hidden disability, discussing implications for policy and practice for a broad range of rehabilitation providers. Understandings of hidden disability gained by clinical experts, researchers and people with lived experience of SCI will be discussed. Results from the Australian arm of the International Spinal Cord Injury Community Survey, a large population-based survey of lived experience of SCI in Australia (n=1579), and other findings from literature, will also be presented. Thus, the workshop will provide context, lessons learnt and opportunities for further improvement in the provision and outcomes of rehabilitation for SCI, with implications translatable to other settings involving hidden disability.

Speakers
Professor James Middleton, John Walsh Centre for Rehabilitation Research, NSW
Professor Tim Geraghty,  Princess Alexandra Hospital, QLD
Dr Annette Kifley, John Walsh Centre For Rehabilitation Research, NSW
Mr Robert Wynn,  Spinal Cord Injuries Australia,  NSW 

1.5 Free Paper Session - Guidelines, Research and Service Development

  • Professor Karen Barlow, University Of Queensland, QLD: Australia and New Zealand Clinical Practice Guidelines for the Assessment and Management of Mild Traumatic Brain Injury and Persistent Post Concussion Symptoms for adults and children
  • Professor Ian Cameron, Northern Sydney Local Health District, NSW: Australian Clinical Guidelines for Health Professionals Managing People with Whiplash-Associated Disorders, Fourth Edition: Chapter 4 Treatment
  • Dr Allison Yates, University of Melbourne, VIC: Examining potential Assessment of Quality of Life (AQoL)-8 respondent error in the Spinal Cord Injury Physical Activity (SCIPA) ‘Hands On’ cost-utility analysis
  • Dr Pushpa Suriyaarachchi, Nepean Hospital, NSW: Mood disorders in the inpatient rehabilitation setting: Prevalence and outcomes with early recognition of anxiety and depression
  • Dr Kisani Manuel, Flinders Medical Centre, VIC: Hospital-based health professionals’ perceptions of frailty in older people
  • Professor Ian Cameron, Northern Sydney Local Health District, NSW: The World Rehabilitation Alliance - Operationalizing Rehabilitation 2030

Concurrent Sessions 2
Tuesday 12 September 2023, 1.30 pm - 3.00 pm

2.1 Lessons learnt and what can rehabilitation medicine services do better to help our culturally and linguistically diverse Australian and New Zealand population
Chair: Dr Howard Flavell,  Royal Darwin and Palmerston Regional Hospital, NT 

There are significant challenges delivering Rehabilitation Medicine services to Australia’s and New Zealand’s first nation people as well as to Pacific Islanders.The four speakers will share a wealth of experience and passion to optimise outcomes amongst this population group.

 Prof Marshall has encountered the major difficulties delivering care for first nation people with spinal cord injury living in remote communities with limited resources. She will present on the challenges but also detail the strategies that can be employed to optimise outcomes in this setting via a recording but will be available via Zoom for questions.

Tracey is a rehabilitation physician who has spent many years working as a  doctor and rehabilitation physician in the Pacific and North Queensland and is passionate about improving rehabilitation care to  first nations peoples. She will be presenting on the relevance of rehabilitation in these settings and  engagement with local communities including the skilled health professionals especially doctors and physician.

Howard and Laura will present on the challenges facing first nation people in the Northern Territory who have sustained strokes and amputations. Dr Sindhoora Shetty (his colleague in  Darwin) has compiled the presentation on amputees. There will be case studies and data to detail strategies employed to optimise outcome.

 Dawn will present from a Māori and Aotearoa perspective. Me mahi tahi tātou mo te oranga o te katoa - We must work together for the wellbeing of all.  The rehabilitation journey for whānau Māori is complex. The voice of our Māori people is a taonga - treasure. It provides, to those with a listening ear, clarity for making the changes and improvements needed to achieve better rehabilitation outcomes for whānau Māori.  The challenge for the rehabilitation medicine physician is how to utilise this taonga in a meaningful way to engage and support Māori whānau throughout the entirety of their rehabilitation journey.  

Speakers

Professor Ruth Marshall, Central Adelaide Local Health Network, SA
Dr Tracey Symmons, Townsville University Hospital, QLD
Dr Howard Flavell,  Royal Darwin and Palmerston Regional Hospital, NT
Dr Dawn Adair, Auckland Spinal Rehabilitation Unit, New Zealand
Dr Laura Goodwins, Northern Adelaide Local Health Network, SA 

2.2 Transition Medicine - From Paediatric to Adult Rehabilitation
Chair: Dr Kavitha Muthukrishnan,  St Vincent's Hospital, VIC 

This session aims to provide a broad overview of Transition Medicine in Australia and will include a discussion with paediatric and adult transition medicine physicians and aims to highlight the challenges faced for patients, families and health care professionals. This session will provide an introduction to Transition Medicine and issues involved when young patients are faced with adult medicine including multiple doctors, multiple hospitals, including discussion of the limitations in adult services to care for complex patients. The presentation will include the current issues in this field.

Speakers
Ms Evelyn Culnane, The Royal Children's Hospital, VIC
A/Professor Barry Rawicki,  Masada Hospital, VIC
Dr Jayasri Srinivasan, Royal Children’s Hospital Melbourne, VIC

2.3 Diverse clinical and non-clinical roles as a Rehabilitation Medicine Physician in different stages of career and life

Chair: Dr Yan Chow, Austin Health, VIC 

After spending many years studying in medicine and specialty training, there is a whole world that awaits you beyond working in a hospital and outpatient setting.

Rehabilitation Medicine has been traditionally hospital based. The evolution has been going into community and ambulatory services. We talk about the "patient journey", let's reflect on what your career journey can be with a FAFRM!

This session has three diverse AFRM Fellows at different career and life stages who will show how you can use your skills and experience for other job opportunities. You will come away with a new perspective on improving your career direction.

Speakers
Dr Tom Na, Alfred Health And Epworth Healthcare, VIC
Dr Shari Parker, St Vincent’s Private Hospital, NSW
Professor Peter Disler, University Of Melbourne and Monash University, VIC

2.4 Principles and practice of involving consumers in quality activities, service development and rehabilitation research – moving from tokenism to authenticity, value and meaning
Chair: Professor Tim Geraghty, Princess Alexandra Hospital, QLD 

Consumer involvement in quality activities, service development and rehabilitation research can be of great value when done well. In this workshop, we will explain the imperatives driving consumer involvement and the need to shift from tokenistic involvement to that which is authentic and meaningful. We will also address some of the common challenges to incorporating consumer involvement and lay out some basic principles that, when applied, increase the likelihood of successful involvement. The consumer involvement spectrum will be explained, and we will direct workshop participants to examples of contemporary resources that can support consumer involvement. Finally, a case example of consumer involvement in the service development activities of the Spinal Outreach Team will be explored.

Speakers
Dr Delena Amsters, Princess Alexandra Hospital, QLD
Miss Kiley Pershouse, Princess Alexandra Hospital, QLD

2.5 Free Paper Session - Neurorehabilitation

  • Mr Jonathan Ho, University Of Queensland, QLD: Paediatric brain connectivity recovery after TBI
  • Dr Shrikant Pande, Changi General Hospital, SINGAPORE: Seizures Following Brain Injury Factors Increasing The Incidence
  • Professor Gavin Williams, Epworth Healthcare & The University of Melbourne, VIC; Ballistic resistance training improves mobility more than usual physiotherapy intervention following traumatic brain injury: a randomised controlled trial
  • Ms Fen-Ling Kuo, Shuang Ho Hospital, Taipei Medical University, TAIPEI: A randomized trial of a 3D-printed assistive device in functional performance for patients with neurological impairment
  • Dr Thorlene Egerton, The University Of Melbourne, VIC: Effectiveness and feasibility of telehealth for improving falls-related outcomes in community-dwelling adults with neurological conditions? A systematic review and meta-analysis
  • Ms Hsinchieh Lee, Taipei Medical University, TAIWAN: Improvement of Walking Ability in Stroke Patients via Balance Training with the Pablo System: A Randomized Controlled Trial

Concurrent Sessions 3
Wednesday 13 September 2023, 10.30am – 11.45am
 

3.1 Mindful SensoriMotor Training for the treatment of Phantom Limb Pain
Chair: Professor Max Ortiz-Catalan, Chalmers University Of Technology, Sweden

Phantom limb pain (PLP) affects 30-80% of individuals with limb amputations and can significantly impact daily life functioning. Despite the availability of numerous treatments, PLP remains difficult to treat. Recently, a novel treatment for PLP called Phantom Motor Execution (PME) has been developed by Prof. Max Ortiz Catalan and his team. PME uses phantom exercises in augmented and virtual reality to treat PLP. The patient sees a virtual limb projected over their stump and learns to control it using electrodes on the remnant limb. This way, the patient (re)learns to move his phantom limb, which in turn reduces PLP. An international randomized controlled trial showed that half of the participants still had significantly less PLP six months after completing PME treatment. PME has been further improved by Phantom Motor Imagery and incorporating Sensory Training using a tactile display; improved treatment called Mindful SensoriMotor Training (MiSMT). 

Since MiSMT might be an interesting addition to current treatment methods for many rehabilitation teams, this workshop has been proposed. The workshop will cover theoretical aspects, research results of PME, and a demonstration of the different parts of MiSMT. The first part will focus on the theory and research behind the treatment, while the second part will provide a live demonstration of PME and Sensory Training.

Speakers
Ms Shahrzad Damercheli, Chalmers University of Technology, Sweden
Ms Mirka Buist, Gothenburg University, Sweden
Professor Max Ortiz-Catalan, Chalmers University Of Technology, Sweden 

3.2 Rehabilitation-in-the-Home: Review and Way Forward

Chair: Dr Benjamin Chen, Gold Coast Health, QLD 

The concept of Rehabilitation-in-the-Home has garnered significant interests among clinicians as well as health administrators alike, with various iterations of such services being established in both public and private sectors for different purposes from enhanced community rehabilitation to hospital bed substitution. Does the concept work? Is it a viable and innovative way of delivering rehabilitation? Where does Rehabilitation-in-the-Home fit in the overall scheme of rehabilitation service delivery? Let Professor Poulos, Dr Leslie Gan and Dr Vyv Wong untangle the myth from fact for you...

Speakers
Professor Christopher Poulos, Hammond Care, NSW
Dr Leslie Gan, Logan Hospital, QLD
Dr Vun Vun Wong,  Consultant Rehabilitation Medicine, SA

3.3 Advanced Orthotics Updates

Chair: Dr Michael Chou,  Alfred Health, VIC 

This Advanced Orthotic Update session will focus on the latest developments in Neuromuscular Orthotics that are available being used  within Australia  and in the US.  Mr Darren Pereira, an experienced orthotist from Melbourne, and Professor Alberta Esquenazi from Moss Rehab, Philadelphia, US, will be sharing their knowledge and clinical experience in using these advanced new orthotics in clinical setting and research. 

With the availability of NDIS, such advanced orthotics may become more affordable and may benefit more rehabilitation patients in Australia in the future.  This session should be most informing and stimulating.

Speakers
Mr Darren Pereira, Neuromuscular Orthotics, VIC
Professor Alberto Esquenazi, Moss Rehab, United States 

3.4 Free Paper Session - Rehabilitation Research

  • Dr Tim Geraghty, Princess Alexandra Hospital, QLD: Understanding the research capacity building needs of medical officers in rehabilitation services
  • Dr Annette Kifley, John Walsh Centre for Rehabilitation Research, NSW: Long-term compensation outcomes after non-catastrophic road traffic injury: findings from two cohort studies
  • Professor James Middleton, Kolling Institute, NSW: A value-based systems approach of care delivery for people with a spinal cord injury in NSW supported by discrete-event Dynamic Simulation Modelling
  • Dr Edwin Luk, Royal Melbourne Hospital, VIC: Goal attainment with integrated upper-limb spasticity management including botulinum toxin A (BoNT-A): Sub-analysis of Australian data from the ULIS-III study
  • Dr Anupam Datta Gupta, Central Adelaide Local Health Network, SA: A Systematic Review and Meta-Analysis of Efficacy of Botulinum Toxin A for Neuropathic Pain