A meeting of minds—WCPT 2007

Article Outline

• Copyright

Vancouver, Canada hosted this year's World Confederation for Physical Therapy Congress which attracted around 3500 delegates from 84 countries. The theme for this year was Moving Physical Therapy Forward. A substantial programme comprising 220 scientific sessions over 4 days representing 1641 abstracts left delegates with difficult decisions on which presentations to attend. The rich depth and breadth of Physical Therapy around the world was truly represented. Thought provoking key notes, focused symposia and workshops covered topics as diverse as genomics and female mutilation. As one of the scientific judges I attended many sessions that I would not normally choose outside the field of sports-specific physical therapy. What struck me is that there is a lot of knowledge transfer that can be applied from other fields and disciplines. Abstracts have been published by Elsevier and are available on line at: 〈http://www.wcpt.org/abstracts2007/WCPT2007.html〉. Elsevier, through three of its journals, Physical Therapy in Sport, Manual Therapy, and Physiotherapy, have agreed with WCPT to publish several of the papers presented at the Congress. Please look out for these papers over 2009.

This year's WCPT also hosted the inaugural meeting of the International Society of Physiotherapy Journal Editors (ISPJE). Around 35 physiotherapy journals worldwide, including PTiS, had been identified prior to this meeting, and a further 10 titles were identified during the course of the meeting. The aim of the society is to promote the dissemination of Physical Therapy research. Congratulations to Dr. Louise Ada and Dr. Rob Herbert from Australia who have been recently elected Chair and Secretary, respectively, of this new organisation. Many of the editors at this meeting, including the editors of PTiS, ran a workshop during WCPT entitled Writing for Publication. This was well attended by over 250 delegates. Dr. Louise Ada (Australian Journal of Physiotherapy) and Dr. Haxby Abbott (New Zealand Journal of Physiotherapy) presented an overview of the review process and top tips for getting through this. This presentation can be found at: 〈http://www.wcpt.org/congress/programme/workshops/index.php〉.

Subsequent smaller workshops enabled delegates to meet with Journal editors on publication issues relevant to them. I was impressed that the majority were either contemplating publishing for the first time or were relatively new to publishing.

As with any good conference, old friendships were renewed and new friendships formed, with discussion and debate continuing outside the presentation halls. WCPT in Vancouver was both stimulating and refreshing, and I would encourage those who have not previously submitted abstracts to consider the next WCPT conference in Amsterdam, Holland in 2011. This leads us on to the final issue of PTiS for 2007.

Clinical evaluation of lower extremity biomechanics during open and closed kinetic chain activity is common practice during assessment of lower limb dysfunction. Increased dynamic knee valgus with associated medial femoral rotation during closed chain activity, such as a single/double leg squat or drop jump, has been observed in subjects presenting with patellofemoral dysfunction and poor proprioception. Additionally, increased knee valgus angles have been shown to be predictive of ACL injury. Theories as to the potential causes of increased dynamic knee valgus include poor distal anatomical biomechanics, including over pronation of the foot, and poor proximal neuromuscular control around the hip. Whilst clinicians would seek to correct these dysfunctions, this subject warrants further investigation.

In this issue, two pieces of original research in this area are presented. The first, by Levinger, Gilleard and Coleman investigate dynamic knee valgus in female subjects with patellofemoral pain (PFPS) compared to a control group during a single-leg squat. Femoral frontal angle and femoral deviation were measured using a single camera. Results demonstrated a significantly larger femoral frontal angle in those subjects with PFPS compared to the control group, and no differences in femoral deviation. This study supports the evidence of increased dynamic knee valgus occurring in association with PFPS. However, cross-sectional studies, such as this, are unable to indicate whether this observation is the cause or effect of PFPS.

Carcia and Martin present the second study investigating the effect of gender on gluteus medius activity during a drop jump. Whilst, no significant differences were found between genders, a larger variability in female EMG activity was reported. The authors raise some interesting points under study limitations with regard to analysis of EMG activity and the potential role of gluteus maximus and the hip lateral rotators on controlling dynamic knee valgus.

In the next original article, Rasool and George report on a 4-week single leg dynamic balance training in a group of young healthy recreational male athletes. Subjects were randomised into either a training or control group, and those in the training group trained only one of the legs, this was also randomised. Dynamic stability was assessed using the Star Excursion Balance Test (SEBT) at baseline, 2 and 4 weeks in both groups. SEBT scores in the trained leg demonstrated significant improvement at 2 and 4 weeks compared to the control group, and interestingly, there were smaller, but significant changes in the untrained leg compared to the control group. No changes were demonstrated in the control group. This study raises interesting questions on the potential cross over effects of training, and shows that short periods of intervention can have a positive effect (in the short term) in this subject group.

Fatigue has been suggested to be a contributory factor in ankle sprain injuries in soccer, nearly 50% have been reported to occur in the last third of the game. Grieg and Walker-Johnson investigated the effect of soccer-specific fatigue on functional stability in a small group of 10 semi-professional soccer players. Several parameters of balance were evaluated and a change in balance strategy was found towards the latter stages of fatigue. These findings could support the use of proprioceptive training in the fatigued as well as rested state during training and competition.

Herrington and McCulloch present a pilot study comparing eccentric training with ultrasound plus deep transverse frictions in the management of Achilles tendinopathy in 25 subjects randomised into one of the intervention groups. VISA-A questionnaires revealed both groups improved significantly over the 12-week intervention period; however, the eccentric training group had significantly greater VISA-A scores at 12 weeks. This study adds to the substantial evidence available for the role of eccentric training for the management of this particular pathology.

Case studies and case reports are a valid method of reporting specific interventions and/or outcomes. However, of all the different article types in the Physical Therapy literature, journals such as PTiS receive the fewest of these. Additionally, case reports are notoriously difficult to solicit and tend to be very variable in methodology and quality. Sousa and colleagues present a timely literature review on case research in sports physiotherapy. Only 51 papers from the published literature since 1999 satisfied the inclusion criteria, and of these only 8% dealt with unsuccessful cases. Amongst these and other findings, the authors discuss interesting aspects of case research.

Like many sports, PTiS relies on a big team. As this is the last issue of eighth volume, Greg and I would like to extend a big thank you to the associate editors, editorial board and international advisory board for all their help and support. Many thanks also to the ‘unsung heroes’, the reviewers, who spend great deal of time and effort considering and commenting on submitted manuscripts. All those who have contributed this year are listed in the back of this issue.

Have a happy festive season, and we will be back in 2008.