DOCTOR APOLINARY TARNAWSKI (1851-1943) - THE PIONEER OF NATURAL MEDICINE AND PHYSIOTHERAPY IN GERIATRICS IN POLAND

Doctor Apolinary Tarnawski (1851-1943) was undoubtedly the precursor of modern natural medicine, preventive medicine, and geriatric physiotherapy in Poland. Based on the experience gained from foreign scientific travel, own knowledge and experience, he developed an original method that he successfully used in his own clinic in Kosów. His assumptions proved to be timeless, and despite the passage of many years have not lost their relevance.

[The Danish history of rehabilitation - and what is the doctor's role in the future?]

Not least tuberculosis caused the growth of many spas. In Denmark, the Society for Physical Therapy and Dietetic was formed in 1902, and in 1921 it changed its name to the Danish Physiatrists Society, later the Danish Society for Physiatrists and Rehabilitation. In the early 1980's the National Board of Health decided, that all specialties should rehabilitate patients within their own area, and the specialty for rehabilitation was abolished. Therefore, all doctors need to have knowledge of the biopsychosocial model and the involvement of other professional groups and sectors.

Richard's back: death, scoliosis and myth making

The body of a mediaeval monarch was always under scrutiny, and Richard III's was no exception. In death, however, his body became subject to new forms of examination and interpretation: stripped naked after the battle of Bosworth, his corpse was carried to Leicester and exhibited before being buried. In 2012, it was rediscovered. The revelation that Richard suffered from scoliosis prompts this article to re-evaluate the historical sources about Richard's physique and his posthumous reputation. This article argues that Richard's death and his myth as 'crookback' are inextricably linked and traces attitudes to spinal curvature in the early modern period. It also considers how Shakespeare represented Richard as deformed, and aspects of performance history which suggest physical vulnerability. It then considers Richard's scoliosis from the perspective of medical history, reviewing classical accounts of scoliosis and arguing that Richard was probably treated with a mixture of axial traction and pressure. It demonstrates from the evidence of Richard's medical household that he was well placed to receive hands-on therapies and considers in particular the role of his physician and surgeon, William Hobbes. Finally, it shows how the case of Richard III demonstrates the close relationship between politics and medicine in the period and the contorted process of historical myth making.

[Vojta's method as the early neurodevelopmental diagnosis and therapy concept]

Vaclav Vojta (1917-2000) developed an early diagnostic method of the neurodevelopmental disorder of infants and came up with therapeutic concept consisting in releasing of global motor complexes by means of the stimulation of proper areas on patients body. In the diagnostics apart from very careful observation of the spontaneous movement of the infant and examination of the reflexes that are characteristic for the first weeks of human's life, Vojta applied the examination of the 7 postural reactions. Presence of the trouble in patterns and dynamics of the postural reactions Vojta called Central Nervous Coordination Disorder--CNCD and regarded as work diagnosis or alarm signal indicating necessity of application of the therapy, especially when asymmetry of the muscle tone and primitive reflexes beyond their physiological appearance period are observed or the number of the abnormal reactions exceeds 5. Global motor complexes as reflex locomotion--crawling and rotation--consist of all the partial motion patterns, which are gradually used by healthy infant in the process of postural and motor ontogenesis. Providing the central nervous system with proper external stimulation allows to, using neuronal plasticity, recreate an access to the human's postural development program and gradually replace pathological motor patterns by those more regular. Exercises repeated several times a day rebuilt support, erectile and vertical mechanisms, improve automatic postural control and phase lower limb movement. Affecting especially on autochtonic muscles of the spine exercises balance synergic cooperation of muscle groups in the trunk and those surrounding key body joints. This way they correct body's posture and peripheral motion and pathology of the outlasted primitive reflexes gradually withdraws.

[The contradictive tendencies in medical treatment of the Hellenistic age--diversity versus simplification, chronic extension (physical therapy) versus rapidity, humane medicine versus worldly success]

It is a one-sided view to find the greatness of Hippocrates just in seeking after scientific medicine (medicina scientia) and sublating superstitious treatment. The scientific medicine did not begin with him, and the succeeding generations of him were not one and the same in opinions. For example, there were the confrontations between the school of Kos and that of Knidos in the very age of Hippocrates, as well as the opposition of rationalism and empiricism. The school of Kos was alleged to succeed the tradition of Hippocrates, taking into consideration individual physical conditions and being based on the principle of various clinical methods of physical therapy assuming chronical extension. On the contrary, the school of Knidos tended to define the diseases in simple aspects, paying no much attention to the difference of physical conditions and developmental stages of illness. Futhermore, the latter grasped the diseases rather in the point of individual organs than the disorder of physical state of the body. It can be said that the anatomical knowledge was more useful for the school of Knidos. The difference between the two schools can also be found in what purpose the medicine sought after. While Hippocrates attached much importance to physical therapy and made the people including the poor as object of medical treatment, there were doctors in no small number, we can suppose, in pursuit of money, power, worldly glory. As time passed, however, the two schools gradually got similar to each other, the difference of them reduced as well as the tradition of Hippocrates faded. The opposition between rationalism and empiricism in the Hellenistic Age shared, in some aspect, the difference of Kos and Knidos. According to Celsus, the conflict between rationalism and empiricism did not refer to pharmacy or anatomy, but just to diet. The rationalism materialized various methods of therapy considering environmental elements as well as individual physical conditions, but the empiricism in reality tended to expedite simplification of treatment. This tendency of simplification of the latter corresponded to the contemporary need of society, that is, speedy and effective treatment for the wounded in war or for epidemic in the army, farms of collective labour or much crowded cities. The bigger the groups were, the more the methods of treatment got simplified, individual conditions not much accounted. Then, the empiricism came to be united with anatomy, as the anatomy, being much developed in the process of curing the wounded in war, goes with simplification of medical treatment in the hospital of large scale. It can be said that the origin of simplified definition of diseases goes back far to the school of Knidos. On the other hand, in Hippocrates the drugs were in contrast to the diet. While the diet was to help health and rehabilitate physical conditions, the drugs were to result in strong effects of change. The drugs like as poison, eye-salve, ointment were to be made use of for rapid, effective change of physical state or for the treatment of a concrete, limited part of the body, These drugs were also much developed in the Hellenistic Age of the state of chronic war. In initial stages, the toxical drugs as well as the anatomy and surgical operations must have been developed on peaceful purpose, such like as 'theriaca' detoxicating (antidoting) animal's poison, or for easing childbirth. With the increasement of social inequality and unexhausted human desire, however, the toxical drugs or anatomical knowledges got to be used for undesirable purposes. Thus, we can not estimate Hippocrates simply in the point whether he developed scientific medicine or not. The great fame of Hippocrates could be found rather in his method of medical treatment as well as the principle of medicine, as he believed that the medicine should not be exploited for worldly power or wealth but for the convenience of all the people. He pursued healthy life matching to natural state(physis) and took much account of different physical states of individual to embody various methods of treatment, which presupposed chronic delay. The opposite to the Hippocratic medicine is called for the wounded by war, or the collective labourer of large farm with intensive labour exploitation. The medical treatment for them assumed anatomical surgery and drugs of rapid, strong effect.

[Defense industry technologies in contemporary medicine]

The article considers one of the Russian defense industry enterprises and its considerable contribution to the development and manufacture of medical equipment, including portable non-contact type intraocular pressure meters. Information on the pressure meters is given.

Historical perspectives of autonomy within the medical profession: considerations for 21st century physical therapy practice

As a part of the American Physical Therapy Association's (APTA) vision statement, by the year 2020, physical therapists "will hold all privileges of autonomous practice." This vision statement and the ideals held within it are elemental to the direction of our continued growth as a profession. Many members and nonmembers, however, appear confused and perhaps even intimidated by the concept of autonomous practice. This paper will review and discuss the processes used by other health care professions to gain autonomy within the US health care system. In particular, the processes used by physicians, which were extremely effective and have been used as a template by many other health professions, including physical therapy. Further discussion will focus on the physical therapy profession, emphasizing the parallels with medicine and considering many issues relevant to the goal of autonomous practice. By understanding the past and considering the present, readers will develop an appreciation of (1) the foundation for autonomous practice in health care, (2) the vision of the APTA and why the profession is well positioned to achieve this vision, and (3) the factors we need to consider to hold (and maintain) all privileges of autonomous practice.

[Application of innovative technologies in development of Yangan-Tau health resort complex]

The author reviews geophysical, geological, medical and biophysical studies of therapeutic factors of a unique health resort and sanatorium Yangan-Tau conducted with participation of geological and medical research institutes. Continuous monitoring of biophysical therapeutic factors, experimental and clinical basis of novel rehabilitation techniques allow development of the sanatorium complex Yangan-Tau.

Russian electrical stimulation: the early experiments

Russian forms of electrical stimulation became popular to a large extent as a result of the activities of Kots, who claimed force gains of up to 40% in elite athletes as a result of what was then a new form of stimulation. He did not provide details of his published work, nor did he give references. Russian electrical stimulation became popular despite the lack of research in the English-language literature. No studies published in English examined whether the "10/50/10" treatment regimen (10 seconds of stimulation followed by 50 seconds rest, repeated for 10 minutes) advocated by Kots is optimal, and only one study addressed whether maximum muscle torque was produced at an alternating current frequency of 2.5 kHz. The few studies that compared low-frequency monophasic pulsed current and Russian electrical stimulation are inconclusive. This article reviews and provides details of the original studies by Kots and co-workers. The authors contend that these studies laid the foundations for the use of Russian forms of electrical stimulation in physical therapy. The authors conclude that there are data in the Russian-language literature that support the use of Russian electrical stimulation but that some questions remain unanswered.

[Idiopathic scoliosis and Scheuermann's kyphosis. Historical and current aspects of conservative treatment]

Although in practice since antiquity the nonoperative treatment of spinal deformities is still controversial. Giving preference to orthotic treatment and physiotherapy the historical development of nonoperative treatment will be demonstrated by the examples of idiopathic scoliosis and Scheuermann's kyphosis. It is surprising how early essential and still valuable principles of nonoperative treatment had been acquired and how many of the present-day concepts have remarkable forerunners in the 19th century. In the light of previous knowledge and personal experience the indication, practice and realistic capabilities of modern nonoperative treatment of idiopathic scoliosis and Scheuermann's kyphosis are pointed out.

[Prosecuted for illegally practising medicine: Hendrik Soeter, 'heilgymnast' at Groningen]

During the eighties of the 19th century several physical education teachers who were engaged in physical therapy activities, so called 'heilgymnasten', believed that only a solid organization of serious, educated and well-trained heilgymnasten could bring about a positive change in the situation at hand in the field of physical therapy. On September 1st 1889 the 'Genootschap ter beoefening van de Heilgymnastiek in Nederland' ('Society for practising heilgymnastiek in the Netherlands') was founded. One could say that at first the 'Genootschap' was tolerated. Several well-known Dutch physicians joined the 'Genootschap' as 'extraordinary-member'. Very soon however, some physicians came to see the activies of this organization as a threat to the process of differentiation and specialization in the field of orthopaedic surgery that had just begun. They emphasized that the 'heilgymnasten', who worked relatively independent from physicians in the field of physical therapy, had no legal status; in fact they argued that these practitioners were actually breaking the law. A solution to these problems was sought through law-suits against 'heilgymnasten' to ensure that they would only practise physical therapy under the supervision of physicians. In this paper the plight of one of the Dutch 'heilgymnasten', Hendrik Soeter, who can be considered as a 'victim' of this strategy, will be discussed in more detail. The focus of attention is on the legal proceedings in various courts of justice from the lower to the highest level, as well as on the reactions the law-suit against Soeter provoked from the government and from organizations and practitioners in the fields of physical therapy, physical education and medicine. Although Soeter was finally sentenced to two fines, the verdicts did not bring about the change some people had hoped for. 'Heilgymnastiek' remained a non-regulated activity and the Dutch 'heilgymnasten' had to wait for a legal status for their profession until more than fifty years after the foundatiion of the 'Genootschap'.

[100 years physical therapy and rehabilitation]

Physical medicine and rehabilitation received powerful impulses from orthopaedic surgery, which organizes its pragmatic and scientific interests since 100 years in its own association. A point of breakthrough was reached at the beginning of the 20th century, when progress in surgical and conservative orthopaedics enabled a comprehensive rehabilitation of physically disabled. On the other hand, the professionalisation of care for the handicapped (Krüppelfürsorge) has decisively supported the advancement of orthopaedics. Next to the storming development of orthopaedic surgery step by step the scientific foundations and clear indications for physiotherapy were achieved. The strategy of treatment was adapted to the increasingly active approach to orthopaedic ailments and traumata. This relates as well to wide ranges of rehabilitation and developed the training of specialists. Orthopaedic surgeons were significantly involved in this development as well as the framing of legal regulations safeguarding the entitlement of the disabled.

[The patient's spokesman Trygve Braatöy]

Trygve Braatøy discovered the interplay between tense muscles, respiration and nervosity, which resulted in the now widely recognised psyhomotoric physiotherapy, the first cornerstone of his work. Braatøy was one of the first Norwegian physicians who focused on understanding the doctor-patient relationship. This became the second cornerstone of his work. His care and respect for his patients is indeed a leitmotif in his life and writings. After psychoanalytic training in Berlin and several years in private practice, he served as chief physician in the Department of Psychiatry at Ullevaal Hospital from 1946 to 1952, resigning that year from his post to write Pasienten og laegen (The Patient and the Physician), a protest against alienation in the doctor-patient relationship induced by prevailing attitudes in the hospital system.

[Physiotherapy as manual therapy]

Manual therapy includes methods where the therapist's hands are used to stretch, mobilize or manipulate the spinal column, paravertebral structures or extremity joints. The aims of these methods are to relieve pain and improve function. In Norway only specially qualified physiotherapists and chiropractors are authorized to perform manipulation of joints (high velocity thrust techniques). To become a qualified manual therapist in Norway one must have a minimum of two years of clinical practice as physiotherapist followed by two year full time postgraduate training in manual therapy (a total of six years). Historically the Norwegian manual therapy system was developed in the 1950s by physiotherapists and medical doctors in England (James Cyriax and James Mennell) and Norway. As a result doctors allowed physiotherapists to use manipulation as a treatment method of both spinal and peripheral joints. In 1957 the Norwegian health authorities introduced reimbursement for manual therapy performed by physiotherapists.

A historical cross-disciplinary perspective on the professional doctorate in occupational therapy

Clinical doctorates are emerging in occupational therapy. By examining the development of clinical doctorates in medicine, dentistry, psychology, pharmacy, nursing, and physical therapy, implications can be drawn for the future of occupational therapy education. These histories offer us a sense of the distinct purpose and curricular structure of the professional doctorate, its successes and problems, its general sequence of unfolding, the political dynamics surrounding it, and the potential it holds for supporting the profession's capacity for service to patients.

Stanley Paris Award Lecture. Reflections on the history and future of orthopaedic physical therapy

Carolyn Wadsworth, MS, PT, CHT, OCS, deliver the 1998 Paris Distinguished Service Award Lecture at the Combined Sections Meeting in Boston in February. Wadsworth is the fifth recipient of the Paris Award, which is the Orthopaedic Section's highest honor given to commemorate a member's exceptional and enduring service. The Paris Distinguished Service Award was established in 1990 and is named after Stanley V. Paris, PhD, PT, founder and first president of the Orthopaedic Section. Born in Dunedin, New Zealand, Paris immigrated to the U.S. in 1966. He developed physical therapy practices in Boston, Hamilton, Bermuda, and Atlanta; established the Institute of Graduate Health Sciences in Atlanta, GA; and is currently president of the University of St. Augustine, St. Augustine, FL. Paris is a strong advocate of assertive professional practice, clinical specialization, and strengthening leadership in physical therapy. He also champions wellness, exemplified by his personal achievements in sailing the Atlantic Ocean, swimming the English Channel, and completing the Ironman Triathlon. Carolyn Wadsworth, recipient of the 1998 Paris Award, has served as secretary and president of the Orthopaedic Section and is currently editor of the Orthopaedic Section's Home Study Course. She owns a private practice, teaches nationally, and has written two books, Examination and Mobilization of the Spine and Extremities (1988) and Orthopedic Review for Physical Therapists (1998). Major components of the speech she presented at the Orthopaedic Section Awards Ceremony are highlighted in this article.