Physical therapy publications

Torture survivors introduction to physiotherapy: Torture and sequelae after torture

Prip, K & Amris, K. (2003), Rehabilitation and Research Centre for Torture Victims, 45 pages.
 
This booklet was reviewed by Brittany Burton, doctoral physical therapy student at the University of Minnesota, 2014.
 
Link is to the article from the Dignity-Danish Institute Against Torture library. 
 
Introduction: Explanation of what the Rehabilitation and Research Centre for Torture Victims (RCT) is and the objectives of this organization which is based in Denmark.

Children, torture and psychological consequences

Alayarian, A. (2009). Torture: Journal of Rehabilitation of Torture Victims and Prevention of Torture, 19(2), 145-156.
 
Impact of torture on children may vary depending on the child’s coping strategies, cultural and social circumstances. In this paper the author gives a brief introduction of the work the Refugee Therapy Center does with children, discusses the effects of torture on children and presents a vignette and some examples of clinical intervention.

* The International Rehabilitation Council for Torture Victims (IRCT)’s Journal on Rehabilitation of Torture Victims and Prevention of

Chronic Pain and PTSD: The Perpetual Avoidance Model and its Treatment Implications

This article examines the interplay between chronic pain and PTSD and treatment implications. Various risk factors, models and treatment recommendations are explored. The authors conclude that the treatment for traumatized patients suffering from PTSD and chronic pain should include a biopsychosocial approach, combining education about the maladaptive behaviors leading to disability, as well as exposure therapy, relaxation, biofeedback, and therapeutic exercise.

Complementary and alternative medicine in the treatment of refugees and survivors of torture: a review and proposal for action

By Mckenna Longacre, MM, Ellen Silver-Highfield, Puja Lama, and Michael A. Grodin, MD. This article reviews the scientific medical literature for the efficacy and feasibility of some complementary and alternative medicine (CAM) modalities including meditation, Ayurveda, pranayama/yogic breathing, massage/body-work, dance/movement, spirituality, yoga, music, Traditional Chinese Medicine and acupuncture, qigong, t’ai chi, chiropractic, homeopathy, aromatherapy and Reiki specifically with respect to survivors of torture and refugee trauma. 

Published in TORTURE Volume 22, Number 1, 2012

Complementary therapies for treating survivors of torture

Vargas, C., O’Rourke, D. & Esfandian, M. Refuge: Canada’s Periodical on Refugees, 22(1), 129-137.
 
This article was reviewed by doctoral physical therapy student from the University of Minnesota, Angela Pitar, 2014.
 
Link to full text article from the Dignity-Danish Institute Against Torture is below.
 
Background - the assumptions that physical pain, unexplained by medical or physical findings, is psychosomatic in nature has been long standing and pervasive as was pain reported by survivors of torture attributed to psychological trauma.

CVT Physical Therapy Survey Results

In 2014, CVT conducted a Physiotherapy Survey. Through this survey, we hoped to learn about the physiotherapists working with torture survivors, the availability of physiotherapy services, and the types of clients receiving physiotherapy services. We sent surveys to roughly 200 email addresses and received 87 responses in English, French, and Spanish. The attached report shares the compiled data and findings.

Declaration for physiotherapists: Guidelines concerning torture and other cruel, inhuman and degrading treatment or punishment

World Confederation for Physical Therapy, (1996), Torture Quarterly, 6(4), 103.
This article was reviewed by Charlotte Hoium, doctoral physical therapy student from the University of Minnesota, 2014.
The exact wording of the declaration from the 1995 World Confederation of Physiotherapy  is listed below.
  1. PTs shall not condone or participate in torture or cruel, inhuman or degrading procedures.
  2. The PT shall not provide anything to facilitate the practice of torture or other forms of cruel, inhuman or degrading treatment.
  3. The PT shall not be present during any procedure during which torture or other

Examination by the Physiotherapist

Amris, K. & Prip, K. (1994). Torture Quarterly Journal on Rehabilitation of Torture Victims and Prevention of Torture, Suppl. 1, 14-27.
 
This article was reviewed by Angela Pitar, doctoral physical therapy student at the University of Minnesota, 2014. 
 
The link to the full text of the article from Dignity-Danish Institute Against Torture is below.
 
Purpose - the purpose of physical therapy is to reduce pain, improve function, and educate patients on how to cope with pain.

Fundamentals: Mental Health Services Resources

Publications

Berliner, P., Mikkelsen, E. N., Bovbjerg, A., &Wiking, M. (2004). Psychotherapy treatment of torture survivors. International Journal of Psychological Rehabilitation, 8, 85-96.

Cohen, J.A., Mannarino, A.P., and Deblinger, E. (2006) Treating Trauma and Traumatic Grief in Children and Adolescents, The Guilford Press

Fabri, M.R., (2001). Reconstructing safety: Adjustments to the frame in the treatment of survivors of political torture. Professional Psychology: Research and Practice, 32(5), 452-457.

Herman, J.

Increasing Activity and Improving Function in Chronic Pain Management

Chronic pain is a condition of complexity that requires a multi-dimensional approach. Unfortunately, not many patients who suffer from chronic pain are able to use a clinic or program that addresses chronic pain management due to their location or finances. The goal of this article is to give an overview of approaches that may be helpful to physiotherapists in their own practice relating to chronic pain.

Interaction between patient and physiotherapist in psychiatric care : The physiotherapist's perspective

Gyllensten, A., Gard, G., Hansson, L., & Ekdahl, C. (2000), Advances in Physiotherapy, 2(4), 157-167.
This article was reviewed by Charlotte Hoium, physical therapy doctoral student at the University of Minnesota, 2014.
The article may be obtained free of charge from Dignity-Danish Institute Against Torture by emailing them at library@dignityinstitute.dk and including a list of desired articles.
Purpose:  to investigate what factors the physiotherapy experts in psychiatric physiotherapy believed to be important in the interaction between the patient and the physiotherapist.

Introduction

HOW TO USE THIS GUIDE  

This book is a starting point for professionals who work with torture treatment centers, such as: therapists, social workers, attorneys, nurses, physicians, and administrators. This book can be read in its entirety, or the professional can read the areas pertinent to specific disciplines. By reaching out to members of torture treatment programs in the United States, the reader should be able to build a network services, either community-wide or within an agency, to better meet the needs of their clients.

Medical

Survivors of torture often present for care in medical settings, and sometimes in torture treatment programs.  The medical portion of HealTorture.org is primarily, but not exclusively, geared to primary care providers (PCPs) which includes family doctors, internists, nurse practitioners and physician assistants.  Other staff members in medical settings such as nurses and medical assistants can also facilitate survivors’ healing.

Mind and body-Physiotherapy and complementary therapy

Hough, A. (1992). Paper presented at the International Conference of Centres, Institutions and Individuals Concerned With the Care of Victims of Organized Violence: Health , Political Repression and Human Rights, Santiago, Chile. 
 
This article was reviewed by University of Minnesota physical therapy doctoral student, Angela Pitar, 2014. 
 
The article may be obtained free of charge by emailing library@dignityinstiture.dk
 
Background - Torture victims often present with a multitude of problems and complementary therapy seeks to address each problem using a comprehensive and collaborative

Muscular imbalance found in examination of posture in torture victims

Skylv,G. (1992). Poster presented at 2nd World Congress on Myofascial Pain and Fibromyalgia, Copenhagen, Denmark. 
 
This article was reviewed by Brittany Burton, doctoral physical therapy student at the University of Minnesota, 2014.
 
A free copy of the article may be requested from Dignity-Danish Institute Against Torture, by emailing library@dignityinstiture.dk.
 
Background: The aim of torture is not only physical but psychological as well, and globally seems to be focused on the vulnerabilities of the victim.

Pain: physiologic mechanisms used in physical therapy

 Skjoerboek, I. (1994). Torture Quarterly, Suppl. 1, 33-35.
 
This article was reviewed by Angela Pitar, doctoral physical therapy student at the University of Minnesota, 2014. 
 
The link to the article from the Dignity-Danish Institute Against Torture, is below.
 
Background - the definition of pain is an unpleasant sensory and emotional experience associated with the actual or potential tissue damage, or described by the patient in terms of such damage. Detailed descriptions of mechanisms of pain and treatment implications are made.
 
Physiology of pain - the perception of pain is either affected

Physical Therapy/Physiotherapy

Physiotherapy (Physical Therapy: these terms will be used interchangeably on this website) is a growing field in the area of torture survivor treatment. Survivors of torture are often affected by chronic pain and by difficulty in carrying out functional activities.
 
Research carried out by Dignity-Danish Institute Against Torture suggests that up to 80% of torture survivors could benefit from receiving physiotherapy. A worldwide survey of torture treatment centers carried out by the Center for Victims of Torture staff shows that a majority of clients receive physical therapy 51% of the time

Physiotherapy and rehabilitation of the common complaints and findings in torture victims

Mayanja, F. (1996). African Centre for the Treatment and Rehabilitation of Torture Victims. 26 pages. 
This booklet was reviewed by Stephanie Green, doctoral physical therapy student at the University of Minnesota, 2014. 
The booklet is available free of charge from Dignity-Danish Institute Against Torture. Please email them at library@dignityinstitute.dk to request this booklet. 
Introduction
The African Centre for the Treatment and Rehab of Torture Victims in Uganda is continuing to grow and become recognized by various institutions.

Physiotherapy as empowerment : Treating women with chronic pelvic pain

Mattsson, M., Wilkman, M., Dahlberg, L. & Mattson, B. (2000). Advances in Physiotherapy, 2(3), 125-143.
reviewed by Aaron O’Donnell, University of Minnesota doctoral physical therapy student, 2014
This article is available free of charge from Dignity-Danish Institute Against Torture. Please email them at library@dignityinstitute.dk and include a list of desired articles and your mailing address.
 
Background: A large group of CPP (chronic pelvic pain) patients are “inexplicable” from a medical point of view.

Physiotherapy examination and treatment

Jacobsen et al.
Link and reference information will be posted soon.
This article was reviewed by Mark Deschepper, physical therapy doctoral student at the University of Minnesota, 2014.
 
Introduction:
Most torture survivors complain of pain the locomotor system with many experiencing pain through all daily routines including sleep. Living with pain and performing daily tasks are significantly difficult for survivors. Physical torture leads to damage in the muscles, joints, and neurovascular system, concentration, and memory.

Physiotherapy for torture victims I: Chronic pain in torture victims: Possible mechanisms for the pain

Prip, K. & Amris, K. Torture Quarterly: Journal on Rehabilitation of Torture Victims and Prevention of Torture, 10(3), 73-76.
 
This article was reviewed by doctoral physical therapy student, Angela Pitar, from the University of Minnesota, 2014. 
 
A link to the article from the Dignity-Danish Institute Against Torture library is below.
 
Background - Throughout the years, several chronic muscular pain syndromes have been described in victims of torture with common findings of:  regional or diffuse pain in the musculoskeletal system often associated with poor sleep, tiredness, paresthesia, headache,

Physiotherapy for torture victims II: Treatment of chronic pain

Amris, K. & Prip, K. (2000), Torture Quarterly: Journal on Rehabilitation of Torture Victims and Prevention of Torture, 10(4), 112-16.
 
This article was reviewed by Stephanie Greer, University of Minnesota doctoral physical therapy student.
 
The link to the article from the Dignity-Danish Institute Against Torture, follows below.
 
Background - Several studies of torture victims have shown that physical complaints are common even years after torture and that pain in relation to the musculoskeletal system is a dominating symptom.

Physiotherapy Outcomes at the Center for Victims of Torture-Nairobi program

Since CVT’s physiotherapy program began in Nairobi, around 260 clients have been assessed at both intake and six month follow up on the Pain and Discomfort Inventory (PDI). On all items, clients showed statistically significant improvements in levels of pain and functionality. Approximately 130 clients have been assessed at both time periods with the Disability Rating Index (DRI) and we observe statistically significant improvements in functional ability for 10 of the 12 activities.

Nearly all of the clients are also receiving, or have received psychosocial counseling services as well.

Physiotherapy: Body-Centred Approach to Working with Victims of Torture and Trauma

By Veena O’Sullivan (Physiotherapist)* - BAppSc (Phty), MAppSc (Phty), Grad Dip (Counselling) Physical pain is rarely an isolated sensation, and is almost always accompanied by emotion and meaning. Traumatised clients tend to dissociate traumatic memory from feelings, as well as accompanying physiological sensations. Thus the emotional trauma gets trapped in the body, often somatised in the form of chronic physical pain. Clients are not necessarily able to identify that this is so, as the process is usually unconscious. In our physiotherapy sessions I guide clients to gain some insights as to how the body sensations, the feelings and images from traumatic experiences are inter-related. In doing so, clients gain a clearer awareness of the body-mind connections, and thereby are able to better understand how to prevent and/or release pain. ___ *Veena O’Sullivan has been a registered physiotherapist since 1981. She is a Sydney University graduate, with both undergraduate and post-graduate qualifications in physiotherapy (Bachelor and Master Degrees). She also has a Graduate Diploma in Counselling. She has worked both in Australia and overseas, with wide experience in clinical and academic settings. Currently, she works both in private physiotherapy practice and at STARTTS**. **STARTTS- Service for the Treatment and Rehabilitation of Torture and Trauma Survivors, Sydney Australia.

Prevalence of pain in the head, back and feet in refugees previously exposed to torture: A ten-year follow-up study

This article looks at the change over 10 years concerning pain in the head, back, and feet among previously tortured refugees now residing in Denmark, and to compare associations between methods of torture and pain at baseline and after 10 years. Pain in the head, back, and feet were chosen because they are frequently reported symptoms. Conclusions were that: Pain increased, despite treatment at RCT; Treatment does not decrease risk of continuing or increasing symptoms of pain; 20 years after torture took place, increasing proportions of survivors seems to suffer from pain associated with the type and bodily focus of the torture. This presents a considerable challenge to future evidence based development of effective treatment programs.

Psychosomatic group treatment helps women with chronic pelvic pain

Albert, H. (1999). Journal of Psychosomatic Obstetrics and Gynaecology, 20(4), 216-225.
 
Reviewed by Brittany Burton, doctoral physical therapy candidate from the University of Minnesota, 2014. 
 
Please email them at library@dignityinstitute.dk and include a list of desired articles and your mailing address.
 
Background: In this study, group treatment for women with chronic pelvic pain based on physical, psychosomatic and behavioral therapeutic principles of treatment was assessed.

Sequelae in Soft Tissues after Beating, Suspension, and Fixation

Prip, K. (1994), Torture Quarterly, Suppl. 1, 28-31.
 
This article was reviewed by University of Minnesota doctoral physical therapy student Angela Pitar, 2014. 
 
The link to the full text from Dignity-Danish Institute Against Torture is below.
 
Background: Many movement impairments are found in torture survivors, since they were placed in fixed positions for prolonged periods of time.  This article discusses the effects of tissue stress/strain, the phases of injury, and different management approaches for the different phases. 
 
 
Background -
  • when tendons are loaded, all the fibers straighten out

Survivors of torture and trauma: A special group of patients with chronic pain

Roche, P. (1992). Australian Physiotherapy, 38(2), 156-157.
This article was reviewed by a physical therapy student at the University of Minnesota. More information is to follow. 
A copy of the article may be obtained free of charge from Dignity-Danish Institute Against Torture by emailing them at library@dignityinstitute.dk and including your mailing address.
This brief letter describes where physical therapists may find more information about the special needs of torture survivors as well as common sequelae from torture and recommendations for physical therapy treatment.
 
Two major sources of

Torture Survivors: Pain Pattern and Disability

Prip, K. (2005). Lunds University. 37 pages.
This booklet is available free of charge from Dignity-Danish Institute Against Torture. Please email them at library@dignityinstitute.dk and include a list of desired articles and your mailing address.
This booklet was reviewed by Victor Chow, doctoral physical therapy student at the University of Minnesota.
Background: In “Torture Survivors: Pain Pattern and Disability”, the researchers strived to categorize their subjective and objective findings regarding physical impairments of torture victims.

Torture! Violence! Physiotherapy?

Faure, M. (1995). South African Journal of Physiotherapy, 5(3), 49-51.
This article was reviewed by Charlotte Hoium, doctoral physical therapy student at the University of Minnesota.
It is available free of charge by request to Dignity-Danish Institute Against Torture by emailing library@dignityinstitute.dk
Background: In this brief article, a description of a four day long training seminar about physical therapy and torture was made, as well implications for physical therapy education are made. Special considerations for treating torture survivors are described.
Possible Implications for

Tortured Refugees' Expectations of a Multidisciplinary Pain Rehabilitation Programme

Refugees have often been exposed to torture in their countries of origin. Rehabilitation of tortured refugees living in Denmark is offered by the specialized Rehabilitation and Research Centre for Torture Victims in Copenhagen. After an interdisciplinary assessment eligible patients are recommended rehabilitation. In this article, it is noted that there is diversity among refugees in their expectations from pain programs and that the clients expect to have dialogue with the members of their health care team about participation in recommended activities, and to question and not just to accept professional suggestions.