Description

Some specialized torture treatment centers have observed benefits among their patients from physical treatment modalities such as physical therapy or massage. Primary care or other clinics treating torture survivors may also consider such interventions when addressing complaints of chronic pain and physical symptoms.  Because torture is usually directed in part toward the physical being of the victim, attention to the body can be especially therapeutic, both emotionally and physically.  In this webinar we will look into issues addressed by Physical Therapy  including pain, decreased body awareness and proprioception, weakness, decreased mobility and need for equipment, such as walking aides, braces and shoe inserts. We will look at what are indications for referral to PT, and special considerations for physical therapists working with survivors of torture.

Objectives

After attending in this webinar participants will be able to:
 
1)  Describe 4 issues present in survivors of torture that may be addressed by PT
2)  Identify 3 indicators for referral to PT and 2 key points for facilitating appropriate PT referral
3)  Identify 3 ways that PT’s can avoid re-traumatization when working with clients who are torture survivors
4)  Identify 3 common techniques used by PT’s in work with survivors of torture

Presenter:  Laura Pizer Gueron

Laura Pizer Gueron has been a Physical Therapist since 1983 after graduating from University of Wisconsin-Madison. She obtained a Master's degree in public health education from the University of Minnesota in 1990.  Laura began providing PT as a volunteer at the Center for Victims of Torture in 1992, and has treated clients at CVT for 21 years. Laura has worked as a PT trainer in Thai villages and in the Ban Vinai refugee camp, and provided PT services to patients in Israel, India, and Rosebud reservation in South Dakota. In 2010, she completed her transitional doctorate in PT from Shenandoah University. Laura has worked at Gillette Lifetime Care Clinic with teens and adults with childhood-onset conditions since 2001, and has worked as the PT Advisor to CVT's new torture treatment program in Nairobi, Kenya, since November of 2012.

Resources from the webinar

Alternative instructions for making a rice heating pad

The following articles are available in full for free download through Dignity – the Danish Institute Against Torture:

• Amris, K., &  Prip, K.  (1994). Introduction to examination by the physiotherapist. Torture (supplementum 1), 15-27. http://doc.rct.dk/doc/tort1994.suppl.1.3.pdf
• Amris, K., &  Prip, K.  (2000). Physiotherapy for Torture Victims (I): Chronic pain in torture victims: possible mechanisms for the pain. Torture, 10 (3) 73-76. http://doc.rct.dk/doc/TORT2000-3-3.pdf
•  Amris, K., &  Prip, K.  (2000). Physiotherapy for Torture Victims (II): treatment of chronic pain. Torture, 10 (6) 112-116. http://doc.rct.dk/doc/TORT2000-4-5.pdf
• Holten, N., Prip, K., Tived, L. (1995) Physiotherapy for Torture Survivors: a basic introduction. Copenhagen. International Rehabilitation Council for Torture Victims. http://doc.rct.dk/doc/mon1995.135.pdf
• Hough, A. (1992). Physiotherapy for Survivors of Torture. Physiotherapy.   http://www.freedomfromtorture.org/sites/default/files/documents/Hough-%20PhysiotherapyforSurvivors%20.pdf
• Prip, K. (1994). Sequelae in soft tissues after beating, suspension and fixation. Torture Quarterly. http://doc.rct.dk/doc/tort1994.suppl.1.4.pdf
• Skjaerback, I. (1994). Pain physiological mechanisms used in physiotherapy. Torture quarterly. http://doc.rct.dk/doc/tort1994.suppl.1.5.pdf

For the list at the Dignity Library of all 404 articles, lectures, etc. about PT and torture, the link is: http://www.reindex.org/RCT/main/Hits.php?ColSearch=node0_0&qe=physiotherapy&tgtGroup%5B%5D=1032&tgtGroup%5B%5D=1033&PortalMode=1&tgtPos=1&SearchMode=lay

The following may be requested, free, via library@dignityinstitute.dk  - they will mail a copy to you:

• Torture Survivors-Introduction to Physiotherapy. World Confederation for Physical Therapy--Barcelone, Spain 2003
• Falanga Torture-Diagnostic Considerations, Assessment and Treatment. Amris, K, and Prip, Karen. (59 page book)

Also recommended:

• Prip, K., Persson, A., Sjölund, B. Self-Reported activity in tortured refugees with long-term sequelae including pain and the impact of foot pain from falanga: a cross-sectional study. Disability and rehabilitation, 33 (7) 569-578. Available for purchase
• Scheermesser, M., Bachmann, S., Schamann, A. (2012). A qualitative study on the role of cultural background in patients' perspectives on rehabilitation. BMC Musculoskeletal Disorders, 13:5  free online access at http://www.biomedcentral.com/1471-2474/13/5
• Sluka K., (2009) Mechanisms and Management of Pain for the Physical Therapist. Seattle.   IASP Press Seattle. http://ebooks.iasp-pain.org/mechanisms_and_management_of_pain_for_the_physical_therapist/