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Question: Discuss about the Conference Industry of China. Answer: Introduction The conference industry is in its peak state. With the increase in awareness among people and the inquisitive nature has lead to the growth of the sector. Conferences are being held on a variety of topics and each topic is being shown and discussed round the globe. This report aims at analyzing the conference industry in Shanghai, China (Allen et al., 2012). The report introduces the concept of a conference and the nature of the industry. Trends around the globe as well as in the city have been discussed. The next section follows the demand and supply problems and suggestions on how to manage them. Recommendations have been made to show a road ahead for the city in this sector. Literature Review The event industry According to Davidson (2002), the event industry is one of the largest industries in the globe. It comprises of various events like a job fair, a festival, a social event, a business conference or a management event. The industry is often referred to as the event management or event planning. The industry consists of one-person planner to large companies engaged in creating experiences for the people. The events organized by them may be a corporate event or a social event depending on the need. The conference industry The conference industry forms a major part of the event industry. In the 21st century, where the world has become a global village, conferences form an essential part of the success of an organization. Various organizations like Deloitte, Pepsi, Ali baba, Amazon, and Microsoft and so on hold various conferences throughout the year (Fenich, 2014). These conferences need to be arranged and organized thereby increasing the importance of the event management sector. To begin with, the definition of a conference will be provided. A conference can be described as a meeting of group members or people who discuss or confer about a topic. Confer refers to an exchange of ideas and discussions about a relevant topic. This topic can range from sustainable management issues, news conferences, academic conferences and so on. Some of the types of conferences have been given below: Convention- refers to a meeting of people in a group belonging to a company in a particular field. Academic conference- Usually referring to the domain of science where relevant topics are discussed Parent-teacher conference- Conducted by the school where the administration informs the parents about their latest development (Rogers, 2013). Professional Conference- referring to the professional council of the country regarding a new act. Trade fair- Between various sellers Athletic Conference- a competitive group of teams generally spread geographically. The booming industry According to the US Statistics, events, conferences and conventions are expected to rise by 44% in 2020, which is far ahead of the projected growth of other industries. The demand of conference space has been increasing and various hotels like Ritz Carlton and Montage have received various bookings for their conference rooms. The conference industry encompasses a variety of fields with almost exhaust any conference goer person (Jones, 2014). It has been observed that almost every day some conference takes place in a certain corner of the world. . A conference goer could travel to a new city every week and attend a conference based on smart grid, cloud computing, farming methods, mathematics and ageing. The conference industry can conduct its own award and natural conferences. Various companies like Google, Apple and Microsoft have become the conference hosts. These conferences help these giants to improve their distribution chain and to strengthen their ties. Conferences are believed to be seminars, which can help a company to meet thousands of people at one time. Wurman is planning to conduct a conference called 555, which will be providing a platform to five global leaders in five cities on consecutive five Mondays that will encourage intellectual ideas and talk about architecture, future travel and energy (Hiller, 1995). The conference industry has faced various difficulties. It faced a boom during the 1990s and took a bad turn during after 9/11. Risks involved According to Lee (2006), there is certain amount of risks involved in the industry. The success of a conference is extremely essential in order to earn profits for the firm (Homburg, Vollmayr, Hahn, 2014). Many times the conference might get cancelled which may then threaten the efforts of the organizers. Trends of conference industry The conference industry has been doing well in the last few years with its growth parallel with the growth of internet. The number of conference has been increasing in size and the numbers of conferences that have been taking place are increasingly tremendously (Getz Page, 2016). These conferences have been increasing because they have gone global and are not restricted to limited topic discussed by a company in their domain or relating to their company issues. These conferences have been dealing with a variety of topics like renewable energy, sea plundering. The new trend is that the conferences might also have an online component. There needs to be a pre-reading component available online so that the members of the conference can read about the conference and come prepared for it. The online preview will also provide various details about the speakers and members. Conferences are beneficial because they help to share knowledge and bring about awareness for the people. Generally, the knowledge about a particular field remains restricted to the particular field. However, the aim of some of the conferences is to break these barriers and foster knowledge as well as creativity (Getz Page, 2016). The new concept of TED Conferences has developed and brought about thousands of people together under one roof. These people share their experiences and bring about convocation of ideas. The TED conferences started from an economic forum and have transformed itself into an idea fest attended by thousands of speakers including the head of states. Various discussions take place by Panelists like human longevity, cell phone app industry, and economic investment in Africa and so on. These types of topics are helpful for students who can apply their theoretical knowledge and use it to discuss these topics among themselves and get real world information. Earlier these conferences were restricted to those who attended the meetings but now it is not so. Every moment of the conference is posted online and filmed for public banter. Other advantages include these conferences have lead to worldwide awareness and funding. Many medical science conferences have brought about findings from all around the globe, which has helped in collaboration (Ahmad et al., 2012). This collaboration has formed various documents. According to Jones (2014), the information is being spread around to various body of organizations and people around the globe as well as people are becoming better informed and those who are not informed it is instigating them and it gives rise to a sense of necessity to get together and discuss about the various topics so that the world becomes closer. Latest conferencing trends in Shanghai, China The use of technology has become extremely important in order to enhance the experience of the conference goers. The events are being made more interactive which is better for the learning process. User-friendly applications are also being used by the organizers and sponsors as well as members alike in order to keep a track of the events and this makes the movement paperless. Sending live videos and building up content is another trend popular in China for the various conferences. With the growing popularity if Facebook and Instagram, this trend was bound to become popular. As conferences are becoming increasingly popular, the conferences are asking for larger rooms and additional space for offering healthy mails for the attendees (Andersson et al., 2015). The tastes of the conference goers also vary and therefore these needs have to be taken care of by the conference management team. Video and teleconferencing techniques are also extremely popular in the city. Other experts suggest that due to the advent of technology, the event organizers are able to start the conversation even before it is possible to with the help of technology. Another remarkable trend in the industry is the unique themes and venues (Chon Weber, 2014).Earlier the conferences use to take place in more professional environments, however these days the options have become more ordinary like places in museums, building sites and many more. In China, gift taking is generally not acceptable however, the participants attending the seminar need to be encouraged and they can be welcomed with a personal note or a gift like a diary. They can also be provided with coupons and reservations of their choice (Weber, 2001). There are various demands for AV equipments with the members making use of voting keypads, WebEx streaming and photo booths. Corporate in China expect to get more out of the management and want to get full value for money. Airbnb trend has also had a huge impact on the particular industry with group reservations made with hotels replaced by delegates paying for their own accommodation. The latest trend in the industry at China has been that the companies engaging in the conference prefer attending a conference that lasts for more than two days rather than attending a conference that is based on a single day (Davidson, 2002). They enjoy dinners that are more formal rather than informal ones. The dinner trends have been evolving in China with people opting for healthier food and therefore this has affected the industry greatly (Lee, Kao Yang, 2014). Various conferences taking place in China: International Conference On Software And Information Engineering ((ICSIE-17)) This conference is based on knowledge sharing based on the field of Engineering. It is usually held in Swiss hotel Grand Shanghai. International Conference on Business, Economics, Social Science Humanities (BESSH) Based on the field of economics and science, this seminar will be held at Leisure Inn and discuss about the world economy. China Marketing Summit This summit is held in China every year and it is necessary attend conference for any group of people who want to attend to market of China (Best, 2012). Global Sources Summit This is a great opportunity for the entrepreneurs and small businesses who want to build a business. Various strategic ideas are discussed to help these entrepreneurs to build a business. Managing Supply and Demand Issues in the Conference Industry in Shanghai According to Park Boo (2010), the main reasons why the supply and demand problems take place are the nature of the service industries. What makes these industries is that they are required immediately. Managing this difference is difficult to manage and the company should make sure that it is able to adhere to the needs of the consumers. As the Event industry has become the new sought after industry, there have been many companies who engage themselves in this operation and thus the supply side has been exceeding. This could be stated as the trend say 5 years back. However, as per the latest trend the conference industry has been doing extremely well and therefore, the demand for arranging conferences has been increasing (Kotler, 2012). As these demands have been increasing, the existing industries have been finding it extremely difficult to cope up with the needs of the demand. The demand and supply occurs in China because: Services are direct, they cannot be stored therefore, and this leads the managers without an alert as to when these services may be demanded. There is a huge amount of producer and consumer interaction in services such as a conference and the consumer provides constant input as to how the task has to be done. This is a mixed blessing as on one hand it provides a source of ideas but on the other it provides interference for the managers. The consumption of goods and services can be delayed however; the services have to be delivered instantly. This is the reason why there is a lot of problem because the conference sponsors find it difficult to find the right event managers who will deliver the conference of their choice. According to Rompf, Brieter Severt (2008), managing this demand and supply can be a difficult task hence it is better is better to form a creative solution and expand the base so that the company can manage the business. The manager can alter the demand by developing an off-peak pricing system whereby complementary services are offered so that the customers are attracted (Kay, 2005). They can even create a non-peak demand, which will help the firm to balance the business. The supply that is being created can also be controlled so that so that the demand can be matched with it. In order to manage a huge supply, the part time employees can be employed so that during the peak seasons the demand can be balanced. Efficiency has to be managed and improved so that the balance can be removed and during the peak season lot of mistakes can be made and therefore, during the lean season the company can improve their skills and manage to gear up for the peak season. Recommendations- How to stay ahead in the conference industry: The following can be applied by the conference industry in China so as to adopt better efficiency and race ahead and stead in the conference industry Adopt Data Analytics Data analytics can be applied in the field of event management. The previous year trends can be observed and a pattern can be formed in order to anticipate the demand, which is present. Data is a new field whereby analysis of data can help in decision-making. Build up Architecture As the numbers of conferences, which are being held, are increasing tremendously and therefore it should be seen that the required architecture for the industry is being prepared for so that the demand for the increased conferences can be met with easily. Use technology The technology should be applied in every field of conferencing. Videos. Mails, applications, AV. These all should be made use of so that the consumers can be dealt with easily and all the data can be kept under one umbrella (Mullins, Walker Boyd Jr, 2012). For separate conferences, an application can be formed which can be shared with the goers as well as the organizers. The schedule and various other data can be presented on the application for easy use. Conclusion Therefore, from the discussion it can be stated that the conference industry emerged as a popular topic in the 90s. During the 2007-2008 periods, it was under a dull period. Again post 2015, the conference industry has been doing well. With the upcoming trends and latest technology, the industry has become one of the most sought after industries. In Shanghai, the industry has been doing well. Shanghai is a host to various conferences on a variety of topics. The Chinese have applied various trends into their process of doing business and thereby performed well. Following the stated recommendations and suggestions, the industry will be able to perform even better in Shanghai. References Ahmad, N. L., Yusuf, A. N. M., Shobri, N. D. M., Wahab, S. (2012). The relationship between time management and job performance in event management.Procedia-Social and Behavioral Sciences,65, 937-941. Allen, J., O'toole, W., Harris, R., McDonnell, I. (2012).Festival and Special Event Management, Google eBook. John Wiley Sons. Andersson, A., Deng, J., Du, K., Zheng, M., Yan, C., Sko?ld, M., Gustafsson, O. (2015). Regionally-varying combustion sources of the January 2013 severe haze events over eastern China.Environmental science technology,49(4), 2038-2043. Best, R. (2012).Market-based management. Pearson Higher Ed. Chon, K. S., Weber, K. (2014).Convention tourism: International research and industry perspectives. Routledge. Davidson, R (2002) Leisure Extensions to Business Trips, English Tourism council. Fenich, G. G. (2014).Planning and management of meetings, expositions, events and conventions. Pearson Higher Ed. Getz, D., Page, S. J. (2016).Event studies: Theory, research and policy for planned events. Routledge. Hiller, H (1995) `Conventions as mega events: A new model for convention host city relationships`, Tourism Management(16:5) pp 375-379 Homburg, C., Vollmayr, J., Hahn, A. (2014). Firm value creation through major channel expansions: evidence from an event study in the United States, Germany, and China.Journal of Marketing,78(3), 38-61. Jones, M. (2014).Sustainable event management: A practical guide. Routledge. Kay, A (2005) ` China`s Convention and Exhibition Centre Boom`, Journal of Convention and Event Tourism 7 (1) Kotler, P. (2012). Marketing Management, millenium edition: Custom Edition for University of Phoenix. Lee, J., Kao, H. A., Yang, S. (2014). Service innovation and smart analytics for industry 4.0 and big data environment.Procedia Cirp,16, 3-8. Lee, M J (2006) `Analytical Reflections on the Economic Impact Assessment of Conventions and Special Evnts`, Journal of Convention Event Tourism (8:3) pp 71-85 Park, E Boo, S (2010) ` An assessment of convention tourism`s potential contribution to environmentally sustainable growth` Journal of Sustainable Tourism, (18:1) pp 95-113 Rogers, T. (2013).Conferences and Conventions 3rd edition: A Global Industry. Routledge. Rompf, P, Brieter, D Severt, K (2008) ` Destination selection criteria: key success factors evolve and dominate Event Management ,(12) pp 27-38 Weber K (2001) `Meeting planners` use and evaluation of convention and visitor bureaus`. Tourism Management 22(6)

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Motivation and Happiness - Essay Example This is illustrated in the motive of peer approval which becomes a motive to the individual to the extent that it satisfies his need of belonging and social recognition. There are common implications in the terminology of motivation whether we speak of it as motive, drive, need, impulse, wish, want id or valence. There is the implied existence of a force, of some degree of intensity that activates and arouses behavior. The object or goal of this force defines its direction. Motives may either be physiological or psychological. Physiological motives drive the individual to meet his body needs for food, water, and sleep. A kindergarten child may not be attentive in the class because he is malnourished or he did not eat breakfast. A college student cannot concentrate on the class discussions for he was sleepless the night before. Psychological needs, those that are not basically physiological are more numerous and have more variations depending on the theory that one subscribes to. It is generally accepted that psychological need cannot be separated from physiological needs. The two are interdependent. Each affects the other. Maslow's theory is consistent with the basic objectives of the teaching-learning process in particular and of the educational system in general, that is, to develop the potentials of the learners. The theory states that self-actualization cannot be achieved unless the lower levels of needs are satisfied. Thus, the learners' biological needs must be met. The student must feel that he belongs to the group. He must have self-esteem before he can self-actualize. An atmosphere conducive to the meeting of these needs is important. No fast rules can be stated here. But suffice to say that the teacher's awareness of his pupils' need cannot be overemphasized. His ingenuity to create situations facilitative of self-actualization is thereby challenged. Of course, there are hindrances to this such as big classes that make it difficult for the teacher to recognize individual differences and heavy teaching loads that may take away the teacher from the learners. When man wants to attain happiness and freedom, man has to satisfy his needs and motivation transpires giving the person enough reason to reach for his goals. With the Brave New World, freedom is being discussed in relation to social stratification and social order. Motives, wants and needs and also drives often spoken of interrelatedly may be broken into classifications as physiological and psychological motives. The physiological motives are also referred to as biological, organic, primary or basic. A large part of man's activity is devoted to the maintenance of bodily needs - the need for food, water, air, excretion, sleep, activtity, shelter and sexual needs. These comprise the first stage in Maslow's hierarchy of needs. Man is attracted towards states which are pleasant and draws away from stimulations which are unpleasant. Man naturally looks for relationships that are warm and affectionate. During infancy, this need is very often satisfied by loving parents who provide the warm emotional security that will etermine to a large extent, later personal adjustments in life. In Huxley's work, "All members of society are conditioned with the values that the World State idealizes. Children are trained to

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Efficacy Of Dynamic Splinting Health And Social Care Essay The procedure has proven to both reliable and durable. A successful total knee replacement allows patient to resume almost all activities of daily living with minimal difficulty. In most cases patients no longer require external aids or chronic medications. Finally total knee replacement helps patients to maintain their overall self esteem. Total knee replacement is indicated when there is unremitting severe pain in the knee with or without deformity. The pain/ deformity may be due to osteoarthritis, Rheumatoid arthritis and various non specific arthritis. It relieves pain, provides mobility and correct deformity. Total knee replacement is a surgical procedure in which injured or damaged parts of the knee joint are replaced with artificial parts. The procedure is performed by seperating the muscles and ligaments around the knee to expose the knee capsule. The knee capsule is opened, exposed the inside of the joint. 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It is attached above to the medial epicondyle of femur, below to the medial margin and the adjoining medial surface of tibia. Function: restrain valgus rotation Lateral collateral ligament: Function: restrain varus rotation and resist internal rotation kneeanat Anterior cruciate ligament: It is attached below to the anterior part of the intercondylar area of tibia between the anterior ends of lateral and medial semilunar cartilages. Above it is attached to the posterior part of the medial surface of lateral femoral condyle. Function: To resist anterior displacement of the tibia on the femur when the knee is flexed To resist varus or valgus rotation of the tibia, especially in the absence of the collateral ligaments Resists internal rotation of the tibia. Posterior cruciate ligament: It is attached below to the posterior part of intercondylar area of tibia, posterior to the attachment of posterior end of medial semilunar cartilage. Above it is attached to the anterior part of lateral surface of the medial condyle of femur. Function: To allow femoral rollback in flexion Resist posterior translation of the tibia relative to the femur Controls external rotation of the tibia with increasing knee flexion. Retention of the PCL in total knee replacement has been shown biomechanically to provide normal kinematic rollback of the femur on the tibia. This also is important for improving the lever arm of the quadriceps mechanism with flexion of the knee. MUSCLES OF KNEE JOINT: Quadriceps femoris Popliteus Semitendinosus Semimembranous Sartorius Biceps femoris Gastrocnemius Plantaris BURSAE AROUND THE KNEE JOINT: Anteriorly: The suprapatellar bursa The prepatellar bursa Superficial intrapatellar bursa Deep infrapatellar bursa Laterally: A bursa between lateral collateral ligament and biceps tendon A bursa between lateral collateral ligament and popliteus tendon Popliteus bursa lies between the popliteus and lateral condyle of femur. Medially: The tibial inter tendinous bursa( pes anserine bursa) A bursa between medial collateral ligament and semimembranous tendon A bursa between semimembranous tendon and tibia. Posteriorly: A bursa between lateral head of gastrocnemius and capsule. Semimembranous bursa(brodies bursa) NERVE SUPPLY: Femoral nerve Sciatic nerve Obturator nerve BLOOD SUPPLY: The arterial supply to knee joint, is from the branches of Popliteal artery Femoral artery Tibial artery TIBIO-FEMORAL ARTHROKINEMATICS: Viewed in the sagittal plane, the femurs articulating surface is convex while the tibias in concave. We can predict arthrokinematics based on the rules of concavity and convexity: During Knee Extension During Knee Flexion Open Chain Closed Chain Open Chain Closed Chain Tibia Glides Anteriorly On Femur Femur Glides Posteriorly On Tibia Tibia Glides Posteriorly On Femur Femur Glides Anteriorly On Tibia from 20o knee flexion to full extension from full knee extension to 20o flexion Tibia rotates externally Femur rotates internally on stable tibia Tibia rotates internally Femur rotates externally on stable tibia THE SCREW-HOME MECHANISM: Rotation between the tibia and femur occurs automatically between full extension (0o) and 20o of knee flexion. These figures illustrate the top of the right tibial plateau as we look down on it during knee motion. top of tibial plateau top of tibial plateau top of tibial plateau During Knee Extension, the tibia glides anteriorly on the femur. During the last 20 degrees of knee extension, anterior tibial glide persists on the tibias medial condyle because its articular surface is longer in that dimension than the lateral condyles. Prolonged anterior glide on the medial side produces external tibial rotation, the screw-home mechanism. THE SCREW-HOME MECHANISM REVERSES DURING KNEE FLEXION top of tibial plateau top of tibial plateau top of tibial plateau When the knee begins to flex from a position of full extension, posterior tibial glide begins first on the longer medial condyle. Between 0 deg. extension and 20 deg. of flexion, posterior glide on the medial side produces relative tibial internal rotation, a reversal of the screw-home mechanism. TOTAL KNEE REPLACEMENT Total knee replacement is indicated when there is unremitting severe pain in the knee with or without deformity. The pain/ deformity may e due to osteoarthritis, Rheumatoid arthritis and various non specific arthritis. It relieves pain, provides mobility and correct deformity. Total knee replacement is a surgical procedure in which injured or damaged parts of the knee joint are replaced with artificial parts. The procedure is performed by seperating the muscles and ligaments around the knee to expose the knee capsule. The knee capsule is opened, exposed the inside of the joint. The end of the femur and tibial are removed. The artificial parts are cemented into place. The knee will consist of metal shell at the end of the femur, a metal and plastic trough on the tibia and if needed a plastic button in the cap. In a way this could be more appropriately called a Knee resurfacing operation. E:New FolderNAGU PROJECTimAGESTotal-Knee-Replacement.jpg The total knee replacement can be: Unicompartmental arthroplasty: The Articular surface of femur and tibia, either the medial or lateral compartment of the knee are replaced by an implant. Eg: osteoathritis. Bicomprtmental arthroplasty: In bicompartmental arthroplasty, the articular surface of tibia and femur of both medial and lateral compartments of the knee joints are replaced by an implant. The third compartment i.e.., the patellofemoral joint is however left intact. Tricomprtmental arthroplasty: the articular surface of the lower femur, upper tibia and patella are replaced by prosthesis. Most commonly performed arthroplsty. The prosthesis consists of a tibial component, a metal femoral component and a high molecular weight polyethylene button for articular surface of the patella. TKA GOALS Restore mechanical alignment [neutral tibiofemoral alignment = 4 °-6 ° of anatomic valgus], Horizontal joint line, Soft tissue balance (ligament), (Patella tracking (Q-angle) INDICATION Oteoarthritis Rheumatoid arthritis Hemophilic arthritis Traumatic arthritis Sero negative arthrides Crystal deposition disease Pigmented villonoular synovitis Avascular necrosis Bone dysplasias Asymmetric arthrits CONTRA INDICATION Absolute contraindications Recent or curren joint infection Sepsis or systematic infection Neuropathic arthropathy Painful solid knee fusion Relative contraindications Severe osteoporosis Debilated poor health Non functioning extensor mechanism Painless, well functioning arthrodesis Significant peripheral vascular diseases TKA Complications Death: 0.53% Periprosthetic Infection: 0.71% Pulmonary emboli: 0.41% Patella fracture: Component Loosening: Tibial tray wear: Peroneal Nerve Palsy: 0.3% to 2% Periprosthetic Femur Fracture: Periprosthetic Tibial Fracture: Wound Complications / Skin slough: rare Patellar Clunk Syndrome: rare Patellofemoral Instability: 0.5%-29% DVT: Instability: Popliteal artery injury: 0.05% Quadriceps Tendon Rupture: 0.1% Patellar Tendon Rupture: Stiffness: Fat Embolism MCL rupture NEED AND SIGNIFICANCE OF STUDY: Need of the study: To reduce flexion contracture To improve range of motion To improve functional activity Significance of the study: This study is to evaluate the efficacy of dynamic splinting for knee flexion contracture following a total knee arthroplasty. Statement of the problem: To study the efficacy of dynamic splinting for knee flexion contracture following a total knee arthroplasty. Hence the study is entitled as efficacy of dynamic splinting for knee flexion contracture following a total knee arthroplasty. Objectives: To reduce flexion contracture To improve range of motion To analyze the effect of dynamic knee splint Null hypothesis: The null hypothesis can be stated as follows there is no significant difference in knee flexion contracture after the application of dynamic knee splint. Alternate hypothesis: The hypothesis can be stated as follows there is significant difference in knee flexion contracture after the application of dynamic knee splint. 2. REVIEW OF LITERATURE: 1. TOTAL KNEE ARTHROPLASTY: Simon H Palmer, MD, Consultant Surgeon: Sep 21, 2010 Osteoarthritis destruction of the knee is the most common reason for total knee replacement. Jayant joshi, prakash kotwal says that total knee replacement relieves pain, provides mobility corrects deformity. 2. FLEXION CONTRACTURE: J. Ilyas; A.H. Deakin; C. Brege; and F. Picard Flexion contracture is a common deformity encountered in patients requiring total knee arthroplasty (TKA). Department of orthopaedics, golden jubilee national hospital, clydebank, glasgow, g81 4hx, uk. One hundred and four continuous TKA were completed by a single consultant using the OrthoPilot (BBraun, Aesculap) navigation system and Columbus implants. Seventy-four knees had preoperative flexion contracture (including neutral knees) while 30 were in hyperextension. Ouellet D, Moffet H. Arthritis Rheum October 2002 Large movement deficits are present, especially in single-limb support pre-op and 2 months following TKA. Huei-Ming Chai, PHD. November 24, 2008 total knee arthroplasty limits range of motion 3. DYNAMIC SPLINT: Dennis l armstrong, m.d. Buck willis, phd evaluates the efficacy of dynamic knee extension splinting for knee flexion contracture following TKA. Finger  E, Willis  FB Health Physical Education, Recreation, Texas State University, Cases Journal 2008, Physical therapy alone did not fully reduce the contracture and dynamic splinting was then prescribed for daily low-load, prolonged-duration stretch. Finger E, Willis B 29Dec2008: Dynasplint offers extension Systems to aid in rehabilitation and recovery from flexion contracture. Clinical studies have demonstrated greatest average reduction in rehabilitation time and cost with the use of Dynasplint Systems in conjunction with physical therapy. Willis FB Biomechanics.2008 Jan; 15 After surgery, a patient is often left with shortened connective tissue and may have a difficult time walking normally again. Wearing a dynamic knee splint will lengthen and remodel the tissue to restore range of motion. McClure P, Blackburn L, Dusold C Ideally, wearing your Dynasplint for 6-8 continuous hours yields the best results as it allows a safe, long lasting remodeling of the soft tissue. Cliffordr.Wheeless, Iii, Md.December3, 2008. The purpose of this report is to review the use of external fixator for the gradual correction of severe knee flexion contractures that limit patient function. James f. Mooney iii, md, l. Andrew koman Posted: 05/01/2001 Average preoperative flexion contracture was 80.5 °. Each patient achieved full extension. There was one recurrence, despite bracing, which was managed with replacement of the fixator and soft tissue procedures 4. CONVENTIONAL PHYSICAL THERAPY FOR KNEE ARTHRITIS: Jan.K.Richardson, Pt, Phd, Ocs Said that arthritis is a degenerative disease of the cartilage and bones that results in pain and stiffness in affected joint. There is no cure for arthritis, but physical therapy can make living easier and less painful. Brigham And Womens Hospital Department of Rehabilitation Services Physical Therapy .ROM along with proper soft tissue balance is required to ensure proper biomechanics in the knee joint. Aggressive post-operative PT has been shown to be effective in improving patient outcomes and shortening length of stay Balint G And Sz Ebenyl.B Showed that therapeutic exercises decreases pain, increases muscle fatigue and range of motion as well as improve endurance and aerobic capacity. Weight reduction is proven in obese patients with OA of knee. Therapeutic heat and cold, electrotherapy, acupuncture are widely used. Dr. Margriet van baar reported that significant beneficial effects from exercise therapy including improvements in self reported pain, disability, walking ability and overall sense of well being. Dorr LD.   J Arthroplasty June 2002 CPM helps achieve knee range of motion quicker in first post-op weeks but at final follow-ups, no difference in final range of motion Byrne, et al.   Clin Biomech October 2002 Deficits in knee strength balanced by increased hip extensor work; rehab should optimize bilateral hip and knee function after TKA McManus et al 2006, Jorge et al 2006 the higher frequencies (90-130Hz) to stimulate the pain gate mechanisms thereby mask the pain symptoms. Ozcan et al, 2004 Low frequency nerve stimulation is physiologically effective (as with TENS and NMES) and this is the key to IFT intervention. Adedoyin, R. A., et al. (2002).IFT acts primarily on the excitable (nerve) tissues, the strongest effects are likely to be those which are a direct result of such stimulation (i.e. pain relief and muscle stimulation). National Taiwan University Hospital, November 2008 PNF stretching techniques has been used frequently for patients with total knee arthroplasty in clinical practice to increase range of motion effectively and reduced knee pain during exercise. Huei-Ming Chai, PHD November 24, 2008 PNF stretching technique is a therapeutic technique using the PNF concept to the related muslces either to increase neuro-inhibition mechanism for releasing muscle spasm and elongating muscle length, or to increase neuro-excitation mechanism for enhancing muscle strength Harold B. James H. Beaty, MD Range-of-motion exercises, muscle strengthening, gait training, and instruction in performing activities of daily living are important. 5. GONIOMETRIC MEASURENT FOR ROM: Carlos Lavernia, MD, Range of motion assessment through direct observation without a goniometer provides inaccurate findings. Mark D. Rossi, PhD, PT, CSCS The Journal of Arthroplasty Vol. 23 No. 6 Suppl. 1 2008 Measured scores using a goniometer provided an improved degree of accuracy, but results appear to be dependent on the clinician performing the measurement. Richard l. Gajdosik Associate Professor Physical therapists may accept most knee goniometric measurements as clinically valid, and the evidence indicates that most of these measurements are reliable. 6. KNEE SOCIETY SCORE: Gil Scuderi, MD-Chair; Jim Benjamin, MD; Jess Lonner, MD; Bob Bourne, MD and Norm Scott, MD, 2007,The Knee Society rating system (KSS) was first published in CORR in 1989 and has become the standard clinical evaluation system for reporting results for patients undergoing Total Knee Replacement. John N. Insall, MD, Lawrence D. Dorr, Scott, MD Rationale of the Knee Society clinical rating system. Clin Orthop Relat Res. 1989 Nov:The Knee Society has proposed this new rating system to be simple but more exacting and more objective. MD, Richard D. Scott, MD, and W. Norman It is hoped the knee society rating system will become universally accepted and will be adopted by all authors, even if they wish to report results using a customary scoring method as well. 3. MATERIALS AND METHODOLOGY: MATERIALS: Evaluation tool: Goniometry Knee society score Outcome measure: Range of motion Knee score Function score Material used: Dynamic knee splint METHODOLOGY: (A) Study design: 30 subjects with flexion contracture following unilateral TKA assigned in two groups. GROUP A: 15 subjects: Dynamic Splint Along With Conventional Physiotherapy. GROUP B: 15 subjects: Conventional Physiotherapy. (B) Study setting: This study was carried out in the department of physical medicine and rehabilitation, Sri Ramakrishna hospital, Coimbatore. (C) Study duration: This study was carried out for a period of 6 months. (D) Sampling: Random sampling. INCLUSION CRITERIA: Age: 45 to 70 years. Both sex Flexion contracture : 20 12 deg (post operatively) Unilateral TKA Reduced flexibility in AROM of knee extension Pain that is worsened by bending over while legs are straight Impaired gait pattern Ability to understand informed consent and experiment responsibilities EXCLUSION CRITERIA: Fractures Bilateral TKA TKA Knee sepsis Osteomyelitis or any orthopedic infection Extensor mechanism dysfunction Psoriasis Knee joint neuropathy Previous Stroke or Brain Injury STATISTICS TOOL: The data collected was analyzed using independent t-test. The test was carried out between two groups. Independentt test was used to compare the effectiveness of treatment between the groups. t = S = X1 = Difference between pretest and posttest values of Group I X2 = Difference between pretest and posttest values of Group II = Mean difference of Group I = Mean difference of Group II n1 = No. of samples in Group I n2 = No. of samples in Group II S = Combined standard deviation TREATMENT: Dynamic knee Extension splint: The Rebound Effect http://www.dynasplint.com/uploads/user-uploads/rebound2.gif 53% Average Reduction in Time and Cost Associated with ROM Rehabilitation High-force, short-duration stretching favors recoverable, elastic tissue deformation, whereas low-force, long-duration stretching enhances permanent plastic deformation. In the clinical setting, high force application has a greater risk of causing pain and possibly ruptures of tissue. Dynasplint Systems improve range of motion by creating permanent, non-traumatic tissue elongation and remodeling, thus virtually eliminating the range of motion rebound effect often observed in the clinical setting. RangerKnee2 Features Benefits LLPS (Low-Load, Prolonged-Duration Stretch) technology has been proven to successfully treat joint stiffness and limited range of motion. Early application can reduce time and cost associated with range of motion rehabilitation Simple, adjustable and reproducible bilateral tensioning System Available for rent or purchase Biomechanically correct Comfortable to wear Each Dynasplint System is recycled to reduce waste and help the environment A Dynasplint Systems consultant will fit your patients and oversee their treatment to ensure the best possible results Over a quarter of a million patients have been successfully treated with Dynasplint Systems Conveniently labeled and easy to use Patient Wearing Protocol Please review the tension your Dynasplint consultant set for you initially. In the beginning, the splint should be worn for 2-4 hours. Do not increase the tension until you can tolerate overnight wear. Time is the most important factor and your first goal should be 6-8 hours of pain free wear. After achieving this time goal, when you take the splint off if you have less than 1 hour of post-wear stiffness, turn tension up by one on both sides. However if you are unable to wear the splint for a prolonged period of time, decrease the tension by a half to one full turn. During the process of regaining your range of motion, if you have any question or concerns contact your Dynasplint consultant. http://www.wheelessonline.com/images/i1/imk11.jpg CONVENTIONAL TREATMENT: MODALITIES FOR PAIN CONTROL, EDEMA REDUCTION: Moist Heat Functional electrical stimulation Transcutaneous electrical stimulation Ice therapy Interferential therapy Galvanic Stimulation JOINT MOBILIZATION: Flexion restriction Position: patient seated Posterior glide of tibia on femur-grade 3 Oscillation with 30 second hold, Repeated 5 times with patellar mobilization of inferior glides (5 mins) Extension restriction Position: patient prone with patella off of table Anterior glide of tibia on femur- grade 3 oscillation and static hold (10 secs in 3 repetitions) with patellar mobilization superior glides (5 mins) EXERCISE PROGRAM: Closed and open kinetic chain strengthening exercises Proprioceptive/balance exercises targeting the trunk and lower extremity musculature Partial body weighted squats Gait training Range of motion exercises Heel slide (supine sitting) Stretching (prone/supine) to increase knee extension ROM GAIT TRAINING: Forward Walking Sidestepping Backward or Retro-Walking FUNCTIONAL TRAINING: Standing Transfer Activities Lifting Carrying Pushing or Pulling Squatting or Crouching Return-to-Work Tasks ENDURANCE TRAINING: Upper body exercise. Ambulation activities One-leg cycling, using non-operative leg with resistance to motion. BALANCE/PROPRIOCEPTION TRAINING: Tandem Walking Lateral Stepping over/around objects Weight-Shifting Activities Closed Kinetic Chain Activities 5. DATA ANALYSIS AND INTERPRETATION: KNEE EXTENSION ROM: GROUP I Pre test (Two months after TKA) Post test (conventional PT with SPLINT) Difference X1 16 0 16 16 1 15 16 2 14 16 2 14 16 4 12 14 0 14 14 0 14 14 1 13 14 1 13 14 2 12 12 0 12 12 0 12 12 1 11 12 1 11 12 1 11 Mean=12.93 PRE TEST AND POST KNEE EXTENSION ROM: GROUP I KNEE EXTENSION ROM: GROUP II Pre test (Two months after TKA) Post test (conventional PT without splint) Difference X2 18 7 11 18 6 12 18 6 12 18 6 12 18 4 14 16 7 9 16 7 9 16 4 12 16 4 12 16 4 12 14 3 11 14 4 10 14 4 12 14 2 12 14 2 12 Mean=11.46 t=2.82 s.dev=1.42 degrees of freedom = 28 The probability of this result, assuming the null hypothesis, is 0.009 PRE TEST AND POST KNEE EXTENSION ROM: GROUP II KNEE SCORE AND FUNCTION SCORE: S.No. Parameters Groups Mean S.D.Value t Value 1. Knee Scores Group A 18 4.47 3.06 Group B 13 2. Function Score Group A 35.6 4.98 3.01 Group B 30.1 MEAN DIFFERENCE BETWEEN KNEE SCORE AND FUNCTION SCORE DEMOGRAPHIC DATA THE AGE OF THE SAMPLES BETWEEN 45 -70 YEARS IN EACH GROUP Age (years) No. of Samples Total Group A Group B 45-50 4 3 7 50-55 5 4 9 55-60 2 5 7 60-65 2 2 4 65-70 2 1 3 TOTAL NUMBER OF MALES AND FEMALES IN EACH GROUP Sex No. of Samples Total Group A Group B Male 8 10 18 Females 7 5 12 TOTAL NUMBER OF RIGHT AND LEFT SIDE INVOLVEMENT IN EACH GROUP Side of involvement No. of Samples Total Group A Group B Right 11 8 19 Left 4 7 11 5. DISCUSSION Total knee arthroplasty (TKA) is considered the treatment of choice for patients with intractable pain and substantial functional disabilities who have not had acceptable relief and functional improvement after conservative treatment. Knee flexion contracture is a common pathology following TKA affecting up to 61% of these patients. The purpose of the study is to determine the effectiveness of dynamic splinting in treating patients with flexion contracture following Unilateral TKA. Literature review states that there is significant difference between dynamic splinting and conventional physiotherapy management in reducing flexion contracture following Unilateral TKA. A total of thirty patients with unilateral TKA were selected under inclusive criteria and were randomly allocated into an experimental group and control group as Group A and group B respectively. In each group 15 Individuals were allotted In Group A, dynamic splint along with conventional physiotherapy was given and in Group B, Conventional physiot