Thursday, November 17, 2011

ISPO 2011


On Thursday, 3rd November, I had the pleasure of attending the 2011 Annual Scientific Meeting of ISPO (International Society for Prosthetics and Orthotics) Australia. This year’s theme was the Psychosocial Impact of Disability and Limb Loss. The article I've posted here will be published in the upcoming Summer edition of the Amputee Journal.

To kick proceedings off, there was a brief address from 13 year old Jake Widjaya, who, like myself, was born with limb difference. He started campaigning for limb difference awareness at age 9 and released a DVD called my special hand that focuses both on his childhood experiences as well as advise for parents and peers of children experiencing limb difference. As someone who has shared in Jake’s experiences, I think his courage is remarkable and I’m both extremely proud of him as well as grateful for his accomplishments in generating awareness and of his chosen direction and attitude.

Then it was over to Pamela Gallagher for her keynote address. Pamela travelled all the way from Dublin Ireland to share with us her insight into the world of the Psychosocial Impact of Disability and Limb Loss – right after talking to us about the rugby! Pam’s address focused on the issues we experience as amputees, especially our psychological wellbeing, body image and goal engagement, and how the clinicians who care for us can do a better job by understanding what the issues are and how to better respond to them. The study she is involved with is centred around improving our quality of life and breeding resilience and positive outcomes. She presented us with some alarming statistics – her studies indicate that between 20 and 40% of amputees have indicators for depression. She then outlined the complex challenges an amputee faces and which impact our adjustment. The most positive and profound insights Pam shared with us were about self worth and acceptance. Our self worth, not just as amputees but as human beings, is established by overcoming the challenges that life presents us. This is how we achieve psychological growth. Days come and days go, regardless of whether they are “good” or “bad” and resilience is the ability to forge ahead with that very fact in mind. She asked if acceptance was always appropriate... It isn’t! There are situations in which we are entitled to be angry. There are situations in which anger will spark action and this action will result in a positive outcome. Just look back at how segregation came to an end, how women won the right to vote, etc. We don’t have to accept disability as a sentence to misery or a limited life. It is what we choose to make it.
Pam talked about the importance of goals and how necessary they are to enable us to experience purpose, fulfilment and ultimately happiness. I was interested to learn of two different variations of goal setting – one being Tenacious Goal Pursuit, where we modify our own behaviour and lifestyle to fit our goals, and the other being Flexible Goal Adjustment, where we adjust our goals to suit the situation. Both methods were shown to reduce depressive symptoms and improve perceived quality of life.. It beckons the question: What are you working towards??

After morning tea, it was over to Sydney based Psychologist Chris Basten to talk to us about Responding to the Emotional Needs of Amputees. His focus was on how occupational therapists, physios and other therapists including psychologists and psychiatrists can best assist amputees cope with the task of adaptation. He talked about the emotional problems commonly experienced by amputees, such as depression, anxiety and PTSD, and ways to both identify and address these issues. He explained the importance of a positive attitude, optimism and accepting responsibility for ensuring your own positive outcome – as well as accepting that it’s perfectly OK to need help to do so and reach out to your support network, which could be friends and family, a psychologist, or the Amputee Association’s peer support network. He talked about how important it is for amputees to focus on your strengths and find ways to increase your confidence, as well as the tremendously important role of goal setting and achievement in leading fulfilling and rewarding lives. I can definitely vouch for that being true!

Right after Chris, I was delighted to hear the findings of the lovely Sarah Eskandari’s PHD, which examines Body Image as an Important Factor for Adjustment to Amputation. Sarah’s study surveyed 218 amputees and supported an alarming statistic: that while 5-8% of the general population experience depression, the condition affects between 20-30% of amputees. Those who viewed their bodies negatively subsequent to amputation reported more symptoms of depression and anxiety, as well as a poorer perceived quality of life.

We then heard from Andrew Steele of Body Care Solutions (Melbourne), who outlined to us a case study in which elective amputation resulted in exceptionally positive outcomes. The goal of his message was to prompt the medical faculty to consider amputation as a valid treatment option which is not limited to negative psychosocial impacts. Weighing up the pros and cons of amputation versus reconstruction was enlightening.

Lastly, Carla Negri from Ossur Asia-Pacific (Sydney) presented a review of the Psychological Benefits Associated with Physical Activity for Persons with Lower Limb Amputation. Like Sarah’s presentation, the topic discussed by Carla was of special interest to me as an athlete and personal trainer focussed on wellness. My favourite article that Carla brought to our attention focused on investigating the relationship between participation in physical activity and body image in 56 lower limb amputees. The study highlighted a significant difference between the inactive group and the active group (who participated in a minimum of 2 hours aerobic activity weekly, in sessions no shorter than 20 minutes) and a positive relationship between physical activity level and body image – it’s another good reason for us all to get out there and get moving! In a 1985 study, Valliant et al. Found that physical activity for the disabled population can be an incentive to reshape their lives in a positive directions. Our focus needs not to be returning to our previous activity level: it should be achieving a healthy activity level and a balanced lifestyle, that accommodates our physical condition, whatever it may be. There’s ALWAYS a way to work up a sweat – and improved proprioception, confidence and coordination are just a few of the reasons we should want to.

I loved sitting in on the ISPO conference and wish I could have been at the symposium the day before. There is always next year though! It was such a valuable experience, which I hope I have been able to pass on and share with you in some small way J