Janet Howard Carr (22 May 1933 – 4 November 2014) [1] was an Australian physiotherapist and academic whose research focused on stroke rehabilitation. She was a professor at the University of Sydney and published numerous textbooks.
Janet Howard Carr (22 May 1933 – 4 November 2014) [1] was an Australian physiotherapist and academic whose research focused on stroke rehabilitation. She was a professor at the University of Sydney and published numerous textbooks.
Janet Carr was born in 1933 to Howard and Gladys Carr. Carr is one of three children to Howard and Gladys Carr, and grew up on their sheep-grazing property at Kerr's Creek, 25 kilometres from Orange, New South Wales. She walked across paddocks to attend classes in a one-room one-teacher school, Kinross Wolaroi School, before going to board at PLC (now Kinross Wolaroi), in Orange. Being raised in the bush gave Janet a lifelong love of the Australian landscape and a firm belief in the value of education, especially for girls. [1] She later moved to Sydney to study physiotherapy at the University of Sydney and graduated in 1955. [1]
In her early career as a physiotherapist, Carr worked in the United Kingdom, Canada and Switzerland before returning to Australia to work in hospitals in Mount Isa and Sydney. In 1973, she began tutoring in the field of neurological rehabilitation at the Royal Prince Alfred Hospital in Sydney. [1] She also began writing academic texts with her colleague Roberta Shepherd; their first textbook was published in Australia in 1976. Their first textbook to be published internationally, Physiotherapy in Disorders of the Brain (1980), focused on treatments to help brain-damaged patients to relearn motor skills and was followed by The Motor Relearning Programme for Stroke (1982). [2]
Carr was made a fellow of the Australian College of Physiotherapists in 1983 for her work in neurological physiotherapy. She was awarded a Kellogg Scholarship in 1984 to travel to Columbia University to study biomechanics and motor skill learning; this research earned her a doctorate. Carr and Shepherd's subsequent textbook, Movement Science: Foundations for Physical Therapy Practice in Rehabilitation, was published internationally and was particularly influential in the United States. Their textbook Neurological Rehabilitation: Optimizing Motor Performance, the product of a joint Rockefeller Grant, [1] was first published in 1998 and revised in 2010. [2]
Another example of Carr's work is her study in which she followed "a cohort of children with down syndrome, and their families from six weeks old, all the way through the age of 21, and beyond." [3] In one of Carr's many books, she wrote a piece to help assist parents in raising children who are mentally disabled. In one review of this book, a woman named Mary Croxen reviewed her book saying that "They [the family of Down’s syndrome patients] also require assistance with two very fundamental aspects of the child-rearing process, which can indeed be broken down into specifics according to the approach adopted by Janet Carr". [4]
By 2010, Carr had written or edited 13 textbooks, most of them with Shepherd. [2] Her main aim in writing these texts was to reconcile the gap between research and practice in physiotherapy. [2] She visited thirty countries to teach and present research, and presented a lecture series at the University of Ljubljana in 2012. An example of the impacts Carr's lectures had on young pupils of the sciences is a personal account from Rebecca L. Craik in which she said "When I was a student learning how to treat people with neuromuscular disorders, the interventions were primarily passive. Carr and Shepherd embraced neuroscience findings on motor control and motor learning and emphasized the relevance of those findings in transforming clinical practice and adopting a new approach. They were successful in knowledge translation and helped to change care for people with neuromuscular disorders. Many would agree that they were pioneers in guiding faculty and clinicians in the evidence-based practice concepts that are used today." Another quote from Craik is "I had the privilege of meeting this wonderful lady when she was a doctoral student at Columbia Teachers College. She inspired me then, and the incredible contribution that she has made in transforming clinical practice continues to inspire me." [5] Carr became a member of the Australian College of Physiotherapists in 2013 and was an honorary professor at the University of Sydney until her death in 2014. [1]
Hemiparesis, or unilateral paresis, is weakness of one entire side of the body. Hemiplegia is, in its most severe form, complete paralysis of half of the body. Hemiparesis and hemiplegia can be caused by different medical conditions, including congenital causes, trauma, tumors, or stroke.
Neurology is the branch of medicine dealing with the diagnosis and treatment of all categories of conditions and disease involving the brain, the spinal cord and the peripheral nerves. Neurological practice relies heavily on the field of neuroscience, the scientific study of the nervous system.
Physical therapy (PT), also known as physiotherapy, is one of the allied health professions. It is provided by physical therapists who promote, maintain, or restore health through physical examination, diagnosis, management, prognosis, patient education, physical intervention, rehabilitation, disease prevention, and health promotion. Physical therapists are known as physiotherapists in many countries.
Polyneuropathy is damage or disease affecting peripheral nerves in roughly the same areas on both sides of the body, featuring weakness, numbness, and burning pain. It usually begins in the hands and feet and may progress to the arms and legs and sometimes to other parts of the body where it may affect the autonomic nervous system. It may be acute or chronic. A number of different disorders may cause polyneuropathy, including diabetes and some types of Guillain–Barré syndrome.
Hypotonia is a state of low muscle tone, often involving reduced muscle strength. Hypotonia is not a specific medical disorder, but a potential manifestation of many different diseases and disorders that affect motor nerve control by the brain or muscle strength. Hypotonia is a lack of resistance to passive movement, whereas muscle weakness results in impaired active movement. Central hypotonia originates from the central nervous system, while peripheral hypotonia is related to problems within the spinal cord, peripheral nerves and/or skeletal muscles. Severe hypotonia in infancy is commonly known as floppy baby syndrome. Recognizing hypotonia, even in early infancy, is usually relatively straightforward, but diagnosing the underlying cause can be difficult and often unsuccessful. The long-term effects of hypotonia on a child's development and later life depend primarily on the severity of the muscle weakness and the nature of the cause. Some disorders have a specific treatment but the principal treatment for most hypotonia of idiopathic or neurologic cause is physical therapy and/or occupational therapy for remediation.
The Bobath concept is an approach to neurological rehabilitation that is applied in patient assessment and treatment. The goal of applying the Bobath concept is to promote motor learning for efficient motor control in various environments, thereby improving participation and function. This is done through specific patient handling skills to guide patients through the initiation and completing of intended tasks. This approach to neurological rehabilitation is multidisciplinary, primarily involving physiotherapists, occupational therapists, and speech and language therapists. In the United States, the Bobath concept is also known as 'neuro-developmental treatment' (NDT).
Acalculia is an acquired impairment in which people have difficulty performing simple mathematical tasks, such as adding, subtracting, multiplying and even simply stating which of two numbers is larger. Acalculia is distinguished from dyscalculia in that acalculia is acquired late in life due to neurological injury such as stroke, while dyscalculia is a specific developmental disorder first observed during the acquisition of mathematical knowledge. The name comes from the Greek a- meaning 'not' and Latin calculare, which means 'to count'.
Hypertonia is a term sometimes used synonymously with spasticity and rigidity in the literature surrounding damage to the central nervous system, namely upper motor neuron lesions. Impaired ability of damaged motor neurons to regulate descending pathways gives rise to disordered spinal reflexes, increased excitability of muscle spindles, and decreased synaptic inhibition. These consequences result in abnormally increased muscle tone of symptomatic muscles. Some authors suggest that the current definition for spasticity, the velocity-dependent over-activity of the stretch reflex, is not sufficient as it fails to take into account patients exhibiting increased muscle tone in the absence of stretch reflex over-activity. They instead suggest that "reversible hypertonia" is more appropriate and represents a treatable condition that is responsive to various therapy modalities like drug or physical therapy.
A neuromuscular disease is any disease affecting the peripheral nervous system (PNS), the neuromuscular junction, or skeletal muscle, all of which are components of the motor unit. Damage to any of these structures can cause muscle atrophy and weakness. Issues with sensation can also occur.
Kinross Wolaroi School is an independent Uniting Church co-educational early learning, primary, and secondary day and boarding school, located in Orange, a rural city 260 kilometres (160 mi) west of Sydney, New South Wales, Australia. Founded in 1886 it is the oldest school in Orange and is situated across two campuses.
Neurorehabilitation is a complex medical process which aims to aid recovery from a nervous system injury, and to minimize and/or compensate for any functional alterations resulting from it.
Aquatic therapy refers to treatments and exercises performed in water for relaxation, fitness, physical rehabilitation, and other therapeutic benefit. Typically a qualified aquatic therapist gives constant attendance to a person receiving treatment in a heated therapy pool. Aquatic therapy techniques include Ai Chi, Aqua Running, Bad Ragaz Ring Method, Burdenko Method, Halliwick, Watsu, and other aquatic bodywork forms. Therapeutic applications include neurological disorders, spine pain, musculoskeletal pain, postoperative orthopedic rehabilitation, pediatric disabilities, and pressure ulcers.
Physical therapy education varies greatly from country to country. Worldwide, physical therapy training ranges from basic work site education in hospitals and outpatient clinics to professional doctoral degree and masters programs.
The UCL Queen Square Institute of Neurology is an institute within the Faculty of Brain Sciences of University College London (UCL) and is located in London, United Kingdom. Together with the National Hospital for Neurology and Neurosurgery, an adjacent facility with which it cooperates closely, the institute forms a major centre for teaching, training and research in neurology and allied clinical and basic neurosciences.
Electrodiagnosis (EDX) is a method of medical diagnosis that obtains information about diseases by passively recording the electrical activity of body parts or by measuring their response to external electrical stimuli. The most widely used methods of recording spontaneous electrical activity are various forms of electrodiagnostic testing (electrography) such as electrocardiography (ECG), electroencephalography (EEG), and electromyography (EMG). Electrodiagnostic medicine is a medical subspecialty of neurology, clinical neurophysiology, cardiology, and physical medicine and rehabilitation. Electrodiagnostic physicians apply electrophysiologic techniques, including needle electromyography and nerve conduction studies to diagnose, evaluate, and treat people with impairments of the neurologic, neuromuscular, and/or muscular systems. The provision of a quality electrodiagnostic medical evaluation requires extensive scientific knowledge that includes anatomy and physiology of the peripheral nerves and muscles, the physics and biology of the electrical signals generated by muscle and nerve, the instrumentation used to process these signals, and techniques for clinical evaluation of diseases of the peripheral nerves and sensory pathways.
Mary Pauline Galea is an Australian physiotherapist and neuroscientist at University of Melbourne. She resides in Melbourne, Australia. Galea is a professorial fellow at the University of Melbourne's Department of Medicine at the Royal Melbourne Hospital and a Senior Principal Fellow in the Florey Institute of Neurosciences and Mental Health. She was foundation professor of clinical physiotherapy and director of the Rehabilitation Sciences Research Centre at the University of Melbourne and Austin Health. She is internationally recognised for her work in spinal cord injury and rehabilitative interventions.
Berta Bobath, MBE was a German physiotherapist who created a method of rehabilitation and therapy known as the Bobath concept in 1948. The Chartered Society of Physiotherapy believe "it is the most popular approach for treating neurologically-impaired patients in the western world."
Roberta Barkworth Shepherd is an Australian physiotherapist. She is known for her work on physiotherapy education and research.
Charlotte Jane Sumner is an American neurologist. She is a professor in the Departments of Neurology and Neuroscience at Johns Hopkins School of Medicine. Dr. Sumner cares for patients with genetically mediated neuromuscular diseases and directs a laboratory focused on developing treatments for these diseases. She co-directs the Johns Hopkins Muscular Dystrophy Association Care Center, the Spinal Muscular Atrophy (SMA), and the Charcot-Marie-Tooth (CMT) clinics, which deliver multidisciplinary clinical care, engage in international natural history studies, and provide cutting edge therapeutics.
Monique Marie Ryan is an Australian paediatric neurologist and politician. She is currently the member of parliament for the federal seat of Kooyong after defeating Josh Frydenberg at the 2022 Australian federal election.
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