Eli Carmeli

University of Haifa, H̱efa, Haifa, Israel

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Publications (117)204.5 Total impact

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    ABSTRACT: Blood pressure (BP) variability (BPV) contributes to target organ damage independent of BP. The authors examined the effect of a 1-year multidisciplinary intervention on BPV in patients with the metabolic syndrome (MetS) as defined by criteria from the Third Report of the Adult Treatment Panel. Forty-four nondiabetic patients underwent clinical and biochemical profiling, 24-hour ambulatory BP monitoring (ABPM), body composition, carotid intima-media thickness, and carotid-femoral pulse wave velocity (PWV). The intervention targeted all MetS components. BPV was assessed by the standard deviation of daytime systolic BP derived from ABPM. Patients with low and high BPV (lower or higher than the median daytime standard deviation of 11.6 mm Hg) did not differ in regards to systolic and diastolic BP, age, fasting glucose, glycated hemoglobin, and body mass index, but the high-variability group had higher values of low-density lipoprotein and leg fat. The 1-year intervention resulted in weight reduction but not BP-lowering. BPV declined in the high-variability group in association with lowering of PWV, C-reactive protein, glycated hemoglobin, alanine aminotransferase, asymmetric dimethylarginine, and increased high-density lipoprotein cholesterol. A multidisciplinary intervention independent of BP-lowering normalized BPV, lowered PWV, and enhanced metabolic control. J Clin Hypertens (Greenwich). 2015:1–6.
    Journal of clinical hypertension 09/2015; DOI:10.1111/jch.12685 · 2.96 Impact Factor
  • Eli Carmeli · Dror Aizenbud · Oren Rom
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    ABSTRACT: Clarifying the confusion regarding the term "muscle death" is of great importance, especially for clinicians. In response to various stimuli, skeletal muscle may undergo pathological changes, leading to muscle atrophy and consequently resulting in the loss of muscle strength and function. Depending on the stimulus, skeletal muscles can be induced to die through different mechanisms mainly via apoptosis, autophagy and necrosis. Muscle death may occur secondary to various physiological and pathological conditions such as aging, starvation, immobilization, denervation, inflammation, muscle diseases and cancer. This overview aims to elucidate the medical terminology and pathways used to describe muscle death, which are commonly confused. In addition, some of the common pathological conditions that lead to muscle death such as cachexia and sarcopenia of aging are dwelled on.
    Advances in Experimental Medicine and Biology 05/2015; 861. DOI:10.1007/5584_2015_140 · 1.96 Impact Factor
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    ABSTRACT: Objective: Dynamic visual inputs can cause visual vertigo (VV) in patients with vestibulopathy, leading to dizziness and falls. This study investigated the influence of VV on oculomotor responses. Methods: In this cross-sectional, single-blind study, with experimental and control groups, 8 individuals with vestibulopathy and VV, 10 with vestibulopathy and no VV, and 10 healthy controls participated. Oculomotor responses were examined with 2-dimensional video-oculography. Participants were exposed to dynamic visual inputs of vertical stripes sweeping across a screen at 20 deg/sec, while seated or in Romberg stance, with and without a fixed target. Responses were quantified by optokinetic nystagmus frequency (OKNf) and gain (OKNg). Results: Seated with no target, VV participants had higher OKNf than controls (37 ± 9 vs. 24 ± 9 peaks/sec; P < 0.05). In Romberg stance with no target, they had higher OKNf than controls (41 ± 9 vs. 28 ± 10 peaks/sec; P < 0.05). With a target, OKNf was higher in VV participants compared to controls (7 ± 7 vs. 1 μ 2 peaks/sec; P < 0.05). In Romberg with no target, OKNg was higher in the VV group (0.8 ± 0.1) compared to controls (0.6 ± 0.2; P=0.024). OKNf and OKNg did not differ according to VV status. Conclusions: VV participants had increased OKNf and OKNg compared to healthy participants. Visual dependency should be considered in vestibular rehabilitation.
    Journal of Vestibular Research 08/2014; 24(4):305-11. DOI:10.3233/VES-140519 · 1.19 Impact Factor
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    Eli Carmeli
    Frontiers in Public Health 07/2014; 2:91. DOI:10.3389/fpubh.2014.00091
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    ABSTRACT: Objectives: To summarize the current knowledge relating to diagnosing and treating Scheuermann's disease. Scheuermann's disease is the most common cause of structural kyphosis in adolescence. Methods: A literature-based narrative review of English language medical literature. Results and conclusions: Recent studies have revealed a major genetic contribution (a dominant autosomal inheritance pattern with high penetrance and variable expressivity) to the etiology of Scheuermann kyphosis with a smaller environmental component (most probably mechanical factors). The natural history of Scheuermann kyphosis remains controversial, with conflicting reports as to the severity of pain and physical disability. Since we cannot predict which kyphotic curves will progress, we are unable to determine effectiveness of brace treatment. Physical therapy is scarcely mentioned in the literature as an effective treatment for Scheuermann kyphosis. Although there is little evidence that physical therapy alone can alter the natural history of Scheuermann's disease, it is often used as the first choice of treatment. Brace treatment appears to be more effective if an early diagnosis is made, prior to the curvature angle exceeding 50° in patients continuing to grow. Surgical treatment is rarely indicated for severe kyphosis (>75°) with curve progression, refractory pain, or a neurologic deficit. Rigorous methodology clinical trials are essential to evaluate the efficacy of conservative interventions, especially different exercises and manual therapies and their combinations with braces.
    Journal of Back and Musculoskeletal Rehabilitation 06/2014; 27 (2014)(4):383–390. DOI:10.3233/BMR-140483 · 0.71 Impact Factor
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    ABSTRACT: Aims: To describe the difference in functional reach test (FRT) distance and velocity during “self-selected” and “as-fast-as-possible” reach velocities, and to describe the age-related differences associated distance and velocity in the two tests. Methods: A cross-sectional study included 73 healthy volunteers, 20–95 years of age. Reach ability while standing was measured during three trials performed at a “comfortable speed”, and three performed as fast as possible. A web camera was used to record the tests at a frequency of 15 Hz. Major findings: The forward reach was by mean longer in 1.2 cm (± 4.9 cm) (F1;70 = 4.9, p = 0.03) in the self-selected speed condition. In addition, values were significantly higher among the younger group; during the self-selected speed by 5.8 ± 2.1 cm and by 7.2 ± 2.1 cm during the as-fast-as-possible condition (F1;70 = 11.6, p < 0.001), the backward movement in the self-selected speed was smaller by 1.2 cm (± 4.9 cm) (F1;70 = 6.3, p = 0.01),The mean reach backward in both condition was significantly different between age groups (F1;70 = 15.3, p < 0.001), values were significantly higher among the older participants. In addition, a significant interaction effect was noted (F1;70 = 3.8, p = 0.05); combination of older age and as-fast-as-possible condition was associated with increased backward movement. Principal conclusion: By using simple technology and a new measure of balance assessment that measure the quality of functional reach, therapists may discover new information regarding balance performance and falls.
    05/2014; 16(3). DOI:10.3109/21679169.2014.911957
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    Eli Carmeli · Bita Imam
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    ABSTRACT: The rapid growth in the number of individuals living with intellectual and developmental disabilities (IDD) along with their increased longevity present challenges to those concerned about health and well-being of this unique population. While much is known about health promotion and disease prevention in the general geriatric population, far less is known about those in older adults with IDD. Effective and efficient health promotion and disease prevention strategies need to be developed and implemented for improving the health and quality of life of older adults living with IDD. This is considered to be challenging given the continued shrinkage in the overall health care and welfare system services due to the cut in the governmental budget in some of the western countries. The ideal health promotion and disease prevention strategies for older adults with IDD should be tailored to the individuals' health risks, address primary and secondary disease prevention, and prevent avoidable impairments that cause premature institutionalization. Domains of intervention should include cognitive, mental and physical health, accommodations, workplace considerations, assistive technology, recreational activities, and nutrition.
    Frontiers in Public Health 04/2014; 2:31. DOI:10.3389/fpubh.2014.00031
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    ABSTRACT: This study examined reliability and validity of the Zuk Assessment for diagnosis of motor problems and determined standardized scores in an Israeli population aged 5 to 6 years. For standardization, 156 children recruited from 13 Kindergartens of typically developing children were evaluated with the Zuk Assessment. Intrarater and interrater reliability were examined on 2 samples of 15 and 13 children, respectively. A total of 151 children referred for motor problems were examined with the Zuk and Movement Assessment Battery for Children assessment tools for validation of the Zuk Assessment. Findings showed that the Zuk total score had a normal distribution similar to that found in the literature identifying 5.1% (-2 standard deviations) and 12% (between -1 and -2 standard deviations) of children with motor-related problems. Reliability was indicated by high intraclass correlation scores both in intrarater (intraclass correlation = .89) and interrater (intraclass correlation = .95) paradigms. The Zuk assessment identified differences in subgroups, namely, typical, suspicious, and impaired, as found in the Movement Assessment Battery for Children, confirming the Zuk validity.
    Journal of child neurology 01/2014; 29(5). DOI:10.1177/0883073813513836 · 1.72 Impact Factor
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    ABSTRACT: The aim of this study was to evaluate the effect of an intensive physical therapy protocol in patients who contract 'Intensive Care Unit Acquired Weakness' (ICUAW), in terms of muscle strength, breathing and functional indices. This was a prospective, single blinded study, in a general hospital intensive care unit. Patients who required mechanical ventilation longer than 48 hours and who were expected to remain mechanically ventilated for at least another 48 hours were randomly divided into two intervention groups: Group I (n=9) - the Routine care group, received physical therapy according to our daily custom protocol. Group II (n=9) - the Intensive treatment group, were treated by the same protocol twice a day. The main outcome measures included the Medical Research Council physical strength examination (MRC); Maximal inspiratory pressure (MIP); Hand grip dynamometer and Sitting balance test. Significant strength improvement from first (T1) to second (T2) measurements was demonstrated for variables MIP and MRC in favor of the intensive treatment group (p<0.05). The intensive treatment group also required shorter intensive care length of stay (LOS) than the routine care group (p=0.043). It is possible that an intensive therapy protocol may facilitate the initial recovery process in patients who suffer from intensive care unit acquired weakness.
    The Clinical Respiratory Journal 12/2013; 9(1). DOI:10.1111/crj.12091 · 1.51 Impact Factor
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    ABSTRACT: Background: There is growing evidence that increased blood pressure (BP) variability contributes to target organ damage, independent of BP levels. Advanced age, diabetes and female gender are associated with increased variability but the exact pathophysiological mechanisms underlying abnormal variability are still debated. Aims: to study the correlation between variability in ambulatory blood pressure monitoring (ABPM) metabolic parameters and end target organ damage in subjects afflicted with the metabolic syndrome patients. Methods: Eighty two (39 women, 43 men, mean age of 51) non-diabetic subjects who fulfilled the ATPIII criteria for the metabolic syndrome participated in the present study. Baseline assessment included clinical and biochemical profiling, 24 ambulatory blood pressure monitoring (ABPM; Spacelab90020), subcutaneous periumbilical fat biopsy, region-defined body composition with DEXA and carotid intima-media thickness. The intervention targeted all assessed risk factors and was implemented through frequent interactions with a multidisciplinary team including an endocrinologist and dietician with personalized physical training. If needed, patients were medicated to control hypertension and dyslipidemia. BP variability was assessed by the standard deviation (STD) of daytime systolic BP derived from the ABPM records. Results: Median daytime standard deviation of systolic blood pressure was 11.3mmHg. Subdivided by this median variability level, two population of subjects with the metabolic syndrome were formed, people whose STD was less than 11mmHg (low variability; LV) and those with STD that exceeded 11mmHg (high variability; HV). Of critical importance is the fact that the two groups did not differ in terms of (LV, HV respectively): systolic (121.5, 125.2mmHg) and diastolic (74.3, 76.6 mmHg) pressure by ABPM, age (53, 50y), fasting glucose (96.7, 99.8), HBAIC (5.7, 5.8%) and BMI (34, 33.7kg/m2). However, despite these similarities the HV group had higher CRP (4.79 vs. 1.51 mg%; p=0.05), SGPT (36.9 vs28.9; p<0.05), LDLc (122.9 vs 103.6mg%; p<0.05) and carotid intima media thickness (794.7µm vs. 730.3 µm; p=0.03). Additionally, despite similar BMI, the HV group had higher fatness as seen in the total body fat fraction (41.7%, 38%, p=0.05), legs (36% vs. 29.9%; p=0.04) and genycoid (41.4 vs. 36.5%; p= 0.06). Following 1 year of intervention, which resulted by in weight reduction in both group, but no blood pressure lowering , a reduction BP variability as assessed by daytime standard deviation was seen only with the HV group (12.94 vs 11.3, p=0.01), but not in the LV group. Conclusion: In subjects with the metabolic syndrome, higher BP variability is linked to increased CRP, LDL cholesterol, SGOT (likely indicative of higher degree of fatty liver), intima-media thickness and increased body fatness despite indistinguishable BMI. Increased blood pressure variability in the metabolic syndrome can be normalized through a multidisciplinary intervention and co-targeting of multiple risk factors, independent of blood pressure
    The Annual Conf. of the Israel Soc. of Hypertension; 12/2013
  • Eli Carmeli · Bita Imam · Ran Levi · Joav Merrick
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    ABSTRACT: The authors undertook a study to determine whether hand grip strength is associated with body sway rate among older adults with intellectual disability. They employed cross-sectional data from a nonrandomized controlled trial. Subjects were 16 older adults (8 females and 8 males; mean age 51.3 year) with mild-to-moderate intellectual disability residing in a supported living facility in Israel. Voluntary hand grip strength was measured isometrically using Jamar® hydraulic dynamometer, and body sway was assessed by Posture Scale Analyzer. Multivariate adjusted logistic regression model was used. Findings showed that hand grip strength in both arm flexed and extended was associated with body sway (−.608 to −.879), particularly among males. In females, the association was found only in eyes open condition, whereas in males it was found with both eyes closed and open. The authors concluded that hand grip strength was found to be negatively correlated with body sway rate and that low grip strength was associated with greater body sway. Low grip strength may be a rehabilitative impairment worthy of further investigation as a modifiable factor linked to sway rate among older adults with intellectual and developmental disability.
    Journal of Policy and Practice in Intellectual Disabilities 12/2013; 10(4). DOI:10.1111/jppi.12055 · 0.97 Impact Factor
  • Oz Zur · Ayelet Ronen · Itshak Melzer · Eli Carmeli
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    ABSTRACT: The vestibulo-ocular response (VOR) may not be fully developed in children with an intellectual and developmental disability (IDD). This study aimed to identify the presence of VOR deficit in children and young adults with unspecified mild-to-moderate intellectual and developmental disability and its effect on balance control. Twenty-one children and young adults with IDD ranging in age from 8 to 22 years (mean 17.5±3.9 years) were included in the study. The VOR was evaluated with the Head Impulse Test and the Static and Dynamic Visual Acuity Test (S&D-VAT). Postural stability was measured in an upright standing position by the Clinical Test for Sensory Interaction in Balance (CTSIB), single leg stance (SLS) during eyes open and eyes closed, and Romberg stance under eyes open and eyes closed conditions using a force platform. Reduced vestibulo-ocular responses were found in 13 of 21 (62%) participants who were able to complete testing. In the fifth condition of the CTSIB (standing on foam with eyes closed), those without VOR deficit were able to maintain balance longer than those with VOR deficit (29s [median 30] vs. 12s [median 7.3], respectively; p=0.03). The study demonstrates potential effects of VOR deficit in children and young adults with IDD and some significant differences in balance control between those with and without a VOR deficit. VOR function in children and young adults with IDD should be routinely tested to enable early detection of deficits.
    Research in developmental disabilities 04/2013; 34(6):1951-1957. DOI:10.1016/j.ridd.2013.03.007 · 4.41 Impact Factor
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    ABSTRACT: Background: Obesity, particularly abdominal obesity, is associated with insulin resistance leading to type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). Co-occurrence of metabolic risk factors for T2DM and CVD suggested the existence of a "metabolic syndrome" (MetS). The prevalence of MetS increases with age. Older age and obesity are two of the most powerful risk factors for uncontrolled hypertension, a major determinant of stroke and mortality, particularly in older age. Attempted weight loss is associated with lower all-cause mortality, regardless of age. Aims: To compare the effects of 1year intensive nutritional control and tailored exercise program in younger and older MetS patients. Methodology: Presented preliminary results are based on 31 patients that completed 1 year of intervention involving frequent interaction with a multidisciplinary team comprised of physicians, dietician and a physiologist. The range of patient ages was 21-74 with a median age of 55. Nine men were above and 9 below the median age; five women were above and 8 bellow median age. If needed, patients were medicated to control hypertension, dyslipidemia. In addition patients were offered weekly personalized dietary and physical exercise guidance. Upon recruitment and a year after body composition and body weight were measured. Results: Gender: In women baseline weight, total lean mass and total gynecoid and android fat mass, positively correlated with weight loss regardless of age (r=0.8, 0.56, 0.62 and 0.72, respectively; p<0.05). In contrast, in men there was a negative correlation between baseline weight, BMI, android fat and total lean tissue to weight loss, after 1 year of intervention (r= -0.57, -0.56 and -0.56, respectively; p<0.05). Gender and Age: Baseline lean mass was positively related to weight loss in younger women (r= 0.72, p<0.05) but correlated negatively with weight loss in men (r= -0.71, p<0.05). In older men gynecoid fat mass positively correlated with weight loss (r=0.83, p<0.05). Conclusions: In the context of MetS, women with higher baseline body mass (accounted for by higher lean and regional fat tissues) and older men, with feminine-like fat distribution, were the best weight losers
    The 42nd Israel Endocrine Society Annual Meeting; 04/2013
  • Oz Zur · Eli Carmeli
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    ABSTRACT: Dizziness is one of the most troublesome symptoms of vestibular disorders, although its description remains somewhat imprecise, encompassing vertigo, lightheadedness, disequilibrium and giddiness. Symptoms include sensitivity to motion stimuli and discomfort with open spaces, such as empty streets and bridges. It is accompanied by varying degrees of anxiety and phobic behaviors. Several tools have been developed in an attempt to quantify the degree of disability, self-perceived health status and quality of life in patients with dizziness. This review focuses on the University of California, Los Angeles Dizziness Questionnaire (UCLA-DQ), which is used to assess the effect of dizziness on quality of life. This paper also includes a summary of the advantages and disadvantages of the UCLA-DQ and compares it to other instruments used to assess dizziness. In spite of a few disadvantages, we believe that this multidimensional questionnaire is an appropriate tool for evaluating patients with vestibular impairment. It should be used during the acute phase of symptoms, as well as during and after rehabilitative therapy, to assess patient improvement.
    Journal of Vestibular Research 01/2013; 23(6):279-83. DOI:10.3233/VES-130480 · 1.19 Impact Factor
  • Mohammed Morad · Carmeli E · Merrick J
    International history of disability, Edited by Hanes R, 01/2013: chapter A short history of disability aspects from Israel.; University of Toronto.
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    ABSTRACT: Adults with Down syndrome (DS) are often physically inactive, which may accelerate the onset of disease and aging symptoms. Eight older persons with DS (aged 54-61), and 10 younger persons with DS (aged 26-35) living in a residential care center were examined. Eighteen age- and gender-matched individuals without DS served as control groups. Sensory-motor tasks and Posture Scale Analyzer (PSA) were used to examine coordination and standing stability. The isokinetic muscle strength test was used for muscle strength investigation. The functional performance, coordination, and leg muscle strength of the older adults with DS were more impaired than both the younger DS and the control groups. The older DS group showed lower sway rate and more symmetrical weight-bearing distribution during quiet standing than both the younger DS and the control groups. Our observations may have significant implications for understanding movement dysfunction in older adults with DS.
    Research in developmental disabilities 03/2012; 33(1):165-71. DOI:10.1016/j.ridd.2011.09.008 · 4.41 Impact Factor
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    ABSTRACT: The Offi ce of the Medical Director of the Ministry of Social Affairs in Israel is responsible for the medical service in residential care centers for persons with intellectual disability (ID). A standard annual questionnaire was developed during 1997-1998, and the fi rst national survey study was conducted in 1998. The present paper presents the fi ndings of the 2009 national survey, for which the following information was gathered via questionnaires: age, gender, and level of ID of persons served at the residential care center in question, status of the population served, functional profi le, nursing, medical, and allied professional staff, number of annual examinations, preventive medicine aspects, medications, number of annual cases of infectious disease, annual unintentional injuries, number of deaths, number of hospitalizations, internal residential center hospitalization, ambulatory out-patient use, use of outside laboratory examinations, and dental care. In 2009, 7067 persons were served in nine government, 41 private, and 13 public centers. The average number of persons served per center was 112.17 (range 21-324). The survey in 2009 showed that 78 % of the population with ID in residential care in Israel was between the ages of 20 and 60 years old, 45 % with severe or profound ID, 41 % with moderate, and 13 % with mild ID. In total, 25 % were nursing patients, 19 % were confi ned to a wheelchair, 33 % had epilepsy, 87 % were found to be receiving medication daily for chronic illness, and 54 % received psychotropic medication for psychiatric illness.
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    Research in Developmental Disabilities 03/2012; 33(2):781. DOI:10.1016/j.ridd.2011.12.003 · 3.40 Impact Factor
  • Eli Carmeli · Joav Merrick · Bita Imam · Ran Levy
    Health 01/2012; 04(09):769-774. DOI:10.4236/health.2012.429119 · 0.51 Impact Factor
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    ABSTRACT: This study assessed the potential therapeutic benefi t of using HandTutor™ in combination with traditional rehabilitation in a post-stroke sub-acute population. The study compares an experimental group receiving traditional therapy combined with HandTutorTM treatment, against a control group receiving only traditional therapy. An assessor-blinded, randomized controlled pilot trial, was conducted in the Reuth rehabilitation unit in Israel. Thirty-one stroke patients in the sub-acute phase, were randomly assigned to one of the two groups (experimental or control) in sets of three. The experimental group (n = 16) underwent a hand rehabilitation programme using the HandTutorTM combined with traditional therapy. The control group (n = 15) received only traditional therapy. The treatment schedules for both groups were of similar duration and frequency. Improvements were evaluated using three indicators: 1) The Brunnström-Fugl-Meyer (FM) test, 2) the Box and Blocks (B&B) test and 3) improvement parameters as determined by the HandTutorTM software. Following 15 consecutive treatment sessions, a signifi cant improvement was observed within the experimental group (95% confi dence intervals) compared with the control group: B&B p = 0.015; FM p = 0.041, HandTutor™ performance accuracy on x axis and performance accuracy on y axis p < 0.0003. The results from this pilot study support further investigation of the use of the HandTutorTM in combination with traditional occupational therapy and physiotherapy during post stroke hand function rehabilitation.
    Physiotherapy Research International 12/2011; 16(4):191-200. DOI:10.1002/pri.485

Publication Stats

2k Citations
204.50 Total Impact Points


  • 2013–2015
    • University of Haifa
      • • School of Physiotherapy
      • • Faculty of Social Welfare and Health Sciences
      H̱efa, Haifa, Israel
  • 2001–2014
    • Tel Aviv University
      • • Department of Physical Therapy
      • • Sackler Faculty of Medicine
      Tell Afif, Tel Aviv, Israel
  • 2004
    • National Institute of Child Health and Human Development
      Maryland, United States
  • 1994–1996
    • Technion - Israel Institute of Technology
      • Ruth and Bruce Rappaport Faculty of Medicine
      Haifa, Haifa District, Israel