Who Should Attend?Ms Cusick is committed to the idea of fostering the collaborative and educated team management of complex neuromotor problems. Therefore, this course is open to a range of clinicians who are likely to work together as a rehabilitation team — if you are a...
...you will find this course valuable to your practice. * Physical Therapy Assistants may attend as part of a team that includes a qualified Physical Therapist. Orthopedic Technicians are welcome if accompanied by a CO, CPO, or PT from the same facility. |
Course Description
This intermediate-level course has received enthusiastic and lasting acclaim from participating clinicians for high academic standards, the clinical relevance of the content, and the energizing and practical new and effective management ideas. With an emphasis on the foot and ankle – the body-ground interface - Ms. Cusick briefly reviews numerous anatomical, physiologic, and functional factors that commonly operate in individuals with movement disorders related to central nervous system dysfunction.
She organizes this complex body of information into key components of evaluation and management, as she reviews several new concepts that have emerged from research in the fields of kinetics, biomechanics, muscle physiology, pathokinesiology, neuromotor development, and rehabilitation. The latter field of discussion features several new tools and strategies, including TheraTogs™, the R-Wrap© Orthosis, the ProGlide® Q-Ankle, the Flexcast© Preparatory AFO, partial unweighting, strengthening, the range maintenance AFO, orthotic posting principles and orthotic selection, targeting, and patella alta taping.
The program ends with a videotaped case presentation featuring a person with neuromotor dysfunction, to demonstrate a musculoskeletal assessment and the organization of this data compiled with observational gait analysis into a management program, followed by a lab session on TheraTogs strapping techniques and patella alta taping.
Participants receive a comprehensive set of handouts with current references (leave space in your luggage for this), a copy of the Ms. Cusick’s 2-hour instructional videotape entitled Legs & Feet: a Review of Musculoskeletal Assessments (1999), and a set of 4 musculoskeletal assessment tools.
Course Objectives
Participants completing this course will be able to:
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Identify 8 immature, normal, developmental features of spinal and lower extremity skeletal structure and joint alignment, and discuss related assessment procedures, management implications, and management precautions.
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Define torsion, version, antetorsion, anteversion, retroversion, varus, valgus, abductus, adductus, inversion, eversion, pronation, supination, equinus, and calcaneus.
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Discuss the clinical and functional relevance of the passive and active length-tension relationships, particularly R1 (a.k.a. L1 and L0 and "first catch") end range.
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Distinguish between spasticity, tone, and extensibility, and apply the definitions to management modalities such as dorsal rhizotomy, cryotherapy, neurolytics, stretching, positioning, serial casting, and maintenance orthoses.
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Describe the pathophysiologic influence of excessive muscle recruitment on muscle, connective tissue, nerve, blood vessels, and skin.
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Discuss the relationship between muscle transformation, strength, and EMG activity.
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Distinguish between kinetics and kinematics with regard to gait analysis.
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Relate gait pathomechanics to the issue of kinetics, and to potential kinetic influences of orthoses of different configuration.
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Discuss conservative hypoextensibility management methods and principles, including serial casting, neurolytic agents, R-Wrap® orthoses, maintenance AFOs, weight bearing stretches, and stretch-splinting.
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Explain targeting as a therapeutic management principle, relative to orthotic, splinting and casting interventions.
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Explain the concept of relative flexibility and apply it to TheraTogs interventions.
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Distinguish between muscle dominance and strength and discuss strapping and taping implications.
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Regarding patella alta taping and TheraTogs, discuss contraindications and precautions relative to skin care and underlying skeletal characteristics.
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Use an organizational tool to sort the findings of a videotaped musculoskeletal, postural, and clinical gait assessment into descriptive categories with related intervention or management options.
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Achieve novice skill level in the donning and use of the TheraTogs™ orthotic strapping system.
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Achieve novice skill level in patella alta taping.
Anticipated Course Schedule
Day 1 |
|
| 8:00 | Coffee and Registration |
| 8:30 | Welcome, and introductory remarks |
Developmental Lower Extremity Features |
|
| 8:45 | Skeletal Modeling Mechanisms |
| 9:15 | Review of major developmental changes at the femur, hip, and knee joints. |
| 10:30 | Break |
| 10:50 | Review of major developmental changes at the leg and ankle |
| 12:00 | Lunch and Library Time |
Requirements for Balanced Muscle Function |
|
| 1:00 | Applying Physiology and Muscle Balance Theory to Musculoskeletal Assessment. |
| 2:00 | Spasticity vs. Tone, and Pathophysiology of Muscle Transformation |
| 2:30 | Break |
Obtaining Musculoskeletal Findings |
|
| 3:00 | Overview of Selected Assessments in the Sagittal Plane: Torso, Hip, Hamstrings Length, Standing Knee Angle, And Patella Position: Norms And Clinical Relevance Of Findings. |
| 4:00 | Assessments in the Frontal Plane: Pelvis, Leg Lengths, Hips, and Knees |
| 5:00 | Discussion/Questions |
| 5:15 | Independent Study Time - Reference Library and Videotaped Cases, available as long as facility remains open. |
Day 2 |
|
| 7:30 | Coffee and Library Time |
Foot Function/ Assessment/ Pathomechanics |
|
| 8:00 | LE Assessments Review, continued: Genu varum/valgum, thigh/foot angle, axial leg rotation, and leg lengths. |
| 9:40 | Break |
| 10:00 | Review of Foot Joint Motions in the Open and Closed Kinetic/Kinematic Chains |
| 12:00 | Lunch and Library Time |
| 1:00 | Review of Assessments of the Ankle and Foot with Known Norms and Clinical Implications |
| 2:30 | Break |
| 3:00 | Foot Pathomechanics and Posting Principles - Implications for Orthotic Modifications and Below-Knee Serial Casting Interventions |
| 5:00 | Discussion/Questions |
| 5:15 -- | Independent Study Time - Reference Library and Videotaped Cases, available as long as facility remains open. |
Day 3 |
|
| 7:30 | Coffee and Library Time |
| 8:00 | Name That Foot Deformity! Common Deformities in Children with CNS Dysfunction |
Hypoextensibility and Spasticity Management |
|
| 8:45 | Physiologic Rationale for Various Nonsurgical Interventions, Including: Neurolytics, Positioning, R-Wrap© Orthosis, Serial Casting, Flexcast Preparatory AFO©, and Maintenance |
| 9:45 | Break |
Selecting Orthoses and Rehabilitation Strategies from a Kinetics Point of Vie |
|
| 10:00 | Development of Walking: CNS Maturation - Influence on Gait Pattern and Goal-Setting |
| 11:30 | Review of Gait Features Relative to Kinetics |
| 12:00 | Lunch and Library Time – Normal Gait Video (30 minutes) - optional |
Selecting Orthoses and Rehabilitation Strategies from a Kinetics Point of View |
|
| 1:00 | Considering the Energy Sources, and Energy Cost, of Each of the Phases of Gait, Relative to Using New Interventions. |
| 2:30 | Break |
| 3:00 | Resume Orthotic Options Review |
| 4:15 | TheraTogs Donning and Strapping Demo (with volunteer from class) |
| 5:15 | Discussion / Questions |
| Tomorrow, participants bring or wear shorts (preferably biking shorts) and please do not use skin lotion on your legs | |
| 5:30 | Independent Study - Reference Library and Videotaped Cases, available as long as facility remains open. |
Day 4 |
|
| 7:30 | Coffee and library time |
Putting It All Together |
|
| 8:00 | Bringing Clinical Observations, Principles of Kinetics, Biomechanics, Muscle Balance Theory, and New Rehabilitation Strategies to the Management Plan. (Case Presentations 1 & 2) |
| 10:15 | Short break – change for lab if necessary |
| 10:30 | Bringing Clinical Observations, Principles of Kinetics, Biomechanics, Muscle Balance Theory, and New Rehabilitation Strategies to the Management Plan. (Case Presentations 3 & 4) |
| 11:45 | Patella Alta taping technique review |
| 12:00 | Lunch and Library Time – optional Normal Gait Video (30 minutes @ 12:30) |
| 1:00 | Introductory Practicum Lab: Patella alta taping and TheraTogs donning & strapping techniques |
| 3:30 | Complete the Course Evaluation |
| 4:00 | Final Q&A |
| 5:00 | Adjourn |
Restrictions
Capacity of this workshop is limited. Completed and paid registrations will be processed on a first-come, first served basis. The lab on the last day is limited to 40 therapists. First 40 therapists can participate in the lab, the rest can observe.
Video Recording policy: Videotaping of this program is prohibited. Audiotaping for personal review is permitted with permission from the Instructor.
