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.
Enrollment in the seminar sessions is not limited, but participation
in lab sessions is limited to 24 attendees.
This course features supervised labs on LE musculoskeletal assessments, taping techniques, and TheraTogs application. Completion qualifies participants for enrollment in a Part II: Serial Casting and Splinting course, at a later date.
This program offers experienced clinicians a range of alternatives to the standard approaches to management of lower extremity deformity as it occurs in children with developmental disabilities. The level is intermediate to advanced. The content can be challenging to any practitioner who does not ordinarily think in biomechanical terms. Prerequisite readings are assigned, and at the discretion of the sponsor, participants receive a comprehensive and current collection of hand-outs with extensive, topic-specific reference lists, and a set of 3 new assessment tools and, at the discretion of the sponsor, an instructional videotape reviewing 30 musculoskeletal assessment procedures.
The seminar component features a thorough review of the plane-based terminology used to accurately and clearly identify components of alignment, function and deformity, particularly pertaining to the foot. Ms. Cusick also reviews developmental features of lower extremity skeletal design and alignment, the biomechanics of the closed kinetic chain, and new findings in muscle physiology and the kinetics of gait, all of which are applied to clinical management strategies for children and adults with CNS dysfunction.
These principles are then used in lab sessions to gain skills in musculoskeletal assessments required to collect an objective data base for comparison - to establish an awareness of selected movement strategies and of the efficacy of interventions - and, by systematically reviewing the findings, to generate an educated plan of intervention with the aid of orthoses and/or splints, progressive casting with or without neurolytic agents, and/or rigid or kinetic taping for neuromuscular re-education. Taping and strapping techniques comprise an introductory lab session.
Following a presentation of a wide variety of orthotic designs and principles and taping techniques, videotaped case studies are used to model a components-based clinical problem-solving process used to design and prioritize intervention strategies. Independent study time is offered for further review.
This course is open to physical and occupational therapists, pediatric orthopedists, rehabilitation physicians, orthopedic and rehabilitation medicine residents or interns, orthotists, physical therapy assistants accompanied by a supervising physical therapist, orthopedic technicians accompanied by a team physical therapist, and podiatrists. Teams of clinicians are strongly encouraged to attend together.
This course also serves as an advanced course for those clinicians who attended a comparable program more than 5 years ago, and fulfills the prerequisite for attending a Cusick-taught splinting and serial casting practicum course within 5 years.
Upon completion of both the lecture and workshop components of this course, participants will be able to:
Recognize the modeling influences of certain movement components and gait patterns, both normal and compensatory, on bone structure and joint alignment in the lower extremities.
Define torsion, antetorsion, version, anteversion, calcaneal torsion, planar dominance, varus, valgus, and plane-referenced alignment and movement features.
Use specific musculoskeletal assessment techniques to identify features of alignment and structure in the lower extremity, and discern proximity to known age-related norms.
Discuss the lower-extremity closed-chain relative to orthotic and taping interventions.
Accurately identify a variety of foot deformities common to children and adults with CNS dysfunction, according to their specific joint deviations and plane-based descriptors.
Explain the transformation of muscle and connective tissues due to persistent chronic rectuitment.
Discuss muscle length and related capacity for contractile force generation.
Explain the principles of relative flexibility and the length-tension relationship as they apply to muscle function and to taping for neuromuscular re-education in the population.
Explain the principles and precautions pertaining to the use of taping techniques for this population.
Explain the physiologic rationale for using serial casting and other nonsurgical methods of gaining soft tissue extensibility. Apply principles of kinetics in gait to orthotic prescription and the selection of new rehabilitation strategies.
Discuss the goals of orthotic intervention, using Perry's five criteria for efficient gait.
Discuss the purposes, advantages and disadvantages of using splints as a management intervention for children. Distinguish between splints and orthoses and explain.
Discuss the advantages and disadvantages of various designs of LE splints and orthoses, including the R-Wrap, and explain the limitations of existing orthotic efficacy research.
Explain the principle of posting, and give examples in plane-based context as they apply to casting and to orthotic design, and to the closed kinetic chain.
Achieve novice skill level in using tape to reduce patella alta.
Achieve novice skill level in using TheraTogs™ to enhance movement training and posture.
Bring knowledge of developmental orthopedics, muscle transformation, and the closed kinetic chain to the assessment of at least one child or adult with neuromotor deficit, and suggest logical taping, orthotic hypoextensibility management and therapeutic exercise interventions.
Anticipated Course Schedule
Day 1: Seminar and Lab
8:30 Registration and Pretest 9:00 Introduction
(Note: On Days 5, 6, and 7, we’ll start at 8:30AM. Please mark your calendars.)
9:15 Developmental Orthopedics – Lower-Extremity Skeletal Modeling Mechanisms 10:00 Break and Library Time 10:30 Resume Developmental Orthopedics – Review of Normal Changes in Bone and Joint Structure and Alignment – Spine, pelvis, hips, femurs 12:00 Lunch and Library Time 1:00 Resume Developmental Orthopedics – knees, legs, ankle joints, and feet. 2:30 Break and Library Time 3:00 Review of Muscle Balance Theory – Application to the Rehabilitation of Children with CNS Dysfunction 4:45 Questions/Discussion 5:00 Adjourn Independent study: Library remains available tonight in accordance with sponsor’s rules.
Day 2: Seminar and Lab
(Bring shorts for lab in case any kids have to cancel. )
8:00 Library open, and selected videotapes are available for review - Coffee and tea available 9:00
Review of Musculoskeletal Assessments in the Sagittal Plane: Trunk, Pelvis, Hip, Knee, Patella
10:30 Break and library time 11:00 Resume Assessments Review 12:00 Lunch 1:00 Review of Musculoskeletal Assessments in the Frontal Plane: Trunk, Hip, Knee 2:00 Change into shorts and prep (clean, shave) skin around the knees for lab. 2:15 LAB: Introduction to Patella Alta Taping - Assessment and Techniques 3:30 Pre-Lab Demonstration: Using New Tools / Assign Children, Groups 3:45 LAB: Assessment Procedures in Sagittal and Frontal Planes – Nondisabled children volunteer 5:45 Clean up, Restore Seminar Layout. 6:00 Adjourn Independent study: Library remains available tonight in accordance with sponsor’s rules.
Day 3: Seminar and Lab
Bring shorts and a pillow today. (No formal breaks during this lab.)
8:00 Library open, and selected videotapes are available for review 9:00 Review Assessment Procedures in the Transverse Plane: Pelvis, Hip, Femur, Knee, Leg 10:30 Break 11:00 Resume Assessments Review 12:00 Lunch 1:00 Clinical Application of Musculoskeletal Findings: TheraTogs Donning and Strapping Demonstration 2:00 Try-on TheraTogs LAB 3:30 Pre-Lab Demonstration of the First 2 Assessment Procedures 3:45 LAB: Assessment Procedures in the Frontal and Transverse planes 5:45 Clean Up / Restore Seminar Layout 6:00 Adjourn Independent study: Library remains available tonight in accordance with sponsor’s rules.
Day 4: Independent Study
Attendance is optional. This time is dedicated to those who need time to absorb, digest, read on, watch videotaped cases, find resources. Classroom is open from 8:30-whatever time in the evening that’s permitted. Instructor is on duty from 10:30-3:30 PM to review assessment procedures, discuss and explain concepts, help with finding pertinent references and with selecting and discussing videotaped case studies from Instructor's library, and counsel those who want to play with TheraTogs.
Day 5: Seminar and Lab
Bring shorts and pillow today
8:00 Library is open / videotaped cases and info are available 8:30 Structural Anatomy of the Ankle and Foot;
Biomechanics of the Lower Extremity in the Closed Chain
10:00 Break 10:30 Resume Foot and Ankle Biomechanics Review 12:00 Lunch. Please ask coordinator if you may stay after hours to use the library. 1:00 Open-Chain Assessment Procedures for Foot and Ankle 2:30 Break and library time 3:00 LAB: Open-Chain Assessments of the Foot 5:00 Adjourn Independent study: Library remains available tonight in accordance with sponsor’s rules.
Day 6: Seminar and Lab
Bring shorts and pillow today
8:00 Library is open / videotaped cases and info are available, please change into lab clothes. 8:30 Resume Open-Chain Assessments Lab – The Ankle 9:15 Review of Closed-Chain Assessments Of The Leg And Foot 9:30 LAB: Closed-Chain Assessments (no formal breaks during this lab) 11:00 Foot Function In Gait - Ideal Kinematics, Kinetics, and Biomechanics 12:00 Lunch and library time 1:00 Closed-Chain Compensations For Structural Foot Deformities / Orthotic Posting Principles 2:30 Break 2:45 Selecting Kinetics-Related Orthotic Designs 4:00 Break 4:15 Resume Orthotic Designs review 5:00 Adjourn Independent study - LAST DAY: Library remains available tonight in accordance with sponsor’s rules.
Day 7: Seminar and Case Presentation
8:00 Library is open / videotaped cases and info are available, please change into lab clothes. 8:30 Name That Foot Deformity! 10:00 Break 10:30 Review Muscle Physiology and Pathophysiology in the Presence of Chronic Recruitment. 11:00 Hypoextensibility Management: A Review of Principles and Options 12:00 Lunch and library time 1:00 Serial Casting Principles and Options 2:15 Short break 2:30 Resume lecture 3:15 Break and set up for lab 3:45 LAB: Full LE Assessment on Nondisabled Children 5:45 Restore the room for tomorrow’s case presentation. 6:00 Adjourn
Day 8: Seminar and Case Presentation
8:30 Coffee and tea – Hear details regarding the child to be assessed. 9:00 Case Presentation – Participatory Assessment Lab with the Help of an Individual with CNS Dysfunction
No formal break during this 2-hour assessment.
11:00 Break 11:15 Review Findings And Make Management Recommendations 12:30 Turn in course evaluations and adjourn.
Capacity: Enrollment in the seminar sessions is not limited, but participation
in assessment & taping labs is limited to 24 attendees.
Video Recording policy: Videotaping of this program is prohibited. Audiotaping for personal review is permitted with permission from the Instructor.