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See also... TheraTogs, Inc | Updated: 04-Mar-2008
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Courses in LE Deformity Management for Children and Adults with CNS Dysfunction


Serial Casting the Foot & Ankle


4-Day Program
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...

  • Physical Therapist
  • Orthotist
  • Physical Medicine and Rehabilitation Physician
  • Orthopedist
  • PT Assistant*
  • Podiatrist
  • Occupational Therapist**
  • Orthopedic Technician*

...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.

**  Occupational Therapists are welcome if LE splinting or casting is included in their treatment responsibilities.

Enrollment is limited to 80 for Seminar portion of the course; Lab enrollment is limited.

Course Description

This course features a review of the development, biomechanics, and pathomechanics of the foot and ankle complex in the open and closed chain, with implications for designing casts and orthoses for optimum effectiveness. Musculoskeletal assessment procedures are reviewed in seminar and in supervised lab sessions, as the findings apply to documentation of casting results and to systematic clinical decision-making regarding foot and ankle alignment and posting in casts and orthoses.

Rationale for various hypoextensibility management strategies is supported by a discussion of current theories concerning muscle transformation secondary to chronic recruitment. Spasticity is distinguished from tone and from soft tissue pathophysiologic adaptation, with clinical implications. The Instructor discusses the relationship between contracture formation and habitual distribution of the body center of mass and the load-bearing foot in standing and gait, and reviews heel-wedging, the contoured plaster footboard, the R-Wrap© orthosis, positioning, stretching, and serial casting.

Gait kinetics principles are presented and applied to a review of orthotic posting options.

This course is designed for the practitioner who has experience in working with children with foot and ankle alignment problems associated with CNS dysfunction and ligament laxity. Physical therapists, orthotists, pediatric orthopedists, physicians in physical medicine and rehabilitation are welcome. Ms. Cusick believes that team education fosters more effective teamwork.

Participants in the seminar program receive a comprehensive set of handouts with current references, a copy of the Ms. Cusick's instructional videotape entitled Legs & Feet: A Review of Musculoskeletal Assessments (1997); and a monograph entitled Serial Casting to Restore Soft Tissue Extensibility in the Ankle and Foot (2007).

Participants in the lab sessions will receive a set of handouts, a set of 4 tools used in musculoskeletal assessments, a copy of the Ms. Cusick's illustrated manual entitled Serial Casts: Their Use in the Management of Spasticity-Induced Foot Deformity (1990); and an instructional videotape with accompanying manual entitled Cast Fabrication Techniques #1: The FlexCast© Preparatory AFO (2000).

Course Objectives

Participants completing this course are expected to be able to:

Lab Session participants:

Anticipated Course Schedule

Day 1: Seminar

 
8:15 Registration and settle in.
9:00 Review of Anatomy and Closed-Chain Function of the Subtalar and Midtarsal Joints Using Plane-Based Terminology
10:00 Break
10:30 Biomechanics of the Closed Kinetic Chain
12:00 Lunch and Library Time
1:00 Ideal Ankle, STJ and MTJ Function in Gait - Power Sources, Load Line Characteristics
1:30 Pathomechanics of Triceps Surae Hypoextensibility: Implications for Posting Casts and Orthoses
2:00 Short Break
2:15 Kinesiologic and Physiologic Requirements for Optimum Muscle Function / Pathophysiology: Muscle Transformation in the Presence of Chronic Recruitment
2:45 Muscle Balance Theory: Implications for Foot Deformity Management
3:30 Short Break
3:45 Hypoextensibility Management: Orthotic Interventions (Owen’s “Tuned” AFO/Footwear concepts; the R-Wrap AFO); Weight Line Training; Positioning
4:45 Questions and discussion
Post-Session Adjourn
Optional Independent Study
 


Day 2: Seminar

 

 

7:45

Independent Study/ Library Review/ Breakfast

8:30

Assessing the Foot and Ankle: Review of Open- Chain Assessments

10:00 Break
10:30 Developmental Features of the Foot and Ankle
12:00 Lunch and library time

1:00

Name That Foot Deformity!

2:00 Short Break
2:15 Pathomechanics of Various Foot Design Problems: Implications for Posting Casts and Follow-up Orthoses
3:15 Short Break
3:30 Serial Casting: Precautions, Contraindications, Limitations, Guidelines, and Principles of Management/ Fabrication Options
4:30 Videotaped Case Presentations
5:00 Questions / discussion
Post-Session

Seminar-only attendees turn in evals; adjourn -
Optional Independent Study

 


Day 3: Lab Session

 
Lab participants, bring shorts today and tomorrow.
7:15 Independent study
8:15 Breakfast and settle in
8:30 LAB: Open-Chain Assessments of the Foot and Ankle
10:00 Short Break
10:15 LAB: Resume Open Chain Assessments
12:00 Lunch, library time
1:00 LAB: Closed-Chain Assessments of the Foot
2:30 Short Break
2:45 LAB: Resume assessments
3:45 LAB: Positioning the Patient and Rehearsing the Cast Molding Grip
4:15 Review of Casting Materials
5:00 Adjourn
Post-Session Optional Independent Study
 


Day 4: Lab Session — Cast Fabrication

 
Lab participants, bring shorts today - wear clothes you can get plaster on!.
8:00 Breakfast (snacks available all day - graze at will)
8:30 DEMO: Plaster/Soft Cast Below-Knee Cast Fabrication
9:30 LAB: BK Cast Fabrication - first team makes this one
11:00 DEMO: Footboard Fabrication demo
11:30 DEMO: FlexCast Fabrication Demo
12:00 Working lunch on premises.
12:30 LAB: Participants make cast(s) of choice: plaster/Soft Cast combo, footboard, and/or FlexCast, as time permits.
2:45 Break
3:00 Resume lab
5:30 Clean-up/ Turn in Evaluations
6:00 Adjourn

Restrictions

Capacity: Enrollment in the seminar segment of the course is limited to 80 attendees. Enrollment in the lab segment is limited - contact sponsor for details.

Video Recording policy: Videotaping of this program is prohibited. Audiotaping for personal review is permitted with permission from the Instructor.

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