Welcome to Progressive GaitWays…

An Open Letter to Caretakers and Therapists for Children with Diplegic CP

BCusick_OutsideProgressive GaitWays president and founder Beverly (Billi) Cusick writes:

“I’ve seen hundreds of families of children with diplegia, in consultation sessions in which I routinely undertake an orthopedic assessment and evaluate postural control, movement strategies, and existing orthoses. Common denominators have emerged that appear to operate to contribute to common problems of contracture development and recurrence, and to diminishing movement skills so often seen with advancing age in children with diplegia.

“I’ve composed the attached letter for caretakers and therapists of children with diplegia to bring them together in their understanding of the sources of many common musculoskeletal problems, and of the fundamental skills and strategies that are needed for effective remediation.”

Clinicians are welcome to download and share this letter with their colleagues, clients, and prescribing physicians.
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Training & Events Calendar

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¡Ahora disponible en español! (Translated by Ursula Ivancic, Kinesióloga Fisiatra Neurorehabilitación Pediátrica Buenos Aires, Argentina)

Jul
17
Fri
LAB: Developmental Orthopedics – Assessment Skills Follow-Up @ Long Beach, CA
Jul 17 all-day

BevLab_160Developmental Orthopedics – Assessment Skills Lab Session

Lab participants will execute 14 musculoskeletal assessments on each other under supervision. These participants will complete the program by participating in a live case presentation in which they will be asked at random to execute an assessment procedure.

Prerequisites. This lab program is open only to clinicians who have completed the one-day seminar program entitled: Developmental Orthopedics of the Trunk & Lower Extremity.

Enrollment is limited to 15 participants. After 15 are registered, additional interested attendees may place themselves on a wait list. If there is sufficient interest, we will offer an additional lab session the following day. Enrollment status is determined on a first-come, first-served basis.

This is an intermediate-level course; prerequisite training is required as noted above, and pre-course review materials are issued.

Dress for Lab. Lab enrollees should come dressed to undergo LE assessments requiring skin marking and palpation of the greater trochanter and fibula head.

Aug
15
Sat
NUEVAS ESTRATEGIAS DEL MANEJO DE LA DEFORMIDAD DEL PIE PEDIÁTRICO CON YESOS SERIADOS- ¿POR QUÉ Y CÓMO? @ Ciner
Aug 15 – Aug 17 all-day

Si usted tiene cualquier consulta o preocupación, por favor contáctenos a nosotros directamente. Haremos lo mejor para poder ayudarlo. Esperamos conocerlo en el Curso!

Sep
17
Thu
Developmental Orthopedics of the Trunk & Lower Extremity @ Baltimore MD
Sep 17 all-day

This introductory program features an overview of the processes and principles that contribute to pediatric orthopedic development. These principles are applied to pathomechanics commonly observed in children with hypotonia, cerebral palsy, excessive foot pronation, and intoed gait. The content presented in this program is considered fundamental to any (future) discussion of the specific features of orthopedic trunk and lower extremity development.

Save $20 – Bring a colleague along!

Download a full Course Description for reference.

7.0 contact hours
CEUs for PT’s & Orthotists
LEVEL: Intermediate

Sep
18
Fri
Introduction to New Paradigms in Pediatric Equinus Deformity Management @ Baltimore MD
Sep 18 all-day
Introduction to New Paradigms in Pediatric Equinus Deformity Management @ Baltimore MD | Atlanta | Georgia | United States

A One-Day Review of Sciences & Strategies for Optimizing AFO’s

The landscape of considerations of ankle function in balance and gait, and of strategies for managing ankle plantarflexion contracture – i.e., equinus deformity – is changing to embrace the roles of the somatosensory system and postural control both as causative factors and intervention strategies. Instructor Beverly Cusick, PT, MS, COF, C/NDT reviews the relevance of ankle function in postural control, and discusses the physiology of muscle transformation and the role of spasticity in contracture formation.

The content features challenges to the rationale and effectiveness of common equinus deformity intervention paradigms including stretching, blocking ankle plantarflexion at 0° with orthoses, injecting the gastrocnemius muscle with toxin, and surgically lengthening any aspect of the triceps surae muscle-tendon unit. The course presents new orthotic and training strategies, based upon the work of Shirley Sahrmann, Mary Weck, and Elaine Owen, with emphasis on children with pyramidal-types of cerebral palsy.

A full Course Description is available for download.

7.0 contact hours
CEUs for PT’s & Orthotists
LEVEL: Intermediate

Evaluation & Management of Pediatric Toe Walking from PT & OT Perspectives @ San Diego, CA
Sep 18 – Sep 19 all-day
Evaluation & Management of Pediatric Toe Walking from PT & OT Perspectives @ San Diego, CA | Rochester | New York | United States

This exciting workshop covers therapeutic evaluation & treatment of pediatric equinus gait (“toe walking”) – offering a new, structured approach to evaluation and management of this common pediatric indication.

It is common for the practitioner to feel lost when a child presents with a toe walking gait pattern. Both evaluation and treatment of these children are often frustrating for all involved and frequently results in inaccurate evaluation with ineffective intervention and poor achievement of results. Long term results are rarely achieved with either resultant surgical intervention and/or a re-occurrence of the problem.

However, if the clinician asks the right questions and follows a deliberate approach, she or he can address toe walking with better outcomes and less frustration. This excellent course is designed to alleviate the chaotic approach to the treatment of pediatric toe walking by giving attendees exactly what they need – the right questions to ask, and a deliberate, organized approach to intervention.

Download a detailed Course Description for reference.

15 contact hours
CEUs available for PT’s & Orthotists

Sep
19
Sat
LAB: Developmental Orthopedics – Assessment Skills Follow-Up (BWI) @ University of Baltimore - Merrick School of Business
Sep 19 all-day

BevLab_160Developmental Orthopedics – Assessment Skills Lab Session

Lab participants will execute 14 musculoskeletal assessments on each other under supervision. These participants will complete the program by participating in a live case presentation in which they will be asked at random to execute an assessment procedure.

Prerequisites. This lab program is open only to clinicians who have completed the one-day seminar program entitled: Developmental Orthopedics of the Trunk & Lower Extremity.

Enrollment is limited to 15 participants. After 15 are registered, additional interested attendees may place themselves on a wait list. If there is sufficient interest, we will offer an additional lab session the following day. Enrollment status is determined on a first-come, first-served basis.

This is an intermediate-level course; prerequisite training is required as noted above, and pre-course review materials are issued.

Dress for Lab. Lab enrollees should come dressed to undergo LE assessments requiring skin marking and palpation of the greater trochanter and fibula head.

Sep
25
Fri
Evaluation & Management of Pediatric Toe Walking from PT & OT Perspectives @ Cleveland, OH
Sep 25 – Sep 26 all-day
Evaluation & Management of Pediatric Toe Walking from PT & OT Perspectives @ Cleveland, OH | Baltimore | Maryland | United States

This exciting workshop covers therapeutic evaluation & treatment of pediatric equinus gait (“toe walking”) – offering a new, structured approach to evaluation and management of this common pediatric indication.

It is common for the practitioner to feel lost when a child presents with a toe walking gait pattern. Both evaluation and treatment of these children are often frustrating for all involved and frequently results in inaccurate evaluation with ineffective intervention and poor achievement of results. Long term results are rarely achieved with either resultant surgical intervention and/or a re-occurrence of the problem.

However, if the clinician asks the right questions and follows a deliberate approach, she or he can address toe walking with better outcomes and less frustration. This excellent course is designed to alleviate the chaotic approach to the treatment of pediatric toe walking by giving attendees exactly what they need – the right questions to ask, and a deliberate, organized approach to intervention.

Download a detailed Course Description for reference.

15 contact hours
CEUs available for PT’s & Orthotists

New Paradigms in Foot & Ankle Deformity Management with Serial Casting (Part 1) @ Ottawa CTC
Sep 25 – Sep 27 all-day
New Paradigms in Foot & Ankle Deformity Management with Serial Casting (Part 1) @ Ottawa CTC | Ottawa | Ontario | Canada

This course is designed for the practitioner who has experience in working with children or adults with CNS neuromotor dysfunction, including physical therapists, orthotists, pediatric orthopedists, and physical medicine and rehabilitation physicians. We believe that team education fosters more effective teamwork. The didactic content can be adapted for an audience that is concerned with an adult population, substituting live case presentations for videotaped cases.

Course Brochure and Registration Info…  •  Course Description • Program Schedule

The content covered in this program currently includes the following topics:

  • The emerging sciences of postural control acquisition and maintenance, including the role of the somatosensory system as it is currently understood in relation to load-bearing alignment of the torso, lower limbs, and feet.
  • Foot and ankle functional anatomy, biomechanics, development, and pathomechanics in relation to body weight orientation over the base of support and to designing orthotic modifications to optimize foot development and function.
  • Body weight distribution on the foot and through load-bearing joints as a causative factor in contracture formation, early onset of pain, and degenerative joint disease.
  • Muscle physiology and pathophysiology in the presence of chronic use of compensatory postural control mechanisms while distinguishing spasticity from connective–tissue contractility and muscle transformation.
  • Skeletal modeling mechanisms underlying the process of use-related ankle and foot development.
  • Characteristics of and factors contributing to healthy foot development.
  • Elements of gait development that relate to and support foot development.
  • The kinesiology and pathokinesiology related to – and in support of – the safe and effective use of below-knee casts and orthotic interventions designed to improve postural alignment and control and to reduce developmental, flexible foot and ankle deformities that commonly develop in the presence of central nervous system dysfunction, hypotonia, and ligament laxity in childhood. Discussion of orthotic options includes Elaine Owen’s Tuned AFO/Footwear Combinations, heel lifting and weight-line training, orthotic posting and foot packaging principles and strategies.
  • Hypoextensibility management is distinguished from the alteration of movement strategies, and includes discussions of interventions such as positioning, resting splints, manual stretching, neurolytics, and serial casting.
  • Common developmental foot deformities are identified and described in terms of plane-based anatomical components. Musculoskeletal assessment procedures are reviewed as the findings lead the clinician to a systematic clinical decision-making process regarding orthotic design in terms of desired load-bearing foot and limb joint alignment, magnitude of segment enclosure, degrees of freedom provided or restrained, and posting options. Soft-tissue extensibility findings are also used in the documentation of the effects of assorted orthotic intervention strategies.

Labs feature closely-supervised trials of several ankle and foot assessment procedures, with findings applied to orthotic posting and design. Materials will be provided for 1.5 days of training in fabrication of two types of below-knee casts, and for undertaking posting trials to preview effects of proposed orthotic modifications.

Sep
27
Sun
LABS: Assessment, Posting, and Below-Knee Cast Fabrication (Part 2) @ Ottawa CTC
Sep 27 – Sep 29 all-day
LABS: Assessment, Posting, and Below-Knee Cast Fabrication (Part 2) @ Ottawa CTC | Ottawa | Ontario | Canada

Labs feature closely-supervised trials of several ankle and foot assessment procedures, with findings applied to orthotic posting and design. Attendees will work in groups of three with rotating assignments – practice subject, practitioner, and prompter.

Materials will be provided for 2.5 days of training in fabrication of two types of below-knee casts, and for undertaking posting trials to preview effects of proposed orthotic modifications.

Course Brochure and Registration Info  •  Course Description, Objectives & Schedule

Oct
9
Fri
Evaluation & Management of Pediatric Toe Walking from PT & OT Perspectives @ UMN Conference Center
Oct 9 – Oct 10 all-day
Evaluation & Management of Pediatric Toe Walking from PT & OT Perspectives @ UMN Conference Center | Saint Paul | Minnesota | United States

This exciting workshop covers therapeutic evaluation & treatment of pediatric equinus gait (“toe walking”) – offering a new, structured approach to evaluation and management of this common pediatric indication.

It is common for the practitioner to feel lost when a child presents with a toe walking gait pattern. Both evaluation and treatment of these children are often frustrating for all involved and frequently results in inaccurate evaluation with ineffective intervention and poor achievement of results. Long term results are rarely achieved with either resultant surgical intervention and/or a re-occurrence of the problem.

However, if the clinician asks the right questions and follows a deliberate approach, she or he can address toe walking with better outcomes and less frustration. This excellent course is designed to alleviate the chaotic approach to the treatment of pediatric toe walking by giving attendees exactly what they need – the right questions to ask, and a deliberate, organized approach to intervention.

Download a detailed Course Description for reference.

15 contact hours
CEUs available for PT’s & Orthotists

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