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)

Apr
11
Sat
Developmental Orthopedics of the Trunk & Lower Extremity @ Wee Care Therapy, Ltd.
Apr 11 all-day

Developmental Orthopedics of the Trunk & Lower Extremity:

A Review of Operating Processes with Implications for Management

Saturday, April 11, 2015
Registration:  7:30 am
Time:  8:00 am – 5:30 pm
Cost:  $195.00 (Price includes an assessment kit valued at $65)
Contact Hours: 7.25
IL EI: Pending Approval

Presented by:
Beverly Cusick, PT, MS, NDT, COF

Location:
Hampton Inn & Suites
8936 Calumet Ave
Munster, IN  46321

Target Audience:
Clinicians who are likely to work together to maximize physical function as a rehabilitation team, including PT, OT, Orthotists, Rehabilitation Physicians, and Orthopedists.

Course Level:
Intermediate- pre-course readings are assigned

Seminar Description:
This introductory program features an overview of the processes that contribute to pediatric orthopedic development, including the following:

Skeletal modeling mechanisms and influences.
Therapeutic limits on influencing the skeletal modeling process.
The influences of the biomechanics of ideal neonatal alignment on modeling the spine and lower extremity joints and on postural control acquisition.
The roles of postural control and massed practice on the orthopedic and functional development.
Developmental changes in muscle and connective-tissue extensibility.
Common errors of lower-extremity skeletal modeling in children with CNS dysfunction.
Strategies for optimizing somatosensory input, postural alignment, and postural control.
Using musculoskeletal assessment findings to gauge effectiveness of therapeutic management.

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.

Seminar Objectives:

Participants will:

Distinguish between skeletal maturation and skeletal modeling.
Distinguish between mechanisms of strain and load, and apply this distinction to the “Golden Age.”
Describe the modeling effects of compression, tension, and loaded torque strains.
Describe the typical developmental changes that occur in spinal and lower-extremity alignment.
Describe the normal sequential acquisition of antigravity muscle function in the torso.
Relate normal neonatal soft-tissue constraints to the development of spine curves.
Discuss the role of somatosensory input in postural control and movement skills acquisition.
Describe the ideal features of weight distribution on the foot segments in standing position in infants, preschoolers, and adults.
Relate standing foot, spinal, and pelvic alignment to body weight distribution onto the feet and to muscle recruitment strategies needed to maintain postural control.
Discuss the normal emergence of R1 (first catch) end range of motion in the lower-extremity muscles.
Differentiate between spasticity and soft-tissue adaptation to chronic, tonic muscle recruitment.
Describe the evidence of a history of routine muscle recruitment strategies in range of motion findings.
Given the presence of excessive femoral torsion in a 9-year-old boy, explain the decision to defer corrective efforts to an orthopedic surgeon.
Explain the rationale for lifting under the heel and allowing the ankle to align in plantarflexion in the presence of equinus deformity.
Suggest strategies for delivering massed practice in improved postural alignment.

Schedule:

8:00  Register / Continental breakfast
8:25  Introductions
8:30  Overview of Developmental Changes in the Spine and Lower Extremities
8:45  Skeletal Modeling Mechanisms
9:15  The Somatosensory System in Postural Control Acquisition (or, Where’s the Weight?
9:45  Break
10:15 Biomechanics of Ideal Neonatal Alignment in Postural Control Acquisition
10:45 Walking as an Influence on Orthopedic Development
11:30 Developmental Changes in Lower-Extremity Muscle Extensibility
12:00 Lunch
1:00  Common Problems of Postural Control in Children with Diplegic Cerebral Palsy
2:00  Videotaped case – Emilia
2:15  Short Break
2:30  Common Lower-Extremity Modeling Errors
3:30  Short Break
3:45  Using Musculoskeletal Assessment Procedures as Evidence of Skeletal Modeling, Muscle Balance, History of Use, and Success of Neuromotor   Re-Education
4:45  Videotaped Case: Setting Management Priorities
5:15  Questions and Discussion
5:30  Turn In Course Evals and Adjourn
About the Speaker:

EDUCATION:

1972 – BS in PT from Bouve College at Northeastern University (Boston) in 1972, summa cum laude.
1988 – MS in Clinical and College Teaching for Allied Health Professionals – University of Kentucky in Lexington.

WORK EXPERIENCE:

1 year – PT staff at (now) Spaulding Rehabilitation Center, Boston, MA
3 years – PT staff and Director for UCP Center, Lawrence, MA
9 years – PT staff at Children’s Rehab. Center (now, Kluge Center),   Charlottesville, VA.
3 years – PT Education faculty, College of Health Related Professions at MUSC, Charleston, SC, and Director of PT Services for the Div. Of   Developmental Disabilities at MUSC.
1 year, consultant, Cardinal Hill Hospital’s Head Trauma & Pediatrics teams – Lexington, KY.
4 years, assisting in the PT Department at Children’s Hospital at Stanford, Palo Alto, CA.
23 years in private practice.

Apr
17
Fri
Developmental Orthopedics of the Trunk & Lower Extremity @ Children's Healthcare of Atlanta (CHOA)
Apr 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.

Apr
18
Sat
Introduction to New Paradigms in Pediatric Equinus Deformity Management @ Children's Healthcare of Atlanta (CHOA)
Apr 18 all-day

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.

Apr
20
Mon
Pediatric Foot & Ankle Deformity Management with Serial Casting: Why & How (SOLD OUT) @ Telluride, CO
Apr 20 @ 11:00 am – Apr 25 @ 12:30 pm

TUITION INCLUDES THE FOLLOWING:

  • A small instructor-attendee ratio of 1:6
  • 2 DVDs for precourse review: Legs & Feet: A Review of Musculoskeletal Assessments (2005)
    and Foot Talk (2009) – a 2-hour lecture with PPT CD on functional anatomy of the foot and ankle.
  • A 5-piece tool kit
  • An illustrated handout of lectures and supplemental readings: >400 pages in a ring binder
  • An illustrated handout of assessment procedures, posting instructions, and cast fabrication procedures
  • A memory stick loaded with relevant, topic-specific reference lists and readings
  • Supplies for casting and posting labs
  • Food and beverages for breakfast and 2 breaks/day – lunch is on your own
  • An on-site library of related texts and articles, and an on-site museum of below-knee casts and orthoses
  • Administrative support for obtaining CEUs
  • On-site attendee discounts on purchase of posting supplies to take home and get started.
Apr
27
Mon
Pediatric Foot & Ankle Deformity Management with Serial Casting: Why & How (SOLD OUT) @ Telluride, CO
Apr 27 @ 11:00 am – May 2 @ 12:30 pm

TUITION INCLUDES THE FOLLOWING:

  • A small instructor-attendee ratio of 1:6
  • 2 DVDs for precourse review: Legs & Feet: A Review of Musculoskeletal Assessments (2005)
    and Foot Talk (2009) – a 2-hour lecture with PPT CD on functional anatomy of the foot and ankle.
  • A 5-piece tool kit
  • An illustrated handout of lectures and supplemental readings: >400 pages in a ring binder
  • An illustrated handout of assessment procedures, posting instructions, and cast fabrication procedures
  • A memory stick loaded with relevant, topic-specific reference lists and readings
  • Supplies for casting and posting labs
  • Food and beverages for breakfast and 2 breaks/day – lunch is on your own
  • An on-site library of related texts and articles, and an on-site museum of below-knee casts and orthoses
  • Administrative support for obtaining CEUs
  • On-site attendee discounts on purchase of posting supplies to take home and get started.
May
1
Fri
Evaluation & Management of Pediatric Toe Walking from PT & OT Perspectives @ Baltimore, MD
May 1 – May 2 all-day

A comprehensive seminar that provides valuable tools for evidence-based evaluation, assessment and treatment of pediatric toe-walking with a descriptive, organized approach for health care professionals.

May
8
Fri
Evaluation & Management of Pediatric Toe Walking from PT & OT Perspectives @ St. Paul, MN
May 8 – May 9 all-day

A comprehensive seminar that provides valuable tools for evidence-based evaluation, assessment and treatment of pediatric toe-walking with a descriptive, organized approach for health care professionals.

Jun
12
Fri
Developmental Orthopedics of the Trunk & Lower Extremity @ Tarrytown NY
Jun 12 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.

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.

Sep
18
Fri
Introduction to New Paradigms in Pediatric Equinus Deformity Management @ Baltimore MD
Sep 18 all-day

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.

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