Welcome to Progressive GaitWays…

The Cusick Center for Learning (CCL) has opened its doors!

The first program in the series The Golden Rule of Managing Pediatric Orthopedic and Motor Development is now available for your professional development – at your convenience, in a pre-recorded webinar!

Program 1: Early Postural Control Acquisition

In this hour-long webinar, Beverly (Billi) Cusick reviews key biomechanical and sensory-motor aspects of early postural control acquisition – the essential foundation for building competent limb use and movement skills. She then demonstrates her “golden rule” concept with two clinical cases, and provides a detailed Q&A segment based on the discussions from the original live webinar.

In conclusion, Ms. Cusick traces the timeline, mentors, and influences that led her to the development of the Golden Rule – a valuable review that ‘connects the dots’ between the contributions of numerous well-known pioneers in physical rehabilitation.

Register Now | Download the course description

Kudos for Program 1:

I took a course from Billi over 20 years ago (Biomechanics) and it transformed my practice.  Love how she integrated  all the  approaches (NDT, Sahrmann, Tschnarter etc..). Excellent information with clear application, and the science behind the art of postural control facilitation. It was concise, easy to follow, and packed full of golden nuggets. I actually bought Kathleen Porters book and will be sharing it with coworkers at the clinic including office staff!

Enjoyed the historical approach with references to the scientific basis behind the techniques. Good reminder of finding the balance between stability and mobility in order to enhance function.

Coming Next – Session 2: Expanding Postural Control into Movement

In Session 2, Ms. Cusick discusses the biomechanical and somatosensory aspects of the developing infant’s progress after stabilizing the body center of mass in prone and supine positions. In this next phase of early movement acquisition, lying leads to rolling and body weight is displaced in the frontal plane and elevated off the surface into quadruped position. The instructor’s golden rule is applied in suggested biomechanical and somatosensory strategies for remediating deficits.

… Attendees gave the live webinar a ‘thumbs up’:

It’s very difficult to get clear, concise information regarding infant motor development and I really appreciate the quality of information as well as the convenience of the presentation type.

Billi is a wealth of knowledge which she shares in a clear, concise and clinically applicable way. The webinar feels intimate and allows interaction at the end through questions and comments in real time. The webinar allows learning in 1 hours chunks of time, with the opportunity to watch again for the week that follows. The handout follows the slides exactly and
can be downloaded ahead of time to maximize learning.

Registration coming soon… | Download course description

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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.
BilliSig_75

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

Calendar of Events

Oct
9
Fri
Evaluation & Management of Pediatric Toe Walking from PT & OT Perspectives @ UMN Continuing Education & Conference Center - Rm 52
Oct 9 – Oct 10 all-day
Evaluation & Management of Pediatric Toe Walking from PT & OT Perspectives @ UMN Continuing Education & Conference Center - Rm 52 | 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

Dec
11
Fri
Evaluation & Management of Pediatric Toe Walking from PT & OT Perspectives @ University of Baltimore - William H. Thumel Sr. Business Center (RM BC-225)
Dec 11 – Dec 12 all-day
Evaluation & Management of Pediatric Toe Walking from PT & OT Perspectives @ University of Baltimore - William H. Thumel Sr. Business Center (RM BC-225)  | 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

Feb
26
Sun
Pediatric Neuromotor Rehabilitation LAB (Part 2) @ KidZ TherapEZE
Feb 26 all-day
Pediatric Neuromotor Rehabilitation LAB (Part 2) @ KidZ TherapEZE | Killeen | Texas | United States

Lab for Pediatric Neuromotor Rehabilitation (Part 2)

On Day 4, fifteen lab participants will execute 8 musculoskeletal assessments under supervision. These participants will complete the program by participating in a case presentation, in which they will be asked at random to explain ongoing procedures, to try executing an assessment procedure. Instructor will undertake orthotic modifications and interventions as are indicated by the child’s function and findings.

Participants completing the lab sessions on Day 4 are expected to be able to:

  • Acquire novice-level skill in executing 8 LE musculoskeletal assessment procedures:
    • sacral angle
    • 2-Joint hip flexor test
    • hip rotation in extension
    • Modified Ryder’s Test
    • hamstring muscle length test (R1)
    • patella angle
    • thigh/foot angle
    • passive Ankle DFOM with knee extended – R1 & R2.
  • Case presentation: be prepared to execute one assessment procedure upon request, and explain the
    assessment procedure.

 

Jan
21
Sun
Sparking Change in the Treatment of Children with Diplegic Cerebral Palsy @ Hotel Pennsylvania
Jan 21 @ 8:30 am – 5:30 pm
Sparking Change in the Treatment of Children with Diplegic Cerebral Palsy @ Hotel Pennsylvania | New York | New York | United States

New Course from Beverly Cusick PT, MS, C/NDT, COF & Susan Hastings PT, DPT, PCS!

In children born premature and those with diplegic cerebral palsy (CP), findings obtained with diffusion tensor imaging (DTI) have brought significant challenges to the common definition of CP as “a motor disorder caused by a static lesion to the upper motor neurons resulting in spasticity”.

Beverly Cusick, PT, MS, NDT, COF, discusses findings by researchers that question the definition and challenge the common notion that spasticity is present and that it causes contracture formation and gait pathology in children with diplegia. She discusses the confusion over the difference between increased tone and hyperreflexia and introduces some new thinking regarding EMG activity in tissues under stretch. She concludes by proposing an alternative to “spasticity reducing” interventions by addressing postural control deficits and remediation.

Susan Hastings, PT, DPT, PCS, discusses requirements for motor learning to occur, and introduces functional electrical stimulation (FES) and whole body vibration (WBV) as treatment-augmenting interventions along with supporting research.

This one-day course is a pre-requisite for either of the two follow-up lab sessions:

  • Functional Electrical Stimulation for the Child with Cerebral Palsy (Hastings)
  • Bringing Orthopedic Assessment Findings to Management Planning (Cusick).

Read more…

Jan
22
Mon
Lab: Functional Electrical Stimulation for the Child with Cerebral Palsy (Hastings) @ Touro College
Jan 22 @ 8:30 am – 5:30 pm
Lab: Functional Electrical Stimulation for the Child with Cerebral Palsy (Hastings) @ Touro College | New York | New York | United States

Functional E-Stim Lab by Susan Hastings, PT, DPT, PCS

With the goal of simplifying electrical stimulation as a treatment modality and helping participants to gain confidence in its use, participants will use the Empi Continuum unit (provided) in teams of two. They will learn to set the unit parameters at different therapeutic levels and apply stimulation to their partner. Each participant will see and feel the differences between different settings, and between letting the unit cycle on and off (NMES) and using a hand switch to augment functional movement (FES).

Registration is limited to 20 participants who have taken the Sparking Change pre-requisite course. 

May
19
Sat
Posture & Torso Alignment for Pediatric Neuromotor Training (CTF 1) @ Four Points by Sheraton Pleasanton
May 19 all-day

Sponsored by

Course Summary

This introductory program features a review of relevant pediatric orthopedic issues and sciences pursuant to neuromotor re-education for posture and torso alignment, including:

  • Skeletal modeling mechanisms and influences
  • The role of the somatosensory system in postural control acquisition and movement
  • Fundamentals of S.A. Sahrmann’s muscle balance theory
  • Practice-related skills acquisition

Attendees will validate their understanding of these principles and issues in the afternoon lab session, using the TheraTogs Posture & Torso Alignment system. Grouped in teams of three, attendees will be guided through a series of donning and strapping applications that demonstrate the biomechanical principles and management techniques reviewed in the morning session.

ProCert has awarded certification to Certified TheraTogs Fitter Level 1 (CTF 1).

Approval pending through FSBPT for Certified TheraTogs Fitter Level 2 (CTF 2).

May
20
Sun
Pediatric In-toeing & Out-Toeing Management for Neuromotor Training (CTF 2) @ Four Points by Sheraton Pleasanton
May 20 all-day

Course Summary

This program builds upon the foundation laid in the Posture & Torso Alignment (CTF Level I) workshop. It features a brief review of pediatric orthopedic lower-extremity (LE) skeletal and joint development as it occurs in the transverse plane – i.e. medial and lateral joint rotation and medial and lateral long bone torsion – and in relation to deviations in foot progression angle (FPA) – i.e. in-toeing and out-toeing.

Lecture content includes these topics:

  • Transverse-plane (TP) LE skeletal and joint modeling events with rotation strapping precautions
  • A review of elements of postural control acquisition and maintenance that pertain to TP LE bone and joint development and alignment
  • An implementation of SA Sahrmann’s muscle balance theory in the context of the kinesiology of LE rotation strapping applications
  • A review of three musculoskeletal assessment procedures used to identify sources of deviations in FPA and to document changes in a replicable manner.

Mar
2
Sat
Wearable Therapy: TheraTogs™ Systems, Uses, & Scientific Foundations
Mar 2 – Mar 5 all-day

Wearable Therapy: TheraTogs™ Systems, Uses, & Scientific Foundations

A 3.5-Day Didactic Program

Facilitator: Beverly Cusick, PT, MS, NDT, COF/BOC

Day 1 of this program features an overview of sciences of neuromotor and orthopedic development including established principles of kinesiology and biomechanics, physiologic adaptation of body tissues to routine use, new developments in motor learning, and the role of the somatosensory system in this process. The instructor demonstrates the implementation of the sciences in an introduction to TheraTogs Orthotic Garment and Strapping Systems as a modality for expanding successes in therapy sessions into daily life to optimize functioning alignment and stability, and reviews published research.

Day 2 of this program expands upon the introductory content presented on Day 1 with a discussion of skeletal modeling mechanisms and the achievement of postural control as a foundation for movement acquisition. She explores the nature of muscle tone and the relationship of muscle tone to routine use, both typical and pathologic. The program ends with suggestions for using TheraTogs in early intervention to optimize resting postures and the acquisition of essential ingredients for postural control.

Day 3 of this program applies the content from Days 1 and 2 and delves into functioning alignment issues related to the spine, the ankles, and unequal limb length. After demonstrating the Dragonfly TLSO and the molding and fitting process, the instructor reviews the assessment of ankle dorsiflexion range of motion as an important component of optimizing the support base with orthotics. She brings ankle ROM to discussions of postural control deficits and functioning malalignment as they occur in children with idiopathic toe walking, equinus deformity, hemiplegic cerebral palsy, and scissor gait. The program ends with a discussion of the typical development of the hip joint and femur in the transverse plane with a lab session devoted to distinguishing between femoral anteversion and antetorsion.

Day 4 is a half-day program that applies the content from Days 1-3 and is devoted to the biomechanical and developmental factors inherent in intoed and out-toed gait. Instructor reviews the related – and refined – musculoskeletal assessment procedures of hip rotation ROM, modified Ryder’s Test for femoral torsion, and the Thigh-Foot Angle and applies the findings to the safe use of TheraTogs strapping applications. The didactic program ends with suggestions for further research.

Jun
14
Fri
Sparking Change in the Treatment of Children with Diplegic Cerebral Palsy @ CCS Santa Clara County
Jun 14 – Jun 18 all-day
Sparking Change in the Treatment of Children with Diplegic Cerebral Palsy @ CCS Santa Clara County | New York | New York | United States

New Course from Beverly Cusick PT, MS, C/NDT, COF & Susan Hastings PT, DPT, PCS!

In children born premature and those with diplegic cerebral palsy (CP), findings obtained with diffusion tensor imaging (DTI) have brought significant challenges to the common definition of CP as “a motor disorder caused by a static lesion to the upper motor neurons resulting in spasticity”.

Beverly Cusick, PT, MS, NDT, COF, discusses findings by researchers that question the definition and challenge the common notion that spasticity is present and that it causes contracture formation and gait pathology in children with diplegia. She discusses the confusion over the difference between increased tone and hyperreflexia and introduces some new thinking regarding EMG activity in tissues under stretch. She concludes by proposing an alternative to “spasticity reducing” interventions by addressing postural control deficits and remediation.

Susan Hastings, PT, DPT, PCS, discusses requirements for motor learning to occur, and introduces functional electrical stimulation (FES) and whole body vibration (WBV) as treatment-augmenting interventions along with supporting research.

This one-day course is a pre-requisite for either of the two follow-up lab sessions:

  • Functional Electrical Stimulation for the Child with Cerebral Palsy (Hastings)
  • Bringing Orthopedic Assessment Findings to Management Planning (Cusick)

Flyer & Registration

Read more…

Sep
13
Fri
Sparking Change in the Treatment of Children with Diplegic Cerebral Palsy (Warsaw, Poland) @ INSTYTUT TERAPII FUNKCJONALNEJ DZIELNY MIŚ
Sep 13 all-day
Sparking Change in the Treatment of Children with Diplegic Cerebral Palsy (Warsaw, Poland) @ INSTYTUT TERAPII FUNKCJONALNEJ DZIELNY MIŚ | New York | New York | United States

New Course from Beverly Cusick PT, MS, C/NDT, COF

In children born premature and those with diplegic cerebral palsy (CP), findings obtained with diffusion tensor imaging (DTI) have brought significant challenges to the common definition of CP as “a motor disorder caused by a static lesion to the upper motor neurons resulting in spasticity”.

Ms. Cusick discusses findings by researchers that question the definition and challenge the common notion that spasticity is present, that it causes contracture formation and gait pathology in children with diplegia, and that it is a suitable target for “spasticity reducing” interventions. She discusses the confusion over the difference between increased tone and hyperreflexia; challenges to the validity of the Modified Ashworth Scale and the Modified Tardieu Scale as spasticity tests; and presents abundant reported evidence of shortfalls of effectiveness of, and complications associated with commonly-administered spasticity treatments including intrathecal baclofen, botulinum toxin-A injections, and selective dorsal rhizotomy.

Ms. Cusick concludes the program with a presentation of several science-based management strategies for children with diplegic cerebral palsy and suggestions for clinical research involving clinicians in orthotics and associated rehabilitation team members.

(Note: Course lecture and handouts are in English.)

Read more…

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