The Tyranny of Evidence…
Beverly Cusick, PT, MS, NDT, COF/BOC pushes back on the current culture of dependence on single-focus, short-term clinical studies that ignore the complex morbidities of cerebral palsy – and the sciences that address them.
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!
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.
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.
In Program 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 Program 2 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 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.
An Open Letter to Caretakers and Therapists for Children with Diplegic CP
Progressive 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.
¡Ahora disponible en español! (Translated by Ursula Ivancic, Kinesióloga Fisiatra Neurorehabilitación Pediátrica Buenos Aires, Argentina
Calendar of Events
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.