Welcome to Progressive GaitWays…

“…the current demand for ‘evidence’ as a justification for intervening overlooks the shortfall of evidence and discourages the emergence of clinical evaluation, skill building, and science-based innovation.”

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.

Read more…

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.

Program 2: Expanding Postural Control into Movement

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.

Program 1 is a prerequisite for Program 2. | Download Program 2 course description

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

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

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Progressive GaitWays online store!

 

 

Or, download the PGW Order Form to place your order offline.

Apr
7
Sun
New Paradigms in Foot & Ankle Deformity Management @ Instytut Terapii Funkcjonalnej Dzielny Mis sp. z.o.o. [Warsaw]
Apr 7 all-day
New Paradigms in Foot & Ankle Deformity Management @ Instytut Terapii Funkcjonalnej Dzielny Mis sp. z.o.o. [Warsaw] | Manchester | New Hampshire | United States

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

  • Foot and ankle 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.
  • 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 occur 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, and orthotic posting and foot packaging principles and strategies.

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.

Full Course Description

Apr
9
Tue
Shining a Light on the Role of Spasticity in Children with Diplegic CP @ Instytut Terapii Funkcjonalnej Dzielny Mis sp. z.o.o. [Warsaw]
Apr 9 all-day
Shining a Light on the Role of Spasticity in Children with Diplegic CP @ Instytut Terapii Funkcjonalnej Dzielny Mis sp. z.o.o. [Warsaw]

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.

For more information, please download the Course Description.

 

 

Shining a Light on the Role of Spasticity in Children with Diplegic CP @ Instytut Terapii Funkcjonalnej Dzielny Mis sp. z.o.o. [Warsaw]
Apr 9 all-day
Shining a Light on the Role of Spasticity in Children with Diplegic CP @ Instytut Terapii Funkcjonalnej Dzielny Mis sp. z.o.o. [Warsaw]

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.

For more information, please download the Course Description.

 

 

Apr
10
Wed
New Paradigms in Foot & Ankle Deformity Management @ Instytut Terapii Funkcjonalnej Dzielny Mis sp. z.o.o. [Warsaw]
Apr 10 all-day
New Paradigms in Foot & Ankle Deformity Management @ Instytut Terapii Funkcjonalnej Dzielny Mis sp. z.o.o. [Warsaw] | Manchester | New Hampshire | United States

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

  • Foot and ankle 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.
  • 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 occur 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, and orthotic posting and foot packaging principles and strategies.

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.

Full Course Description

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…

Jan
10
Fri
Developmental Orthopedics of the Trunk & Lower Extremity (2-Day) @ Weeefun Therapy for Children
Jan 10 – Jan 11 all-day

Sponsored by…


Weeefun Therapy for Children, San Dimas, CA

This two-day course is designed for experienced Rehabilitation team members, including orthotists, physical therapists, occupational therapists, physical medicine and rehabilitation physicians, and pediatric orthopedists currently working with babies and younger children. This program features an overview of somatosensory function and development, the role of postural control in movement acquisition and physiologic adaptation, skeletal modeling mechanisms and influences with ideal and pathomechanical features of orthopedic development of the trunk and lower extremity.

For more details, review the full course description or download a copy for reference.

7.0 contact hours
LEVEL: Intermediate

Feb
7
Fri
Developmental Orthopedics of the Trunk & Lower Extremity (2-Day) @ Wasatch Presbyterian Church
Feb 7 – Feb 8 all-day

Sponsored by…


Professional Therapies, Salt Lake City, UT

This program features an overview of somatosensory function and development, the role of postural control in movement acquisition and physiologic adaptation, skeletal modeling mechanisms and influences, and ideal and pathomechanical features of orthopedic development of the trunk and lower extremity.

View the course description or download a copy for reference.

14.0 contact hours • 14.0 Approved CE course by UPTA • 14.0 Pending with ABCOP
LEVEL: Intermediate

 

Feb
21
Fri
Pediatric Trunk Posture – The Significance of Extension @ NAPA Center
Feb 21 @ 6:30 pm – 8:30 pm

Sponsored by:

Target Audience: Rehabilitation team members, including physical therapists, occupational therapists, orthotists, physical medicine and rehabilitation physicians, and pediatric orthopedists.

Course Description: This after-hours program details the scientific and clinical evidence which supports the well-known pediatric management principle: “proximal stability precedes distal mobility.”

The instructor describes the ideal sequence of neuromotor acquisition and resting postures, and documents the relationship of faulty trunk control to limb muscle contracture in children with diplegic CP. She explores a number of management strategies that include positioning and orthotic aids.

Finally, the instructor introduces the new, code-verified, TherAlign DragonFly™  TLSO System as an example of a modality that can effectively address postural management issues.

The lecture runs from 6:30 – 8:30 pm. 2.0 contact hours; CEU credits are pending.

Instructor: Deborah Stack, PT DPT PCS

Course Description & Registration

Mar
19
Thu
Developmental Orthopedics of the Trunk & Lower Extremity (2-Day) @ Brain & Spine Physiotherapy Clinic
Mar 19 – Mar 20 all-day
Developmental Orthopedics of the Trunk & Lower Extremity (2-Day) @ Brain & Spine Physiotherapy Clinic | Navan | County Meath | Ireland

Sponsored by…

Brain and Spine Physiotherapy Clinic-Children Services, Navan, County Meath, Ireland

This program features an overview of somatosensory function and development, the role of postural control in movement acquisition and physiologic adaptation, skeletal modeling mechanisms and influences, and ideal and pathomechanical features of orthopedic development of the trunk and lower extremity.

View the course description or download a copy for reference.

7.0 contact hours
LEVEL: Intermediate

 

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