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

Oct
16
Fri
Posture & Torso Alignment for Pediatric Neuromotor Training (CTF Level I ) @ Mercy Hospital - McAuley South in the Von Gontard Conference Center
Oct 16 all-day
Posture & Torso Alignment for Pediatric Neuromotor Training (CTF Level I ) @ Mercy Hospital - McAuley South in the Von Gontard Conference Center | Saint Louis | Missouri | United States

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

Save $20 – Bring a colleague with you!

A full Course Description is available for download.

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

Oct
17
Sat
Pediatric In-toeing & Out-Toeing Management (CTF Level 2) @ Mercy Hospital - McAuley South in the Von Gontard Conference Center
Oct 17 all-day
Pediatric In-toeing & Out-Toeing Management (CTF Level 2) @ Mercy Hospital - McAuley South in the Von Gontard Conference Center | Saint Louis | Missouri | United States

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.

Save $20 – Bring a colleague along!

Download a full Course Description for reference.

7.75 contact hours
CEUs for PT’s & Orthotists
LEVEL: Intermediate
PREREQUISITE: Posture & Torso Alignment (CTF Level I)

Dec
4
Fri
Posture & Torso Alignment for Pediatric Neuromotor Training (CTF Level I ) @ UNC Charlotte - Center City, RM 1104
Dec 4 all-day
Posture & Torso Alignment for Pediatric Neuromotor Training (CTF Level I ) @ UNC Charlotte - Center City, RM 1104 | Charlotte | North Carolina | United States

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

Save $20 – Bring a colleague with you!

A full Course Description is available for download.

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

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

Dec
1
Thu
New Paradigms in Foot & Ankle Deformity Management @ Nicklaus Children's West Kendall Outpatient Center
Dec 1 – Dec 2 all-day
New Paradigms in Foot & Ankle Deformity Management @ Nicklaus Children's West Kendall Outpatient Center | Miami | Florida | 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. 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

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.

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. 

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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