Archive: CSM 2012: Clinical Electrophysiology and Wound Management Programming

  • This is archived programming for CSM 2012. See current programming.

    Browse Clinical Electrophysiology and Wound Management sessions by day. Return to the main topic menu.

    Tuesday, February 7 | Wednesday, February 8 | Thursday, February 9 | Friday, February 10 | Saturday, February 11 

    * Should you choose to preselect sessions during the registration process, please be advised that preselection is not a guarantee of a seat. Attendees are asked to preselect to better determine room size and all efforts will be made to accommodate sessions in the largest rooms possible. All attendees are encouraged to show up to sessions early. Attendees are also encouraged to select alternative sessions in the event their first choice is full. 

    Tuesday, February 7 (Preconference)

    Teaching and Demonstrating Nerve Conduction Studies and Electromyography in PT Education Programs, Part 1

    Time: 8:00 am-5:30 pm (See Program for Room)

    (Joint Program: Education)

    Speakers: Andrew J. Robinson, PT, PhD, James T. Mills

    Level: Intermediate

    Preconference Pricing: Standard Plus (2 Day) 

    CEUs: 1.7 (17 contact hours/CCUs)

    This 2-day preconference program provides a conceptual understanding of nerve conduction studies (NCS) and needle electromyography (EMG) accompanied by hands-on experiences to prepare the PT academic program educator to teach and demonstrate these evaluative procedures to entry-level physical therapy students. The speakers will provide discussion and participant performance of selected motor nerve conduction and sensory nerve conduction tests. In addition, the speakers will demonstrate how to safely insert needle electrodes into skeletal muscles to examine their electrical activity at rest and during voluntary contraction in normally innervated skeletal muscles. Course faculty will discuss the similarities between a clinical neuromuscular exam and the NCS/EMG exam and the value of understanding the EMG/NCS exam to improve students' basic clinical skills. This course is specifically designed to assist educators in using the educational curriculum guidelines on electrophysiological examination and evaluation prepared by the Section on Clinical Electrophysiology and Wound Management.

    Upon completion of this course, you'll be able to:

    • Discuss the anatomical and physiological basis for basic nerve conduction studies and needle clinical electromyography.
    • Use and adjust a modern electroneuromyograph for the purposes of the demonstration of nerve conduction studies and electromyography.
    • Perform motor and/or sensory nerve conduction studies on the peripheral nerves of healthy adults.
    • Safely perform needle insertion and EMG examination of superficial muscles of the upper and/or lower limbs of healthy adults.
    • Discuss how the understanding of the EMG/NCS exam can improve students' basic clinical exam skills.
    • Read an EMG/NCS report and interpret and integrate the results into a prognosis to select of intervention(s) for patients.
    • Compare and contrast the nerve conduction and electromyographic findings.

    Wednesday, February 8 (Preconference)

    Physical Therapist Entry-Level Integumentary Content: What Should I Include and How Do I Do It?

    Time: 8:00 am-5:30 pm (See Program for Room)

    (Joint Program: Education)

    Speakers: Karen A. Gibbs, Sharon Lucich, PT, CWS, Heather McCormack, PT, DScPT, CWS, Stephanie L. Woelfel, PT, MPT, CWS, FACCWS

    Level: Multiple Level

    Preconference Pricing: Standard Plus 

    CEUs: 0.8 (8 contact hours/CCUs)

    This session is designed to help academic faculty improve integumentary curriculum delivery in their education programs. Attendees will learn to identify appropriate entry-level integumentary content; methods of improving content delivery, with specific examples of hands-on activities for labs; and ideas for testing student knowledge and skill. Tips on choosing textbooks and how to incorporate more integumentary content into your program will also be covered. Come prepared to participate in the discussion, share your experiences of what does and does not work, and learn from each other, as well as from the instructors. Participants are strongly encouraged to bring all posted session handouts, as well as their own current integumentary content outlines or syllabi for this productive, hands-on work session.

    Upon completion of this course, you'll be able to:

    • Explain why basic, entry-level integumentary content is vital to the practice of physical therapy and why academic programs need to incorporate at least the minimum required content.
    • Access APTA professional documents and utilize this information in planning and revising current entry-level integumentary curricula.
    • Take at least 2 new strategies back to your program to improve integumentary content delivery during lecture and hands-on lab sessions.
    • Explore reasonable venues for assembling appropriate supplies to augment hands-on learning experiences.
    • Discuss ideas regarding integumentary textbook choices and identify at least one that would be appropriate for your program.
    • Evaluate options for expanding integumentary learning opportunities off-campus.
    • Identify options for recruiting assistance with integumentary content delivery.
    • Brainstorm creative ways in which to incorporate more integumentary content in an already busy curriculum and identify at least 2 new possible venues to explore in your own program.
    • Apply at least 2 new strategies for testing student integumentary knowledge and skill through written and hands-on activities.
    • Demonstrate knowledge and skill with equipment and supplies common to integumentary care, such as advanced dressings and bandaging, wound filling, irrigation (syringe, catheter, pulsed lavage with suction), debridement, compression, and suture removal.

    Low-level Laser Therapy: From Bench to Bedside

    Time: 8:00 am-5:30 pm (See Program for Room)

    Speakers: David Baxter, TD, DPhil, MBA, Juanita Anders, PhD

    Level: Intermediate

    Preconference Pricing: Standard Plus 

    CEUs: 0.6 (6 contact hours/CCUs)

    Over the past decade, the availability and clinical application of low-level laser therapy systems have expanded rapidly in the US physical therapists are well placed to effectively incorporate these systems into routine clinical practice; however, there is continuing confusion over the principles and practice of effective application and a dearth of high-quality courses for clinicians. Many practitioners report a lack of confidence in utilizing these devices safely and effectively and confusion over the relevance of laser treatment parameters such as dosage. This full-day course will prepare autonomous physical therapists to utilize and apply low-level laser therapy systems in routine clinical practice safely and effectively. A hands-on practical workshop will cover the principles and practice of low-level laser therapy. The speakers will review the biological and biophysical bases of phototherapy; explain best practices, including technical and safety aspects of low-level laser therapy and laser acupuncture; and a summarize current evidence of clinical effectiveness.

    Upon completion of this course, you'll be able to:

    • Define the key biophysical characteristics of currently available laser therapy systems.
    • Discuss the biological basis of low-level laser therapy for tissue repair and pain relief.
    • Incorporate an evidence-based approach to clinical decision-making as part of application of low-level laser therapy and laser acupuncture.
    • Apply low-level laser therapy and laser acupuncture in a confident, safe, and effective manner to promote tissue healing and manage pain.

    Teaching and Demonstrating Nerve Conduction Studies and Electromyography in PT Education Programs, Part 2

    Time: 8:00 am-5:30 pm (See Program for Room)

    (Joint Program: Education)

    Speakers: Andrew J. Robinson, PT, PhD, James T. Mills

    Level: Intermediate

    Preconference Pricing: Standard Plus (2 Day) 

    CEUs: 1.7 (17 contact hours/CCUs)

    This 2-day preconference program provides a conceptual understanding of nerve conduction studies (NCS) and needle electromyography (EMG) accompanied by hands-on experiences to prepare the PT academic program educator to teach and demonstrate these evaluative procedures to entry-level physical therapy students. The speakers will provide discussion and participant performance of selected motor nerve conduction and sensory nerve conduction tests. In addition, the speakers will demonstrate how to safely insert needle electrodes into skeletal muscles to examine their electrical activity at rest and during voluntary contraction in normally innervated skeletal muscles. Course faculty will discuss the similarities between a clinical neuromuscular exam and the NCS/EMG exam and the value of understanding the EMG/NCS exam to improve students' basic clinical skills. This course is specifically designed to assist educators in using the educational curriculum guidelines on electrophysiological examination and evaluation prepared by the Section on Clinical Electrophysiology and Wound Management.

    Upon completion of this course, you'll be able to:

    • Discuss the anatomical and physiological basis for basic nerve conduction studies and needle clinical electromyography.
    • Use and adjust a modern electroneuromyograph for the purposes of the demonstration of nerve conduction studies and electromyography.
    • Perform motor and/or sensory nerve conduction studies on the peripheral nerves of healthy adults.
    • Safely perform needle insertion and EMG examination of superficial muscles of the upper and/or lower limbs of healthy adults.
    • Discuss how the understanding of the EMG/NCS exam can improve students' basic clinical exam skills.
    • Read an EMG/NCS report and interpret and integrate the results into a prognosis to select of intervention(s) for patients.
    • Compare and contrast the nerve conduction and electromyographic findings.

    Thursday, February 9

    Deep-Tissue Injury: Can Physical Therapy Make an Impact?

    Time: 8:00 am-10:00 am (See Program for Room)

    Speaker: Elizabeth A. Altenburger, PT, MSPT, Jaimee Haan, PT, CWS, Elizabeth Longmuir, PT, DPT

    Level: Intermediate

    With the heightened sense of urgency related to hospital-acquired conditions, wound specialists face added demands related to early identification and prevention of pressure ulcers. In 2007, the National Pressure Ulcer Advisory Panel released updated pressure ulcer definitions that included a new category, deep tissue injury (DTI). One alarming trend is the growing percentage of DTIs that convert to stage 3 and stage 4 pressure ulcers. Based on Hornaker's work, IU Health Methodist Hospital developed an integrated treatment protocol for DTIs. In this presentation, the speakers will review the history of DTI, share strategies for early identification and treatment, and discuss the results of their recent study examining the effectiveness of this new treatment protocol.

    Upon completion of this course, you'll be able to:

    • Define deep tissue injury and understand the mechanism of injury.
    • Recognize the importance of early identification and documentation of deep tissue injury as it relates to hospital-acquired conditions.
    • Describe the role of a physical therapist in the identification, prevention, and treatment of deep tissue injury.
    • Analyze the current body of evidence related to the treatment of deep tissue injury and the need for future research related to the treatment of deep tissue injury.

    A User-Friendly Framework for Evidence-based Decision Making in Electrotherapy, Part 1

    Time: 8:00 am-10:00 am (See Program for Room)

    (Joint Program: Neurology)

    Speaker: David M. Selkowitz, PT, PhD

    Level: Multiple Level

    This is the first half of a 2-part presentation providing a user-friendly framework for clinical decision making and application involving electrotherapy. It is designed to demystify electrotherapy and reduce the fear factor commonly involved in learning and practicing electrotherapy. This session will include the scientific and theoretical bases and the practical applications of electrotherapeutic strategies in the management of neuromusculoskeletal dysfunction. The speaker will draw upon critical analysis of the literature, the available evidence, and clinical experience in exploring what is known, what is theorized, and what is "mythical" and unsubstantiated regarding the physical and physiological effects and clinical use of electrical stimulation.

    Upon completion of this course, you'll be able to:

    • Recognize and distinguish appropriate and recommended terminology for electrotherapy and associated devices.
    • Describe the parameters of the electrotherapeutic stimulus.
    • Identify the physiologic responses to electrotherapy and determine which are necessary to promote particular treatment goals.

    Alternative and Complementary Approaches to Wound Healing

    Time: 10:30 am-12:30 pm (See Program for Room)

    (Joint Program: Neurology)

    Speaker: Karen Albaugh, PT, DPT

    Level: Intermediate

    It has often been said that physical therapy is both an art and a science, and wound management is no exception. A holistic approach to the individual is central to non-Western healing traditions. This session will examine the characteristics of conventional medicine and compare it to alternative and complementary approaches to health, emphasizing the conceptual differences in healing and symptom management. Several alternative modalities offer insight with respect to wound management. This session will discuss the use of the following integrative modalities in wound healing: mind-body techniques (guided imagery, positive affirmations, and prayer), aromatherapy, botanical medicine (diet and herbal supplements), acupuncture, and light therapy. Attendees will gain a better understanding of the growing body of evidence for these modalities and begin to consider integration of these approaches into in their own clinical practice.

    Upon completion of this course, you'll be able to:

    • Compare the principles and theories of conventional Western medicine with that of complementary and alternative medicine.
    • State key integrative concepts related to healing.
    • Describe the effect of stress on wound healing.
    • Examine the evidence for various alternative modalities in wound healing.
    • Develop a strategy to integrate complementary approaches into practice.

    A User-Friendly Framework for Evidence-based Decision Making in Electrotherapy, Part 2

    Time: 10:30 am-12:30 pm (See Program for Room)

    (Joint Program: Neurology)

    Speaker: David M. Selkowitz, PT, PhD

    Level: Multiple Level

    This is the second half of a 2-part presentation providing a user-friendly framework for clinical decision making and application involving electrotherapy. It is designed to demystify electrotherapy and reduce the fear factor commonly involved in learning and practicing electrotherapy. This session will include the scientific and theoretical bases and the practical applications of electrotherapeutic strategies in the management of neuromusculoskeletal dysfunction. The speaker will draw upon critical analysis of the literature, the available evidence, and clinical experience in exploring what is known, what is theorized, and what is "mythical" and unsubstantiated regarding the physical and physiological effects and clinical use of electrical stimulation.

    Upon completion of this course, you'll be able to:

    • Assess the indications, precautions, and contraindications for the use of electrotherapeutic devices with respect to different patient management situations.
    • Design appropriate methods of combining and manipulating parameters of electrotherapy to produce the desired physical and physiologic effects and associated treatment goals.
    • Evaluate different types of electrotherapeutic devices with respect to their potential physical and physiological effects and, therefore, their potential treatment uses.
    • Choose and use the most appropriate electrotherapeutic device available and manipulate the electrotherapeutic parameters to obtain the desired neurophysiologic responses appropriate for particular treatment goals.

    Understanding the Basics of Clinical Application of EMG/NCS Testing: Clinical Case Studies

    Time: 3:30 pm-5:30 pm (See Program for Room)

    (Joint Program: Education)

    Speaker: James T. Mills, PT, MS, ECS, OCS, John Lugo, PT, MS, ECS, Gregory Ernst, PT, PhD, ECS, OCS

    Level: Basic

    This course will present a series of clinically oriented electromyography and nerve conduction testing (EMG/NCS) case studies for the clinician with a novice understanding of these tests. Case studies will include pathological conditions (eg, mononeuropathies, nerve root lesions, polyneuropathies) commonly encountered in physical therapist practice. Through this series of cases, attendees will learn the process of determining the physiological status (eg, myelinopathy, axonopathy, conduction block, denervation, axonal regeneration) of the conditions and the localization of the lesions by EMG/NCS testing. Proper evaluation and interpretation of electrophysiological data and reports will be discussed.

    Upon completion of this course, you'll be able to:

    • Perform a basic and accurate evaluation and interpretation of EMG/NCS reports of uncomplicated mononeuropathies, nerve root lesions, and polyneuropathies.
    • Describe the electrophysiological presentations of uncomplicated mononeuropathies, nerve root lesions, and polyneuropathies in varying physiological states.
    • Anatomically localize a neuropathic lesion based upon electrophysiological findings.
    • Properly correlate clinical signs and symptoms with electrophysiological findings.

    Friday, February 10

    Effective Wound Pain Management in the Aging Adult

    Time: 8:00 am-10:00 am (See Program for Room)

    (Joint Program: Geriatrics)

    Speakers: Jill Heitzman, PT, DPT, GCS, CWS, CEEAA, FACCWS, Carrie Sussman, PT, DPT

    Level: Intermediate

    The aging adult has many issues that are sometimes overlooked and attributed to the aging process. With regards to the aging skin, pain is often overlooked. Common diagnoses affect sensation, and too often pain associated with wound conditions goes untreated. This session will look at the aging integumentary system, the relationship of the other aging physiological systems, and the relationship to the neurologic component of pain. Common integumentary conditions will be presented with a discussion of the presence and management of wound pain.

    Upon completion of this course, you'll be able to:

    • Discuss the aging process of the integumentary system.
    • Explain how the aging physiological systems affect the integumentary system and wound healing
    • Analyze the neurological component of wound pain.
    • Identify pain issues associated with common wound conditions.
    • Effectively manage wound pain with pharmaceuticals and nonpharmaceuticals including biophysical agents.

    Infection Prevention and Wound Management: Clinical, Ethical, and Economic Issues

    Time: 10:30 am-12:30 pm (See Program for Room)

    (Joint Program: Acute Care, Hand Rehabilitation)

    Speakers: Harriett B. Loehne, PT, DPT, CWS, FACCWS, Stephen A. Streed, MS, CIC

    Level: Intermediate

    This session describes the factors associated with an increased risk of infection related to wound care and offers prevention strategies designed to lower the risk of health care-associated infections (HAIs). Presenters will discuss the primary pathogens involved in wound infections, their reservoirs and mode(s) of transmission, and the intrinsic patient factors that lead to added risk of infection. The impact of infections in terms of added length-of-stay and patient morbidity and mortality will be covered, along with the economic and social implications for the care provider system. Finally, caregiver responsibilities including health and personal hygiene and the need for careful adherence to standards of practice will be related to adverse patient outcomes in a way that clearly promotes individual and organizational accountability.

    Upon completion of this course, you'll be able to:

    • List the main pathways of at least 5 pathogens commonly associated with wound infection and identify how these agents can ultimately gain entry into the patient.
    • Identify and employ infection prevention and control techniques during irrigation and dressing changes and treatment with pulsed lavage with suction, low-frequency ultrasound, and negative pressure wound therapy.
    • Cite the impact of wound infection in terms of added patient morbidity, mortality and length-of-stay, and the adverse, unrecoverable economic costs and negative social implications associated with preventable infections and public reporting of HAIs.

    Residency Programs: Elevating Electrodiagnosis and Wound Management to the Next Level

    Time: 3:30 pm-5:30 pm (See Program for Room)

    (Joint Program: Education)

    Speakers: Edward Mahoney, PT, DPT, Stanley K. McCallon, PT, DPT, Joseph McCulloch, PT, PhD, CWS, FAPTA, John Lugo, PT, MS, ECS, Michael Lescallette, PT, DPT, MS, ECS, Gregory Ernst, PhD, Roger M. Nelson, PT, PhD, FAPTA, Robert Kellogg, PT, PhD, ECS

    Level: Basic

    This session explores the history, development, and implementation of residency programs for electrodiagnosis and wound management. Presenters will discuss changes in the education process for these programs as well as the standards required by the American Board of Physical Therapy Residency and Fellowship Education (ABPTRFE). Perspectives from various stakeholders will be discussed, and there will be a question-and-answer session.

    Upon completion of this course, you'll be able to:

    • Explain the requirements necessary for the establishment of a residency program set forth by ABPTRFE.
    • Identify components of a successful residency program in electromyography/nerve conduction velocity.
    • Identify components of a successful residency program in wound management.
    • Relate the potential benefits and difficulties to your own setting to determine whether or not a residency would be feasible.
    • Describe the integration of a residency program into an existing physical therapy school, from an administrative perspective.

    Saturday, February 11

    Preparing the Wounded Foot for Ambulation

    Time: 8:00 am-10:00 am (See Program for Room)

    (Joint Program: Geriatrics)

    Speakers: Rose Hamm, PT, DPT, Pamela Scarborough

    Level: Intermediate

    Physical therapists are committed to optimizing function for all patients regardless of diagnosis. For the patient who has a foot wound, ambulation may be limited by the location of the wound; pain; decreased range of motion in the ankle, foot, and toe; improper footwear; or compromised balance once fitted with the proper footwear. The purpose of this course is to present best-practice interventions for the most-frequently treated foot wounds, with an emphasis on the diabetic foot; to discuss how gait can contribute to wounds as well as how wounds can affect gait; and to illustrate strategies to redistribute foot pressures (using specialized footwear and orthotics) so that the patient may ambulate while facilitating wound healing.

    Upon completion of this course, you'll be able to:

    • Differentially diagnose arterial, pressure, and neuropathic wounds on the foot.
    • Relate changes in the foot due to diabetes complications to wound prevention, formation, and treatment.
    • Design a plan of care for the patient with each of these wound types.
    • Observe gait abnormalities that contribute to or are caused by foot wounds.
    • Select the appropriate footwear for patients with foot wounds.
    • Fabricate an orthotic to assist in redistributing pressure on the plantar foot surface.

    Atypical Wounds

    Time: 10:30 am-12:30 pm (See Program for Room)

    (Joint Program: Acute Care)

    Speakers: Jennifer A. Gardner, PT, DPT, Marcy Turkos, PT, DPT

    Level: Multiple Level

    Physical therapists may encounter a number of wounds from causes other than pressure, neuropathy, venous/arterial disease, surgery, or infection. This session highlights characteristics of a number of less common causes of wounds, including pemphygus, calciphylaxis, sickle cell disease, vasopressor-associated symmetrical peripheral gangrene, melanoma, and psoriasis.

    Upon completion of this course, you'll be able to:

    • Identify atypical wounds.
    • Determine appropriate diagnostic tests for these wounds.
    • Determine appropriate treatment interventions.
    • Identify what wounds need to be referred to other specialists.
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