Archive: CSM 2012: Neurology Programming

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

    Browse Neurology 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)

    A Comprehensive Approach to Evidence-based Rehabilitation of Patients With Parkinson Disease: Across the Continuum of Disability, Part 1

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

    Speakers: Terry Ellis, PT, PhD, NCS, Leland E. Dibble, PT, PhD

    Level: Intermediate

    Preconference Pricing: Standard Plus (2 Day) 

    CEUs: 1.6 (16 contact hours/CCUs)

    Parkinson disease is considered a chronic health condition that must be successfully managed over a period of many years. Despite advances in medical management, patients with Parkinson disease experience a decline in quality of life and physical function over the course of the disease. There is a growing body of evidence revealing the benefits of physical therapy and exercise in improving participation, activity limitations, and impairments of body structure and function in people with Parkinson disease. The speakers will begin by discussing differential diagnosis; pharmacological/surgical intervention; evidence-based approaches to examination, diagnosis, prognosis, and intervention; and the responsiveness of commonly used outcome measures in patients with Parkinson disease. The most current research supporting specific elements of treatment will be highlighted, including the use of external cueing, treadmill training, cardiopulmonary/vascular fitness training, strengthening, and balance training.

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

    • Distinguish between idiopathic Parkinson disease and other causes of Parkinsonism in the examination process.
    • Discuss commonly used pharmacologic interventions, mechanisms of action, side effects, and implications for rehabilitation in patients with Parkinson disease.
    • Recognize the potential benefits/risks of deep brain stimulation for patients with Parkinson disease and identify those symptoms most likely to respond to surgical intervention.
    • Effectively select responsive outcome measures across the continuum of disability in patients with Parkinson disease.
    • Identify prognostic indicators that may impact the progression of disability.
    • Summarize the evidence supporting the benefits of physical therapy and exercise for patients with Parkinson disease.
    • Develop an evidence-based treatment approach to the management of patients with Parkinson disease across the continuum of disability.
    • Describe a model of care in which physical therapists intervene to optimize physical function and quality of life over the course of the disease.

    Neurologic Practice Essentials: Exploring Neuroplasticity and Its Rehabilitation Implications, Part 1

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

    Speakers: James V. Lynskey, PT, PhD, Deborah Backus, PT, PhD, Andrea L. Behrman, PT, PhD, FAPTA, Marghuretta D. Bland, PT, DPT, MSCI, Lara Boyd, Nancy Byl, PT, PhD, FAPTA, Beth Fisher, PT, PhD, Thomas (George) Hornby, PT, PhD, Robbin Howard, Teresa J. Kimberley, PT, PhD, Deborah Larsen, Jennifer L. Moore, PT, DHS, NCS, John Scholz, Mike Studer, PT, MS, NCS, CEEAA

    Level: Multiple Level

    Preconference Pricing: Standard Plus (2 Day) 

    CEUs: 1.6 (16 contact hours/CCUs)

    As neuroscience advances, physical therapists are challenged to remain current with new concepts and their translation to clinical practice. This 2-day course will update clinicians on the current scientific understandings of neuroplasticity processes as well as behavioral and non-behavioral variables that underlie changes in movement and function in persons with movement dysfunction. The speakers will present animal, human, and clinical research responsible for shifting the paradigm of rehabilitation and will culminate in discussions of key clinical practice questions and suggestions for structuring intervention. Video cases in neurodevelopment, neurotrauma, and neurodegenerative disorders will provide opportunity for collaborative small-group activities and discussions of how neuroplasticity research is relevant to and feasible in clinical practice.

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

    • Identify basic neuroanatomical and neurophysiological processes as they relate to advances in neuroplasticity research.
    • Identify multifactorial variables that influence neuroplasticity and rehabilitation management.
    • Critically examine current concepts in neuroplasticity and discuss their clinical relevance related to individuals with neurodevelopmental, neurotrauma, and neurodegenerative disorders.
    • Discuss "take-home messages" for practice, including designing interventions that can be implemented in the clinical environment.
    • Identify clinical barriers to the delivery of evidence-based practice and suggest potential solutions.

    Wednesday, February 8 (Preconference)

    A Comprehensive Approach to Evidence-based Rehabilitation of Patients With Parkinson Disease: Across the Continuum of Disability, Part 2

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

    Speakers: Terry Ellis, PT, PhD, NCS, Leland E. Dibble, PT, PhD

    Level: Intermediate

    Preconference Pricing: Standard Plus (2 Day) 

    CEUs: 1.6 (16 contact hours/CCUs)

    Parkinson disease is considered a chronic health condition that must be successfully managed over a period of many years. Despite advances in medical management, patients with Parkinson disease experience a decline in quality of life and physical function over the course of the disease. There is a growing body of evidence revealing the benefits of physical therapy and exercise in improving participation, activity limitations, and impairments of body structure and function in people with Parkinson disease. The speakers will begin by discussing differential diagnosis; pharmacological/surgical intervention; evidence-based approaches to examination, diagnosis, prognosis, and intervention; and the responsiveness of commonly used outcome measures in patients with Parkinson disease. The most current research supporting specific elements of treatment will be highlighted, including the use of external cueing, treadmill training, cardiopulmonary/vascular fitness training, strengthening, and balance training.

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

    • Distinguish between idiopathic Parkinson disease and other causes of Parkinsonism in the examination process.
    • Discuss commonly used pharmacologic interventions, mechanisms of action, side effects, and implications for rehabilitation in patients with Parkinson disease.
    • Recognize the potential benefits/risks of deep brain stimulation for patients with Parkinson disease and identify those symptoms most likely to respond to surgical intervention.
    • Effectively select responsive outcome measures across the continuum of disability in patients with Parkinson disease.
    • Identify prognostic indicators that may impact the progression of disability.
    • Summarize the evidence supporting the benefits of physical therapy and exercise for patients with Parkinson disease.
    • Develop an evidence-based treatment approach to the management of patients with Parkinson disease across the continuum of disability.
    • Describe a model of care in which physical therapists intervene to optimize physical function and quality of life over the course of the disease.

    Neurologic Practice Essentials: Exploring Neuroplasticity and Its Rehabilitation Implications, Part 2

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

    Speakers: James V. Lynskey, PT, PhD, Deborah Backus, PT, PhD, Andrea L. Behrman, PT, PhD, FAPTA, Marghuretta D. Bland, PT, DPT, MSCI, Lara Boyd, Nancy Byl, PT, PhD, FAPTA, Beth Fisher, PT, PhD, Thomas (George) Hornby, PT, PhD, Robbin Howard, Teresa J. Kimberley, PT, PhD, Deborah Larsen, Jennifer L. Moore, PT, DHS, NCS, John Scholz, Mike Studer, PT, MS, NCS, CEEAA

    Level: Multiple Level

    Preconference Pricing: Standard Plus (2 Day) 

    CEUs: 1.6 (16 contact hours/CCUs)

    As neuroscience advances, physical therapists are challenged to remain current with new concepts and their translation to clinical practice. This 2-day course will update clinicians on the current scientific understandings of neuroplasticity processes as well as behavioral and non-behavioral variables that underlie changes in movement and function in persons with movement dysfunction. The speakers will present animal, human, and clinical research responsible for shifting the paradigm of rehabilitation and will culminate in discussions of key clinical practice questions and suggestions for structuring intervention. Video cases in neurodevelopment, neurotrauma, and neurodegenerative disorders will provide opportunity for collaborative small-group activities and discussions of how neuroplasticity research is relevant to and feasible in clinical practice.

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

    • Identify basic neuroanatomical and neurophysiological processes as they relate to advances in neuroplasticity research.
    • Identify multifactorial variables that influence neuroplasticity and rehabilitation management.
    • Critically examine current concepts in neuroplasticity and discuss their clinical relevance related to individuals with neurodevelopmental, neurotrauma, and neurodegenerative disorders.
    • Discuss "take-home messages" for practice, including designing interventions that can be implemented in the clinical environment.
    • Identify clinical barriers to the delivery of evidence-based practice and suggest potential solutions.

    The Role of the Physical Therapist in the Evaluation and Management of Athletes Following Sports Concussion

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

    Speakers: Susan L. Whitney, PT, DPT, PhD, NCS, Anne Mucha, PT, MS, NCS, Dana Hinderliter, PT, Michael Collins, PhD

    Level: Intermediate

    Preconference Pricing: Standard 

    CEUs: 0.7 (7 contact hours/CCUs)

    Up to 3.8 million concussions occur annually in the US. Due to serious long-term consequences that may arise from incomplete recovery and improper management, much national attention has been devoted to this injury. Concussion often results in a multitude of symptoms, deficits in cognitive function, and impairments in balance. Effective management employs a multidisciplinary team approach. The role of the physical therapist as a member of the core team is evolving. Due to the prevalence of ongoing balance dysfunction along with symptoms of dizziness, motion sensitivity, and deconditioning following this brain injury, physical therapists are uniquely qualified to intervene. This 1-day course will provide an overview of the most recent evidence related to postconcussive disorders. The team approach to evaluation and management of patients will be presented. Case studies will illustrate physical therapy intervention along with neuropsychological and medical management.

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

    • Discuss the importance of a team approach in the effective management of individuals with concussion.
    • Draw upon the latest research and guidelines related to sports concussion.
    • Identify factors that contribute to prognosis and outcome following concussion.
    • List the key components of medical, neuropsychological, and physical therapy assessment in patients with concussion.
    • Explore the latest advances in balance assessment in concussion.
    • Apply new knowledge gained from case studies that illustrate sports concussion with comorbid balance and vestibular dysfunction.
    • Analyze the role of ocular motor abnormalities in the evaluation, prognosis, and management of individuals with concussion.
    • Examine ocular motor function.
    • Describe the stages of exertional training post concussion and apply these to postconcussion rehabilitation.

    Thursday, February 9

    *OVER CAPACITY -- Degenerative Disease SIG: Multiple Sclerosis: PT Exam and Intervention Across the Spectrum of Disability

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

    Speakers: Herb Karpatkin, PT, DSc, NCS, MSCS

    Level: Intermediate

    Multiple sclerosis is being diagnosed increasingly across different age groups, including pediatrics and geriatrics, suggesting that management must integrate growth/development and comorbidities commonly associated with aging. Therefore, it may be better to see multiple sclerosis as a disease that occurs not only across a wide spectrum of disability, but over a continuum of time and age. This session will propose a systematic evidence-based model for managing individuals with MS across the continuum of the disease. Physical therapy intervention can result in meaningful improvements in function, body structure, and participation, regardless of age or disease severity. The most recent evidence will be presented regarding physical therapy evaluation and treatment across the continuum of disease.

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

    • Distinguish between pathology, impairments, and functional limitations that are due to MS, and those that are secondary to aging or the developmental process.
    • Describe the variations in clinical presentation in individuals with MS across the disease continuum.
    • Analyze the unique clinical issues and intervention considerations in children with pediatric MS.
    • Understand intervention strategies indicated for older adults with MS.
    • Evaluate the unique clinical presentation of individuals with MS of various ages and levels of disability.
    • Apply the examination, intervention, and outcome measures research evidence that address specific age and levels of disability due to MS.

    The Anne Shumway-Cook Lectureship: Opportunities and Challenges of Translating Neurorehabilitation Research Into Practice

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

    (Joint Program: Research)

    Speakers: Carolee Winstein, PT, PhD, Rebecca L. Craik, PT, PhD, FAPTA, James Gordon, PT, PhD, FAPTA, Anne Shumway-Cook, PT, PhD, FAPTA, Mike Studer, PT, MHS, NCS, CEEAA

    Level: Intermediate

    This session is focused on the opportunities and challenges of translating neurorehabilitation research into practice. The speakers will define the opportunities within the T1-T2 translational medicine framework and current health care environment. The majority of the session will focus on the barriers and challenges using a range of examples of recently completed and ongoing T1 and T2 randomized controlled trials in neurorehabilitation (eg, EXCITE, EVEREST, LEAPS). An expert panel will engage the audience in a dialog on important issues including: 1) Does it have to take 17 years from discovery to change practice? 2) What is our unique responsibility in the scientific process of translation? 3) How can we best leverage the federal investment in translational research to advance our profession's research agenda?

    Upon completion of this course, you will be able to:

    • Describe the science in the process of translating-getting down to the more important elements.
    • Explore challenges and opportunities in using animal models to inform human research.
    • Integrate theoretical and conceptual basis of neurorehabilitation before adopting an approach (eg, CIMT).
    • Discuss challenges and possible solutions to the length of time it takes to translate research findings to the clinic (eg, Does it have to take 17 years from discovery to change practice?).

    *OVER CAPACITY -- Balance and Falls SIG: Technological Innovations for Balance and Falls in Research and Clinical Practice

    Time: 10:30 am-12:00 pm (See Program for Room)

    (Joint Program: Health Policy and Administration)

    Speakers: Renee M. Hakim, PT, PhD, NCS, Cynthia Gibson-Horn, PT, Tiffany Shubert, PT, Marjorie Skubic, PhD, MS

    Level: Multiple Level

    For 5 years, the Neurology Section Balance and Falls Special-Interest Group has been on a mission to define balance, identify assessment and outcome measures that best fit our current understanding of balance, categorize interventions for balance dysfunction and fall risk, and compare and contrast patient care along the lifespan continuum and across practice settings. The next step is to address technological advances in the management of balance and falls. Remember when virtual reality and holographic images were only found in science fiction? The future is now here! This session will highlight technologies currently available for the assessment and treatment of individuals with balance deficits and fall risk. A panel discussion will address advancements in gaming technology, using technology in the clinic, and identifying mobility trends that indicate the need for earlier intervention.

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

    • Examine evidence-based technologies and technological strategies that can be used in clinical and research realms for analysis of balance and falls.
    • Specify the features of non-wearable technology that identify candidates for fall risk assessment.
    • Evaluate the potential effectiveness of technologies that can be applied to fall risk assessment.
    • Identify at least 7 unique games that can improve balance.
    • Describe at least 7 ways to modify the game environment to challenge balance.
    • Discuss atypical measures of documenting functional improvement.

    Reports and Recommendations From the Neurology Section Task Force on Outcome Measurement for Individuals With Multiple Sclerosis

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

    Speakers: Kirsten Potter, PT, DPT, MS, NCS, Diane D. Allen, PT, PhD, Susan E. Bennett, PT, DPT, EdD, NCS, MSCS, Kathleen Brandfass, PT, MS, Evan T. Cohen, PT, PhD, MA, NCS, Gail L. Widener, PT, PhD, Amy Yorke, PT, MPT, NCS

    Level: Multiple Level

    The Multiple Sclerosis (MS) Outcome Measures Task Force was appointed by the Neurology Section of APTA. The intentions were to: 1) conduct an evidence-based review of outcome measures; 2) evaluate the utility of outcome measures and provide recommendations for those appropriate for clinical practice, education, and/or research; 3) generate a list of systems review questions to include in examinations; and 4) identify needs for future research. Each recommendation was based on an analysis of the constructs measured, a synthesis of psychometric data, and a consensus evaluation of the appropriateness of the outcome measure. This session will provide an overview of the Task Force's process; discuss recommended outcome measures for clinical practice, education, and research; use case scenarios to illustrate the selection of outcome measures; and provide recommendations for future research.

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

    • Identify challenges faced by physical therapists when examining patients with MS.
    • Briefly discuss benefits and barriers of outcome measure use in clinical practice.
    • Present the rationale for developing a core set of outcome measures for use in examining individuals with MS.
    • Identify the recommended MS outcome measures "core sets" for clinical practice, education, and research, and provide a rationale for their inclusion.
    • Compare and contrast outcome measures appropriate for use in different clinical settings and for patients with MS with varying levels of disability.
    • Given a particular patient with MS, determine the appropriate outcome measures to apply in the assessment of the person's current status and progress.
    • Discuss recommendations for future research on outcome measures for individuals with MS.

    Stroke SIG: Incorporation of the Upper Extremity in Poststroke Physical Therapy

    Time: 3:30 pm-5:00 pm (See Program for Room)

    Speakers: Diane Nichols, PT, NCS, Kathleen Brady, PT, MPT

    Level: Intermediate

    New information is being generated on recovery of arm movements after stroke. A majority of this research is being performed by physical therapists who are applying fundamental treatment principles. Yet, for a variety of reasons, the hemiparetic upper extremity is rarely a target of physical therapy treatment. An open discussion of this issue will be led by senior clinical and research PTs, Diane Nichols and Kathleen Brady. Topics will include: How much attention should be paid to the upper extremity in poststroke acute and subacute rehabilitation? What is/should be the role of physical therapists in treating the upper extremity? Which aspects of upper-extremity function should be targeted by physical therapy interventions? What are some useful ways to incorporate the upper extremity into poststroke physical therapy treatment?

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

    • Discuss specific aspects of upper-extremity function that are impaired after stroke and can be addressed by physical therapy interventions.
    • Recognize the possible benefits of incorporating the stroke-affected upper extremity into physical therapy treatment.
    • List specific treatment ideas for incorporating the hemiparetic arm into physical therapy treatment.

    Vestibular SIG: The Use of Optokinetic Stimulation in Vestibular Rehabilitation

    Time: 3:30 pm-5:00 pm (See Program for Room)

    Speaker: Marousa Pavlou, PT, PhD

    Level: Intermediate

    Customized vestibular rehabilitation incorporating optokinetic stimuli (OKS) is more beneficial than in isolation for improving dizziness, postural instability, and space and motion discomfort symptoms in patients with chronic peripheral vestibular symptoms. However, many clinicians do not have access to expensive, space-consuming, research study equipment, and treatment frequency is often not feasible in clinical practice. This course will focus on how to transfer OKS from a research setting to a clinical setting. Session topics will include: assessment of space and motion discomfort symptoms; low-tech OKS devices for clinical practice; and incorporating and progressing OKS exposure within a vestibular rehabilitation program. Case studies will illustrate OKS intervention for patients with a peripheral vestibular disorder and for patients with migraine-associated dizziness, which combines peripheral and central vestibular components.

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

    • List key components of an assessment for space and motion discomfort.
    • Describe low-tech OKS devices that can be used in clinical practice.
    • Discuss factors to consider when incorporating and progressing OKS exposure within a vestibular rehabilitation program.
    • Discuss cases that illustrate intervention for space and motion discomfort in patients with a peripheral vestibular disorder, as well as for patients with migraine-associated dizziness.

    Brain Injury SIG: Military Initiatives for Assessment/Intervention of Individuals With Concussion/Mild Traumatic Brain Injury

    Time: 3:30 pm-5:00 pm (See Program for Room)

    (Joint Program: Federal Physical Therapy)

    Speakers: Margaret M. Weightman, PT, PhD, Karen McCulloch, PT, PhD, NCS

    Level: Multiple Level

    The Rehabilitation and Reintegration Division of the Office of the Surgeon General, US Army, supported the development of the Rehabilitation Mild Traumatic Brain Injury Toolkit in recognition of the need for evidence informed clinical decision making with wounded Service members. The physical therapy-related elements of the Toolkit are informed by Clinical Practice Guidance: Occupational and Physical Therapy Mild Traumatic Brain Injury and are applicable to civilian practice for individuals with concussion or mild TBI. This roundtable discussion will highlight military initiatives to institute standards of care, training for PTs, and development of assessments for return-to-duty decision making using dual-task and multitasking methods for service members with mild TBI.

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

    • Describe the mechanism and context of mild TBI common in military settings and highlight the differences in causes and comorbidities as compared to civilian and sports injury.
    • Identify elements of the Rehabilitation Mild TBI Toolkit that can be implemented in clinical practice for both service members and civilians with concussion or mild TBI.
    • Discuss military initiatives for the assessment and treatment of service members with mild TBI, including training initiatives for PTs charged with their rehabilitation.

    NCS Reception and Presentation: Developing Clinical Expertise Through Case Discussions

    Time: 6:30 pm-8:00 pm (See Program for Room)

    Speakers: Cynthia M. Zablotny, PT, DPT, MS, NCS, Kristin Parlman, PT, DPT, NCS

    Level: Intermediate

    Congratulations to new and recertified ABPTS-certified neurologic clinical specialists! New and current NCS's are invited to a reception offering networking opportunities with others who share a passion for neurologic clinical practice, followed by a presentation to introduce group case discussions to promote evidence-based practice in the clinical setting. The presenter, Kristin Parlman, PT, DPT, NCS, has extensive experience using case discussions as an integral part of neurologic physical therapy clinical education within a large teaching hospital. A patient case will be used to demonstrate the process of developing a clinical question, engaging clinicians in the literature search, facilitating group discussion, and applying research evidence. Participants will have the opportunity to modify this approach to meet the needs of their own clinical setting. Note: RSVP required.

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

    • Describe a model for integrating case discussions into a clinical practice setting.
    • Understand the benefits of using group case discussions to promote evidence-based practice and professional development.
    • Describe alternative models of case discussions to meet the varying learning needs of participants at all levels of clinical and professional development.

    Friday, February 10

    Action Potential: How and Why to Get Involved With the Neurology Section!

    Time: 8:00 am-9:00 am (See Program for Room)

    Speakers: Sandra Billinger, PT, PhD, FAHA, Judith Burnfield, PT, PhD, Patty Scheets, PT, DPT, NCS

    Level: Intermediate

    Want to get involved in the Neurology Section? Physical therapists who practice in neurology often express an interest in getting involved with the Neurology Section, but many have conveyed a lack of awareness of the structure and function of the section and the ways to become involved. This session will provide a succinct overview of the organization of the section including the responsibilities associated with each position. Many physical therapists are also interested in further professional development that may span a variety of areas including clinical practice, leadership, research, and education. Examples will be provided to demonstrate how participation in the section can facilitate one's professional growth in a particular area of interest.

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

    • Recognize the role of the Neurology Section, the benefits of being a member, and the ways in which you can become involved.
    • Describe the organizational structure of the Neurology Section and the responsibilities associated with each position (elected and appointed) .
    • Explain how participation in the section is applicable to your career goals in the areas of improving clinical skills, leadership, research, and education.

    Degenerative Disease SIG: Cardiopulmonary Dysfunction and Amyotrophic Lateral Sclerosis

    Time: 8:00 am-9:30 am (See Program for Room)

    Speakers: Mohammed S. Sanjak, PT, PhD, Andrew D. Ray, PT, PhD

    Level: Multiple Level

    Amyotrophic Lateral Sclerosis (ALS), also known as "Lou Gehrig's Disease," is a progressive neurodegenerative disease that affects nerve cells in the brain and the spinal cord. The complex and progressive nature of the disease requires expert intervention at the time of diagnosis and throughout the course of the disease. This session will feature a review of the pathophysiology of ALS, a discussion of the cardiovascular/pulmonary changes that occur secondary to the disease, and an exploration of respiratory exercise interventions. During the concluding question-and-answer period, the presenters will address specific educational needs of the physical therapist or physical therapist assistant who encounters individuals diagnosed with ALS.

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

    • Discuss the pathophysiology and the staging of ALS and its implication on treatment.
    • Identify the changes that occur in the respiratory system of an ALS patient and the proper techniques to manage these symptoms.
    • Discuss the topic of exercise as a treatment strategy/therapeutic technique in managing ALS.

    Spinal Cord Injury SIG: Parenting After Spinal Cord Injury

    Time: 8:00 am-9:30 am (See Program for Room)

    (Joint Program: Women's Health)

    Speaker: Heather K. Henderson, PT, DPT, NCS

    Level: Basic

    There is extensive research on fertility and the ability of people with spinal cord injury (SCI) to become parents; however, little has focused on what comes next: parenting with physical limitations. Participants will interact with a panel of experts in the team approach to parenting after SCI. Panel members will include PT, OT, rehab engineer, and parents with SCI. Discussion will include functional considerations during pregnancy/labor and delivery, pre-delivery infant care training, parent adaptive devices for mobility, infant/toddler care adaptive devices, adaptive techniques for infant/toddler care, ergonomics, and energy conservation.

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

    • Discuss barriers to parenting for people after SCI.
    • Describe how adaptive devices and adaptive techniques will improve safety and function for mothers during pregnancy.
    • Describe how adaptive devices and adaptive techniques will improve safety and function for parent and infants/toddlers.

    Balance/Falls and Vestibular SIGs: Vestibular and Balance Hi-Tech Gadget Show Case

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

    Speakers: Anne K. Galgon, PT, MSPT, PhD, Jeffrey M. Hoder, PT, DPT, Julie K. Tilson, PT, DPT, MS, NCS, Steven Allred, MPT, MBA, Rene' D. Crumley, PT, DPT, NCS, Cecelia Griffith, PT, DPT

    Level: Multiple Level

    This session presents the current advances in technologies and devices that may enhance examination and intervention in vestibular and balance rehabilitation. Integrating technology into clinical practice designed for postural control, gait, and visual/vestibular integration will be discussed, and a framework for evaluating technology for clinical utility will be presented. In an interactive session, you will be guided through questions for critically evaluating the utility of hi-tech devices in vestibular and balance rehabilitation. The presenters also will guide you through critical appraisal of the technology by interacting with devices and discussing their application to enhance clinical practice. Reference lists for technology for postural control, gait, and visual/vestibular integration will be available as downloadable handouts.

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

    • Critically appraise hi-tech devices to support clinical practice.
    • Discuss advantages and disadvantages of 3 devices used to examin vestibular and/or balance disorders.
    • Discuss advantages and disadvantages of 3 devices used in intervention with individuals with vestibular and/or balance disorders.

    Knowledge to Action: Evidence, Collaboration, and Improved Patient Outcomes in Neurorehabilitation

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

    Speakers: Sue Ann Sisto, PT, PhD, Katherine J. Sullivan, PT, PhD, Mary Schmidt, PT, Julie J. Hershberg, PT, DPT, NCS

    Level: Basic

    Knowledge translation (KT) is a dynamic, interactive process between rehabilitation researchers and evidence-based clinicians. KT integrates new knowledge from clinical research with the realities of clinical practice to create innovative approaches to clinical care. This session demonstrates how partnerships between rehabilitation researchers and clinicians can create KT strategies in the clinical setting, which can lead to health improvements for children and adults with disabilities. Three examples demonstrate how the KT process can translate knowledge to action in the clinical environment. Rehabilitation researchers and clinical specialists will lead you through an interactive knowledge-to-action session, and in the process, identify KT messages that can be shared in the clinic or educational settings.

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

    • Describe the essential elements of the knowledge-to-action framework and its application to neurorehabilitation practice and improved health outcomes for people with disabilities.
    • Based on the International Classification of Function (ICF) and quantitative statistical methods, describe a clinical model that objectively identifies the key impairment and activity outcome measures and therapist-patient treatment targets most likely to increase participation for a person with a walking disability after stroke.
    • Describe how rehabilitation researchers and clinicians have created a KT network for improved clinical care and functional outcomes for people after spinal cord injury.
    • Through an interactive session, identify clinical outcome tools that all physical therapists can use to identify changes in balance and walking ability for any person who needs physical therapy, from intensive care through return to home and community life.

    *OVER CAPACITY -- Spinal Cord Injury SIG: Exploring the Potential for Upper-Limb Functional Improvements in People With SCI

    Time: 10:30 am-12:00 pm (See Program for Room)

    Speaker: Deborah Backus, PT, PhD

    Level: Intermediate

    Evidence shows that people with incomplete spinal cord injury (SCI) have potential for upper limb (UL) function improvement, and that the underlying recovery mechanisms may be neurally mediated. Data will be presented showing improved somatosensory perception, motor output, and function in people with chronic incomplete tetraplegia. Although preliminary, these findings suggest that treatment to improve UL function should focus on improving motor control, not just compensation. This presentation will also discuss the application of the principles underlying the facilitation of neural plasticity and functional changes (intensity, repeated practice, attention, and somatosensory augmentation) for improving UL function in people with tetraplegia. The use of interventions combining repeated movement, somatosensory augmentation, and attention/focus may lead to greater improvements in UL function in people with either acute or chronic incomplete tetraplegia.

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

    • Provide a rationale for considering the use of activity-based interventions to improve upper limb function in people with tetraplegia due to SCI.
    • Describe current activity-based treatment approaches being evaluated for efficacy to improve upper limb function in people with incomplete tetraplegia due to SCI.
    • Discuss strategies to overcome barriers to using the evidence for rehabilitation of the upper limb in people with tetraplegia.

    Getting Published in JNPT: A Chat With the Editorial Board

    Time: 10:30 am-12:00 pm (See Program for Room)

    Speakers: JNPT Editor-in-Chief, Edelle C. Field-Fote, PT, PhD, Associate Editors, Lara Boyd, PT, PhD, Lee Dibble, PT, PhD, George Fulk, PT, PhD, Kathy Gill-Body, DPT, MS, NCS, Lisa Harvey, PT, PhD, Catherine Lang, PT, PhD

    Level: Intermediate

    The Journal of Neurologic Physical Therapy (JNPT) is your Neurology Section journal. Do you have ideas to enhance the usefulness of the journal's print or digital content? Have you thought about submitting an article, but were uncertain about what it entails? Do you have questions about becoming a reviewer? This informal discussion session will provide information about becoming involved with JNPT either as a contributor or reviewer for the Neurology Section's journal. The editor and associate editors look forward to chatting with you.

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

    • Discuss how JNPT policies strive to insure a thorough, objective, and fair peer-review process for all editorial content.
    • Discuss what JNPT editors look for in a submission.
    • Describe the process a manuscript goes through after submission to JNPT.
    • Identify the issues that commonly prevent submissions from attaining a high score.
    • Learn about the process for becoming a JNPT reviewer.

    The Neurological Impact of Forced Exercise in Parkinson Disease and Its Translation Into Clinical Care

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

    (Joint Program: Geriatrics)

    Speakers: Susan M. Linder, PT, DPT, NCS, Jay L. Alberts, PhD, Kathy Szirony, PT

    Level: Intermediate

    This session provides the scientific background and rationale for the use of forced exercise in Parkinson disease (PD) and outlines the global improvements in motor and nonmotor functioning using this intervention for patients with PD. Clinical and functional magnetic resonance imaging (fMRI) data from a randomized controlled trial are presented detailing the specific effects of voluntary and forced exercise. Presenters will discuss ther experience in the development of a standard of care for rehabilitation, comprising a multi-disciplinary approach with a team of neurologists, physical, speech, and occupational therapists and exercise physiologists. This collaborative, patient-centered model integrating best medical practice, innovative scientific research, and evidence-based rehabilitation with objective and quantitative outcomes will be outlined in detail.

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

    • Describe the cellular response in the central nervous system to forced exercise and explain the potential mechanisms underlying exercise-induced neuroplasticity, neuroprotection, and synaptogenesis based on animal and human studies.
    • Explain the neurophysiologic rationale for the use of forced exercise in patients with PD.
    • Discuss the motor and nonmotor neurologic impact observed in patients with PD following forced exercise.
    • List the components of an evidence-based interdisciplinary approach to the management of patients with PD.
    • Systematically describe the methods of applying scientific research to the comprehensive rehabilitation of patients with PD.
    • Discuss the application of forced exercise in the management of other diseases and conditions including obesity and stroke.

    The Art of Documentation: Effective and Clear Documentation of Nontraditional Therapeutic Activities

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

    Speakers: Genevieve Pinto-Zipp, PT, EdD, Kathryn Mitchell, PT, DPT, NCS, Valerie Teglia, PT, DPT, NCS, Ann Williamson, PT, DPT, NCS, Heather A. Hayes, PT, DPT, NCS

    Level: Multiple Level

    Clinicians are using various nontraditional treatments, such as video gaming and virtual reality, and novel therapeutic activities for interventions. Patient responses to intervention need to be described accurately, using terminology that emphasizes underlying principles of impairment, activity, and participation limitation being addressed within the plan of care. The ICF framework can provide support for documenting the use of non traditional approaches as meaningful therapeutic interventions. You will engage in thought-provoking, decision-making activities that focus on addressing key elements associated with several therapeutic activities currently being used in the clinic, such as virtual reality gaming, constraint-induced movement therapy, and partial body-weight support in order gain an appreciation of the elements that can be included in documentation to present a more clear and accurate description of the patients plan of care.

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

    • Explain the impact that accurate and clear documentation has on physical therapy service delivery.
    • Integrate the ICF framework into the documentation of nontraditional therapeutic activities to clearly articulate the connection between the client's goals and the skilled care provided.
    • Write daily notes with accuracy and clarity for nontraditional interventions, such as virtual reality games, CIMT, and partial body-weight support for the neurologic patient.

    Brain Injury SIG: Concussion Management in the Adolescent Athlete

    Time: 3:30 pm-5:00 pm (See Program for Room)

    (Joint Program: Orthopaedics)

    Speakers: Anne Mucha, PT, MS, NCS, Sean Learish, PT, MPT

    Level: Intermediate

    The Centers for Disease Control and Prevention estimate that more than 3.8 million sports concussions occur annually. Although the spotlight is often cast on concussion in the professional athlete, the vast majority of sports-related concussions occur in young student-athletes. This session highlights the most recent evidence surrounding concussion diagnosis and management in young people and will illustrate how the adolescent athlete is managed via an interdisciplinary approach within the University of Pittsburgh Medical Center Sports Concussion Program. A clinical case will demonstrate key aspects of concussion management in the adolescent athlete.

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

    • Describe the pathophysiology, signs, and symptoms of concussion.
    • Recognize factors contributing to prognosis and outcome following concussion in young athletes.
    • Describe negative outcomes related to concussion.
    • Identify management principles for rehabilitation of the concussed adolescent athlete.
    • Recognize the role of physical therapy in the multidisciplinary management of concussion.
    • Apply the principles of exertional rehabilitation to concussion management in adolescents.

    Cognitive and Motor Contributions to Dual-Task Walking Deficits in People With Parkinson Disease

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

    (Joint Program: Geriatrics, Acute, Research)

    Speakers: Valerie E. Kelly, PT, PhD, James B. Leverenz, MD, Anne Shumway-Cook, PT, PhD, FAPTA

    Level: Intermediate

    Gait impairments in patients with Parkinson disease (PD) are known to be exacerbated under dual-task conditions, which require the simultaneous performance of cognitive or motor tasks while walking. The consequences of gait impairments in PD include increased risk for falls and disability, loss of independence, and reduced quality of life. Both cognitive and motor factors contribute to dual-task walking deficits in people with PD, and these impairments may influence the effect of interventions designed to improve dual-task walking. This session reviews cognitive and motor impairments in people with PD, including the prevalence, pathophysiology, assessment, and potential neural mechanisms that contribute to dual-task walking deficits. The clinical implications of cognitive and motor impairments for physical therapy evaluation and treatment of dual-task walking deficits in people with PD will be discussed.

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

    • Describe the prevalence and consequences of single and dual task gait impairments in people with PD.
    • Review cognitive impairments in people with PD, including their prevalence, pathophysiology, assessment of cognitive impairments, associations with dual-task walking deficits in PD, and potential neural mechanisms underlying their contribution to dual task walking deficits.
    • Review motor impairments in people with PD, including their prevalence, pathophysiology, assessment of motor impairments, associations with dual-task walking deficits in PD, and potential neural mechanisms underlying their contribution to dual task walking deficits.
    • Discuss the clinical implications of research on motor and cognitive deficits to the assessment and treatment of dual-task walking deficits in people with PD. c

    Myelin Melter and Neuro Section Business Meeting: Leading the Way in Neurologic Physical Therapy

    Time: 6:30 pm-10:00 pm (See Program for Room)

    Saturday, February 11

    Advances in the Assessment and Rehabilitation of Patients With a Peripheral Vestibular Disorder

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

    Speaker: Marousa Pavlou, PT, PhD, MCPS

    Level: Advanced

    Approximately 50-80% of individuals completing a customized vestibular rehabilitation program show improvements in symptoms and postural stability. However, complete recovery is less common and occurs in approximately a third of cases-why this occurs is not entirely clear. This course will provide further insight into factors affecting recovery and future intervention strategies for patients completing a customized vestibular rehabilitation program. The speaker will discuss balance strategies used by patients with peripheral vestibular disorders when walking in urban environments; the relationship between the neuropsychological assessment and dual-tasking ability during complex standing and gait tasks; and management of space and motion discomfort. In addition, the speaker will examine the potential impact of these findings on the future management intervention strategies for patients with a peripheral vestibular disorder.

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

    • Discuss the latest research related to gait in urban environments and the relationship between dual tasking and cognitive function in patients with a peripheral vestibular disorder.
    • Describe the potential impact of these findings on the future assessment, management, and intervention strategies for patients with peripheral vestibular disorders.
    • Discuss the use of optokinetic stimulation in the management of space and motion discomfort in this patient group.

    Strategies for Successful Implementation of Routine Outcome Measurement in Clinical Practice

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

    (Joint Program: Research)

    Speakers: Jennifer L. Moore, PT, DHS, NCS, Allan J. Kozlowski, PT, PhD, Mary Keehn, PT, DPT, MHPE

    Level: Multiple Level

    The use of standardized outcome measurements has been recommended by rehabilitation experts for many years. Health care professionals understand the importance of assessing functional outcomes, and many efforts have been made to increase the implementation of these measures into clinical practice. Despite these efforts, the use of standardized measures to monitor patient progress and evaluate outcomes is limited. Many organizational and individual barriers-such as limited access, time, and knowledge-may prevent knowledge translation in this area. This course will focus on improving clinicians' ability to implement routine outcome measurement into clinical practice, including how to address common barriers, appropriately select outcome measurements for clinical practice, and implement strategies that facilitate routine use. The speakers will provide a brief description of several free online resources to support the appropriate selection of instruments.

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

    • Identify common barriers and facilitators of routine outcome measurement administration.
    • Describe successful strategies for routine implementation of outcome measurements in clinical practice.
    • Summarize important characteristics of instruments used in clinical settings.
    • Access free online resources to support the selection of outcome measures for clinical practice.

    The LEAPS Trial Revisited: Discussion of Research, Current Evidence, and Clinical Practice in Post-stroke Rehabilitation

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

    (Joint Program: Research)

    Speakers: Steve Wolf, PT, PhD, FAPTA, FAHA, Andrea L. Behrman, PT, PhD, FAPTA, Dorian K. Rose, PT, PhD, Julie K. Tilson, PT, DPT, MS, NCS, Scott Janis, PhD, Carol Richards, PT, PhD, FCAHS, Anne Shumway-Cook, PhD, Edelle C. Field-Fote, PT, PhD, Thomas (George) Hornby, PT, PhD, Craig Moore, PT, MS, Julie Hershberg, PT, DPT, NCS

    Level: Multiple Level

    Building upon the primary and secondary outcomes of the LEAPS (Locomotor Experience Applied Post-Stroke) trial, this forum will address the LEAPS trial design and results relative to the current state of rehabilitation trials and directions for future design; current evidence for physical therapy interventions for walking recovery; and implications for practice both today and in the future. A discussion, led by the LEAPS Investigative Team, will interpret and apply the LEAPS results to the rehabilitation of patients/clients within today's health care environment.

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

    • Describe the design of the LEAPS trial.
    • Discuss clinical decision-making based on evidence from the LEAPS trial and other studies designed to improve walking post-stroke.
    • Apply knowledge gained from the LEAPS trial to today's clinical practice.
    • Identify gaps, needs, and strategies for incorporating walking recovery research into clinical practice.

    Physical Therapists Providing Evidence-based Exercise Programs: Making It Work in Parkinson Disease

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

    (Joint Program: Geriatrics)

    Speakers: Teresa Steffen, PT, PhD, Anne Langenfeld-Smith, PT, Jonathan T. Mathwig, PT

    Level: Intermediate

    A new role for physical therapists is taking back the long-term rehabilitation of a client population who benefits from ongoing exercise programming. This includes working on wellness to improve or maintain current functional skills. Goals of clients will vary from ambulation skills to travel and professional speaking. Can local physical therapists make this happen in their communities? What approvals are needed and from whom? How much financial incentive would it take to participate in this twice a week for an hour? Who could facilitate in making this a reality? Where will you do this?

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

    • Develop community exercise programs using professionals.
    • Discuss how to find relevant evidence to support the program.
    • Encourage financial support for a class from the institution, client, insurer, therapists, and community.
    • Explain how to use volunteer help to assist the class.
    • Discuss our Wisconsin experience of 12 Parkinson exercise group classes.

    *OVER CAPACITY -- Stroke SIG: Current Concepts in Post-stroke Gait Rehabilitation

    Time: 10:30 am-12:00 pm (See Program for Room)

    Speakers: Darcy Reisman, PT, PhD

    Level: Intermediate

    There are an large number of treatment options available for walking after stroke, and new approaches are being continuously developed and marketed. At the same time, rehabilitation researchers are providing information on the efficacy of particular treatment approaches and, more importantly, on the process of locomotor recovery itself. What to make of it all? Darcy Reisman possesses a unique combination of experience and knowledge areas-from biomechanics to neurophysiology to clinical practice-that can provide an informative perspective on the current state-of-the-art science of post-stroke gait rehabilitation. Reisman is an assistant professor in the Department of Physical Therapy at the University of Delaware. Her own work in the area of hemiparetic gait has examined such factors as interlimb coordination, walking speed, and motor adaptation.

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

    • Identify the effects of factors such as walking speed, treadmill walking, and functional electrical stimulation on hemiparetic gait characteristics.
    • Define motor adaptation and discuss evidence for the adaptability of hemiparetic gait.
    • Recognize complimentary treatment approaches that could be combined in the rehabilitation of hemiparetic gait.

    Getting Your Clients Complex Seating and Mobility Technology: Evaluation, Documentation and Reimbursement

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

    (Joint Program: Acute Care, Health Policy and Administration, Pediatrics)

    Speakers: Barbara A. Crane, PT, PhD, ATP, Laura Cohen, PT, PhD, ATP, Barbara Crume, PT, ATP

    Level: Basic

    This course will provide evidence-based strategies for evaluating seating and technology needs of individuals with mobility impairments across the lifespan and practice settings. Topics will include assessment of ambulation function, including safety and efficacy; identifying the type of mobility assistive equipment needed, the length of time equipment will be necessary, and a treatment planning for fitting; letters of medical necessity; and training and re-assessment. Finally, to ensure appropriate reimbursement for your services, management of visits and the use of CPT codes will be discussed. The course will prepare you to assist your clients in successfully navigating the funding and reimbursement maze to obtain the mobility devices that they need for maximum activity and participation.

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

    • Recognize the need for a mobility device evaluation and prescription.
    • Perform relevant evaluations and examinations for mobility device selection.
    • Identify and record the appropriate information as it relates to basic wheelchair documentation for insurance coverage.
    • Determine funding requirements and generate an appropriate letter of medical necessity for a mobility device.
    • Use CPT codes and manage visits to ensure appropriate reimbursement for seating and mobility services.

    Contemporary Principles for Optimizing Motor Learning for Patients With Neurologic Impairments

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

    Speaker: Michael Majsak, PT, EdD

    Level: Intermediate

    Motor learning involves a set of processes that may be disrupted as a result of neurologic pathology. Physical therapy promotes motor learning by manipulating task conditions, structuring the conditions and schedules of practice, and providing the appropriate frequency/timing of external feedback and physical assistance. A number of studies have shown patterns between specific types of manipulations (eg, random versus blocked practice, delayed external feedback) and learning. To apply these methods, PTs must consider the cognitive and physical resources of patients, the complexity of the tasks to be learned, and the amount of practice that is possible. This course will provide an evidence-based review of how PTs can manipulate task and practice conditions to optimize the engagement of patients with various resources and limitations in learning capacity.

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

    • Describe the processes involved in motor learning and how they are disrupted in patients with various types of neurologic pathologies.
    • Examine how task and practice conditions can be manipulated to optimize the engagement of patients.
    • Create and modify the conditions of practice sessions for patients with neurologic pathologies to promote processes of motor learning.

    Differential Diagnosis and Management of Atypical Benign Paroxysmal Positional Vertigo

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

    Speakers: Janet O. Helminski, PT, PhD, Kathy D. Hall, PT, EdD, Timothy C. Hain, MD

    Level: Multiple Level

    Benign paroxysmal positional vertigo (BPPV) is the single most common cause of vertigo and is frequently misdiagnosed. This course will focus on the process of differential diagnosis for BPPV based on history and findings from positional testing with the use of oculography. Fluid dynamics and anatomical alignment of the canals and computer simulations will serve as the foundation for the interpretation of nystagmus and the differential diagnosis and treatment of typical and atypical BPPV. The differential diagnostic process and treatment will be illustrated with the use of cases and digital oculography recordings.

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

    • Apply the process of the differential diagnosis in the management of BPPV.
    • Identify examination findings that would suggest the need for a referral to a physician.
    • Describe normal fluid dynamics of the canals and abnormal responses due to BPPV.
    • Differentiate between AC- and PC-BPPV based on findings in positional testing.
    • Identify LC-BPPV by using the differential diagnosis process to interpret findings in positional testing.
    • Use BPPV particle repositioning maneuvers, taking into account the anatomical alignment of the canals.
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