This is archived programming for CSM 2012. See current programming.
Browse Orthopaedics 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.
Time: 8:00 am-5:30 pm (See Program for Room)
Speakers: James M. Elliott, PT, PhD, Shaun P. O'Leary, PT, PhD
Preconference Pricing: Standard Plus (2 day)
CEUs: 1.5 (15 contact hours/CCUs)
Exercise for the patient with neck pain: How do you know which exercises would be most beneficial for your patient with neck pain? Is the exercise program effectively increasing your patient's regional endurance, strength, and function? How many exercises should be prescribed? How can we improve exercise adherence? Join us for an opportunity to address these and other questions to enhance your skills in prescribing exercise for the management of chronic neck pain. This 2-day course will detail the collaborative research findings from the Centre of Clinical Research Excellence in Spinal Pain, Injury, and Health and The Centre for Advanced Imaging at the University of Queensland, Australia; and the Department of Physical Therapy and Human Movement Sciences in the Feinberg School of Medicine at Northwestern University, Chicago, IL. This course will feature details related to the examination, selection, administration, and progression of specific exercises for patients with pain and physical impairments related to traumatic and non-traumatic neck pain. An evidenced-based approach will be used to demonstrate the scientific basis of clinical tests and non-invasive MRI measures used in a variety of research and clinical settings to measure pain and physical impairment in patients with neck disorders. Emphasis will be on differentiating the varied clinical presentation of patients with traumatic and non-traumatic neck pain. Furthermore, the speakers will discuss clinical decisions related to the progression of exercise for the anterior and posterior neck muscles as well as the axioscapular musculature.
Upon completion of this course, you'll be able to:
Speakers: William O'Grady, PT, DPT, OCS, LFAAOMPT, DAAPM, Michael O'Donnell, PT, DPT, OCS, FAAOMPT, Ann Porter-Hoke, PT, DPT, OCS, FAAOMPT
This course is designed to maximize physical therapists' ability to successfully modify manipulation techniques to produce the best results. These techniques will focus on operator stance, posture, and handling; patient positioning; and modifying factors. This course will be primarily dedicated to hands-on lab practice. Guided discussions will provide for rationale, indications, and contraindications of manipulation and risks.
Speakers: RobRoy L. Martin, PT, PhD, Keelan Enseki, PT, MS, ATC, SCS, CSCS, Hal Martin, MD
Level: Multiple Level
Preconference Pricing: Standard Plus
CEUs: 0.7 (7 contact hours/CCUs)
Diagnosis and treatment of individuals with non-arthritic hip-related pathology can be difficult due to the close interrelationship among the lumbopelvic complex, soft tissue structures, and the hip joint itself. This lab-intensive course will outline an evaluation algorithm to assist with the differential diagnosis process for pathologies associated with the hip region. These specific evaluation techniques will allow for a classification-based plan of care and include hands-on mobilization techniques and innovative exercises. Essential diagnostic imaging techniques, including radiographs, magnetic resonance imaging arthrogram, and diagnostic injections, will be integrated into the evaluation process. Arthroscopic surgical procedures and techniques for postsurgical rehabilitation will also be discussed. This unique course will offer the teaching expertise of an orthopedic surgeon who specializes in hip arthroscopy. Clinicians will learn how to implement these evaluation and treatment techniques into their practice. Concerns for the rehabilitation of athletes with sport-specific considerations will also be reviewed, including clinical pearls and perils to help improve patient outcomes.
Speakers: Stephanie Albin, PT, DPT, OCS, FAAOMPT, Christian Little, PT, DPT, OCS, FAAOMPT
CEUs: 0.8 (8 contact hours/CCUs)
This 1-day, hands-on, laboratory-based course will focus on the use of mobilization and manipulation techniques that can be incorporated into the plan of care for individuals who have had extensive trauma to the foot and ankle, as well as those individuals with chronic overuse conditions. The morning session will initially focus on the current evidence to support the use of the manual therapy techniques to be presented, followed by hands-on laboratory experiences. The afternoon sessions will focus on case studies to integrate the manual therapy concepts and techniques presented in the morning session. In addition, a discussion and practice session on the use of mobilization of movement will also occur in the afternoon session. Best available evidence will be integrated into all discussion and laboratory sessions. The intent of this course is to provide attendees with useful, clinically relevant information that can be immediately applied to various practice settings.
Speakers: Douglas M. White, PT, DPT, OCS, Wayne Smith, PT, DPT, MEd, SCS, ATC, Joel Fallano, PT, DPT, MS, OCS
Sonography is fast becoming an adjunct to physical therapy management of orthopedic and sports conditions, from professional athletes and Olympians to outpatient clinics with a general orthopedic patient population. This course will provide an overview of the physics of sonography and the physical therapy application of musculoskeletal sonography for common hip, knee, and ankle conditions. The speakers will present techniques for imaging the lower extremity and identifying normal anatomy and abnormal morphology. The indications for, and limitations of, sonography and other imaging modalities in musculoskeletal conditions will be discussed, as well as the practical aspects of incorporating sonography into PT practice. Participants will apply techniques learned using hands-on sessions with live demonstrations and practice sessions.
Speakers: William O'Grady, PT, DPT, OCS, LFAAOMPT, DAAPM, Michael O'Donnell, PT, DPT, OCS, FAAOMPT, Ann Porter-Hoke, PT, DPT, OCS, FAAOMPT
Time: 8:00 am-10:00 am (See Program for Room)
Speakers: Todd E. Davenport, PT, DPT, OCS, John Meyer, PT, DPT, OCS, FAFS, Terry Grindstaff, PT, PhD, SCS, CSCS, ATC
Ankle instability is one of the most common foot and ankle conditions managed by physical therapists. Sponsored by the Orthopaedic Section Foot & Ankle Special-Interest Group, Part 1 of this 2-part session will provide attendees with the optimal evaluation and treatment strategies for the management of individuals with ankle instability. The current best practice model as outlined in the Ankle Instability Clinical Guidelines currently being developed by the Orthopaedic Section's ICF Foot & Ankle Workgroup will provide the framework for this presentation. The speakers will highlight current controversies in practice and research. During the second hour of programming, the speakers will address the examination and management of syndesmotic or "high" ankle sprains, considered to be one of the most complex types of ankle sprains. The anatomy of the distal tibiofibular syndesmosis, mechanisms of injury, evaluation, differential diagnosis, appropriate imaging, rehabilitation, and return-to-activity guidelines will be presented based on current, best available evidence. The format for this session will include lecture and interactive discussions between presenters and attendees.
Upon completion of this course, you'll be able to:
Speakers: Dee W. Edington, PhD, Joanette Lima, PT, MS, CIE, CPE, Cory Blickenstaff, PT, MS, OCS
A culture of wellness at job sites, including every physical therapy practice setting, benefits individuals, society, and corporate health. Starting with their own workplace, PTs have a unique opportunity to assist industry in the creation of a healthy and high-performing workforce. Conclusions from longitudinal studies encourage a change from the illness/injury model to one that promotes and gives incentives for wellness. This session will examine an evidence-based, transformational approach to creating a healthy and high-performing workforce. in the speakers will address how individual health promotion, organizational environments, and workplace cultures impact health care cost containment, disability, productivity, and human resource development. Following the main' presentation, the PT's' role in this novel approach will be explored through a case study and panel discussion with Dee Edington, PhD, and physical therapists currently working with corporations.
Speakers: Emilio (Louie) J. Puentedura, PT, DPT, GDMT, OCS, FAAOMPT
There is good evidence to support manual therapy directed to the cervical spine in some patients with neck pain. These manual therapy techniques include passive joint mobilization (non-thrust techniques) and thrust joint manipulation (TJM). Many physical therapists may be reluctant to utilize TJM to the cervical spine because of perceived risks associated with thrust techniques applied to this region. This session will provide an opportunity for participants to take a renewed, critical look at TJM to the cervical spine and consider risks and benefits. The speakers will present new research from recent studies. The first is a randomized clinical trial comparing outcomes of patients with neck pain who met a clinical prediction rule for thoracic spine TJM and received TJM to their cervical spine instead of the thoracic spine. The second study is a review of documented case reports of serious adverse events associated with TJM to the cervical spine to determine if the TJM was used appropriately and if the events could have been prevented. The final study present results of a survey on educational opportunities in TJM for Doctor of Physical Therapy students and novice clinicians. The information presented should provide for a more thoughtful analysis of the use of TJM in the cervical spine.
Time: 10:30 am-12:30 pm (See Program for Room)
Speakers: Joshua Cleland, PT, PhD, Joel Bialosky, PT, OCS
A substantial body of knowledge exists demonstrating the benefits of manual therapy for the management of a variety of conditions. However, it appears that the evidence is often lost in translation, as there exists considerable variation in physical therapist practice. Specifically, manual therapy interventions are often underutilized, potentially leading to suboptimal patient outcomes. Perhaps some of the reason for the underutilization may be related to lack of clarity surrounding the mechanisms of manual therapy. While traditional philosophies have relied on a biomechanical explanation for the observed effects, recent evidence suggests that a complex cascade of neurophysiologic effects may be at work. This lecture will discuss recent evidence related to the mechanisms behind many of our manual therapy interventions.
Speakers: Todd E. Davenport, PT, DPT, OCS, John Meyer, PT, DPT, OCS, FAFS, Terry L. Grindstaff, PT, PhD, SCS, ATC
Ankle instability is one of the most common foot and ankle conditions managed by physical therapists. Sponsored by the Foot & Ankle Special-Interest Group, the first hour of programming in this second of 2 sessions will include a panel discussion of case studies involving an individual with ankle instability and an athlete with a syndesmotic ankle sprain, followed by a question-and-answer session. The format for this 1-hour course will be lecture as well as interactive discussion between presenters and course participants. During the second hour of this session, the Foot & Ankle Special-Interest Group will conduct the group's annual business meeting.
Time: 3:30 pm-5:30 pm (See Program for Room)
Speakers: George Davies, PT, DPT, Todd S. Ellenbecker, PT, DPT, MS, SCS, OCS, Robert C. Manske, PT, DPT, Kevin Wilk, PT, DPT
This educational session will provide the outpatient practitioner with information on how to examine, evaluate, and treat what is quickly becoming one of the most common shoulder pathologies in the overhead athlete-glenohumeral internal rotation deficit (GIRD). A summary will involve application of the session material to several case studies to allow participants to apply techniques described in real-life patient scenarios.
Speakers: John D. Childs, PT, PhD, MBA, Julie Fritz, PT, PhD, Anthony Delitto, PT, PhD, FAPTA, Jeffrey W. Hathaway, PT
Are terms like pay for performance, network tiering, patient steerage, and consumer-driven health care new to your lexicon? In light of recent health care reform initiatives, the nation is now discussing the accountable care organization, or ACO. Given the fragmented physical therapy market for outpatient services, how can physical therapists align themselves to remain viable within an ACO model? "Paramount to understanding how PTs can thrive in this environment is defining value and understanding that it is dependent upon achieving optimal clinical outcomes relative to the cost of care." Come join a lively discussion on defining value in physical therapy service delivery. Attendees will learn how to capture the attention of health care system and insurance plan managers by creating a physical therapy ACO that delivers the "triple aim" of health care reform: 1) achieving measurable quality outcomes; 2) delivering an exceptional patient experience; and 3) reducing per capita cost of care.
Speakers: Dana Dailey, PT, Kathleen A. Sluka, PT, PhD
This session provides the information needed for the evaluation and treatment of patients with chronic pain. Chronic pain is a challenging diagnosis for the clinician and the patient. To better understand how to evaluate chronic pain, the underlying mechanisms of chronic pain based on the current science will be presented. The latest research will be discussed in terms of translating science and research into clinical practice. Chronic pain diagnoses such as low back pain and fibromyalgia will be reviewed and the biopsychosocial model of pain will be used for developing an individual plan of care and self management strategy for patients with chronic pain. Evidence-based tests and normative data will be presented in order to establish an objective baseline and ongoing assessment. Treatment topics and progression of treatment will be reviewed with an emphasis on self-management skills for daily care, exacerbation of symptoms, and evidence-based treatment. Case studies will demonstrate patient evaluation, treatment, and management strategies.
Speakers: Mary P. Massery, PT, DPT, Jeffrey T. Stenback, PT, OCS, Amy Humphrey, PT, DPT, OCS, MTC
Control of spine stability and postural equilibrium has relevance across the fields of physical therapy practice, from performing arts to management of continence to neurologic balance disorders and respiratory diseases. There is accruing evidence that "core" training extends beyond the abdominal muscles to achieve dynamic trunk control. This session challenges you to acknowledge a broader definition of proximal postural control. Novel research will be presented using a model of postural control (The Soda Pop Can Model) that extends from the lips (vocal folds) at the top of the trunk to the hips (pelvic floor) at the bottom of the trunk and includes abdominal, paraspinal, intercostals, and diaphragm muscles. The speaker will describe how the interactions between breathing, talking, continence. and postural stability contribute to postural control and the consequences of inadequate postural control such as low back pain, incontinence, impaired respiratory health, and compromised balance. The speakers will compel you to evaluate and treat postural control deficits from a multisystem approach considering both physiologic and physical deficits; challenge performing arts PTs to understand the link between breathing and efficient movement; andprovide performing artist case studies to enhance integration of this information.
(Joint Program: Private Practice)
Speakers: Michael Ross, PT, DHSc, OCS, William G. Boissonnault, PT, DHSc
Many patients with orthopedic disorders have had some form of diagnostic imaging, yet they routinely have limited knowledge of how their diagnostic imaging results relate to their current problem. What should physical therapists know about diagnostic imaging, such as plain film radiography, magnetic resonance imaging, bone scans, and computed tomography, to facilitate appropriate patient education and management, as well as maximize outcomes? This session discusses diagnostic imaging principles that can be immediately integrated into clinical practice. The indications and diagnostic utility for different imaging procedures for the spine and extremities will be described. Patient case examples will offer evidence for the appropriate use of diagnostic imaging as well as demonstrate how to place imaged pathology into the appropriate clinical context to assist with the evidence-based evaluation and management of the patient. An emphasis of this session is on clinical decision making principles in an outpatient, direct access physical therapy setting. However, the principles presented will be applicable to any clinical setting.
Speakers: Chris Maher, PT, PhD, Mark J. Hancock, PT, Chad E. Cook, PT, PhD
APTA's Vision 2020 is for physical therapists to be practitioners of choice to whom consumers have direct access for the diagnosis, treatment, and prevention of selected health maladies, including low back pain. US PTs increasingly are working in direct access (primary care) settings and are increasingly assuming patient management roles that were traditionally the domain of the physician. There are obvious challenges but also tremendous opportunities for the profession to evolve and so contribute to more cost-effective management of back pain in primary care. At the same time that the scope of practice is changing, there has also been an explosion of research on managing low back pain in primary care. However, many PTs do not have the time to distill this large volume of research down to the key information they need to guide their practice. This session does it for you. It provides an overview of contemporary diagnosis, prognosis, and treatment studies to provide important take-home messages for the management of LBP in primary care. The presenters will draw upon their own research as well as other key studies in the area. The moderated debate will allow for active interchange between you and the presenters.
Speakers: John Woolf, PT, MS, ATC, COMT, Beth A. Haggerty, MSW, Terry Hickey, MS
PTs are being exposed to literature that elucidates the need for a biopsychosocial model of care. However, most are ill-equipped to successfully integrate a biopsychosocial and a biomedical world view. As outcomes become increasingly important in an evolving health care system, PTs will need to maximize patients' participation in their rehabilitation. Even if PTs recognize the psychosocial barriers to a successful outcome, they have little training in how to motivate patients and change ineffective behaviors. PTs need key strategic communication skills such as motivational language, behavior change techniques, precision information gathering, and measuring therapeutic alliance to consistently create positive therapeutic alliances.. This session provides specific descriptions of neurobiology of relationship, health belief model, and therapeutic alliance, and exposes you to the following skills to maximize patient outcomes: provider-patient rapport including state management and patient calibration; eliciting patient worldview of the perceived problem, resources, goals, pathway to goals, and barriers to success; and measuring the level of therapeutic alliance.
Speaker: Narelle Stubbs, PT, PhD, BApp, ScPT, MAnSt
Equine back pain often presents with more than one lesion or problem, including the presence of limb lameness. Osseous lesions of the thoracolumbar spine and the lumbopelvic complex are widely recognized as significant causes of equine back pain, poor/loss of performance, and altered back and limb kinematics.
(Joint Program: Pediatrics)
Speaker: Hagit Rajter Berdishevsky, PT, MSPT, SST, MDT
Despite nearly 100 years of Schroth therapy for scoliosis in Europe, American medicine commonly argues that physical exercise has no effect on reducing or reversing scoliosis curvature. In recent decades, however, peer-reviewed literature with scientific data supports the effect of Schroth therapy on the scoliotic body and has shown many clinical and radiological positive outcomes. These effects are statistically significant and include a decrease of curve progression, curve reversal, improved vital capacity, improved pain scores, reduction in the need for bracing/surgery, and psychological enhancement. The Schroth Method includes pattern specific exercises for scoliosis and is described to be the current best practiceby the International Society on Scoliosis Orthopedic and Rehabilitation Treatment. The therapeutic exercises focus on trunk isometric muscle strengthening and active lengthening, rotational breathing, and over-correction of the scoliotic posture.
Speakers: James M. Elliott, PT, PhD, Shaun P. O'Leary, PT, PhD, Barbara Cagnie, PT, PhD
Informed decision making in the management of the patient with neck pain requires knowledge of the neuromuscular mechanisms underlying the diverse patterns of pain and physical impairments. Such knowledge may help to guide interventions and in particular, appropriate exercise prescription. This 2-hour course will feature the collaborative MRI and clinically based research programs from the Department of Physical Therapy and Human Movement Sciences at Northwestern University; the Centre of Clinical Research Excellence in Spinal Pain, Injury and Health at The University of Queensland, Australia; and the Department of Rehabilitation Sciences and Physiotherapy at Ghent University in Belgium. The speakers will discuss the implications of basic science research for the clinical management of the patient with traumatic and non-traumatic neck pain. The session will detail the group's research pertinent to the assessment, sub-group classification, and prescription of exercise for patients with neck pain. Key areas of the presentation will be the mechanistic basis for pain and physical impairments in the neuromusculoskeletal system as well as the observed contrasts between traumatic and non-traumatic neck pain. The speakers will review several novel measurements that have been developed to quantify/classify neuromuscular mechanisms in neck disorders, including muscle functional magnetic resonance imaging measures for the study of cervical and axioscapular motor behavior, and advanced MRI measures (including magnetic resonance spectroscopy of the spinal cord and diffusion weighted imaging of the paraspinal muscles).
(Joint Program: Pediatrics)
Speakers: Hagit Rajter, PT, MSPT, SST, MDT
In Part 2 of this course, attendees will practice the therapeutic exercises focusing on trunk isometric muscle strengthening and active lengthening, rotational breathing, and over-correction of the scoliotic posture. The speakers will discuss conservative management of scoliosis at all ages, with a review of the most recent literature. Topics will include a review of the Schroth method, pathomechanics of the 3-D scoliotic body blocks, Schroth-specific classification, and sub-grouping individual patterns into an easy therapeutic cluster using the progression of the Schroth exercises.
Speakers: Mary Fran Delaune, PT, Justin Elliott, Douglas M. White, PT, DPT, OCS, Deydre S. Teyhen, PT, PhD, OCS, Leslie Adrian, PT
Ultrasound imaging for musculoskeletal conditions started in the 1960s and has been rapidly expanding in use. Within physical therapy, use of this technology shows significant promise, especially in its ability to augment the assessment of human movement. Ultrasound imaging can be used to provide additional information on the status of body structures, aiding in clinical management; and as treatment adjunct to facilitate motor function and quality of motion. Through this technology, physical therapists can assess muscle length, depth, diameter, cross-sectional area, volume and potential angles, changes in these features, tissue movement and deformation, impact on other body structures, and resulting function. This panel discussion will focus on how physical therapists can use ultrasound imaging to evaluate tissue morphology and function to aid clinical evaluation within their scope of practice.
Research related to the changes in neuromotor control that occur with back pain has translated to the development of new rehabilitation strategies for the lumbo-pelvic muscles in human back-pain patients. This is an example of where anatomical and biomechanical research in the human creates an essential platform for future neuromotor control research in the horse.
Speakers: Kevin Wilk, PT, DPT, Christopher Powers, PT, PhD, Geoffrey S. Van Thiel, MD, MBA
The purpose of this course will be to provide scientific and clinical evidence for the treatment of patients with patellofemoral dysfunction. Patellofemoral joint dysfunction is one of the most common lesions treated by the physical therapist in the orthopaedic and/or sports physical therapy setting. The speakers will discuss these new advancements and provide specific treatment techniques. The non-operative treatment and surgical treatment for these patients with this lesion have changed significantly in the past 5 years. The speakers will present an evidence-based approach to non-operative, operative, and post-surgical treatments for patients with patellofemoral dysfunction.
Speakers: Jason Tonley, PT, DPT, OCS, Marcie Harris-Hayes, PT, DPT, MSCI, OCS
Impairments of the hip have been implicated in low back pain-such as limited range of motion, decreased strength, and poor neuromuscular control-however, findings have been inconclusive. These inconclusive findings may be due to heterogeneous samples used in studies. Use of low back pain subgroups may assist in clarifying the role of hip impairments in low back pain, particularly if the subgroups are based on lumbar spine movement strategies associated with the production of symptoms. This speakers present current evidence implicating hip impairments as a contributing factor in lumbar spine disorders, including an update of the anatomical and biomechanical factors of the hip that affect the alignment and movement strategies of lumbar spine. This course will review examination procedures used to indentify inter-regional dependence of the hip and spine and the use of these exam procedures to guide treatment will be demonstrated. This discussion will be followed by resident and fellow case presentations highlighting the clinical reasoning and patient management strategies used when the hip was treated as a primary impairment for lumbar spine pain.
Speakers: Joseph Godges, PT, DPT, RobRoy L. Martin, PT, PhD, Christopher R. Carcia, PT, PhD, SCS, OCS, James W. Matheson, PT, DPT
The International Classification of Functioning, Disability and Health (ICF) is a unified model of functioning and disability that was recently developed by the World Health Organization. The ICF provides standard language and a framework for the description of health and health-related states in terms of body structure and function, activity, and participation in life situations. The ICF provides a useful framework for PTs to direct the examination, treatment, and evaluation of patients. In 2006, the Orthopaedic Section of APT undertook a project to develop evidence-based guidelines, based on the ICF model, for the examination and treatment of common musculoskeletal conditions. The purpose of this presentation is to summarize the status of this project, including clinical practice guidelines on the physical therapist management of plantar fasciitis, achilles tendinitis, and ankle sprains. In addition, the speakers will discuss strategies to integrate evidence-based practice guidelines into clinical practice.
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