Archive: CSM 2013: Neurology Programming

  • This is archived programming for CSM 2013. See current programming.

    Browse Neurology sessions by day. Return to the main topic menu 

    Sunday, January 20 | Monday, January 21 | Tuesday, January 22 | Wednesday, January 23 | Thursday, January 24 

    * Should you choose to preselect regular (not preconference) Tuesday-Thursday 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. 

    Sunday, January 20 (Preconference)

    Multiple Sclerosis From Diagnosis to Intervention: Translating Science Into Clinical Practice, Part 1

    Location: San Diego Convention Center | 4

    Time: 8:00 am - 5:00 pm

    Speakers: Linda A. Csiza, PT, DSc, NCS; Herb Karpatkin, PT, DSc, NCS; Evan Cohen, PT, MS, PhD, NCS; Donna Fry, PT, DSc, NCS, MSCS; Eduard Gappmaier, PT, PhD

    Level: Intermediate

    CEUs: 1.6 (16.0 contact hours/CCUs)

    Preconference Pricing: Standard Plus (2B) 2 Day

    Multiple sclerosis (MS) affects 350,000 people in the United States and more than 2.5 million people worldwide. It is a disease of great variability, leading to a spectrum of disability—which can range from mild to severe—with no stereotypical presentation. With a greater understanding that MS is a disease that significantly impacts mobility, the frequency with which individuals with MS participate in physical therapy has increased. However, MS is a unique disease that requires a specific understanding of its characteristics in order to provide competent treatment. There is an ever-growing body of research available to guide clinicians in the physical therapy management of individuals with MS. The primary goal for this preconference course is to propose a systematic evidence-based model for the physical therapy care of individuals with MS across the continuum of the disease. Research suggests that individuals with MS can show meaningful improvement in body structure/function, activity, and participation as a result of appropriate medical management and physical therapy intervention. A panel of experts will present the most current evidence in support of the full range of care in individuals with MS. The topics discussed in this course will move from medical diagnosis and treatment to the full spectrum of physical therapy examination through intervention.

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

    • Outline impairments of body structure/function, activity, and participation limitations associated with MS, and analyze variations in clinical presentation across the disease continuum.
    • Characterize the pathology and medical interventions currently used in the treatment of people with MS.
    • Plan an evidence-based physical therapy examination for persons with varying levels of disability related to MS.
    • Analyze the recommendations of the MS EDGE taskforce on the selection and use of appropriate outcome measures.
    • Describe the process of neuroplasticity as it relates to the disease process.
    • Deduce and develop evidence-supported intervention strategies.
    • Integrate theories and concepts based on the evidence in analysis of cases.

    Monday, January 21 (Preconference)

    Correlating Neuroanatomy with Patient Presentation and the Neurologic Exam

    Location: San Diego Convention Center | 14A

    Time: 8:00 am - 5:00 pm

    Speakers: Desiree Lanzino, PT, PhD

    Level: Intermediate

    CEUs: 0.9 (9.0 contact hours/CCUs)

    Preconference Pricing: Standard (1A)

    The vision for physical therapy practice, according to APTA's Vision 2020 statement, asserts the role of the physical therapist as an autonomous, first-line practitioner of choice who will evaluate and treat patients directly for care. With that in mind, this 1-day course is designed to strengthen the skills of all physical therapists' neurologic screening, examination, and differential diagnosis proficiency. After an overview of the central nervous system, the neurologic exam will be presented in a manner that demonstrates how each component assesses a different neurologic level. Attendees will view a video of a neurologic screening exam and practice the neurologic exam on each other. The speaker will present clinically relevant neuroanatomy in a step-wise fashion, from the dorsal cortex to the spinal cord through the use of neuroimaging. At each level, evidence-based case scenarios that incorporate a variety of pathologies will be used to improve clinical reasoning by identifying expected signs and symptoms.

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

    • Describe how each level of the nervous system is assessed by the neurologic examination.
    • Perform a neurologic screening examination.
    • Identify the functions of the major areas of the central nervous system.
    • Based on the area of CNS pathology, identify the expected clinical presentation, describe the components of the neurologic exam useful for elucidating those signs and symptoms, and identify when symptoms are not consistent with diagnosis or area of pathology.

    Differential Diagnosis and Treatment of Typical and Atypical Benign Paroxysmal Positional Vertigo

    Location: San Diego Convention Center | 5B

    Time: 8:00 am - 5:00 pm

    Speakers: Janet O. Helminski, PT, PhD; Janet Callahan, PT, MS, NCS 

    Level: Multiple Level

    CEUs: 0.9 (9.0 contact hours/CCUs)

    Preconference Pricing: Standard (1A)

    Benign paroxysmal positional vertigo (BPPV) is the single most common cause of vertigo and is frequently misdiagnosed. This preconference course will focus on the process of differential diagnosis for BPPV and particle repositioning maneuvers for the treatment of typical and atypical BPPV based on fluid dynamics and anatomical alignment of the canals and computer simulations. Attendees will use case histories and digital oculography recordings to formulate differential diagnoses and design comprehensive treatments, as well as practice positional tests and particle repositioning maneuvers.

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

    • Apply the process of the differential diagnosis in the management of BPPV.
    • Describe normal fluid dynamics and anatomical alignment of the canals and abnormal responses due to BPPV.
    • Differentiate between AC- and PC-BPPV based on findings of positional testing.
    • Differentiate between LC-BPPV and other diagnoses based on findings of positional testing in the transverse plane in the recumbent position and in the pitch plane in sitting.
    • Treat typical and atypical BPPV with particle repositioning maneuvers, taking into account the anatomical alignment of the canals.
    • Identify examination and treatment findings that would suggest the need for referral to a physician.

    Multiple Sclerosis From Diagnosis to Intervention: Translating Science Into Clinical Practice, Part 2

    Location: San Diego Convention Center | 4

    Time: 8:00 am - 5:00 pm

    Speakers: Linda A. Csiza, PT, DSc, NCS; Herb Karpatkin, PT, DSc, NCS; Evan Cohen, PT, MS, PhD, NCS; Donna Fry, PT, DSc, NCS, MSCS; Eduard Gappmaier, PT, PhD

    Level: Intermediate

    CEUs: 1.5 (15.0 contact hours/CCUs)

    Preconference Pricing: Standard Plus (2B) 2 Day

    Multiple sclerosis (MS) affects 350,000 people in the United States and more than 2.5 million people worldwide. It is a disease of great variability, leading to a spectrum of disability—which can range from mild to severe—with no stereotypical presentation. With a greater understanding that MS is a disease that significantly impacts mobility, the frequency with which individuals with MS participate in physical therapy has increased. However, MS is a unique disease that requires a specific understanding of its characteristics in order to provide competent treatment. There is an ever-growing body of research available to guide clinicians in the physical therapy management of individuals with MS. The primary goal for this preconference course is to propose a systematic evidence-based model for the physical therapy care of individuals with MS across the continuum of the disease. Research suggests that individuals with MS can show meaningful improvement in body structure/function, activity, and participation as a result of appropriate medical management and physical therapy intervention. A panel of experts will present the most current evidence in support of the full range of care in individuals with MS. The topics discussed in this course will move from medical diagnosis and treatment to the full spectrum of physical therapy examination through intervention.

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

    • Outline impairments of body structure/function, activity, and participation limitations associated with MS, and analyze variations in clinical presentation across the disease continuum.
    • Characterize the pathology and medical interventions currently used in the treatment of people with MS.
    • Plan an evidence-based physical therapy examination for persons with varying levels of disability related to MS.
    • Analyze the recommendations of the MS EDGE taskforce on the selection and use of appropriate outcome measures.
    • Describe the process of neuroplasticity as it relates to the disease process.
    • Deduce and develop evidence-supported intervention strategies.
    • Integrate theories and concepts based on the evidence in analysis of cases.

    Tuesday, January 22

    The Anne Shumway-Cook Lectureship—The Brain Is Plastic: A Pathway for Guiding the Future of Physical Therapy

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

    Speakers: Nancy Byl, PT, PhD, MPH, FAPTA

    Level: Multiple Level

    This lecture will capture the principles of aberrant and positive plasticity and how these principles should guide the development of the physical therapy profession from pediatrics to geriatrics and cardiopulmonary to neuromusculoskeletal challenges.

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

    • Summarize the history of discovery of brain plasticity.
    • Outline the principles of developing learning-based therapies.
    • Selectively integrate the principles of plasticity in pediatrics, teenage years, and geriatrics.
    • Integrate the principles of plasticity in treating patients with cardiopulmonary and metabolic disease.
    • Facilitate the recovery of function in patients with musculoskeletal dysfunction through the principles of plasticity.
    • Discuss the challenges of implementing the principles of neural adaptation in patients with degenerative conditions.
    • Summarize the importance of motivation, curiosity, expectation, and commitment of the individual patient and family member.
    • Review the evidence supporting mental imagery, rehearsal, and guided imagery to enhance healing and learning.

    Decision Making in Upper-Extremity Management Post Stroke

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

    Level: Multiple Level

    This is a joint program. See full description at Hand Rehabilitation programming.

    Functional Electrical Stimulation Programs for People With Spinal Cord Injury: Clinician and Consumer Perspectives in the Clinic and at Home

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

    Speakers: Jennifer French, MBA; Candy Tefertiller, PT, DPT, ATP, NCS; Therese E. Johnston, PT, PhD, MBA; Lisa Lombardo, PT, MPT

    Level: Multiple Level

    Functional electrical stimulation (FES) utilization is increasing in both clinical and home settings. There are decades of evidence-based applications of FES for spinal cord injury. This course will focus on the practical application of FES from a programmatic perspective within the clinic, as well as the consumer perspective in the clinic and at home. Course content will include information about implementing an FES program in the clinic and at home, discussion of the evidence, FES parameters, utilization of surface systems as well as currently available implantable systems. Video and photographs of practical and real-world examples will be incorporated as appropriate. A panel of consumers who use FES on a daily basis will be included to facilitate discussion regarding implementation and perceptions.

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

    • Evaluate the current evidence for the use of FES for people with SCI.
    • Discuss FES parameter applications and modifications to achieve optimal outcomes in individuals with neurologic disabilities.
    • Discuss the opportunities and challenges of implementing FES in the clinical setting.
    • Recognize multiple uses of FES from the perspectives of the consumer and clinician.
    • Assess practical applications for successful implementation in the clinic and the home environment for FES.
    • Identify lower cost alternatives to commercially available FES technologies and the financial implications of FES programs and technologies.
    • Explore current technology surrounding implantable FES systems and current functional applications for implantable FES systems.

    Making Fitness Fun: Parkinson Disease and Nontraditional Community-based Group Exercise

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

    Speakers: Gammon M. Earhart, PT, PhD; Stephanie A. Combs, PT, PhD, NCS

    Level: Multiple Level

    This 2-hour session will introduce participants to current evidence in the literature delineating the benefits of community-based, nontraditional group exercise programs in the care of individuals with Parkinson disease (PD). Exercise approaches to be reviewed include boxing, dance, and Tai Chi. The discussion will include information about how these approaches impact individuals with PD across the spectrum of disability from body structure and function through participation. The discussion will also focus on the social and motivational aspects of community-based, group exercise approaches. In addition to synthesizing the scientific literature to date, practical information will be provided regarding the incorporation of said approaches into clinical practice, as well as for the development of community partnerships for long-term health promotion. This session will include videos and/or demonstrations to illustrate the various approaches, recommendations and guidelines for implementing programs in one's own setting, and interactive discussion with participants about their own experiences working with individuals with PD.

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

    • Identify how physical activity levels differ in individuals with PD as compared to age-matched controls.
    • Describe nontraditional, community-based exercise approaches for the management of PD that are supported by the literature and list their specific benefits across the full spectrum of disability.
    • Discuss the social and motivational aspects of participation in group exercise.
    • Recognize the recommendations for incorporation and implementation of the non-traditional exercise approaches into the clinic and the community.
    • Locate resources to assist in the process of translating the scientific evidence into practice.
    • Interpret the significance of establishing and aligning community partners for long-term promotion of health and fitness for individuals with PD.

    Dual-Task and Context-Dependent Learning to Modify Functional Motor Performance, Balance, and Fall Risk, Part 1: Theoretical Background and Interpretive Considerations

    Time: 11:00 am–1:00 pm (See Program for Room)

    Speakers: Beth Crowner, PT, DPT, MPPA, NCS; Valerie E. Kelly, PT, PhD; Ya-Yun Alice Lee, PT

    Level: Intermediate

    Motor performance, including ambulation and postural control, is associated with not only aspects of physical function such as strength and balance, but also attentional ability and environmental context. There is a wealth of research examining dual-task paradigms that have important implications for neurorehabilitation. While dual-task training introduces an interference effect during skill acquisition, the increased attentional demands of this training paradigm may yield better balance performance in complex environments. There is also emerging evidence demonstrating the impact of context on motor learning. It is often observed that individuals often demonstrate superior performance of a motor task within the context in which it was originally learned, in comparison to performing a motor task within a novel context. This behavior is called context-dependent learning (CDL), and there is some evidence to suggest that people with conditions such as Parkinson disease may be more context-dependent learners in comparison to individuals without neurological impairment. This 2-part series will describe, compare, and contrast dual task and CDL. Part 1 will emphasize the theory and background of dual task and CDL, including interpretive considerations surrounding current paradigms used in research and underlying substrates associated with brain processing.

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

    • Describe how context affects motor performance, dual-task balance, and walking paradigms, and their use in research and clinical practice.
    • Discuss the theoretical background as well as methodological and interpretive considerations surrounding the use of dual-task paradigms.
    • Explain potential mechanisms and neural substrates associated with context-dependent learning.
    • Discuss the relationship among impaired dual-task balance and walking performance and functional deficits, fall risk, and disability in the geriatric and neurologic populations.

    Gait Retraining: Taking the Next Step Forward in Rehabilitation

    Time: 11:00 am–1:00 pm (See Program for Room)

    Level: Basic

    This is a joint program. See full description at Research programming.

    Physical Therapy Management for Patients With Disorders of Consciousness

    Time: 11:00 am–1:00 pm (See Program for Room)

    Speakers: Carolyn Tassini, PT, DPT, NCS; Natalie Sibley, PT, DPT, NCS

    Level: Multiple Level

    This presentation will provide background information on disorders of consciousness. It will prepare the physical therapist for examination and treatment of individuals with severe traumatic brain injury. This presentation will outline the physical, cognitive, and functional impairments seen with this population as well as the signs and symptoms of associated medical complications. Commonly used medications and their therapeutic implications also will be discussed.

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

    • Describe disorders of consciousness including the vegetative state, minimally conscious state, and coma.
    • Understand the common neurologic and medical complications associated with severe traumatic brain injury.
    • Identify the components of a thorough physical therapy evaluation, including special tests and the most commonly used outcomes measures including the CRS-R, GCS, and DRS.
    • Recognize the common physical, cognitive, and functional impairments seen as a result of severe traumatic brain injury.
    • Identify appropriate physical therapy interventions along with the specialized equipment utilized and prescribed for this population.
    • Write objective and functional therapeutic goals for this population.
    • Identify commonly used medications and their impact on physical therapy.

    Redirecting Inappropriate Patient Sexual Behavior, Part 1

    Time: 11:00 am–1:00 pm (See Program for Room)

    Level: Basic

    This is a joint program. See full description at Education programming.

    Robotic Assistive Devices to Improve Quality of Life for Persons With Amputation and Paraplegia

    Time: 11:00 am–1:00 pm (See Program for Room)

    Speakers: Michael Goldfarb, PhD; Clare Hartigan, PT, MPT

    Level: Intermediate

    Recent advances in robotics technology have brought some new possibilities with respect to the development of assistive devices for purposes of enhancing the mobility and functionality of individuals with physical disabilities. This session will focus on the development of 3 such assistive devices, which are intended to provide enhanced mobility and functionality for persons with lower-limb loss, upper-limb loss, and paraplegia, respectively. Specifically, the talk will describe the development of a powered transfemoral prosthesis for lower-extremity amputees, the development of a multigrasp hand for upper-extremity amputees, and the development of a lower-limb exoskeleton for legged mobility assistance in individuals with paraplegia.

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

    • Describe the functionality of a technologically advanced hand prosthesis for individuals with transradial amputation.
    • Describe the functionality of a lower-limb robotic prosthesis for individuals with transfemoral amputation.
    • Identify appropriate persons with SCI who may benefit from a robotic exoskeleton for legged mobility.
    • Describe the functionality of the Vanderbilt exoskeleton and how a patient with paraplegia would operate the device for the purposes of sit to/from stand and gait on level surfaces.

    Balance Screenings for Cancer Survivors: Development and Progress of an Onsite Program

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

    Level: Multiple Level

    This is a joint program. See full description at Oncology programming.

    Dual-Task and Context-Dependent Learning to Modify Functional Motor Performance, Balance, and Fall Risk, Part 2: Clinical Implications and Applied Interventions

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

    Speakers: Melissa S. Doyle, PT, DPT, NCS; Julie A. Hershberg, PT, DPT; Robbin Howard, PT, DPT, NCS; Mary Beth Osborne, PT, DPT; Joanne M. Wagner, PT, PhD

    Level: Intermediate

    Motor performance, including ambulation and postural control, is associated with not only aspects of physical function such as strength and balance, but also attentional ability and environmental context. There is a wealth of research examining dual-task paradigms that have important implications for neurorehabilitation. While dual-task training introduces an interference effect during skill acquisition, the increased attentional demands of this training paradigm may yield better balance performance in complex environments. There is also emerging evidence demonstrating the impact of context on motor learning. It is often observed that individuals often demonstrate superior performance of a motor task within the context in which it was originally learned, in comparison to performing a motor task within a novel context. This behavior is called context-dependent learning (CDL), and there is some evidence to suggest that people with conditions such as Parkinson disease may be more context-dependent learners in comparison to individuals without neurological impairment.

    This 2-part series will describe, compare, and contrast dual task and CDL. Clinical observations suggest there are differences in motor learning and performance for individuals with various neurological injuries, and that these differences may interfere with generalizing learned motor skills in different contexts. Recent evidence will be presented to demonstrate that this difficulty may be due to dual task interference and CDL. Accordingly, Part 2 of this series will further discuss clinical implications and interventions involving dual task and CDL for individuals with multiple sclerosis, Parkinson disease, and brain injury. Case presentations will be used to demonstrate the clinical measurement of CDL, and group interaction will be facilitated to problem solve dual task and CDL treatment strategies.

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

    • Explain the factors contributing to dual-task-related decrements in postural control and gait in persons with multiple sclerosis and brain injury.
    • Apply principles of context-dependent learning to a clinical case in an individual with Parkinson disease.
    • Discuss potential interventions for people with multiple sclerosis and brain injury with dual-task-related decrements in gait.
    • Compare and contrast difficulties with context-dependent learning and dual task performance.

    Stroke SIG: Emerging Technologies for Enhancing Poststroke Arm Rehabilitation

    Joint Program: Hand Rehabilitation

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

    Speakers: Mindy Levin, PT, PhD; Michelle Harris-Love, PT, PhD

    Level: Multiple Level

    Technologies are emerging that have the potential to enhance beneficial neuroplastic changes after stroke. This session will discuss 2 specific examples: virtual reality (VR)/robotics and transcranial magnetic stimulation (TMS). VR/robotics can incorporate principles of motor learning into rehabilitation through interactive learning, enhanced motivation to perform highly repetitive practice, and provision of ecologically valid practice environments. These technologies can be used to create functional practice environments that can be graded to meet specific therapeutic objectives and client capabilities.

    The speakers will address the principles of robotic and VR-based interventions for upper-limb motor recovery and explore the advantages and drawbacks to their implementation for clinical and home-based rehabilitation. Another emerging technology, TMS, is a technique that allows noninvasive brain stimulation. Attendees will learn the background and basic principles of TMS, its usefulness as a tool to inform and possibly augment the rehabilitation process, and the main paradigms by which TMS is applied. The speakers also will examine the exciting prospect that, when combined with rehabilitation training such as that offered through VR/robotics, TMS modulation of cortical excitability could enhance the effects of rehabilitation and lead to greater levels of recovery than are currently attainable with rehabilitation alone.

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

    • Describe different types of robotic and virtual reality systems and platforms available for clinical and/or home use for rehabilitation of upper limb motor function.
    • Explain the terminology and describe the attributes of virtual reality, robotics, and TMS.
    • Assess the strengths and weaknesses of each type of technology with respect to their ability to address rehabilitation goals.
    • Appreciate the evidence for the effectiveness of virtual reality and robotics for upper limb function and recovery in patient populations.
    • Discuss the ways that TMS could be used to enhance and inform stroke rehabilitation.

    Redirecting Inappropriate Patient Sexual Behavior, Part 2

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

    Level: Basic

    This is a joint program. See full description at Education programming.

    Spinal Cord Injury: Neurophysiology to Therapeutic Interventions

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

    Speakers: Monica A. Perez, PhD; Christine K. Thomas, PhD; Richard K. Shields, PT, PhD, FAPTA; Jonathan Wolpaw, MD

    Level: Multiple Level

    Control of voluntary movements is disrupted after spinal cord injury (SCI). Many descending and ascending inputs to higher centers are interrupted contributing to deficits in motor function leading to a reorganization of the neuromusculoskeletal system. However, recent evidence suggests that individuals with SCI may be able to combine different sources of inputs to control motor tasks that cannot be performed with voluntary drive alone. The first aim of this symposium is to discuss the physiological consequences of SCI and its effects in the control of voluntary movements. The speakers will explore the physiological basis for strategies to enhance control of functional tasks, as well as factors that contribute to corticospinal modulation after SCI. In recent decades, evidence has shown that plasticity in the central nervous system plays a key role in the recovery of motor function after SCI. The second aim of this symposium is to discuss current strategies aimed at enhancing neuroplasticity after SCI, including repetitive electrical stimulation and operant conditioning. The speakers will examine how the interaction of plasticity in the brain and spinal cord induced by these protocols might contribute to the long-term therapeutic effects of these strategies after SCI and how neuronal plasticity can be the result of environmental mechanical stimuli. Advances and limitations in all these areas of research will be highlighted.

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

    • Discuss the consequences of spinal cord injury on skeletal muscle function.
    • Examine adaptations in cortical and spinal cord mechanisms during voluntary activity after human SCI.
    • Describe current strategies used to induce CNS plasticity and their implications for future rehabilitation strategies in humans with SCI.

    Wednesday, January 23

    NCS Breakfast/Reception and Presentation: Become a Bridge Builder! Promoting Knowledge Translation in Neurologic Rehabilitation

    Time: 6:45 am–8:00 am (See Program for Room)

    Speakers: Cynthia M. Zablotny, PT, DPT, MS, NCS; Julie K. Tilson, PT, DPT, MS, NCS

    Level: Intermediate

    Congratulations to our new and recertified ABPTS Neurologic Clinical Specialists (NCSs)! New and current NCSs 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, Julie Tilson, PT, DPT, MS, NCS, has 14 years of experience promoting evidence based practice in a variety of clinical settings. She also has developed a substantial research program to understand the best methods to promote evidence based rehabilitation. She will illustrate how new and current NCSs can use their passion for high-quality neurologic rehabilitation to bridge the gap between research and practice in their facilities and beyond. Note: Session access restricted to NCSs; RSVP required.

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

    • Describe why a neurologic clinical specialist plays a critical role in promoting evidence based neurologic rehabilitation.
    • Implement new ideas for staying uptodate with emerging evidence and for avoiding "evidence overload."
    • Promote your facility's success with knowledge translation.
    • Describe ways that a neurologic clinical specialist can contribute to evidence-based neurologic practice at a national/international level.

    Degenerative Disease SIG Presentation: Cerebellar Contributions to Sensorimotor Function and Learning

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

    Speakers: Amy Bastian, PT, PhD

    Level: Intermediate

    The cerebellum is one of many brain areas involved in movement control and motor learning. The presenter will discuss the newest findings on cerebellar mechanisms of movement coordination and how this information can help reduce ataxia. She also will describe new and unexpected results demonstrating that cerebellar damage impairs active proprioception. Additionally, Bastian will discuss how motor adaptation—a cerebellum dependent form of motor learning—can be augmented using noninvasive brain stimulation during walking. Finally, she will describe how cerebellum-dependent mechanisms of motor learning can be leveraged to improve walking symmetry in stroke survivors via split-belt walking training paradigms. Overall, this presentation will cover the newest information about cerebellar control of movement, sensory function, and learning, and how it might inform rehabilitation.

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

    • Describe a fundamental mechanism of cerebellar ataxia and how this might be improved through rehabilitation interventions.
    • Discuss why cerebellar damage will affect active proprioception (ie, limb position sense after active movement), but not passive proprioception (ie, limb position sense after a passive movement).
    • Describe how noninvasive brain stimulation over the cerebellum can alter motor adaptation.
    • Discuss evidence that cerebellum-dependent learning mechanisms can be used to improve walking patterns of individuals who have cerebral stroke.

    Genomics, Part 1—Linking Molecules and Genes to Clinical Practice: A Closer Look at the Spine

    Joint Program: Orthopaedics, Education, Federal Physical Therapy, Research, Geriatrics

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

    Speakers: Steven Wolf, PT, PhD; Allon Goldberg, PT, PhD; Michele Crites Battié, PT, PhD

    Level: Basic

    Completion of the Human Genome Project and HapMap Project hold the promise of significant advancements in diagnosis and interventions for common diseases. Many conditions and impairments encountered by physical therapists have genetic underpinnings, including disease phenotypes such as stroke, arthritis, diabetes, and heart disease. Studies show that genetic factors explain variable amounts of physical performance. The proportion of the variance in performance explained by genes may range from low (16% for 10-meter gait speed) to high (64% for trunk flexibility assessed as sit and reach).

    Part 1 of this 2-part session, will include an overview of basic genomics terminology as well as the influence of genetics on common impairments and conditions encountered by physical therapists. The presenters will discuss studies highlighting the influence of genetics on conditions such as lumbar disc degeneration and low back pain, and on familial aggregation (a proxy for total genetic effects) of disc degeneration.

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

    • Explain terminology commonly used in medical genetics.
    • Outline the role of projects such as the Human Genome Project and HapMap Project in advancing potential to improve human health.
    • Discuss the concept of human genetic variation and the influence of genetic variants on health, disease, and human performance.
    • Discuss heritability and identify the proportion of the variance in common human performance measures that can be explained by genetic factors.
    • Outline the role and influence of genetic factors on lumbar disc disease, low back pain, spinal stenosis, and lumbar flexibility/ROM, including clinical implications for rehabilitation professionals.

    Getting Published in JNPT: A Chat With the Editorial Board

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

    Speakers: Leland E. Dibble, 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 ensure 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.

    Stroke SIG: Robotics and Virtual Reality for Gait Rehabilitation Post Stroke

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

    Speakers: Judith Deutsch, PT, PhD, FAPTA

    Level: Intermediate

    This course will use the most recent evidence published in a Cochrane Review as a starting point to talk about advances in virtual reality (VR) for rehabilitation of walking post stroke. A review of the VR work in walking over the past decade will set the stage for discussing current options for practice. Interactive video games will be reviewed for their proposed and reported evidence. A practical approach to analyzing and incorporating the technology will be the topic of the final discussion.

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

    • Define virtual reality and interactive video gaming.
    • Assess benefits and limitations of current VR technologies for walking poststroke.
    • Summarize the state of knowledge on VR for walking poststroke.
    • Analyze a video game for the relevant impairments and feedback.
    • Apply information about VR and interactive video gaming to practice.

    Genomics, Part 2—Linking Molecules and Genes to Clinical Practice: Recovery After Stroke

    Joint Program: Orthopaedics, Education, Federal Physical Therapy, Research, Geriatrics

    Time: 11:00 am–1:00 pm (See Program for Room)

    Speakers: Steven Wolf, PT, PhD; Steven Cramer, MD; Jeffrey Kleim, PhD; Catherine Curtis, PT, EdD

    Level: Basic

    Stroke is a common condition affecting almost 6 million survivors in the United States. Studies have shown plasticity of the brain after stroke, with many factors influencing recovery. Genetic factors appear to have considerable impact on poststroke recovery. Polymorphisms in a number of genes have been studied and implicated in brain plasticity after stroke. In Part 2 of this 2-part series, the impact of genetic factors on brain plasticity and recovery after stroke will be discussed. Results of studies on the brain-derived neurotrophic factor (BDNF) and apolipoprotein-E (ApoE) genes will be presented in relation to recovery and plasticity. BDNF and ApoE polymorphisms modulate cognitive and motor learning in healthy individuals. Results of physical therapy are variable among people with stroke, with such variability likely to be associated with many factors including genetic polymorphisms. Information from studies of genetic factors on stroke recovery will enhance our ability to predict which patients will most likely benefit from rehabilitation interventions. Knowledge of specific genotypes of these and other genes may be useful in guiding the creation of new rehabilitation interventions. The session will conclude with a presentation on resources available to clinicians to enhance knowledge of genetic factors associated with stroke and physical recovery, including ethical, legal, and social concerns.

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

    • Explain and discuss the concept of plasticity of the nervous system with regard to recovery after stroke.
    • Outline and discuss the influence of genetic factors such as brain-derived neurotrophic factor (BDNF) and apolipoprotein-E (ApoE) genes in stroke recovery, including clinical implications for rehabilitation professionals.
    • Outline and discuss the role of genetic factors in processes such as learning and attention to task during rehabilitation after stroke.
    • Retrieve relevant resources to further knowledge on the role of genetic factors associated with stroke and physical recovery, including publicly funded websites such as GeneTests and National Human Genome Research Institute.

    Impairments Associated With Pediatric Brain Tumors and Implications for Physical Therapy

    Joint Program: Pediatrics, Oncology

    Time: 11:00 am–1:00 pm (See Program for Room)

    Speakers: Ashley DiIenno, PT, DPT; Natalie Danner, PT, DPT

    Level: Multiple Level

    This session will provide background information on pathology and medical treatment interventions for the most common pediatric brain tumors. It will prepare the physical therapist for evaluation and treatment of the child with a diagnosis of a brain tumor. The presenters will outline the common functional impairments, cognitive impairments, and effects of the brain tumor, along with the side effects of medical interventions including chemotherapy, radiation therapy, and brain tumor resection.

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

    • Describe the most commonly seen pediatric brain tumors and their pathology.
    • Identify the medical interventions used to treat different brain tumors based on pathology and location.
    • Recognize common impairments seen as a result of brain tumor location and their necessary medical treatments.
    • Perform appropriate examination techniques for this population.
    • Implement appropriate treatment interventions along with equipment/orthoses prescription.

    Outcome Measures Recommendations From the Neurology Section Spinal Cord Injury EDGE Task Force

    Joint Program: Education

    Time: 11:00 am–1:00 pm (See Program for Room)

    Speakers: Jennifer H. Kahn, PT, DPT; Christopher Newman, PT, DPT; Phyllis D. Palma, PT, DPT; Rachel Tappan, PT, MPT; Candy Tefertiller, PT, DPT, ATP, NCS; Eileen Tseng, PT, DPT; Wendy Romney, PT, DPT; Cara L. Weisbach, PT, DPT

    Level: Multiple Level

    The Spinal Cord Injury (SCI) Evidence Database to Guide Effectiveness (EDGE) Task Force was appointed by APTA's Neurology Section to make recommendations on the use of outcome measures in SCI. This work evolved from the Neurology Section's Toolbox course and Educational Consensus Guidelines group, as well as the Section on Research EDGE Task Force. Goals were to evaluate existing measures and make recommendations for their use in the SCI population in the clinical, academic, and research settings. Additionally, as part of the process, EDGE collaborated with The Rehabilitation Measures Database (www.rehabmeasures.org) to review measures and disseminate information to clinicians, educators, and researchers. A consensus process was used to rate measures based on identification of important constructs relevant to SCI, synthesis of psychometric data, and clinical utility.

    In this session, the presenters will provide an overview of the process of the SCI EDGE Task Force, highlighting measures that are recommended for SCI using a variety of case examples (such as acute and chronic SCI, and motor complete and incomplete SCI), and outlining how to implement these measures into clinical, academic, or research practice.

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

    • Identify recommended outcome measures to use with individuals with SCI across a variety of patient types including acute, subacute, chronic, and motor incomplete and complete SCI.
    • Identify recommended outcome measures to use with individuals with SCI across all ICF domains, body structure/function, activity, and participation.
    • Identify appropriate outcome measures to integrate into your clinical practice when treating individuals with SCI.
    • Determine what outcome measures should be included in an entry-level physical therapist program curriculum.
    • Discuss the need for areas of future research in outcome measures for SCI.

    Postdeployment Rehabilitation of Mild Traumatic Brain Injury: A Team Approach

    Time: 11:00 am–1:00 pm (See Program for Room)

    Level: Intermediate

    This is a joint program. See full description at Federal Physical Therapy programming.

    Aquatic Physical Therapy to Improve Balance Dysfunction in Older Adults

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

    Level: Basic

    This is a joint program. See full description at Aquatic Physical Therapy programming.

    Functional Electrical Stimulation Programs for People With Spinal Cord Injury: Clinician and Consumer Perspectives in the Clinic and at Home

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

    Speakers: Jennifer French, MBA; Candy Tefertiller, PT, DPT, ATP, NCS; Therese E. Johnston, PT, PhD, MBA; Lisa Lombardo, PT, MPT

    Level: Multiple Level

    Functional electrical stimulation (FES) utilization is increasing in both clinical and home settings. There are decades of evidence-based applications of FES for spinal cord injury. This course will focus on the practical application of FES from a programmatic perspective within the clinic, as well as the consumer perspective in the clinic and at home. Course content will include information about implementing an FES program in the clinic and at home, discussion of the evidence, FES parameters, utilization of surface systems as well as currently available implantable systems. Video and photographs of practical and real-world examples will be incorporated as appropriate. A panel of consumers who use FES on a daily basis will be included to facilitate discussion regarding implementation and perceptions.

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

    • Evaluate the current evidence for the use of FES for people with SCI.
    • Discuss FES parameter applications and modifications to achieve optimal outcomes in individuals with neurologic disabilities.
    • Discuss the opportunities and challenges of implementing FES in the clinical setting.
    • Recognize multiple uses of FES from the perspectives of the consumer and clinician.
    • Assess practical applications for successful implementation in the clinic and the home environment for FES.
    • Identify lower cost alternatives to commercially available FES technologies and the financial implications of FES programs and technologies.
    • Explore current technology surrounding implantable FES systems and current functional applications for implantable FES systems.

    Instrumentation of Balance and Gait Assessment for Treatment Planning

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

    Speakers: Laurie A. King, PT, PhD; Fay B. Horak, PT, PhD

    Level: Intermediate

    This course will demonstrate how clinicians can use instrumented measures of balance and gait to assess mobility impairments that guide treatment for neurorehabilitation. Current balance and gait assessments in rehabilitation are usually limited to stop-watch times or subjective rating scales. Although useful for determining the need for rehabilitation, these tests are not objective, often are insensitive to mild constraints, and do not guide intervention. Instrumented measures can address these issues. For example,—new, small, lightweight, wireless sensors record and transmit body accelerations and angular velocities. Several groups have developed algorithms that can automatically provide metrics from the sensors' signals during prescribed clinical tests, such as the Timed Up and Go test, Clinical Test of Sensory Integration for Balance, Two-minute Gait test, and new Stand and Walk test. The validity (both clinical and laboratory), reliability (test-retest and interrater), and responsiveness to intervention (medication and rehabilitation) for these measures will be summarized. Examples of how inertial sensors have proven useful in rehabilitation of Parkinson disease, multiple sclerosis, and traumatic brain injury will be presented.

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

    • Review how instrumented gait and balance analysis can be carried out in the clinic to identify specific underlying impairments that may not be apparent with clinical tests.
    • Illustrate how objective measures of balance and gait can be used to design a specific treatment plan.

    A New Outcome Measure for Spinal Cord Injury Based on Pre-injury Function, Not Compensation: Neuromuscular Recovery Scale

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

    Speakers: Michele Basso, PT, EdD; Andrea Behrman, PT, PhD; Craig Velozo, PhD, OTR; Jeffrey J. Buehner, PT, MS; Elizabeth C. Watson, PT, DPT, NCS; Sandra Wojciehowski, PT, DPT

    Level: Multiple Level

    Quantifying recovery after spinal cord injury (SCI) in the clinic is a challenge. The few instruments specifically designed for SCI typically measure compensation. After SCI, a wide range of recovery occurs so that any new instrument must be sensitive, reliable, and valid. The new Neuromuscular Recovery Scale (NRS) was developed and refined by clinicians and scientists in the Reeve Foundation NeuroRecovery Network (NRN), 7 outpatient clinical sites in the US. The NRS is innovative in that scores are based on normal, pre-injury performance criteria. This session will present the psychometric properties of the NRS, including interrater and test-retest reliability and validity using item-response theory. Descriptions of the items that comprise the NRS will be provided as will standardization procedures. Video case studies and hands-on demonstrations across complete and incomplete SCI by skilled clinicians will maximize learning and increase effective translation into clinical use. Interpretation of the scores and discussion of how they can be used to guide rehabilitation will be drawn from widespread use of the NRS in the NRN.

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

    • Compare and contrast the key factors in compensation-based instruments and the new Neuromuscular Recovery Scale (NRS).
    • Apply and interpret several items from the NRS for clinical practice.
    • Describe the interrater and test-retest reliability of the NRS when used to assess complete and incomplete SCI.
    • Describe the validity of the NRS to assess complete and incomplete SCI.
    • Discuss the process of developing new, clinically relevant outcome measures for individuals with SCI.

    Vestibular SIG—Vestibular Disorders of Central Origin: Creating Clinically Based Evidence

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

    Speakers: Anne K. Galgon; PhD, Kim Gottshall, PT, PhD; Herb Karpatkin, PT, DSc, NCS; Jeffery Hoder, PT, DPT

    Level: Multiple Level

    This session examines how clinicians use theoretical mechanisms of neuroplasticity and vestibular adaptation and clinical practice experiences together to manage individuals with central vestibular involvement. The presenters will provide case studies comparing and contrasting the clinical reasoning and decisions used to examine and provide intervention to individuals from 3 diagnostic groups—stroke, traumatic brain injury, and multiple sclerosis. A suggested framework for managing central disorders will include appropriate examination for impairments in oculomotor, vestibulocular, and vestibulospinal systems; disease-specific and individual factors that affect prognosis; and selection of interventions that match the patient's impairments and limitations of activities and participation. Recommendations for future research will be made to test components of the clinical framework.

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

    • Discuss the vestibular pathways and pathologies that are central in origin.
    • Discuss theoretical mechanisms that would support recovery of function after a central insult.
    • Select appropriate tests and measures to identify impairments that result from the central pathways involvement.
    • Identify strategies used by experts in the field to reduce symptoms of dizziness, improve balance control, and optimize function in individuals with central vestibular involvement.
    • Describe the similarities and differences in management strategies that experts are using to improve function in individuals with central vestibular involvement within different diagnostic groups.

    TBI EDGE Recommendations: Application to Practice, Teaching, and Research

    Joint Program: Education

    Time: 3:00 am–5:00 am (See Program for Room)

    Speakers: Anna Lisa de Joya, PT, DSc, NCS; Erin Donnelly, PT; Katie Hays, PT, DPT; Tammie Johnson, PT, DPT; Karen L. McCulloch, PT, PhD, NCS; Coby Nirider, PT, DPT; Heidi Roth, PT, MS, DHS; Sue Saliga, PT, MS, DHSc; Irene Ward, PT, DPT

    Level: Multiple Level

    The TBI (traumatic brain injury) EDGE (Evaluation Database to Guide Effectiveness) Task Force was appointed by the Neurology Section of APTA to develop recommendations for outcome measure use. An 8-member task force reviewed outcome measures across the ICF (International Classification of Functioning, Disability, and Health) continuum—covering body structure/function, activities, and participation—that would reasonably be used by physical therapists. Recommendations were derived from outcome measure psychometric properties, clinical utility, and literature demonstrating validity of each measure in individuals with TBI. This presentation will provide an overview of the process and apply recommendations to a clinical case, content in an entry-level curriculum, and a research project. In addition, the presenters will highlight the task force's collaboration with rehabmeasures.org as a means to disseminate recommendations.

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

    • Describe the process used to develop EDGE recommendations by the Neurology Section task force groups.
    • Identify factors important in recommending an outcome measure, including reliability, validity, guidance for interpretation, and clinical feasibility.
    • Describe TBI EDGE-recommended outcome measures in ICF areas of body structure/function, activity, and participation.
    • Identify TBI EDGE recommended outcome measures for a clinical case example. Illustrate the use of TBI EDGE recommendations to modify content in an entry-level curriculum.
    • Apply TBI EDGE recommendations to design for a research project.
    • Identify gaps in current research and discuss recommendations for future research on outcome measures for individuals with TBI.

    Thursday, January 24

    Accelerating Motor Learning and Sustaining Outcomes Through Support for Fundamental Psychological Needs

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

    Speakers: Rebecca Lewthwaite, PhD; Sarah Blanton, PT, DPT, NCS; Lois B. Wolf, PT, MMSc, MBA; Carolee J. Winstein, PT, PhD, FAPTA; Laurie Wishart, BScPT, Dip P&OT, MSc, PhD

    Level: Multiple Level

    Support for patients' fundamental psychological needs (autonomy, competence, and social relatedness) is of universal importance but has special significance for physical therapy. Recent evidence links stronger motor learning and performance to opportunities for choice and control, positive feedback and enhanced expectations, and learning with others. This 2-hour course will intersperse focused presentations of recent basic, applied, and clinical research with videotaped clips of physical therapists and patients with stroke working collaboratively in ways designed to build self-efficacy for movement and self-management skills, and support autonomy. Researchers and physical therapists providing motivationally enhanced investigational stroke rehabilitation in a multicenter randomized controlled trial will discuss their experiences. Distinguished physical therapists and clinical researchers will address research, practice, and professional implications of the presented evidence. Attendees and presenters will collaborate to identify barriers and solutions to further effective, evidence-based support for patients' basic psychological needs. This session is designed to bring the science of fundamental psychological needs to clinicians working in varied age and diagnostic contexts. In addition, the speakers will provide examples that demonstrate both effective incorporation and insight into the challenges of integrating new skills into established practice styles.

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

    • Summarize research regarding the roles of autonomy, competence (expectations/self-efficacy), and social relatedness in motor learning.
    • Identify at least 2 challenges in the integration of the research evidence into professional education and/or clinical practice.
    • Consider a definition of professional expertise that includes skill in supporting patients' fundamental psychological needs.

    Functional Electrical Stimulation Programs for People With Spinal Cord Injury: Clinician and Consumer Perspectives in the Clinic and at Home (added to programming January 22, 2013)

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

    Speakers: Therese E. Johnston, PT, PhD, MBA; Deborah Backus, PT, PhD; C. Scott Bickel, PT, PhD; Samuel C. Lee, PT, PhD; Kevin McCully, PhD

    Mobile Health Technologies

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

    Speakers: George D. Fulk, PT, PhD; Edward Sazonov, PhD; James Cavanaugh, PT, PhD, NCS

    Level: Multiple Level

    Wearable mobile health sensors provide the ability to accurately and precisely monitor and measure steps taken, calories burned, transitions, time spent doing certain activities, and other health parameters while patients go about their everyday activities in their home and community. These data can be used to determine the effectiveness and impact of physical therapy interventions. Accelerometers and other body-worn sensors can wirelessly transmit data from home to remote locations so that physical therapists can monitor patient health as well as offer the ability for patients to self-monitor activity, receive feedback, and set goals to increase mobility and activity levels to improve health outcomes.

    The purpose of this session is to provide attendees with an overview of different types of body-worn sensors and how they can be used in the clinic and for research purposes. The speakers will present information on commercially available sensors, different signal processing and pattern recognition techniques, the use of body-worn sensor outcomes in research studies, different methods of interpreting sensor data, and how to use activity monitors in the clinic.

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

    • Compare different types of body-worn sensors for use in the clinic and in research.
    • Describe signal processing and pattern recognition techniques used to process sensor data.
    • Discuss how step activity data from body-worn sensors can be used to analyze outcomes from research studies.
    • Compare the use of activity monitors for research and for clinical practice.
    • Explain how activity monitors could be used in the clinic to monitor and improve physical therapy outcomes.

    Video Analysis of Eye Movements in Individuals With Peripheral and Central Vestibular Disorders

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

    Speakers: Susan L. Whitney, PT, DPT, PhD, NCS, FAPTA; Susan J. Herdman, PT, PhD, FAPTA; Michael C. Schubert, PT, PhD

    Level: Advanced

    Attendees will be exposed to eye movement videos and patient/therapist interactions, and then they will be asked to interact with the presenters by responding using clicker technology. The presenters will then spend time reviewing the eye movements and interactions based on the audience response.

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

    • Recognize the typical forms of benign paroxysmal positional vertigo (posterior, horizontal, and anterior canal).
    • Describe central signs and symptoms demonstrated on the video that suggest brain pathology.
    • Identify atypical eye movements via video analysis that are not vestibular in origin.

    Exercise Interventions Targeting Neuroplasticity and Neuroprotection in Adults With Neurodegenerative Diseases

    Time: 11:00 am–1:00 pm (See Program for Room)

    Speakers: Ellen McGough, PT, PhD; Neva Kirk-Sanchez, PT, PhD; Mark Nelson, PT, MPT; James G. Moore, PT, PhD

    Level: Multiple Level

    This course will focus on evidence related to the effects of exercise in adults with neurodegenerative disease. Exercise programs targeting neuroprotective mechanisms will be presented, including mode, frequency, intensity, and duration. The speakers will provide strategies for addressing barriers and challenges to exercise testing and implementation.

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

    • To discuss challenges related to aerobic exercise implementation in individuals with neurodegenerative disease.
    • To describe methods for evaluating exercise capacity (eg, aerobic capacity) in adults with neurodegenerative disease.
    • To describe evidence-based exercise interventions, including mode, frequency, intensity, and duration.
    • To describe characteristics of delivery systems that address cognitive, physical, and environmental barriers.

    Neurological Rehab: Strategies for Maximizing "Intensity" Across the Rehabilitation Continuum

    Time: 11:00 am–1:00 pm (See Program for Room)

    Speakers: Kathryn D. Mitchell, PT, DPT, NCS; Mike Studer, PT; Catherine E. Lang, PT, PhD; Heather Hayes, PT, DPT, NCS; Beth Crowner, PT, DPT, MPPA, NCS; Mary Beth A. Osborne, PT, DPT

    Level: Intermediate

    Research has revealed that increased intensity of task-based activities leads to neural adaptation and measurable changes in function. This model is applicable to individuals with acute and degenerative neurological conditions. In the current health care climate, clinicians are expected to maximize both efficiency and patient client outcomes with limited resources. This push to maximize intensity can be challenging. Using didactic and case-based discussions, the speakers in this intermediate-level session will review the term "intensity" and provide examples of how intensity can be used across the neurologic rehabilitation continuum of care. Intensity has been defined in the literature many ways and may refer to speed, resistance, accuracy, multitasking, endurance, and practice amount. These 6 aspects of intensity will be reviewed, with specific attention to the practical use of increasing intensity across the continuum of care. Consideration for maximizing efficiency of patient outcomes will be discussed in relation to patient acuity (medical and rehabilitative), patient readiness, and environmental constraints that may affect planning and implementation in practice settings across the continuum of care.

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

    • Define the term intensity and recognize its multiple definitions.
    • Cite evidence that shows that increased intensity of treatment intervention improves patient outcomes.
    • Identify creative methods of providing efficient, intensive interventions across the continuum of care.
    • Identify and apply a framework for the provision of increased intensity across the continuum of care.
    • Recognize the importance of integrating personal and contextual factors into the design of patient-specific, intensive interventions.

    Using Vestibular Function Testing to Assess and Treat Vestibular System Dysfunction

    Time: 11:00 am–1:00 pm (See Program for Room)

    Speakers: Patricia J. Flemming, PT, DSc, GCS; Sarah Grantham, AuD, CCC-A; Cathey Norton, PT; Amy Pause, PT, DPT

    Level: Intermediate

    Many audiologists now focus their practice in the area of vestibular function testing. Those physical therapists who are able to practice collaboratively with these audiologists have an opportunity to gather additional objective clinical data to support physical therapy diagnosis and treatment. This session will present current audiological tests performed during comprehensive vestibular function testing, including the latest technology available in that field. Physical therapists specializing in vestibular rehabilitation will present case studies with unilateral, bilateral, and central vestibular pathologies that illustrate the use of vestibular function testing in physical therapy patient management.

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

    • List the primary diagnostic vestibular function procedures used in the identification of peripheral and central vestibular system deficits and interpret what each test tells you with respect to the functional integrity of the vestibular system.
    • Differentiate between a compensated versus uncompensated peripheral vestibular system disorder as well as complete versus subtotal bilateral peripheral vestibular system hypofunction.
    • Discuss challenges faced in physical therapy assessment and management of concurrent unilateral hypofunction and benign paroxysmal positional vertigo.
    • Identify the most common causes for bilateral vestibular hypofunction.
    • Discuss functional impairments and rationale for treatment in patients with bilateral vestibular hypofunction.
    • Identify central and peripheral causes of vestibular dysfunction.
    • Discuss the importance of diagnostic audiological testing, in addition to physical therapy examination, in identifying and differentiating impairments that impact physical therapy interventions in patients with vestibular dysfunction.
    • Discuss the importance of physical therapy examination in conjunction with vestibular function testing for comprehensive assessment of static versus dynamic vestibular system compensation.
    • Describe how vestibular rehabilitative therapy goals for treatment will vary based on the type and degree of vestibular dysfunction.

    Altering Task Conditions to Influence Motor Behavior After Stroke

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

    Speakers: Jill C. Stewart, PT, PhD, NCS; Sydney Schaefer, PhD

    Level: Basic

    Task-oriented training has emerged as an important and viable approach to stroke rehabilitation. To date, the amount of repetition (massed practice) during task-oriented training has been emphasized as a key variable for changing motor performance over time. Recent research has shown, however, that changes in contextual factors can have an immediate impact on motor performance within a single-session of task practice in individuals with stroke. Context is operationally defined as the dynamic interaction between the person, the task, and the environment. This session will discuss how the behavioral and neural effects of context may complement the effects of repetition to maximize the benefits of task-oriented training after stroke. The speakers will review several contextual factors that have been shown to alter movement patterns within and across bouts of training after stroke, such as task instruction, task goal, and practice structure. Altering one or more of these factors during training may be a feasible and cost-effective way to positively influence motor behavior in a clinical setting.

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

    • Identify contextual factors that have been shown to positively and negatively influence motor performance.
    • Describe how movement and brain recruitment can be immediately altered by changes in context after stroke.
    • Discuss the clinical relevance of changing contextual factors during task-oriented training for stroke rehabilitation.

    Diagnosis Dialogue for PTs in the Neurology and Pediatrics Sections

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

    Level: Multiple Level

    This is a joint program. See full description at Pediatrics programming.

    Neglect: Current Concepts in Assessment and Treatment

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

    Speakers: Sam Pierce, PT, PhD, NCS; Robin Myers, PT, DPT, NCS

    Level: Multiple Level

    This presentation will review the current research literature regarding the mechanisms of neglect to assist physical therapists to better understand the syndrome of neglect. The speakers will focus on the application of evidence-based treatment strategies for the assessment and treatment of neglect to improve patient outcomes.

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

    • Discuss the current neuroscience literature that identifies mechanisms for neglect.
    • Compare and contrast the different methods to assess neglect.
    • Describe the evidence base regarding the methods that are used to treat neglect.
    • Apply and adapt treatment methods of neglect to the hospital and home environments.
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