Archive: CSM 2013: Federal Physical Therapy Programming

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

    Browse Federal Physical Therapy sessions by day. Return to the main topic menu 

    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. 

    Tuesday, January 22

    Ride 2 Recovery Project HERO: Cycling to Rehab Service Members and Veterans

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

    Speakers: Barbara Springer, PT, PhD, OCS, SCS

    Level: Intermediate

    Ride 2 Recovery's Project HERO (Healing Exercise Rehab Opportunity) programs, located at military hospitals, Warrior Transition Units, and Wounded Warrior Regiment Units, help wounded, ill, and injured service members and veterans heal physically and psychologically through cycling with hand cycles, recumbent bikes, tandems, and traditional road bikes as part of their rehabilitation. Ride 2 Recovery specializes in adapting and building custom bikes so that almost anyone can ride. One of the major goals for the healing heroes in these programs is to participate in 1 or more of the 7 long-distance Ride 2 Recovery Challenges each year. These Challenges not only build confidence, strength, mobility, and endurance, but also promote peer-to-peer counseling and create a network where service members and veterans enjoy a continuous support system of those with similar injuries and symptoms who understand what they are experiencing.

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

    • Describe Ride 2 Recovery's Project HERO.
    • Identify where to refer wounded, ill, or injured active duty service members and veterans who are interested in cycling.
    • Explain the benefits of using cycling as part of rehabilitation.
    • Learn that just about anyone can cycle, no matter what their disabilities are.

    Advanced Management of the Patient With Traumatic Brain Injury: What Is "Best Practice" for Gait and Balance Dysfunction?

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

    Speakers: Dennis Klima, PhD; Karen L. McCulloch, PT, PhD, NCS

    Level: Neurology

    This session will focus on current management of gait and balance dysfunction among patients who have sustained a traumatic brain injury (TBI). Topics will include a review of current best practice interventions, including body-weight supported treadmill unweighting, virtual reality, isokinetic strength training, and dual-task activities along the TBI recovery trajectory. Select gait and balance examination tools will be presented, along with their psychometric strengths and limitations. These tests include both salient clinical tests and advanced posturography. The return to participation focus will address requisite locomotion norms for community navigation, subsequent deficits which emerge among individuals with TBI, and evidence-based balance and gait interventions to facilitate community re-entry.

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

    • Describe pertinent demographic features of traumatic brain injury related to gait and balance dysfunction.
    • Describe 8 major tools used to examine gait and balance dysfunction specific to individuals who have sustained a TBI, including their psychometric strengths, limitations, and utility.
    • Characterize and classify major locomotion deficits observed among individuals with TBI, including concussion and blast injuries.
    • Discuss current evidence-based interventions incorporated within the patient/client management model to treat deficits in gait and balance dysfunction, including: body-weight supported treadmill training, virtual reality, dual-task initiatives, isokinetic strength training, electromechanical gait devices.
    • Fuse neuromuscular and cognitive strategies during locomotion training in conjunction with patients' specific recovery stage.

    Physical Therapy Collaborations: A Key to Best Practice

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

    Speakers: Nikki Butler, PT, DPT, OCS; Janet Papazis, PT, DPT; Timothy Pendergrass, PT, DSc, SCS, ATC

    Level: Intermediate

    The US Army Rehabilitation and Reintegration Division (R2D) provides policy and program guidance from the Office of the Surgeon General across the spectrum of care in the military. The goal is to identify evidenced-based best practices in order to enhance the readiness of the soldier and the unit. Some of the best practices from clinical to strategic levels include the synchronization and integration of physical therapy services into multidisciplinary teams, formal committees, and national organizations. Several ongoing Army initiatives provide unique examples of this synchronization with other programs. In R2D programs, the physical therapist plays a key role in the major lines of effort such as traumatic brain injury, pain management, amputee care, musculoskeletal injury evaluation and treatment, and other allied health focus areas. At an organizational level, the rehabilitation and reintegration physical therapy staff officer collaborates with academia, public health, senior military leadership, Veteran's Affairs, and other nonprofit organizations in establishing policy and evaluating/promulgating best practices. Additionally, through R2D programs, the US Army rehabilitation specialists collaborate on efforts at an international level with our allied military counterparts. This knowledge-sharing of programs and research efforts across the world assists in indentifying new developments, best practices, and in providing information and education on achievements across the continuum of rehabilitation and reintegration.

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

    • Identify several Army Initiatives demonstrating collaborations of the physical therapist at a program level as part of inter/multi disciplinary team.
    • Identify the physical therapist role at the organization level.
    • Understand ongoing synchronization of international efforts for physical therapists in the military.

    Prosthetic Advances: Evidence and Experience in the Care of Injured Service Members

    Joint Program: Research

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

    Speakers: John Fergason, CPO, Johnny Owens MPT, Christopher Ragabo PT, PhD

    Level: Multiple Level

    Individuals who have experienced lower-limb amputation as the result of combat injuries commonly experience multiple surgical procedures and extensive rehabilitation. Individuals with amputation have traditionally demonstrated a marked decrease in physical function. Recent advances in prosthetic technologies and intensive rehabilitation have, however, increased the level of mobility and resulting function that patients can expect to achieve. The speakers will provide an overview of recent advances in prosthetic technologies and associated scientific evidence and will share experience gained in the rehabilitation and assessment of patients using these novel devices. The session will cover the basic mechanics behind the function of the devices, identify techniques for maximizing mobility and physical function, and look forward to upcoming developments. Discussions will focus on recent developments in prosthetic technologies and ramifications for the treating clinician who may encounter patients using these devices.

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

    • Discuss the demonstrated and perceived benefits and limitations associated with using recently developed prosthetic technologies.
    • Discuss the role of clinical gait and strength assessment in selecting prosthetic devices.
    • Compare and contrast conventional and new prostheses.
    • Describe how the information gained during the lecture can be applied to your clinical practice.

    Wednesday, January 23

    Management of Neuromuscular Dysfunction Using Intramuscular Manual Therapy and Trigger Point Dry Needling

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

    Speakers: Kimberley L. Jordan, PT, MPT; Dawn Hall, PT, MPT, PhD

    Level: Basic

    In January 2012, APTA published a white paper supporting the use of trigger point dry needling/intramuscular manual therapy (TDN/IMT) in physical therapy practice. Currently, 27 states include the use of TDN/IMT in the scope of physical therapy of their respective state practice acts. Yet, this manual technique is relatively unknown by physical therapist. Using acupuncture-type needles, TDN/IMT addresses biomechanical muscle imbalances resulting in strength deficits, muscular/flexibility limitation, postural dysfunctions, and painful/swollen/stiff joints. TDN/IMT encourages relaxation of trigger points, improves muscle function, and stimulates neural pain control pathways (ie gate-control theory, neurotransmitter activation, opioid release) to reduce or alleviate pain. TDN/IMT is a powerful adjunctive addition to traditional treatment approaches in physical therapy.

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

    • Define motor banding and clinical presentations of neuromuscular dysfunction.
    • Describe neuromyofascial pain as it relates to orthopedics and neuromuscular pain.
    • Delineate and clarify dry needling research as it relates to neuromyofascial pain.
    • Describe the application and technique used in dry needling.

    US Army Spectrum of Care: Readiness, Rehabilitation, and Reintegration

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

    Speakers: Timothy Pendergrass, PT, DSc, SCS, ATC; Janet Papazis, PT, DPT; Nikki Butler, PT, DPT, OCS; Deydre S. Teyhen, PT, PhD, OCS

    Level: Intermediate

    The US Army Rehabilitation and Reintegration Division provides policy and program guidance from the Office of the Surgeon General across the spectrum of care. The goal is to identify evidenced-based best practices and enhance the readiness of the soldier and the unit. The burden of injuries requires innovative approaches to address readiness, rehabilitation, and reintegration. The Iron Horse Performance Optimization (IHPO) program involves an operational unit which uses different approaches to address unit readiness, including musculoskeletal action teams, physical readiness training, hybrids of extreme conditioning programs, Olympic lifting, reconditioning, screening tests, and functional testing. These processes may be similar to the types of programs used with civilian organizations and sports teams. An innovative aspect of this IHPO program is the application of technology to capture the performance measures. The Military Power Performance and Prevention (MP3) uses technological tools to gather and record data. This technology reduces data collection time and potential for error in recording. The MP3 initiative is targeted at developing an injury risk model for predicting likelihood of musculoskeletal injury in soldier populations. By developing an injury risk model, the program's innovators hope to influence that risk to reduce medical nonreadiness in the nation's fighting force.

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

    • Identify several of the unique ongoing strategic initiatives in the U.S Army.
    • Be familiar with the incidence of musculoskeletal injuries in the US Army.
    • Recognize current US Army injury prevention and human performance optimization programs, such as the Iron Horse Program and the application of technology of the MP3.

    Postdeployment Rehabilitation of Mild Traumatic Brain Injury: A Team Approach

    Joint Program: Neurology

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

    Speakers: Kim Gottshall, PT, PhD; Steve Pluth, PhD; Kimberly Singer, OT; Michael Podlenski, PTA

    Level: Intermediate

    The team approach to the patient with postdeployment mild traumatic brain injury will be presented by a vestibular physical therapist, occupational therapist, neuropsychologist, and physical therapist working with polytrauma. Novel treatments utilizing CAREN virtual reality training, iPad applications, driving simulators, and salsa dance will be presented. The key roles of each team member will be stressed and emphasis will be made on the need for these patients to be managed by a truly interdisciplinary team.

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

    • Define the team approach to the patient with mild traumatic brain injury.
    • Differentiate the roles of each team member of the interdisciplinary team in the evaluation and treatment of the patient with mild traumatic brain injury.
    • Demonstrate specific rehabilitation techniques for patients with postdeployment mild traumatic brain injury.

    Clinical Practice Recommendation for Service Dogs in the Veterans' Administration System of Care

    Joint Program: Health Policy and Administration, Geriatrics

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

    Speakers: Jennifer C. Reneker, PT, MSPT, NCS; Kendra Betz, PT, MSPT, ATP

    Level: Intermediate

    This course is designed to educate participants on the recent development and implementation of the clinical practice recommendation (CPR) titled, "Veteran Evaluation for Use of Guide Dog/Service Dog (GD/SD) in Plan of Care." In response to recent legislation, Veterans Dog Training Therapy Act (HR 3885), the undersecretary for health directed the Veterans Administration (VA) to coordinate the development of a CPR for guide dogs (GD) and service dogs (SD). The CPR establishes the uniform basis by which a determination is made whether a specific veteran's rehabilitation and restorative care might be enhanced by a GD/SD. If the determination is that a GD/SD is likely to enhance rehabilitation and restorative care, the VA will provide approved benefits such as hardware and veterinary costs for said dog after the veteran obtains the GD/SD from an accredited GD/SD organization. The indication of SD is the broad descriptive category for a dog that works with an individual with 1 or more disabilities. This broad category includes a more specific subgroup of dogs called mobility dogs. Mobility dogs (MD) are specifically trained to provide physical assistance to a person with a physical disability that impacts gait, balance, strength, dexterity, or other musculoskeletal or neurological functioning associated with mobility. Within the VA system of care, physical therapists will be primary contributors to the assessment of specific patients to determine if an MD is appropriate and fits within their rehabilitative care plan. It is therefore imperative that PTs are adequately trained and develop an understanding of the indications and contraindications for recommending a MD as well as the types of assistance MDs can provide.

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

    • Interpret the CPR for SD/GD application in clinical practice.
    • Justify the appropriateness of an MD through clinical assessment.
    • Manage the referral of a veteran for an MD.
    • Value the use of MDs as an alternate component of the rehabilitative plan of care.

    Extreme Conditioning Programs: Evaluating and Managing the Risk

    Joint Program: Sports Physical Therapy

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

    Speakers: Danny J. McMillian, PT, DSc, OCS, CSCS; Jason Steere, PT, DPT, ATC, CSCS

    Level: Basic

    Extreme conditioning programs (ECPs; eg, CrossFit, P90X, Insanity, Gym Jones, PT Pyramid, and others) are characterized by high-volume, high-intensity workouts. Such programs create great demands on the metabolic and musculoskeletal systems. In the last decade, ECPs have become exceedingly popular, especially in the tactical athlete communities (eg, military, police, fire, and rescue). Emerging problems associated with ECPs have been identified, to include muscle strains, torn ligaments, stress fractures, and mild to severe cases of potentially life-threatening exertional rhabdomyolysis. Concern with such trends led the Department of Defense and American College of Sports Medicine to convene a workshop to define the problem, set guidelines for safe implementation, and direct future research considerations. Similarly, this session will define the risk associated with ECPs, identify strategies for reducing the risk, and suggest best practices for working with individuals who desire to continue participation in such programs.

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

    • Define the risk associated with extreme conditioning programs.
    • Identify current evidence to guide intervention strategies to reduce the risk.
    • Modify common practices of extreme conditioning programs in order to reduce the risk while maintaining the benefits.

    Thursday, January 24

    How Is It the Same and How Is It Different? The Unique Challenges of Managing Low Back Pain in the Military Health Care System

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

    Speakers: Daniel Rhon, PT, DPT, DSc, OCS, FAAOMPT; Tanja Roy, PT

    Level: Intermediate

    Low back pain (LBP) is the leading cause of ambulatory visits in the military, both in the US and while deployed to combat zones. It has the highest 5-year risk for permanent disability in the US Army out of all musculoskeletal conditions, at approximately 20%. Direct costs related to managing musculoskeletal injuries in the Department of Defense are over $550 million annually, and LBP is the single-highest musculoskeletal complaint in both times of peace and war, and combat and garrison settings alike. This has created a significant challenge for military health care providers. Effectively managing military patients with LBP presents many challenges similar to those in civilian settings; however, there are several unique clinical considerations. A better understanding of the larger picture formed by factors that include the patient presentation, the associated conditions relevant to high-deployment posture, and the military health care system can empower clinicians to improve delivery and quality of care. The speakers will not only summarize current evidence for LBP management in the military and what is currently known as "big picture," but also will discuss application and management from a clinical perspective—providing a pragmatic integration of evidence into the military clinic setting.

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

    • Identify common global challenges to managing low back pain in both the military and civilian populations.
    • Recognize the unique challenges to managing low back pain in the military population.
    • Recognize how the biopsychosocial model applies to this unique patient population.
    • Discuss how effectively influencing the health care system is just as important as managing the patient.
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