Evidence Based Therapeutic Exercise for Cervical Spine Disorders
This preconference will be a hands on course that will include:
- Review of the neuromuscular impairments found in patients with neck pain disorders
- Practical session including movement analysis and specific muscles tests for the cervical region
- Practical session presenting a specific exercise approach for managing cervical neuromuscular dysfunction
- Practical session including movement analysis and specific muscles tests for the scapular region
- Practical session presenting an exercise approach for managing axio-scapular muscle dysfunction
- Assessment and management of sensorimotor disturbances in neck pain
including impaired proprioception, oculomotor control disturbances and
impaired balance. Includes both theory and practical session
- Overview of the similarities and differences between
whiplash-induced pain and idiopathic neck pain and the implications for
management
- Consider the impact of central sensitization on rehabilitation
- Key principles of evidence based therapeutic exercise for neck pain disorders
- Presentation of the overall management of patients with neck pain disorders
A Paradigm Shift in Patient Education: Are We Making Cueing Too Complicated?
Presenters: Christina Gomez, Ciara Burgi, Adeeb Khalfe
Exercise is an integral component of rehabilitation to compliment manual
therapy intervention. Therapists use a combination of strategies to
maximize outcomes, particularly in the athletic population where there
is significant pressure to return to high-level performance. By
integrating optimal attentional focus strategies with exercise, athletes
will be able to enhance efficiency of movement, improve carryover to
athletic activity, and ultimately elevate performance. Through a series
of case examples, this course will take the audience through a
comprehensive treatment plan including movement assessment, manual
therapy intervention, and exercise prescription, focusing on appropriate
cueing to optimize movement. This will be achieved through an
interactive lab to maximize acquisition of knowledge and skill.
AAOMPT Student Special Interest Group Presents: Hands on Deck — Students Learning from the Masters
Student Special Interest Group
Five to ten experienced members of AAOMPT and Fellows of The Academy
will volunteer to discuss the conference theme - the roles of the
orthopaedic manual physical therapists - as well as provide
demonstration and feedback for 5-6 basic and widely utilized manual
techniques by orthopaedic manual therapists to student members of AAOMPT
who are in attendance at the 2016 Annual Conference.
Acute dizziness after sports-related concussion: Can physical
therapists offer better treatment than just physical and cognitive
rest?
Presenters: Jennifer Reneker, Megan Donaldson
This session will highlight recently published research on physical
therapy for dizziness after a sports-related concussion. The
presentation will include a compendium of clinical tests that should be
included in a comprehensive assessment to identify underlying anatomic
causes of dizziness after concussion. The complex relationships between
the neurological and skeletal system will be highlighted along with
common patient presentations. Following this, there will be a discussion
of intervention techniques, the timing of these techniques, and safety
parameters that should be exercised when treating patients in the acute
phase of recovery after a sports-related concussion.
Advancing the Physical Therapist as a Provider in Hospital Emergency Care
Presenter: Carleen Jogodka
Despite a slow but steadily increasing number publications and
presentations on the EDPT practice at local, state, national and
international meetings, very few physical therapists have a sufficient
exposure or understanding of the role PTs play in the emergency
department (ED). As a result, there continues to be a shortage of PTs
ready to work in this environment without additional advanced
preparation. This is even more true for PTs with advanced OMPT training
where experience and efficiency managing musculoskeletal conditions
would be a great benefit for many reasons.
- Using low back pain as one of the most common conditions
Many PT providers may agree there are numerous benefits for a large
number of ED conditions to both individual patients and the healthcare
system in addressing commonly encountered conditions, for example low
back pain. Despite the evidence for early access to PT for problems such
as LBP, few EDs offer PT as an immediate treatment choice when patients
check in for this condition. Instead, patients are faced with standard
medical management of prescription medications and referrals to
surgeons. While part of the identified problem is the bureaucracy of
initiating a new care pathway, another commonly identified problem is
finding PTs trained and willing to work in this environment.
- How can highly trained PT providers prepare themselves to help with this public health problem?
However, the cycle of basic logistical questions concerning fundamental
goals of the ED at large and PT skills remain. These elements are
essential to efficiently meet the needs of this unique setting. This
section is to review the background, purpose, and function of the EDPT
practice, including highlighted differences between this and traditional
PT work settings.
- New program development
Discuss various approaches how new programs are starting. Share existing
available resources for start-up and existing programs. Address common
questions related to administrative issues, staffing, and daily
practice.
- Growth of an existing programs
Review and discuss the evolution of the first full-time and longest
established EDPT program. This section will include a query of session
attendees to engage dialogue about what type of services are currently
provided, and future goals of providers and their respective programs.
Communication and Leadership Strategies to Lead Us Through The next 25 Years
Presenter: Colette Seymann
Research has shown that incentives work best when people are performing a
simple task. So how do we motivate and inspire others in our complex
world? How do we develop trust and rapport so that we gain insight into
what really motivates an individual or group? This course will explore
various styles of leadership as they apply to physical therapists,
including their strengths and challenges. Participants will be able to
identify their own leadership styles, the styles of others, and discover
how to maintain authentic and flexible communication that minimizes
conflict and maximizes opportunities. Participants will be able to
communicate more effectively with other leaders, colleagues, referral
sources and students in a way that inspires others to contribute to the
future of our profession.
Comprehensive Knee Rehabilitation for the Manual Physical Therapist: Targeting Muscular Inhibition
Presenters: Bryan Pickens and Chris Allen
This session will include a discussion of arthrogenic muscle inhibition
and its role in the symptomatic knee joint. Participants will learn the
importance of recognizing and reducing inhibitory mechanisms to
quadriceps activation in order to provide a safe return to function
while reducing the development of osteoarthritis. The session will
include a description of the integration of exercise to not only
facilitate the patient's return to function but also to address the
underlying muscular activation deficits. Precision and clinical
reasoning are essential not only to the application of manual
intervention but also to the exercise prescription as part of a
comprehensive approach. The presenter will share observations from
experience using this approach and will present a case study.
Conservative management of neurovascular entrapments of the
upper extremity: A clinical reasoning challenge for orthopaedic manual
physical therapists
Presenter: Laura Kenny
60 min breakout session. Discuss key treatment strategies developed over
25 years by Peter Edgelow PT, DPT, from his experience treating over
1000 patients diagnosed with neurovascular entrapment. Use case examples
to demonstrate why manual therapy interventions may not be effective,
yet the skilled manual therapist is still the best clinician to treat
this patient. Demonstrate an assessment technique that guides your
clinical reasoning. Respond to questions.
Current concept for the use of manual therapy in managing shoulder disorders
Presenters: Dan Rhon, Joshua Cleland, Bob Boyles
This course will provide the attendee with up to date knowledge on
manual therapy interventions for various shoulder disorders, using a
hands-on clinical interactive approach. The session will focus on
adequate screening, reassessment, dosing, and effective use of thrust
and non-thrust techniques directed at the glenohumeral joint,
acromioclavicular joint, scapula-thoracic complex, the ribs, and the
cervical and thoracic spine. Knowledge will be drawn from multiple
randomized clinical trials that the presenters have published over the
years.
Current Concepts in Headache Management and Implications for the Manual Therapist
Presenters: Jonathan Borger, Sean Griech
The session will cover current theories in chronic headache diagnosis
and management, with a focus on cervicogenic-type headaches. It will
include exam techniques and assessment of structures typically involved
in cervicogenic headaches. Lastly, the session will focus on treatment
approaches, covering both deficits in neuromuscular control, and manual
therapy interventions to restore normal biomechanics and function.
Decreasing barriers to performing manual therapy: Altering
textbook techniques for individuals without the textbook manual
therapist body
Presenters: Mitchell Selhorst, Mindy Galleher
This session will focus on creative problem solving methods to develop
alternative ways for smaller individuals to perform traditional manual
therapy techniques. This ability is particularly important, not only
for the smaller individual who struggles to perform joint mobilizations
and manipulations, but also for mentors or instructors. It is vital for a
mentor or instructor to be able to identify and teach alternative
methods so their students or residents can perform manual therapy in the
clinic. We will discuss (1) the problems our orthopedic residency
program has encountered when attempting to teach manual therapy to
individuals of a smaller body size who were physically unable to perform
select traditional techniques. (2) The problem solving used and the
methods devised to help the mentor and resident individualize manual
therapy techniques to their specific body type. (3) Discuss and
demonstrate specific examples of alternatives we have found useful.
Expanding the scope and application of manual therapy as a neurophysiological input to influence cortical changes
Presenters: Francois Prizinski, Mark Powers
The 1 hour lecture will review the default circuitry of pain and
protective responses. It will review how compensated or antalgic
movement is only meant to be a temporary solution and how it's
usefulness is outlived in subacute and chronic pain populations. This
changes the cortex in functional connectivity, gray mater volumes, and
overall reinforced confidence to move. Emerging research had shown that
the GTO and Titin binding to calcium creates tension well outside of the
normal actin and myosin crossbridging. Research has shown that
eccentric strengthening or creating 'tension' from a lengthened position
influences the frontal lobe and premotor cortex. This provides
perspectives in how manual therapy may be utilized for the overall goal
of modulating symptoms to optimize motor control and cortical changes
for future studies to examine.
Integration of home exercise with manual therapy strategies: Does it work and is it worthwhile?
Presenters: Gail Deyle, Chris Allen
The session will be an interactive opportunity to underscore the
exceptional opportunities and challenges associated with exercise
prescription. The presenters will provide lecture and facilitate
discussion on ways to improve and expand the roles of exercise in
orthopaedic manual physical therapy. The presentation will include the
use of physical forces through appropriately targeted and dosed exercise
to be stimuli for protecting and healing injured tissues and
structures. Physical therapists have traditionally focused
rehabilitation and restoration largely without formal attention to
creating healing stimuli or avoiding adverse stimuli. Also presented
will be the effects of exercise on stimuli sensitive tissues and
desensitization which subsequently influences pain states and function.
Precision and clinical reasoning in exercise prescription is essential
to producing the desired well tolerated stimuli. Participants will also
be exposed to the current body of evidence associated with home exercise
compliance. There will be frank discussion on the challenges associated
with facilitating long term compliance with exercise programs. The
presenters will share their observations from years of experience using
exercise as part of interventions applied under clinical research trial
conditions.
Lumbar Spine Surgical Decision Making for Three Patients:
Case Based Reflections on the Interprofessional Collaboration between
the Patients, Orthopaedic Manual Physical Therapist and Neurosurgeon
Presenters: Bryan Dennison, Michael Leal, Michael Song
This session will review the expanding role of the OMPT as it pertains
to patient advocacy and interprofessional communication. Specifically
three case based examples of interprofessional communication between an
OMPT practitioner and neurosurgeon will be reviewed. A description of
the strategies used to develop and maintain the interprofessional
relationship will be presented. As the collaboration was
patient-centered, patient videos will be included providing the patient
perspective on this collaboration. The panel of presenters in this
session will include the treating OMPT and neurosurgeon.
Making the leap from student to clinician: Clinical reasoning tips for novice physical therapist
Presenters: Amanda Grant, Margaret Wicinski, Catherine Patla
This breakout session will take the learner through a series of complex
clinical cases emphasizing the critical thinking process for clinical
reasoning. This course teaches a framework to guide the thinking and
reasoning processes, leading to improved confidence with implementation
of precise, effective manual therapy interventions in challenging
patient case scenarios. Spine and extremity cases will be discussed.
Manipulation in Weight Bearing: optimizing seated techniques with HVLAT after screening
Presenters: Alec Kay, Brian Power
We will present current AAOMPT and IFOMPT guidelines for screening
patients for adverse events with cervical manipulation. Lecture on
indications and contraindications for HVLAT in general and specifically
for weight bearing techniques. The participants will then have the
opportunity to practice the techniques as they will be performed sitting
and can be done in this lab setting.
Medical Screening for Tomorrows Manual Physical Therapist
Presenters: Derek Clewley, Elizabeth Lane, Christina Myers
This course will review the current concepts and strategies to screen
for medical conditions. An overview of the healthcare dilemma will
introduce the need for PTs to be in the position to provide and be
recognized as primary care providers. A review of the current
literature and guidelines for screening for common conditions will be
provided. Systems and strategy approaches including the use of a
classification model will be investigated specifically as it relates to
today and tomorrows physical therapist with rising productivity and work
load expectations. Clinical reasoning models specifically
hypothetico-deductive and heuristic will be compared and contrasted.
Movement and Manual Therapy: The sum is greater than the parts
Presenters: Robert LeBeau, April Oury
The session will incorporate short modules of lecture followed by
demonstration of live patients. Clinical reasoning and problem solving
would be discussed to compare and contrast movement based therapies and
orthopedic manual therapies. Evaluation and treatment progressions
will demonstrate best practices for the combination of manual and
movement therapies to obtain the best results.
Real time demonstrations with question and answer sessions will be
employed.
Non-Specific Effects in Manual Therapy: Contextual Factors Can Help or Harm Clinical Outcomes
Presenters: Mark Shepherd, Tim Flynn, Mark Kargela
This session will focus on the importance of contextual factors when
applying orthopedic manual physical therapy in clinical care. We will
explore the medical literature describing contextual factors that frame
the therapeutic alliance such as patient expectation/personal equipoise,
placebo and nocebo effects, non-verbal communication. Case-based
examples and discussion will enhance the clinical application of these
factors as it relates to the orthopedic manual therapist.
Orthopaedic Manual Physical Therapy Management of Shoulder
Pain: Clinical Reasoning Integrating Pain Science and Strength and
Conditioning Principles
Presenters: Bryan Dennison, Michael Leal, Janice Lwin
This session will include a review of the evidence for the pathobiology
of shoulder pain with a strategy for evaluating and treating different
pain states. Therapeutic exercise prescription, including program
design, for the shoulder utilizing S&C principles will be discussed.
Finally, suggested exercises for the shoulder will be reviewed.
Practical Application and Opportunities for Advanced Practice Physical Therapy
Presenters: Brent Perdrizet, Richard Zaruba, Evan Kelley
Practical applications of advanced practice patterns utilizing direct
access to imaging, pharmacy, laboratory and direct referral seen in
current literature and based on expert presenter experience will
illustrate how these skills are being utilized OMPT today. Future
opportunities and challenges to advancing collaboration of physical
therapists as members of the healthcare team to improve outcomes for the
orthopedic client through direct access to diagnostic testing,
laboratory, pharmacy services and direct specialist referral will be
presented and clarified though this seminar.
Red Flags and Red Herrings: Clinical Decision Making in the Assessment and Treatment of Headaches
Presenters: Michael O'Donnell, Lyssa Cleary
The session will be a combination discussion demonstration using three
case vignettes to discuss presentations of headaches that require
immediate medical attention, co treatment with physician and treatment
directed by the therapist.
Regional interdependence of shoulder girdle pathology and
spine dysfunction: implications for manual therapy examination and
intervention
Presenters: Arie van Duijn, Eric Shamus
This course provide an overview of current evidence and treatment
regarding the concept of regional interdependence of the shoulder girdle
and the spine, especially the cervical and upper thoracic spine. The
course will contain a lecture and laboratory component. Current
literature on the interdependence of shoulder and spine dysfunction will
be discussed. Applicable manual therapy techniques for the shoulder
girdle and spine will be demonstrated.
Screening for OMPT Patients' Psycho-Social Needs in NMS Primary Care Physical Therapy Environment
Presenter: Bob DuVall
This session will expound on the need for OMPTs to routinely and
formally medically screen all patients for psychosocial comorbidities.
Historically, PTs have formally screened for biologic and visceral
co-morbid conditions, however, contemporary evidence eludes to the
necessity of critically examining for psychosocial finding so to
optimize patient outcomes. Methods and tools to collect psychosocial
data and the subsequent clinical reasoning of said data will be
presented. Attendees will be leave with a 6 step clinical reasoning
algorithm that will assure accountable critical thinking as essential
for optimizing patient outcomes.
Spinal Manipulation Refinement: Future Practice based on Evidence and Clinical Decision Making for Safety and Patient Comfort
Presenters: Alec Kay, Brian Power
Combination of lecture, demonstration, and lab practice in the
application of HVLAT techniques in the spine. Emphasis will be placed on
safety and patient comfort both from a screening and technique
standpoint. We will present IFOMPT and AAOMPT recommendation for
cervical spinal manipulation in terms of precautionary testing.
Strategies for Teaching Manual Therapy to Out-Sized Students and Entry-Level Clinicians
Presenters: Matthew Lee, Charles Hazle
Evidence continues to accumulate as to the effectiveness of manual
therapy in the management of patients with musculoskeletal disorders;
however, students and practitioners are frequently out-sized by their
patients when performing manual therapy. Rising rates of obesity in the
US foreshadow this continuing to be a practice issue. Many students
and novice clinicians entering practice, particularly smaller in
stature, encounter difficulties in performance of manual therapy
techniques. The results may include abandonment of manual approaches
and the development of practice habits inconsistent with standards of
care. Other students or practitioners may assume elevated risk for
work-related musculoskeletal disorders by overexertion, potentially
affecting career trajectories and quality of life.
This session is designed for manual therapy instructors who teach
students and entry-level practitioners encountering size disadvantages
in patient care arising from being small in stature or from having large
patients. Many techniques can be adapted or alternate techniques
chosen to improve the practice skills of size disadvantaged students and
practitioners. A simple model for choosing alternate manual treatment
strategies has been developed to assist in instruction and delivery of
manual therapy in such circumstances. Within an evidence-guided
approach, this session will include demonstrations and explanations for
practitioners to adapt a variety of techniques, both thrust and
non-thrust, and problem-solving around being out-sized. Modifying
positions and mechanics with the practitioner, the patient, and
application of external props/aids, will be used to assist the
significantly out-sized students and clinicians to be effective with
less risk. Beyond the demonstrated techniques, instructors can learn a
problem solving method of adapting techniques or choosing alternate
methods for their students or novice practitioners out-sized by
patients.
Subacute Effects of Cervicothoracic Spinal Manipulation in
Addition to Shoulder Manual Therapy Plus Exercise Intervention in
Individuals with Subacromial Impingement Syndrome: A Randomized,
Controlled Clinical Trial Pilot Study
Presenters: Alexis Wright, Alicia Emerson-Kavchak
Session will start with small group discussion where attendees will be
asked in groups of 5-10 to identify how they would treat a patient
presenting to the clinic with subacromial impingement. After 10 minutes,
session attendees will be given an overview of the current state of the
literature with regards to treatment of subacromial impingement with a
focus on manual therapy techniques directed at the shoulder or
cervicothoracic spine in addition to exercise interventions. Session
speakers will critically appraise the literature highlighting the pros
and cons of the current state of the evidence and introduce the purpose
of their clinical trial pilot study which was to examine the subacute
effects of cervicothoracic intervention in the presence of subacromial
impingement rather than simply reporting the immediate effects. Speakers
will go on to report the methodology of their pilot study and report
their findings which demonstrated there were no between-groups
differences in pain or function in those who did or did not receive
cerviocothoracic manual therapy; however, both groups demonstrated
significant within-groups improvements at 2 weeks, 4 weeks, and at
discharge in overall level of pain reports and both self reported
function (SPADI) and functional performance (test of resistance). The
session will end with group discussion with regards to the interventions
attendees chose at the beginning of the session and whether or not they
would use these same techniques or would they change their treatment
approach based on the findings from our study.
Understanding the foundations of manual therapy across professions to enlighten the future of OMPT
Presenter: Cameron MacDonald
An informative presentation on the foundational history of manipulative
therapy and the initial growth of the physical therapy, osteopathy,
chiropractic and orthopedic medicine professions. Attendees will be able
to consider the question of where did the manual therapy professions
garner their foundations and what preceded them in both western and
eastern cultures. Many other tangents will also be considered!
The History of the AAOMPT: Lessons learned on advocacy and advancement of OMPT
Presenters: Kenneth Olson, Elaine Lonnemann, Stanley Paris
The session will include a discussion of the professional and political
environment that led to the formation of the AAOMPT, the impact the
Academy has had on the national and international physical therapy
profession over the past 25 years, and recommendations on how lessons
learned from our history should be used to guide the future direction of
the Academy. The session will be presented by a founding member, a
past president, and a past executive committee member who together have
served on the executive committee of the Academy for 19 or the 25-year
history and have also served state, national, and international
professional organizations over the past 25+ years.
The Kinesiopathologic Model - A Theoretical Construct of the Movement System
Presenter: Shirley Sahrmann
This session will provide the background necessary to understand the
movement system and why this system has been designated as the identity
of physical therapy. The kinesiopathologic model which proposes that
movement induces pathology will be described. That includes the factors
proposed to contribute to movement impairments. Examples of movement
system impairment syndromes will be described.
The Language of Pain: Define It, Speak It, Integrate It
Presenters: Dana Tew, Jennifer Frerich, Sarah Lohmann
Speakers will briefly lecture on basic neurophysiology of chronic pain,
review current research on pain education, and spend the majority of the
time discussing how to put this information into practice with patients
in a step-wise logical fashion.
The Link Between Concussion and Whiplash Associated Disorder. The Manual Therapist as a Primary Player
Presenter: Richard Kring
The session will focus on system integration of cranial and cervical
trauma. It will use video demonstration of case examples, reflection by
way of review and questions of the audience and discussion of commonly
seen complications. Audience will be provided with clinical scenarios to
solve and a discussion following provide insight into treatment.
The Physical Therapists� role as motivator for change — Do you have the right tools?
Presenter: Amy Garrigues
The #1 Global Burden of Disease is Low Back Pain, neck pain is in the
top 5 — these are our patients! Do you struggle with patients reporting
chronic low back pain associated with significant disability? Do you
have patients that are ambivalent about their condition? Do you have
patients that say they want to get better, but have difficulty adhering
to their rehabilitation program? You are not alone! This session will
explore the use of motivational interviewing in chronic musculoskeletal
conditions to elicit change by moving your patients beyond ambivalence.
Learn the 4 basic skills utilized in motivational interviewing, review
evidence to support this approach and discuss the importance of
developing self-efficacy in patients with chronic pain.
'Three-Dimensional' Development of Clinical Reasoning with Participation in Post-Professional Programs; a proposed model
Presenters: Beth Collier, Maggie Gebhardt
This one-hour lecture format course will first highlight the current
research on clinical reasoning of students and experts. Secondly, the
progressive theoretical model that emerged from our pilot research will
be presented, specifically detailing the three dimensions of clinical
reasoning (logic, presence, and performance) and the attributes that
emerged from contextual data gathered during and after patient
evaluations and examinations. The 'three-dimensional' development of
clinicians across training levels will be clearly demonstrated. This
emerging model will serve as the foundation for further exploration of a
comprehensive clinical reasoning approach.
Treating the Lower Kinetic Chain in the Throwing Athlete
Presenters: Toko Nguyen, Benjamin Renfrow
Evaluation and treatment of the throwing athlete can be a challenging
area of rehabilitation due to the high demands of the throwing motion.
The ability to effectively assess and treat components in the kinetic
chain that commonly fail the thrower and predispose them to injury is
critical in successful rehabilitation of the elite thrower. This course
will discuss the proper recognition of the potential weak links in the
kinetic chain with an emphasis on how the hip, knee, and foot/ankle
influence many of the common upper extremity pathologies in the thrower.
The course will include a strong lab component to demonstrate proper
assessment and treatment with advanced manual therapy clinical reasoning
and intervention techniques.
Understanding the foundations of manual therapy across professions to enlighten the future of OMPT
Presenter: Cameron MacDonald
An integrated lecture on the evolving (and recovered) knowledge of both
the common and disparate roots of manual therapy across the four main
professions � physical therapy, chiropractic, osteopathy and
orthopedic medicine. The foundational knowledge for this lecture is
drawn primarily from 1750 - 1920, with other very interesting
inclusions. Example includes the heritage of Cyriax, not James, but his
father Edgar and the influences that led to the formation of the first
Osteopathic school in Kirksville Missouri in the late 1800's.
Upper Cervical Screening in OMT: Updating Practice through Clinical Reasoning
Presenter: Bradley Myers
For decades manual therapists have utilized upper cervical testing as a
method to screen for dysfunctions related to vascular and
osteo-ligamentous pathology. These procedures continue to be a
cornerstone for clinical reasoning in entry-level and post-professional
programs to this day. Current evidence suggests an alternative approach
to screening the upper cervical region for these conditions dependent
upon sound clinical reasoning rather than relying upon testing of
questionable utility. This session aims to identify the limitations in
the historical practice of upper cervical screening and provide a
contemporary framework for the manual therapist that is supported by the
current state of evidence.
Traditionally the screening test for vertebro-basilar insufficiency
(VBI) and/or cervical artery dysfunction (CAD) included prepositioning
the patient in combinations of extension and rotation of the cervical
spine. Considerable disagreement exists regarding the ability of
positional testing to produce altered blood flow in asymptomatic or
symptomatic patients (Erhardt et al, Rushton et al). This discrepancy
calls into question the clinical utility of the test (Rushton et al).
Several authors have suggested an increased focus on clinical reasoning,
consistent with the most recent IFOMPT guidelines (Rushton et al).
In addition to vascular testing, routine clinical practice includes
testing of upper cervical osteo-ligamentous integrity. The examination
targets the support systems for atlano-occipital and atlanto-axial
joints including: transverse ligament of atlas, alar ligaments,
tectorial membrane, and odontoid process. Although these tests appear
to have fair to strong construct validity the diagnostic properties
preclude utilization as a test intended to identify occult or suspected
osteo-ligamentous dysfunction (Hutting et al).
The suggested framework for upper cervical screening will rely heavily
upon clinical reasoning, supplemented by current evidence regarding the
epidemiology and clinical presentation of underlying upper cervical
spine dysfunction (Biller et al, Rushton et al, Schytz et al). A sound
understanding of the presentation of CAD and upper cervical instability
masquerading as musculoskeletal complaints is paramount to properly
identifying those patients possessing an increased risk of occult
dysfunction.
Vertically integrated OMPT: The role of the Orthopaedic Manual Physical Therapist in a Health System, A Panel Discussion
Presenters: Eric Robertson, Cindy Hon, Ivan Matsui, Anya Blankenship, Matt Willey
While manual therapy is often applied in a 1:1 setting, OMPT's can serve
valuable roles within health systems. Using a nationally leading health
system as a case study, this moderated panel discussion will review and
highlight the various roles that OMPT's serve in the system. Particular
focus will be on the role of physical therapists as primary care
providers, the integral role of advanced clinical training within the
health system, innovative patient management models, the role of
physical therapy within inter-professional healthcare teams, and how
OMPT's can play a critical mentoring role in ways you might not at first
imagine. From video visits to residency and fellowship training, from
consultative care models to serving as a moral and ethical compass,
OMPTs have shaped one of this country�s leading health systems in an
substantial and profound way. This session will first review each panel
member�s role in the organization, and then will embark on an
audience-included moderated panel discussion as we delve into this
exciting topic.