Session Descriptions

AAOMPT Annual Conference Session Descriptions

PRE CONFERENCE COURSE DESCRIPTION

Wednesday: Osteopathic Manipulation (Part 1)
Thursday: Osteopathic Manipulation (Part 2)

This course is ideal for people who have experience in manual therapy but who see the need to be safer, more effective and more efficient. Participants will have learnt manipulative methods aimed at freeing joints but only by using too much force. This force often causes pain, discomfort and fear in the patient and sometimes apprehensive and nervousness in the practitioner! The patient will often experience an adverse reaction and additional trauma to the dysfunctional region. What will be demonstrated and then practised by participants will be a safer method using minimal force in the mid range of the joint, thereby reducing possible trauma but increasing effectiveness of the manipulation. These techniques are simple to use and learn but obviously need practise to perfect. The principle of this method can be described by flexing the wrist, now using the other hand push the wrist into more flexion, this will cause discomfort. But now put the wrist into some ulnar flexion, then into full supination, now the amount of flexion needed to reach the end of flexion is less than before. Now add compression to the wrist by squeezing it with the other hand, again the range of flexion will reduce. Therefore, by using multiple levers (minimum quantity of each lever, however), and there are more than I have described here, the force needed to manipulate will dramatically reduce plus the wrist will feel less overall tension but there will be a specific target point of tension.

This is just one example of what we are achieving at the joint surfaces. Each joint has a method of finding the quantity and direction of levers to produce this effect of less strain and trauma. Patients much prefer this approach and I feel this enhances the participant's success rate and therefore, the success in their clinic setting.

Thursday: Physical Therapists as First Contact MSK Providers: How to Get There?
Presenter: Linda Woodhouse

There is evidence that early diagnosis and management of MSK disorders using education and active "non-surgical" interventions are effective at reducing the need for more costly interventions within the health care system. This interactive workshop will give participants an opportunity to learn and collaborate on how to develop the role of physiotherapists as primary care MSK providers."

KEYNOTE

Friday, Oct 24: 11:00 am - 12:00 pm Keynote Address
Clinical Reasoning in Manipulation
Presenter: Laurie Hartman

This presentation aims to demonstrate a safer, more effective and efficient method of manipulation. The principle involved in this method uses a maximum number of levers but a minimum amount of each lever to reach the target segment without causing stress or trauma to the joint.

Clinical Reasoning for Manual Physical Therapists
Darren Rivett

'Clinical reasoning' refers to the thinking and decision-making skills which underpin clinical practice. These skills are central to professional autonomy and without clinical reasoning the role of the manual physical therapist is arguably reduced to that of a technician under the direction of the physician.

The rise of evidence-based medicine (EBM) poses both opportunity and threat to manual physical therapy. The opportunity rests in conducting research to demonstrate the benefits and safeness inherent in manual therapy. The threat resides in having our practice dictated by EBM, especially clinical prediction rules. Skilful clinical reasoning enables EBM to inform clinical decision-making while retaining our professional autonomy.

Professor Darren Rivett is co-author of the internationally acclaimed book 'Clinical Reasoning for Manual Therapists'.

Friday 9:05 am- 10:00 am Keynote Address
Physical Therapists as First Contact MSK Providers: How to Get There?
Presenter: Linda Woodhouse

A functional approach to the treatment of TFCC problems: the anterior glide syndrome of the medial column of the hand
Presented By:
Pieter Kroon
Brenda Boucher

Ulnar-sided wrist pain and loss of function is not an uncommon complaint among patients presenting to physical therapy with wrist pain. The TFCC is a ligamentous system providing stabilization to the ulnar aspect of the wrist. Injury to this system results in a disruption of stabilization and can occur either with an acute traumatic event or as a result of degenerative changes from chronic repetitive stresses. This hands-on course integrates the clinician s clinical expertise with current best evidence to treat patients with ulnar-sided wrist pain and dysfunction. Lecture and lab activities will focus on components of examination, evaluation, diagnosis, prognosis, intervention and home exercise programs.

Clinical Reasoning and Evidence-Based Practice: The Power of Combining Both
Presented By:
Brian Russ
Matt Willey
Amy Pakula

This session will demonstrate a clinical reasoning model to management of a multifactorial patient using a case-based presentation format. The case will highlight how subtle differences in both subjective and objective data collected during the examination can change the management process. The three speakers will each discuss a different approach to management based on these subtle differences in the patient examination and build a case for the pros and cons of each method. The emphasis of the session will be on Maitland concepts of the semi-permeable brick wall, patient-centered care, and the integration of current evidence in the decision making process. (6)

Clinical Reasoning in Manipulation (Breakout Session 1 & 2)

In the breakouts we will demonstrate Osteopathic manipulation by using a small number of techniques using this principle. In practice participants would be able to incorporate these techniques plus use the principles of maximum numbers of levers but minimum quantity of each lever in their own well-loved and well-used personal techniques in everyday clinical life.

Clinical Reasoning and Neurodynamic Testing and Treatment.
Presented By:
Michael Shacklock

This session describes the clinical reasoning associated with planning a safe and precise physical examination, making a diagnosis and selection of treatment techniques, clarifying these aspects for the clinician.

Clinical Reasoning and Treatment of the Overhead Athlete
Presented By:
Toko Nguyen
Benjamin Renfrow

Effective treatment of the overhead athlete is a challenging area in sports medicine and rehabilitation. Proper evaluation and clinical reasoning is critical in developing a proper intervention plan. The course will discuss in-depth clinical reasoning approaches in the evaluation and treatment of the overhead athlete and the proper implementation of manual therapy and exercise to effectively move the overhead athlete from rehab to high performance.

Clinical Reasoning as a Foundation in Management of Patients Post-Concussion
Presented By:
Anthony Kinney
Amy Garrigues

This educational presentation will incorporate the best available evidence in the management of patients following a concussion. Lecture and laboratory demonstration will provide participants with an evidence-based approach to evaluation and treatment of patients post-concussion.

Clinical Reasoning for the Manual Physical Therapy Student
Presented By:
Evan Petersen

The course will consist of a brief introduction to clinical reasoning including some of the common errors in reasoning made by practitioners during the patient encounter. A systematic way of gathering information will then be taught including how to formulate and later test initial working hypotheses. Emphasis will be placed on the patient-centered interview and an advanced physical therapy examination. Finally, a published manual therapy case study will be reviewed highlighting examples of clinical reasoning within all aspects of the patient encounter.

Clinical Reasoning in Mechanical Diagnosis and Therapy (MDT) and OMPT: Classification, Intervention, and Impact on Musculoskeletal Health Care
Presented By:
Ronald Schenk
Brian McClenahan

Classification has been identified as a critical factor in musculoskeletal management of low back pain since the Delitto, Fritz, Erhard landmark study 1992 which compared the outcomes of patients treated according to classification to patients treated according to the AHCPR Guidelines. While classification and patient outcomes remain critical to patient management, the future of healthcare will depend on predicting long-term outcomes, and reducing costs associated with recidivism through management strategies that are proven to be efficacious.

Case studies will be presented supporting a proposed algorithm for the examination of low back pain based on the TBC model, with further exhaustion of repeated end range movements to determine if the patient would fall into the centralization (specific exercise, directional preference) treatment based category, or may be directed into the others (mobilization, manipulation, stabilization, traction categories). These other categories were first described by Delitto et al and assessed via patient response methods such as those of Maitland, Sahrmann, and McKenzie, with the latter focusing on centralization, directional preference, and postural correction designed to self-manage present and future episodes of low back pain.

Clinical Reasoning: Integrating Trigger-Point Dry Needling within an Evidence-Based Practice Framework
Presented By:
Tim Flynn
Andrew Bennett
Kevin Wait

Physical Therapists using Trigger-Point Dry Needling are skilled at the fine motor skills and requisite foundational knowledge related to using this technique, but are motor skills and anatomical knowledge enough to maximize patient outcomes? Do clinicians know when to use this technique, and perhaps more importantly, when NOT to use this technique? This session will provide insight and raise critical questions related to clinical reasoning and applying evidence into the practice of TDN. Case studies will be used to integrate TDN within an evidence-based framework applying clinical pearls throughout the evaluation and management process. This session will guide participants through a critical analysis of the current literature and how this should guide our decision making process. Clinical vignettes and insights will be provided related to the critical elements associated with this technique, such as patient positioning, meaningful comparable signs, and intentional patient language to maximize functional outcomes.

Clinical Reasoning: Must It Be an Enigma? An Integrated and Comprehensive Construct for Effective Clinical Reasoning Applications
Presented By:
Mark Erickson

This course introduces a novel, integrated, comprehensive, user-friendly and effective clinical reasoning model for application to entry-level didactic and clinical PT education, post-professional education and clinical practice. It integrates the Biopsychosocial and Patient/Client Management Models to clarify clinical reasoning processes across five lines of thought for better decisions that lead to better care. Discussion centers on 1) understanding the multiple lines of thought used during clinical reasoning, 2) describing how subjective and objective examination data are used to inform decisions across the lines of thought, 3) analyzing the relationship between the lines of thought, 4) the use of reflection across the lines of thought, and 5) the relevance of the model in teaching and assessing clinical reasoning abilities at entry level and post-entry level education environments as well as clinical practice. Examples are used to facilitate application of the model and functional diagnostic reasoning templates are introduced. Survey research data related to entry level and post-professional education applications are presented.

Clinical Research-Pearls, Pitfalls, and Perils
Presented By:
Paul Mintken
Chad Cook
John Childs

This session will focus on educating clinicians on the process of getting involved in research, including pearls, pitfalls and perils. This distinguished panel will offer insights and recommendations on how clinicians and researchers may work together to improve research and patient care.

Clinical Reasoning for Manual Physical Therapists
Presented By: Darren Rivett

Success in manual physical therapy is essentially based on the clinical triumvirate of:

Technical proficiency
Communication skill, and
Knowledge accessibility.

Yet, why do some practitioners get better clinical results than other practitioners when they have all essentially completed the same training and the same examinations of clinical knowledge and associated skills? Research has shown that it is the clinical thinking and decision-making skills that separate the acknowledged clinical expert from the 'run of the mill' therapists. These cognitive skills collectively constitute the processes known as 'Clinical Reasoning' which underpin and bind the clinical triumvirate.

Clinical reasoning is a particularly difficult skill to understand and acquire as it is not readily visible when observing the expert as they interact with the patient. It requires a questioning and reflective approach to clinical practice, and skilful clinical reasoning is best acquired using multiple real-life clinical cases with like-minded colleagues and a facilitator. The effort of acquiring skilful clinical reasoning is very worthwhile however, as clinical experts are demonstrably more efficient and more effective than their peers.

This pre-conference session will equip you with the conceptual understanding and learning tools to grow your skills in clinical reasoning as you continue your evolving journey as a manual physical therapist. Following a review of the contemporary theory of collaborative clinical reasoning, the session will consist of a variety of developmental and interactive exercises using a range of stimulus material, including actual clinical cases and clinical reasoning debriefings featuring eminent internationally recognised manual practitioners.

Professor Darren Rivett is co-author of the internationally acclaimed book 'Clinical Reasoning for Manual Therapists'.

Coccygeal Internal Mobilization: Clinical Reasoning and Treatment for Diagnoses Beyond the Pelvic Floor
Presented By: Brian Weber and Gregg Johnson

This session will examine the history of manual therapy in the treatment of the coccyx. Review of inter-regional dependency theory and differential diagnosis related to the coccyx and surrounding structures. Relevant clinical anatomy will be reviewed including bony anatomy, adjacent musculature, ligaments and internal organs that can be treated through intrarectal mobilization. An in depth discussion of patient treatment including patient set up, informed consent and step by step procedure for treatment of the coccyx and surrounding structures.

Communication As The Key To Clinical Reasoning
Presented By: Colette Seymann

What determines if people will trust us? How do we get past barriers and establish strong patient relationships with even the most challenging patients? And even more importantly, how do we teach these skills to our students and interns in the fast paced clinical world? In this session we will identify external behavioral styles that allow us to quickly gain initial rapport, bringing what most of us do unconsciously to a conscious level so we can teach our students. Then using that initial rapport, to dive deeper to uncover peoples underlying drivers and motivators. We will then be able to motivate even the 'unmotivated' patient to do what is necessary to reach their goals.

Differential Diagnosis Between Pain of Lumbar Origin and Pain of Peripheral Origin: Central Sensitization
Presented By:
Stacy Soappman
Kathy Berglund

The diagnosis of knee, foot, or leg pain does not always indicate that the pain is originating there. This session will highlight the conference theme of differential diagnosis by exploring lumbar pathology and discussing how, through central sensitization, it can manifest itself peripherally. We will explore the concept of central sensitization and how it can manifest itself as a peripheral problem leading to an inaccurate diagnosis. This session will also include instruction in how to perform a lumbar scan to accurately diagnose what specific lumbar pathology could be producing the patient s peripheral symptoms. The lumbar scan is an easy diagnostic tool to use on any patient presenting with lumbar pain or peripheral pain of insidious origin that will rapidly give results as to the origin of the patient s dysfunction.

Differential Diagnosis of the Cervical Spine: A clinically reasoned approach
Presented By:
Kathy Berglund

The presentation will start out with a brief review of the literature with regards to classification strategies for neck pain. From this, the anatomy, neuroanatomy and biomechanics of the upper cervical spine and the lower cervical spine will be compared and contrasted. Following this, the audience would participate in developing essential illness scripts distinguishing symptoms presenting from the upper CS versus symptoms presenting from the lower cervical spine. Particular emphasis will be directed to the trigeminocervical nucleus in the pars caudalis and it's neurological influence on symptoms emanating from the upper cervical spine. After the symptoms are categorized, the audience will then participate in another clinical reasoning exercise to select what objective tests and measures should be utilized for examination of the upper CS with particular emphasis on how to differentiate between symptoms reproduction from the AO, AA and C2/3 joints. Similarly the audience will also reason through appropriate objective tests and measures for the lower cervical spine. The clinical reasoning exercises will be linked back to the literature review and the basic science review and the common pathologies one would expect to find in each area. The illness scripts for common pathologies producing symptoms in both the upper and lower CS will then be discussed, by selecting the essential signs that would be present following an examination. From here, if there is time remaining, treatment strategies will then be matched, through sound clinical reasoning, to impairments that were found. IE if a hypomoible C2/3 on the L was causing the patient to have a painful hypermobility on the R C2/3, how to treat it.

Dry Needling and Clinical Reasoning: Is there enough information?
Presented By:
Frank Gargano
Yun-tao Ma
David Griswold

The information that will be presented in this session is the culmination of 40 years of research and experience into a systematic approach to the application of the physiological mechanisms of dry needling. The information in this training session will introduce the knowledge and clinical rationale required to effectively identify and treat soft tissue pain and dysfunction. Specific topics pertaining to clinical reasoning will include needling dosages, duration of treatment, needling depths, and treatments for specified neuromuscular conditions. The systemic approach integrates traditional treatment approaches with a model of peripheral nervous system sensitization. This model explains neuromuscular and biomechanical dysfunction in terms of the body working as an integrated system and not in isolated parts or regions.

Temporomandibular Disorders: An Introduction to Examination and Management.
Presented By:
Stephen Shaffer
Jean-Michel Brismée

This breakout session will utilize lecture and video presentation to cover clinically relevant highlights pertaining to the temporomandibular joint and associated disorders. There will be an emphasis on research informed content whenever possible. Participants will learn an overview of appropriate evaluation and management knowledge and skills. Additionally, clinical reasoning and discussion of manual therapy techniques will be emphasized as part of the content.

Fostering Orthopedic Clinical Reasoning Skills in the Physical Therapist Student
Presented By:
Gretchen Seif
Debora Brown

Clinical reasoning is a continuum of learning that occurs throughout the didactic and clinical educational components of the physical therapy (PT) curriculum and is critical to the practice of PT. Clinical reasoning can be defined as the decision-making process used by clinicians to determine the appropriate examination and treatment interventions. While educators and clinicians agree that it is important to foster these skills in physical therapy students, there is limited evidence on the best practice. Many authors agree that hands-on time with patients is essential to the development of these skills. Additionally, the practice of clinical reflection is another essential component of the clinical reasoning process and can contribute to the development of effective decision making in new therapists. The presenters will discuss a continuum of activities used in a DPT program to foster clinical reasoning skills in physical therapist students for patients with orthopedic conditions during the early part of the curriculum. Examples of class activities during orthopedic courses, assignments during orthopedic clinical practicums and reflective presentations at the conclusion of orthopedic clinical practicums will be given to allow others to immediately implement these strategies in their own DPT programs or as a clinical instructor.

Immediate influence of psychosocial variables and centrally mediated pain in acute musculoskeletal injury.
Presented By:
Karin Townson
Jason Steere

This course will explore the manifestations of centrally mediated pain on acute vs. chronic musculoskeletal injuries. It is widely understood that psychosocial variables can play a significant role in the expression of central sensitization with chronic injuries. These variables can also affect individuals in the initial stages of injury. This course will describe the mechanisms behind and possible clinical signs and symptoms of centrally mediated pain in the acute musculoskeletal client. It will also provide suggested evidence-based model for clinical reasoning with these cases.

Making Correct Decisions while using System 1 and System 2 Thinking
Presented By:
Chad Cook

The session involves lecture, discussion, images, and case-based decision making. The cases are designed to orient the learner to different forms of decision making errors. System 1 and system 2 thinking is introduced and examples from the medical and non-medical literature are used. Pros and cons of decision making models are compared and newer models such as clinical prediction rules are evaluated for their appropriate strategy of use and strengths and weaknesses.

Manual Therapy Dosage? Translating Forces and Reasoning into Manual Prescriptions
Presented By:
Jason Silvernail
Brad Tragord

Are you providing the correct dosage of manual therapy to your patients? How do you know? This session will provide you precise feedback on your manual therapy treatment, both from expert Fellowship-trained clinicians and a biomechanical visual feedback system. This will be an interactive lecture and lab that highlights the current literature pertaining to manual therapy forces and dosage and provides ample opportunity to practice and get specific direct feedback to improve your practice. You will leave this session with a clear understanding of the literature on the forces used in manual therapy and a clinical reasoning process to integrate manual therapy prescriptions into your plan of care to maximize your results based on the basic science of manipulative therapy and the relevant randomized controlled trials.

Medical Screening for the Spine: Can a questionnaire assist with a systems review to support clinical reasoning?
Presented By:
Shala Cunningham
Erik Womeldorf

Discussion of the limitations of red flags due to the inability to demonstrate severity of the symptom and cluster symptoms. Introduction to the ScreenAssist questionnaires for the lumbar spine. A brief demonstration of the utility of the questionnaire through a active participation case study. By performing the casy study, participants will learn how the scoring guide clusters symptoms based on severity and system orientation to provide a recommendation that can be utilized as a adjunct to clinical reasoning.

Merging your OMPT toolbox and sports skills set in the high-level athlete: An Evidence-Based and Clinical Reasoning Approach
Presented By:
Andrew Morcos
Emmanuel Yung
Marie Potter

The overall theme of this preconference session is to present clinical reasoning skills rooted in evidence-based practice when dealing with the high-level injured athlete. With the use of well-reasoned manual techniques and movement analysis, participants will augment their repertoire of clinical skills/tools in their OMPT toolbox. It is becoming more evident in the literature that using clinical reasoning to clarify how problems in the spinal region can influence the outcome of managing orthopaedic conditions of the extremity. Many of the individual assessment techniques and treatment approaches have been reported in isolation in the literature but these have not been presented as a combined manual and sports therapy approach to providing patient-centered care. It is a common pitfall for many students and clinicians that the interplay between spinal regions and related extremity symptom contribution is often missed leading to ineffective interventions. This course aims to provide the missing link in how to correctly identify contributions from these spinal regions and from manual and sports therapy examination approaches so that specific interventions are targeted to the cause and source of extremity problems thereby achieving desired outcomes. Case examples will provide participants with the clinical reasoning skills used by manual and sports clinical specialists in common patient scenarios. These examples will also demonstrate the use of functional testing to determine the readiness of athletic patients to return to sports activities.

Musculoskeletal Imaging and Clinical Reasoning: Collaborative Effort between Musculoskeletal Radiologists and Physical Therapists
Presented By:
Sara Bertrand
Sara Abrams

This presentation will discuss clinical instances where findings from the imaging tests could and should help to guide clinical decision making algorithms. Specifically we will focus on imaging findings which are not routinely reported, for example, soft tissue integrity, transitional lumbosacral anatomy, and congenital spinal deformities. Case examples will demonstrate how imaging may influence patient education, prognosis, and clinical decision making.

Neuropathic or Peripheral Nerve Pain in the Causation and Maintenance of many Orthopedic Diagnosis's
Presented By:
Jack Stagge

In this breakout session and two day pre-conference course, participants will learn how to integrate Bob Elvey's Core Evaluation Techniques to rule in or rule out Neuropathic or PNP (Peripheral Nerve Pain) Syndromes as the causation or the maintainer of many Orthopedic Maladies. By applying these sensitive and specific testing techniques within their clinical reasoning strategies, therapists will be able to prove or disprove their initial causation hypothesis. This enhanced clinical reasoning data will obviously lead to more efficacious treatment and more precise diagnosis.

Prediction-Enhanced Clinical Reasoning: What is the Prognosis?
Presented By:
Jason Beneciuk
Anne Thackeray

The purpose of this presentation is to describe how clinical epidemiology can be used to enhance clinical reasoning by providing information about prognosis. Specifically related to interpretation of prognostic studies, we will review: 1) key components of study designs (e.g., population, predictors, and outcomes); 2) clinical implications of identifying modifiable and non-modifiable risk factors for poor outcomes; 3) commonly used appraisal tools. Recent prognostic research involving musculoskeletal pain conditions will be used to describe how clinical reasoning can potentially be enhanced.

Putting it all together: Integrating dry needling and neurodynamics into clinical practice utilizing an understanding of pain sciences and an orthopaedic manual physical therapy clinical reasoning strategy
Presented By:
Joe Donnelly
Beth Collier
Maggie Gebhardt

This course will focus on the application of clinical reasoning in the management of the complex pain patient with integration of dry needling and neurodynamic manual therapy techniques. Emphasis will be placed on diagnostic and management strategies to most effectively and efficiently direct patient outcomes.

Script Concordance Testing: Constructing Clinical Reasoning Assessments for the Ongoing Evaluation of the Manual Therapy Fellowship Student.
Presented By:
Brett Windsor

The session will be largely practical. An introduction will focus on a definition of the Script Concordance Testing (SCT) method, the theoretical background, and a summary of the more recent research regarding the method. Focus will quickly shift to the practical application of the SCT and how to use it within the context of a manual therapy clinical fellowship program. Learning activities will focus on constructing an SCT that can be used as the basis for a learning module within a manual therapy clinical fellowship program. This will include construction of the test, building a reference panel, scoring the test, and developing methods to interpret the outcomes and communicate the results to the learners. All participants will depart the session with a constructed SCT assessment. The course will conclude with a discussion about the steps forward for both learning and research.

Shaping Clinical Reasoning in Orthopedic Physical Therapy Using Case Studies and Vignettes for Entry-level and Fellowship Students
Presented By:
Carina Lowry
Carol Courtney

Although clinical reasoning is an essential aspect of Physical Therapist education, it is often difficult to succinctly describe and facilitate the thought processes behind student clinical reasoning (Rushton, 2009). In this session, we will compare clinical reasoning and metacognition, or the ability to critically think about your own clinical reasoning. Metacognition is often seen as essential in progression towards mastery level practice, and often indicates the student is able to use a hypothetico-deductive model reasoning process (Rushton, 2009). In this session, we will describe different clinical reasoning strategies and how to teach students to reflect using metacognition.

Pattern recognition is also linked to mastery of clinical practice (Rushton, 2009). The virtual patient has been used in Physical Therapy education, medical education, and psychology for many years. Use of these virtual patients will be described as well as how to construct an appropriate case to stimulate critical thinking. Virtual patients can be used with interactive platforms in a learn-as-you-go format (Salminen, 2014). Use of a clinical reasoning pattern recognition notebook can facilitate hypothesis building in both novice and experienced student clinicians and will also be discussed (Jone, 1992).

The case study in various forms can be used to explore what method the student is using for clinical reasoning and to discuss reasoning in parallel using varied hypotheses and evidence. These cases can be short reasoned cases available for discussion in classroom or small group settings with an expert clinical facilitator (Jones and Rivett, 2005). More in depth reasoning can be revealed by written case studies guided by narrative reasoning and diagnostic reasoning (Jones and Rivett, 2005). In this session, we will describe how to facilitate student writing to express key reasoning concepts in a case report format (McEwen, 2009). Use of mentor/clinical instructor and text to guide student in patient selection, development of exam techniques, interventions, and outcomes (collaboration of CI/student) will be discussed. Incorporation of evidence based practice and research techniques to review literature related to diagnosis, intervention, prognosis, and outcomes will also be described. We will outline use of a learning platform and text to guide student writing as well as peer to peer review of each section and/or peer to clinical faculty review of the case report to ensure student is progressing during the writing process.

The lateral column compression syndrome; a clinical reasoning approach to evaluation and treatment of cuboid dysfunction
Presented By:
Pieter Kroon
Tim Kruchowsky

During the session we will describe the anatomy and biomechanics of the foot and ankle. We will introduce the concept of 'lateral column compression' and how it causally relates to the presence of lateral foot pain. A well reasoned treatment approach will be introduced, consisting of joint mobilizations/manipulations, soft tissue mobilizations and stabilization exercises

The M.I.P. Algorithm: A Clinically Applicable Bio-Psycho-Social Model for Motor Control
Presented By:
Joseph Brence
Francois Prizinski

The Motivation, Input, Plan is a clinically applicable model for motor control. This presentation is a comprehensive discssion on addressing motor control deficits. Learning the MIP algorithm can assist a Physical Therapist ability to clinically reason and solve complex movement-based problems in any practice setting. In an attempt to move away from a series of techniques or interventions alone, the M.I.P algorithm takes into account biological, psychological and social factors, which influence quality of movement. A biopsychosocial approach to motor control will be presented and discuss motivations and realistic expectations, somatosensory techniques (manual therapy), visual and auditory inputs (clinician-directed) and cortical planning to execute movement.

The role of manual therapy in inter-regional dependence of hip pathology and lumbar dysfunction.
Presented By:
Eric Shamus
Arie van Duijn

There will be a lecture and demonstration component. Current literature will be discussed on the interdependence of hip and spine dysfunction. Applicable manual therapy techniques for the hip joint will be demonstrated.

To Needle or not to needle: that is the question
Presented By:
Rob Stanborough
Michelle Layton

This session will review both indications for dry needling and contra-indications. The most recent and relevant research will be used to explain the benefits of dry needling and the underlying physiology. Safety will also be covered by discussing the risks involved with a variety of muscle treatments.

When Clinical Decision Making Overrules the Evidence
Presented By:
Paul Mintken
Amy McDevitt
Kristin Carpenter

This session will present cases in which clinical decision making and best available evidence may conflict. Current best evidence may support a specific intervention, but there may be clinician and patient factors that suggest an alternative path. In the world of evidence based medicine, clinical decision making is often minimized, but it plays a vital role in determining the most safe and effective plan of care. Patient expectation and psychosocial factors also play important roles in the equation. Research such as clinical prediction rules were never meant to be prescriptive, rather they are tools to inform and improve clinical decision making. We will present cases where clinical decision making and published research evidence may conflict, and discuss the integration of research, clinical expertise and patient values.

Recurrent Symptoms: Lessons Learned from Returning Patients
Presented By:
Kornelia Kulig

This lecture explores the correlates between clinical presentations and laboratory findings in two common painful musculoskeletal conditions that have a recurrent pattern of symptoms; tendinopathies and low back pain. The discussion will draw on the presentation of movement strategies, tissue pathology and centrally driven behaviors during painful and non-painful periods and will develop hypotheses for diminishing symptom recurrence.