Session Descriptions

Pre-Conference Sessions

How to Use the Best Evidence in Physical Therapy

Presenter(s): Leo Costa

This is a 1-day workshop aiming to help the participants to better understand the concepts of evidence-based practice. By the end of this workshop, the participants will be able to 1) Formulate a clinical question; 2) Identify the best research design to respond specific research questions; 3) Locate the best evidence using PubMed or PEDro databases; 4) Identify risk of bias in randomized controlled trials and 5) Implement these findings in clinical practice.

Thrust Joint Manipulation Skills for the Spine

Presenter(s): Louie Puentedura, Bill O'Grady

Awaiting Description

Resistance Enhanced Manipulation

Presenter(s): Greg Johnson

Training will be provided on a new and innovative method of delivering manipulation to peripheral and spinal restricted segments. This session will train participants how to facilitate a specific, localizing contraction to better localize and protect adjacent segments to set up for the manipulative procedure. This one day hand-on pre-conference course will provide training of apply REM to the major peripheral and spinal articulation.

Byproducts of Lumbar Disc Degeneration; Oscillatory Manual and Exercise Intervention

Presenter(s): Doug Creighton

This course will include the instruction and participant practice of initial, intermediate and advanced stabilization exercises for lumbar segmental hypermobility/instability secondary to early grade disc degeneration. In addition, numerous graded oscillatory angular and traction-based lumbar mobilizations will be instructed and practiced and will assist clinicians in enhancing his/her management of patients with disc degeneration resultant lumbar radiculitis, early grade lumbar disc degeneration and resultant segmental instability, advanced grade disc degeneration and resultant segmental motion loss (hypomobility) and lateral and central canal stenotic narrowing.

Thrust Joint Manipulation Skills for the Extremities

Presenter(s): Louie Puentedura, Bill O'Grady

Awaiting Description

Managing Thoracic Cage Movement Impairments ‐ Moving Beyond Manipulation of the Thoracic Facet Joints: Implications for Pulmonary Function and Regional Interdependence

Presenter(s): John Krauss, Christie Smith

The thoracic spine is inherently less mobile than the adjacent spinal regions largely due to the bony connections of the ribs and sternum, the stabilizing ligaments, and the intrinsic and extrinsic muscles attaching in this region. Mannen et al. concluded that removal of the ribs and intercostal muscles results in an 18.6% increase in thoracic flexion/extension ROM, a 37.4% increase in lateral flexion, and a 77% increase in axial rotation. Despite the known influence of the rib cage on movement of the thorax region, past and current research has focused on restoring mobility in this area primarily through treatment of the thoracic spine with less attention to the management of the posterior and anterior rib articulations and adjacent musculature. Motion impairments of the thoracic cage impact performance of the pulmonary system and adjacent spinal and body regions including the cervical spine, lumbar spine, and the shoulder girdle. There are multiple factors that may reduce movement performance of an individual’s thoracic spine and rib cage including general postural impairments, scoliosis, postural kyphosis, Scheuermann"s kyphosis, age, obesity, and pulmonary disorders. Maintaining movement throughout the entire thoracic cage is essential for an individual’s ability to attain positions and postures associated with optimal inter and intra-regional motion performance and to facilitate ideal pulmonary function. As the compliance of the rib cage is reduced, an individual’s ability to expand the rib cage effectively and efficiently is decreased and may lead to extrinsic restrictive lung disease. Alternatively, conditions resulting in hyperinflation of the lungs, such as chronic obstructive pulmonary disease (COPD), may be complicated by the resistance of the rib cage to recoil during exhalation, contributing to the increased residual volume (RV) and alterations of rib cage dimension seen in this population. Changes in the ribs ability to elevate and depress in both restrictive and obstructive lung disease impact the joint mobility at all articulations of the thoracic cage and the respiratory muscle length and function. Obstructive and restrictive lung disease have routinely been managed with a wide range of medication, breathing treatments, oxygen supplementation, exercise counseling and training, education on energy conservation techniques, education on breathing strategies, and in severe cases surgery. However, management of the known changes in the rib cage compliance has less frequently been addressed in the literature. It’s common practice in other regions of the body to restore range of motion followed by training the muscles in the new ranges gained. In this population, training of the inspiratory and expiratory muscles are encouraged despite the motion impairments of the thoracic cage and therefore the muscles are being trained at a non-optimal length. Based on current research regarding the treatment of patient’s with pulmonary dysfunction, addressing the passive and active motion impairments of the entire thoracic cage appear to be one of the missing links in the management of this population. This pre-conference course will provide insight into a comprehensive examination and intervention approach used for managing thoracic spine and rib cage motion impairments. The patient focus for this course will include orthopedic and medical conditions. The orthopedic focus will be on the implications of motion impairments of the thoracic cage on the thoracic, cervical, and lumbar spine, and the shoulder girdle. The discussion regarding medical conditions will highlight the interconnection between motion of the thoracic cage and obstructive and extrinsic restrictive lung disease. Examination techniques will include procedures used to diagnose impairments of the various aspects of the neuromusculoskeletal system as well as those used to diagnose impairments relating to articular mobility (joint mobility of the spine, spinal costal, costal chondral, sternal costal), muscle performance (length, power, endurance), and motor performance (activation, regulation, coordination). Interventions will focus on manual therapy, therapeutic exercise, and patient education. More specifically, the interventions will highlight techniques used to restore mobility in the spinal and rib articulations, enhance muscle performance, promote self-management of respiration, and improve posture, flexibility, and mobility.

Emerging Concepts in Transitioning the Athlete from Rehab to High Performance

Presenter(s): Mauricio Elizondo, Toko Nguyen

Functional progression of a patient in a rehabilitation setting can be a challenge, especially for athletes that are progressing back into their sport or activity. This pre-conference workshop will provide the clinician with some manual therapy strategies and clinical thinking skills to progress an athlete from basic rehabilitation exercises, to functional evaluation and training, to sport specific drills and performance training that can be applied in any clinical setting.

Directional preference, load progression, and repeated movements for the management of lower quarter impairments.

Presenter(s): Joshua Kidd

To date there is limited evidence in identifying prognostic indicators for painful lower quarter pathology. Traditional models include using pathoanatomical diagnostic labels. Despite the multitude of orthopedic tests and classifications, the pathophysiology of many lower quarter disorders is not well understood and may be treated without consideration of the spine as a source of pain. As a result, examination and interventions may be directed to the lower quarter inappropriately, resulting in a misuse of clinical resources, and more importantly, a misdirection in the treatment for the individual seeking care. Taking into consideration the shortcomings of conventionally used examination procedures, a growing body of opinion favors implementing a different approach than the pathoanatomical model in the assessment and diagnosis of musculoskeletal disorders. This session will introduce different models of movement-based classification systems as alternative methods that may fill the current care gap in the effective assessment and diagnosis of musculoskeletal disorders, leading practitioners toward better patient care. Several new peer-reviewed publications will be discussed that show the reliability and validity of movement-based classification systems, including a recent study demonstrating the prevalence of isolated lower quarter pain that emanates from the spine; recently published in the Journal of Manual and Manipulative Therapy. After laying foundational knowledge of movement-based classification systems the participants will be instructed in the use of repeated end range movements, load progression, and the identification of directional preference for the both spine and lower quarter to classify patients accordingly. This will include video demonstration and group interaction to highlight the diagnostic process and the subgroup classification system to treat lower quarter pain. At the conclusion of the session participants will understand movement-based classification including the use of repeated movements and load progression to classify lower quarter impairments. The course participant will gain immediate incite and tools to include in their current treatment methods that will be clinically applicable.

Breakout Sessions

Clinical decision making for exercise dosage related to Tissue Repair Training: How I invented “The Matrix”

Track: Clinical Track

Presenter(s): Jim Rivard

Enhancing tissue repair and stress/strain tolerance is best addressed through active rehabilitative exercise. The manual therapist can build on their clinical decision making around exercise dosage to improve tissue stress/strain tolerance through adapting algorithmic thinking for exercise dosage when considering the pathoanatomical tissue diagnosis. Knowing what to ask can be more important than knowing how to answer the question. The evidence-guided approach can easily include a tissue-guided approach to improving healing and function. This lecture will update histological evidence for tissue repair as well as the clinical application of tissue repair training.

Does manual therapy have a role in treating patellofemoral pain?

Track: Clinical Track

Presenter(s): Dhinu Jayaseelan, Andrew Post

Patellofemoral pain syndrome (PFPS) is a prevalent condition seen in the orthopedic clinical setting. Despite a substantial amount of literature guiding best practice, a large proportion of individuals with the condition do not achieve preferred outcomes at discharge or at long-term follow up. Exercise to improve muscle performance of local, proximal and distal components may be effective, however many individuals with PFPS present with central sensitization, impaired psychosocial function, and mobility deficits. To some extent, manual therapy can address each of these factors that may contribute to symptom persistence. In this session, the speakers will present current evidence on the management of PFPS, and highlight gaps in the literature. Through a case-based decision making model, the speakers will provide rationale for and against the integration of manual therapy interventions. A laboratory component, guided by expert clinicians, will allow the audience to rapidly apply gained conceptual data to improve clinical relevance and psychomotor skills.

Correlation between serratus anterior and upper rib dysfunction to shoulder pain: Research update and new manual techniques for the shoulder clinician.

Track: Clinical Track

Presenter(s): Mauricio Elizondo, David Kempfert

There is abundant research on the role of the serratus anterior in shoulder dysfunction and pain. However, most of the research is focus on its action on the scapula and not upper rib mobility. Upper rib dysfunction can correlate to shoulder pain, especially in overhead patients. This lecture will discuss the most recent literature, biomechanics, and how to incorporate manual therapy techniques to your patients to improve clinical outcomes.

Modern management of the stiff and painful shoulder

Track: Clinical Track

Presenter(s): Eric Chaconas, Mark Shepard

Shoulder mobility deficits are a common occurrence in painful shoulder conditions such as adhesive capsulitis and post-operative stiffness. High irritability of the painful shoulder is a contributing factor to persistent stiffness and poor outcomes. A body of evidence has recently emerged for the stiff and painful shoulder demonstrating effectiveness with modern interventions. In this 2 part session a shoulder irritability model of care will be discussed along with the current evidence for nervous system targeted progressions, manual therapy and exercise covering the spectrum of irritability levels. Lab activities in part one will include techniques that will cater to those patients with high irritability, such as tactile discrimination, graphesthesia and graded motor imagery. The lab in part two will include progressive manual therapy techniques from several patient positions along with exercise and loading programs to be used in varying levels of shoulder irritability.

Bridging the Gap Between Pelvic Health and Orthopedic Physical Therapy

Track: Clinical Track

Presenter(s): Kimberly Durant, Ashlie Crew

As orthopedic manual therapists, can we really claim to be evaluating the whole musculoskeletal system if we are not including screening of the pelvic floor especially for patients with hip and low back pain? There is an established link between pelvic floor dysfunction and low back pain. A recent cross-sectional study (2,341 participants) found a higher prevalence of stress urinary incontinence in women with chronic low back pain compared to those not reporting low back pain (49% vs 35%). A Canadian Community Health Survey from 2017, analyzed 125,645 responses and found that both men and women diagnosed with urinary incontinence were twice as likely to also have a low back pain diagnosis. Another study of 200 females with low back pain found that 78% also suffered from urinary incontinence. Clearly, there is a link that we need to be addressing better. In this session, we will review relevant history questions, external examination and treatment techniques, and outcome measures that every orthopedic physical therapist should be using for patients with low back and hip pain. Types of underactivity dysfunctions including incontinence and prolapse will be reviewed. Also, we will discuss when it is appropriate to refer to a physical therapist with training in internal assessment and treatment. Let’s start evaluating the whole system and stop avoiding the pelvic floor!

Integrating foot/ankle interventions within the lower extremity kinetic chain: The missing link

Track: Clinical Track

Presenter(s): David Kempfert, Megann Schooley

The foot/ankle is arguably the most important segment of the lower extremity kinetic chain as it is responsible for absorbing ground reaction forces, adapting to multiple surfaces, and transmitting load for propulsion during weight bearing activities (i.e. gait, jumping, running, etc.). The foot and ankle are susceptible to many types of impairments and/or pathologies due to its complex anatomy and biomechanics. Soft tissue injuries (i.e. ligamentous, fascial, etc.) may predispose an individual to functional limitations and present as a risk factor for further injury. Limited dorsiflexion is a common impairment that has been shown following lateral ankle sprains and is the most common risk factor for developing plantarfascitis. Clinically, dorsiflexion is emphasized at the talocrural joint secondary to the greatest degrees of motion occurring at this specific synovial junction; however, successful dorsiflexion requires proper hindfoot mobility encompassing the talocalcanealnavicular junctions. Therefore, the purpose of this masterclass is to present the complex biomechanics of the foot/ankle, and to demonstrate innovative manual therapy techniques and exercise progressions to meet the unique needs of clients from the general population to the elite athlete.

A Breath of Fresh Air: Manual Therapy for Dyspnea

Track: Clinical Track

Presenter(s): Steven Kinney, Jeremy Houser

Most of the research on manual therapy has focused on the benefits for patients in pain. However, emerging research has also looked at manual therapy as an intervention for patients with difficulty breathing. The presenters will discuss how manual therapy can amplify the benefits of exercise therapy. This two part session will review the evidence for manual therapy when treating these conditions. Mechanisms of these benefits will also be discussed. In the second part of this session, participants will practice these techniques during a lab component. Clinical decision making when using these techniques will be discussed.

The Utility of Non‐Traditional Physical Therapy Interventions As A Means Of Holistic Management & Treatment Of Chronic Pain.

Track: Clinical Track

Presenter(s): Chase Edwards

The utilization of holistic or integrative based treatment approaches aim to address a patient a whole system versus isolated segments. The practice integrates conventional and alternative therapies to prevent and treat disease and, most important, to promote optimal health. The efficacy of holistic based treatment approaches within physical therapy practice employee traditional physical therapy interventions with nonconventional intervention strategies aimed at addressing all aspects of health and wellness. Physical Therapists are in a primes position to discuss this multimodal treatment approaching targeting: sleep hygene, evidence based nutritional recommendations within scope of practice, lifestyle and activity modifications, and restoring autonomy and internal locust of control to patients. One such case employing this holistic approach of physical therapy intervention for a patient suffering from chronic pain and opioid dependence. This case emphasized sleep hygiene promotion, pain neuroscience education techniques, evidence based nutritional recommendations targeting anti-inflammatory properties of daily nutrition, manual therapy interventions, progressive loading and gym based exercise plan, and traditional therapeutic exercise strategies.

After the Cavitation: Clinical Strategies and Coaching Techniques to Optimize Motor Learning

Track: Translational Knowledge

Presenter(s): Matthew Pugliese, Scott Siverling, Eric Trauber, John Castro

Individuals with spinal pain often display impaired somatosensory control, reduced movement variability and disturbances in balance, proprioception and postural control. Manual therapy interventions are commonly implemented to reduce pain, improve function and induce neurophysiological effects. Current evidence suggests that the benefits of mobilizations and manipulations are short-lived and their overall value is reduced when they are performed in isolation. Exercise regimens often improve motor performance but fail to create permanent changes indicative of motor learning. This session will define the differences between motor performance and learning, and explain the appropriate use of retention testing. The importance of practice volume, mental rehearsal and variability of training will be thoroughly described by the presenters. Techniques to enhance expectances, promote confidence, increase self-efficacy and task interest will be detailed. The influence of autonomy on motor learning and patient motivation will be illustrated with the use of multiple case examples. Specific emphasis will be placed upon appropriate patient feedback and communication strategies to promote an external focus of attention. The learner will be provided with a modern approach to motor learning and appreciate methods that can immediately be used in the clinic.

Introduction to Motivational Interviewing in Physical Therapy

Track: Translational Knowledge

Presenter(s): John Seivert

This 1/2 to full day workshop will focus on understanding the basic concepts of motivational interviewing (MI). This session will focus on real life transcripts of patient and PT interactions demonstrating the effectiveness of MI in helping patients make positive changes. Upon completion of the session each participant will have new tools to use in helping patients make changes with ideas and plans that have come from the patient, not the PT trying to fix the problem.

Chronic Spinal Pain: A Proposed Physical Therapy Model for Evaluation and Management

Track: Translational Knowledge

Presenter(s): Ronald Schenk, Joseph Lorenzetti

This interactive case-based breakout will describe and discuss physical therapy approaches designed to manage chronic musculoskeletal spinal pain. An analysis of the literature regarding the efficacy of the Mechanical Diagnosis and Therapy (MDT) and Pain Mechanism Classification System (PMCS) in managing people with psychosocial factors will be followed by case examples of patients examined and treated who fall into chronic pain subgroups. Preliminary data regarding the efficacy of integrating these approaches will be analyzed.

That's not my brand, is It? How to market your OMPT in 2020

Track: Professional Issues

Presenter(s): Matthew Daughtery

Currently, orthopaedic manual physical therapists (OMPTs) have professional and advocacy issues specific to our profession. More specifically, OMPTs have an identity crisis with the public, which causes OMPTs to miss out on career opportunities have difficulty sustaining their practices and ultimately serve less patients. Some of this identity crisis is due to OMPTs limited business training. We need focused efforts to correct this identity crisis through business training sessions with a focus on marketing to improve public awareness and perception. This may lead to improved opportunity within the health field and a foothold in prevention, wellness and rehabilitation in this metamorphosis of musculoskeletal health evolution. The implications of session may cause positive social change toward the OMPT’s direct and indirect patient marketing. This could lead to economic growth in the physical therapy practice market, as well as improved patient access to physical therapy services through a greater number of physical therapy practices. Description of session This evidenced based session will cover the topics of: brand awareness, relationship marketing, perceived quality, social media and online marketing, and word-of-mouth marketing to advance participants knowledge on these topics. Crowd interaction will be encouraged with the use of A/V aides, KahootIT quizzes and a Q and A session.

Coaching, Mentoring and Sponsoring: Professional Development in Physical Therapy Practice & Education

Track: Teaching/Mentoring

Presenter(s): Bryan Pickens, Chris Allen, Jon Umlauf

An influncial mentor plays a crucial role in the professional development of physical therapists and other medical professionals. Recently, an effort to distill what the best mentors do has emerged as a question of particular interest. The abstract concept of a "mentor" is difficult to define, but usually contains elements of mentorship, coaching, and sponsorship. While the overall construct of mentorship is recognized to be extremely valuable in physical therapy education, mentors often must play the role of a coach or sponsor to best influence the mentee. While the importance of mentoring has long been understood, the specific function of coaching and sponsoring is rapidly gaining attention in the development and growth of medical professionals. Mentoring involves establishing a relationship between a more experienced individual and a less experienced individual. However, mentoring is typically directive, with the mentor intentionally transferring specific knowledge and skills and guiding the learner’s activities. Coaching, on the other hand, supports a developmental process through regular meetings over time with a coach to create goals, identify strategies to manage existing and potential challenges, improve performance, and further professional identity development toward reaching the individual’s highest potential. Coaches, after reviewing objective data on performance, help individuals gain insights into their own assumptions, clarify meaning about relevant outcomes, and help identify specific actions needed to achieve the desired result. Sponsorship, in addition to mentorship, is critical for successful professional development. Understanding sponsorship as a distinct professional relationship may help faculty and academic leaders make more informed decisions about using sponsorship as a deliberate professional development strategy. With sponsorship, a protégé is put forward by a sponsor for high-visibility, professional development opportunities. This may include a recommendation for a leadership role, award, or a high-profile speaking opportunity. This session will define each of these concepts in great depth. Attendees will gain a deeper understanding of these roles and determine how and when to use each of them to influence the professional development of other physical therapists.

Systematic Clinical Reasoning: From Novice to Expert in No Time

Track: Teaching/Mentoring

Presenter(s): Evan Petersen, Stephanie Thurmond

The development of clinical reasoning needs to be seen as part of a learner continuum and grounded in explicit teaching and learning strategies. Due to the variability in clinical reasoning for students in entry-level and even advanced level physical therapy programs, a systematic approach to introducing effective strategies and instructional tools is needed to improve this essential skill. Clinical reasoning is essential to understanding a patient’s pain and in determining the appropriate vigor and extent of the physical exam and intervention. This pre-conference will highlight the use of several clinical reasoning strategies and tools that can facilitate the development of clinical decision-making. Attendees will learn to utilize these tools in the clinical and academic settings to improve clinical reasoning and effective decision-making. The pre-conference is targeted for first time AAOMPT conference attendees and fellows-in-training.

Yes You Can! Exploring Professional Associations, State Practice Acts, and the Role of Physical Therapists as Comprehensive Healthcare Advocates.

Track: Professional Issues

Presenter(s): Chris Dickerson, Mark Shepard

In the year 2020, it has become undeniably evident that the optimal management of many patients extends well beyond the tissues or regions where the symptoms are experienced. In keeping with the biopsychosocial model of patient care, clinicians may often recognize that their patients require consultation in multiple facets of their lives to achieve optimal health and wellness. Many physical therapists voice uncertainty as to whether or not addressing sleep, nutrition, stress management, or other wellness factors is within their scope of practice. We will explore the recommendations from multiple professional organizations, as well as the verbiage in all 50 state practice acts to answer those questions.

Shared Decision Making in Physical Therapy: A case series focusing on feasibility in the rehabilitation setting

Track: Translational Knowledge

Presenter(s): Laura Thornton, Jackson McNeal, Dominque Tull

Shared decision making, a process that focuses on achieving patient-centered healthcare, has been increasingly accepted in clinical medicine. The goal of shared decision making is to enhance and restore patients’ autonomous capacity by engaging them in collaborative deliberation on available treatment options. Clinicians help to clarify treatment options by informing on best available evidence and helping patients actively consider options before supporting an informed, well-considered, and confident decision. This process is specifically relevant when a decision requires specific behavior change and when there is more than one reasonable option for treatment. Evidence suggests consistent improvement in patients’ knowledge and more accurate perceptions of risk led to increased confidence in decisions in the medical realm. There is lack of guidance on how to accomplish this in the rehabilitation setting despite research supporting therapeutic alliance as a key component to successful outcomes. This session will detail examples of shared decision making in outpatient physical therapy to showcase the feasibility in the rehabilitation setting. A lecture format will be used with emphasis on case-based learning to provide attendees with a practical application of shared decision making in the outpatient setting with patients with musculoskeletal complaints. Each case will describe the process in which shared decision making was implemented and provide integration strategies for clinicians.

Implement Therapeutic Alliance Assessment to Redefine Your Patient’s Musculoskeletal Health

Track: Translational Knowledge

Presenter(s): Christina Myers, Lindsey Hughey, Glenn Thompson

This session will start with an overview of the background and significance of therapeutic alliance as it relates to the practice of physical therapy and then will move deeper into the use of assessment tools for therapeutic alliance including interactive assessment during the session. Learners will come away with tools to implement therapeutic alliance assessment for both their patients and themselves and will be able to immediately implement these assessment techniques into their daily practice.

Cervicogenic Headache: Putting the Patient in Control

Track: Teaching/Mentoring

Presenter(s): Cora Aytona, Jane Borgehammer, Ron Schenk

Relationship to Conference Theme: With patient empowerment having the potential to lessen the progression toward chronicity, progressing procedures from patient generated to physical therapist generated forces may allow people experiencing mechanical headaches to potentially self-treat. Presenters: Cora Aytona, Jane Borgehammar, Ron Schenk, other MDT and Daemen Fellows in attendance to assist in lab instruction Description of Session: This session will consist of lecture and video presentations of cases of people with upper cervical musculoskeletal conditions, particularly headaches and will include practical demonstrations and presentation of supporting evidence. The presenters will introduce the concepts of MDT clinical decision making and critical thinking regarding the application of manual physical therapy procedures for the upper cervical spine. Analysis of the MDT of patient cases as well as the peer-reviewed literature in regards to non-thrust manipulation, therapeutic exercise and the indications and contraindications to manipulation will be discussed. Supervised practical sessions will promote the development of psychomotor skill in the application of MDT clinician procedures including non-thrust manipulation and cervical spine stabilization exercises.

Enhancing clinical and classroom performance through reflective writing

Track: Teaching/Mentoring

Presenter(s): Chris Allen, Bryan Pickens, Jon Umlauf, Ben Just

The process of reflective writing facilitates lifelong learning and for physical therapists of all skill levels. Reflective practice helps clinicians integrate psychosocial and patient-centered approaches into practice and to consider the complexity of the patient/physical therapist interaction from multiple perspectives. As a learning tool, reflective writing helps the clinician and mentor probe for meaning within an encounter and facilitates a comprehensive clinical reasoning process. This is a continuation of a break-out session presented at AAOMPT 2019, where we introduced the process of reflective writing and advice on providing feedback to learners. In this session, we will review the process and benefits of reflective writing and build on these concepts to provide an interactive session for clinicians and educators. Participants will learn strategies to implement reflective writing in a learning environment and to facilitate advanced clinical practice. Presenters will discuss strategies for writing and tools to facilitate a more in-depth reflective process. These include prompts to help students reflect on their problem-solving process for ill-structured problems and clinical reasoning. Additionally, we will provide the theoretical underpinnings that support these writing tactics. We will also discuss prompts for written student reflection to assist mentors in their role in providing feedback for reflective writing. These will allow mentors to provide “just in time” and scaffolded feedback. These prompts should engage and encourage mentees to integrate reflective writing into their practice. During this interactive session, participants will complete a guided reflective writing exercise and learn how to apply useful tools to provide structured feedback.

Multi‐modal Approach in the Treatment of the Hypermobile Patient

Track: Translational Knowledge

Presenter(s): Laura Fisher, David Johnson

Joint hypermobility syndrome (JHS) is a commonly misdiagnosed and mismanaged condition in the physical therapy setting. Individuals with JHS have demonstrated lower scores on quality of life measures across the lifespan, and present unique challenges to even the most skilled clinician. Generalized hypermobility has been linked to an increased risk of injury in contact sports; and hypermobile athletes have been shown to miss more training time, competitive games, and take longer to recover. In addition to the unique physical characteristics present in these patients, they have also been shown to present with increased risk of depression, anxiety, fear avoidance behaviors, and agoraphobia. There is a significant knowledge gap among physical therapists regarding appropriate evaluation and treatment of the hypermobile patient population. A large study among Physical Therapists showed that 38.8% were unfamiliar with JHS and 73.2% did not know the Beighton criteria for diagnosing JHS. Physical Therapy can be a valuable part of the management of these patients and could potentially reduce healthcare costs. This presentation is an opportunity to tremendously improve the quality of life of hypermobile physical therapy clients by reviewing recommendations on examination and diagnosis of hypermobility as well as providing a multimodal treatment plan.

Evaluating research is > p‐values alone: a clinician’s guide to interpreting statistical influence

Track: Translational Knowledge

Presenter(s): Bradley Myers

Remaining up-to-date with emerging evidence can be challenging for clinicians for many reasons. Obtaining access to journal articles and allocating time for reading can be burdensome. For most OMPT clinicians the difficulty does not end there as interpreting research findings in relation to clinical practice can be a daunting task for even the seasoned clinician. Unfortunately, the historical implementation of Null-Hypothesis Significance Testing and the p-value has been called into question by statistical experts. The evolution of statistical inference requires more critical evaluation than the basic cut-off value of p < .05. This session is intended to provide an update on statistical inference while reviewing and applying important concepts to recent evidence. Additionally a simple framework will be provided for busy clinicians to utilize when assessing clinical research in the future.

The Wild Wild West of Dry Needling: Why Research Needs to Catch Up to Clinical Practice

Track: Translational Knowledge

Presenter(s): Cody Mansfield, Nina Kelly

This session will give a brief history of dry needling, discuss the limitations of dry needling research, and review implementation and safety of various dry needling techniques.

Reasoning for the good of all: The benefits of Fellow provided mentorship to entry‐level students working with the highly complex patients common to pro bono practice

Track: Teaching/Mentoring

Presenter(s): Garrett Naze, Alicia Emerson, Kevin MacPherson

Based on census polling in 2018, an estimated 27.5 million people in the United States did not have health insurance at any point during the year.(1) This number does not include those without physical therapy benefits as a part of their health plan or those who have exhausted a capped number of physical therapy visits/dollars per calendar year, meaning the number of people without access to physical therapy is likely to be greater. Thus, the value of a pro bono physical therapy clinic from the patient perspective is quite apparent. Practicing in a pro bono setting may not always be considered as a viable option for clinicians to further develop elevated clinical reasoning as advanced practitioners. FAAOMPT-trained clinicians working in a pro bono setting can better define themselves as the practitioner of choice in managing patients with frequently complex presentations. Additionally, FAAOMPT-trained clinicians who provide mentoring in pro bono clinics can assist with transcurricular integration of diagnostic and/or screening for referral material that is typically taught, and learned, in silos, enhancing student understanding of the complex movement system. Adverse social determinants of health disproportionately increase the risk for persistent musculoskeletal pain in marginalized populations.(2,3,4) It has been proposed that lacking health insurance itself should be considered a comorbidity(5) and/or a health risk factor(6) given the poor health outcomes reported in populations without insurance.(7,8) Thus, populations that do not have any, or limited, access to health care, often present to pro bono clinics with multiple comorbidities that need to be considered when establishing the plan of care. Therapists working in this setting are required to develop advanced medical screening and crucial triage skills, a strong working knowledge of the proper pharmacological strategies, and knowledge of other local pro bono and at-risk resources for specific populations that should be used in the care for this patient population. FAAOMPT-trained clinicians, having learned more efficient clinical reasoning strategies,(9) may better respond to challenges of highly complex patient presentations. Similarly, mentoring entry-level Doctor of Physical Therapy (DPT) students treating high-complexity patients early in their education may better prepare them for future clinical experiences and entry into the profession.(10) If a student is comfortable managing a patient with a high-complexity presentation, they will be ultimately more equipped to manage a patient of less complexity. Mentoring also exposes clinicians to FAAOMPT-calibur practice and can stimulate interest in enrolling in fellowship training to develop into more complete practitioners. In conclusion, providing care in a pro bono setting benefits the patients, the clinicians, and the future of our profession and organization. This course will present these benefits as well as provide resources for FAAOMPTs to engage in pro bono physical therapy practice.

So, You’re Interested in Academia? A roadmap to prepare OMPTs in their transition

Track: Teaching/Mentoring

Presenter(s): Michael Bourassa, Jodi Young

The Orthopaedic manual physical therapist has a long history of excellence in research, clinical reasoning, practice management, and post-doctoral training. It is these values that have led OMPTs to become leaders in the profession and serve in a variety of academic roles. Within the last decade, the total number of physical therapy programs has grown dramatically. Doctor of Physical Therapy (DPT) programs grew by 50 and Residency/fellowships have increased from 50 to 296. The need for faculty members is high, however, the transition into academics is not an easy one for most clinicians. The Academic and Clinical Faculty Special Interest Group (ACF SIG), in collaboration with the Early Professional Special Interest Group (EP SIG), will focus on providing a framework to guide members into varying academic roles. The presentation will consist of multiple speakers, each with diverse academic experience. The aim of this session is to focus on the OMPT as an educator and discuss key points to consider during the transition into an academic role.

The Journey from Resident to Mentor: Young Padawan to Jedi Master

Track: Teaching/Mentoring

Presenter(s): Amy Hsieh, Mara Hochman, Taylor Cole, Alexa Edwards

Residencies and fellowships continue to grow rapidly in our profession, and we must continually ask ourselves where we fall in the learning continuum. As a resident or fellow in training, do you ever wonder when you will accumulate enough knowledge to practice like your mentor? As a mentor or program director, do you ever ask yourself how you can best support a mentee who is different from you? This session will enhance your understanding and practical application of how to increase the efficacy of teaching and mentoring in a post-professional program. The talk will discuss the residency experience, the transition from resident to mentor, and the role residency directors play in facilitating growth within their programs. We will also examine how continued mentoring of faculty who are residency graduates is imperative to their growth and the institution’s investment into their workforce. It will challenge you to grow personally and professionally with the goal of creating healthy learning environments that promote leaders.

What does the evidence suggest? Exercise therapy (ET) and targeted dosage in the management of individuals presenting with chronic NP

Track: Translational Knowledge

Presenter(s): Mark Wilhelm, Megan Donaldson, Josh Cleland, Ken Learman, David Griswold

Currently, there is a lack of evidence-based dosage recommendations for exercise therapy (ET) prescription for the management of NP-associated disorders. Clinicians are encouraged to use exercise in the management of neck pain but how do they select exercises and dosing in the variability of information. The presenters were authors on a published study which conducted an SR and MA on the optimal exercise dosage recommendations for treatment of chronic NP. The authors want to share the learned lessons and clinical implications from this study. Authors will discuss the studies that evaluating the type and dosage effect of ET on pain and disability in the management of individuals with chronic NP. Video and interactive polling will be used during this session.

What PT’s need to know about Regenerative Medicine and Orthobiologic Injections.

Track: Teaching/Mentoring

Presenter(s): Greg Johnson, Christopher Centeno

Some of the most exciting recent advances in musculoskeltal care has been achieved within Regenerative Medicine. Through the use of Orthobiologic Injections (platelet-rich plasma, stem cells, and other tissues) major progress has been achieved in helping heal degenerative and traumatic tissue changes. This presentation will illuminate how injections performed under exacting image-guidance can help patients avoid traditional orthopedic surgery. The medical literature and basic concepts will be discussed. In addition, how orthobiologics change physical therapy paradigms will be reviewed. In addition, the role of how Physical Therapy can be an important adjunct for the pre-injection preparation phase and the post-injection rehabilitation and care.

Taking Clinical Education to the Next Level: Integrating Advanced Clinical Reasoning Strategies into the Continuum of Physical Therapy Education.

Track: Teaching/Mentoring

Presenter(s): Josh Halfpap, Jon Umlauf, Danielle Anderson

Students often elect to attend physical therapy residency and fellowship programs because their practice has stagnated and not maximizing clinical outcomes. A central tenet of post-professional programs is the advancement of clinical reasoning skills. However, due to the seemingly complex nature of clinical reasoning systems, these principles are often delayed until and can impede optimal growth of young clinicians. Implementing a systematic, structured approach to clinical reasoning process early can provide a framework for students to improve their ability to think critically and equip students and young clinicians with the tools needed to enhance their understanding of the patient"s condition and develop a comprehensive management strategy. We contend the process can be broken down and applied at the earliest levels of entry-level clinical education, providing students with the tools required to advance their craft sooner after graduation. This interactive lecture will discuss the current literature regarding clinical reasoning concepts and established training strategies. We will provide valuable tools that clinical mentors can immediately implement to train and measure a junior clinician"s clinical reasoning skills.

Are we at the table? Maximizing collaborations to impact the care of those with arthritis

Track: Professional Issues

Presenter(s): Emily Slaven

In this session, the impact that arthritis has on the American population will be considered. The complete data set from the Arthritis Foundation’s Live Yes Insights survey will be shared with attendees where the topics of pain, limited motion, and difficulty with walking are key themes of the first round of this data. Discussion of how we as orthopaedic manual therapists should be integral of the management of those individuals with arthritis will occur. Ideas for mechanisms for better collaboration with entities such as the Arthritis Foundation will be explored.