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Sparking Change in the Treatment of Children with Diplegic Cerebral Palsy – NYC – Jan. 21, 2018 & LI – Jan. 23, 2018

Beverly Cusick, PT, MS, C/NDT, COF & Susan Hastings, PT, DPT, PCS

January 21, 2018 * New York City * Sunday – 8:30 am – 5:30 pm

OR

January 23, 2018 * Long Island * Tuesday – 8:30 am – 5:30 pm

In children born premature and those with diplegic cerebral palsy (CP), findings obtained with diffusion tensor imaging (DTI) have brought significant challenges to the common definition of CP as “a motor disorder caused by a static lesion to the upper motor neurons resulting in spasticity”. Beverly Cusick, PT, MS, NDT, CTF, discusses findings by researchers that question the definition and challenge the common notion that spasticity is present and that it causes contracture formation and gait pathology in children with diplegia. She discusses the confusion over the difference between increased tone and hyperreflexia and introduces some new thinking regarding EMG activity in tissues under stretch. She concludes by proposing an alternative to “spasticity reducing” interventions by addressing postural control deficits and remediation. Susan Hastings, PT, DPT, PCS, discusses requirements for motor learning to occur, and introduces functional electrical stimulation (FES) and whole body vibration (WBV) as treatment-augmenting interventions along with supporting research. She brings the didactic principles into practical application using videos, slides, and documentation of the case of a child with diplegic CP that spans 10 years of intervention, illustrating the effectiveness of engaging in a comprehensive treatment regimen that includes postural control training, functional strengthening, casting and orthoses, a soft body orthotic alignment system, practice, FES and WBV, and without injecting toxins or severing nerve roots.

Cost:

NYC – January 21, 2018
Cost: $300.00 Early | $320.00 Regular

OR

Long Island – January 23, 2018
Cost: $280.00 Early | $300.00 Regular
*Please note Long Island course will not offer refreshments

Early registrations must be postmarked or received on-line 21 days before the course.

A 10% discount will be give when 3 or more registrations are received at the same time (use code group3). 

 

$300.00$320.00 $280.00$300.00

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Product Description

Learning Objectives:
Participants completing this course are expected to be able to:

· Discuss the proof of validity of JW Lance’s definition of spasticity (1980).
· Discuss the evidence supporting the causative role of spasticity in deformity development and gait pathology.
· Discuss the evidence supporting the Modified Ashworth Scale as a valid test of spasticity.
· Explain diffusion tensor imaging (DTI) and discuss recent findings in children with diplegic CP.
· Describe R1 (L1, Lo) end range on the passive length-tension curve and discuss its developmental normalcy.
· Relate postural control to limb muscle recruitment and physiologic adaptation.
· Describe the muscle recruitment strategy needed to remain upright in the presence of a chronically anterior
displacement of the body COM in standing and in walking. Relate this strategy to development of common soft tissue contractures in children with diplegic CP.
· Explain the relevance of EMG data in gait as evidence of spasticity.
· Discuss the evidence of long-term effects – on deformity, strength, postural control, and gait pathology – of treating “spasticity” in children with diplegic CP using Botulinum toxin-A injections and selective dorsal rhizotomy.
· Explain the rationale for building trunk and hip control of postural alignment and the body COM as a contracture prevention and management strategy.
· Relate the principles of motor control to its enhancement through use of FES and WBV.
· Explain the features and effects of NMES/Functional Electrical Stimulation on muscle tone when used to
stimulate the agonists – the muscles that are tonically recruited and that become stiff.
· Explain the optimum features of Whole Body Vibration (WBV) and potential effects on muscle tone.
· Discuss FES and WBV with attention to differences in terminology and outcome measures in the current occurring in the literature.
· Discuss the rationale for choosing FES and WBV equipment and techniques for children compared to adults.
· Explain how to incorporate FES into therapeutic exercise and other interventions such as serial casting and
bracing.

Cost:

NYC – January 21, 2018
Cost: $300.00 Early | $320.00 Regular

OR

Long Island – January 23, 2018
Cost: $280.00 Early | $300.00 Regular
*Please note Long Island course will not offer refreshments

Early registrations must be postmarked or received on-line 21 days before the course.

A 10% discount will be give when 3 or more registrations are received at the same time (use code group3).

 

Sunday – January 21, 2018

OR

Tuesday – January 23, 2018

8:30 – Managing body weight: postural control acquisition, accompanying limb muscle recruitment strategies, and evidence of related limb muscle adaptation to use history.

9:15 – Mismanaging body weight: postural control and sensory processing deficits in children with diplegia, and related limb muscle adaptation to compensatory, tonic recruitment

9:45 – Short Break – 15 minutes

10:00 – What do we know about physiologic changes comprising common lower extremity muscle contractures?

10:15 – What do we know about spasticity and its role in causing deformity and gait pathology?

10:45 – What do we know about the long-term effects – on postural control, muscle strength, deformity, and gait pathology – of neurolytic and surgical “spasticity-reducing” interventions for children with diplegia?

11:45 – What else have we got to offer? Strategies for building fundamental body weight management skills and collecting evidence of effectiveness.

12:15 – Questions and Discussion

12:30 – Lunch (on your own)

1:30 – Putting principles into practice. Introducing Casey – a 10 year case report featuring several management strategies and modalities.

2:30 Break – 15 minutes

2:45 – Resume the case report illustrating motor learning after using above strategies.

3:30 – Critical review of recent literature on FES/NMES and WBV.

4:15 – Complementing Treatment with FES to enhance skill training, strength training, and endurance training.

5:15 – Questions and discussions

5:30 – Adjourn

Target Audience:
Pediatric physical therapists, orthotists, physical medicine rehabilitation physicians, pediatric
orthopedists

Course Level:
Beginner and Intermediate

Educational Credits:
7.5 contact hours. Certificates will be awarded.

Application has been made to NJ Board of PT Examiners for CE credits approval.

Recognized by the NY State Education Department’s State Board for Physical Therapy as an approved provider of physical therapy and physical therapy assistant continuing education.   Approved for 7.5 contact hours.

Cost:

NYC – January 21, 2018
Cost: $300.00 Early | $320.00 Regular

OR

Long Island – January 23, 2018
Cost: $280.00 Early | $300.00 Regular
*Please note Long Island course will not offer refreshments

Early registrations must be postmarked or received on-line 21 days before the course.

A 10% discount will be give when 3 or more registrations are received at the same time (use code group3).