Rehab Essentials

COURSE OBJECTIVES

1. Critically evaluate primary sources of evidence on functional outcomes and assessments for patients with neurological disorders and integrate the results into case-based clinical decision-making.
2. Demonstrate understanding of information test properties as they relate to outcome measures used with individuals with neurological impairment and in research reports.
3. Critically evaluate systematic reviews and meta-analyses as sources of clinical evidence on therapeutic interventions for persons with neurological health conditions; demonstrate integration of information obtained from intervention studies to the management of the individual patients.
4. Describe theories of neuro-plasticity following lesions to the nervous system and discuss implications for therapeutic interventions for patients with neurological health conditions
5. Describe current models/theories of normal and neuro-pathological balance and gait function; discuss the implications of this information for the evaluation of and interventions for gait impairments and functional limitations for patients with neurological health conditions.
6. Describe the emerging role of technology neurorehabilitation.
7. Understand the interaction of cognition as it relates to mobility and discuss how this interaction may impact physical therapy care.

NOTE: The complete syllabus is available in the resources section of this Learning Path. Module-specific presentations will be available within each module.

Pain is a common complaint and one of the most frequent reasons people seek healthcare. The person training to be a clinician or the practicing clinician can grow frustrated with management of pain because traditional instruction falls short on providing an adequate understanding of pain. The overall goal of this primer is to supplement traditional instruction by providing content that allows the individual that completes this primer to gain a “transformed understanding” of pain consistent with Institute of Medicine guidelines. Primer content will emphasize examples in musculoskeletal pain from selected studies reported in the peer-review literature. Musculoskeletal pain was selected as the core of this primer because of its overall prevalence and high societal impact.

Meet your Instructor

Steven Z. George, PT, PhD, is director of musculoskeletal research (Duke Clinical Research Institute) and vice chair of clinical research (Orthopaedic Surgery) at Duke University. He is an active member of the American Physical Therapy Association, American Pain Society, and International Association for the Study of Pain. He is past program director at the University of Florida, having taught the evidence-based practice sequence for 10 years. His speaking experiences include symposia, educational, and keynote presentations at national and international conferences. In 2016 he was the 21st John H.P. Maley Lecturer, and the title of his lecture was “Pain Management: Road Map to Revolution.”

This course is designed to acquaint the physical therapist and physical therapist assistant with basic knowledge regarding monitoring of heart rate, rhythm and common dysrhythmia’s utilizing an electrocardiogram (EKG). EKG alterations during myocardial ischemia and infarction will be covered. Differentiation of the EKG alterations and dysrhythmia’s will be categorized into non-threatening, potentially dangerous or life-threatening events. Correlation to hemodynamic changes e.g. pulse palpation, arterial line, swan-ganz catheter and heart sounds will also be covered. EKG’s will be presented relevant to various patient populations.

Meet our Presenter

Steven H. Tepper, PT, PhD, FAPTA Dr. Tepper is President of Rehab Essentials, Inc., which powers the transitional DPT program at University of Montana. He is also a “freelance” professor with the Universities of Delaware, George Washington, and Maryland. Dr. Tepper received his BS in Physical Therapy and a PhD in Experimental Pathology from the University of Maryland. He taught at University of Maryland for 12 years and then spent 13 years Shenandoah University where he was a full professor and Director of the entry-level and transitional-DPT programs. He has authored several chapters and peer reviewed journal articles on various topics. His professional highlights include President of the Cardiovascular and Pulmonary Section of the APTA, Task Force Member on Clinical Practice Guidelines III for the APTA, recipient of the Cardiovascular and Pulmonary Sections Linda Crane Merit Award 1999, University of Maryland Alumnus of the Year 2003, Robert C. Bartlett Award for Innovation in Fundraising from the Foundation for Physical Therapy 2005, the APTA’s Lucy Blair Service Award recipient, 2013, Charles Magistro Service Award from the Foundation for PT in 2016, became Catherine Worthingham Fellow in 2016, Awarded the Barbara Cossoy Service Award for an individual who has made extraordinary contributions to the University of Delaware’s Physical Therapy Program 2019 and received the Spirit of Philanthropy Award from the Foundation for PT Research in 2020. Dr. Tepper has a passion for teaching.

This course provides an introduction to clinical informatics applied to multiple heath care settings from a rehabilitation perspective. It provides a context of challenges in the contemporary healthcare environment and conceptual frameworks to address these challenges and enhance value at population and patient levels. A model for translation of evidence into practice is used to explore the pivotal nature of clinical data by leveraging the electronic health record (EHR). Participants will compare real examples of collection and utilization of outcome measures and process measures, and learn key concepts to advocate for EHR build of data collection within feasible workflows. The course will differentiate between several healthcare professionals as our non-traditional partners to achieve value initiatives. A foundation is defined for data security, data privacy, and quality assurance for secondary use of EHR data. Participants will design an outcomes report and a process report. Lastly, EHR add-ons such as wearables and apps are demonstrated to add value to clinical programs.

Meet our Presenter

Kelly Daley, PT, MBA is the Director Rehabilitation Informatics and Analytics for the Department of Physical Medicine and Rehabilitation (PM&R) at the Johns Hopkins Hospital in Baltimore, Maryland. Kelly Daley leads multidisciplinary informatics and analytics initiatives for the department of PM&R at JHH and is faculty at the Johns Hopkins University. She has been a funded member of PCORI study teams focusing on pragmatic physician, therapist, and neuropsychologist care of back pain by leveraging the EMR for clinical decision support and data. She provides invited lectures on topics ranging from informatics to operations in various settings including numerous national DPT programs and conferences sponsored by the APTA and Johns Hopkins as well as others. Her passion is to ensure that the EMR and other hospital systems support a learning organization for clinical quality and value.

SPECIAL NOTICE

The course is designed to be a competency, rather than a typical CEU course. The "recorded time" for the course does not accurately reflect the amount of time the learner will spend. It will take the average learner about 10 hours to complete given the nature of the content, and interaction anticipated by the participant. This course will be useful for a therapist working in a state that allows them to order imaging, but does not have any evidence of being "competent" beyond graduating from an accredited program.

Course Description

This course illustrates peer-reviewed musculoskeletal imaging cases from the archives of the Journal of Orthopedic and Sports Physical Therapy (JOSPT). These cases demonstrate excellent clinical decision skills and appropriate referral to imaging by physical therapists resulting in optimal patient care. The design of the course is interactive. The student is asked to make clinical decisions throughout each case. A valuable feature of this course is the opportunity for the student to make a wrong clinical decision and see how it can lead to adverse consequences. The student is provided rationales to understand why a decision is wrong. The course then returns the student to the critical decision point and allows them to choose a correct action. The cases then proceeds as in actuality, with optimal patient outcomes.

Prior to the cases, an overview of imaging modalities and evidence-based imaging guidelines are presented. The student is tasked with utilizing the American College of Radiology Appropriateness Criteria throughout the cases to emphasize correct choice of patient condition and variant when accessing this standard resource.

Meet our Instructors

Lynn N. McKinnis, DPT, PT, OCS Lynn is currently a Physical Therapist at Concordia Lutheran Ministries in Cabot, PA. She has authored several text books and articles all in the topic area she presents in this course.

Michael E. Mulligan, M.D. Michael is currently a professor in the Department of Diagnostic Radiology and Nuclear Medicine at the University of Maryland School of Medicine.

This course will present to the physical therapy clinical doctoral learner methods to remain current in coding and payment policy issues. These strategies are vital to thrive in today's healthcare environment. Changes in Medicare/Medicaid, third party payers and out of pocket payments will always remain. The course will include material to assist the physical therapist in daily practice and the profession as it prepares for the future.

Meet the Instructor

Robbie B. Leonard, PT, DPT is a 1986 graduate of Clemson University (B.S. Microbiology), a 1988 graduate of Duke University (M.S. Physical Therapy) and a 2017 graduate of the University of Montana (tDPT). Robbie has worked in the rehabilitation industry since 1988 in many different capacities. In the last ten years she has worked as the VP of Administration for a PT owned private practice that grew from 9 clinics to over 35 in 3 states during her tenure. She most recently served as the COO for the Medical Billing Center (MBC) which is a therapy specific billing company who bills for over 80 private therapy practices across the country. Robbie still serves in an independent contracting role as the Chief Learning Office for MBC. Robbie is currently the co-founder and a consultant with 8150 Advisors. 8150 is a consulting group whose mission is to help outpatient therapy clinics prosper in today’s challenging healthcare environment.

This course provides an introduction to Population Health Management and builds the context for the essential role that multi-faceted, scale-able health promotion and prevention interventions play in achieving sustainable, value-based health outcomes at national and global levels. This course will lay the foundation for assessing and developing population health initiatives using the social-ecological framework. In Part 1, participants will evaluate the economic burden and prosperity costs of chronic disease management. In Part 2, participants will survey historical and contemporary population health initiatives to close the gap between disease management and sustainable community health. In Part 3, participants will evaluate evidence-based interventions for key health behaviors.

Meet your Instructor

Dr. Jennifer Gamboa, PT, DPT, OCS is the CEO of Body Dynamics, Center for Sustainable Health. A Physical Therapist by training, she founded BDI as an integrated health clinic in 1995. Throughout her practice, she’s seen first-hand the profound changes people can realize when “we meet them where they are,” and help them navigate towards their best self. Working with an integrated team requires courageous collaboration, deep curiosity and respect for multiple approaches, and an understanding that there is always a next small step. Living upstream on the spectrum of health care, Jen and her team have been privileged many times over to help roll clients off medications and maximize their health potential even if living with chronic disease, including Parkinson’s, MS, post-Polio, and post-stroke.

In 2013, Jen began working on the Sustainable Health Index, a health assessment tool, health literacy training program, and communication/engagement platform so that she could scale the upstream health model beyond her bricks and mortar practice and into the employer and population health space. The Sustainable Health Index launched as a commercially viable product in June 2018. SHI provides with Jen the opportunity to impact health at scale in employer settings, university settings, municipalities and even countries. Stay tuned, many interesting projects are coming down the pike.

The purpose of this course is to facilitate learning of fundamental principles associated with the use of therapeutic modalities as they apply to the clinical practice of physical therapy.

This will be accomplished via a series of self-directed learning modules designed to enhance clinical decision making which guides the appropriate use of therapeutic modalities as well as best-practice approaches for their utilization.

Meet our Instructor

Michael T. Lebec, PT, PhD Professor, Northern Arizona University, Department of Physical Therapy and Athletic Training

Thanks for choosing the APTA Learning Center!

This course is designed to expose physical therapists to the examination and treatment of patients or clients with integumentary disorders. Learners will receive instruction on best practices to integrate and apply existing evidence into comprehensive patient-client management programs. This course is designed to challenge students to differentiate and prioritize clinical findings based upon level of acuity, patient preference, and knowledge of anatomy, pathophysiology, pharmacology, and diagnostic imaging. Case scenarios will integrate principles of differential diagnosis and establishment of long-term management of patients with integumentary disorders.

Meet the instructor

Joseph McCulloch, PT, PhD, CWS®, FAPTA Dr. McCulloch is a graduate of the physical therapy program at the Medical College of Virginia/Virginia Commonwealth University. He received his Master's degree from New York University and his doctorate from the University of New Orleans.

Much of Dr. McCulloch’s initial training in wound management was obtained during his 8 years of service with the United States Public Health Service (USPHS) in New York City and New Orleans.

Dr. McCulloch joined the faculty of LSU Health Sciences Center (LSUHSC) in 1979 where he focused his teaching and research efforts in the area of wound management.

In 1996, Dr. McCulloch became a Certified Wound Specialist ®, credentialed by the American Board of Wound Management (ABWM). As a specialist, he served on the Examination Committee of the ABWM for two decades, ten years as Exam Chair. Following his service to the ABWM, he was appointed Chairman of the Board of Trustees of the American Board of Wound Management Foundation (ABWMF), the educational support wing of the ABWM.

In 1990, Dr. McCulloch co-edited the first comprehensive textbook in wound management for rehabilitation professionals. The text, entitled Wound Management: Evidence Based Practice, is currently available in its 4th Edition. Dr. McCulloch retired as Dean of the School of Allied Health Professions at LSU Health Sciences Center in June of 2019 and presently operates a private wound management educational consulting business, JoeMcCullochNet.

COURSE OBJECTIVES

1. Critically evaluate primary sources of evidence on functional outcomes and assessments for patients with neurological disorders and integrate the results into case-based clinical decision-making.
2. Demonstrate understanding of information test properties as they relate to outcome measures used with individuals with neurological impairment and in research reports.
3. Critically evaluate systematic reviews and meta-analyses as sources of clinical evidence on therapeutic interventions for persons with neurological health conditions; demonstrate integration of information obtained from intervention studies to the management of the individual patients.
4. Describe theories of neuro-plasticity following lesions to the nervous system and discuss implications for therapeutic interventions for patients with neurological health conditions
5. Describe current models/theories of normal and neuro-pathological balance and gait function; discuss the implications of this information for the evaluation of and interventions for gait impairments and functional limitations for patients with neurological health conditions.
6. Describe the emerging role of technology neurorehabilitation.
7. Understand the interaction of cognition as it relates to mobility and discuss how this interaction may impact physical therapy care.

NOTE: The complete syllabus is available in the resources section of this Learning Path. Module-specific presentations will be available within each module.

This course is designed to bring the learner up to Doctor of Physical Therapy entry-level educational competence in the area of women’s and pelvic health physical therapy, primarily in the cognitive domain of learning. The course focuses on pelvic floor dysfunction and management of musculoskeletal dysfunction in the obstetric patient, with some content related to breast cancer. It does not cover osteoporosis, lymphedema, or chronic pain syndromes such as lymphedema; conditions sometimes covered under the women’s health umbrella. These topics, though germane to the area of women’s health, are often covered elsewhere in entry-level curricula as well as in their own continuing education courses.

Meet the Instructor

Jill S. Boissonnault, PT, PhD, is an American Board of Physical Therapy Specialists Certified Specialist in Women’s Health and an Associate Professor at Shenandoah University, Physical Therapy Program where she teaches professional issues, therapeutic exercise related to the spine, women’s health, and research. She teaches continuing education seminars in women’s health physical therapy on musculoskeletal management of obstetrics clients and on pelvic floor dysfunction. Dr. Boissonnault is a past president and founder of the International Organization of Physical Therapists in Women’s Health, a subgroup of the World Confederation for Physical Therapy (WCPT). She received her bachelor of science in physical therapy from the University of Illinois, her master’s in orthopedic physical therapy from Northwestern University, and her PhD from the University of Wisconsin–Madison, in curriculum and instruction with a minor in women’s studies. She has held various leadership positions within the Section on Women’s Health of the American Physical Therapy Association (APTA), including treasurer from 1983–1989, vice president 1995–1999, and education director 2005–2006. In 2000, Dr. Boissonnault was awarded the Elizabeth Noble Award; in 2006, the Wisconsin Physical Therapy Association Mentor of the Year Award, and APTA’s Lucy Blair Service Award; and in 2011, WCPT’s International Service Award. She is the author of numerous professional articles and textbook chapters.

This course in 14 hours of recorded lectures will present the primary drug classes and the physiologic basis of their action. Drugs will be grouped according to their general effects and the type of disorders they are routinely used to treat. Special emphasis will be placed on drugs that are commonly used to treat people receiving physical therapy. This course will likewise address how drug therapy interacts with physical therapy, and how drugs can exert beneficial effects as well as adverse side effects that impact on rehabilitation.

In addition the course includes these add-ons: gastrointestinal drugs, drug treatments for infection, and complimentary or alternative medicines, that are not available in the specialized pharmacological courses. Overall you will save 15% by taking the bundled course!

NOTE: Please complete Part 1 prior to taking the other Lessons.

The stand-alone specialized courses are:

- Pharmacology in Rehabilitation: Basic Principles (LMS-735)Prerequisite

- Pharmacology in Rehabilitation: Cardiovascular and Pulmonary Medications (LMS-736)

- Pharmacology in Rehabilitation: Geriatric Pharmacology (LMS-737)

- Pharmacology in Rehabilitation: Musculoskeletal Medications (LMS-738)

- Pharmacology in Rehabilitation: Neuromuscular Medications (LMS-739)

This Course is the Prerequisite for the multi-course series "Pharmacology in Rehabilitation":

- Pharmacology in Rehabilitation: Cardiovascular and Pulmonary Medications (LMS-736)

- Pharmacology in Rehabilitation: Geriatric Pharmacology (LMS-737)

- Pharmacology in Rehabilitation: Musculoskeletal Medications (LMS-738)

- Pharmacology in Rehabilitation: Neuromuscular Medications (LMS-739)

You may also be interested in the All-inclusive "Pharmacology in Rehabilitation" Course:

- Pharmacology in Rehabilitation (LMS-709)

NOTE: There is a prerequisite required for this course - see below

This content area addresses drugs that affect the cardiovascular and pulmonary systems. Cardiovascular medications are grouped according to their primary mechanism of action, and will include the diuretics, beta blockers, vasodilators, ACE inhibitors, calcium channel blockers, nitrates, and digitalis glycosides. Drugs used to control coagulation disorders will then be addressed, followed by the pharmacologic management of hyperlipidemias. This course then discusses pulmonary medications, such as drugs used to control respiratory irritation and secretions (antitussives, decongestants, mucolytics, expectorants, antihistamines), drugs that promote bronchodilation (beta agonists, xanthines, anticholinergics), and drugs that decrease airway inflammation (glucocorticoids, cromones, leukotriene modifiers). This content area concludes with a survey of endocrine pharmacology, focusing on drug management of diabetes mellitus, androgens, female hormones, and thyroid disorders.

Please Note: This course is part of a series. Courses in this series includes:

-Pharmacology in Rehabilitation: Basic Principles (LMS-735)Prerequisite

- Pharmacology in Rehabilitation: Geriatric Pharmacology (LMS-737)

- Pharmacology in Rehabilitation: Musculoskeletal Medications (LMS-738)

- Pharmacology in Rehabilitation: Neuromuscular Medications (LMS-739)

You may also be interested in the All-inclusive "Pharmacology in Rehabilitation" Course:

- Pharmacology in Rehabilitation (LMS-709)

NOTE: There is a prerequisite required for this course - see below

This content area addresses geriatric pharmacology, and focuses on specific patient population and not specific drugs. Issues relevant to geriatric pharmacology will be discussed first, with particular emphasis on why drug effects and adverse reactions are often different in older patients compared to younger individuals. This content area concludes with a survey of cancer chemotherapy.

Please Note: This course is part of a series. Courses in this series includes:

-Pharmacology in Rehabilitation: Basic Principles (LMS-735)Pre-Requisite

- Pharmacology in Rehabilitation: Cardiovascular and Pulmonary Medications (LMS-736)

- Pharmacology in Rehabilitation: Musculoskeletal Medications (LMS-738)

- Pharmacology in Rehabilitation: Neuromuscular Medications (LMS-739)

You may also be interested in the All-inclusive "Pharmacology in Rehabilitation" Course:

- Pharmacology in Rehabilitation (LMS-709)

NOTE: There is a prerequisite required for this course - see below

This content area addresses drugs that affect the musculoskeletal system. Medications used to treat pain and inflammation will be discussed first, with particular emphasis on analgesic and anti-inflammatory applications seen routinely in physical rehabilitation. Drugs used to control skeletal muscle hyperexcitability and treat muscle spasms and spasticity will then be addressed. Implications of general anesthetics and local anesthetics are discussed, focusing on their use in surgical, postsurgical, and other clinical situations. This content area concludes with a summary of how specific medications can help improve function and reduce disability in patients with rheumatoid arthritis or osteoarthritis.

Please Note: This course is part of a series. Courses in this series includes:

-Pharmacology in Rehabilitation: Basic Principles (LMS-735) Prerequisite

- Pharmacology in Rehabilitation: Cardiovascular and Pulmonary Medications (LMS-736)

- Pharmacology in Rehabilitation: Geriatric Pharmacology (LMS-737)

- Pharmacology in Rehabilitation: Neuromuscular Medications (LMS-739)

You may also be interested in the All-inclusive "Pharmacology in Rehabilitation" Course:

- Pharmacology in Rehabilitation (LMS-709)

This course will explore the physical therapist’s role as an interdependent practitioner working within a collaborative medical model. Inherent in the responsibilities associated with this role is the ability to recognize clinical manifestations that suggest that physician (e.g., MD, DO) contact is warranted regarding a client’s health status. A proposed examination scheme promoting a more efficient and effective collection and evaluation of the examination data, will be the primary focus. Professional communication with the patient/client and the physician will also be a central theme.

Meet the Presenter

Bill Boissonnault, PT, DPT, DHSc, FAPTA, is executive vice president of professional affairs for APTA. Until recently, he was a professor at the University of Wisconsin-Madison and senior physical therapist at the University of Wisconsin Hospital/Clinics. He earned a bachelor’s degree in physical therapy from the University of Wisconsin-Madison, a master’s degree and doctor of health sciences degree from the University of St Augustine, and a doctor of physical therapy degree from the Institute of Health Professions-Massachusetts General Hospital. He is a fellow of the American Academy of Orthopaedic Manual Physical Therapists. He has published numerous articles related to patient direct access to physical therapist services, consulted with more than 70 hospitals and clinics regarding implementation of Wisconsin’s direct access model, and served on the WPTA task force for promoting the adoption of the model.