Friday, October 11, 2024
7:00AM - 8:00AM - REGISTRATION / COFFEE
8:00AM - 9:30AM - SESSION 1
Claire Bingham, PT, DPT, ATC, Board-Certified Specialist in Orthopaedic Physical Therapy Claire Bingham, PT, DPT, ATCis a Board-Certified Specialist in Orthopaedic Physical Therapy who graduated from the University of North Georgia with her Doctorate of Physical Therapy in 2017. She currently lives in Mooresville, NC and has worked for the past 7 years at OrthoCarolina. After becoming a Board-Certified Specialist in Orthopaedic Physical Therapy in 2020, her job duties expanded and she now along with treating patients works as a Clinical Specialist at OrthoCarolina to assist with the development of treatment protocols and improve the overall level of education of employees. Dr. Bingham has given presentations at the OrthoCarolina Sports Symposium both in 2023 and 2024. DESCRIPTION: During this presentation, we will address improving your skills in exercise prescription for post-operative shoulder patients. By delving into electromyography studies, the goal of the lecture will be to improve your understanding of shoulder muscle activation during movement, especially movements that are commonly used during the rehabilitation process, which will allow you to improve the quality of your exercise prescription throughout all post-operative phases of recovery. OBJECTIVES: Upon completion of this educational section, participants will be able to: -State healing timelines and understanding of tissue tolerance during phases of healing -State average maximum voluntary contraction rates of muscles during common shoulder movements -Apply understanding of healing timelines and EMG findings to exercise prescription of the post-operative shoulder patient with completion of case studies REFERENCES: Brudvig TJ, Kulkarni H, Shah S. The effect of therapeutic exercise and mobilization on patients with shoulder dysfunction: A systematic review with meta-analysis. J Orthop Sports Phys Ther. 2011;41(10):734-748. doi:10.2519/jospt.2011.3440 Edwards PK, Ebert JR, Littlewood C, Ackland T, Wang A. A systematic review of electromyography studies in normal shoulders to inform postoperative rehabilitation following rotator cuff repair. J Orthop Sports Phys Ther. 2017;47(12):931-944. doi:10.2519/jospt.2017.7271 Ghodadra NS, Provencher MT, Verma NN, Wilk KE, Romeo AA. Open, mini-open, and all-arthroscopic rotator cuff repair surgery: Indications and implications for rehabilitation. J Orthop Sports Phys Ther. 2009;39(2). doi:10.2519/jospt.2009.2918 Littlewood C, Bateman M, Clark D, et al. Rehabilitation following rotator cuff repair: A systematic review. Shoulder & Elbow. 2015;7(2):115-124. doi:10.1177/1758573214567702 Salles JI, Velasques B, Cossich V, et al. Strength training and shoulder proprioception. J Athl Train. 2015;50(3):277-280. doi:10.4085/1062-6050-49.3.84 Kelly BT, Kadrmas WR, Speer KP. The manual muscle examination for rotator cuff strength. Am J Sports Med. 1996;24(5):581-588. doi:10.1177/036354659602400504 Cools AM, Dewitte V, Lanszweert F, et al. Rehabilitation of scapular muscle balance. Am J Sports Med. 2007;35(10):1744-1751. doi:10.1177/0363546507303560 Ekstrom RA, Bifulco KM, Lopau CJ, Andersen CF, Gough JR. Comparing the function of the upper and lower parts of the serratus anterior muscle using surface electromyography. J Orthop Sports Phys Ther. 2004;34(5):235-243. doi:10.2519/jospt.2004.34.5.235 Neumann DA, Camargo PR. Kinesiologic considerations for targeting activation of scapulothoracic muscles - part 1: Serratus anterior. Braz J Phys Ther. 2019;23(6):459-466. doi:10.1016/j.bjpt.2019.01.008 Camargo PR, Neumann DA. Kinesiologic considerations for targeting activation of scapulothoracic muscles – part 2: Trapezius. Braz J Phys Ther. 2019;23(6):467-475. doi:10.1016/j.bjpt.2019.01.011 Reinold MM, Wilk KE, Fleisig GS, et al. Electromyographic analysis of the rotator cuff and deltoid musculature during common shoulder external rotation exercises. J Orthop Sports Phys Ther. 2004;34(7):385-394. doi:10.2519/jospt.2004.34.7.385 Burn MB, McCulloch PC, Lintner DM, Liberman SR, Harris JD. Prevalence of scapular dyskinesis in overhead and Nonoverhead athletes. Orthop J Sports Med. 2016;4(2):232596711562760. doi:10.1177/2325967115627608 Kibler WB, Uhl TL, Maddux JWQ, Brooks PV, Zeller B, McMullen J. Qualitative clinical evaluation of SCAPULAR DYSFUNCTION: A reliability study. J Shoulder Elbow Surg. 2002;11(6):550-556. doi:10.1067/mse.2002.126766 Huang T-S, Ou H-L, Huang C-Y, Lin J-J. Specific kinematics and associated muscle activation in individuals with Scapular dyskinesis. J Shoulder Elbow Surg. 2015;24(8):1227-1234. doi:10.1016/j.jse.2014.12.022 Townsend H, Jobe FW, Pink M, Perry J. Electromyographic analysis of the glenohumeral muscles during a baseball rehabilitation program. Am J Sports Med. 1991;19(3):264-272. doi:10.1177/036354659101900309 Hogan C, Corbett J-A, Ashton S, Perraton L, Frame R, Dakic J. Scapular dyskinesis is not an isolated risk factor for shoulder injury in athletes: A systematic review and meta-analysis. Am J Sports Med. 2020;49(10):2843-2853. doi:10.1177/0363546520968508 Pozzi F, Plummer HA, Sanchez N, Lee Y, Michener LA. Electromyography Activation of Shoulder and Trunk Muscles: Closed Chain vs. Open Chain Exercises. J Electromyogr Kinesiol. 2022 Feb;62:102306. doi:10.1016/j.jelekin.2019.05.007. Erin Weeks, PT, DPT Erin Weeksreceived her MPT from the University of North Carolina – Chapel Hill and her DPT from the University of Montana. She has been a Certified Wound Specialist through the American Board of Wound Management since 2013. As the wound care clinical specialist at Carolinas Rehabilitation in Charlotte, NC, her work has focused on patient and staff education and implementing evidence-based practices for patients with integumentary conditions. She has over 15 years' experience treating patients with complex neurological injuries and is a clinical and didactic faculty member of the Atrium Health Neurologic Physical Therapy Residency. She is the principal investigator of Carolinas Rehabilitation's current physical therapy wound care research study and a guest instructor for UNC-CH's DPT program integumentary content. Kelly Werts, PT, DPT Kelly Wertsreceived her Bachelor of Arts in Health Science degree from Clemson University in 2009 and her Doctorate of Physical Therapy degree from Emory University in 2012. She is currently employed full time as a Physical Therapist (PT) at Carolinas Rehabilitation - Charlotte on the Spinal Cord Injury (SCI) team. In addition to SCI and neurodegenerative diseases, she has additional training to specialize in wound care and vestibular therapy. She is a co-investigator or PT assessor on several research studies, including studies looking at psychometric properties of SCI outcome measures and PT wound care in the SCI population. She is a current member of the Neurology Section of the APTA and APTA North Carolina. She is looking to advance her career and share knowledge by mentoring and leading therapists to perform quality and evidence-based care. DESCRIPTION: Chronic wounds are a complex and common problem in neurological physical therapy (PT) which impact patient burden of care, therapy treatment interventions, and discharge disposition. Research supports an interdisciplinary approach for wound management in which physical therapists play a vital role. Carrie Sussman, a wound care PT, is known to have said therapists should “treat the whole patient, not the hole in the patient.” However, many therapists have limited practical knowledge and clinical experience implementing best practices for chronic wound management. Through lecture, discussion, and review of patient case studies, attendees will explore interdisciplinary programming ideas to implement in their facilities. Examples include PT wound care modalities (i.e., pulsed wound irrigation and electrical stimulation), multidisciplinary wound care rounds, pressure injury specific outcome measures, and seating strategies such as pressure mapping. These strategies are effective in improving care and outcomes for patients with chronic wounds. OBJECTIVES: REFERENCES: Bates-Jensen BM, McCreath H, Patlan A, et al. Reliability of the Bates-Jensen Wound Assessment Tool (BWAT) for Pressure Injury Assessment: The Pressure Ulcer Detection Study. Wound Repair Regen. 2020;27(4):386-395. doi: 10.1111/wrr.12714.Reliability DesJardins H, Char S, Marasco P, Hsu YC, Guo L. Efficacy of Hydromechanical Therapy in Nonhealing,Chronic Wounds as a Cost- and Clinically Effective Wound Care Modality. Wounds. 2021;33(11):296-303. Gaspar S, Peralta M, Marques A, Budri A, Gaspar de Matos M. Effectiveness on hospital-acquired pressure ulcers prevention: a systematic review. Int Wound J. 2019;16(5):1087-1102. doi:10.1111/iwj.13147 Karahan A, Abbasogulu A, Isik SA, et al. Factors Affecting Wound Healing in Individuals with Pressure Ulcers: A Retrospective Study. Ostomy and Wound Management. 2018;64(2):32-39. Kisala PA, Tulsky DS, Choi SW, Kirshblum SC. Development and psychometric characteristics of the SCI-QOL pressure ulcers scale and short form. Journal of Spinal Cord Medicine. 2015;38(3):303-314. doi:10.1179/2045772315Y.0000000017 Olsson M, Järbrink K, Divakar U, et al. The humanistic and economic burden of chronic wounds: A systematic review. Wound Repair and Regeneration. 2019;27(1):114-125. doi:10.1111/wrr.12683 Powers JG, Higham C, Broussard K, Phillips TJ. Wound Healing and Treating Wounds: Chronic Wound Care Management. J Am Acad Dermatol. 2016;74(4):607-625. doi:10.1016/j.jaad.2015.08.070 Rajendran SB, Challen K, Wright KL, Hardy JG. Electrical Stimulation to Enhance Wound Healing. Journal of Functional Biomaterials. 2021;12(2):40. doi:10.3390/jfb12020040 Sussman C, Bates-Jensen BM. Wound Care: A Collaborative Practical Manual for Health Professionals. 4th ed. Lippincott, Williams & Wilkins; 2012. Woelfel S, Gibbs KA. The Role of Physical Therapists in Wound Management: An Update. Apta. Published 2017. Accessed February 3, 2018. http://www.apta.org/PTinMotion/NewsNow/2017/3/2/WoundManagement/ Cheyenne Brown, PT, DPT, Board Certified Geriatric Clinical Specialist Dr. Browngraduated from the University of North Carolina at Chapel Hill with her DPT and became a licensed physical therapist in 2018. She has practiced in acute care settings in Alabama and North Carolina, and she is currently maintaining an unrestricted license to practice physical therapy in North Carolina. She continues to practice PRN in an acute care hospital. She was a clinical instructor for 4 years and is a credentialed clinical instructor level 2 through the APTA. She obtained her Board Certification in Geriatric Physical Therapy in 2021. She began working at Winston-Salem State University as the Interim Director of Clinical Education in September 2023. Sara Migliarese, PT, PhD, Board Certified Neurologic Clinical Specialist Dr. Migliarese, PT, PhD, NCS, MSCSserves as the Program Assistant Director (Assistant Chair) and is a licensed physical therapist in the state of North Carolina who has 38.5 years of post-licensure experience, including 20 years as a full-time faculty member. She holds other clinical certifications, including APTA Herdman Certified Vestibular Specialist, Cervicogenic Dizziness certification, and the Multiple Sclerosis Specialist Certification from the Consortium of Multiple Sclerosis Centers. She has completed a 1-year course in Effective College Instruction from the Association of Colleges and University Educators (ACUE, 2023). She holds the rank of Professor in a tenured position in the Physical Therapy Department in the School of Health Sciences. She serves as the Director of the MSFit pro bono clinic, Director of the WSSU Novant Neurologic Clinical Residency Program, and as the Ambassador for Community Engagement for the School of Health Sciences. Nancy Smith, PT, DPT, PhD Dr. Smithserves as a Professor in the Doctor of Physical Therapy Program and the director of the transitional DPT program. She is a licensed physical therapist in the State of North Carolina with 24 years of post-licensure experience, including 14 years as a full-time faculty member. She holds a master’s degree in physical therapy (Saint Louis University, 2000), a transitional DPT (Saint Louis University, 20005), and a Ph.D. in Curriculum and Instruction (North Carolina State University, 2018). In addition, she has a specialty certification in Geriatrics as recognized by the APTA Specialty Board (2010, 2020). She also completed a 1-year course in Effective College Instruction from the Association of Colleges and University Educators (ACUE). She is in a tenured position in the School of Health Sciences Physical Therapy Department. Jennifer Martin, PT, MS, DPT, Board Certified Geriatric Clinical Specialist Dr. Martin, PT, DPT, GCSserves at the rank of Clinical Associate Professor and is a licensed physical therapist in the state of North Carolina. She has 19 years of post-licensure experience, including 10 years as a full-time faculty member and 7 years of full-time clinical practice. Dr. Martin joined the WSSU faculty as Co-Director of Clinical Education, and then Director of Clinical Education, where she served for 7 years before transitioning to full-time teaching in 2023. She holds multiple certifications and credentials, including Basic Credentialed Clinical Instructor (APTA, 2006), Advanced Credentialed Clinical Instructor (APTA, 2007), Herdman Certified Vestibular Specialist (Emory U, 2012), Level 1 Credentialed Clinical Instructor Trainer (APTA, 2019), Level 2 Credentialed Clinical Instructor (APTA, 2023), and Basic Life Support Instructor (AHA, 2012). She is in a clinical track position in the School of Health Sciences Department of Physical Therapy. DESCRIPTION: Presenters will recognize that diversity is multidimensional and approach the equity gap from various experiences. In this session, participants will gain the tools to create and adjust educational practices from admission to graduation. The audience will be introduced to information justifying the need for an equitable program structure that supports students. Learners will identify equitable teaching practices and tools through case examples that include the needs of diverse learners using a multicultural education framework. Learners will practice in small groups to design educational programs that promote student success and engage in problem-solving by developing student-centered remediation plans. Learners will explore post-graduation success strategies targeting success with licensure and employment. Information will be presented using a framework based on transformative learning theory as the audience will be guided through self-reflection and critical assessment of their current teaching practices. Anticipated outcomes focus on actionable plans for change specific to their program. OBJECTIVES: Attendees will be able to: 1. Cultivate a culture of belonging and inclusion 2. Design equitable teaching practices 3. Create effective learning strategies and remediation plans that meet the needs of diverse learners 4. Prepare diverse students for post-graduate success REFERENCES: 1. A Commitment to Diversity, Equity, and Inclusion. APTA. Published April 1, 2024. Accessed April 11, 2024. https://www.apta.org/apta-magazine/2024/04/01/commitment-diversity-equity-inclusion?utm_campaign=magazine&utm_medium=social&utm_source=facebook&utm_content=Brew7c9966b8fcb64f8c84c0c2d29e094ae4 2. Ryan CL, Cant R, McAllister MM, Vanderburg R, Batty C. Transformative learning theory applications in health professional and nursing education: An umbrella review. Nurse Education Today. 2022;119:105604. doi:https://doi.org/10.1016/j.nedt.2022.105604 3. Parnes MF, Suárez-Orozco C, Osei-Twumasi O, Schwartz SEO. Academic Outcomes Among Diverse Community College Students: What Is the Role of Instructor Relationships? Community College Review. 2020;48(3):277-302. doi:https://doi.org/10.1177/0091552120909908 4. van Schaik SM, Reeves SA, Headrick LA. Exemplary Learning Environments for the Health Professions. Academic Medicine. 2019;94(7):975-982. doi:https://doi.org/10.1097/acm.0000000000002689 5. Harackiewicz JM, Priniski SJ. Improving Student Outcomes in Higher Education: The Science of Targeted Intervention. Annual Review of Psychology. 2018;69(1):409-435. doi:https://doi.org/10.1146/annurev-psych-122216-011725 6. Matthews ND, Rowley KM, Dusing SC, Krause L, Yamaguchi N, Gordon J. Beyond a Statement of Support: Changing the Culture of Equity, Diversity, and Inclusion in Physical Therapy. Physical Therapy. 2021;101(12). doi:https://doi.org/10.1093/ptj/pzab212 7. Hayat AA, Shateri K, Amini M, Shokrpour N. Relationships between academic self-efficacy, learning-related emotions, and metacognitive learning strategies with academic performance in medical students: a structural equation model. BMC Medical Education. 2020;20(1). doi:https://doi.org/10.1186/s12909-020-01995-9 8. Siller H, Tauber G, Hochleitner M. Does diversity go beyond sex and gender? Gender as social category of diversity training in health profession education – a scoping review. GMS Journal for Medical Education. 2020;37(2):Doc25. doi:https://doi.org/10.3205/zma001318 9. Bakouetila-Martin M, Duke B, Pantoja-Aming A, et al. The Experiences of Black Students in Physical Therapy Education in Texas: A Qualitative Study. Journal of Physical Therapy Education. 2023;37(4):278. doi:https://doi.org/10.1097/JTE.0000000000000301 Michelle Green PT, DPT Dr. Greenhas nearly 20 years of experience in the acute and acute rehab setting treating patients with a variety neurologic and orthopedic conditions. The past 10 years have been spent in academics at Campbell University where she is an Associate Professor and Assistant Program Director in the DPT Program. Dr. Green focuses her workshops on treatment development based on the ICF Model and identification of impairments limiting functional deficits from a task-analysis, hypothesis-driven approach. Her background in Pilates, Yoga and NDT has influenced her assessment and treatment approach providing her with an enhanced insight to movement assessment, and guided -movement re-education. Dr. Green travels nationally presenting lectures on topics including Stroke Rehab, Geriatric Strength Training, Management of Patients who “Push” and Developing Functional Core Stability. Ms. Green is a graduate of Ithaca College in Ithaca, NY, lives in Fayetteville, NC. DESCRIPTION: Lateropulsion, formerly called "Pusher Syndrome", is a challenging clinical presentation. Therapists often struggle to find the best approach for this unique presentation. Developing an effective management plan is enhanced with a solid understanding of what it is, how to assess it, and why it occurs. Part 1 will focus on identifying the common characteristics of pushers, reviewing evidence supporting assessment tools for confirming the presence of pushing as well as evidence related to why it occurs. OBJECTIVES: REFERENCES: Dai S, Piscicelli C, Clarac E, Baciu M, Hommel M, Pérennou D. Balance, Lateropulsion, and Gait Disorders in Subacute Stroke. Neurology. 2021;;96(17):e2147-e2159. f*ckata K, Amimoto K, Inoue M, Shida K, Kurosawa S, Inoue M, Fujino Y, Makita S, Takahashi H. Effects of performing a lateral-reaching exercise while seated on a tilted surface for severe post-stroke pusher behavior: A case series. Top Stroke Rehabil. 2021;28(8):606-613. Gomes-Osman J, Kloos A. Lateropulsion: An Overlooked Driver of Balance and Gait Deficits in Stroke? Neurology. 2021 Apr 27;96(17):779-780. Nolan J, Godecke E, Singer B. The association between contraversive lateropulsion and outcomes post stroke: A systematic review. Top Stroke Rehabil. 2022;29(2):92-102. Ramaswamy S, Rosso M, Levine SR. Body Lateropulsion in Stroke: Case Report and Systematic Review of Stroke Topography and Outcome. J Stroke Cerebrovasc Dis. 2021 May;30(5):105680. Saj A, Honore J, Davroux J, Coello Yannaux M. Effect of posture on the perception of verticality in neglect patients. Stroke. 2005;(36):2203-5. van der Waal C, Embrechts E, Loureiro-Chaves R, Gebruers N, Truijen S, Saeys W. Lateropulsion with active pushing in stroke patients: its link with lesion location and the perception of verticality. A systematic review. Top Stroke Rehabil. 2022;1-17. Bergmann J, Krewer C, Müller F, Jahn K. A new cutoff score for the Burke Lateropulsion Scale improves validity in the classification of pusher behavior in subactue stroke patients. Gait Posture. 2019 Feb;68:514-517. doi: 10.1016/j.gaitpost.2018.12.034. Epub 2018 Dec 26. PMID: 30623845. Koter R, Regan S, Clark C, Huang V, Mosley M, Wyant E, Cook C, Hoder J. Clinical Outcome Measures for Lateropulsion Poststroke: An Updated Systematic Review. J Neurol Phys Ther. 2017 Jul;41(3):145-155. doi: 10.1097/NPT.0000000000000194. PMID: 28628548.
Enhancing Post-Operative Shoulder Rehabilitation: Optimizing Exercise Prescription through EMG Studies
Treating the Whole Patient: Physical Therapy Bridging the Hole in the Wound Care Interdisciplinary Team
Expanding Bridges over the Equity Gap in Physical Therapy Education: From Admission to Graduation
Patients who "Push" (Part 1) : Toward an Enhanced Understanding, and Assessment
9:30AM - 10:15AM - POSTER SESSION 1 ~ VISIT WITH EXHIBITORS ~ MORNING BREAK
10:15AM - 11:45AM - SESSION 2
Karlyn Green PT, DPT Karlyn Greenis an Assistant Professor in the Doctor of Physical Therapy Program at Campbell University in North Carolina. In addition, Karlyn continues to work at Duke University Hospital as a physical therapist on the cardiopulmonary floors. She is an APTA board certified specialist in cardiovascular and pulmonary physical therapy and orthopedic physical therapy. She completed her Bachelor of Science degree in exercise science with a minor in psychology from University of California, Davis in 2005 and her Doctor of Physical Therapy degree from Mount St. Mary’s College, Los Angeles in 2008. Karlyn completed an orthopedic residency with HealthCare Partners/Kaiser Permanente and a cardiopulmonary residency with Duke University Hospital System. Karlyn served as a residency mentor in the Duke Cardiopulmonary residency after her completion of the program. Karlyn is enthusiastic about research that combines the orthopedic and cardiopulmonary disciplines but is currently completing research focused on pre- and post-operative outcomes after heart transplant or left ventricular assist device implantation. She has published in the Cardiopulmonary Physical Therapy Journal about building initial COVID protocols and helped author the re-write of the Restrictive Lung Disease chapter in Essentials of Cardiopulmonary Physical Therapy. Karlyn has presented at Combined Sections Meetings, an American Association of Cardiovascular and Pulmonary Rehabilitation conference, and at North Carolina APTA conferences. She is active in the Academy of Cardiopulmonary Physical Therapy holding an office on the nominating committee, volunteering on the education committee and membership committees. As part of her service to Harnett County, she currently serves as the faculty advisor for the Campbell DPT Pro Bono Clinic. Megan Jackson, SPT Megan Jacksonearned her bachelor's degree at Campbell University in 2022 and is currently a second year DPT student at Campbell University. Megan is currently a student ambassador, works in the Pro Bono Clinic and is active in the community. She is currently pursuing her interests in research, cardiopulmonary physical therapy, and sports performance. Megan will earn her Doctor of Physical Therapy in December of 2025 and hopes to pursue a residency program after graduation. Luke Montavon, PT, DPT, CSCS, is currently practicing within the Orthopedic Clinical Residency at the Cincinnati VA Medical Center. Luke graduated from Campbell University’s Doctor of Physical Therapy Program in December 2023. He also earned his Certified Strength and Conditioning Specialist certification from the National Strength and Conditioning Association while earning his DPT and plans to sit for the Orthopedic Clinical Specialist certification in early 2025 after completing his residency. Luke is passionate about providing excellent care, education, and self-efficacy training to his patients. In particular, he focuses on normalizing resistance training in patients of all ages, genders, and experience, so they may age gracefully, be empowered to participate in all activities involving carrying or loading their bodies and building physical resilience against injury/pain. Luke’s other areas of interest include chronic pain management, physical readiness/rehabilitation for tactical athletes, and treatment strategies for tendinopathies. During his PT education, Luke began participating in research investigating various screening strategies available to outpatient orthopedic PTs for patients with cardiovascular comorbidities. As a competitive powerlifter, Luke ranks in the 98th percentile of all drug-tested competitors in the 181–183-pound weight class. DESCRIPTION: There are many options for assessing cardiac risk prior to initiating aerobic exercise including questionnaires, use of cardiac risk factors, algorithms, and diagnostics tests. While many professionals use such methods prior to referral to physical therapy (PT), there is no one consistent approach used by PT. A scoping review of literature across disciplines was conducted to better understand the options for assessing cardiac risk prior to initiating aerobic exercise. The results of that literature search and the applicability to physical therapy will be discussed. OBJECTIVES: REFERENCES: Aasvee K, Kurvinen E, Tur I. Obesity as a risk factor for early myocardial infarction in men. Papers on Anthropology. 2002;11:19-26. Appelman Y, van Rijn BB, ten Haaf ME, Boersma E, Peters SAE. Sex differences in cardiovascular risk factors and disease prevention. Atherosclerosis. 2014;241(1):211-218. doi:10.1016/j.atherosclerosis.2015.01.027 Bairey Merz N. Assessment of patients at intermediate cardiac risk. Am J Cardiol. 2005;96(8):2J-10J. doi:10.1016/j.amjcard.2005.06.023 Bakogiannis C, Stavropoulos K, Papadopoulos C, Papademetriou V. The impact of various blood pressure measurements on cardiovascular outcomes. Current Vascular Pharmacology. 2021;19(3):313-322. doi:10.2174/1570161118666200330155905 Baskett RJF, Buth KJ, Collicott C, Ross DB, Hirsch GM. Preoperative cardiovascular risk factor control in elective coronary artery bypass graft patients: a failure of present management. Can J Cardiol. 2002;18(4):397-402. Burtscher M, Pachinger O, Schocke MFH, Ulmer H. Risk Factor Profile for Sudden Cardiac Death During Mountain Hiking. International Journal of Sports Medicine. 2007;28(7):621-624. doi:10.1055/s-2007-964850 Chaitman BR, Miller DD. Perioperative cardiac evaluation for noncardiac surgery noninvasive cardiac testing. Prog Cardiovasc Dis. 1998;40(5):405-418. doi:10.1016/s0033-0620(98)80014-5 Cook JW, Pierson LM, Herbert WG, et al. The influence of patient strength, aerobic capacity and body composition upon outcomes after coronary artery bypass grafting. Thorac Cardiovasc Surg. 2001;49(2):89-93. doi:10.1055/s-2001-11703 Denissen SJAM, van der Aalst CM, Vonder M, Oudkerk M, de Koning HJ. Impact of a cardiovascular disease risk screening result on preventive behaviour in asymptomatic participants of the ROBINSCA trial. European Journal of Preventive Cardiology. 2019;26(12):1313-1322. doi:10.1177/2047487319843396 Fu FH. The prevalence of cardiovascular disease risk factors of Hong Kong Chinese. / Prevalence des facteurs de risque de maladies cardiovasculaires chez les chinois de Hong Kong. Journal of Sports Medicine & Physical Fitness. 2001;41(4):491-499. Gidlow CJ, Ellis NJ, Cowap L, et al. Cardiovascular disease risk communication in NHS Health Checks using QRISK®2 and JBS3 risk calculators: the RICO qualitative and quantitative study. Health Technol Assess. 2021;25(50):1-124. Han BH, Han K, Yoon KH, Kim MK, Lee SH. Impact of mean and variability of high-density lipoprotein-cholesterol on the risk of myocardial infarction, stroke, and mortality in the general population. Journal of the American Heart Association. 2020;9(7). doi:10.1161/JAHA.119.015493 Huffman FG, Zarini GG, Cooper V. Dietary glycemic index and load in relation to cardiovascular disease risk factors in Cuban American population. International Journal of Food Sciences & Nutrition. 2010;61(7):690-701. doi:10.3109/09637481003752267 Kaw R, Nagarajan V, Jaikumar L, et al. Predictive Value of Stress Testing, Revised Cardiac Risk Index, and Functional Status in Patients Undergoing Noncardiac Surgery. J Cardiothorac Vasc Anesth. 2019;33(4):927-932. doi:10.1053/j.jvca.2018.07.020 Lee CHA, Ismail H, Ho KM, Riedel B, Schier R. Thresholds of functional capacity using the four-question (modified) Duke Activity Status Index (M-DASI-4Q) as a screening tool: observations from the Measurement of Exercise Tolerance Before Surgery (METS) study. Br J Anaesth. 2021;126(3):e92-e94. doi:10.1016/j.bja.2020.11.023 Lepira FB, Kayembe PK, M’buyamba-Kabangu JR, Nseka MN. Clinical correlates of left ventricular hypertrophy in black patients with arterial hypertension. Cardiovasc J S Afr. 2006;17(1):7-11. Lindbohm JV, Sipilä PN, Mars NJ, et al. 5-year versus risk-category-specific screening intervals for cardiovascular disease prevention: a cohort study. Lancet Public Health. 2019;4(4):e189-e199. doi:10.1016/S2468-2667(19)30023-4 Heidi Kempert, PTA Heidi Kempertis a physical therapist assistant that has worked at the Cleveland Clinic Children’s Hospital for Rehabilitation for 14 years. She is a current member of the APTA and recently completed her pediatric advanced proficiency program through the APTA. She has experience with inpatient pain rehab, inpatient rehab, outpatient services, and school based physical therapy services. Heidi has published 13 articles in peer reviewed journals, newsletters, and commentaries. Additionally, she has presented symposiums, platforms, and webinars nationally and internationally on topics including chronic pain, student sports injury prevention, case studies, pediatric yoga, and coordination disorders. DESCRIPTION: There are approximately 5,500 new cases of complex regional pain syndrome (CRPS) annually. Symptoms include edema, tremors, skin discoloration, allodynia, and immobility. Along with the physical symptoms, individuals with CRPS typically demonstrate fear avoidance, kinesiophobia, and have difficulty functioning in age appropriate, daily activities. In this session we will review what CRPS is and the different treatment interventions physical therapist can utilize. The speaker will provide background information on evidence-based treatment methods, common biomechanic barriers to treatment, integration of biopsychosocial skills, and discuss progression planning as it relates to return to work, sports, and leisure activities. Time will be set aside for case examples and case discussions to improve implementation of concepts discussed. OBJECTIVES: REFERENCES: Li TS, Wang R, Su X, Wang XQ. Effect and mechanisms of exercise for complex regional pain syndrome. Front Mol Neurosci. 2023;16. doi:10.3389/fnmol.2023.1167166 Harden RN, McCabe CS, Goebel A, Suvar T, Grieve S, Bruehl S. Complex Regional Pain Syndrome: Practical Diagnostic and Treatment Guidelines, 5th Edition. Pain Medicine (United States). 2022;23:S1-S53. doi:10.1093/pm/pnac046 Chang C, McDonnell P, Gershwin ME. Complex regional pain syndrome – Autoimmune or functional neurologic syndrome. J Transl Autoimmun. 2021;4. doi:10.1016/j.jtauto.2020.100080 Vescio A, Testa G, Culmone A, et al. Treatment of complex regional pain syndrome in children and adolescents: A structured literature scoping review. Children. 2020;7(11). doi:10.3390/children7110245 Lohnberg JA, Altmaier EM. A review of psychosocial factors in complex regional pain syndrome. J Clin Psychol Med Settings. 2013;20(2):247-254. doi:10.1007/s10880-012-9322-3 Smart KM, Wand BM, O'Connell NE. Physiotherapy for pain and disability in adults with complex regional pain syndrome (CRPS) types I and II. Cochrane Database Syst Rev. 2016;2(2):CD010853. Published 2016 Feb 24. doi:10.1002/14651858.CD010853.pub2 Pollard C. Physiotherapy management of complex regional pain syndrome. New Zealand Journal of Physiotherapy. 2013; 41(2): 65-72. https://nzjp.otago.ac.nz/nzjp/article/view/58 Tileston KR, Griffin A, Wagner JFM, O'Day MN, Krane EJ. Team Approach: Complex Regional Pain Syndrome in Children and Adolescents. JBJS Rev. 2020;8(4):e0174. doi:10.2106/JBJS.RVW.19.00174 Tay MC, Rider JV. Pediatric Complex Regional Pain Syndrome and Occupational Therapy Intervention: A Scoping Review. OTJR (Thorofare N J). 2024;44(2):168-178. doi:10.1177/15394492231197612 Erpelding N, Simons L, et al. Rapid treatment-induced brain changes in pediatric CRPS. Brain Structure Function. 2016; 221:1095-1111. DOI 10.1007/s00429-014-0957-8 Mary Swiggum, PT, PhD, Board-Certified Clinical Specialist in Pediatric Physical Therapy Mary Swiggum, PT, PhD, Board-Certified Specialist in Pediatric Physical Therapy, is an Associate Professor in the Doctor of Physical Therapy program at Wingate University and a contract therapist for Full Circle Pediatric Therapy. Mary is the co-chair of the Trauma Informed Care Community of Practice of the APTA Peds Academy. Her research interests surround psychosocial issues in pediatric physical therapy such as procedural pain, reporting of child abuse and neglect, and trauma and scholarship of teaching and learning in pediatric physical therapy. Mary presented about the basics of Trauma Informed Care alongside Jaclyn Polk at last year’s APTA NC Annual Conference. Jaclyn Polk, PT, DPT, Board-Certified Clinical Specialist in Orthopaedic Physical Therapy Jaclyn Polk, PT, DPT, Board-Certified Clinical Specialist in Orthopaedic Physical Therapy, is an assistant professor in the Doctor of Physical Therapy program at Wingate University. Jaclyn received her Doctor of Physical Therapy degree from the University of Delaware. Jaclyn’s research interests are in the areas of clinical education, wellness, management of student stress, running gait, and pelvic floor rehabilitation. Jaclyn is currently working towards a Doctor of Health Sciences degree in Education and Academia from Radford University. Jaclyn actively promotes the profession of Physical Therapy through involvement with APTA NC, volunteering at various community events, and offering pro bono clinical services in orthopedics and pelvic floor rehabilitation. Jaclyn presented about the basics of Trauma Informed Care alongside Mary Swiggum at last year’s APTA NC Annual Conference. DESCRIPTION: In our roles as physical therapists and physical therapist assistants, we encounter individuals who have experienced trauma, influencing their well-being, treatment adherence, and engagement in therapy sessions. Moreover, as healthcare providers, we are susceptible to secondary traumatic stress from our interactions with these individuals. This session aims to equip academicians and clinicians with the knowledge and skills necessary for trauma-informed care education. Through a blend of lectures, discussions, and case studies, participants will gain insights into various types of trauma, its prevalence, and the lifelong impact of traumatic stress. Moreover, we will explore the principles of trauma-informed education. Join us to discover how integrating trauma-informed practices can enhance patient outcomes, empower students, and promote resilience within our students and ourselves. OBJECTIVES: REFERENCES: Bosse JD, Clark KD, Arnold S. Implementing trauma-informed education practices in undergraduate mental health nursing education. J Nurs Ed. 2021;60 (12):707-711. Blodgett C, Dorado J. A selected review of trauma-informed school practice and alignment with educational practice. CLEAR Trauma Center. San Francisco, CA: University of California. 2016;1:1-88. Brunzell T, Stokes H, Waters L. Shifting teacher practice in trauma-affected classrooms: Practice pedagogy strategies within a trauma-informed positive education model. School Mental Health. 2019;11(3):600-614. Cannon LM, et al. Trauma-informed education: Creating and pilot testing a nursing curriculum on trauma-informed care. Nurse Educ Today. 2020;85:104256. Carello J, Butler LD. Practicing what we teach: Trauma-informed educational practice. J Teach Soc Work. 2015;35(3):262-278. Cavanaugh B. Trauma-informed classrooms and schools. Beyond Behav. 2016;25(2):41-46. Doughty K. Increasing trauma-informed awareness and practice in higher education. J Contin Educ Health Prof. 2020;40(1):66-68. Hooper AM, H]yder M, Colclough T, Mann D. Re-envisioning learning through a trauma-informed lens: empowering students in their personal and academic growth. J Scholarship of Teaching and Learning. 2023;23(3):74-94. Jackson ML, Jewell VD. Educational practices for providers of trauma-informed care: a scoping review. J Pediatr Nurs. 2021;60:130-138. Perry DL, Daniels ML. Implementing trauma-informed practices in the school setting: A pilot study. School Mental Health. 2016;8:177-188. Stokes H. Leading trauma-informed education practice as an instructional model for teaching and learning. Front Educ. 2022;7. Stokes H, Brunzell T. Leading trauma-informed practice in schools. Leading Manag. 2020;26(1):70-77. Thomas MS, Crosby S, Vanderhaar J. Trauma-informed practices in schools across two decades: An interdisciplinary review of research. Rev Res Educ. 2019;43(1):422-452. Michelle Green PT, DPT Dr. Greenhas nearly 20 years of experience in the acute and acute rehab setting treating patients with a variety neurologic and orthopedic conditions. The past 10 years have been spent in academics at Campbell University where she is an Associate Professor and Assistant Program Director in the DPT Program. Dr. Green focuses her workshops on treatment development based on the ICF Model and identification of impairments limiting functional deficits from a task-analysis, hypothesis-driven approach. Her background in Pilates, Yoga and NDT has influenced her assessment and treatment approach providing her with an enhanced insight to movement assessment, and guided -movement re-education. Dr. Green travels nationally presenting lectures on topics including Stroke Rehab, Geriatric Strength Training, Management of Patients who “Push” and Developing Functional Core Stability. Dr. Green is a graduate of Ithaca College in Ithaca, NY, and lives in Fayetteville, NC. DESCRIPTION: Following examination and identification of the patient with lateropulsion ("pusher" patient), the clinician is challenged with developing a treatment plan which appropriately challenges the patient and specifically addresses limiting impairments to guide improvement toward function. Part 2 focuses on utilizing available evidence related to identified impairments and applying it with appropriate safety, positioning, intensity and progression via a categorization system which guides treatment intervention based on the ICF Model of Disablement. This is accomplished via a mix of lecture, video and case review. OBJECTIVES: REFERENCES: Nolan J, Godecke E, Singer B. The association between contraversive lateropulsion and outcomes post stroke: A systematic review. Top Stroke Rehabil. 2022;29(2):92-102. Nolan J, Jacques A, Godecke E, et al. Clinical practice recommendations for management of lateropulsion after stroke determined by a Delphi expert panel. Clin Rehabil. 2023;37(11):1559-1574. Paci M, Macchioni G, Ferrarello F. Treatment approaches for pusher behaviour: a scoping review. Top Stroke Rehabil. 2023;30(2):119-136. Birnbaum M, Brock K, Clark R, Muir S, Burton E, Hill KD. Standing weight-bearing asymmetry in adults with lateropulsion following stroke. Gait Posture. 2021;90:427-433. Nolan J, Godecke E, Spilsbury K, Singer B. Post-stroke lateropulsion and rehabilitation outcomes: a retrospective analysis. Disabil Rehabil. 2022;44(18):5162-5170.
Is it safe to initiate aerobic exercise? Methods for Assessing Cardiac Risk Prior to Initiating Aerobic Exercise
Physical Therapy Treatment of Complex Regional Pain Syndrome and Centralized Pain Syndromes in Pediatrics
Trauma-Informed Educational Practice: Empowering Students to Foster Healing and Resilience
Management of Patients who "Push" (Part 2)
11:45AM - 1:30PM - LUNCH ~ MEMBERSHIP MEETING
1:30PM - 3:00PM - SESSION 3
Lynnz Brewer, DPT, ATC Lynnz Breweris an ATC and future DPT with clinical experience working with LGBTQIA+ individuals in performing arts, outpatient orthopedics/pelvic health settings. Lynnz self-identifies as a pansexual non-binary transgender man (he/him/his and they/them/theirs). He regularly presents Safe Zone (LGBTQIA+) trainings for East Carolina University and is an active advocate for LGBTQIA+ visibility and inclusivity within the medical and general community. During their last clinical rotation, they actively interacted with the Charlotte’s Trans Health organization and presented an inservice to gender affirming providers on the role of pelvic health physical therapists in gender affirming care. He serves on the APTA NC DEI committee and the Programming Committee for PT Proud. PT Proud is a special interest group in the APTA’s Academy of Leadership & Innovation. They have been recognized for their advocacy work for LGBTQIA+ inclusivity/visibility by ECU’s Dr. Jesse R. Peel LGBTQ Center with the Samantha Hamilton Award for LGBTQIA Leadership Excellence in 2023 and they were recently admitted into the DEI Hall of Fame during the 2024 APTA NC Student Conclave. Deidra Charity, PT, DPT Board Certified Sports Clinical Specialist Deidra D. Charity, PT, DPT(she/her) is an Assistant Professor at the University of North Carolina at Chapel Hill where she is engaged in clinical practice and academic instruction for UNC’s Division of Physical Therapy. She graduated from UNC at Chapel Hill with a BA in Exercise and Sport Science and her Doctor of Physical Therapy degree. She is a residency trained Board-Certified Clinical Specialist in Sports Physical Therapy and a Certified Strength and Conditioning Specialist. She has a passion for sports rehabilitation, injury risk reduction, professional development, and improving diversity within the profession. She is a member of the American Academy of Sports Physical Therapy and the Academy of Orthopaedic Physical Therapy. She is actively involved with APTA NC where she serves as Chair of the DEI committee and is a delegate to the House of Delegates. In North Carolina, she has led statewide efforts to increase student exposure to the field of physical therapy and she serves as an APTA PT Moves Me Ambassador. She’s been recognized as an Emerging Young Leader by the APTA, and she was selected as a Centennial Scholar by the AASPT. DESCRIPTION: This educational session will provide a basic overview of terminology as it relates to biological sex, gender identities and sexual orientation. Presenters will impart practical ways to create an inclusive environment for LGBTQIA+ individuals in various spaces, but specifically the healthcare setting. Attendees will gain a greater understanding of health disparities that impact LGBTQIA+ individuals and learn of person-specific medical interventions that are important to consider when treating LGBTQIA+ individuals in a physical therapy setting. The goal of this educational session is to enhance attendees’ knowledge, strategies, and clinical skills to improve their ability to provide inclusive, evidence-based, and optimal care for LGBTQIA+ individuals. Participants in this session will have the opportunity to ask questions anonymously, to foster a safe space for meaningful engagement and learning. OBJECTIVES: 1. Utilize appropriate terminology for inclusive communication with LGBTQIA+ individuals 2. Recognize health disparities that impact LGBTQIA+ individuals 3. Implement strategies to create inclusive spaces for patients and colleagues who identify as LGBTQIA+ 4. Integrate specific health and wellness considerations into a holistic approach to clinical care for LGBTQIA+ individuals REFERENCES: Chang SC, Singh AA, Dickey LM. A Clinician’s Guide to Gender-Affirming Care: Working with Transgender and Gender-Nonconforming Clients. New Harbinger Publications; 2018. Hare M, Arena S. LGBTQ+ Competency in Physical Therapy. Home Healthcare Now. 2024;42(2):114-115. doi: 10.1097/NHH.0000000000001236. Glick J, Leamy C, Hewlett Molsberry A, Kerfeld C. Moving Toward Equitable Health Care for Lesbian, Gay, Bisexual, Transgender, and Queer Patients: Education and Training in Physical Therapy Education. Journal of Physical Therapy Education. 2020;34(3):192-197. doi: 10.1097/JTE.0000000000000140. Primeau CA, Philpott HT, Vader K, et al. Knowledge, behaviours, and training related to 2SLGBTQIA+ health education amongst entry-level physiotherapy students in Canada: results of a nationwide, cross-sectional survey. BMC Med Educ. 2023;23(1):519. doi:10.1186/s12909-023-04499-4 Charles D, Clay R, Moroney B, et al. The lack of LGBTQIA cultural competency in physical therapy education. Journal of allied health. 2022;51:47-51. Tatta J, Dillon FR. Queering the Physical Therapy Curriculum: Competency Standards to Eliminate LGBTQIA+ Health Disparities. Phys Ther. 2023. doi:10.1093/ptj/pzad169 Tatta J, Phillips RS, Ryder LR, Haberman A, Kakimi M, Miller OG. A Call to Action: Develop Physical Therapist Practice Guidelines to Affirm People Who Identify as LGBTQIA. Phys Ther. 2024. doi:10.1093/ptj/pzae049 Hofmann MC, Mulligan NF, Bell KA, et al. LGBTQIA+ Cultural Competence in Physical Therapy: An Exploratory Qualitative Study from the Clinician's Perspective. Phys Ther. 2024. doi:10.1093/ptj/pzae010 Ross MH, Hammond J, Bezner J, et al. An Exploration of the Experiences of Physical Therapists Who Identify as LGBTQIA+: Navigating Sexual Orientation and Gender Identity in Clinical, Academic, and Professional Roles. Phys Ther. 2022;102(3):pzab280. doi:10.1093/ptj/pzab280 Coleman E, Radix AE, Bouman WP et al. Standards of Care for the Health of Transgender and Gender Diverse People, Version 8, International Journal of Transgender Health. 2022;23(1):S1-S259, DOI: 10.1080/26895269.2022.2100644 Tara Caberwal, PT, DPT, DSc, FAAOMPT, OCS, COMT Dr. Tara Caberwalis an Assistant Professor at Campbell University’s Doctor of Physical Therapy program in Buies Creek, NC. She has over 15 years of clinical practice in military healthcare on Fort Bragg, NC serving as a contract physical therapist for the THOR3 Human Performance program within Special Operations. Dr. Caberwal has completed her Doctorate of Science in Physical Therapy (DScPT), is an APTA Board-Certified Orthopaedic Clinical Specialist (OCS), and Fellow of the American Academy of Orthopaedic Physical Therapy (FAAOMPT). Her research interests include chronic pain, TBI, and improving resiliency of the active-duty soldier. DESCRIPTION: Gain practical insights into identifying and treating dysfunctions within the ankle complex’s subtalar and transverse tarsal joints. This session will enhance your ability to recognize signs and symptoms of lower extremity pathology which may develop secondary to dysfunctions within the ankle complex. Participants will briefly review how biomechanical load distribution can impact the lower kinetic chain, and how abnormal load can disrupt the lower kinetic chain. Through lecture and lab-based activities, participants will be equipped with essential assessment and treatment skills including joint manipulation techniques, neuromuscular reeducation, and therapeutic exercises to reinforce all manual therapy techniques. Don’t miss this valuable opportunity to refine your clinical expertise and improve patient outcomes! OBJECTIVES: Upon completion of this educational session, participants will be able to: 1. Recognize early signs and symptoms of lower extremity pathology associated with ankle complex dysfunction. 2. Identify specific dysfunctions within the subtalar and transverse tarsal joints, through comprehensive assessment techniques. 3. Demonstrate proficiency in performing joint manipulation techniques of the subtalar and transverse tarsal joints. 4. Apply evidence-based neuromuscular re-education and therapeutic exercises to reinforce manual therapy interventions. REFERENCES: 1. Hertel J, Corbett RO. An Updated Model of Chronic Ankle Instability. J Athl Train. 2019;54(6):572-588. doi:10.4085/1062-6050-344-18 2. Lin CI, Houtenbos S, Lu YH, Mayer F, Wippert PM. The epidemiology of chronic ankle instability with perceived ankle instability- a systematic review. J Foot Ankle Res. 2021;14(1):41. Published 2021 May 28. doi:10.1186/s13047-021-00480-w 3. Lee S, Song K, Lee SY. Epidemiological study of post-traumatic ankle osteoarthritis after ankle sprain in 195,393 individuals over middle age using the National Health Insurance Database: A retrospective design. J Sci Med Sport. 2022;25(2):129-133. doi:10.1016/j.jsams.2021.08.018 4. Brockett CL, Chapman GJ. Biomechanics of the ankle. Orthop Trauma. 2016;30(3):232-238. doi:10.1016/j.mporth.2016.04.015 5. Williams LR, Ridge ST, Johnson AW, Arch ES, Bruening DA. The influence of the windlass mechanism on kinematic and kinetic foot joint coupling. J Foot Ankle Res. 2022;15(1):16. Published 2022 Feb 16. doi:10.1186/s13047-022-00520-z 6. Dygut J, Piwowar M. Muscular Systems and Their Influence on Foot Arches and Toes Alignment-Towards the Proper Diagnosis and Treatment of Hallux Valgus. Diagnostics (Basel). 2022;12(12):2945. Published 2022 Nov 25. doi:10.3390/diagnostics12122945 Kyle Covington, PT, DPT, PhD Dr. Covingtonis associate professor and Director of Educational Innovation and Director of Postprofessional Education for Duke University's Doctor of Physical Therapy Program, including Duke DPT’s Faculty Development Residency program which is accredited by the American Board of Physical Therapy Residencies and Fellowships. He received his bachelor of sciences degree from Wake Forest University in Health and Exercise Science. In 2004 he graduated from Duke University’s Doctor of Physical Therapy Program. He completed his PhD studies at North Carolina State University in 2015 focusing on Educational Research and Policy Analysis in Adult Education. Dr. Covington has extensive experience in clinical and didactic curriculum and program development with a concentrated interest in integrated collaborative learning models. His research interests focus on professional development in the clinical learning partnership between instructors and students and on best practices of educational assessment and evaluation in the health professions. He has held several offices in the APTA North Carolina including President from 2016-2019. He has served 12 terms as a delegate to the American Physical Therapy Association’s national House of Delegates. He is an elected member of the American Physical Therapy Association’s Board of Directors and is the Vice Speaker of the APTA’s House of Delegates. Additionally, Dr. Covington is a board-certified neurologic specialist, emeritus. Kyle is also the proud father along with his wife Suzanne, of two children, Claire and Graham. Marissa Carvalho, PT, DPT, MSQM Marissa Carvalho, PT, DPT, MSQMis the Senior Business Manager for the Division of Nephrology in the Department of Medicine at Duke University. She graduated from the Duke Doctor of Physical Therapy program in 2012 and attained her Master of Science in Quantitative Management degree with a focus in Health Analytics through Duke University’s Fuqua School of Business in 2023. Marissa is a board-certified clinical specialist in Orthopaedic Physical Therapy and a Fellow of the American Academy of Orthopaedic Manual Physical Therapists. She has led multiple quality improvement and implementation projects, and has presented at the state and national level. Marissa is the Director of Payer Relations for APTA NC and is on the Hospital Committee for the Partnership for Quality Measurement Pre-Rulemaking Measure Review. Marissa is passionate about the utilization of data in health care to drive positive change and optimize care. DESCRIPTION: The goal of this interactive session is for participants to learn about the APTA’s recently released landmark report outlining the economic value of PT in the US and its impacts nationally and locally. The session will describe the methodology, findings, and roll-out strategy behind the report on the Economic Value of Physical Therapy in the United States. Participants will be primed to consider how they can leverage this information to shape the future of our profession. National and State association leaders will lead participants in discussions to explore practical ways to apply the report’s findings in their workplace, local, and state communities and work with other interested parties to impact care, payment, and reimbursem*nt. OBJECTIVES: REFERENCES: Physical Therapy Association. The Economic Value of Physical Therapy in the United States. 2023. https://www.valueofpt.com/ Childs JD, Harman JS, RodegheroJR, Horn M, George SZ. Implications of practice setting on clinical outcomes and efficiency of care in the delivery of physical therapy services. J OrthopSports PhysTher. 2014 Dec;44(12):955-63. Fritz JM. Physical therapy in a value-based healthcare world.J OrthopSports PhysTher. 2012;42(1):1-2. doi:10.2519/jospt.2012.0101 Institute of Medicine 2001. Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, DC: The National Academies Press. https://doi.org/10.17226/10027. Institute of Medicine 2013. Best Care at Lower Cost: The Path to Continuously Learning Health Care in America. Washington, DC: The National Academies Press. https://doi.org/10.17226/13444.
LGBTQIA+ Considerations for the Physical Therapy Setting
“Walk This Way”: Moving Past Drawer Tests And Single-Leg Balance
The Economic Value of Physical Therapy in the United States: Making APTA’s Report Valuable to Your Patients, Your Clinic, and Your Community.
3:00PM - 3:30PM - AFTERNOON BREAK ~ VISIT WITH EXHIBITORS
3:30PM - 5:00PM - SESSION 4
Calvin Hung, PT, FACHE Calvin Hung, PT, FACHE, is Vice President of Rehabilitation Regional Operations and Integration with Atrium Health, part of Advocate Health. He received his BS from the University of North Carolina at Chapel Hill, a Masters in Physical Therapy from Emory University, and a Masters in Health Administration from the University of North Carolina at Charlotte. Calvin's work in the realm of diversity, equity, and inclusion at Atrium Health includes: founding two of Atrium Health's Employee Resource Groups; starting and leading a regional diversity council; serving as faculty on Atrium Health's award-winning Diversity Certificate Program; and being recognized as Atrium Health's 2017 Diversity Champion Award given to 1 employee showing exemplary work in the space of DEI. In addition, Diversity MBA recognized Calvin as one of the Top 100 Executives Under 50 in 2016. Calvin has facilitated over 30 courageous conversations within Atrium Health since 2015. Calvin is the past-Secretary for APTA NC and is currently serving as a delegate to the House of Delegates. Deidra Charity, PT, DPT Deidra D. Charity, PT, DPTis an Assistant Professor at the University of North Carolina at Chapel Hill where she is engaged in clinical practice and academic instruction for UNC's Division of Physical Therapy. She is a residency trained Board-Certified Clinical Specialist in Sports Physical Therapy and a Certified Strength and Conditioning Specialist. She is a member of the American Academy of Sports Physical Therapy and the Academy of Orthopaedic Physical Therapy. She is actively involved with APTA NC where she serves as Vice-Chair of the Diversity, Equity, and Inclusion committee and is a delegate to the House of Delegates. In North Carolina, Deidra has led statewide efforts to increase student exposure to the field of physical therapy including leading opportunities to introduce physical therapy to underrepresented minority groups. Deidra has also served as the Primary Speaker for a Course in the DEI Certificate Series within the APTA Learning Center in 2022. DESCRIPTION: This session will explore the impact of unconscious bias on career opportunities, professional development, and employee satisfaction through an interactive panel discussion. Several panelists will share their personal and professional experiences navigating diversity challenges in the course of their career. Participants in this session will have the opportunity to ask questions and engage in the conversation in a safe space, facilitating an environment where everyone belongs and creating a launching point for future conversations to be explored after the session end. OBJECTIVES: Upon completion of this educational session, participants will be able to: REFERENCES: Marcelin JR, Siraj DS, Victor R, Kotadia S, Maldonado YA. The Impact of Unconscious Bias in Healthcare: How to Recognize and Mitigate It. J Infect Diseases 2019: 220 Suppl 2, S62-S73. Consul N, Strax R, DeBenedectis CM, Kagetsu NJ. Mitigating Unconscious Bias in Recruitment and Hiring. J AM Coll Radiology 2021, 18(6): 769-773. Mezu-Ndubuisi OJ. Unmasking Systemic Racism and Unconscious Bias in Medical Workplaces: A Call to Servant Leadership. J Am Heart Assoc 2021, 10(7): e018845. Persaud S. Addressing Unconscious Bias: A Nurse Leader's Role. Nurse Admin Q 2019, 43(2): 130-137. Sumra H, Riner AN, Arjani S, Tasnim S, Zope M, Reyna C, Anand T. Minimizing Implicit Bias in Search Committees. Am Journal of Surgery 2022, 224(4): 1179-1181. Gonzalez CM, Lypson ML, Sukhera J. Twelve Tips for Teaching Implicit Bias Recognition and Management. Medical Teacher 2021, 43(12): 1368-1373. Jason Pelletier, PT, DPT, Board-Certified Clinical Specialist in Neurologic Physical Therapy Dr. Jason Pelletieris an Assistant Professor in the Department of Physical Therapy at High Point University. He is a licensed Physical Therapy in North Carolina, is a board-certified neurologic clinical specialist (NCS), certified brain-injury specialist (CBIS), and holds an advanced Olympic lifting certificate (AOLC). Prior to his physical therapy career, he worked for 4 years as a NCAA track and field and strength and conditioning coach. His clinical experience includes 5-years in inpatient rehabilitation and as an outpatient fitness consultant for adults with neurological disabilities. He now teaches Neuroscience and Advanced Exercise Prescription to 3rd year students within the Doctor of Physical Therapy program at High Point University, and is engaged in research on the implementation of wearable technology to promote long-term fitness for neurologic populations in and out of the clinical setting. He also owns a small consulting business to help neurologic populations reach their fitness goals. Personally, he enjoys triathlon training and exercises of all variety, and is passionate about promoting long-term holistic health and well-being for his clients and students' future clients. Jenny Reynolds, PT, DPT, Board-Certified Clinical Specialist in Orthopedic Physical Therapy Dr. Jenny Reynoldsis an Assistant Professor in the Department of Physical Therapy at HPU. She obtained a Bachelor’s degree in Kinesiology with emphasis in Movement Science from Penn State University and went on to complete her Doctorate in Physical Therapy from Emory University in Atlanta, GA. Dr. Reynolds completed an orthopedic residency program through Upstream Rehabilitation Institute and is a Board Certified Orthopedic Clinical Specialist. She has 5+ years of clinical experience as a physical therapist treating in outpatient orthopedics, 4 years of experience as a clinical instructor for DPT students, and currently serves as a mentor for physical therapists completing an orthopedic residency program. As part of High Point University’s DPT faculty, she now teaches Therapeutic Exercise, Dry Needling, and Modalities to 1st year students and assists in teaching Advanced Exercise Prescription to 3rd years students. Personally, she enjoys weightlifting and cycling and has a passion for helping patients maintain active lifestyles. DESCRIPTION: The mission of the PT profession includes the promotion of life-long wellness and fitness. Yet after PT or PTA school, many clinicians feel ill-equipped to prescribe a basic fitness routine beyond therapeutic interventions, as this goes beyond most curricular requirements. Through lecture and group collaboration, participants in this educational session will learn to utilize a simplified, step-by-step framework to develop and progress a general fitness routine which addresses global fitness goals for an untrained adult that meets ACSM guidelines. After this educational session, participants will be able to prescribe fitness training after skilled PT and will be better equipped to progress their initial rehabilitative interventions toward these long-term fitness goals for most adult populations. Participants will also be encouraged to adapt this simplified framework to meet the needs and better fit the characteristics of special population groups, including pediatrics, geriatrics, and neurologic. OBJECTIVES: REFERENCES: Liguori, G. ACSM's Guidelines for Exercise Testing and Prescription (11th Edition). Wolters Kluwer Health; 2021. Ormsbee MJ, Carzoli JP, Klemp A, et al. Efficacy of the Repetitions in Reserve-Based Rating of Perceived Exertion for the Bench Press in Experienced and Novice Benchers. J Strength Cond Res. 2019;33(2):337-345. doi:10.1519/JSC.0000000000001901 Graham T, Cleather DJ. Autoregulation by "Repetitions in Reserve" Leads to Greater Improvements in Strength Over a 12-Week Training Program Than Fixed Loading. J Strength Cond Res. 2021;35(9):2451-2456. doi:10.1519/JSC.0000000000003164 Paluch AE, Bajpai S, Ballin M, et al. Prospective Association of Daily Steps With Cardiovascular Disease: A Harmonized Meta-Analysis. Circulation. 2023;147(2):122-131. doi:10.1161/CIRCULATIONAHA.122.061288 Arnett DK, Blumenthal RS, Albert MA, et al. 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines [published correction appears in Circulation. 2019 Sep 10;140(11):e647-e648] [published correction appears in Circulation. 2020 Jan 28;141(4):e59] [published correction appears in Circulation. 2020 Apr 21;141(16):e773]. Circulation. 2019;140(11):e563-e595. doi:10.1161/CIR.0000000000000677 Oliva-Lozano JM, Muyor JM. Core Muscle Activity During Physical Fitness Exercises: A Systematic Review. Int J Environ Res Public Health. 2020;17(12):4306. Published 2020 Jun 16. doi:10.3390/ijerph17124306 Lehtonen E, Gagnon D, Eklund D, Kaseva K, Peltonen JE. Hierarchical framework to improve individualised exercise prescription in adults: a critical review. BMJ Open Sport Exerc Med. 2022;8(2):e001339. Published 2022 Jun 7. doi:10.1136/bmjsem-2022-001339 Kelly Reynolds, PT, DPT, PhD Board-certified clinical specialist in neurologic physical therapy Kelly Reynolds, PT, DPT, PhDis a Medical Instructor in Duke University's Doctor of Physical Therapy program in Durham, NC. She is board-certified clinical specialist in neurologic physical therapy. She earned a B.S. in Education from the University of Virginia in 2001, her DPT degree from Virginia Commonwealth University in 2004, and her PhD from Rocky Mountain University of Health Professions in 2023. She teaches in anatomy, geriatrics, and neurorehabilitation courses at Duke and has presented locally and nationally on topics including spasticity management, neurologic outcome measures, neuroplasticity, gait progression following spinal cord injury, and ethics in caring for older adults. Her clinical work has focused on adult neurorehabilitation with an emphasis on spinal cord injury and geriatrics. Ashley Kinsey, PT, DPT Board-certified clinical specialist in geriatric physical therapy Ashley Kinseyis a Durham, NC native who went on to complete her Doctor of Physical Therapy degree at Wheeling University in Wheeling, West Virginia prior to returning to the Raleigh-Durham area. Ashley’s career has spanned multiple treatment settings including Skilled Nursing, Long Term Care, Acute Care, and Outpatient Physical Therapy. In 2017 she completed a residency in Geriatrics with the Durham VAMC prior to transitioning to Duke Rehabilitation Services providing care as an Outpatient Physical Therapist with a focus in geriatric care. Ashley currently works in Brier Creek, North Carolina serving the geriatric and neurologic population as a Board-Certified Specialist in Geriatric Physical Therapy. She also provides services in the Duke Joint Health Program as a Primary Osteoarthritis Provider. She enjoys working with learners by serving as a clinical instructor, working as a Teaching Assistant, and lecturing as a Course Director in the geriatric elective for the Duke Doctor of Physical Therapy Program. DESCRIPTION: Addressing balance dysfunction is a priority of physical therapy practitioners in virtually all practice settings and working with all patient populations. Using a systematic approach to determining the most likely balance diagnosis(es) allows the practitioner to speculate about likely causes of balance dysfunction and generate targeted interventions that are intentional and specific to each unique patient. This session will review and apply the recommendations from the Balance Diagnosis Task Force, published in 2021, including the resultant 10 recommended balance diagnoses. Participants will learn about and practice: evaluating underlying determinants of balance using results from common tests and measures to inform the balance diagnosis selecting optimal interventions for a given balance diagnosis. Learning will occur through lecture, video with discussion, and a case presentation. OBJECTIVES: REFERENCES: Gill-Body KM, Hedman LD, Plummer L, et al. Movement System Diagnoses for Balance Dysfunction: Recommendations From the Academy of Neurologic Physical Therapy's Movement System Task Force. Phys Ther. 2021;101(9):pzab153. doi:10.1093/ptj/pzab153 Shumway-Cook A, Woollacott M, Rachwani J, Santamaria V. Motor control: Translating research into clinical practice. 6th ed. Wolters Kluwer; 2023. Sun M, Min L, Xu N, Huang L, Li X. The Effect of Exercise Intervention on Reducing the Fall Risk in Older Adults: A Meta-Analysis of Randomized Controlled Trials. Int J Environ Res Public Health. 2021;18(23):12562. Published 2021 Nov 29. doi:10.3390/ijerph182312562 Gerards MHG, McCrum C, Mansfield A, Meijer K. Perturbation-based balance training for falls reduction among older adults: Current evidence and implications for clinical practice. Geriatr Gerontol Int. 2017;17(12):2294-2303. doi:10.1111/ggi.13082 Zhao R, Feng F, Wang X. Exercise interventions and prevention of fall-related fractures in older people: a meta-analysis of randomized controlled trials. Int J Epidemiol. 2017;46(1):149-161. doi:10.1093/ije/dyw142 Horak FB, Wrisley DM, Frank J. The Balance Evaluation Systems Test (BESTest) to differentiate balance deficits. Phys Ther. 2009;89(5):484-498. doi:10.2522/ptj.20080071 Kimmery Migel, PT, DPT, PhD, OCS, High Point University, High Point, NC. Dr. Migel is an Assistant Professor in the Department of Physical Therapy at High Point University. She currently teaches in the Musculoskeletal Practice curriculum which includes examination, evaluation, and management of cervicomandibular dysfunction. Dr. Migel’s research explores neuromuscular and motor control following orthopedic injuries. Cory Alcon, PT, DPT, PhD, OCS, CSCS, High Point University, High Point, NC. Dr. Alcon is an Assistant Professor in the Department of Physical Therapy at High Point University. He currently teaches in the Musculoskeletal Practice curriculum which includes examination, evaluation, and management of cervicomandibular dysfunction. Dr. Migel’s research explores pain science based education to manage chronic pain in people with orthopedic injuries. DESCRIPTION: Research suggests that 50-75% of the population experiences temporomandibular dysfunction (TMD) at some time in their lives, however most physical therapists are inadequately trained in managing TMD. Skilled intervention can have a profound impact on a patient’s quality of life. The purpose of this laboratory based session is to provide physical therapists introductory skills to evaluate and treat the most common TMD pathologies. OBJECTIVES: 1 – Understand the basic anatomical and movement science of the TMJ. 2 – Describe the signs and symptoms associated with the major TMJ dysfunctions. 3 – Perform an appropriate examination for TMD. 4 – Apply manual therapy, neuromuscular control, and therapeutic exercise intervention strategies based on examination results. REFERENCES: Gil-Martínez A, Paris-Alemany A, López-de-Uralde-Villanueva I, La Touche R. Management of pain in patients with temporomandibular disorder (TMD): challenges and solutions. J Pain Res. 2018;11:571-587. Published 2018 Mar 16. doi:10.2147/JPR.S127950 Hong SW, Lee JK, Kang JH. Relationship among Cervical Spine Degeneration, Head and Neck postures, and Myofascial Pain in Masticatory and Cervical Muscles in Elderly with Temporomandibular Disorder. Arch Gerontol Geriatr. 2019;81:119-128. doi:10.1016/j.archger.2018.12.004 Lindfors E, Arima T, Baad-Hansen L, et al. Jaw Exercises in the Treatment of Temporomandibular Disorders-An International Modified Delphi Study. J Oral Facial Pain Headache. 2019;33(4):389–398. doi:10.11607/ofph.2359 Schiffman EL, Velly AM, Look JO, et al. Effects of four treatment strategies for temporomandibular joint closed lock. Int J Oral Maxillofac Surg. 2014;43(2):217-226. doi:10.1016/j.ijom.2013.07.744 Calixtre LB, Moreira RF, Franchini GH, Alburquerque-Sendín F, Oliveira AB. Manual therapy for the management of pain and limited range of motion in subjects with signs and symptoms of temporomandibular disorder: a systematic review of randomised controlled trials. J Oral Rehabil. 2015;42(11):847-861. doi:10.1111/joor.12321
Diversity Dialogues 2.0: A Panel Discussion Around Personal Diversity Experiences
Crash Course in Fitness Prescription Beyond the PT Clinic
Clinical Decision Making in the Diagnosis and Treatment of Balance Dysfunction
Evaluation and Treatment of Temporomandibular Dysfunction: What You Need to Know
5:30PM - 7:30PM - SOCIAL EVENT - BREWERS KETTLE
Saturday, October 12, 2024
7:00AM - 8:00AM - REGISTRATION / COFFEE
8:00AM - 9:30AM - SESSION 1
Cory Alcon PT, DPT, PhD Board-Certified Clinical Specialist in Orthopaedic Physical Therapy Dr. Cory Alconis Assistant Professor in the Department of Physical Therapy at HPU. He is a Board Certified Orthopedic Clinical Specialist with specific expertise in managing chronic neuromusculoskeletal pain conditions. Dr. Alcon holds a bachelor’s degree in Kinesiology from the University of North Carolina at Greensboro, received his Doctorate in Physical Therapy from Winston-Salem State University and his PhD from Texas Woman’s University in Dallas, TX with a concentration in pain neuromodulation. His research agenda focuses on harnessing the power of neuroplasticity to better manage the cognitive and affective dimensions of the pain experience. This includes the use of non-invasive brain stimulation techniques to prime specific brain regions prior to participation in cognitive behavioral therapy. At High Point he serves as the Director Curriculum and Outcomes while directing the Musculoskeletal Practice and Pain Science courses. His passion for teaching is founded on the desire to assist students in becoming complete clinicians that are psychologically informed, movement focused, and manually skilled. DESCRIPTION: Most patients improve with PT management. However, those that don’t are often viewed as the problem. But are we the reason these patients don’t progress? Research suggests that providers lack knowledge, training, and confidence when managing patients with complex pain presentations. This in turn leads to poorer patient outcomes and increased provider burnout. This collaborative session aims to update providers with practical knowledge and skills needed to effectively evaluate, classify, and manage challenging pain cases. You will learn to create individual “pain profiles” for your patients to help better match interventions with priority impairments. OBJECTIVES: Upon completion of this education session, participants will be able to classify patients’ pain as nociceptive, neuropathic, or nociplastic. Upon completion of this education session, participants will be able to develop a patient's "pain profile" based on priority impairments. Upon completion of this education session, participants will effectively structure a plan of care based on a complex pain case scenario. REFERENCES: Blouin JE, Cary MA, Marchant MG, Gyurcsik NC, Brittain DR, Zapski J. Understanding Physiotherapists' Intention to Counsel Clients with Chronic Pain on Exercise: A Focus on Psychosocial Factors. Physiother Can. 2019;71(4):319-326. doi:10.3138/ptc-2018-38 Forbes R, Ingram M. New-graduate physiotherapists' readiness for practice and experiences of managing chronic pain; a qualitative study. Physiother Theory Pract. 2021;37(11):1177-1184. doi:10.1080/09593985.2019.1692394 Fitzcharles MA, Cohen SP, Clauw DJ, Littlejohn G, Usui C, Häuser W. Nociplastic pain: towards an understanding of prevalent pain conditions. Lancet. 2021;397(10289):2098-2110. doi:10.1016/S0140-6736(21)00392-5 Cohen SP, Vase L, Hooten WM. Chronic pain: an update on burden, best practices, and new advances. Lancet. 2021;397(10289):2082-2097. doi:10.1016/S0140-6736(21)00393-7 Chimenti RL, Frey-Law LA, Sluka KA. A Mechanism-Based Approach to Physical Therapist Management of Pain. Phys Ther. 2018;98(5):302-314. doi:10.1093/ptj/pzy030 Catherine Bardsley Wright PT, DPT, MHA, Board-Certified Clinical Specialist in Neurologic Physical Therapy Catherine Bardsley Wright, PT, DPT, MHAis a Board-Certified specialist of Neurologic Physical Therapy who lives in Wilmington, NC and is the Therapy Manager at Novant Health Pender Medical Center and Therapy Resource Pool for the Coastal Market. She has been with Novant Health NHRMC since 2007 and has worked in Acute, Inpatient Rehab, Outpatient and Skilled Nursing settings. She received her DPT at MGH Institute for Health Professions in 2007, became a APTA Neurologic Clinical Specialist in 2017, and received her MHA from UNC Gilling School of Public Health in 2020. Dr. Wright has also been a North Carolina representative the APTA House of Delegates since 2022 and received her 200 -hr YTT in 2024. She spends any of her remaining time with her husband, 2 sons and Labrador retriever. DESCRIPTION: Follow the story of ‘Snu’, our whimsical AI generated creature, as she learns to navigate the world of the Skilled Nursing Facility. The ABC’s of SNU will take you on a journey through the skilled nursing world and the dozens of acronyms associated within the regulatory environment. Join Snu as she strives to understand the differences in facility type, and how her PT practice and responsibilities change at the different levels of care. We will look at the differences Med A and Med B, section GG, and what the heck is a CAA. She will finally dive into the opportunities that are unique to the skilled world to maximize the care and function of her patients and residents. “The world of the SNU can be rough, And the rules for a PT can be tough, From OBRA to Restorative Care SNU’s ABC’s will make it fair To learn the basics of all this stuff.” OBJECTIVES: Upon completion of this educational session, participants will be able to: * Differentiate between the types of facilities and level of care provided at them. * Describe how traditional Medicare A and Medicare B is used in reference to payment of therapy services and DME. *Describe how to utilize restorative nursing and maintenance therapy to maximize patient outcomes. * Explain the differences between OBRA and PPS , and what these mean to a therapist. REFERENCES: Coleman, A; McLaughlin, E; Floren, M. Practitioner Burnout and Productivity Levels in Skilled Nursing and Assisted Living Facilities, Part 1: A Descriptive Quantitative Account. The American Journal of Occupational Therapy, 2024, Vol. 78(1), 7801205090. https://doi.org/10.5014/ajot.2024.050341 Prusynski, RA; Gustavson, AM; Shrivastav, SR; Mroz, TM. Rehabilitation Intensity and Patient Outcomes in Skilled Nursing Facilities in the United States: A Systematic Review. Physical Therapy, Volume 101, Issue 3, March 2021, https://doi.org/10.1093/ptj/pzaa230 State Operations Manual Appendix PP - Guidance to Surveyors for Long Term Care Facilities. Centers for Medicine and Medicaid Services. Updated February 3, 2023. Accessed April 30, 2024. https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107ap_pp_guidelines_ltcf.pdf State Operations Manual Chapter 7 - Survey and Enforcement Process for Skilled Nursing Facilities and Nursing Facilities. Centers for Medicare and Medicaid Services. Updated February 10, 2023. Accessed April 22, 2024. https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/som107c07pdf.pdf Stikeleather, SJ; Simmons, TM. Maintenance Physical Therapy: Consideration for a Continuous Practice Paradigm for Physical Therapists. Topics in Geriatric Rehabilitation 37(3):p 152-162, July/September 2021. | DOI: 10.1097/TGR.0000000000000321 Lance Mabry, PT, DPT Dr. Lance Mabryis an Assistant Professor at High Point University Doctor of Physical Therapy Program in High Point, North Carolina where he teaches diagnostic imaging and primary care. He received his doctorate in physical therapy from U.S. Army-Baylor University and is a board certified orthopaedic specialist. He completed fellowship training in manual therapy and primary care though Kaiser Permanente. Lance retired from the United States Air Force after serving in both Operation Iraqi Freedom and Operation Enduring Freedom. He has roughly 30 peer reviewed publications focusing primarily on the clinical integration of musculoskeletal imaging into physical therapist practice. He has extensive public speaking experience including educational sessions at APTA-NC Annual Conference and platform presentations at APTA Combined Sections Meeting. Kevin Mullen, SPT Kevin Mullen, SPTis a 3rd year doctoral physical therapy student at High Point University. Kevin presented a poster at the APTA Combined section meeting 2024 and a case study poster at the APTA-NC annual conference in 2023. He has served as the president of the military student special interest group at High Point University. Kevin was a member of the APTA-NC student conclave committee and helped set up the event to allow students to network and learn from potential future employers. Meghan Crowfoot, SPT Meghan Crowfoot, SPThas previously presented multiple posters at the state and national conferences. Discussed physical therapy legislative initiatives with Congresswoman Kathy Manning and Senator Ted Budd as part of the APTA Key Contact program. Headed the HPU inaugural DEIJ committee and serves on the HPU Pro Bono Physical Therapy Student Board. DESCRIPTION: The authority for physical therapists to refer patients directly to a radiologist for diagnostic imaging has expanded rapidly in recent years. Twelve states currently allowing PT imaging referral, and many more (including North Carolina) plan to pursue this in the near future. Both future and practicing physical therapists need foundational imaging education to integrate diagnostic imaging results into their practice. The purpose of this course is to provide entry-level (or refresher) training to physical therapists to allow for easy integration into practice. The course will aim to dispel biases related to diagnostic imaging (i.e. imaging results don’t clinically correlate) and provide easy ways to understand the most common imaging modalities (radiographs, MRI, CT). This course will be taught via lecture, class participation, and Kahoot skills checks. OBJECTIVES: Upon completion of this educational session, participants will be able to: REFERENCES: 1. Brinjikji W, Diehn F, Jarvik J, et al. MRI findings of disc degeneration are more prevalent in adults with low back pain than in asymptomatic controls: a systematic review and meta-analysis. American Journal of Neuroradiology 2015;36(12):2394-99. 2. Brinjikji W, Luetmer PH, Comstock B, et al. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. American journal of neuroradiology 2015;36(4):811-16. 3. Crowell MS, Dedekam EA, Johnson MR, Dembowski SC, Westrick RB, Goss DL. Diagnostic Imaging in a Direct-Access Sports Physical Therapy Clinic: A 2-Year Retrospective Patient Analysis. International journal of sports physical therapy 2016;11(5):708. 4. Crowell MS, Mason JS, McGinniss JH. Musculoskeletal imaging for low back pain in direct access physical therapy compared to primary care: an observational study. International Journal of Sports Physical Therapy 2022;17(2):237. 5. Crowell MS, Mason JS, Morris JB, Dummar MK, Kuwik PA. Diagnostic Imaging for Distal Extremity Injuries in Direct Access Physical Therapy: An Observational Study. Int J Sports Phys Ther 2023;18(2):431-38 doi: 10.26603/001c.73314 [published Online First: 20230402]. 6. Crowell MS, Thomasma E, Florkiewicz E, et al. Validity and Responsiveness of a Modified Balance Error Scoring System Assessment Using a Mobile Device Application in Patients Recovering from Ankle Sprain. Int J Sports Phys Ther 2024;19(4):440-50 doi: 10.26603/001c.94608 [published Online First: 20240401]. 7. Jenkins HJ, Downie AS, Maher CG, Moloney NA, Magnussen JS, Hanco*ck MJ. Imaging for low back pain: is clinical use consistent with guidelines? A systematic review and meta-analysis. The spine journal : official journal of the North American Spine Society 2018;18(12):2266-77 doi: 10.1016/j.spinee.2018.05.004 [published Online First: 2018/05/08]. 8. Keil AP, Baranyi B, Mehta S, Maurer A. Ordering of Diagnostic Imaging by Physical Therapists: A 5-Year Retrospective Practice Analysis. Phys Ther 2019 doi: 10.1093/ptj/pzz015 [published Online First: 2019/02/05]. 9. Mabry LM, Notestine JP, Moore JH, Bleakley CM, Taylor JB. Safety Events and Privilege Utilization Rates in Advanced Practice Physical Therapy Compared to Traditional Primary Care: An Observational Study. Mil Med 2020;185(1-2):e290-e97 doi: 10.1093/milmed/usz176 [published Online First: 2019/07/20]. 10. Mabry LM, Severin R, Gisselman AS, et al. Physical Therapists Are Routinely Performing the Requisite Skills to Directly Refer for Musculoskeletal Imaging: An Observational Study. The Journal of manual & manipulative therapy 2022;30(5):261-72 doi: 10.1080/10669817.2022.2106729 [published Online First: 20220813]. 11. Mabry LM, Keil A, Young BA, et al. Physical therapist awareness of diagnostic imaging referral jurisdictional scope of practice: an observational study. The Journal of manual & manipulative therapy 2023:1-11 doi: 10.1080/10669817.2023.2296260 [published Online First: 20231221]. 12. Moore JH, Goss DL, Baxter RE, et al. Clinical diagnostic accuracy and magnetic resonance imaging of patients referred by physical therapists, orthopaedic surgeons, and nonorthopaedic providers. J. Orthop. Sports Phys. Ther. 2005;35(2):67-71 doi: 10.2519/jospt.2005.35.2.67. 13. Moore JH, McMillian DJ, Rosenthal MD, Weishaar MD. Risk determination for patients with direct access to physical therapy in military health care facilities. J Orthop Sports Phys Ther 2005;35(10):674-8 doi: 10.2519/jospt.2005.35.10.674 [published Online First: 2005/11/22]. 14. Nelson E, Gordon E, Cropes M, et al. Survey of Wisconsin Physical Therapist Radiograph Ordering Behaviors and Implementation: A Mixed-Methods Approach. J. Orthop. Sports Phys. Ther. 2020;50(1):CSM18. 15. Nelson EO, Freeman J, Worth R, Brody LT. Private physical therapy practice implementation of direct referral for radiograph imaging: an administrative case report. Physiother Theory Pract 2023;39(10):2234-40 doi: 1 Joel Robert Thompson, PT, DPT, CPhT, CLT, MA Joel Robert Thompson, PT, DPT, CPhT, CLT, MAis a Physical Therapist specializing in inflammation and inflammatory arthritis who is currently a PhD student within UNC-CH's Human Movement Sciences Curriculum. He works within UNC's Rheumatic and Musculoskeletal Research (RMR) Lab with a current focus in exploring how physical therapy may be utilized and included within routine rheumatological management to preserve function and valued activities throughout the lifespan and disease progression of patients with inflammatory arthritis. He is also partly responsible for delivering the pharmacology and inflammatory arthritis content within UNC-CH's DPT program. He has received the Rheumatology Research Foundation's Health Professional Online Education Grant for Advanced Rheumatology Coursework. His research has been presented at the national conferences for the American College of Rheumatology (ACR) and the Spondylarthritis Research and Treatment Network (SPARTAN). DESCRIPTION: Enthesitis poses a significant challenge for physical therapists, as it's increasingly recognized as a common source of pain and dysfunction. This educational session offers a comprehensive review of its biomechanics, pathophysiology, and treatment strategies tailored specifically for PTs. Through engaging lecture and interactive discussion, attendees will gain invaluable insights into the complexities of insertional inflammation, enhancing their diagnostic and therapeutic skills. By delving into the latest research and clinical practices, this session aims to equip PTs with the knowledge and tools necessary to effectively manage and treat enthesitis, ultimately improving patient outcomes and quality of care. Join us for an enlightening exploration into this critical aspect of musculoskeletal health. OBJECTIVES: -Analyze the biomechanical factors contributing to enthesitis development, incorporating insights from recent research studies such as the impact of mechanical loading on tendon and ligament integrity. -Evaluate the pathophysiological mechanisms underlying enthesitis, citing evidence from relevant literature, including the role of mechanical strain and stromal cells in driving inflammation and new bone formation. -Discuss evidence-based treatment modalities for enthesitis management, including pharmacological interventions and physical therapy strategies informed by the latest guidelines and recommendations. -Formulate comprehensive assessment strategies for detecting enthesitis in clinical practice, integrating knowledge of characteristic physical examination findings and ultrasound imaging techniques. -Appraise the association between physical activity and enthesitis severity in conditions such as psoriatic arthritis, drawing from studies exploring the impact of exercise and medication on ultrasound-detected enthesitis. REFERENCES: Crowe LAN, Akbar M, de Vos RJ, et al. Pathways driving tendinopathy and enthesitis: siblings or distant cousins in musculoskeletal medicine?. Lancet Rheumatol. 2023;5(5):e293-e304. doi:10.1016/S2665-9913(23)00074-7 Gracey E, Burssens A, Cambré I, et al. Tendon and ligament mechanical loading in the pathogenesis of inflammatory arthritis. Nat Rev Rheumatol. 2020;16(4):193-207. doi:10.1038/s41584-019-0364-x Jacques P, Lambrecht S, Verheugen E, et al. Proof of concept: enthesitis and new bone formation in spondyloarthritis are driven by mechanical strain and stromal cells. Ann Rheum Dis. 2014;73(2):437-445. doi:10.1136/annrheumdis-2013-203643 López-Medina C, Puche-Larrubia MÁ, Granados R, et al. Achilles enthesitis on physical examination leads to worse outcomes after 2 years of follow up in patients with ankylosing spondylitis from REGISPONSER-AS registry. Arthritis Res Ther. 2023;25(1):8. Published 2023 Jan 13. doi:10.1186/s13075-023-02988-x McGonagle D, Stockwin L, Isaacs J, Emery P. An enthesitis based model for the pathogenesis of spondyloarthropathy. additive effects of microbial adjuvant and biomechanical factors at disease sites. J Rheumatol. 2001;28(10):2155-2159. Mistry RR, Patro P, Agarwal V, Misra DP. Enthesitis-related arthritis: current perspectives. Open Access Rheumatol. 2019;11:19-31. Published 2019 Jan 25. doi:10.2147/OARRR.S163677 Nguyen QT, Jacobsen TD, Chahine NO. Effects of Inflammation on Multiscale Biomechanical Properties of Cartilaginous Cells and Tissues. ACS Biomater Sci Eng. 2017;3(11):2644-2656. doi:10.1021/acsbiomaterials.6b00671 Perrotta FM, Scriffignano S, Benfaremo D, Ronga M, Luchetti MM, Lubrano E. New Insights in Physical Therapy and Rehabilitation in Psoriatic Arthritis: A Review. Rheumatol Ther. 2021;8(2):639-649. doi:10.1007/s40744-021-00298-9 Ringold S, Angeles-Han ST, Beukelman T, et al. 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Treatment of Juvenile Idiopathic Arthritis: Therapeutic Approaches for Non-Systemic Polyarthritis, Sacroiliitis, and Enthesitis. Arthritis Care Res (Hoboken). 2019;71(6):717-734. doi:10.1002/acr.23870 Schett G, Lories RJ, D'Agostino MA, et al. Enthesitis: from pathophysiology to treatment. Nat Rev Rheumatol. 2017;13(12):731-741. doi:10.1038/nrrheum.2017.188 Simon D, Kleyer A, Bayat S, et al. Biomechanical stress in the context of competitive sports training triggers enthesitis. Arthritis Res Ther. 2021;23(1):172. Published 2021 Jun 21. doi:10.1186/s13075-021-02530-x Watad A, Cuthbert RJ, Amital H, McGonagle D. Enthesitis: Much More Than Focal Insertion Point Inflammation. Curr Rheumatol Rep. 2018;20(7):41. Published 2018 May 30. doi:10.1007/s11926-018-0751-3 Wervers K, Herrings I, Luime JJ, et al. Association of Physical Activity and Medication with Enthesitis on Ultrasound in Psoriatic Arthritis. J Rheumatol. 2019;46(10):1290-1294. doi:10.3899/jrheum.180782 Woodburn J, Hyslop E, Barn R, McInnes IB, Turner DE. Achilles tendon biomechanics in psoriatic arthritis patients with ultrasound proven enthesitis. Scand J Rheumatol. 2013;42(4):299-302. doi:10.3109/03009742.2012.747626
“It's Me, Hi, I'm the Problem, It's Me”: Are We the Problem When Treating Pain?
The ABC’s of SNFs and SNUs
Diagnostic Imaging Fundamentals
Enthesitis: A review of the biomechanics, pathophysiology, and treatment of insertional inflammation for Physical Therapists.
9:30AM - 10:15AM - POSTER SESSION 2 ~ VISIT WITH EXHIBITORS ~ MORNING BREAK
10:15AM - 11:45AM - SESSION 2
Lance Mabry, PT, DPT Dr. Lance Mabryis an Assistant Professor at High Point University Doctor of Physical Therapy Program in High Point, North Carolina where he teaches diagnostic imaging and primary care. He received his doctorate in physical therapy from U.S. Army-Baylor University and is a board certified orthopaedic specialist. He completed fellowship training in manual therapy and primary care though Kaiser Permanente. Lance retired from the United States Air Force after serving in both Operation Iraqi Freedom and Operation Enduring Freedom. He has roughly 30 peer reviewed publications focusing primarily on the clinical integration of musculoskeletal imaging into physical therapist practice. He has extensive public speaking experience including educational sessions at APTA-NC Annual Conference and platform presentations at APTA Combined Sections Meeting. Don Goss, PT, PhD Don Goss, PT, PhDreceived a direct commission into the US Army in 1995, graduating from the Army Baylor PT program with a MPT in 1997. For 12 years, he served in a variety of assignments including Camp Casey, Korea; Stuttgart, Germany; and Fort Bragg, NC. He completed a PhD in Human Movement Science with a concentration in running biomechanics from the University of North Carolina at Chapel Hill. Dr. Goss taught in the Army Baylor Doctoral program in physical therapy from 2012-2014. Don served as Program Director and for the West Point Sports Medicine PT Fellowship, from 2014-2019. He has been awarded several Department of Defense research grants totaling nearly $10 million to study wearable technology, gait re-training with runners, injury prediction, and injury prevention in military service members. In summer 2019, COL Goss took over as the Officer in Charge of Physical Therapy at Fort Bragg, NC. He retired from the Army in summer 2020, and he accepted a position as Associate Professor at High Point University in the Department of Physical Therapy. DESCRIPTION: Diagnostic imaging education was instituted as a mandatory requirement for physical therapy doctoral education by the Commission on Accreditation in Physical Therapy Education in 2016. However, diagnostic imaging education for physical therapists has typically been disproportionately focused on appropriateness of the imaging referral with comparably less attention on the clinical responsibilities inherent once imaging is completed. Recent state board rulings, educational guidelines from the Imaging Special Interest Group, as well as contemporary research all emphasize the importance of an appropriate response to completed imaging. The purpose of this course will be to enhance clinical reasoning surrounding imaging findings, to enhance clinical communication between physical therapists and other healthcare professionals, and to navigate the responsibilities physical therapists encounter once their patient has received diagnostic imaging (regardless of the ordering provider). This course will be taught via lecture, class participation, and small group interactions. OBJECTIVES: Upon completion of this educational session, participants will be able to: REFERENCES: 1. Mabry LM, Keil A, Young BA, et al. Physical therapist awareness of diagnostic imaging referral jurisdictional scope of practice: an observational study. Journal of Manual & Manipulative Therapy:1-11 doi: 10.1080/10669817.2023.2296260. 2. Mabry LM, Severin R, Gisselman AS, et al. Physical Therapists Are Routinely Performing the Requisite Skills to Directly Refer for Musculoskeletal Imaging: An Observational Study. The Journal of manual & manipulative therapy 2022;30(5):261-72 doi: 10.1080/10669817.2022.2106729 [published Online First: 20220813]. 3. Rajasekaran S, Dilip Chand Raja S, Pushpa BT, Ananda KB, Ajoy Prasad S, Rishi MK. The catastrophization effects of an MRI report on the patient and surgeon and the benefits of ‘clinical reporting’: results from an RCT and blinded trials. European Spine Journal 2021;30(7):2069-81 doi: 10.1007/s00586-021-06809-0. 4. Castillo C, Steffens T, Sim L, Caffery L. The effect of clinical information on radiology reporting: a systematic review. Journal of medical radiation sciences 2021;68(1):60-74. 5. Collier D, Labranche E, Mabry LM. Ruling in Cervical Myelopathy by Diagnostic Cluster. JOSPT Cases 2021;1(2):92-93 doi: 10.2519/josptcases.2021.10049. Shane Mathew, PT, DPT Shane Mathewis a recent graduate from the Duke Health Orthopaedic Residency in 2024. He grew up in Fort Lauderdale, Florida and received his Bachelors in Health Education in 2019 and Doctorate in Physical Therapy in 2023 from the University of Florida. His earliest experiences with physical therapy stem from being a physical rehabilitation volunteer at a local VA Clinic from the ages of thirteen to seventeen. His professional and research interests include applied musculoskeletal practice, interventions for chronic pain, clinical leadership, DEI initiative expansion, and healthcare informatics. He is currently involved in multiple physical therapy communities ranging from serving on the APTA NC Scholarship Committee, APTA Next Generation Leadership Strategic Planning Committee, and the Society of APTA Association Leadership Scholars. Corry Brinken, PT, DPT Corry Brinkenis the 2024-2025 Orthopaedic Resident Physical Therapist for the Duke University Health System. He grew up in New York and attended college in Connecticut where he received his Bachelors in Exercise Science in 2021 and Doctorate in Physical Therapy in 2024 from Sacred Heart University. His professional interests include working with medically complex ICU-level patients across the continuum of care and sports injury prevention and rehabilitation within college athletics. Corry has been an active member within the APTA holding several positions at the state and national level serving on the Student Board of Directors and the Steering Group as a part of the newly created student council. Corry Brinken is the 2024-2025 Duke Orthopedic Resident and would be receiving direct mentorship throughout the design and implementation of the lecture as he seeks out continued growth in the areas of teaching/presenting. David Jones, PT, CWS, GCS David Jones, PT, CWS, GCS is a senior Physical Therapist at Duke Hospital in acute care since 2000. David received his MPT from the University of St Augustine for Health Sciences in 2000. He is a Certified Wound Specialist through the American Board of Wound Management since 2006 and an APTA board-certified geriatric specialist in 2017. David has been the trauma mentor for Duke’s Orthopaedic PT Residency since its start in 2012. He assists teaching both the Wound and Integument Course and Advanced Practice Clinical in wound care in the Duke University Doctor of Physical Therapy program. His areas of practice include post-surgical, trauma, abdominal transplant, orthopaedics, amputee, general medicine, wound, and ICU. DESCRIPTION: Trauma is common and has effects on an individual’s health and well-being throughout the life course. The term “trauma” moves beyond physical trauma, and refers to the psychological or emotional response to a threatening event. Little is known about how injured patients understand their health and healthcare needs during post-acute recovery. Trauma-Informed Care (TIC) is an emerging strengths-based delivery approach that utilizes principles of cultural competence, respect, and collaboration. This model also incorporates empathetic support to facilitate effective coping and address trauma-related distress for both survivors and their families. There is growing evidence to support that use of a multidisciplinary approach, establishment of care continuity, along with TIC are effective in improving patient outcomes in both the physical and mental aspects of rehabilitation. This discussion will explore the nuances of a trauma-informed approach to care and the importance of early intervention strategies for addressing patient’s rehabilitative needs following trauma. OBJECTIVES: Upon completion of this educational session, participants will be able to: - Identify key challenges in ensuring continuity of care for trauma patients transitioning from hospital to clinic settings. - Differentiate between acute and post-acute care needs of trauma survivors, focusing on the specific role of physical therapists in each setting. - Develop a plan for effective communication and information exchange between hospital staff and clinic physical therapists, including essential elements to be documented in patient records. - Apply principles of trauma-informed care in the clinic setting, including strategies for creating a safe and supportive environment for trauma survivors. - Evaluate the effectiveness of their current practices in supporting continuity of care for trauma patients and identify areas for improvement within their clinics. REFERENCES: Barreca J, Swiggum M. Trauma-informed care in pediatric physical therapy as A... : Pediatric physical therapy. LWW. April 2024. Accessed April 24, 2024. https://journals.lww.com/pedpt/fulltext/2024/04000/trauma_informed_care_in_pediatric_physical_therapy.14.aspx?casa_token=QhbCKnTG-dkAAAAA%3AppMRd0fr0VU0wsE-iJM5k2Y3aNvQ37MZWO5Cm-buB5vh1eItZxD0v0MxFy9coj5hsBOgcsr9FPPfwA2vzUmZYtEg. Brandolino A, deRoon-Cassini TA, Biesboer EA, et al. Improved follow-up care for gun violence survivors in the trauma quality of Life Clinic. Trauma Surgery & Acute Care Open. February 21, 2024. Accessed April 24, 2024. https://tsaco.bmj.com/content/9/1/e001199.abstract. Kaufman E, Whitehorn G, Orji W, et al. Patient Experiences of Acute and Postacute Care After Trauma. Journal of Surgical Research. November 2023. Accessed April 24, 2024.https://www.sciencedirect.com/science/article/pii/S002248042300272X?casa_token=YdwGo8vpVysAAAAA%3AKAz74s5GU86vHlT1IqQ4PBL6UHShuAxhsJBy2ApIU8fZmQ6UlMHLUHNTjLpwtJ8ZxLdqLcZQ2q8. Knight C. Trauma informed practice and care: Implications for field instruction - clinical social work journal. SpringerLink. June 21, 2018. Accessed April 24, 2024. https://link.springer.com/article/10.1007/s10615-018-0661-x. Lovell RC, Greenfield D, Johnson G, Elji*z K, Amanatidis S. Optimising Outcomes for Complex Trauma Survivors: Assessing the Motivators, Barriers and Enablers for Implementing Trauma Informed Practice Within a Multidisciplinary Health Setting - BMC Health Services Research. SpringerLink. April 2, 2022. Accessed April 24, 2024. https://link.springer.com/article/10.1186/s12913-022-07812-x. Valerie Adams, PT, DPT Board-Certified Clinical Specialist in Women’s Health Physical Therapy Certified Lymphedema Therapist Valerie Adams, PT, DPTis a Board-Certified Clinical Specialist in Women’s Health Physical Therapy and a Certified Lymphedema Therapist. She has a particular interest in the pregnant and postpartum patient populations. She has served as a clinical instructor for DPT students and is a mentor for the Duke University Women’s Health Residency program. She has teaching experience with the Duke DPT program and has lectured for the Elon DPT program. Valerie has provided numerous in-services to nurses and advance practice providers on topics pertaining to women’s and pelvic health. She currently practices within the Duke University Health System in Durham, NC specializing in pelvic health, women’s health, and oncology. In her spare time, Valerie volunteers as a doula for the UNC Birth Partners Program. Amanda Heath, PT, DPT Board-Certified Clinical Specialist in Women’s Health Physical Therapy Board-Certified Clinical Specialist in Oncologic Physical Therapy Certified Lymphedema Therapist Amanda Heath, PT, DPT, is a Board-Certified Clinical Specialist in both Women’s Health Physical Therapy and Oncologic Physical Therapy. Amanda has a passion for teaching and helping to ensure women’s health and oncology specialties are represented so that patients and the public have access to these critical areas of physical therapy. She currently practices within the Duke University Health System in Durham, NC specializing in pelvic health, women’s health, and oncology. Amanda serves as a mentor in the Duke University’s Women’s Health Residency program and as a mentor for new employees. She has presented at multiple conferences and DPT programs across NC including the APTA Combined Sections Meeting, Duke University Nurse Practitioners Program, Duke University DPT program, Campbell University DPT program, Elon University DPT program, NC WIC conference, and at NC AHEC. Amanda Heath is also a Certified Lymphedema Therapist. Jennifer Thornton-Jones, PT, DPT Board-Certified Clinical Specialist in Women’s Health Physical Therapy Board-Certified Clinical Specialist in Oncologic Physical Therapy Jennifer Thornton – Jones, PT, is a Board-Certified Specialist in both Women’s Health Physical Therapy and Oncologic Physical Therapy. She is one of the Co-Directors of Duke University’s Women’s Health Residency. She has a particular clinical interest in treating peripartum conditions, and in improving quality of care and access for pregnant and postpartum individuals. She has worked on multiple projects within Duke to increase perinatal access to and education around physical therapy in the postpartum period. She is passionate about increasing physical therapy knowledge around women’s health concerns, and serves as a mentor for the women’s health residency and a Clinical Educator for the Duke DPT program. She has experience presenting and lecturing for multiple multidisciplinary groups within Duke University Health System, including educating the Labor and Delivery nursing team on pelvic floor considerations during labor. She has previously presented at the APTA NC conference in 2018 and 2023. DESCRIPTION: This educational session will outline the development and implementation of a comprehensive peripartum physical therapy program in a large health care system. There have been admirable efforts to improve awareness of the benefits physical therapy can provide in the acute and early postpartum period. However, barriers to PT access in the perinatal period are difficult to overcome and patient access to PTs with advanced training in treating this population remains limited. This session will provide attendees with information on how to approach their own program development. We will discuss the initial phase of identifying the need for quality improvement and the outreach efforts undertaken with the labor and delivery team. We will then detail the development and implementation process of the three-part framework comprising: expanded access to outpatient PT for pregnant patients, pelvic health PT care in the immediate postpartum hospital setting, and postpartum telehealth service at 2-3 weeks postpartum. OBJECTIVES: Upon completion of this educational session, participants will be able to: 1. Identify the best ways to promote the benefits of physical therapy in peripartum care to key stakeholders 2. Design a comprehensive postpartum physical therapy program to enhance continuity of care following delivery. 2. Describe barriers to postpartum physical therapy access. 3. Develop strategies to overcome barriers to postpartum physical therapy access. REFERENCES: ACOG Committee Opinion No. 736: Optimizing Postpartum Care. Obstet Gynecol. 2018;131(5):e140-e150. doi:10.1097/AOG.0000000000002633 Physical Activity and Exercise During Pregnancy and the Postpartum Period: ACOG Committee Opinion, Number 804. Obstet Gynecol. 2020;135(4):e178-e188. doi:10.1097/AOG.0000000000003772 Berghella V, Saccone G. Exercise in pregnancy!. Am J Obstet Gynecol. 2017;216(4):335-337. doi:10.1016/j.ajog.2017.01.023 Cairns AE, Pealing L, Duffy JMN, et al. Postpartum management of hypertensive disorders of pregnancy: a systematic review. BMJ Open. 2017;7(11):e018696. Published 2017 Nov 28. doi:10.1136/bmjopen-2017-018696 Centers for Disease Control and Prevention. Pregnancy mortality surveillance system. https://www.cdc.gov/reproductivehealth/maternal-mortality/pregnancy-mortality-surveillance-system.htm. Published March 23, 2023. Accessed April 1, 2024. Mou T, Nelson L, Lewicky-Gaupp C, Brown O. Opportunities to Advance Postpartum Pelvic Floor Care With a Health Equity-based Conceptual Framework. Clin Obstet Gynecol. 2023;66(1):86-94. doi:10.1097/GRF.0000000000000757 Centers for Medicare and Medicaid Services. Increasing Access, Quality, and Equity in Postpartum Care in Medicaid and CHIP: A Toolkit for State Medicaid and CHIP Agencies. https://www.medicaid.gov/sites/default/files/2023-08/ppc-for-state-and-medicaid-toolkit.pdf. Published August 10, 2023. Accessed April 1, 2024. Chandi Edmonds, PT, DPT, Board-Certified Clinical Specialist in Pediatric Physical Therapy Chandi Edmonds, PT, DPT, is an Assistant Professor and Assistant Director of Clinical Education at Tufts University’s hybrid DPT Program in Seattle, WA. She received her Master’s and Doctorate degrees in physical therapy from Northwestern University in Chicago, IL. Dr. Edmonds’ passion for underserved communities led to her first clinical position at a large county hospital where she gained experience in neurologic, orthopedic, burn and cardiovascular care for children and adults. During this time, she discovered an excitement for the pediatric population and later gained extensive experience in neonatal and pediatric intensive care units, home based early intervention programs, and school systems in Chicago and Los Angeles and earned her board certification as a Pediatric Clinical Specialist in 2014. Dr. Edmonds’ teaching experience includes serving on faculty and as director of clinical education at various traditional and hybrid DPT programs. Currently she serves as a Clinical Director for Special Olympics North Carolina FUNFitness. Dr. Edmonds hopes to encourage others to serve communities who are under-resourced to help improve health equity in the U.S. Mica Mitchell, PT, DPT, Board-Certified Clinical Specialist in Pediatric Physical Therapy Mica (Mee-kuh) Mitchell, PT, DPT, C/NDTis an Assistant Professor of Physical Therapy at the College of Saint Mary’s Hybrid Doctor of Physical Therapy Program in Omaha, NE. She has worked as a pediatric physical therapist in a variety of settingssince 2003. Dr. Mitchell has received her Doctor of Physical Therapy (DPT) degree with a specialization in pediatric science from Rocky Mountain University of Health Professions, a Master in Physical Therapy degree obtained from East Carolina University. She is an American Board of Physical Therapy Specialties (ABPTS) Board-Certified Clinical Specialist in Pediatric Physical Therapy. Dr. Mitchell has a passion for pediatrics which includes her volunteer work as a FUNfitness Clinical Director with Special Olympics. Dr. Mitchell is driven by a desire to encourage the experience of belonging for minoritized individuals and underrepresented groups through representation and justice. Vicki Tilley PT, Board Certified Specialist in Geriatric Physical Therapy Vicki Tilley PT, Board Certified Specialist in Geriatric Physical Therapy is a graduate of the University of Delaware. She is the Health Director for Special Olympics North Carolina, responsible for development and implementation of health, wellness and fitness activities and Healthy Athletes screening to support the 45,000 athletes of SONC. She is also the owner of ElderFit Physical Therapy and Consulting, an outpatient practice that focuses on care of the older adult in their home or community setting with a focus fall prevention. Between 1999 and 2023, Tilley worked as a Global Clinical Consultant and co-founder of the FUNfitness Screening program for Special Olympics International, working globally to support implementation and growth of the screening program. Tilley has been an active member of the American Physical Therapy Association and APTANC for 37 years, belonging to several professional sections and academies and holding leadership roles throughout her professional career. She has just completed a three-year term as a Director on the American Physical Therapy Association Board of Directors. DESCRIPTION: Individuals with intellectual disabilities and diverse abilities are often denied or have limited access to health care services. At the same time, health care providers often feel underprepared to treat patients with intellectual disabilities. These two factors can lead to a sequela of chronic conditions, limited mobility, and decreased life expectancy. Special Olympics (SO) has recognized the barriers to good health experienced by their athlete population and has developed Special Olympics Health. SO Health includes health screening programs, inclusive health education and training and advocacy. FUNfitness is a Physical therapist led physical function screen that is an important part of our athlete screening program. This presentation will provide the audience with challenges found from health screenings and discuss ways for the PT profession to increase engagement with Special Olympics athletes and participate in the inclusive health movement. OBJECTIVES: Upon completion of this educational session, participants will be able to: 1.Explain the characteristics of Special Olympics athletes 2.Understand the Special Olympics organization and the local and global impact 3. Discuss the health issues and health disparities of those with ID and understand the inclusion health movement 4. Experience facilitating FUNfitness screenings items 5. Assess data collected from Special Olympics athletes in North Carolina and the implications on quality of life. 6. Design an individualized action plan for involvement with the inclusive health movement. REFERENCES: 1. Williamson HJ, Contreras GM, Rodriguez ES, Smith JM, Perkins EA. Health Care Access for Adults With Intellectual and Developmental Disabilities: A Scoping Review. OTJR: Occupational Therapy Journal of Research. 2017;37(4):227-236. doi:10.1177/1539449217714148 2. Cook S, Hole R. Trauma, intellectual and/or developmental disability, and multiple, complex needs: A scoping review of the literature. Res Dev Disabil. 2021;115:103939. doi:10.1016/j.ridd.2021.103939 3. Bohannon RW, Crouch RH. Two-Minute Step Test of Exercise Capacity. Journal of Geriatric Physical Therapy. 2019;42(2):105-112. doi:https://doi.org/10.1519/jpt.0000000000000164 4. Thomas J, O’Neal S. Relationship of Functional Reach Test scores and falls in Special Olympics athletes. Journal of Intellectual Disability Research. 2019;63(6):587-592. doi:https://doi.org/10.1111/jir.12600 5. North Carolina Health Equity Facts. UNC Center for Health Equity Research. Accessed May 3, 2024. https://www.med.unc.edu/cher/resources-2/north-carolina-health-equity-facts/ 6. Henry E, Chandler C, Laux J, et al. Evaluating Leadership Development Competencies of Clinicians to Build Health Equity in America. Journal of Continuing Education in the Health Professions. Published online May 17, 2022:10.1097/CEH.0000000000000526. doi:https://doi.org/10.1097/CEH.0000000000000526 7. About Intellectual and Developmental Disabilities (IDDs). https://www.nichd.nih.gov/. Published November 9, 2021. https://www.nichd.nih.gov/health/topics/idds/conditioninfo 8. Environmental Protection Agency. (2022, May 11). Health -Neurodevelopmental Disorders. EPA. https://www.epa.gov/americaschildrenenvironment/health-neurodevelopmentaldisorders 9. Wold B, Mittelmark MB. Health-promotion research over three decades: The social-ecological model and challenges in implementation of interventions. Scandinavian Journal of Public Health. 2018;46(20_suppl):20-26. doi:https://doi.org/10.1177/1403494817743893 10. O’Leary L, Cooper SA, Hughes-McCormack L. Early death and causes of death of people with intellectual disabilities: A systematic review. Journal of applied research in intellectual disabilities: JARID. 2018;31(3):325-342. doi:https://doi.org/10.1111/jar.12417. 11. Schalock RL, Luckasson R, Tasse MJ. Intellectual Disability : Definition, Diagnosis, Classification, and Systems of Supports. Aaiidd; 2021. 12. CDC. Make STEADI Part of Your Medical Practice . Centers for Disease Control and Prevention. Published 2019. https://www.cdc.gov/steadi/index.html
Clinical Response to Imaging
Beyond the Bedside: Redefining Trauma-Informed Rehabilitation from Hospital to Clinic
Implementation of an Obstetric Physical Therapy Care Pathway: Inpatient and Telehealth Postpartum Rehabilitation
Join the Inclusion Revolution
11:45AM - 1:30PM - LUNCH ~ AWARDS CEREMONY
1:30PM - 3:00PM - SESSION 3
Kristel Maes, PT, DPT Kristel Maes, PT, DPT, a native from Belgium, has been practicing as a physical therapist since 1999. She has a Masters of Physical Therapy obtained at the Catholic University of Leuven in Belgium. She obtained a transitional Doctorate’s in Physical Therapy from UNC Chapel Hill in NC. Most of her clinical experience lies within the orthopedic field and her specialty is spine. She is a Diplomat in the McKenzie method. She currently serves as the Therapy Services Educator for the Rehabilitation Therapies department at UNC Health in Chapel Hill, NC where she is responsible for all items education related, be it staff, patient or student education. She oversees the administrative and accreditation responsibilities for all PT and OT post-graduate programs. She is the Director for the Women’s Health Physical Therapy Residency and the Neonatal Physical Therapy Fellowship and the Coordinator for the Orthopedic and Pediatric PT residency. She currently serves as the Secretary/Treasurer for the APTA Residency-Fellowship Education SIG and is a site reviewer for ABPTRFE. DESCRIPTION: Our profession continues to grow in a medical world that is becoming more complex. Some physical therapists will be destined to be generalists while others may choose to become specialists. This session will provide an overview of post-professional paths with a focus on clinical residency training detailing what a residency entails, the various models that are currently available to meet the needs of each student and early professional. The participants will learn about the application process and how they can strengthen their position for residency training throughout their academic and early professional career. Participants in the academic field will learn how they can support their students to ensure they achieve their post-professional goals. The presentation will also review the faculty residency training and how it can benefit academic programs. OBJECTIVES: REFERENCES: Hartley GW, Rapport MJ, Osborne R, Briggs MS, Jensen GM. Residency education: Is it now or never? Physical Therapy. 2021;101(4):pzaa225. doi: 10.1093/ptj/pzaa225 Shepard R, Haines L, Abraham K, Lievre AJ. Traits and attributes of a successful physical therapy resident: A delphi study. 2021;35(4): 315-323. doi: 10.1097/jte.0000000000000203 Briggs MS, Whitman J, Olson-Kellogg B, Farrell J, Glaws KR, Walker JM, Clutter J, Tichenor CJ. Employer perceptions of physical therapists' residency and fellowship training: Insights for career development planning. Journal of Physical Therapy Education. 2019; 33(1):40-48. Hartley G, Roach KE, Harrington KL, McNally S. Program-level factors influencing positive graduate outcomes of physical therapy residency programs. Phys Ther. 2019; 99(2):173-182. Osborne R, Jansen C, Black L, Jensen GM. Motivations to Pursue Physical Therapy Residency Training: A Q-Methodology Study of Stakeholder Perspectives. Phys Ther. 2020;23;100(1):57-72 Jensen GM, Hack LM, Nordstrom T, Gwyer J, Mostrom E. National study of excellence in physical therapist education: Part 2- A call reform. Physical Therapy. 2017;97(9):875- 888. doi: 10.1093/ptj/pzx062 Dr. Nathan Savage, PT, DPT, PhD, OCS, ECS, RMSK Assistant Professor Department of Physical Therapy Winston-Salem State University Dr. Savage began clinical practice in 2000 and is Board Certified in Orthopaedic Physical Therapy, Clinical Electrophysiology, and Diagnostic Musculoskeletal Sonography. Dr. Savage received a PhD in Rehabilitation Science from the University of Utah and a Doctor of Physical Therapy degree from the University of Kansas Medical Center and has several peer-reviewed publications including topics in orthopedic physical therapy, ultrasound imaging, electrodiagnostic testing, and curricular innovation. Dr. Savage has lived and worked in Utah, Rhode Island, Tennessee, Utah again, and now calls North Carolina home with his lovely wife Hillary and 3 wonderful children. DESCRIPTION: Contemporary orthopedic physical therapy practice is increasingly incorporating point-of-care ultrasound imaging to extend the clinical examination, including dynamic evaluation of a variety of structures in the neuromusculoskeletal system. Ultrasound imaging is commonly employed by physical therapists to assist in the differential diagnostic process, and at other times to provide real-time biofeedback or track tissue healing over time. One aspect of ultrasound imaging that has been largely underappreciated and underutilized by orthopedic physical therapists is direct tissue visualization and guidance of manual interventional approaches. This educational session will introduce attendees to the use of ultrasound imaging to guide dry needling interventions in the upper extremity, including visualization of traditional acupuncture monofilaments and a novel approach using EMG electrodes to provide mechanical and electrical stimulation. This session will feature lecture content, live demonstrations of ultrasound-guided needling interventions in the shoulder, elbow, and wrist, and discuss clinical applications including patient and examiner safety. OBJECTIVES: 1) Describe ultrasound-guided dry needling interventions, including potential clinical benefits and challenges. 2) Recognize common clinical conditions in the upper extremity that ultrasound-guided dry needling interventions are most appropriate. REFERENCES: 1) Sharif F, Ahmad A, Gilani SA. Effectiveness of ultrasound guided dry needling in management of jumper's knee: a randomized controlled trial. Sci Rep. 2023;13(1):4736. 2) Vas LC. Ultrasound guided dry needling: Relevance in chronic pain. J Postgrad Med. 2022;1:1-9. 3) Perreault T, Ball A, Dommerholt J, Theiss R, Fernández-de-Las-Peñas C, Butts R. Intramuscular Electrical Stimulation to Trigger Points: Insights into Mechanisms and Clinical Applications-A Scoping Review. J Clin Med. 2022;11(20) 4) Brennan K, Elifritz KM, Comire MM, Jupiter DC. Rate and maintenance of improvement of myofascial pain with dry needling alone vs. dry needling with intramuscular electrical stimulation: a randomized controlled trial. J Man Manip Ther. 2021;29(4):216-226. 5) Müller CE, Aranha MF, Gavião MB. Two-dimensional ultrasound and ultrasound elastography imaging of trigger points in women with myofascial pain syndrome treated by acupuncture and electroacupuncture: a double-blinded randomized controlled pilot study. Ultrason Imaging. 2015;37(2):152-67. Tyler Johnston, PT, DPT, EdD Board-Certified Clinical Specialist in Orthopaedic Physical Therapy Tylerhas been practicing PT for the past 8 years after getting his DPT from East Carolina University. He has worked exclusively in OP orthopedics and has specialized in treating individuals suffering with chronic neck and low back pain. He obtained his Orthopedic Certified Specialist certification from the APTA (2022) and graduated with his Doctorate of Education in Kinesiology from the University of North Carolina at Greensboro (2024). His dissertation focused on the relationship developed between the patient and therapist and how therapists use this therapeutic relationship in clinical practice. He is a working clinician who wants to provide education for other working clinician to help them improve their clinical practice. DESCRIPTION: Patients who build a relationship with their physical therapist are able to reach their goals and improve their quality of life when suffering from many conditions. Practice guidelines call for the use of a biopsychosocial (BPS) treatment model in physical therapy and the first step in implementing several BPS treatments is to create a therapeutic relationship (TR) between therapist and patient. The purpose of this presentation is to discuss the evidence supporting TR in clinical practice, the use and knowledge of TR in current clinical practice, and clinical barriers and solutions to these barriers in clinical practice. Attendees will be able to apply tactics to improve their use and effectiveness of TR in clinical practice to improve the quality of life of those they care for. OBJECTIVES: REFERENCES: Johnston, T. Knowledge and Use of the Therapeutic Relationship in Physical Therapy. Dissertation. University of North Carolina at Greensboro; 2024. Myers C, Thompson G, Hughey L, Young JL, Rhon DI, Rentmeester C. An exploration of clinical variables that enhance therapeutic alliance in patients seeking care for musculoskeletal pain: A mixed methods approach. Musculoskeletal Care. 2022;20(3):577-592. doi:10.1002/msc.1615 McCabe E, Miciak M, Roduta Roberts M, Sun H (Linda), Gross DP. Measuring therapeutic relationship in physiotherapy: conceptual foundations. Physiotherapy Theory and Practice. 2022;38(13):2339-2351. doi:10.1080/09593985.2021.1987604 Alotaibi F, Beneciuk J, Holmes R, Kareha S, Hayes D, Fritz J. The Relationship of the Therapeutic Alliance to Patient Characteristics and Functional Outcome During an Episode of Physical Therapy Care for Patients With Low Back Pain: An Observational Study. Phys Ther. 2021;101(4):pzab026. doi:10.1093/ptj/pzab026 Babatunde F, MacDermid J, MacIntyre N. Characteristics of therapeutic alliance in musculoskeletal physiotherapy and occupational therapy practice: a scoping review of the literature. BMC Health Serv Res. 2017;17:375. doi:10.1186/s12913-017-2311-3 Kinney M, Seider J, Beaty AF, Coughlin K, Dyal M, Clewley D. The impact of therapeutic alliance in physical therapy for chronic musculoskeletal pain: A systematic review of the literature. PHYSIOTHER THEORY PRACT. 2020;36(8):886-898. doi:10.1080/09593985.2018.1516015 Melanie R. Seeley, PT Melanie R. Seeley, PT, DPT(expected July 2024) from UNC Chapel Hill, holds an MPT (1997) from Old Dominion University. She is a proud member of the American Physical Therapy Association. As the owner of Pranamix Physical Therapy in the Greater Charlotte Area, NC, Melanie integrates techniques such as MBSR, Yoga, Pilates, and manual therapy for managing pain conditions and long-term disability. With over 2 decades of experience as a physical therapist and 20 years as a yoga and meditation instructor, Melanie creates tailored integrative PT treatment plans for her clients, prioritizing holistic wellness and optimal outcomes. DESCRIPTION: Participate in an integrative physical therapy experience on "The Application of Mindfulness-Exercises to Treat Chronic Pain." Chronic pain affects millions worldwide, posing significant challenges to both individuals and healthcare systems. Our session will delve into the efficacy of mindfulness techniques in managing chronic pain, offering compelling evidence and practical insights, and personal practice of mindfulness techniques, including CBT and MBSR. Through a blend of engaging lecture and interactive discussion, attendees will discover how mindfulness practices can empower patients to better cope with pain and improve their quality of life. OBJECTIVES: Upon completion of this educational session, participants will be able to: 1. Explain the fundamental principles of Mindfulness-Based Stress Reduction (MBSR) in the context of chronic pain management. 2. Identify specific mindfulness techniques that can be applied to alleviate chronic pain symptoms. 3. Discuss the empirical evidence supporting the effectiveness of MBSR in treating chronic pain conditions. 4. Develop a plan to integrate MBSR techniques into their current practice to enhance patient care. 5. Engage in discussions with colleagues regarding the implementation and challenges of utilizing MBSR for chronic pain management. REFERENCES: Majeed MH, Ali AA, Sudak DM. Mindfulness-based interventions for chronic pain. Evidence and applications. Asian J Psychiatr. 2018;32:79-83. Cohen SP, Vase L, Hooten WM. Chronic pain: an update on burden, best practices, and new advances. Lancet. 2021;397(10289):2082-2097. doi:10.1016/S0140-6736(21)00393 Shapner M, Kelly C, Lieberman G, et al. Unlearning chronic pain: A randomized controlled trial to investigate changes in intrinsic brain connectivity following Cognitive Behavioral Therapy. Neuroimage Clin. 2014;5:365-376. Published 2014 Jul 23. doi:10.1016/j.nicl.2014.07.008 Veehof MM, Trompetter HR, Bohlmeijer ET, Schreurs KM. Acceptance- and mindfulness-based interventions for the treatment of chronic pain: a meta-analytic review. Cogn Behav Ther. 2016;45(1):5-31. doi:10.1080/16506073.2015.1098724 Hunt CA, Letzen JE, Krimmel SR, et al. Meditation Practice, Mindfulness, and Pain-Related Outcomes in Mindfulness-Based Treatment for Episodic Migraine. Mindfulness (N Y). 2023;14(4):769-783. doi:10.1007/s12671-023-02105-8 Deegan O, Fullen BM, Hearty C, Doody CM. Acceptability of the combined online interactive mindfulness and exercise programme (MOVE-Online) for adults with chronic pain - A qualitative study. Disabil Rehabil. Published online October 27, 2023. doi:10.1080/09638288.2023.2274875 Diez GG, Anitua E, Castellanos N, Vázquez C, Galindo-Villardón P, Alkhraisat MH. The effect of mindfulness on the inflammatory, psychological and biomechanical domains of adult patients with low back pain: A randomized controlled clinical trial. PLoS One. 2022;17(11):e0276734. Published 2022 Nov 9. doi:10.1371/journal.pone.0276734
A Roadmap to Post-Professional Success: Guiding students and early professionals in the next steps in their career.
Why fly blind? Ultrasound-guided needling interventions in the upper extremity
Knowledge and Use of the Therapeutic Relationship in Physical Therapy
Enhancing Chronic Pain Treatment with Mindfulness-Based Physical Therapy Approaches
3:00PM - 3:30PM - AFTERNOON BREAK ~ VISIT WITH EXHIBITORS
3:30PM - 5:00PM - SESSION 4
Andréas Remis, PT, DPT Duke University Durham, North Carolina 27708 Dr. Andréas Remis is a physical therapist and orthopedic manual therapy fellow at Duke University (2024-25). He graduated with highest distinction from the University of Nebraska Medical Center in 2022 and received post-doctoral training via Orthopedic Residency at Mayo Clinic Florida (2022-23) and Spine Fellowship at the University of Southern California (2023-24). Residency and fellowship have given Dr. Remis extensive experience collaborating with physician colleagues, receiving over 172 hours of learning in clinic and operating room settings. Dr. Remis has presented professionally 19 times, including with orthopedic surgeons and at physical therapy conferences. Dr. Remis is passionate about matching clinical intent to the unique needs of a given patient and strives to improve the quality of life for citizens of our country by increasing the role of physical therapists as primary musculoskeletal experts within healthcare practice and education. DESCRIPTION: Low back pain is the number one worldwide cause of years lived with disability and surgery rates are increasing. However, a significant portion of patients continue to experience persistent pain post-surgery, highlighting the importance of exploring conservative approaches to lumbar spine care. This presentation aims to provide a comprehensive understanding of the lumbar continuum of care, encompassing both conservative management strategies and surgical options. How can physical therapists mitigate back pain's health and economic impact? What role do physical therapists have in optimizing recovery after back surgery? Attendees will leave with improved confidence in managing low back symptoms, including surgical indications and specific post-operative healing timelines according to surgery type. Surgeries discussed will include decompression, fusion, minimally invasive options, and disc replacement. The focus will be on specific factors that physical therapists should consider when optimizing patient management following lumbar surgery. OBJECTIVES: "Upon completion of this educational session, participants will be able to:" REFERENCES: Below is a list of some of the AMA references that will be used in the presentation: Shmagel A, Foley R, Ibrahim H. Epidemiology of Chronic Low Back Pain in US Adults: Data From the 2009-2010 National Health and Nutrition Examination Survey. Arthritis Care Res (Hoboken). 2016;68(11):1688-1694. doi:10.1002/acr.22890 Hurwitz EL, Randhawa K, Yu H, Côté P, Haldeman S. The Global Spine Care Initiative: a summary of the global burden of low back and neck pain studies. Eur Spine J. 2018;27(Suppl 6):796-801. doi:10.1007/s00586-017-5432-9 Kinkade S. Evaluation and treatment of acute low back pain. Am Fam Physician. 2007;75(8):1181-1188. Wu Q, Cui X, Guan LC, et al. Chronic pain after spine surgery: Insights into pathogenesis, new treatment, and preventive therapy. J Orthop Translat. 2023;42:147-159. Published 2023 Sep 30. doi:10.1016/j.jot.2023.07.003 Hon S, Ritter R, Allen DD. Cost-Effectiveness and Outcomes of Direct Access to Physical Therapy for Musculoskeletal Disorders Compared to Physician-First Access in the United States: Systematic Review and Meta-Analysis. Phys Ther. 2021;101(1):pzaa201. doi:10.1093/ptj/pzaa201 Sabnis AB, Diwan AD. The timing of surgery in lumbar disc prolapse: A systematic review. Indian J Orthop. 2014;48(2):127-135. doi:10.4103/0019-5413.128740 Kalevski SK, Peev NA, Haritonov DG. Incidental Dural Tears in lumbar decompressive surgery: Incidence, causes, treatment, results. Asian J Neurosurg. 2010;5(1):54-59. Dowdell J, Brochin R, Kim J, et al. Postoperative Spine Infection: Diagnosis and Management. Global Spine J. 2018;8(4 Suppl):37S-43S. doi:10.1177/2192568217745512 Huang P, Sengupta DK. How fast pain, numbness, and paresthesia resolves after lumbar nerve root decompression: a retrospective study of patient's self-reported computerized pain drawing. Spine (Phila Pa 1976). 2014;39(8):E529-E536. doi:10.1097/BRS.0000000000000240 Akuthota V, Marshall B, Boimbo S, et al. Clinical Course of Motor Deficits from Lumbosacral Radiculopathy Due to Disk Herniation. PM R. 2019;11(8):807-814. doi:10.1002/pmrj.12082 Braxton E Jr, Wohlfeld BJ, Blumenthal S, et al. Postoperative Care Pathways Following Lumbar Total Disc Replacement: Results of a Modified Delphi Approach. Spine (Phila Pa 1976). 2019;44 Suppl 24:S1-S12. doi:10.1097/BRS.0000000000003276 Madera M, Brady J, Deily S, et al. The role of physical therapy and rehabilitation after lumbar fusion surgery for degenerative disease: a systematic review. J Neurosurg Spine. 2017;26(6):694-704. doi:10.3171/2016.10.SPINE16627 Rohlmann A, Schwachmeyer V, Graichen F, Bergmann G. Spinal loads during post-operative physiotherapeutic exercises. PLoS One. 2014;9(7):e102005. Published 2014 Jul 7. doi:10.1371/journal.pone.0102005 Manni T, Ferri N, Vanti C, et al. Rehabilitation after lumbar spine surgery in adults: a systematic review with meta-analysis. Arch Physiother. 2023;13(1):21. Published 2023 Oct 16. doi:10.1186/s40945-023-00175-4 Oosterhuis T, Costa LO, Maher CG, de Vet HC, van Tulder MW, Ostelo RW. Rehabilitation after lumbar disc surgery. Cochrane Database Syst Rev. 2014;2014(3):CD003007. Published 2014 Mar 14. doi:10.1002/14651858.CD003007.pub3 McGregor AH, Probyn K, Cro S, et al. Rehabilitation following surgery for lumbar spinal stenosis. Cochrane Database Syst Rev. 2013;(12):CD009644. Published 2013 Dec 9. doi:10.1002/14651858.CD009644.pub2 Heard JC, D'Antonio ND, Lambrechts MJ, et al. Does physical therapy impact clinical outcomes after lumbar decompression surgery?. J Craniovertebr Junction Spine. 2023;14(3):230-235. doi:10.4103/jcvjs.jcvjs_61_23 Afzal K, Khattak HG, Sajjad AG, et al. Impact of Active Physiotherapy Rehabilitation on Pain and Global and Functional Improvement 1-2 Months after Lumbar Disk Surgery: A Systematic Review and Meta-Analysis. Healthcare (Basel). 2022;10(10):1943. Published 2022 Oct 5. doi:10.3390/healthcare10101943 Wendy Viviers, PT, DPT, MPhil. Board-certified Geriatric Clinical Specialist. South African Sports Clinical Specialist. Wendy Viviers, PT, DPT, MPhil hails from South Africa where she earned a Sports Physiotherapy Specialization degree from the University of Cape Town and ran a successful multidisciplinary clinic focused on the management of Masters athletes on a local and international level for several years. In the U.S., she is a board-certified Geriatric Clinical Specialist, clinician, and Core Faculty member in the Doctor of Physical Therapy program at South College, Atlanta. As a PhD in Exercise Science Candidate and a national Co-Coordinator of the Sustained Athlete Fitness Exam (SAFE), Dr. Viviers is actively engaged in research that aims to quantify the parameters of successful aging using competitive Masters athletes as the blue-print. She has lectured extensively on maximizing athletic performance and decreasing injury risk in Masters athletes of all sporting levels and is passionate about promoting Sport as an age elixir. DESCRIPTION: More women than ever across the lifespan are participating in competitive sport worldwide, with the Olympic Games Paris 2024 predicted to be the first in history to reach full gender equality. Despite this, there is an endemic lack of understanding by healthcare professionals of the unique management needs of female Masters athletes, particularly in relation to athletic performance and injury risk during the menopause continuum. This presentation will demystify the female Masters athlete, with emphasis on identification and evidence-based management of physiological and musculoskeletal sequelae of declining estrogen. Attendees will gain essential knowledge on hormone replacement therapy, how to maximize the post-prandial anabolic response to resistance training, how to attenuate age-related changes in running gait mechanics known to accelerate during the menopause continuum, and how to prescribe effective exercise interventions in this historically neglected demographic of sportswomen aged 35-65 deserving of tailored physical therapy care. OBJECTIVES: Upon completion of this educational session, participants will be able to: 1. Identify the physiological and musculoskeletal changes related to declining estrogen and their potential sequelae impacting athletic performance, injury risk, and running mechanics in female Masters athletes during the menopause continuum. 2. Utilize best evidence to address relative risks of hormone replacement therapy and nutrition and exercise strategies to support muscle anabolism in female Masters athletes during the menopause continuum. 3. Develop exercise interventions to counter changes in muscular fitness, athletic performance, injury risk, and gait mechanics related to declining estrogen in female Masters athletes during the menopause continuum. REFERENCES: 1. Carter E, Bruinvels G, Timmins K, Pedlar C, Martin D. Menopausal symptoms, exercise practices, and advice received in active women: a multi-country survey of Strava app users. Women Health. 2024;64(1):23-31. https://doi.10.1080/03630242.2023.2284730. 2. Simpson SJ, Raubenheimer D, Black KI, Conigrave AC. Weight gain during the menopause transition: evidence for a mechanism dependent on protein leverage. BJOG. 2023;130:4-10. https://doi.10.1111/1471-0528.17290. 3. Huebner M, Ma W. It’s a balancing act! Menopausal symptoms in competitive weightlifters. Exerc Sport Mov. 2023;1(3):e00012. http://dx.doi.org/10.1249/ESM.0000000000000012. 4. Tøien T, Unhjem R, Berg OK, Aagaard P, Wang E. Strength versus endurance trained master athletes: Contrasting neurophysiological adaptations. Experiment Gerontol. 2023;171:112038. https://doi.10.1016/j.exger.2022.112038. 5. Loudon J, Parkerson-Mitchell A. Training habits and injury rate in Masters female runners. Int J Sport Phys Ther. 2022;17(3):501-507. https://doi.org/10.26603/001c.32374. 6. Moore DR. Protein requirements for master athletes: just older versions of their younger selves. Sports Med. 2021;51(1):S13-S30. https://doi.org/10.1007/s40279-021-01510-0. 7. Elam C, Aagaard P, Slinde F, et al. The effects of ageing on functional capacity and stretch-shortening cycle muscle power. J Phys Ther Sci. 2021;33:250-260. https://doi.10.1589/jpts.33.250. 8. Lu C, Liu P, Zhou Y, et al. Musculoskeletal pain during the menopausal transition: a systematic review and meta-analysis. Neural Plast. 2020;25:8842110. https://doi.10.1155/2020/8842110. 9. Dupuit M, Maillard F, Pereira B, et al. Effect of high intensity interval training on body composition in women before and after menopause: a meta-analysis. Experiment Physiol. 2020;105:1470-1490. https://do.10.1113/EP088654. 10. Chidi-Ogbolu N, Baar K. Effect of estrogen on musculoskeletal performance and injury risk. Front Physiol. 2019;9:1834. https://doi.10.3389/fphys.2018.01834. 11. Browne MG, Franz JR. More push from your push-off: Joint-level modifications to modulate propulsive forces in old age. PLoS ONE. 2018;13(8):1-14. https://doi.10.1371/journal.pone.0201407. 12. Bondarev D, Laakkonen EK, Finni T, et al. Physical performance in relation to menopause status and physical activity. Menopause. 2018;25(12):1432-1441. https://doi.10.1097/GME.0000000000001137. Diandrea McCotter, PT, DPT Diandrea McCotterserves as the Inpatient Director of Rehabilitation Services for Duke Health System, where she has devoted 13 years to enhancing patient-centered care, quality improvement, and teamwork. Beyond her clinical leadership, Dr. McCotter has championed efforts to make the department's hiring processes more inclusive. In 2020, in response to the murder of George Floyd, she collaborated with colleagues to establish the rehab department’s DEI committee. She has been instrumental in planning grand round topics addressing issues such as microaggressions and served on the DEI committee's core and practice subcommittees. Additionally, she has served on several panels about healthcare disparities and cultural determinants of health. Her commitment to diversity, equity, and inclusion continues to foster positive change within the department and the broader healthcare community Lori Roskin, PT Lori Roskinis a Physical Therapist (PT) with over 30 years of clinical experience within the Duke University Health System. She is a Certified Orthopedic Manual Therapist who also has also served as a clinic supervisor for 29 years serving MSK adult and geriatric patients leading a team of PT eadership roles within the department include being Chair of the Clinical Ladder Committee and part of the DEI committee. Lori had an instrumental role in blending merit advancement within departmental clinical ladder with DEI requirements in 2022 for Senior Level clinicians. Lori is dedicated to awareness and education that support the mission of DEI with the department and Duke community Stephanie Palacios, PT, DPT, Board-Certified Clinical Specialist in Orthopedic and Neurologic Therapy Stephanie Palacios, PT, DPT is a Physical Therapist in Durham, NC. Stephanie earned her Doctor of Physical Therapy degree from University of Maryland School of Medicine in 2018. She has outpatient and inpatient clinical experience with treating both orthopedic and neurologic conditions through Medstar National Rehabilitation Hospital and Duke University Health System. She is also a co-coordinator for the Orthopedic Physical Therapy Residency program through Duke Health's Department of Physical Therapy & Occupational Therapy. Stephanie has additional teaching experience as an adjunct faculty for University of Maryland Baltimore, Duke University, and Campbell University's Doctor of Physical Therapy programs. Stephanie’s professional interests include integrative physical therapy practice, education and advocacy. Vrunda Kapadia, PT, DPT, MS, Board-Certified Clinical Specialist in Orthopedic and Geriatric Physical Therapy Vrunda Kapadia, PT, DPT, MS, Board-Certified Clinical Specialist in Orthopedic and Geriatric Physical Therapy working as a clinician at the Duke University Hospital and is also an instructor at the Duke Doctor of Physical Therapy Program. In addition to being a clinician and an instructor, Vrunda is actively involved with the APTA as a Delegate for North Carolina, and a founding member of the Multicultural PT Catalyst group of the Academy of Leadership and Innovation. She has presented at various state and national-level presentations on the topics of Leadership and diversity, equity and inclusion for global physiotherapists. Rosie Canizares, PT, DPT, Board-Certified Clinical Specialist in Orthopedic and Sports Physical Therapy Rosie Canizares is the current APTA North Carolina Director of Communications and a Board-Certified Orthopaedic and Sports Clinical Specialist who sees patients at Duke Student Health. As the Coordinator of Alumni Engagement at Duke DPT, she has served on the Diversity Task Force, Diversity & Inclusion Committee, and the Taskforce on Racial Inequality. A medical instructor in the Duke University School of Medicine, she was the Co-Leader of the Faculty Training Subcommittee on the Health Professions Anti-Racism Taskforce, and she recently became an associate director of the Master of Biomedical Sciences program whose mission is to prepare an inclusive group of learners for careers in science, healthcare, and related interdisciplinary professions through respectful team-based learning and professional development. She has been a member of the Duke Rehabilitation Services Department DEI Core Committee since its inception in 2020, and she has annually helped plan and execute the Duke DPT Summer Discovery Program for students interested in the PT profession, especially those from demographic communities that are currently underrepresented among licensed physical therapists. DESCRIPTION: The need for intentional diversity, equity, and inclusion of knowledge and practices throughout the workplace has been illuminated by many national and world events since the onset of COVID. This session will demonstrate the efficacy of a health system’s rehabilitation services department DEI committee in effecting cultural change within the department thus improving patient care and the profession of physical therapy. Through lecture and discussion, initiatives regarding education, recruitment, hiring, and promotions processes will be detailed, including the challenges that have arisen along the way. OBJECTIVES: REFERENCES: Chang, Edward H., et al. “The Mixed Effects of Online Diversity Training.” Proceedings of the National Academy of Sciences, vol. 116, no. 16, 2019, pp. 7778–7783., doi:10.1073/pnas.1816076116. Daphne D. Dodson, PhD, et al. “Listening to Coworkers: A Health System Assessment to Understand and Address Workplace Structural Inequities.” NEJM Catalyst Innovations in Care Delivery, catalyst.nejm.org/doi/full/10.1056/CAT.20.0589. Kong, Dejun Tony, and Phillip M. Jolly. “A Stress Model of Psychological Contract Violation among Ethnic Minority Employees.” Cultural Diversity and Ethnic Minority Psychology, vol. 25, no. 3, 2019, pp. 424–438., doi:10.1037/cdp0000235. Livingston, Robert W.“How to Promote Racial Equity in the Workplace.” Harvard Business Review, 10 Nov. 2020, hbr.org/2020/09/how-to-promote-racial-equity-in-the-workplace. Perdomo, Joanna, et al. “Health Equity Rounds: An Interdisciplinary Case Conference to Address Implicit Bias and Structural Racism for Faculty and Trainees.” MedEdPORTAL, vol. 15, no. 1, 2019, p. 10858., doi:10.15766/mep_2374-8265.10858. Torres, M., Salles, A. and Cochran, A., 2019. Recognizing and Reacting to Microaggressions in Medicine and Surgery. JAMA Surgery, 154(9), p.868. Webster, Jennica R., et al. “Workplace Contextual Supports for LGBT Employees: A Review, Meta-Analysis, and Agenda for Future Research.” Human Resource Management, vol. 57, no. 1, 2017, pp. 193–210., doi:10.1002/hrm.21873.
Strategies for Success in Lumbar Spine Care: Building Physical Therapists' Confidence in Pain Management and Surgical Rehabilitation
Is it HOT in here? Menopause and Sport
United We Work: Building a Stronger Community through Intentional DEI Efforts
