Con Ed

Evidence-based Use of Electrical Stimulation
Course Instructor:  Dawn T. Gulick, PhD, PT, AT, CSCS
Course Description:
Concepts & treatments administered by physical & occupational therapists in the clinical setting are presented.
Course Objectives:

1. Identify information & resources necessary to address a clinical problem & demonstrate effective clinical problem solving skills.
2. Participate in the critical analysis of current research & professional literature.
3. Identify the physiologic effects of applied physical agents on the human body.
4. Describe the indications & contraindications for the use of applied physical agents.
5. Select appropriate physical agents & demonstrate safe & competent use in the administration of physical therapy treatments.
6. Describe the rationale for the choice & use of specific agents in the treatment of certain conditions.
7. Propose appropriate dosage, duration, intensity, area to be treated, & result desired for various physical agents.
8. Integrate the use of physical agents as one component of a treatment plan.
9. Evaluate the agent’s effectiveness & the patient’s physiological response during treatment with various physical agents.
10. Understand & appreciate the delegation of duties regarding application of thermal agents to supportive personnel in a clinical setting.
11. Compare & contrast physical agents in regard to physiological effects & physical alterations obtained.
12. Discriminate between usages of similar physical agents for a given situation.
13. Evaluate the rationale for electrotherapeutic procedures.
14. Demonstrate competence in the application of electrotherapeutic interventions.
15. Evaluate and implement electrotherapeutic protocols to the case studies presented in the laboratory.
16. Demonstrate appropriate problem solving techniques as related to the use of electrotherapeutic interventions and adapt the intervention to meet the needs of the patient.

  Course Content:

	Contact Time	Content
0:00 – 2:00		Module #1 Electrophysiology- Introduction, waveforms, instrumentation, safety
2:00 – 4:00		Module #2 Muscle re-education (motor points) – FES, PENS, cases Edema management – AC (muscle pumping) & DC (polar fluid shift), cases Wound healing – HVGS, cases
4:00 – 6:00		Module #3 Pain management – TENS, Interferential, microcurrent, cases Iontophoresis – phoresor & hybresis, cases

An Eclectic Approach to Drug-free Musculoskeletal Pain Management
Course instructor:  Dawn T. Gulick, PhD, PT, AT, CSCS
Course description
A laboratory course geared towards using current evidence to select from a plethora of options to manage musculoskeletal pain.

• This course will discuss the evidence behind a variety of modalities and techniques for drug-free musculoskeletal pain management. Instruction is the techniques will empower the clinician to apply the knowledge in lab settings to a variety of cases.  Modalities include ultrasound, electrical stimulation, and iontophoresis.  Manual skills include instrument-assisted techniques, manual techniques, and myofascial decompression.
• The key feature is the hands-on, clinical application of the techniques to a variety of cases. Clinical problem-solving and effective documentation are valuable skills. As a clinician, the skills in this course will have immediate application to your clinical practice.

  Course Objectives

• Participate in the critical analysis of current research & professional literature on pain management.
• Identify at least 1 physiologic effects of each intervention in the course, i.e. electrical stimulation, ultrasound, instrument assisted techniques, manual techniques.
• Describe at least 1 indication & 1 contraindication for each intervention.
• Describe the rationale for the choice & use of specific treatment parameters for at least 2 interventions in the course
• Successfully complete the application of 1 case using an intervention presented in this course

  Course Content

Contact Time	Content
0:00 – 0:45	Introduction activity Pain & electrotherapeutic overview
0:45 – 3:15	Electrotherapy pain management – local (MTrP) & regional TENS, Interferential, Nerve Block, Iontophoresis, & Cases
3:150 – 4:30	Ultrasound & Phonophoresis
4:30 – 7:30	Manual techniques – massage, instrument-assisted, myofascial trigger point release & decompression
7:30 – 8:00	Documentation & Post-test

 

Evidence-based Hip Examination Tests
Course Instructor:  Dawn T Gulick, PhD, PT, AT, CSCS
Course Description:
To provide an evidence-based approach to examination techniques used to evaluate the hip.
There are over 50 special tests for the hip.  There are four tests for visceral structures, six for the labrum, and three for impingement.  How does the clinician decide which tests to perform?  Does the data support the use of some tests over others?  What tests are better as screening tools and what tests are strong diagnostic tools?   Do various clusters of tests yield more reliable results?   All of these questions will be answered in a one-hour presentation packed with data to help the clinician prioritize and evaluate the use of various testing procedures.
Course Content:

Contact Time	Content
0:00 – 0:15	Introduction & statistical review
0:15 – 2:00	Medical screening of hip & fracture screening Labral & impingement tests
2:00 – 3:00	Flexibility & soft tissue assessment of the hip Review; Questions

 

Evidence-based Use of Therapeutic Ultrasound
Course instructor:  Dawn T. Gulick, PhD, PT, AT, CSCS
Course Description:
Concepts & treatments administered by physical & occupational therapists in the clinical setting are presented.
Course Objectives:

1. Identify information & resources necessary to address a clinical problem & demonstrate effective clinical problem solving skills.
2. Participate in the critical analysis of current research & professional literature.
3. Identify the physiologic effects of applied physical agents on the human body.
4. Describe the indications & contraindications for the use of applied physical agents.
5. Select appropriate physical agents & demonstrate safe & competent use in the administration of physical therapy treatments.
6. Describe the rationale for the choice & use of specific agents in the treatment of certain conditions.
7. Propose appropriate dosage, duration, intensity, area to be treated, & result desired for various physical agents.
8. Integrate the use of physical agents as one component of a treatment plan.
9. Evaluate the agent’s effectiveness & the patient’s physiological response during treatment with various physical agents.
10. Understand & appreciate the delegation of duties regarding application of thermal agents to supportive personnel in a clinical setting.
11. Compare & contrast physical agents in regard to physiological effects & physical alterations obtained.
12. Discriminate between usages of similar physical agents for a given situation.
13. Demonstrate competence in the application of electrotherapeutic interventions.
14. Evaluate and implement electrotherapeutic protocols to the case studies presented in the laboratory.
15. Demonstrate appropriate problem solving techniques as related to the use of electrotherapeutic interventions and adapt the intervention to meet the needs of the patient.

  Course Content:

Contact Time	Content
0:00 – 0:10	Introduction
0:10 – 2:15	Ultrasound – thermal & mechanical effects
2:15 – 3:15	Phonophoresis
3:15 – 3:30	Cases, review/recap

 

Advanced Therapeutic Modalities
Course instructor:  Dawn T. Gulick, PhD, PT, AT, CSCS
Course Description:
This is an evidence-based course in which the physiologic concepts of therapeutic modalities will be discussed.  The course includes thermal & electrotherapeutic modalities.  Clinical cases will be used to provide examples of problem-solving & critical thinking. 8 contact hours – lecture & laboratory
Course Objectives:

1. Identify information & resources necessary to address a clinical problem & demonstrate effective clinical problem solving skills.
2. Participate in the critical analysis of current research & professional literature.
3. Discuss the physiologic effects of applied physical agents on the human body.
4. Describe the indications & contraindications for the use of applied physical agents.
5. Select appropriate physical agents & demonstrate safe & competent use in the administration of treatments.
6. Describe the rationale for the choice & use of specific agents in the treatment of certain conditions.
7. Propose appropriate dosage, duration, intensity, area to be treated, & result desired for various physical agents.
8. Integrate the use of physical agents as one component of a treatment plan.
9. Evaluate the agent’s effectiveness & the patient’s physiological response during treatment with various physical agents.
10. Compare & contrast physical agents in regard to physiological effects & physical alterations obtained.
11. Discriminate between usages of similar physical agents for a given situation.
12. Evaluate the rationale for electrotherapeutic procedures.
13. Recognize contraindications and demonstrate awareness of safety techniques in electrotherapeutic interventions.

  Course Content:

Contact Time		Content
0:00 – 0:15		Introduction
0:15 – 2:15		Ultrasound & Phonophoresis & Cases
2:15 – 3:00		Electrophysiology- parameters
3:00 – 4:00		Muscle re-education (motor points) – FES, PENS
4:00 – 4:30		Edema management – AC (muscle pumping) & DC (polar fluid shift)
4:30 – 5:00		Wound healing – HVGS
5:00 – 6:00		Pain management – TENS, Interferential, microcurrent
6:00 – 7:00		Iontophoresis – phoresor & hybresis
7:00 – 8:00		Cases, review, recap, questions
			1.00 hours

 

Evidence-based Interventions for Myofascial Trigger Points
Course instructor:  Dawn T. Gulick, PhD, PT, ATC, CSCS
  Course Description:

• The explain the historical and current rationale for the development and therapeutic interventions of myofascial trigger points (MTrP). We will discuss the referral patterns of MTrP and the various treatment techniques and their effectiveness.  Current evidence will be sited throughout.

Course Objectives:

• Identify and understand the diagnostic and unique characteristics of a myofascial trigger point
• Understand the referral pattern of a myofascial trigger point in a variety of muscles
• Compare and contrast historical and current approaches to treating a myofascial trigger point
• Apply the evidence to determine appropriate intervention techniques to manage myofascial trigger points.

  Course Content:

Contact Time	Content
0:00 – 0:10	Introduction
0:10 – 0:20	Pathophysiology of a myofascial trigger point
0:20 – 0:40	Myofascial referral patterns
0:40 – 1:50	Evidence-based interventions
1:50 – 2:00	Case examples, questions, comments, & discussion

   

Lower Extremity Examination Tests
Course Instructor:  Dawn T. Gulick, PhD, PT, ATC, CSCS
  Course Description:

• This is an evidence-based approach to examination techniques used to evaluate the upper extremity.
• Sensitivity, specificity, likelihood ratios, and clustering of tests will be presented to help the clinician prioritize and evaluate the use of various testing procedures

  Course Objectives:

• Understand the importance of medical screening for visceral pathology that may be beyond the scope of practice, i.e. referral patterns and special tests for visceral pathology
• Integrate critical analysis of current research and professional literature in the selection of special tests for diagnosis of upper extremity pathology.
• Understand the statistical rationale for clinical decision making, i.e. sensitivity, specificity, positive and negative likelihood ratios of special tests to determine the most value tests to make a diagnosis and those that are better suited for ruling out a diagnosis (screening).
• Describe the clustering of tests to enhance the likelihood of an accurate diagnosis
• Discriminate between use of tests for screening vs. tests to incriminate a specific tissue, particularly in the cases where special tests may incriminate several different tissues.
• Integrate the use toolbox questionnaires to quantifying a client’s level of pain and function.

  Course Content:

Contact Time	Content
0:00 – 0:15	Introduction
0:15 – 0:45	Statistical importance in clinical practice
0:45 – 1:20	Hip – medical screening, toolbox tests, special tests
1:20 – 2:00	Knee- toolbox tests, special tests
2:00 – 2:30	Ankle and foot – toolbox tests, agility, special tests
2:30 – 3:00	Recap and exam

 

Prevention, Examination, & Intervention of Knee Injuries
Course Instructor:  Dawn T Gulick, PhD, PT, AT, CSCS
 Course Description:
This course begins with a brief overview of the anatomy, biomechanics, and surface palpation of the knee.  Medical screening, examination, evaluation, diagnosis, and prognosis of knee injuries are explored in detail.  The intervention component includes the theory and practical application of therapeutic exercises for the lower extremity based on pathology of the various knee structures.  The principles of joint mobilization, range of motion, stretching, aquatics, and progressive resistance activities are based on the most recent evidence available.  In addition, all of the orthopedic special tests and joint mobilization techniques are explored in a laboratory setting.
Course Objectives:

1. Identify anatomy and biomechanical principles of the knee.
2. Describe the techniques used to successfully perform surface palpation of the structures of the knee.
3. Identify the etiology and underlying pathological processes for specific musculoskeletal conditions of the knee.
4. Describe mechanisms of injury and processes of repair in the tissues of the knee.
5. Identify signs and symptoms of the lower extremity that are beyond the scope of physical therapy practice.
6. Demonstrate the ability to perform and interpret the results of orthopedic special tests for the knee.
7. Describe and demonstrate the physical therapy examination, evaluation, diagnosis, and prognosis appropriate for clients with musculoskeletal involvement.
8. Demonstrate appropriate joint mobilization techniques of the knee to facilitate normal arthrokinematic motion.
9. Describe physical therapy treatments appropriate for limited function of the musculoskeletal system.
10. Describe functional testing and criteria to return to athletic participation or work.

  Course Outline:

Contact Time	Content
0:00 – 1:00	Introduction Anatomy, Biomechanics & Surface Palpation
1:00 – 2:00	Preventing knee injuries a.     Screening for potential injuries b.     Santa Monica PEP program c.     Prophylactic bracing
2:00 – 5:15	Examination – Physical Therapist toolbox a.     Injured – Gathering data i.     Mechanism of injury ii.     Client interview & toolbox tests iii.     Medical screening for systemic pathology iv.     Special tests with statistical support v.     Clustering of signs & symptoms vi.     Isokinetics & functional testing
5:15 – 8:00	Interventions b.     Modalities c.     Mobilization techniques d.     Therapeutic exercise progression i.     Passive to Resistive ii.     Open & closed kinetic chain iii.     Aquatics e.     Diagnostic algorithms & specific interventions by structure f.      Return to play criteria
	Conclusions & Questions

 

Upper Extremity Examination Tests
Course instructor:  Dawn T. Gulick, PhD, PT, AT, CSCS
Course Description:

• This is an evidence-based approach to examination techniques used to evaluate the upper extremity.
• Sensitivity, specificity, likelihood ratios, and clustering of tests will be presented to help the clinician prioritize and evaluate the use of various testing procedures

Course Objectives:

• Understand the importance of medical screening for visceral pathology that may be beyond the scope of practice, i.e. referral patterns and special tests for visceral pathology
• Integrate critical analysis of current research and professional literature in the selection of special tests for diagnosis of upper extremity pathology.
• Understand the statistical rationale for clinical decision making, i.e. sensitivity, specificity, positive and negative likelihood ratios of special tests to determine the most value tests to make a diagnosis and those that are better suited for ruling out a diagnosis (screening).
• Describe the clustering of tests to enhance the likelihood of an accurate diagnosis
• Discriminate between use of tests for screening vs. tests to incriminate a specific tissue, particularly in the cases where special tests may incriminate several different tissues.
• Integrate the use toolbox questionnaires to quantifying a client’s level of pain and function.

  Course Content:

Contact Time	Content
0:00 – 0:20	Introduction & statistical review
0:20 – 1:45	Shoulder tests
1:45 – 2:00	Elbow tests
2:00 – 2:30	Wrist and hand tests
2:30 – 3:00	Recap and exam