Full Course Description
Module 1: Stroke Rehabilitation Master Class: Identifying and Assessing Stroke Impairments
Working with stroke patients is deeply meaningful and incredibly rewarding.
And you strive to help each patient who’s counting on you to facilitate improvements that will change their lives. But some patients are so impaired that treatment becomes overwhelming.
Others make exceptional gains in clinical settings, only to hit a wall in less controlled environments.
As time passes without results, even the most promising patient can feel the sun setting on the person she used to be, growing disengaged and depressed -- convinced she can’t progress further with therapy.
If you’re not up to speed on the latest treatment strategies, she might be right.
Built on today’s best practices, this program will show how to apply effective techniques that completely redefine what’s possible for your patients!
Discover tools and strategies that have helped countless survivors leave their limitations behind, even 10 years post stroke.
Leave this one-of-a-kind training knowing that when your next patient tells you how she hopes to return to work or stay active with her grandkids, you’ll be able to confidently guide her toward rapid functional improvements with the best methods available in neurological rehab!
- Discuss the latest advances in stroke recovery and their implications for therapy.
- Review strategies for identifying the root causes of post-stroke impairments faster.
- Integrate effective interventions that can be used immediately to improve function, multitasking, balance, gait, strength, flexibility and mobility.
- Combine multiple interventions more effectively for better results, including dual task interventions, NDT, constraint induced movement therapy, balance and gait training, exercise, and functional activities.
- Design effective, innovative plans of care for a wide range of neurological impairments.
- Apply the assessments and interventions discussed in this seminar to a series of interactive case scenarios.
Hot Topics and Innovations in Stroke Rehabilitation
Upgrade Your Assessment and Clinical Reasoning Skills
- How your patients can benefit from cutting edge research
Revolutionize Your Rehab Toolbox
- Today’s best evaluations for:
- Sensory and coordination
- Visual changes
- Synergies and motor recovery
- Weakness and reflexes
- Muscle tone and flaccidity
- Perception and cognition
- Postural control
- Gait, balance and coordination
- Hands-on Lab
Combine Techniques More effectively for Better Outcomes
- Effective techniques you can use immediately to:
- Ignite neuroplasticity for breakthrough results
- Restore functional strength more quickly
- Enhance function and multi-tasking ability
- Reduce spasticity
- Restore limb use
- Resolve impairments from a more functional, person-centered perspective
- Improve transfers with less strain
- Prevent falls with effective gait training
- Improve strength, balance and coordination
- Design a more effective home program
- Intensify therapy safely and effectively
- Re-engage difficult or depressed patients
- Hand-on Lab
Design Advanced, Innovative Plans of Care for Your Patients
- Practice integrating:
- Constraint-induced movement therapy
- Task-specific training
- Dual task interventions
- Neuro-developmental Treatment (NDT)
- Neuro-handling techniques
- Balance and gait training
- Postural control
- PNF (proprioceptive neuromuscular facilitation)
- Functional activities
- Therapeutic exercise
- Technological advances
- Neuroplasticity-building interventions
- Hands-on Lab
Case Studies: Put Knowledge to Practice
- Comprehensive treatment strategies for specific impairments, including:
- Pusher syndrome
- Gait and mobility
- Decreased sensation
- Reduced flexibility
- Muscular weakness
- Hand-on Lab
Don’t Leave the Money on the Table!
- Case study 1: Correctly select the root cause of impairment
- Case study 2: Apply advanced gait training and multitasking techniques
- Case study 3: Re-engage a difficult or depressed patient
- Case study 4: Overcome barriers to effective strategy implementation
- Case study 5: Adjust your plan of care for technological advances
- Coding and billing updates
- Justify therapy with the right progress measures
- Avoid denials and audits with these tips
Module 1: Stroke Rehab for Patients who “Push”: Positively Identifying "Pusher" Patients
Pushing behavior presents serious challenges during stroke rehabilitation. Patients who push are often low level, need a lot of assistance, have considerable safety concerns, and do not respond to typical treatment interventions. This recording will show you how to address the root causes of pusher syndrome.
This lab-intensive, recording will show you how to address the root causes of pusher syndrome with evidence-based treatment activities and progressions. Learn how to assess and address the limiting impairments of pusher patients, utilizing the ICF model and principles of neuroplasticity to select the right intervention at the right time, and to maximize treatment outcomes.
Additionally, appropriate assessment tools and functional performance tests will be practiced in order to apply treatment ideas in any environment. You will come away with techniques applicable to other patients who present with similar impairments such as difficulty with midline, retropulsion, trunk malalignments, postural control deficits, and gait dysfunction, making this course a great investment! This dynamic course will take your treatments to the next level!
- Discuss current literature regarding suggested pathology of “pusher syndrome”
- Recognize and list common characteristics and functional presentation of a patient who “pushes”
- Develop a skill set for understanding normal movement as well as executing task analysis for assessments of impairments limitations
- Discuss the criteria critical in categorizing the “pusher” patient as a low, mid, or high-level “pusher”
- Identify appropriate treatment interventions for the low, mid, and high-level “pusher” patient to specifically improve noted activity limitations
- Practice supporting and positioning techniques that enhance safely for the clinician and patient
- Strategize progressions of interventions to reduce impairments and lessen activity limitations to maximize participation for each patient with “pusher syndrome”
ICF MODEL AND ROLE IN ASSESSMENT AND TREATMENT
- ICF Models guide to clinical reasoning
- Levels of ICF definitions and examples
- Correlation with assessment, prognosis and treatment planning
PATHOPHYSIOLOGY OF “PUSHING”
- Role of vestibular system
- Localization of lesions correlating with “pushing”
- Thalamic lesions and “pushing”
- Role of graviceptive systems
- Best support for occurrence of “pushing”
COMMON CHARACTERISTICS OF “PUSHERS”
- Alignment faults (trunk, head, pelvis, femur)
- Movement dysfunction
- Midline deficits
- Other (sensory loss, visual, neglect, cognition)
- Tests to confirm presence of “Pushing”
- Outcome measures
- Role of upper and lower trunk assessment
TASK-ANALYSIS, HYPOTHESIS DRIVE APPROACH
- Why use this framework for clinical reasoning
- What is the framework
- How it guides tasks assessment and guides treatment choices
- How to execute a task analysis
- Neuroplasticity and directing treatment
- Motor control and motor learning theories on set-up and progression
TREATMENT SET-UP FOR SUCCESS (REDUCE RISK, IMPROVE SAFETY, IMPROVE OUTCOMES)
- Choosing a position for treatment
- Align patient for best results
- Activate muscles in coordinated sequenced fashion to mimic functional demands
- Rehabilitation of function
- Compensation or Recovery?
TREATMENT FOR THE LOW, MID AND HIGH-LEVEL “PUSHER”
- Primary characteristic for each level
- Starting point and progression
- Functional re-education considerations
- Use of objects, adjunct, and equipment in treatment
Module 1: Addressing Patient Behavior by Brain Lesion Site: Neurophysiology and Cognitive Impact on Your Treatment
Neuroanatomy is admittedly complex and overwhelming. Clinicians working in rehabilitation are faced with growing caseloads, diminished resources/reimbursement, and increasingly medically complex patients with the expectation of improving outcomes and reducing length of stay. Honing knowledge of clinically-relevant neuroanatomy and neuropathology can predict dysfunction and intuitively create a scaffold for assessment and treatment even before meeting the patient.
Predetermining potential deficits leads to a more tightly defined diagnostic battery and expedites treatment formulation. By deducing the patient’s experience, the clinician can also prepare for behavioral barriers to engagement and understand the healing process with greater compassion.
In this recording, participants will learn intermediate-level neurophysiology as it relates to cognitive-linguistic skills and behavioral control, as well as explore mindfulness techniques for stress reduction. The overlying foci of the course are to arm treating professionals with an improved clinical eye, predicting dysfunction, and expedite the pathway to treatment. Course content will also include patient-focused educational materials for stroke and traumatic brain injury ready to utilize by treating practitioners.
- Categorize the anatomy and function of lobes of the brain as they apply to behavioral control.
- Characterize the neurophysiology of memory and effect of fear/anger upon new learning and memory.
- Analyze the effect of traumatic and non-traumatic injuries upon cognitive centers.
- Connect neurotransmitters with the communication system within the brain.
- Evaluate the optic system and lesion locations that affect engagement and accuracy in therapy.
- Recommend simple neuroanatomy-based techniques to rapidly de-escalate stress for patients and caretakers.
- Assess neuro-behavioral barriers that impact new learning.
Neuroanatomy And The Impact On Cognitive Processing
Optic System And Visual Perception
- Basic neuronal anatomy
- Brain wiring: Association, projection, and commissural fiber tracts
- Brain lobes locations and ties to cognitive processes
- Cerebellum and impact upon cognition
- Case Study 1: Jacob’s anxiety and how pacing the halls become therapeutic
How Neurotransmitters Drive The Bus
- Optic constructs, anterior-posterior fiber tracts
- Visual cortices and unique roles in visual processing
- Effect of tumors, shear injuries, CVA lesions upon visual processing
- Case study 2: Why can’t my patient just see the whole worksheet like I do?
- Group Exercise: Review of vision diagnostics by discipline (PT/OT/SLP)
Executive Functions Of The Frontal Lobe
- Internal communication systems within the brain
- Dopamine pathways and effects on cognition and reward systems
- Serotonin pathways and mood modulations
Communication And The Left Hemispheric Functions
- The Cognitive Pyramid and moving patients upward
- Skull anatomy and effects of shear injury
- Shear injury as it affects anxiety and behavioral health
- Therapy implications for PT/OT/SLP
- Group Exercise: Review of executive function diagnostics by discipline (PT/OT/SLP)
Spatial Processing And The Right Hemispheric Functions
- Broca’s vs. Wernike’s area
- Function of the accurate fasciculus upon communication
The Hidden Processors-Thalamic Influences
- Neurophysiology vs neuropathology, understanding patients’ nonverbal challenges
- Inferential language and social cognition
- A sense of time and spatial organization revealed
- Auditory pathways and neuroanatomy
- Thalamic engagement on sensory information
- Modulation of sleep and vigilance
Memory: How The Hippocampus And The Amygdala Partner
Recovery From Acceleration/Deceleration Injuries: Diffuse Axonal Injury (DAI)
- Memory processes
- Memory types: Right vs left hippocampal functions
- Hypoxia and anoxia upon memory function
- Sleep and memory consolidation, effect of exercise on memory structures
- Amygdala’s influence upon fear-based learning and hijacking executive control
- Case study 3: Nile’s hypoxia and long term rehab outcomes
Agitation Management Strategies
- Microanatomical features of DAI
- CTE: Chronic Traumatic Encephalopathy
- Where medications have failed
Enriching Patient And Clinician Relationships
- Review how working knowledge of the Rancho Los Amigos levels and practitioner tips can avoid confrontation
- Learn trick of the trade for avoiding escalation
- Confabulation and denial – addressing the elephant in the room
- The science behind mediations and mindfulness
- Reigning in the runaway situation
Module 2: Addressing Patient Behavior by Brain Lesion Site: Function, Communication & Your Patient Relationship
Igniting Neuroplasticity after Stroke: Breakthroughs for Improving Motor Recovery
Learn how to ignite recovery in stroke patients with innovative interventions that re-educate the movement patterns needed for compensation and recovery. Find out what is important for neuroplasticity to occur, and discover how to unlock the potential in cognitively impaired patients who cannot communicate or do not understand the goals of treatment. Take home key motor control strategies and targeted treatments for progressing patients from any level toward functional recovery and community reintegration.
- Review the latest research on neuroplasticity and its implications for stroke rehabilitation
- Identify steps for improving task assessment, intervention selection, progressions, and ultimately functional outcomes, using key concepts related to neuroplasticity, motor control, and motor learning
- Compare and evaluate interventions related to compensation and recovery
Review the latest research on neuroplasticity and its implications for stroke rehabilitation
Identify steps for improving task assessment, intervention selection, progressions, and ultimately functional outcomes, using key concepts related to neuroplasticity, motor control, and motor learning
- Describe moto control and motor learning theories
- Introduce 5 Stages of Trask Performance
- Correlate deficits in task performance to identified impairments
- Develop framework for treatment progression based on 5 Stages of Task performance
- Define recovery and compensation
- Identify factors that guide our decisions to move toward interventions for recovery versus compensation
- Premorbid ability
- Stroke prognostic factors
- Stage in recovery
- Process where intervention is occurring
- Insurance/LOS limitations
- Provide evidence for recovery over compensation early in the rehab process
- Promote inclusion of compensation and recovery within treatment progression