Re-Discover the Core: Shift Clinical Understanding to Improve Neuromuscular Re-Education, Stability, Mobility & Function

Credits

Planning Committee Disclosure - No relevant relationships

All members of the PESI, Inc. planning committee have provided disclosures of financial relationships with ineligible organizations and any relevant non-financial relationships prior to planning content for this activity. None of the committee members had relevant financial relationships with ineligible companies or other potentially biasing relationships to disclose to learners.  For speaker disclosures, please see the faculty biography.

Speaker

Trent Brown, MOT, OTR/L, BCG, ATP, CFPS Related seminars and products

Advanced Healthcare

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TRENT BROWN, MOT, OTR/L, BCG, ATP, CFPS, is a practicing therapist in Utah and is one of 36 credential holders of a board certification in gerontology (BCG) from the AOTA. Mr. Brown also holds a certification as an assistive technology professional (ATP) from RESNA. He completed his undergraduate and graduate work at the University of Utah where he is also an adjunct professor. He is employed by the Department of Health (UDOH) to develop, implement, and operate healthcare quality improvement programs and has authored multiple laws to legislate improved patient care. Mr. Brown also reviews clinical documentation for UDOH as an expert witness in reviewing cases. Mr. Brown has over 15 years of clinical experience in skilled nursing, transitional care, acute, and home health. Recently, he served as the VP for the UOTA where he co-authored SB 131, advancing OT practice in the state of Utah, and has received multiple awards for his clinical, academic, and legislative work. Through his expertise in advocating for therapy services authoring law and rule, he has evolved into an expert presenter on ethical and legal issues facing therapy. Mr. Brown has provided courses for thousands of clinicians throughout the country in conferences, private settings, and specialty conferences. Mr. Brown is a master clinician and lecturer on a myriad of topics including joint arthroplasty, core strengthening, documentation, aging, functional mobility, ethics, and fall reduction. He has also been a keynote speaker at multiple events throughout the country.

 

Speaker Disclosures:

Financial: Trent Brown has employment relationships with the Utah Department of Health and the University of Utah. He receives a speaking honorarium and product royalties from PESI, Inc. He has no relevant financial relationships with ineligible organizations.

Non-financial: Trent Brown has no relevant non-financial relationships.

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Objectives

1. Investigate missing components of broadly used definitions of the core and how this leads to clinical misunderstanding and lack of evidence when treating core dysfunction.
2. Evaluate the core with a functional emphasis using transverse, sagittal, and frontal planes with stability, mobility, and functional emphasis.
3. Demonstrate the evolution of contraction for stabilization of the core and spine.
4. Appraise standardized evaluations used to evaluate core weakness and stability.
5. Distinguish evidence-based core activities and exercises emphasizing the re defined core that promote stability and mobility in supine, seated, and standing.
6. Demonstrate dynamic core activities during labs to develop an evolutionary plan of care and to promote functional outcomes.

Outline

• Evidence of function and clinical significance
• Definitions and myths

• Region: Superior, inferior, central
• Anatomy & physiology of stabilizers vs. mobilizers

• I-IIA-IIX-IIB - muscle contraction slow twitch to fast twitch
• Stability vs. mobility of the brain in the geriatric client
• Contract-Relax-Antagonist-Contract principle (CRAC)
• Sherrington’s Law: Are we emphasizing poor patterns during treatment?

• Trunk Impairment Scale (TIS): core stability and mobility control
• Bent Knee Fall Out (BKFO)
• Side lying SLR
• 3-Plane Core Test

• Supine core stability
  • Abdominal Ball Press Lab:
  • Anterior abdominal wall re-education
  • Application: low back pain
  • Trochanter Tension Lab:
  • Supine techniques to contract gluteus medius/minimums, TFL, and QL
  • Application: single leg standing balance for mobility and transfers
• Seated core stability
  • Dolphin Lab:
  • Core dissemination during frontal plane mobility
  • Application: lateral mobility: bed mobility, toileting, functional reach
  • Stable Ball Drop Lab:
  • Stabilizing the anterior and posterior abdominal walls
  • Application: low back pain and fall risk
• Standing core stability
  • Wall Plank Lab:
  • Application: low back pain, LOB, fall risk
  • PNF Chop Lab:
  • PNF functional reaching diagonal patterns
  • Application: high to low reaching during functional tasks

Evidence-Based Strategies for Mobility

• Supine core mobility
  • ASIS Press, Scapular Elevation Lab:
  • Mobilization of the pelvis to reduce soft tissue tightness
  • Application: sagittal plane movement of the upper body over the core
• Seated core mobility
  • Quad Sit-up Lab:
  • Sit-stand utilizing lower extremity emphasis
  • Application: low back pain, sit-stand/transfers
  • Mobile Drop Lab:
  • Core rotation and reaching in all planes with various weighted objects
  • Application: functional reach for ADL’s
• Standing core mobility
  • Standing ASIS, Dynamic Chop Lab:
  • Tactile cues for pelvic extension during sit-stand
  • Application: COG over BOS during upright tasks with reduced energy expenditure

Target Audience

• Physical Therapists
• Physical Therapist Assistants
• Occupational Therapists
• Occupational Therapy Assistants
• Chiropractors
• Athletic Trainers
• Massage Therapists
• Other Rehab Professionals