Course Outline

Referrals for the evaluation and treatment of lumbar and sacroiliac joint pathologies are frequently seen in physical therapy and sports medicine clinics. Disorders in the lumbar spine and sacroiliac regions can be difficult to manage as one diagnosis can present with a multitude of physical exam findings. Determining which findings are relevant and have a high probability of changing the patient’s primary complaint is usually where the clinical challenge lies.

This comprehensive course will provide clinicians with information and techniques that can be utilized the following day in their clinical practice. A systematic assessment of the lumbar spine, sacroiliac region, and hip will be presented. Emphasis will be placed on utilizing current evidence, algorithms, and clinical reasoning in the classification and treatment of syndromes. Specific diagnosis will include lumbar radiculopathy, lumbar spondylosis, lumbar facet dysfunction and lumbar stenosis. Joint dysfunctions that will be addressed will include; innominate positional faults, including upslips and translated innominates. The role of hip hypomobilities issues that can co-exist with lumbar/sacroiliac joint dysfunctions will also be examined. The manual therapy component of this course will integrate the Australian/Maitland and Osteopathic Medicine approaches with current research and effective clinical applications. Neuromuscular stabilization procedures will be evidence based as well, and focus on proven treatment interventions. The majority of the course is laboratory in order to focus on clinicians handling skills and precise performance of techniques and exercises. Learning will be enhanced with computer slide presentations and video analysis projections. Case studies will also be utilized to reinforce clinical reasoning skills. Additionally, the course instruction will provide insight towards differential diagnosis of lumbar pathology, with special attention to concerns for physical therapists involved in the increasingly common practice of direct access.

Course Objectives

• Utilize current evidenced-based information to focus your physical therapy examinations of lumbopelvic disorders.

• Understand the criteria for performing high velocity thrust mobilizations and when not to utilize this technique.

• Interpret exam findings to establish an accurate treatment classification category.

• Identify movement dysfunction in the lumbar spine, pelvic girdle and sacroiliac joint.

• Perform selected intervention strategies for the pelvic girdle and sacroliliac region based on the examination and current evidence.

• Perform selected intervention strategies for the lumbar spine based on the examination and current evidence.

• Incorporate muscle energy techiniques, functional assessment, mobilization, movement reeducation and exercise into a comprehensive therapy program.

• Incorporate slow velocity and high velocity thrust techniques (to include rotations in neutral, flexion and extension) into the treatment strategy.

• Prescribe proper lumbopelvic stabilization exercises for hypermobile lumbopelvic patient presentations.

 

Schedule of instruction

	Day One		Day Two
7:30 8:00	Registration	8:00 9:00	Review Lumbar Spine Anatomy and Biomechanics
8:00 8:30	Rationale for Evidence-Based Practice		• Type I and Type II mechanics, does it matter?
8:30 9:00	Region Specific Red Flags		• Discussion on scientific rationale regarding the physiological effects of high velocity thrust mobilization
	• Non-organic signs in low back pain and Waddel signs		• The audible” Pop” sound, does it matter?
9:00 10:00	Physical Examination Lecture	9:00 10:00	Lumbar Spine Examination Labs
	• Diagnostic classification
	-outcome measures-pre and post treatment		• Review of literature and clinical prediction rules
10:00 10:15	Break		• Lumbar AROM and overpressure
10:15 11:00	Mobilization		• Lumbar unilateral and central
	• Criteria for high velocity thrust mobilization		• Posterior to anterior pressures
	• Criteria for NOT performing high velocity thrust mobilizations	10:00 11:00	Lumbar Spine Intervention (Lab)
11:00 12:00	Pelvic Girdle examination (Lab)		• Lumbar rotation in neutral
	• PSIS palpation		high velocity thrust mobilizations
	• PSIS palpation		• L/S AROM overpressure
	-March test (innominate active posterior and active anterior rotation)		• Lumbar unilateral P-A’s
	• PSIS palpation		• Lumbar spine rotation in neutral
	-focus on positional symmetry		• Reassess
	-ligament tenderness	11:00 12:00	Lunch (On Your Own)
	• ASIS palpation	12:00 1:00	Lumbar Rotation/ SB in Extension
	-focus on positional symmetry		• AROM
	• Sidebending test for sacral mobility		• Unilateral P-A’s in extension
12:00 1:00	Lunch (on your own)		• L/S SB/ROT in Ext manipulation
1:00 2:00	Pelvic Girdle Intervention (Lab)	1:00 2:00	Lumbar Spine rotation/SB in Flexion
	• SIJ region high velocity thrust mobilizations		• AROM
	• Determine an AROM reassessment sign		• Unilateral P-A’s in flexion
	• Examine March, PSIS, symmetry and SIJ ligaments		• Lumbar SB/ROT in flexion manipulation
	• Demo SIJ region high velocity thrust mobilization		• Reassess
2:00 3:00	Repeat SIJ Region Mobilization	2:00 3:00	Seated Thoracolumbar Junction Rotation Mobilization
	• Demonstration SIJ region mobilization modifications	3:00 4:00	Hip Region (Lab)
3:00 4:00	Pelvic Girdle Asymmetry Intervention		• Mobilizations with high velocity thrust options
	• Sagittal Plane Isometric mobilizations	4:00 5:00	Lumbar Spine/SIJ Exercise (Lab)
	• Sagital plane passive mobs		• Criteria for stabilization
	• Home exercise strategies		• Stabilization exercises
4:30 5:00	Pelvic Girdle Case Study Presentation		• Lumbar case study presentation
	• Sacroiliac Joint region mobilization technique review		• Questions/answers

Downloads

Course Brochures are in Adobe PDF format. Right click and choose "Save Target As" to download brochure. If you would like to open the brochure in your browser windows, select the link.

Course Brochure for Current Manual Therapy and Neuromuscular Stabilization Concepts for the Lumbar Spine and Sacroiliac Joint

Scheduled Dates and Locations

Start Date	End Date	Location - **Click to Map It**	Tuition	Hrs	Hotel
Sep 20, 08	Sep 21, 08	ACMH Hospital, Kittanning, PA	$399.00	15.00	View Hotels
Oct 11, 08	Oct 12, 08	Fallon Clinic, Worcester, MA	$399.00	15.00	View Hotels
Nov 01, 08	Nov 02, 08	Clarian Health, Indianapolis, IN	$399.00	15.00	View Hotels
Nov 15, 08	Nov 16, 08	Dekalb Medical Center, Decatur, GA	$399.00	15.00	View Hotels