Level 1 – Solutions for Movement Impairments to the Low Back and Hip and Movement, Alignment and Coordination

physiotherapy training

Level 1 – Solutions for Movement Impairments to the Low Back and Hip and Movement, Alignment and Coordination


Kinetic Control are delighted to be adding a new destination to our teaching repertoire, and so it’s exciting to be breaking new ground in Asia. This Spring experienced tutor Patrik Pedersen of Sweden visits the provinces of Guangzhou and Beijing to deliver two Level 1 courses, starting with Solutions for Movement Impairments to the Low Back and Hip and Movement Alignment and Coordination

Course Introduction (Solutions for Movement Impairments to the Low Back and Hip)

Function and performance require an integrated relationship between the shoulder and neck. Due to this close relationship the neck and shoulder require effective management as a co-ordinated functional unit. This module presents methods of managing movement health of these regions through the evaluation of movement control, allowing for deficits to be brought to light and subsequently managed though bespoke retraining. Although these regions are undoubtedly complex, the module supplies means to restore optimal movement health through its systematic approach. This module employs a movement focused philosophy, within a highly structured process of assessment and retraining, to address issues related those highly integrated regions, the neck and shoulder.

Key Features

* Neck and shoulder movement is evaluated allowing for movement control impairments to be diagnosed and classified
* Presentation of a systematic assessment, clinical reasoning and movement retraining process to significantly reduce the incidence and recurrence of neck and shoulder pain
* Impairment specific retraining of optimal movement control of the neck and shoulder to optimise movement health and improve function

Learning Outcomes

At the end of this course the participant should be able to:

* Acquire skills to evaluate movement and identify movement impairments at the neck and shoulder
* Make a diagnosis of movement impairments
* Relate these movement impairments to the patient’s goals and priorities
* Learn effective strategies to correct these movement impairments
* Consider the neuroscience underpinning the principles of movement evaluation and retraining decision

Introduction to Course (Movement, Alignment and Coordination)

This module and all the related Kinetic Control courses, seek to deliver the ability for you to help all patients to move better, feel better and do more. These courses present movement as the vehicle supplying choice in people’s life, for life; a perspective shifting the emphasis away from pain and pathology, placing movement and movement health at the centre of intervention strategies. The two days of this particular module, employ a movement focused philosophy to those issues related to alignment and co-ordination, considering how both factors may influence any one individual’s movement health.

This module evaluates alignment and offers a classification and clinical interpretation of sustained, habitual alignments effect on movement. This evaluation process directs therapists towards a means of establishing a more optimised movement system. The observation and analysis of patterns of muscle synergies in functional tasks is examined and options for retraining more efficient movement strategies are presented.

Key Features

* Low back, hip, neck and shoulder alignment is classified and analysed for its implications for posture and movement control
* Strategies to correct or improve postural alignment are developed
* A variety of common functional tasks are analysed with respect to the primary muscle groups involved in those tasks. Further detailed observation of the recruitment synergies between the one-joint stabiliser and multi-joint mobiliser synergists is analysed.

Learning Outcomes (Movement, Alignment & Coordination)

At the end of this course the participant should be able to:

* Display a good understanding of why movement matters to postural alignment and recruitment synergies in functional tasks
* Demonstrate an understanding and ability to observe changes in functional movements that reflect changes in relative stiffness and relative flexibility
* Display an ability to observe posture and classify individuals into a relevant alignment subgroups for the low back, the hip, the neck and the shoulder
* Demonstrate an understanding of the implications of alignment classification to changes in muscle length and recruitment, to potential risk of pain and to movement health in general
* Display an ability to discuss strategies and options to minimise or correct some of the negative causes or consequences of postural alignment change
* Demonstrate the ability to observe function tasks or activities and analyse the pattern of synergist recruitment being used and make a judgement as to whether it is appropriate or aberrant.
* Demonstrate the ability to devise a movement retraining strategy to change an aberrant pattern of recruitment into an appropriate pattern of recruitment depending on the task involved and the loading (non-fatiguing movement or fatiguing load) requirements of that task


Patrik Pedersen


16-19 April 2016


4 days


check with organiser


Beijing A-T Sports Medicine Research Center




Jenny Liu








Reporting of Rehabilitation Intervention for Low Back Pain in Randomized Controlled Trials: Is the Treatment Fully Replicable?

caucasian man with back pain with hospital background

Reporting of interventions in RCTs often focused on the outcome value and failed to describe interventions adequately. The aim of this study was to assess the quality of reporting of rehabilitation interventions for mechanical low back pain (LBP) in published RCTs. The team systematically searched for all RCTs in Cochrane systematic reviews on LBP published in the Cochrane Database of Systematic Reviews until December 2013. The description of rehabilitation interventions of each RCT was evaluated independently by 2 of the investigators, using an ad hoc checklist of 7 items. The primary outcome was the number of items reported in sufficient details to be replicable in a new RCT or in everyday practice. They found 11 systematic reviews, including 220 eligible RCTs, on LBP. Of those, 185 RCTs were included. The median publication year was 1998 (I-III quartiles, 1990 to 2004). The most reported items were the characteristics of participants (91.3%; 95% confidence interval [CI], 87.3-95.4), the intervention providers (81.1%; 95% CI, 75.4-86.7), and the intervention schedule (69.7%; 95% CI, 63-76). Based on the description of the intervention, less than one fifth would be replicable clinically. The proportion of trials providing all essential information about the participants and interventions increased from 14% (n = 7) in 1971 to 1980 to 20% (n = 75) in 2001 to 2010.

Despite the remarkable amount of energy spent producing RCTs in LBP rehabilitation, the majority of RCTs failed to report sufficient information that would allow the intervention to be replicated in clinical practice. Improving the quality of intervention description is urgently needed to better transfer research into rehabilitation practices.

Acute Respiratory Distress Syndrome.


Acute respiratory distress syndrome (ARDS) is a serious inflammatory disorder with high mortality. Its main pathologic mechanism seems to result from increased alveolar permeability. Its definition has also changed since first being described according to the Berlin definition, which now classifies ARDS on a severity scale based on PaO2 (partial pressure of oxygen, arterial)/FIO2 (fraction of inspired oxygen) ratio. The cornerstone of therapy was found to be a low tidal volume strategy featuring volumes of 6 to 8 mL per kg of ideal body weight that has been shown to have decreased mortality as proven by the ARDSnet trials. There are other areas of treatment right now that include extracorporeal membrane oxygenation, as well for severe refractory hypoxemia. Other methods that include prone positioning for ventilation have also shown improvements in oxygenation. Positive end-expiratory pressure with lung recruitment maneuvers has also been found to be helpful. Other therapies that include vasodilators and neuromuscular agents are still being explored and need further studies to define their role in ARDS.

Only 2 weeks left to get your IFOMPT conference early bird ticket and book a course with Professor Gwendolen Jull and Dr Julia Treleaven!

IFOMPT 2016 Glasgow

As we move closer to the early bird deadline  of the 4th of April 2016, conference delegate numbers are continuing to grow with over 370 delegates now confirmed to attend.

Social Media Team IFOMPT 2016

The IFOMPT 2016 committee and our conference partner Physiopedia would like to welcome Steve Nawoor and Jack Chew to the social media team for Glasgow 2016. Both Steve and Jack have a proven track record in the use of social media and will be providing entertaining and insightful blogs on the conference programme. The conference committee is delighted that they have agreed to join the team of Chris Mercer, Helen Welch, Laura Ritchie, Jesse Awenus and Alex Chan to provide daily input from Glasgow 2016. For up to date information on the conference follow @ifompt on twitter.

Spotlight on Pre and Post Conference Courses

The Pre and Post Conference Team are pleased to welcome Emeritus Professor Gwendolen Jull and Dr Julia Treleaven to the conference programme to present their course on the Management  of Cervical Disorders.

Course Title: The Management of Cervical Disorders – A research informed approach with an emphasis on therapeutic exercise.
Duration: 2 Days
Dates: 2 and 3 July
Location: Glasgow Caledonian University
Times: 09:00 – 17:00 both days
Course Fees: £250.00 Early bird rate. Course fee will be increased to £295 after 4 April

This course will present the management of cervical disorders within a biopsychological model with an emphasis on therapeutic exercise. An overview of the research into the nature of impairments in neuromuscular, kinematic and sensorimotor control that may occur with neck pain/injury will be provided which informs a therapeutic exercise approach.

This course has a practical emphasis and will explore in detail, the assessment and management strategies for cervical neuromuscular, kinematic and sensorimotor dysfunction. The course also explores incorporation of other management techniques such as education, manual therapy with the exercise program in a multimodal approach to the management of cervical disorders.

The course aim/objective is to ensure that at the completion of the course, the participant will:

  • Have a good understanding of the presentation of patients with cervical disorders within a biopsychosocial framework
  • Have a good understanding of the impairments in neuromuscular, kinematic and sensorimotor function which have been found to be associated with cervical disorders.
  • Develop a good understanding of the clinical reasoning process for differential diagnosis of cervical disorders and the treatment directives from the assessment
  • Develop clinical skills for the recognition and retraining of neuromuscular control in patients with cervical disorders
  • Develop clinical skills for the recognition and retraining of impairments in kinematic control in patients with cervical disorders
  • Develop clinical skills for the recognition and retraining of impairments in sensorimotor control system in patients with cervical disorders
  • Develop clinical proficiency in the integrated management of the articular, muscle and nervous systems through a multimodal approach of patient education, manual therapy and specific therapeutic exercise techniques

We expect this course to attract a large interest from delegates and would advise anyone thinking of attending to book early. Remember these courses can be booked as a stand-alone course separate from the conference. So if you have a colleague or friend interested  in these course please encourage them to check out the courses on offer on the conference website.

#DPTstudent Doing Only #BizPT For A Clinical Experience Part 1

Hi. My name is Ryan. I’m a business intern. I’m a physical therapy student… Wait, what?
“There is no business being taught in DPT programs.” This has been shouted from the rooftops since I arrived in PT school. Let me first state say, that is not entirely correct. From the Mentoring Millennials session at CSM it was apparent that almost every student had a business class in PT school…however it was a business class that had almost all those same students “create their own clinic.”
For every student that just rolled there eyes at that, I’m right there with you. It is a bit of an archaic exercise… even for those students who are interested in the business aspects of physical therapy. 
This leads to this large disconnect. On one side you have all the #bizPT people shouting that schools aren’t preparing the students right. On the other side you have schools that are just trying to squeeze in everything CAPTE requires in order to make sure students will get licensed. Who is left in the middle of these two sides? The students. So where in the hell do you go?
This is called a lead in.  Unfortunately I just used way too many words to lead in to the point behind this article so I hope I don’t lose you. My point is this… take control of your own future in business. Entropy Physiotherapy and Ohio State have been gracious enough to allow me to integrate business into my clinical experience (which I set up last summer through the proper channels) with them for 8 weeks and from this I want to share what I am learning about being a BUSINESS INTERN in a physical therapy-cash based-private practice. 
It has been two weeks and here is a quick run-down. 
  • Even if you don’t want to get into business for yourself, understanding your economic role in healthcare is vital to help patients with their questions and problems. 
  • Business is defined in a multitude of ways. Mine is this… “Business is helping people understand what problems they are having, solving those problems and then getting paid for being part of that process.” This will change. It’s the best I got so far. 
  • As a business intern I’m also a: Website Designer, Photographer, Apps-to-make-things-simpler-guru, Social Media Marketer, Blogger, Accountant, Scape-goat-to-call-the-insurance-compnay-and-be-on-hold-for-1-hour-guy. (The PT’s here said it was 35 minutes… it felt like an eternity.)
  • Business classes in PT school trained us how to bill but you don’t truly understand the impact of that on the patient until they bring it up. “What do you mean you can’t afford it?” **Looks at out-of-network costs** “Holy shit, how can anyone afford this?”
  • Business classes in PT school teach us how to best comply with the current system… But maybe the current system isn’t ideal for physical therapists.
  • Time has a monetary value to it when running your own business. Time spent here versus time spent there creates either a net gain or a net loss. Your time is vital.

This will be divided into multiple parts… The next installment will go into more details of what I actually do on a daily basis (I know, stop being so excited), how I am incorporating business lessons learned here into my own business and who serves up the best pizza in Chicago.
Thanks for reading.
@RyanSmith_ATC @uMovePhysio

Interested in live cases where I apply this approach and integrate it with pain science, manual therapy, repeated motions, IASTM, with emphasis on patient education? Check out Modern Manual Therapy!

Keeping it Eclectic…

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One- and two-year follow-up of a randomized trial of neck-specific exercise with or without a behavioural approach compared with prescription of physical activity in chronic whiplash disorder.

Driver Suffering From Whiplash After Traffic Collision

The objective of this study was to explore whether neck-specific exercise, with or without a behavioural approach, has benefits after 1 and 2 years compared with prescribed physical activity regarding pain, self-rated functioning/disability, and self-efficacy in management of chronic whiplash. Participants were randomized to 1 of 3 exercise interventions: neck-specific exercise with or without a behavioural approach, or physical activity prescription. Self-rated pain (visual analogue scale), disability/functioning (Neck Disability Index/Patient Specific Functional Scale) and self-efficacy (Self-Efficacy Scale) were evaluated after 1 and 2 years. Both neck-specific exercise groups maintained more improvement regarding disability/functioning than the prescribed physical activity group at both time-points (p ≤ 0.02). At 1 year, 61% of subjects in the neck-specific group reported at least 50% pain reduction, compared with 26% of those in the physical activity prescription group (p < 0.001), but at 2 years the difference was not significant.

After 1-2 years, participants with chronic whiplash who were randomized to neck-specific exercise, with or without a behavioural approach, remained more improved than participants who were prescribed general physical activity.

Is the search for right-to-left shunt still worthwhile?

Heart Anatomy vector illustration for medical works

Patent foramen ovale (PFO) is a common disembryogenic defect with well-attested prevalence but dubious etiopathogenetic linkage with cryptogenic stroke and different clinical conditions. Transcranial color-coded Doppler (TCCD) assures high accuracy in diagnosing right-to-left shunt (RLS) and its functional aspects. The aim of the study was to evaluate RLS prevalence and degree in subjects submitted to TCCD for conditions theoretically associated or caused by paradoxical embolism to the brain. This was assessed through PFO assessment, performed in 10 major diagnostic categories and a control group, followed a standardized protocol with a 10 or 20 microbubbles (MB) cutoff to identify any or only large RLS, respectively. Among 2113 patients, a significant larger RLS prevalence was found in stroke (53.3%), TIA (45.7%) and migraine with aura (39.7%) when compared with non-migraineurs controls (25.5%). RLS degree was significantly higher in stroke and TIA patients: The ROC curve from MB load data helped to identify new cutoff values for both normal breathing (42 MB) and Valsalva (139 MB) tests. From logistic regression, a family history for PFO, ASA, and male gender appeared independent predictors of a RLS. By contrast, RLS seemed independent of white matter abnormalities presence on brain neuroimaging or stroke mimics.

In addition to recently defined criteria, genetically determined inheritable traits and epidemiologic characteristics (male gender) should be taken into account when assessing PFO and related cerebrovascular risk profile. A newly defined threshold in TCCD MB count is suggested to discriminate shunts related to stroke and TIA from innocent ones.