Acquire an in-depth understanding of the neuroscience, assessment, principles underlying skill acquisition, and treatment of commonly encountered motor impairments encountered in occupational therapy practice.
Neurological deficits are the most commonly encountered impairments in occupational therapy, and the prevalence is rapidly-increasing. Despite a widely-appreciated impact, few resources and no certifications are available for occupational therapists and occupational therapy assistants. This rigorous certificate program provides unique and specific focus on evaluation, treatment, and neurological underpinnings. Focus areas include neuroscience/neuroanatomy, assessment and treatment of specific conditions (e.g., spasticity), modalities (e.g., orthotics/prosthetics for the paretic upper extremity), and optimal learning conditions for people with neurological impairments. This certificate is provided in two modules that must be taken sequentially. In section one, learners are exposed to foundational concepts in neurologic motor rehabilitation, including neuroanatomy, neuroplasticity, and motor learning in neurologically-impaired populations. In section two, users learn the assessment of specific impairments and participation deficits encountered in neurologic occupational therapy practice.
This series is designed for occupational therapists and occupational therapist assistants interested in learning rigorous strategies for treating patients with neurological conditions.
21 hours of online video lectures and patient demonstrations.
Case-based quizzes to evaluate and improve clinical reasoning.
Recorded Q&A sessions between instructors and practice managers.
Motor Learning Strategies: Interventions at the Environment Levelkeyboard_arrow_downCourse
In this chapter, J.J. Mowder-Tinney discusses the appropriateness of integrating variability into the plan of care. Variability is discussed through problem solving and the challenge point framework to keep the learner actively involved in problem solving during the process of finding movement solutions. Two different options for feedback are discussed along with their impact on function.
A learner’s focus of attention can be either internal, monitoring the way they move, or external, focusing on the actions of their movements and if the goal was achieved. J.J. Mowder-Tinney explores a comparison of two different cueing options to switch from internal to external focus of attention to increase effectiveness and efficiency of movement.
Intensity incorporated into mobility training provides four benefits, which will be discussed throughout this chapter. Learners will be able to gauge the level of intensity based on a patient’s heart rate, as well as use seven dimensions of challenge to adapt a mobility-training program.
J.J. Mowder-Tinney explains the importance of self-control cueing to keep your patient engaged and challenge themselves in motor learning. This practice session gives you quick and easy steps to facilitate your patient's involvement in their therapy. Starting from the beginning, keep your patient engaged and allow them to challenge themselves throughout the rehabilitation process.
Treating Patients with Neurological Deficitskeyboard_arrow_downCourse
Explain neuroplasticity and task oriented training in regards to the latest research and rehabilitation.
Compare and contrast different motor learning theories and how to implement with varying patient presentations.
Compare and contrast outcome measures that can be used for varying levels/settings of CVA.
Identify common problems with patients with pusher syndrome and how to best adjust the environment for treatment.
Describe optional interventions for cerebellar ataxia.
Identify key aspects to include in intervention designs to treat neglect.
Develop an appropriate and challenging intervention program to improve bed mobility.
Develop an appropriate and challenging intervention program to improve sit to stand.
Develop an appropriate and challenging intervention program to improve gait.
Therapeutic Neural Correlates of Motor Learningkeyboard_arrow_downCourse
In this first chapter, Dr. Grooms will review the basic neural anatomy and principles of neuroplasticity, focusing on the brain substrates for motor learning.
This section will expand upon the previous section by highlighting the anatomy and the principles of neuroplasticity to transition to mechanisms of motor learning and how the nervous system programs movement. This is a “bring-it-together" section before going into therapy implications.
This final section will utilize the knowledge of the previous two sections to provide concrete and implemental clinical practice changes to induce adaptive neuroplasticity, as well as highlight future directions for the field.
Motor Rehabilitation Post-Stroke: Principles of Neuroplasticity and Motor Learningkeyboard_arrow_downCourse
Basic physiological and anatomical information about disabling condition forms the background knowledge for therapists. This chapter will remind the attendee of the neuroanatomy and neural mechanisms associated with stroke.
Recovery of motor function after stroke is believed to rely on neural re-organization. The basis for motor rehabilitation approaches comes from basic animal and human studies of how behavioral experience influences neuroplasticity. This chapter will review the literature that has led to the development of basic principles of practice structure and the greatest neuroplasticity.
Rehabilitation needs to be evidence-based so that the most efficacious and effective interventions are provided to individuals with stroke. This chapter will present the evidence for the most-studied motor rehabilitation approaches for hemiparesis post-stroke.
It is clear from research conducted over the past 20 years that therapy facilitates motor recovery from stroke. Despite such rehabilitation however, individuals with stroke continue to experience long-term reduced motor function that interferes with successful engagement in daily activities. More effective interventions are needed. This chapter will describe some new approaches, mostly interventions to be used as instigators of motor practice, that offer promise for enhancing the brain’s ability to re-organize in response to motor practice.
Neuroanatomy for Rehabilitation Professionalskeyboard_arrow_downCourse
This chapter will provide a distinction between the CNS and the PNS to set the stage for deeper explorations of both systems.
This chapter will begin with an explanation of the distinction between neurons and nerves, and review basic cellular anatomy and cell function. The remainder of the chapter will identify the types of cells found in the CNS and the basic function of each cell type.
This chapter will review the main neurotransmitters found in the brain. The two key functions of neurotransmitters (rapid communication vs. neuromodulation) will be discussed. Major locations of cells producing different types of neurotransmitters will be identified.
This chapter will introduce and discuss the functions of the spinal cord and brain stem. The main types of spinal nerves will be reviewed, followed by a review of the twelve cranial nerves.
This chapter will continue the discussion of major brain regions and functions, focusing on the cerebellum and subcortical structures. The main divisions of the cerebellum will be identified, and the function of the cerebellum will be reviewed. The key role of the thalamus will be discussed. Some of the major deficits resulting from damage to the thalamus and basal ganglia will be reviewed.
This chapter reviews the structural components and function of the limbic system. The interactions between the limbic system and other brain regions is vital in the regulation of emotion and memory.
The cerebral cortex, or neocortex, is the newest and most complex part of the brain. It is comprised of four lobes. This part of the brain is critical in higher-level cognitive processes. In this chapter, the organization and function of the cortex will be discussed.
Section 1 QuizQuiz
Introduction to Modified Constraint-Induced Therapykeyboard_arrow_downCourse
Chapter one will describe the phenomenon of learned nonuse in neurologic populations, its relationship to neuroplasticity, the rationale and development of CIT, and challenges associated with its practical clinical administration.
This chapter details the techniques and outcome measures that are used to initiate mCIT in the clinic, including how to screen for the right candidates, the outcome measures that are used.
The last chapter of this course will introduce the user to the practical implementation of mCIT in the clinic and at home. Demonstrations will be shown to explain how the therapy is implemented and adjunctive tools used to increase its efficacy.
Upper Extremity Strategies Along the Post-Stroke Recovery Continuumkeyboard_arrow_downCourse
Participants will be presented with treatment approaches for the post-stroke upper extremity with little to no movement. Risk factors for shoulder pain will be discussed as well as appropriate range of motion and positioning techniques for this population.
This chapter will present treatment approaches for the post-stroke upper extremity that presents with proximal movement, but which the patient considers “non-functional” secondary to lack of distal control.
This chapter will present treatment approaches for the post-stroke upper extremity that has regained movement but remains slow and poorly coordinated in daily living skills. Keys to developing skill in these patients, as well as the development of an independent practice program, will be presented.
Getting a Grip on Upper Extremity Spasticity Assessment and Managementkeyboard_arrow_downCourse
This portion of the course will provide an operational definition of spasticity and briefly discuss its prevalence and functional effects, the joints where it is most likely to be exhibited, and the underlying neurophysiology.
This portion of the course will introduce the user to the Modified Ashworth scale, explaining its rationale, measurement features, what it is measuring, and use in order to ascertain spasticity in the upper and lower extremities.
This section of the course will identify and describe the rationale and application of commonly used medical and therapy approaches to manage spasticity. Emphasis will be placed on the rationale and application of treatments and techniques that can be applied by therapists.
Understanding Recovery and Evolution of Impairments in the Arm and Handkeyboard_arrow_downCourse
This chapter will cover the process of neurological and functional recovery for persons who have acquired brain injury or stroke and their implications on the rehabilitation process. Dr. Bondoc will also explain the nature of spasticity and its impact on movement, functional recovery, and the development of secondary impairments.
This chapter will review neurophysiology of the motor unit and discuss the definition of spasticity and its impact on movement and posture of the arm and hand.
In this chapter Salvador Bondoc will review the somatosensory system and sub-modalities of somatosensation and describe pain and sensory impairments associated with the neurological UE following brain injury.
Physical Agent Modalities for Neurologic Occupational Therapykeyboard_arrow_downCourse
This chapter will introduce the rationale for the use of physical agent modalities (PAMs) in occupational therapist practice, including the theoretical foundations of PAMs, their relationship to the occupational therapist practice framework, and consideration of state laws and regulations regarding the use of PAMs in occupational therapy practice.
Electrical stimulation is commonly used to mitigate pain, reduce spasticity, and increase range of motion in people with neurological impairments. This chapter will review the basic attributes and parameters of electrical stimulation that can be modified by OT professionals, describe the hypothesized mechanisms of electrical stimulation, describe the rationale and evidence supporting its use in clients with neurological impairments, and demonstrate the basic use of electrical stimulation in several basic applications.
Cryotherapy is commonly used to mitigate pain, reduce spasticity, and ameliorate other symptoms in people with neurological impairments. This chapter will review the basic attributes of cold, describe its hypothesized mechanisms, describe the rationale and evidence supporting its use in clients with neurological impairments, and demonstrate the basic use of cryotherapy in several basic applications.
Thermotherapy is commonly used to mitigate pain, reduce spasticity, and ameliorate other symptoms in people with neurological impairments. This chapter will review the basic attributes of heat, describe its hypothesized mechanisms, describe the rationale and evidence supporting its use in clients with neurological impairments, and demonstrate the use of thermotherapy in several basic applications.
Specific Orthoses for Neurological Conditionskeyboard_arrow_downCourse
This chapter will cover conditions of the elbow that would benefit from positioning in an orthosis to maintain tissue length and prevent joint contractures. This volar based elbow orthosis will be described in detail regarding the appropriate thermoplastic material selection, pattern making, and fabrication techniques. Additional tips and tricks will be offered in an easy to follow format.
Many conditions require using an Anterior Elbow Orthosis as an intervention. This chapter details these conditions and offers an easy method for fabrication of an Anterior Elbow Orthosis along with information on appropriate thermoplastic materials.
This chapter will cover conditions of the forearm, wrist, hand and fingers that would benefit from positioning in an orthosis to maintain tissue length and prevent joint contractures. This anti- spasticity orthosis will be described in detail regarding the appropriate thermoplastic material selection, pattern making, and fabrication techniques. Additional tips and tricks will be offered in an easy to follow format.
Section 2 QuizQuiz
CEU Approved21 total hours* of accredited coursework.
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Amy Lee, MPT, OCS
Physical Therapy Central
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Zach Steele, PT, DPT, OCS
Outpatient Physical Therapy & Rehabilitation Services
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Grant R. Koster, PT, ATC, FACHE
Vice President of Clinical Operations, Athletico Physical Therapy