John O’Halloran

Video Runtime: 110 Minutes; Learning Assessment Time: 33 Minutes

This course is a recording of a previously hosted live webinar event. Polling and question submission features are not available for this recording. Format and structure may differ from those of standard MedBridge courses.

Current projections forecast an increase in total hip arthroplasty (THA) procedures of 176 percent by 2040 and 659 percent by 2060, along with an estimated increase for total knee arthroplasty (TKA) projected to be 139 percent by 2040 and 469 percent by 2060.*

The rise in joint replacement same-day surgery, coupled with advances in cutting-edge pain management and surgical techniques such as robotics and computer-assisted surgery, means that rehab practitioners must be educated about joint replacement surgeries and must practice at the highest level of their licenses. The question for us as practitioners is: Are we educationally ready to provide current and progressive rehabilitation for the rising joint replacement population?

Today's patient is quite different from the traditional patient many of us learned about in school. We learned precautions and restrictions, with the goal of rehabilitating patients so they could dress, groom themselves, and perform self-care. Today the rehab practitioner's role has changed, and the baby boomer joint replacement patient has higher expectations of their rehabilitation provider. Today's active baby boomer patients want to use their "new and bionic" prostheses to get down on the floor and play with the grandkids, to ski, and to hike.

This highly interactive webinar will provide the attendee with the evidence-based knowledge to answer patient questions such as: Do I have any hip precautions? Can I kneel on my total knee? Can I run? When can I hike or play tennis again? We will also examine surgery, from traditional to cutting-edge, in addition to evidence-based rehab and return-to-activity guidelines. This one-of-a-kind webinar is a MUST for all practitioners who work with total joint patients.

*Shichman, I., Roof, M., Askew, N., Nherera, L., Rozell, J. C., Seyler, T. M., & Schwarzkopf, R. (2023). Projections and epidemiology of primary hip and knee arthroplasty in Medicare patients 2040-2060. JB & JS Open Access, 8(1), e22.00112. https://doi.org/10.2106/JBJS.OA.22.00112

Learning Objectives

• Evaluate the changes in surgical decision-making with joint arthroplasty
• Consider the changes in surgical procedures and robotics in joint replacement
• Discriminate the changing role of the rehab practitioner with joint replacement today versus the past
• Generalize evidence-based answers to all FAQs from patients regarding joint arthroplasty in order to facilitate patients' participation in their health management plan

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Video Runtime: 61 Minutes; Learning Assessment Time: 18 Minutes

Projections of the volume of total joint arthroplasty in the US in the next 5-10 years are astounding. It is imperative that clinicians in all settings stay current to ensure optimal rehab programs that will parallel the significant advancements in implant technology and, most recently, the movement to same-day surgery and the multimodal pain management protocols.

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Video Runtime: 60 Minutes; Learning Assessment Time: 21 Minutes

There has been a rapid emergence of regenerative medicine and rehabilitation in the nonoperative treatment of osteoarthritis. Therefore, it is imperative that today's clinician be highly informed and able to provide patients with the best evidence available on this hot topic. With respect to optimal patient care, today's clinician should strive to practice at the highest level of their license every day. This one-hour course will provide the clinician with the latest evidence on the application and rehabilitation implications of orthobiologics/regenerative medicine in the nonoperative treatment of osteoarthritis.

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Video Runtime: 124 Minutes; Learning Assessment Time: 9 Minutes

This course is a recording of a previously hosted live webinar event. Polling and question submission features are not available for this recording. Format and structure may differ from standard MedBridge courses.

The U.S. Census Bureau projects that by 2050, the number of persons over the age of 65 in the United States will nearly double to 40.2 million persons. Within this population, many common functional challenges are present that require evidence-based and person-centered care. This webinar will provide a comprehensive approach to providing person-centered care to the aging adult population and highlight key strategies to improve outcomes, including which outcome measures to utilize, how to incorporate motor learning strategies, adjustments to optimize care for occupational therapists, and guidance for diagnosing specific exercise and balance challenges. A top priority, as noted in the evidence, is for therapists to provide sufficient intensity when working with the aging adult. Additionally, participants will have a unique and interactive opportunity to analyze movement with the speakers as well as time for questions on comparing various options for adjusting the approach depending on the setting.

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Video Runtime: 77 Minutes, Learning Assessments: 47 Minutes

With more people requiring joint replacements than ever before, effective acute care and rehabilitation are increasingly essential to successful patient outcomes. In this course, Dr. John O'Halloran reviews the history of joint replacement procedures and how they've transformed to the modern day joint arthroplasty in the shoulder, knee, and hip. Utilizing patient demonstrations and videos, Dr. O'Halloran reveals cutting-edge methods for the acute care and home care clinician. Emphasizing early rehabilitation, patient demonstrations focus on thought-provoking bed and core exercises, as well as functional weight-bearing activities, that can be implemented immediately following joint arthroplasty. This course is part of a five-course series on joint arthroplasty:

• Current Concepts in Joint Replacement: Following Arthroplasty - An Update
• Shoulder Arthroplasty: Return to Function - An Update
• Hip Arthroplasty: Improving Gait - An Update
• Knee Arthroplasty: Increasing Range of Motion - An Update
• Troubleshooting Difficult Cases in Joint Arthroplasty

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Video Runtime: 72 Minutes, Learning Assessments: 34 Minutes

The shoulder is the third most commonly replaced joint in the body. Join Dr. John O'Halloran as he reviews the evolution of shoulder arthroplasty and talks about the surgical procedures used today. This course describes the rehabilitation phases and range-of-motion expectations through lecture, patient videos, and demonstrations. Dr. O'Halloran demonstrates a wide range of manual techniques and therapeutic exercises to promote return of function to the level desired by today's arthroplasty patients. The course finishes with an in-depth look at the indications for a reverse total shoulder arthroplasty surgery and the rehabilitation considerations specific to this procedure. This course is part of a five-course series on joint arthroplasty:

• Current Concepts in Joint Replacement: Following Arthroplasty - An Update
• Shoulder Arthroplasty: Return to Function - An Update
• Hip Arthroplasty: Improving Gait - An Update
• Knee Arthroplasty: Increasing Range of Motion - An Update
• Troubleshooting Difficult Cases in Joint Arthroplasty

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Video Runtime: 62 Minutes, Learning Assessments: 12 Minutes

Following the knee, the hip is the second most commonly replaced joint. Join Dr. John O'Halloran as he provides the history of hip arthroplasty and compares the advantages and disadvantages of different surgical approaches. This course focuses on assessing the gait cycle, both pre- and postoperatively, so that clinicians are better able to identify key patterns of gait compensation. The phases of postoperative rehabilitation and the management of leg length discrepancies at different stages of the patients' rehab are outlined as well. This course is part of a five-course series on joint arthroplasty:

• Current Concepts in Joint Replacement: Following Arthroplasty - An Update
• Shoulder Arthroplasty: Return to Function - An Update
• Hip Arthroplasty: Improving Gait - An Update
• Knee Arthroplasty: Increasing Range of Motion - An Update
• Troubleshooting Difficult Cases in Joint Arthroplasty

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Video Runtime: 80 Minutes, Learning Assessments: 32 Minutes

With an increasing demand for knee replacement procedures, clinicians require up-to-date information on surgical and rehabilitation techniques. Starting with an overview of the history of knee arthroplasty, this course compares minimally invasive and traditional knee arthroplasty methods, such as mobile-bearing versus fixed-bearing surfaces. Dr. John O'Halloran describes the phases of postoperative rehabilitation and range of motion methods, including continuous passive motion and neuromuscular electrical stimulation, using numerous patient demonstration videos. The course finishes with an in-depth discussion of recommendations for return to activity following knee arthroplasty. This course is part of a five-course series on joint arthroplasty:

• Current Concepts in Joint Replacement: Following Arthroplasty - An Update
• Shoulder Arthroplasty: Return to Function - An Update
• Hip Arthroplasty: Improving Gait - An Update
• Knee Arthroplasty: Increasing Range of Motion - An Update
• Troubleshooting Difficult Cases in Joint Arthroplasty

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Video Runtime: 70 Minutes, Learning Assessments: 25 Minutes

With the emergence of the baby boomer generation, there has been a significant rise in joint arthroplasty surgeries in the past five years. The projections are staggering. In the United States, there are 1 million hip and knee arthroplasties, and that number will grow to 5 million in the next 8-10 years. With that growth and the changes in the United States health care reimbursement and utilization control, it is imperative that today's clinician who works with total joints be able to address the difficult cases. Currently, joint arthroplasty patients have outcome data showing approximately 80 percent overall satisfaction at 20 years post-operation. Having said that, patient expectations are higher today than ever before. The clinician who can expedite the rehab process and address the difficult cases will be the clinician that the well-informed patients will seek to do their rehabilitation. This course will provide the clinician treatment sequence strategies incorporating manual therapy and corrective exercises that involve the entire kinetic chain. This course is ideal for all settings and has been developed to address the following difficult cases:

1. The dreaded shoulder hike or shrug in shoulder arthroplasty
2. The total hip patient who has Trendelenburg gait
3. The total knee patient who can't achieve desired range of motion
4. The total knee and hip patient who has persistent pain and has been told by an MD that "the X-rays are perfect" and that "you just need time" and "your knee was the worst one I've ever seen"

This course is part of a five-course series on joint arthroplasty:

• Current Concepts in Joint Replacement: Following Arthroplasty - An Update
• Shoulder Arthroplasty: Return to Function - An Update
• Hip Arthroplasty: Improving Gait - An Update
• Knee Arthroplasty: Increasing Range of Motion - An Update
• Troubleshooting Difficult Cases in Joint Arthroplasty

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Core strengthening exercises are often used as a rehabilitation exercise for athletes. However, today there is currently valid evidence to support incorporating these exercises into all rehab settings to enhance outcomes. Core strengthening exercises help the development of proximal stability for distal mobility and for satisfying the human body's stages of motor control. Traditional fall prevention programs often do not include performing core exercises that facilitate all the facets of core stability, and that is a main focus of this course.

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Fall risk increases significantly as the elderly age. As the human body ages, there is a significant decline in strength, especially in the lower extremities. In addition to the decline in strength, there is a gradual progression of postural changes and loss of flexibility. One area that drastically becomes compromised is the lumbopelvic hip region. The principles of motor control state that to have optimal locomotion, the human body must first achieve a balance between proximal stability and distal mobility. The principle of reciprocal inhibition stresses that when muscle groups become adaptively shortened, opposing muscle groups are also inhibited. In no other region of the human body does this principle have more practical application than the hip. The clinician that designs a fall prevention program that addresses the fundamentals of motor control and identifies patients who are either deficient in mobility or stability of the hips will achieve greater outcomes in reducing falls than their colleagues.

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As the population ages, there is a decline in balance and postural control and thus the increase in falls. To address this, the traditional approach is to practice balance exercises on various surfaces and with rehab tasks that involve perturbation activities to stimulate and facilitate the human body's systems of balance: vestibular, vision, and mechanoreceptors. This course will enhance the attendee's knowledge base by providing evidence-based research on balance to augment what is currently mostly done anecdotally. This course is also designed to excite the attendee in first knowing "what's inside the box" before they can look "outside the box;" to help them get out of the common rut of clinical practice of habit and routine, and jazz up their geriatric population's balance training programs for fall prevention.

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The human body eventually develops age-related changes that affect posture, strength and balance. These physiological changes can reduce a person's activity level and increase the likelihood for a fall. A person's ability to maintain upright posture, strength and balance declines after the fourth decade of life. Thus, to remain active and achieve a longer lifespan of safe, independent living it is imperative that an adult participate in a regular physical fitness program that encompasses all the key components of fitness. Among these are core and hip stability training incorporated with a lifelong progressive balance program. Today's traditional rehabilitation programs designed to address fall risk and prevention are typically performed by clinicians who do not incorporate the evidence that has been identified through research that can help to achieve superior results to what is currently being offered to our geriatric population. Today's geriatric population is more informed and has higher expectations of their rehabilitation providers. The traditional geriatric patient is being replaced by a more active senior, and thus the new term GERIACTIVE! This course will provide the attendee the knowledge of the highest and most current evidence-based research for core and hip stability, as well as balance training, to take your current programs to the next level and challenge the future aging population.

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