Instructional Courses

Maximize your learning experience by adding up to THREE in-depth Instructional Courses to your conference registration. Offered pre- and post-conference, these courses help you dive deep into hot topics and areas of special interest, connect with like-minded colleagues, and add to your total Continuing Education credits earned.

Can't make it to full conference? Instructional Courses are the perfect solution for busy local clinicians, consumers, and researchers who need to know the latest in rehabilitation research. Designed as half-day intensive workshops, they provide outstanding educational value at a modest price. Discounts apply when you register for two or more courses. Continuing Education credits included for your choice of 11 disciplines.

 

1. Coping Skills Training for Survivors of BI ...
2. Fatigue in Traumatic Brain Injury ...
3. Evidence, Expertise and Applicability ...
4. Getting Fit and Staying Active ...
5. Cancer Rehabilitation: An Update ...
6. An Introduction to Longitudinal Data ...
7. Reversing Chronic Disease with Fork ...
8. Inter-Professional Clinical Practice ...
9. A Canadian Brain Injury Rehab ...
10. Advanced Symposium on Teaching ...
11. Cancer Rehabilitation: Utilization of ...
12. An Introduction to Longitudinal Data ...
13. A Multidisciplinary Approach in the ...
14. Everything You Wanted to Know About CARF ...
15. Solving Business and Clinical Dilemmas ...
16. Multimorbidity and Secondary Health ...
17. Building a Research Culture in a Clinical ...
18. Ensuring the Delivery of High-Quality ...
19. Harmonizing the Measurement of ...
20. Functional Electrical Stimulation for Gait: ...
21. Mental Practice for Movement After ...
22. The Role of Physical Therapy across the ...

WEDNESDAY, 8 OCTOBER // MORNING SESSIONS

1. Coping Skills Training for Survivors of Brain Injury and Caregivers: A Workshop #1054
Wednesday, 8 OCT // 8:00 AM – 5:00 PM *Note: This is a full-day session equivalent to two courses.

Faculty
Samantha Backhaus, PhD, Rehabilitation Hospital of Indiana, Indianapolis, IN; Summer Ibarra, PhD, Rehabilitation Hospital of Indiana, Indianapolis, IN

Diagnosis/Area of Practice: Brain Injury
Focus: Clinical practice (assessment, diagnosis, treatment, knowledge translation/EBP)
Intended Audience: Researchers

Emotional challenges are often present in survivors of brain injury (BI) as well as caregivers. These challenges affect the person’s ability to meet rehabilitation goals and affect long-term outcomes, as well as the family’s ability to function. In this workshop, participants will learn how to facilitate an evidenced-based treatment that teaches coping skills in a small group format to individuals with BI and their caregivers. This intervention provides psychoeducation, group therapy, and stress management skills to help families deal with the effects of the injury. Modules of this treatment, which is 20 weeks, include information regarding: (1) Healthy Brain; (2) Effects of Brain Injury; (3) Caregiver Coping Strategies; (4) Expectations for Recovery; Effects of Alcohol and BI; (5) Dealing with Challenges after BI; (6) Signs of Depression; and (7) the 5 R’s of Stress Management. The morning session will be didactic and content-driven, focused on teaching: (1) what research shows regarding the efficacy of this treatment, and (2) the 7 Modules or content of this treatment. By the end of this portion, participants will acquire knowledge on what specific interventions can be provided to help individuals with BI improve emotional functions and adjustment to injury. The afternoon session will be experiential and process-driven, focused on (1) practicing cognitive-behavioral and dialectical-behavioral techniques, and (2) facilitating small group interventions using break-out sessions. At the conclusion of this portion, participants should acquire familiarity and skills on how to conduct these interventions in group therapy.

Learning Objectives
To support the attainment of knowledge, competence, and performance, the learner should be able to achieve the following objectives:

  1. Familiarize oneself with various modules or content areas used in this intervention
  2. Describe cognitive-behavioral and dialectical-behavioral strategies adapted to individuals with BI
  3. Discuss guidelines for facilitating the group therapy
  4. Acquire skills to conduct various coping skills training in small group settings

 

2. Fatigue in Traumatic Brain Injury: Current State of Knowledge and Future Direction #1049
Wednesday, 8 OCT // 8:00 AM – 12:00 PM

Faculty
Angela Colantonio, PhD, University of Toronto, Toronto, ON; Colin M. Shapiro, PhD, FRCPC, Toronto Western Hospital-UHN, Toronto, ON; Tetyana Kendzerska, MD, PhD (C), University of Toronto, Mississauga, ON; Catherine Wiseman-Hakes, PhD, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON; Tatyana Mollayeva, MD, PhD (C), University of Toronto, Toronto, ON

Diagnosis/Area of Practice: Brain Injury
Also relevant to Sleep, Preventive Medicine, Rehabilitation, Neuroscience, Occupational Medicine, Cognitive Science, Policy and Evaluation
Focus: Clinical practice (assessment, diagnosis, treatment, knowledge translation/EBP)
Intended Audience: Researchers and clinicians

Over the last few decades, evidence has been emerging of post-traumatic fatigue (PTF) as a common, long-lasting problem after traumatic brain injury (TBI). The overall health burden of this symptom in TBI is not precisely known, given its multifaceted nature and occurrence within a broader array of signs and symptoms. Moreover, reports on its incidence have been problematic – studies cite a wide range between 21 percent and 73 percent, depending on the population studied and methods of identifying fatigue. Hidden within these statistics are even more troubling trends, such as the injured person's inability to sustain goal-directed exertion and to function independently after the injury. It is critical to note that PTF is a major concern for many individuals with TBI and to clinicians as well as policyholders who allocate resources to deal with this symptom. We are committed to simultaneously educating and thus increasing the understanding of the distinction between post-traumatic excessive sleepiness, apathy, and PTF, and the associated clinical and functional implications. We also aim to facilitate a discussion in this critical area, resulting in multidisciplinary efforts (collaboration of sleep, brain injury, and rehabilitation research) to address this complex problem.

Learning Objectives
To support the attainment of knowledge, competence, and performance, the learner should be able to achieve the following objectives:

  1. Define post-traumatic fatigue (PTF)
  2. Provide an overview of the multifactorial etiology of PTF and be able to distinguish between fatigue, daytime sleepiness and impaired alertness
  3. Recognize the role of the disruption in the neuroanatomical structures which can result in impaired alertness
  4. Discuss appropriate methods for the assessment of fatigue in TBI practice to enhance patient outcomes and reduce potential treatment errors
  5. Understand current pharmacological and non-pharmacological interventions for PTF

 

3. Evidence, Expertise and Applicability: Key Lessons in Development and Implementation of TBI Clinical Practice Guidelines #1073
Wednesday, 8 OCT // 8:00 AM – 12:00 PM

Faculty
Mark Theodore Bayley, MD, FRCPC; UHN Toronto Rehab, University of Toronto, Toronto, ON; Shawn Marshall, MD, MSc, FRCPC, Ottawa Hospital Research Institute, Ottawa, ON; Corinne Kagan, BA, BPS Cert, Ontario Neurotrauma Foundation, Toronto, ON; Isabelle Gagnon, PT, PhD, Montreal Children's Hospital, Montreal, QC; Donna Ouchterlony, MD, St. Michael's Hospital, Toronto, ON; Diana Velikonja, PhD, C.Psych, Hamilton Health Sciences and McMaster University, Hamilton, ON; Carol Ann DeMatteo, OT, MSc, McMaster University, Hamilton, ON; Marie-Eve Lamontagne, PhD, CIRRIS, Québec, QC; David Caplan, Ontario Neurotrauma Foundation, Toronto, ON; Robert William Teasell, MD, FRCPC, St. Joseph's Health Care London, London, ON; Catherine Truchon, PhD, Msc Adm, Institut national d'excellence en santé et services sociaux (INESSS), Québec, QC

Diagnosis/Area of Practice: Brain Injury
Focus: Clinical practice (assessment, diagnosis, treatment, knowledge translation/EBP)
Intended Audience: Clinicians, researchers, administrators, and CPG developers

Ontario Neurotrauma Foundation (ONF) and partners have developed expertise in the development and implementation of clinical practice guidelines (CPGs) for rehabilitation of adult and pediatric traumatic brain injury (TBI) populations, effectively translating research into clinical practice. This course provides an overview of approaches taken in the development and update of CPGs, following established methods of gathering and analysing evidence, evaluating quality of existing guidelines, and engaging multidisciplinary stakeholders in assessing and structuring recommendations for improved practice. This course focuses on lessons learned through the process of creating and implementing a variety of CPGs. It will begin by outlining the wide variety of TBI CPGs and CPG-related projects undertaken by ONF and its partners. These projects will be used throughout the course as examples of initiatives across the spectrum of development and implementation from concussion/mild TBI to moderate and severe TBI, including information on the Pediatric mTBI/Concussion guidelines which are currently in progress, illustrating the challenges and lessons uncovered from these experiences. Topics covered in this course include: standardized approach to guideline development, professional buy-in, stakeholder feedback, consumer relevancy, the use of systematic reviews, systematic and systemic challenges to guideline creation, tools used for implementation, keeping information up-to-date through guideline updates, and finally lessons learned and what we still have to learn about implementation. The wide variety of expertise brought to the table by ONF and its partners as faculty for this course help provide a very comprehensive view of the guideline development and implementation process and its challenges.

Learning Objectives
To support the attainment of knowledge, competence, and performance, the learner should be able to achieve the following objectives:

  1. Describe strategies to include and engage users in the development of clinical practice guidelines
  2. Discuss the roles that evidence, expert opinion and feasibility issues play in building recommendations
  3. Understand lessons from several approaches in knowledge translation that worked and those that did not
  4. Understand the facilitators and barriers to implementation and the influence of these on success

4. Getting Fit and Staying Active: Promoting Long-Term Health and Fitness in the SCI Community #1072
Wednesday, 8 OCT // 8:00 AM – 12:00 PM

Faculty
Nicholas Evans, MHS, ACSM-CES, ACSM-HFS, Shepherd Center, Atlanta, GA; Mark S. Nash, PhD, FACSM, University of Miami Miller School of Medicine, Miami, FL; Audrey Hicks, PhD, McMaster University, Hamilton, ON, Canada; Jennifer French, MBA, Neurotech Network, Tampa, FL; Rachel Cowan, PhD, ACSM-CES, University of Miami, Miami, FL; Scott Bickel, PT, PhD, FACSM, University of Alabama at Birmingham, Birmingham, AL; Eric Harness, CSCS, Project Walk, Carlsbad, CA; Elizabeth Sasso, DPT, Shepherd Center, Atlanta, GA

Diagnosis/Area of Practice: Spinal Cord Injury
Focus: Clinical practice (assessment, diagnosis, treatment, knowledge translation/EBP)
Intended Audience: Clinicians: Physical Therapist (Physiotherapists), Clinical Exercise Physiologists, SCI Researchers, Certified Special Populations Trainers, Physicians

The CDC reports the prevalence of obesity among adults with disabilities is 58 percent higher than the aggregate adult population. In addition to obesity, other serious secondary health complications exist among those with disbabilities, particularly following spinal cord injury, and include cardiovascular disease, pulmonary disorders, and diabetes. Health care professionals must identify existing problems, diagnose relevant issues, and prescribe solutions to health concerns associated with chronic disabilities. This course will review the current health status and risks associated with spinal cord injury. A panel of experts in SCI research, rehabilitation, and community-based programming will provide evidenced-based recommendations for exercise prescription and programming. This will be discussed in the context of promoting healthy lifestyles throughout the continuum of care and developing innovative approaches to promoting exercise participation and adherence across the lifespan. The emphasis will be on the use of technology and web-based systems to reach individuals in various community settings and across the economic spectrum. Specific highlighted approaches will include nutrition, fitness videos, and interactive strategies to motivate participation. The goal of these programs is to achieve community re-integration and reduce the long-term health complications following discharge from clinical rehabilitation programs. The session will end with a discussion of translation of evidence into practice. This instuctional course is supported by the ACRM SCI-ISIG Fitness and Wellness Task Force.

Learning Objectives
To support the attainment of knowledge, competence, and performance, the learner should be able to achieve the following objectives:

  1. Identify the long-term health status and prevalence of secondary complications among those living with spinal cord injuries.
  2. Discuss the existing exercise prescription guidelines for the SCI community and explore successful approaches to implementation and information dissemination across the continuum of care.
  3. Identify innovative strategies for exercise promotion including the use of technology and web-based resources to reach a diverse population.
  4. Create and implement exercise programs to motivate initiation and continuation of participation among the SCI community.

5. Cancer Rehabilitation: An Update and Discussion of Future Care #1055
Wednesday, 8 OCT // 8:00 AM – 12:00 PM

Faculty
Julie K. Silver, MD, Harvard Medical School, Foxborough, MA; Vishwa Raj, MD, Carolinas Rehabilitation, Charlotte, NC; Nicole L. Stout, DPT, Independent consultant, Damascus, MD

Diagnosis/Area of Practice: Cancer Rehabilitation
Focus: Clinical practice (assessment, diagnosis, treatment, knowledge translation/EBP)
Intended Audience: Clinicians

Cancer treatment ideally involves interdisciplinary rehabilitation care. This care that is part of the continuum for other serious illnesses and injuries – such as stroke or traumatic brain injury – is often poorly implemented or entirely missing from cancer care. It is important to consider the multifaceted needs of this population including functional, psychosocial, cognitive and physical issues. Cancer and its various treatments introduce a host of implications that negatively impact function. From the point of diagnosis throughout active treatment and for the duration of a cancer survivor's lifetime there are short- and long-term risks for functional morbidity. Cancer rehabilitation is an important part of the cancer care continuum albeit one that is under-recognized and under-utilized. Though cancer survivors are often counseled to “accept a new normal” this may come at a time when there is still healing that may be accomplished. This course will cover the current state of cancer rehabilitation along with the evidence base to support interventions throughout the continuum of care. Additionally, emerging issues in cancer rehabilitation care, including research needs, national and international guidelines and recommendations will be discussed.

Learning Objectives
To support the attainment of knowledge, competence, and performance, the learner should be able to achieve the following objectives:

  1. Identify the key recommendations from three important reports from the Institute of Medicine
  2. Cite barriers to implementing cancer rehabilitation care
  3. List the steps needed to develop an interdisciplinary cancer survivorship team that includes cancer rehabilitation
  4. Identify evidence to support cancer rehabilitation clinical interventions in various care settings
  5. Identify the gaps in research and recognize areas of practice where research trials would be beneficial

6. An Introduction to Longitudinal Data Analysis Part I: Continuous Outcomes #1048
Wednesday, 8 OCT // 8:00 AM – 12:00 PM

Faculty
Christopher R. Pretz, PhD, Craig Hospital / NDSC, Englewood, CO; Allan John Kozlowski, PhD, Icahn School of Medicine at Mount Sinai, New York, NY; Kristen Dams-O'Connor, PhD, Mount Sinai School of Medicine, New York, NY

Diagnosis/Area of Practice: Diagnosis-independent or NA.
Focus: Research methods (e.g., measurement, research design analytic/statistical methods)
Intended Audience: Researchers and clinicians

As the maturation of longitudinal datasets in rehabilitation (e.g., the Spinal Cord Injury National Dataset and the TBI Model Systems National Dataset) continues, the need for rehabilitation researchers to appropriately assess how outcomes progress over time grows. Fortunately, a number of advanced statistical methodologies are available to accurately assess longitudinal data in the presence of continuous outcomes. Rehabilitation researchers will be advantageously positioned to explore a wide variety of hypotheses regarding temporal effects related to outcome for observational and randomized study designs. This instructional course will provide an overview of these methods. Topics to be discussed include, but are not limited to profile analysis, trend analysis, and linear and non-linear individual growth curve analysis. The course improves upon previously offered instructional courses in that an introduction to utilizing different software packages will be included in the agenda.

Learning Objectives
To support the attainment of knowledge, competence, and performance, the learner should be able to achieve the following objectives:

  1. Understand the different types of longitudinal analyses as related to continuous outcomes
  2. Become familiar with the different software packages used in conducting longitudinal analysis
  3. Properly design/conduct his/her own longitudinal research study
  4. Effectively communicate with statisticians/biostatisticians and other researches with respect to longitudinal analysis of continuous outcomes
  5. Understand the unique characteristics of longitudinal data and how these unique characteristics are accounted for in the analytic process

7. Reversing Chronic Disease with Fork and Knife #1077
Wednesday, 8 OCT // 8:00 AM – 12:00 PM

Faculty
Hans A. Diehl, DrHSc, MPH (Nutrition), FACN, School of Medicine, Loma Linda University, Loma Linda, CA

Diagnosis/Area of Practice: Diagnosis-independent
Focus: Other
Intended audience: Researchers, neuropsychologists and other clinicians, such as physicians, physical therapists, occupational therapists and dietitians

The accomplishments of modern medicine have been prodigious. Even so, the advances in high-tech medicine to take care of acute and episodic diseases have not altered the advances of our modern killer diseases, foremost among them cardiovascular diseases, cancer, and diabetes. Rarely found before WWI, these chronic diseases are now accounting for 70 percent of deaths in North America and consuming 84 percent of the US healthcare budget. Atherosclerotic processes and their accompanying low grade chronic inflammatory processes, largely under the control of an affluent lifestyle, have been identified as the sine qua non of our circulation-related chronic disease epidemic (http://chiphealth.com/About-CHIP/Proven-Results/Atherosclerosis/). This course will provide detailed epidemiological, patho-physiological and clinical evidence how these modern diseases are a largely preventable and reversible food-borne epidemic. Evidence will be shown how human lesions regress, how most type 2 diabetes and essential hypertension will normalize while medication requirements have to be lowered or discontinued, and how people lose excess weight while eating more, all by moving towards a more whole-food, plant-based diet. The Complete Health Improvement Program (65,000 graduates, 30 scientific publications) (www.CHIPhealth.com) will show how you can use this video-assisted intensive educational lifestyle intervention program to educate, motivate and inspire your patients in a group setting and a caring environment to not only turn their established chronic diseases around or reduce their recurrence, but this approach will improve the lives of those suffering from spinal cord injuries and strokes, concerned with co-morbid conditions (overweight, hypertension, diabetes, and depression) and pharmacological side effects.

Learning Objectives
To support the attainment of knowledge, competence, and performance, the learner should be able to achieve the following objectives:

  1. Describe the atherogenicity of the Western Diet (and lifestyle) affecting circulation-related chronic diseases
  2. Recognize the therapeutic efficacy of a simpler, whole food, plant-based diet in arresting and reversing common chronic diseases
  3. Recognize that much of hypertension, T2 diabetes, overweight, CHD is subject to reversal while simultaneously lowering drug requirements
  4. Recognize how patients with spinal cord injury and strokes can alleviate/reduce co-morbidity (depression, overweight, hypertension, hypercholesterolemia, CHD
  5. Describe how patients can be motivated to lower the recurrence of procedures (such as coronary bypass), medication or chronic disease (such as stroke)

14. Everything You Wanted to Know About 2014 CARF Standards and Process and Much More! #1469
Wednesday, 8 OCT // 8:00 AM – 12:00 PM

Faculty
Chris MacDonell, CARF International, Washington, DC

Diagnosis/Area of Practice: Other/ Cross-cutting
Focus: Other
Intended Audience: Clinicians, administrators, quality directors, lead accreditation personnel

This session will focus on introducing CARF and its accreditation process with statistics from the most recent organizational information, and addressing changes in the 2014 CARF Medical Rehabilitation Standards manual being used on all surveys from July 1, 2014 through June 30, 2015. Techniques for imbedding standards into day-to-day practice to decrease anxiety and expense in the survey process, and tips from surveyors about preparation and review of problem areas in standards across medical rehabilitation programs will be discussed. Emphasis will be placed on problem solving and getting your questions answered. Explore how CARF fits into the CMS Quality 2013 and Beyond strategy as well as how person-centered practices can improve the quality of your programs.

Learning Objectives
To support the attainment of knowledge, competence, and performance, the learner should be able to achieve the following objectives:

  1. Identify changes in 2014 CARF Standards manual and how they will impact your organization
  2. Examine different preparation techniques and utilization of standards approaches to determine best fit with your organization
  3. Question person-centered practices in your organization and determine if change, education, and/or dialogue is needed to ensure quality.

16. Multimorbidity and Secondary Health Conditions after SCI: Critical insights and Advances from the North #1517
Wednesday, 8 OCT // 8:00 AM – 5:00 PM

Faculty
Paul Yoo, PhD, Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON, Canada; Mohamad Sawan, PhD, Fellow IEEE, École Polytechnique, Montreal, QC, Canada; Magdy Hassouna, MD, PhD, FRCSC, FACS, and Sukhvinder KalsiRyan, BScPT, MSc, PhD, Toronto Western Hospital, University Health Network, Toronto, ON, Canada; Naaz Desai, MS Rehabilitation Science; José Zariffa, PhD, and B. Catherine Craven, BA, MD, FRCPC, MSc, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada; Pamela Houghton, PT, PhD, School of Physical Therapy, Western University, London, ON, Canada; Lora Giangregorio, PhD, Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada

Diagnosis/area of practice: Spinal Cord Injury
Focus: Clinical practice (assessment, diagnosis, treatment, knowledge translation/EBP)
Intended audience: Researchers and clinicians

Spinal cord injury results in diverse motor, sensory and autonomic impairments which materially contribute to the observed multimorbidity among those aging with spinal cord injury. This Instructional Course will be structured around three themes reflecting different aspects of managing multimorbidity after SCI:

  1. Treatment of neurogenic bladder dysfunction.
  2. Understanding and facilitating neurorecovery through assessment of upper limb function.
  3. Understanding the linkage between body composition and multimorbidity

Participants will have the opportunity to explore advances in technology, assessment and the pathophysiology of multimorbidity after SCI. The course format is intended to facilitate critical thinking, hands on learning and small group discussions.

Learning Objectives
To support the attainment of knowledge, competence, and performance, the learner should be able to achieve the following objectives:

  1. To describe and critically evaluate evolving techniques to treat neurogenic bladder dysfunction after SCI.
  2. To assist clinicians and researchers in selecting the most appropriate methods to assess and monitor
  3. Upper limb function/recovery in the sub-acute phase after SCI.
  4. To understand the relationships between altered body composition and health status after spinal cord injury.

19. Harmonizing the Measurement of Function: From the Acute Hospital Throughout Post-Acute Care #1156
Wednesday, 8 OCT // 8:00 AM – 12:00 PM

Faculty

Paulette Niewczyk, MPH, PhD, UDSMR and Daemen College, Amherst, NY; Pamela Roberts, PhD, MSHA, OTR/L, Cedars-Sinai Medical Center, Los Angeles, CA; Jacquline Mix, MS, Researcher, UDSMR, Amherst, NY; Robert Rondinelli, MD, PhD, UnityPoint Health, Des Moines, IA

Diagnosis/Area of Practice: Other. Medical Rehabilitation, all impairments
Focus: Clinical practice (assessment, diagnosis, treatment, knowledge translation/EBP)
Intended Audience: Clinicians, including physicians, nurses, therapists, discharge planners as well as researchers and hospital/clinic administrators

With the possibility of bundled payment, and the establishment of several accountable care organizations nationwide, it is widely recognized that there is a need to assess the medical and functional status of patients and to track the patients using the same measurements throughout the continuum of healthcare. However, it has been difficult to measure rehabilitation outcomes across an entire episode of care since the items and the rating scales differ between instruments used in different venues of care. Burden of care as the metric to document functional status throughout the continuum of care will be discussed in depth. Several instruments that capture burden of care will be introduced, each with a low burden of assessment to assist clinicians in discharge planning and may aid in changes to payment for rehabilitation care. This session will define the concepts of patient burden of care and measurement of function and participants will be able to recognize the importance of a common outcome assessment metric used throughout the continuum of care. Tools on how to measure functional status, monitor outcomes of care, and assess patient burden of care in the acute care hospital and in post-acute care facilities will be discussed. Several research studies will be presented outlining the study designs and methodologies used, and data results of the research studies will be shared.

Learning Objectives
To support the attainment of knowledge, competence, and performance, the learner should be able to achieve the following objectives:

  1. Define the concepts of patient burden of care and measurement of function and recognize the importance of a common outcome assessment metric used throughout the continuum of care
  2. Explain how to measure functional status, monitor outcomes of care, and assess patient burden of care in the acute care hospital and in post-acute care facilities, including inpatient rehabilitation, skilled nursing facilities, long-term care hospitals, home health and outpatient rehabilitation
  3. Describe results of research projects currently underway that incorporate the functional assessment instruments in various venues of care

20. Functional Electrical Stimulation for Gait: A Clinical Update in Neurorehabilitation #1171
Wednesday, 8 OCT // 8:00 AM – 12:00 PM

Faculty

Michael W. O’Dell, MD, New York-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY; Kari Dunning, PhD, College of Allied Health Sciences, College of Medicine, University of Cincinnati, Cincinnati, OH; Keith McBride, DPT, Bioness, Inc., Valencia, CA; Candy Tefertiller, MPT, ATP, NCS, Craig Hospital, Denver, CO

Diagnosis/Area of Practice: Other/Cross-Cutting, i.e., neurodegenerative disease (e.g., MS, Parkinson’s disease), stroke, spinal cord injury
Focus: Clinical practice (assessment, diagnosis, treatment, knowledge translation/EBP)
Intended Audience: Clinicians

Functional electrical stimulation (FES) is a commonly used technique to enhance ambulation in several neurological populations including stroke, multiple sclerosis (MS) and spinal cord injury (SCI.) There are at least a few commercially available brands on the market in the United States. The technology can be used as either an adjunct to traditional exercise (training) or, more practically, as a real-time strategy to facilitate foot clearance during walking activities. After a brief overview of the physiological effects of lower extremity FES, this session will provide a brief summary of recent clinical evidence evaluating FES for recovery of gait in neurological rehabilitation. Speakers will review disease specific data in stroke, MS and SCI emphasizing the differential orthotic or therapeutic effect of the technology. The session will conclude with questions and answers.

Learning Objectives
To support the attainment of knowledge, competence, and performance, the learner should be able to achieve the following objectives:

  1. Discuss the effects of lower extremity functional electrical stimulation on the peripheral and central nervous systems
  2. Outline recent clinical evidence for the effectiveness of FES to enhance gait in persons with selected neurological disease and injury.
  3. Distinguish an orthotic versus a therapeutic effect of FES on gait in persons with neurological disease and injury.

22. The Role of Physical Therapy across the Patient Care Continuum in Pediatric Oncology #1385
Wednesday, 8 OCT // 8:00 AM – 12:00 PM

Faculty

Susan Miale, PT, DPT, PCS, Stony Brook University, Stony Brook, NY; Raymond McKenna, PT, PhD, Stony Brook University. Stony Brook, NY

Diagnosis/Area of Practice: Cancer rehabilitation. Also relevant to pediatrics.
Focus: Clinical practice (assessment, diagnosis, treatment, knowledge translation/EBP)
Intended Audience: Clinicians

Cancer itself and the many medical interventions used to fight cancer can cause significant problems in the developing child. Children with cancer are at risk for physical, social, functional, and emotional deficits, both during treatment and in the years that follow. As medical treatments improve and survival rates increase, the medical community recognizes the importance of interventions that focus on improving quality of life. Physical therapy can help prevent developmental delay and dysfunction and improve motor performance and quality of life in children with cancer during the active phase of treatment, following completion of treatment, and in palliative care. Physical therapy also plays an important role in the survivorship phase. The speakers will follow the course of physical therapy intervention from diagnosis to survivorship. Specifically, the speakers will discuss the role of physical therapy in the acute care setting and highlight the importance of screening children for developmental delays and functional deficits early in the treatment phase. The speakers will also discuss physical therapy treatment techniques, family education and behavioral modification strategies across all rehabilitation settings (acute care, inpatient rehabilitation, outpatient rehabilitation, early intervention, school system, and home care). The speakers will present evidence for therapeutic intervention in this patient population as it relates to function and quality of life. Lastly, the speakers will discuss the importance and structure of wellness programs aimed at maximizing quality of life. The goal of this course is to provide the listener with an overview of physical therapy intervention across the continuum of care for children with cancer.

Learning Objectives
To support the attainment of knowledge, competence, and performance, the learner should be able to achieve the following objectives:

  1. Demonstrate a basic knowledge of how to effectively screen patients to determine the need for physical therapy services in the acute pediatric oncology setting
  2. Identify various treatment techniques employed by pediatric physical therapists to treat children with cancer and recognize the benefits of physical therapy intervention from an evidence-based perspective
  3. Recognize the value of physical therapy intervention in palliative care
  4. Identify the role of wellness for the pediatric cancer survivor and recognize the benefits of family inclusion in wellness program
  5. Identify strategies to maximize participation in physical therapy intervention and wellness programs for all participants

WEDNESDAY, 8 OCTOBER // AFTERNOON SESSIONS

1. Coping Skills Training for Survivors of Brain Injury and Caregivers: A Workshop #1054
Wednesday, 8 OCT // 8:00 AM – 5:00 PM (Continued from morning)

8. Inter-Professional Clinical Practice Guideline for Vocational Evaluation Following Traumatic Brain Injury: Development, Implementation and Evaluation #1079
Wednesday, 8 OCT // 1:00 PM – 5:00 PM

Faculty
Mary Stergiou-Kita, PhD, University of Toronto, Toronto, ON; Christina Dillahunt-Aspillaga, PhD, University of South Florida, Tampa, FL

Diagnosis/Area of Practice: Brain Injury
Focus: Clinical practice (assessment, diagnosis, treatment, knowledge translation/EBP)
Intended Audience: Clinicians, consumers, educators and program managers

The Inter-professional Clinical Practice Guideline for Vocational Evaluation was developed using both the research evidence and a panel of clinical and academic experts across professional disciplines, e.g., occupational and physical therapy, social work, medicine, speech and langauge pathology, neurpsychology, employment, academia. The steps outlined in the Canadian Medical Association's Handbook on Clinical Practice Guidelines were followed to develop the guideline and included: (1) identification of the key guideline objective and questions; (2) performance of a systematic literature review; (3) gathering a panel; (4) development of recommendations; (5) guideline writing; and (6) pilot testing. The Appraisal of Guidelines for Research and Evaluation (AGREE) instrument was also utilized to ensure a rigourous methodology and a multi-professional panel to ensure representation from relevant future guideline useres. The objectives of the guideline is to make explicit the processes and factors relevant to vocational evaluation to assist evaluators, i.e., healthcare teams, individuals and employers in collaboratively determining if clients are able to work and making recommendations for work entry, re-entry or vocational planning. The resulting guideline includes 17 key recommendations within the following seven domains: (1) evaluation purpose and rationale; (2) initial intake process; (3) assessment of the personal domain; (4) assessment of the environment; (5) assessment of occupational/job requirements; (6) analysis and synthesis of assessment results; (7) development of evaluation recommendations. The guideline can assist clinicians, vocational rehabilitation counselors, health care teams, individuals with TBI, and employers to complete a vocational evaluation to determine work readiness and develop return to work plans.

Learning Objectives
To support the attainment of knowledge, competence, and performance, the learner should be able to achieve the following objectives:

  1. Introduce participants to the guideline
  2. Train participants on how to use the guideline
  3. Explore how participants currently identify the key processes and factors relevant to consider within their vocational evaluations and discuss how their current clinical practices compare to the best practice recommendations
  4. Discuss results from pilot studies completed at two study sites, one in Toronto and one in Florida, investigating vocational evaluation practices in relation to best practice recommendations
  5. Identify potential facilitators and barriers to the guideline's implementation based on evidence from pilot studies completed to date and participants' discussions of their own practice processes

9. A Canadian Brain Injury Rehabilitation Centre for Excellence: Current and Future Directions # 1085
Wednesday, 8 OCT // 1:00 PM – 5:00 PM

Faculty
Peter Rumney, MD, FRCPC; Michelle Keightley; Nick Reed; Ryan Hung; Dayna Greenspoon, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON

Diagnosis/Area of Practice: Brain Injury
Focus: Pediatric Rehabilitation
Intended audience: Clinicians

Key clinician scientists from Paediatric Brain Injury Rehabilitation will present their research and best practice recommendations. Dr. Keightley will discuss current information on the structuring of active rehabilitation along with cognitive rest post-concussion. Dr. Reed with a Constraint Induced Movement Therapy program in children with hemiparesis post-ABI. Dr. Hung will present on the commonality of sleep disorders in children post-ABI and their treatments. Dr. Rumney on the reliability of the KOSCHI with an algorithm to improve the consistency of the KOSCHI scoring.

Learning Objectives
To support the attainment of knowledge, competence, and performance, the learner should be able to achieve the following objectives:

  1. Understanding of the current best practise in Paediatric Mild TBI rehabilitation and improving outcomes
  2. Using current tools in best practice for Outcome Assessment after Paediatric ABI at all levels of severity
  3. Critical evaluation of the use of CIMT in hemiparesis in children post-ABI and current models of treatment
  4. Approaching sleep disorders post-ABI in children from an objective and best practice approach

10. Advanced Symposium on Teaching the International Standards for Neurological Classification of Spinal Cord Injury #1096
Wednesday, 8 OCT // 1:00 PM – 5:00 PM

Faculty
Ronald K. Reeves, MD, Mayo Clinic College of Medicine, Rochester, MN; Mary Schmidt-Read, PT, DPT, MA, Magee Rehabilitation, Philadelphia, PA; members of the American Spinal Injury Association Education Committee

Diagnosis/Area of Practice: Spinal Cord Injury
Focus: Clinical practice (assessment, diagnosis, treatment, knowledge translation/EBP)
Intended audience: Clinicians with experience performing and teaching the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI)

The International Standards for the Neurologic Classification of Spinal Cord Injury (ISNCSCI) are used worldwide. Accurate assessment and classification of spinal cord injuries is becoming increasingly critical to patient management and the measurement of research outcomes. The e-learning course, InSTeP, developed by the American Spinal Injury Association provides the foundation for successful utilization of the ISNCSCI. However, clinicians in SCI medicine need advanced hands-on training to effectively apply and teach the Standards. This interactive pre-course will provide background, case examples, and teaching strategies to refine the participant’s skills in conducting training on the ISNCSCI examination and classification. Suggested Course Preparation: (1) Certificate of completion from the International Standards E-Learning Program (InSTeP) available though the American Spinal Injury Association Learning Center; (2) Proficiency in ISNCSCI examination; and (3) Experience training others the ISNCSCI examination and classification.

Learning Objectives
To support the attainment of knowledge, competence, and performance, the learner should be able to achieve the following objectives:

  1. Determine the level, severity and completeness of even the most atypical SCI cases
  2. Utilize a variety of teaching strategies to meet the needs of a wide range of learning styles and objectives
  3. Demonstrate examination skills for the most challenging and atypical SCI situations

11. Cancer Rehabilitation: Utilization of Inpatient Rehabilitation for the Oncology Patient #1084
Wednesday, 8 OCT // 1:00 PM – 5:00 PM

Faculty
Vishwa S. Raj, MD, Carolinas Rehabilitation, Charlotte, NC; Adrian Cristian, MD, Kingsbrook Rehabilitation Institute, Brooklyn, NY; Eugene Chang, MD, Toronto Rehabilitation Institute, University of Toronto, Toronto, ON: David Harvey, MD; Juravinski Hospital, Hamilton, ON

Diagnosis/Area of Practice: Cancer Rehabilitation
Focus: Other or N/A
Intended audience: Researchers, Clinicians, and Administrators

As the role of rehabilitation becomes more prevalent in the survivorship plan of care, clinicians have become very interested in how oncology rehabilitation services can be delivered to individuals living with cancer diagnoses. Clinical and regulatory environments are changing rapidly, and there has been a significant emphasis on the growth and development of cancer rehabilitation programs throughout the continuum of care. Due to an increased focus on effectiveness and efficiency of clinical services, acute care settings are evaluating a variety of post-acute care options to transition patients such that they receive appropriate levels of both medical and functional care. One underutilized method of delivery is acute inpatient rehabilitation services. The purpose of this instructional course is to review the relevant clinical and legislative issues (both in Canada and the United States) that are relevant to the growth and development of inpatient cancer rehabilitation programs. The evidence basis for inpatient rehabilitation continues to grow, but several variables must be considered when initiating a program to maintain patient safety. In addition, different systems of practice are directly impacted by regional legislative and regulatory policies. Hence the delivery of care may vary according to diagnosis, resources available to the inpatient rehabilitation facility, and geographic location of the rehabilitation unit.

Learning Objectives
To support the attainment of knowledge, competence, and performance, the learner should be able to achieve the following objectives:

  1. Outline the evidence basis regarding the benefits of inpatient rehabilitation for cancer patients
  2. Review how patient safety impacts the delivery of rehabilitation services
  3. Understand how rehabilitation programs may be adapted to account for diagnoses and locally available resources
  4. Examine how the legislative and regulatory environment for inpatient rehabilitation can affect delivery of care for oncology patients both in Canada and the United States

12. An Introduction to Longitudinal Data Analysis Part II: Non-Continuous Outcomes #1044
Wednesday, 8 OCT // 1:00 PM – 5:00 PM

Faculty
Christopher R. Pretz, PhD, Craig Hospital / NDSC, Englewood, CO; Allan John Kozlowski, PhD, Icahn School of Medicine at Mount Sinai, New York, NY; Kristen Dams-O'Connor, PhD, Mount Sinai School of Medicine, New York, NY

Diagnosis/Area of Practice: Diagnosis-independent
Focus: Research methods (e.g., measurement, research design analytic/statistical methods)
Intended Audience: Researchers and clinicians

As the maturation of longitudinal datasets in rehabilitation (e.g., the Spinal Cord Injury National Dataset and the TBI Model Systems National Dataset) continues, the need for rehabilitation researchers to appropriately assess how outcomes progress over time grows. Fortunately, a number of advanced statistical methodologies are available to accurately assess longitudinal data in the presence of non-continuous outcomes, i.e., dichotomous/count data. Rehabilitation researchers will be advantageously positioned to explore a wide variety of hypotheses regarding temporal effects related to outcome for observational and randomized study designs. This instructional course will provide an overview of these methods. Topics to be discussed include, but are not limited to generalized estimating equations, generalized linear mixed models, and application of individual growth curve analysis to probability of event data. The upcoming course improves upon previous versions in that exposure to different software packages will be included in the agenda.

Learning Objectives
To support the attainment of knowledge, competence, and performance, the learner should be able to achieve the following objectives:

  1. Understand the different types of longitudinal analyses as related to non-continuous outcomes
  2. Become familiar with the different software packages used in conducting longitudinal analysis
  3. Properly design/conduct/interpret his/her own longitudinal research study
  4. Effectively communicate with statisticians/biostatisticians and other researches with respect to longitudinal analysis of non-continuous outcomes
  5. Understand the unique characteristics of longitudinal data and how these unique characteristics are accounted for in the analytic process

15. Solving Business and Clinical Dilemmas While Retaining Quality #1474
Wednesday, 8 OCT // 1:00 PM – 5:00 PM

Faculty
Gary Ulicny, PhD, President/CEO, Shepherd Center, Atlanta, GA; Christopher Szybbo, President/CEO, CBI Health Group, Toronto, ON, Canada; Toril Dale, Executive Manager, National Occupational Rehabilitation Center, Rauland, Norway; Michael Choo, MD, Chief Medical Officer, Paradigm Management Services, Concord, CA; Michael Weinstein, MD, Medical Director, Inpatient Medical Rehabilitation Program, Eisenhower Medical Centre, Rancho Mirage, CA; Amy Hayman, Managing Director Cain Brothers, Chicago, IL

Diagnosis/Area of Practice: Diagnosis-independent
Focus: Other
Intended Audience: CEO, COO, Administrative Directors, Clinical leads

Internationally, leaders in rehabilitation organizations are continually confronting increasingly challenging times. Whether the challenges are business related or clinically focused it does not appear that the stress of maintaining quality while meeting multiple stakeholder needs will diminish in the future. True leaders are scrutinizing changes in health and human services around the world and looking for creative solutions that remain person focused, business efficient , and producing results that are meaningful to the person served and the purchaser of services. This session will bring together leaders from different rehabilitation service delivery models and countries to identify business and clinical dilemmas they have faced and solved or failed at and how they are moving their organizations forward. A leader from the world of finance will also do an overview of the health and human services financial trends that organizations should be paying attention to. Participants will be able to identify areas that they are working on and with the presenters learn about a structured way of collecting and sharing knowledge to develop and implement new practice in their organizations.

Learning Objectives
To support the attainment of knowledge, competence, and performance, the learner should be able to achieve the following objectives:

  1. Summarize common themes of dilemmas in both business and clinical arenas for rehabilitation providers.
  2. Analyze results in relationship to your dilemmas and determine potential solutions for your organization.
  3. Describe how knowledge based innovation could be a tool you use to develop and implement new practices in your organization.

17. Building a Research Culture in a Clinical Setting #1636
Wednesday, 8 OCT // 1:00 PM – 5:00 PM

Faculty
Mark Bayley, MD, Brain and Spinal Cord Rehabilitation Program, Toronto Rehabilitation Institute, Toronto, ON, Canada; Chris MacDonell, CARF, Washington, DC; Deborah Backus, PT, PhD, Shepherd Center, Atlanta, GA

Diagnosis/area of practice: Diagnosis-independent
Focus: Clinical practice (assessment, diagnosis, treatment, knowledge translation/EBP)
Intended audience: Clinicians, researchers and administrators in both environments, particularly those in CARF accredited institutions

An encouraging and supportive environment is an essential component for successful engagement of
clinicians in both evidence-based practice and research activities. While many traditional academic settings (e.g., colleges and universities) have well-developed infrastructures to facilitate research processes and nurture novice researchers, clinical settings that are not part of traditional academic departments face several challenges including a clinicians’ lack of formal training in research methods, limited access to research mentors, difficulty securing time/resources for research activities, and insufficient environmental infrastructures to support research processes. In spite of these barriers, it is well recognized that organizations, clinicians, and the people they serve, can greatly benefit from a clinical culture that supports and encourages practitioners’ evidence-based practice and participation in research. The goal of this educational session is to provide strategies for clinicians, clinician-researchers, researchers, and clinical managers to transcend these challenges in order to successfully cultivate strong research cultures in clinical settings.

Learning Objectives
To support the attainment of knowledge, competence, and performance, the learner should be able to achieve the following objectives:

  1. Identify the benefits of and barriers to establishing and cultivating a strong research culture in a clinical setting.
  2. Identify potential environments and opportunities in which clinician-researchers can attain research education and experience.
  3. Understand potential models to help mentor clinician-researchers to help them attain research goals.
  4. Understand potential opportunities and models for managers to support and facilitate clinicians' research activities, and potential models for securing time and resources to support research activities.
  5. Discuss strategies for improving clinical setting infrastructures to better support clinical research activities.

21. Mental Practice for Movement After Stroke: An Instructional Course for Clinicians #1229
Wednesday, 8 OCT // 1:00 PM – 5:00 PM

Faculty
Stephen Page, PhD, MS, MOT, OTR/L, FAHA, The Ohio State University, Columbus, OH

Diagnosis/Area of Practice: Stroke
Focus: Clinical practice (assessment, diagnosis, treatment, knowledge translation/EBP)
Intended Audience: Clinicians

Stroke remains the leading cause of disability and its incidence is expected to rise, yielding an increased prevalence of stroke survivors with life altering deficits. Hemiparesis is one of the most common and disabling stroke-induced impairments. This laboratory test was the first to apply the use of mental practice to increase affected arm function after stroke. Since this work over a decade ago, we have applied mental practice to other impairments, e.g., aphasia, lower extremity function; as well as diagnoses, e.g., spinal cord injury. Yet, despite its widely appreciated empirical support, this easy to use clinical approach remains poorly known and understood by clinicians, with little guidance available for its clinical application. The overall goal of this instructional course is to introduce clinicians to the theory, evidence and application of mental practice to the hemiparetic upper and lower extremities as applied to stroke. The speaker has led multicenter clinical trials testing efficacy and mechanisms and has applied this approach clinically in patients with stroke, SCI, and other neurological conditions. To further emphasize clinical application, unique workshop facets will include multiple video case series and review of outcome measures to best capture clinically-meaningful responses.

Learning Objectives
To support the attainment of knowledge, competence, and performance, the learner should be able to achieve the following objectives:

  1. Describe the inclusion criteria that a patient must meet to benefit from mental practice and action observation
  2. Describe and apply outcome measures to measure mental practice and action observation efficacy in stroke patients
  3. Describe the clinical protocols that should be followed to optimize efficacy of mental practice and action observation

SATURDAY, 11 OCTOBER // MID-DAY COURSES

13. A Multidisciplinary Approach in the Management of Sports Concussion #1078
Saturday, 11 October // 10:00 AM – 2:00 PM

Faculty
Angela Yi, PhD; Tricia Kasamatsu, MA, ATC, Certified Athletic Trainer; Vernon Williams, MD; Jose Posas, MD, Sports Concussion Institute, Anaheim, CA

Diagnosis/Area of Practice: Brain Injury. Also relevant to pain rehabilitation.
Focus: Clinical Practice (assessment, diagnosis, treatment, knowledge translation/EBP)
Intended audience: Clinicians

Traumatic brain injuries sustained in sports have received increased nationwide public attention and there is a growing need for clinicians to be trained in the management of sports concussions. A sports related concussion can result in physical, cognitive, and emotional symptoms and requires a multidisciplinary network of healthcare providers who understand the various facets of sports concussion management that include prevention, assessment, diagnosis, intervention, follow-up care, and education. This instructional course will provide an overview of sports concussion management that will translate evidence and consensus-based guidelines into clinical practice, and incorporate a multidisciplinary team approach to managing sports concussion.

Learning Objectives
To support the attainment of knowledge, competence, and performance, the learner should be able to achieve the following objectives:

  1. Learn foundational information regarding the epidemiology, pathophysiology, and symptoms, of a sports related concussion
  2. Receive an overview of the various components that comprises a comprehensive sports concussion management program
  3. Understand the various roles members of a multi-disciplinary team would serve in managing a sport related concussion and post-concussion syndrome
  4. Explore the role of telemedicine in the delivery of sports concussion management

18. Ensuring the Delivery of High-Quality Fall Prevention: How Rehabilitation Professionals Engage in Quality Improvement #1294
Saturday, 11 October // 10:00 AM – 2:00 PM

Faculty
Anne Deutsch, PhD, RTI International, Rehabilitation Institute of Chicago Center for Rehabilitation Outcomes Research, Northwestern University Feinberg School of Medicine, Chicago, IL; Natalie E. Leland PhD, OTR/L, BCG, FAOTA, University of Southern California, USC Davis School of Gerontology, Los Angeles, CA; Pamela Roberts, PhD, MSHA, OTR/L, SCFES, FAOTA, CPHQ, Cedars-Sinai Medical Center, Los Angeles, CA; Jennifer C. Sidelinker, PT, DPT, GCS, Genesis Rehab Services, Kennett Square, PA

Diagnosis/Area of Practice: Diagnosis-independent
Focus: Clinical practice (assessment, diagnosis, treatment, knowledge translation/EBP)
Intended Audience: Rehabilitation clinicians, administrators, and provider organizations engaging in quality improvement initiatives and facilitating the translation and implementation of evidence into the clinical setting.

To ensure the delivery of high quality care, the Affordable Care Act is focused on minimizing avoidable medical events (e.g., rehospitalization, falls) and improving patient outcomes. Financial incentives are being implemented to hold organizations accountable for their patient outcomes and facilitate improvement in the delivery of efficacious care. For an organization to succeed, clinicians and administrators need to work collaboratively to evaluate care by (1) ensuring documentation reflects delivered care, (2) assessing care alignment with existing evidence, and (3) engaging in continuous quality improvement (QI) initiatives to enhance areas in need of improvement. Therefore, it is imperative that rehabilitation professionals have foundational understanding of how to engage in both evidence-based practice (EBP) and QI programs. This symposium will draw on Donabedian’s seminal healthcare quality work, as well as the translation and implementation science framework of Dr. Titler. Guided by their work, the panel will examine healthcare quality, evidence translation and implementation, and QI initiatives useful to rehabilitation clinicians and administrators. These topics will be discussed in the context of fall prevention in hospital-based and post-acute care settings. The expert panel will include researchers and rehabilitation providers with expertise in fall prevention and QI from diverse rehabilitation organizations (e.g., size, setting). To illustrate clinical implementation of EBP and QI, fall prevention evidence will be reviewed, strategies for engaging stakeholders in quality improvement programing
will be discussed, methods for collection and monitoring of data relative to program outcomes will be presented, and lessons learned from past QI initiatives will be shared.

Learning Objectives
To support the attainment of knowledge, competence, and performance, the learner should be able to achieve the following objectives:

  1. Describe current fall prevention evidence for in-hospital and post-acute care rehabilitation patients
  2. Discuss the role of value-based purchasing in the context of rehabilitation service delivery
  3. Identify the theoretical constructs that support the translation and implementation of evidence into practice
  4. Verbalize the key components of continuous quality improvement.