Meetings 2012 Annual Conference Instructional Courses
Instructional Courses
According to the 2011 Annual Conference Evaluation Survey, a whopping 86 percent of respondents give high ratings to the educational value of the preconference Instructional Course they attended. The majority praised it as EXCELLENT (57%) and 29 percent say it was above average. This year, there’s even more to love!
Led by a distinguished faculty of researchers and clinicians, these courses dig deep into special interest areas and emerging research. You pick the topics and schedules that best fit your needs. Looking for Continuing Education Credits? We've got you covered in NINE disciplines!
Early Career Development Course Pre-Conference: Wednesday, 10 October 2012 1. Innovations in Stroke Rehabilitation-Part I (#694) Presenter: Catherine E. Lang PT, PhD, Washington University, St. Louis, MO; Arlene Schmid, PhD, OTR, Roudebush VA Medical Center, Indianapolis, IN; Robert Teasell, MD, FRCPC, Schulich School of Medicine, Western University of Ontario, London, ON, CA; Lara Boyd, PT, PhD, Brain Research Centre, UBC Hospital, University of British Columbia, Vancouver, BC, CA Diagnosis: Stroke with a clinical practice focus Despite several advances in stroke rehabilitation research, stroke remains the leading cause of serious long-term disability in the United States. This instructional course will help disseminate key research findings by presenting and discussing the most recent evidence, addressing motor impairments in the morning session (Part 1), and addressing cognition and vision impairments in the afternoon session (Part 2). The purpose of the morning session (Part 1) will be to examine how treatment intensity is defined and implemented to address motor impairments after stroke. The presentations will discuss variability in terminology and methods of implementation using examples from current practice and research. In addition, presentations will discuss current best evidence supporting the effective use of methods to increase treatment intensity in stroke rehabilitation, including methods for building intensity within interventions across the continuum of care (e.g. acute hospitalization to community-based practice). Learning Objectives
2. An Update on Rehabilitation in Multiple Sclerosis (#710) Presenter: Ben W. Thrower, MD, Shepherd Center, Atlanta, GA; Albert Lo, MD, PHD, CPH, Brown University, Providence, RI; Sue Bennett, PT, EdD, University of Buffalo, Buffalo, NY; Patricia Bobryk, MHS, PT, MSCS, ATP, Orlando Health, Orlando, FL Diagnosis: Neurodegenerative disorder with a clinical practice focus The field of MS management has seen an explosion of treatment options for delaying the progression of this leading cause of non-traumatic disability in young adults. Unfortunately, no cure exists and disability is still common. In this half-day instructional course, attendees will be given an update on the overall comprehensive management of MS, including relapse management, symptomatic therapies and therapies designed to slow the course of the disease overall. The course will then shift to a focus on rehabilitation issues specific to MS. Learning Objectives
3. Emotions in Check and Problem Solved! Metacognitive Interventions for Individuals with Brain Injury: A Training Workshop (#692) Presenters: Teresa Ashman, PhD, Joseph Rath, PhD, New York University Langone Medical Center, New York, NY; Theodore Tsaousides, PhD; Joshua Cantor, PhD, Mount Sinai School of Medicine, New York, NY Diagnosis: Brain Injury with a clinical practice focus Top-down, metacognitive interventions have been used effectively in rehabilitation following traumatic brain injury (TBI) to improve executive functioning, self-monitoring and self-awareness. This instructional course is a skill-building workshop focusing on two theory-based and empirically-tested metacognitive interventions, Problem Solving (PS) and Emotional Regulation (ER), which can be utilized in either group or individual context. A brief theoretical background will be provided for each intervention, followed by the results of our three randomized clinical trials. Finally, practical, clinician-oriented training in the implementation of the interventions will be provided through hands-on, in-vivo demonstrations. ER is a cognitive-behavioral intervention designed to increase awareness of the nature and impact of emotional reactions on cognition and behavior and to promote skill- development to improve emotional control and appropriate behavioral responses. ER skills reduce impulsivity and avoidance and facilitate an adaptive approach to real life problems. PS is a 5-step approach to problem-solving involving recognition of the existence of a problem, definition of the problem, generation of potential solutions, selection and implementation of solutions, and outcome evaluation. PS is intended to increase anticipatory awareness, cognitive flexibility, divergent thinking, planning, initiation, self-monitoring, and decision-making. Frequent repetition of the steps, use of an acronym, systematic questioning, and use of cues and reminders facilitate memorization and habituation of the problem-solving method and increase frequency of use. Given the negative impact of emotional dysregulation on problem-solving, combining these two interventions (PS and ER) leads to improvements in problem-solving, decision-making, interpersonal communication and relationships and mood. Learning Objectives
4. Management Conundrums Among Patients with Severe TBI: Ethical Considerations and Practice (#729) Presenters: Joseph Fins, MD, Weill Cornell Medical College, New York, NY; Risa Nakase-Richardson, PhD, Catherine Wilson, PsyD, Marissa McCarthy, MD, James A. Haley Veterans Hospital/University of South Florida, Tampa, FL; Joseph T. Giacino, PhD, Harvard Medical School, Boston, MA; Doug Katz, MD, Boston University/Braintree Rehabilitation Hospital, Boston, MA; John Whyte, MD, PhD, Moss Rehabilitation Research Institute, Elkins Park, PA; Stuart A. Yablon, MD, Baylor Institute for Rehabilitation, Dallas, TX; Brian Greenwald, Mount Sinai School of Medicine, New York, NY Diagnosis: Brain Injury with a focus on health/disability policy, ethics and advocacy Clinicians face many challenges in the acute and long-term management of persons with severe TBI. The challenges are magnified when collaborating consultants and family members do not have an accurate understanding of the patient’s diagnosis and prognosis. Further, clinicians are often faced with challenging personal emotions for grieving family members with varied expectations. The collision of these forces results in challenging situations for providers with ethical implications. Although local opportunities exist for peer consultation, opportunities to discuss these issues with leading experts in brain injury ethics and rehabilitation care are rare. The purpose of this course is to present common ethical challenges facing clinicians managing patients with severe TBI with follow-up discussion by a panel of comprised of peers in ethics, rehabilitation medicine, and psychology. Case presentations illustrating common challenges among patients with severe TBI will be presented by providers and researchers working with severe brain injury patients. Cases will illustrate both management and ethical challenges facing clinicians and researchers along with shared practices for resolution. Topics for presentation include (a) management of pain (or not) among persons with disorders of consciousness who are classified as being unresponsive to nociception (i.e., coma, vegetative state), (b) sexual reproduction rights of patients who are not capable or competent to make their own decisions, (c) termination of supportive measures for patients with anticipated poor prognosis (including decision of when to implement DNR status), and (d) denial of treatment of medical comorbidities (e.g., comorbid injuries related to trauma) secondary to expectation of poor prognosis. Learning Objectives
Presenter: Allen Heinemann, PhD, ABPP (RP), FACRM, Allan J. Kozlowski, PhD, PT, Jennifer Moore, PT, DHS, NCS, Jason Raad, MS, Rehabilitation Institute of Chicago, Chicago, IL; Alison Hoens, BScPT, MSc, Physiotherapy at Providence Health Care, Vancouver, BC, CA; Marie Westby, PT, PhD, University of British Columbia, Vancouver, BC, CA Diagnosis: Not diagnosis specific. This presentation is relevant to any rehabilitation setting and has an academic training, research mentoring and research funding focus Implementing evidence-based changes into clinical practice is a necessary but challenging endeavor for rehabilitation clinicians and administrators. Individuals working within complex organizational environments with multiple stakeholders may be tasked with updating their own practice or that of a department or facility. Understanding the theoretical and practical bases for implementing a change in practice may enhance the ability of an individual to facilitate an organizational change. This course will provide learners with an overview of the literature on implementing evidence-informed changes in healthcare and within organizations. The course will review individual and organizational change theories, and summarize implementation frameworks. Rehabilitation change agents from Canada and the United States will describe outcome measure implementation in two different contexts: one in a large, non-profit rehabilitation system of care in the United States, and the other in a network of public outpatient facilities and private clinics which provide service on behalf of a provincial health authority in Canada. Workshop activities will provide learners with tools to evaluate their own settings in regard to identifying of barriers and facilitators to a practice change, selecting strategies for implementation, and evaluating the process and outcomes of a relevant evidence-informed practice initiative. Learning Objectives
Pre-conference: Wednesday, 10 October 2012 6. Innovations in Stroke Rehabilitation Part 2 (#709) Presenter: Elizabeth Skidmore, PhD, OTR/L, University of Pittsburgh, Pittsburgh, PA; Deirdre Dawson, PhD, OT Reg (ON), Rotman Research Institute at Baycrest, Toronto, ON, CA; Sarah E. Wallace, PhD, SLP-CCC, Adult Neurogenic Clinic at Duquesne University, Pittsburgh, PA; Pamela S. Roberts, PhD, OTR/L, SCFES, FAOTA, CPHQ, Richard V. Riggs, MD, Cedars-Sinai Medical Center, Los Angeles, CA; John Ross Rizzo, MD, Rusk Institute of Rehabilitation Medicine, New York, NY Diagnosis: Stroke with a clinical practice focus Despite several advances in stroke rehabilitation research, stroke remains the leading cause of serious long-term disability in the United States.This instructional course will help disseminate key research findings by presenting and discussing the most recent evidence addressing cognition and vision impairments in the afternoon session (Part 2). The afternoon session will contain a series of paper presentations addressing the current state of the science examining cognition and visual impairments after stroke. In particular, presentations will address the influences of cognitive and visual impairments on stroke rehabilitation outcomes and recovery, and innovative approaches to assessing, diagnosing, and treating these impairments. Presentations will place a special emphasis on impairments in executive functions, aphasia, and visual functions. The afternoon session will end with a panel discussion that reviews critical themes that arise in the sessions and derives key points to inform practice and future stroke rehabilitation research studies. Learning Objectives
7. Instrumentation of Clinical Balance and Gait Tests for Rehabilitation Assessment (#728) Presenters: Laurie A. King, PhD, PT, Martina Mancini, PhD, Oregon Health & Science University, Portland, OR; James McNames, PhD, Portland State University, Portland, OR Diagnosis: Brain Injury, Neurodegenerative disorder with a focus on technology This course will introduce how rehabilitation professionals can use the latest inertial senor technology to obtain objective measures of balance and gait. Current assessments of balance and gait in clinical rehabilitation are largely limited to subjective scales, simple stop-watch measures, or complex, expensive machines not practical or largely available. Although accelerometers and gyroscopes have been shown to accurately quantify many gait and balance kinematics, only recently has a comprehensive, portable system become available for clinicians. By measuring body motion during tests that clinicians are already performing, and by providing instant data analysis, the added time for assessment is minimal. By providing instant analysis of balance and gait and comparing a patient’s performance to age-matched control values, therapists receive an objective, sensitive screening profile of balance and gait strategies. This motion screening profile can be used to identify mild abnormalities not obvious with traditional clinical testing, measure small changes due to rehabilitation and to design customized rehabilitation programs for each individual’s specific balance and gait deficits. This course will provide both theoretical and scientific overview as well as a real time demonstration. Learning Objectives
8. Assessment and Treatment of Emotion Recognition Impairment after Brain Injury (#726) Presenters: Barry S. Willer, PhD, University at Buffalo, Buffalo, NY; Flora Hammond, MD, Dawn Neumann, PhD, Indiana University School of Medicine, Indianapolis, IN; Duncan Ross Babbage, PhD, Massey University, Wellington,WN, NZ; Barbra Zupan, PhD, Brock University, St. Catharines, ON, CA Diagnosis: Brain Injury, Stroke, Neurodegenerative disorder (e.g., MS, Parkinson’s disease), Autism spectrum disorder with a clinical practice focus The presenters participated in a NIDRR sponsored research program to develop and test a training program for individuals with impaired emotion recognition resulting from acquired brain injury. Approximately one third of individuals with moderate to severe brain injury have impaired emotion recognition and this has a profound effect on interpersonal relationships. The Emotion Recognition Training (ERT) program was evaluated using a randomized clinical trial. Research sites in Canada, the United States and New Zealand took part. Analysis of the full results will be completed in 2012 but findings indicate that subjects with brain injury showed improvement as a result of the ERT program, and that improvement was greatest at long term follow up. Full details of the research design, outcome measures, statistical analysis and results will be presented during this instructional course. The ERT program is computer based and requires a therapist to conduct the training. We used a computer based therapeutic approach in order to improve transference of the ERT to other rehabilitation programs. That was also one of the reasons why we chose to evaluate the ERT in three different sites. One aim of this instructional course is to establish a group of collaborators willing to evaluate the translation of the ERT into additional clinical settings. Those who attend the course and elect to participate in the translational research project will be provided additional support for implementation as a follow-up to the conference. The 2012 ACRM conference represents the launch for the study results and the ERT program. Learning Objectives
9. Behavioral Measuring and Monitoring to Improve Patient Outcomes: An Evidence-based Meta-Practice (#732) Presenters: James F. Malec, PhD, Jacob Kean, PhD, University of Indiana Medical School/Rehabilitation Hospital of Indiana, Indianapolis, IN; Joseph T. Giacino, PhD, Spaulding Rehabilitation Hospital/Harvard Medical School, Boston, MA; Michael Mozzoni, PhD, Lakeview Neurorehabilitation Center, Effingham, ME; Bonnie Schaude, MA, CCC/SLP, Shepherd Center, Atlanta, GA Diagnosis: Case examples will be primarily from brain injury but techniques and principles can be applied to any diagnostic group. This presentation has a clinical practice focus. The importance of basing clinical practice on established scientific findings is increasingly recognized. In this era of evidence-based practice (EBP), numerous studies with a variety of patient populations have confirmed the benefits of objective monitoring/self-monitoring (MSM) of patient status using reliable and valid measurement methods. MSM is an intervention that improves patient status both directly through timely and strategic changes in the treatment plan and indirectly through supporting nonspecific factors, such as, therapeutic alliance. Potentially applied across a variety of patient populations and problems, MSM constitutes an EBP meta-practice. The beneficial applications of specific methods for MSM will be described, discussed and illustrated through case examples across the continuum of care and recovery after brain injury. J. Giacino will describe cognitive and behavioral assessment methods to monitor recovery of consciousness and appropriately adjust treatment for patients with prolonged disorders of consciousness after brain injury. M. Mozzoni will detail applied behavior analysis of the stimulus-response-consequence sequences for reducing severe behavior disturbance following brain injury. B. Schaude and J. Malec will describe the use of Goal Attainment Scaling to assist patient in post-hospital rehabilitation programs to improve their capacity to set realistic goals for community re-integration and make progress towards these goals. J. Kean will present methods and technologies to assist individuals in monitoring and managing persistent symptoms, problems, and risk factors in the long term after brain injury. Workshop participants will learn specific methods described as well as underlying principles that may be applied to a variety of patient populations and problems. Learning Objectives
10. Introduction to Individual Growth Curve Analysis (#715) Presenters: Christopher Pretz, PhD, Scott Edwin Douglas Kreider, MS, Jeffrey P. Cuthbert, MPH, MS, Craig Hospital, Englewood, CO; Allan J. Kozlowski, PT, PhD, Rehabilitation Institute of Chicago, Chicago, IL; Kristen Dams-O'Connor, PhD, Mount Sinai School of Medicine, New York, NY Diagnosis: Independent with a focus on research methods As we witness the maturation of longitudinal datasets in rehabilitation (e.g., the Spinal Cord Injury National Dataset and the TBI Model Systems National Dataset) the need for rehabilitation researchers to appropriately assess how outcomes progress over time becomes more prevalent. Individual growth curve (IGC) analysis is an extremely powerful and versatile statistical tool for accomplishing this with capabilities for doing so that far exceed those of more traditional approaches (i.e. series of cross-sectional analyses, pre post designs, etc.). With enhancements in software packages and exposure to training such as this, rehabilitation researchers will be better prepared to explore a wide variety of hypotheses regarding temporal effects related to outcome. Learning Objectives
Post-Conference: Saturday, 13 October 2012 1. Differential Diagnosis in Dizziness (#718) Presenters: Susan E. Bennett, PT, DPT, EdD, Lacey Bromley, PT, University at Buffalo, Buffalo, NY Diagnosis: Dizziness Disorders that may be peripheral nervous system, central nervous system or cervicogenic. This presentation has a clinical practice focus. Dizziness is the third most common symptom for which patients seek medical care. This course will focus on differential diagnosis of dizziness disorders spanning peripheral disorders, central nervous system-based disorders and impact of the upper cervical spine in dizziness. Disorders that will be discussed include brainstem stroke, mild traumatic brain injury/concussion, unusual presentations of BPPV, and upper cervical dysfunction. Evidence supporting the examination, differential diagnosis and treatment of dizziness will be discussed with audience participation in three case discussions. Learning Objectives
2. Brain Injury Coping Skills (BICS) Workshop: An Intervention for Survivors of Brain Injury and Caregivers (#827) Presenters: Samantha L. Backhaus, PhD, Summer Ibarra, Rehabilitation Hospital of Indiana, Indianapolis, IN Diagnosis: Brain Injury with a clinical practice focus The Brain Injury Coping Skills Group (BICS) is a 20-week, Cognitive-Behavioral Treatment (CBT) intervention for individuals with brain injury (BI) and their caregivers. This is a small group intervention (although can be applied via various modalities) in which individuals are provided psycho-education, group support, and stress management skills to deal with their injury. Modules include information about the: (1) Healthy Brain; (2) Effects of Brain Injury; (3) Caregiver Coping Strategies; (4) Expectations for Recovery; Effects of Alcohol and BI; Returning to Work and Driving; (5) Dealing with Challenges after BI; (6) Signs and Symptoms of Depression specific to BI; and (7)Stress Management Skills utilizing Beck and Ellis’s models of cognitive restructuring. This intervention is typically provided in an outpatient setting by rehabilitation professionals trained in brain injury as well as cognitive-behavioral techniques. It can be provided by psychologists, rehabilitation therapists, or other rehabilitation professionals that understand BI, making it multidisciplinary in nature. Randomized-controlled studies have shown that participants of this treatment make significant improvements in self-efficacy, maintain the emotional benefits at follow-up, and show improvements in anger control and emotional disinhibition when compared to controls, and even compared to those who receive standard support groups. Participants in this workshop can expect to learn about the components of this intervention, as well as receive a clinical framework for utilizing common neurobehavioral and cognitive-behavioral interventions cited in literature. Workshop participants are expected to already have knowledge of brain injury and its effects. Learning Objectives
3. TBI Practice-Based Evidence Preliminary Study Findings: Opening the Black Box of TBI Rehabilitation (#695) Presenters: Susan D. Horn, PhD, Institute for Clinical Outcomes Research, Salt Lake City, UT; James Young, MD, Rehab Associates of Chicago, Rush University Medical Center, Chicago, IL; Nora Cullen, MD, Toronto Rehab, Toronto, ON, CA; Cynthia Beaulieu, PhD, ABPP-Cn, Brooks Rehabilitation Hospital, Jacksonville, FL; Murray Brandstater, MD, Loma Linda University, Loma Linda,CA Diagnosis: Brain Injury with a clinical practice focus This course will describe the TBI-PBE study design and variables included in the database, present preliminary findings from the TBI-PBE study about treatments and interventions that are associated with better outcomes at discharge and 1-year follow-up, and stimulate discussion about how the findings can be challenged, improved in future analyses, and used in practice treating moderate to severe TBI patients. Learning Objectives
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