OMT Foundations:
Foundations of Orthopedic Manual Therapy Clinical Reasoning
The Foundations course is designed to introduce participants to the clinical reasoning model that underpins all of our courses.
Online - Complete Anytime
Course Description
This class is intended to develop a thinking process that can be applied to virtually every patient. The goal is to lay a foundation for the participant to be a skillful user of the clinical reasoning model conceived by Geoffrey Maitland in the assessment and treatment of patients in orthopedic manual therapy. The intent is to apply hypothetical-deductive-inductive reasoning to patient assessment that liberates the therapist to create change in the behavior of physical dysfunction as a priority over diagnostic categorization.
There are foundational concepts that when applied appropriately & consistently can literally guide the thinking process for making decisions about what we can do with patients who arrive with common clinical presentations and novel circumstances. These foundational concepts will be the primary focus of the class.
Important**
These concepts are the foundation for the clinical reasoning which is applied in all the regional classes. All students are required to have a working knowledge of these concepts prior to taking any of the regional classes. The course is designed to give a command of these foundational concepts to allow the regional classes to maximize student gain during in session coursework. It is effectively the language that we will use in in all clinical course work discussion.
It is on line to eliminate any barrier for the student who wishes to engage in regional course work without waiting to take the class until it becomes available again. You will be guided through all content required for the regional classes in 10-12 section blocks to be done at your leisure.
All regional classes will begin assuming that the adult learner has completed this class. Regression to catch students up is a price to those who already have responsibly completed this and hence will not be done. Once engaged in the regional courses there will be no rigid adherence to “Australian technique”. The instructor has an extensive background in a breadth of technique including Kaltenborn-Evejenth,, Mechanical Diagnosis & Therapy, Proprioceptive Neuromuscular Facilitation, and many others including the reliance on integrating background knowledge with what we see in front of us and innovating the appropriate technique/response. There is a strong bias to patient participation to allow patients to reach independence from the healthcare system.
*The Foundational Concepts*
Subjective examination:
The cornerstone in determining the structure of the objective exam.
Listening to the patient intentionally to derive their experience and integrate it with our knowledge on how their particular problem behaves and hence how we should first exam it and then direct treatment.
Objective Examination
Fueled by the subjective exercise in listening the therapist establishes a working hypothesis and examines in such a way as to support or reject it thereby allowing the exam to direct appropriate care at this moment in time in the case.
Patient presentation:
severity, irritability, nature, stage and stability of the problem(s) will be stratified in a methodology to design the objective exam specifically for the patient at hand.
Hypotheses generation:
The recognition of all possible and the most probable problems that are impairing the current patient.
The working hypothesis:
Establishment of the most likely problem for the patient and the pathway to honestly determine its’ veracity.
Comparable findings:
functional, subjective, and objective parameters that will assess the value of our chosen intervention(s).
Trial treatment:
The testing of our working hypothesis with the intervention that gives the greatest likelihood of immediate change in the patient presentation.
Reassessment:
The immediate comparison of the pre treatment & post treatment status of the comparable findings to establish the value of the treatment. The comparable findings are established and openly re-evaluated to allow both patient and therapist to see that the chosen treatment is effective or needs to be altered.
Self treatment:
All physical impairments respond best to consistent delivery of corrective movement. Every day is far better than 2 or 3 times/week as long after we have proven that these motions are genuinely therapeutic. This is critical and a partnership is formed here between therapists’ intellectual focus in design and the patient personal responsibility in delivery.
Planning Progression:
Establishment of a plan based upon established results for progression of treatment including advancement to patient independence. Therapist and patient should share the goal of independence from care. The therapist will establish a vision and confirm that they are working toward that patient determined goal.
Management plan:
The therapist should educate the patient from the outset through the evolution to independence and teach them how to prevent regression now and in the future as well as how to continue independent advancement of function.
Progression Categories
The primary goal with physical therapy is to enable functional independence and self management. The process falls into one of four basic categories
Intervention:
The patient needs the therapist to do something to alter the present circumstances which deprive them of function. They cannot do this alone and the therapist does the majority of the work.
Rehabilitation:
The patient needs the therapist to facilitate and direct a therapeutic exercise progression enabling the patient to improve their functional ability, both patient and therapist participate.
Management:
The patient understands what to do & not do, applies this consistently but may need periodic assistance from the therapist. The vast majority of this is done by the patient who needs to be consistent over time to enable functionally inconsequential pathology.
Prophylaxis:
The independent patient does the appropriate things to maintain healthy function while avoiding potentially threatening activities. Problems are either resolved or functionally inconsequential.
All patients are unique individuals and respond better to various measures and intensity. The naming of a pathology does little to help in the recovery of function. Establishing the rationale for functional deficits and then identifying which have the most potential for change is the starting ground for advancement. While interest in the imaging studies or diagnostic nomenclature is always present neither party enjoys the luxury of treating the picture or the name. The focus should be on changing the behavior of the problem to allow recovery.
Expert manual therapy is a skill set to be used primarily at the intervention stage. To enable independence invariably requires personal engagement in therapeutic exercise, genuinely therapeutic not some repetition of mindless exercise that everyone with a given diagnosis does. Responsibility for designing and coaching this critical end is the therapists responsibility and we need our patients to take their end of delivery equally serious. The reward for both parties taking responsibility is the amelioration or elimination of the present problem.
Course Objectives
This class is willfully designed to be efficient with your time as well as effective with developing your mental skill set. This will ideally allow all of the regional classes to begin from a common baseline for all applications in class, in the clinic and discussions in classes.
The concepts will be developed in a real patient environment actual cases either on film or live in class. This methodology allows demonstration and clarity for genuine application in your clinical setting.
Foundations Goals
Specific Goals:
1. Develop a conceptual framework for clinical reasoning in OMT.
2. Demonstrate the foundational concepts of clinical reasoning in OMT.
3. Discuss the genuinely common clinical syndromes, the rapid recognition of them and the variations that drive examination & treatment choices.
4. Integration of the foundational principles with real patients.
5. Develop proficiency with the recognition of common clinical syndromes.
6. Develop knowledge of how to proceed with the unrecognized presentation pattern.
7. Understand the decision process for determining how the exam can determine the type of treatment, the volume of treatment & the magnitude.
8. Nurture continued development of skills with accurate and informative feedback from the ‘patient’ therapists with each session.
CEUs: 10 Hours for On-line only version
Registration:
To sign up for this class, please email
phoenixmanualtherapy@gmail.com
