CREDIT:
Earn 3 contact hours (0.3 CEUs)
COURSE DESCRIPTION:
The IF, WHEN, and WHAT of orthotic decision making can be daunting when working with children as they are developing their first weightbearing and gait skills. Consider the benefits of early orthoses (protect ligaments, influence neuromotor patterns, encourage emerging gait/gross motor skills, support intrinsic foot muscles) as well as potential drawbacks & learn decision making based on stage of development, sagittal and coronal plane alignment, and overall individual factors.
LEARNING OBJECTIVES:
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Determine coronal versus sagittal plane alignment impairments and potential orthotic solutions for each
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Differentiate delayed and emerging postures/skills from those requiring orthotic intervention
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Integrate individual findings to create a detailed orthotic plan: timing of intervention, custom versus off the shelf, dosage, integration with other interventions
AUDIENCE:
Therapists working with the birth to three population.
SCHEDULE:
- Evidence-informed practice for early orthotic recommendations
- Challenges to evidence-based practice
- Defining “effective”
- ICF Model
- Balancing competing goals
- Short-term bracing for long-term goals
- Relevant Evidence
- Excessive pronation
- Limited dorsiflexion
- Weakness
- Neuroplastic changes
- Impact on developing systems: developmental kinesioplasticity
- Framework for early orthotic intervention: Why do we use orthoses early in life?
- Protect ligaments for a lifetime of use
- Influence neuromotor activation for emerging motor patterns
- Support gait and functional gross motor skills for on-time mobility
- Begin weightbearing in an efficient length-tension ratio of the foot intrinsic muscles
- Defining Orthotic Groups
- Group 1: Foot orthoses
- Group 2: Supra-malleolar orthoses
- Group 2+: SMO +
- Group 3: AFOs with motion
- Group 4: Solid AFOs
- Group 4D: Dynamic solid AFOs
- Group 5: Sagittal plane only
- Coronal Plane Decision Making
- Key question: What support is required in the coronal (and transverse) planes to allow dorsiflexion to occur at primarily the talocrural (ankle) joint?
Patient groups:
- Neutral hindfoot
- Pronated hindfoot
- Supinated hindfoot
- Special considerations for early intervention decisions: monitoring for emerging skills, timing of orthotic intervention
- Sagittal Plane Decision Making: Orthotic Design and Posting
- Stability and shock absorption
- Establishing developmentally therapeutic gait for gastroc-soleus range of motion
- Developing an individual, comprehensive orthotic plan
- Systems screening
- Personal factors
- Delay versus long-term health condition
- Funding: weighing commercial, off-the-shelf, and custom options, in light of the individual family’s options and priorities
- Orthotics and disability identity
- Dosage
- Minimizing negative impacts of orthotic intervention on Activities, Participation, and Personal Factors
- Alternatives and adjuncts: foot intrinsic strengthening, taping, and more
- Insuring an enriched sensory experience for positive neuroplastic influence despite orthotic use
Case examples and discussion
Post-test
Amanda Hall, PT, MPT, PCS, began teaching clinical education with serial therapeutic casting courses, and has since developed additional coursework based on an integrative approach to treatment for patients with pediatric and neurological health conditions. Her clinical practice is at the Rehabilitation and Specialized Care of Children’s National Hospital (formerly the HSC Pediatric Center) in Washington, DC, where she specializes in treating “outliers” and patients with complex presentations. Her framework is grounded in PNF principles, therapeutic alliance, neuroplasticity, manual therapy, therapeutic gait, and developmental kinesioplasticity. Her framework has a strong focus in patient-centered treatment and adaptive design. As a result, she has received international media attention as the “Madcaster.” Notable presentations include the Combined Sections Meeting of the American Physical Therapy Association, the APTA Pediatrics Annual Conference, and at the National Institutes of Health. She graduated with her Master of Physical Therapy from the University of Washington in 2001 and received her Board-Certification as a Pediatric Clinical Specialist in 2010.
Financial Disclosure: Amanda Hall receives an honorarium from Education Resources, Inc.
Non-Financial Disclosure: Amanda Hall has no relevant non-financial relationships to disclose.
Once you purchase an online course you will have access to the course materials. If you have purchased this course, please ensure you have logged in to your account in order to take the exam.
Once you purchase an online course, you will have the opportunity to take an exam to test your retention of the material. If you have purchased this course, please ensure you have logged in to your account in order to take the exam. The exam must be completed with a pass rate of 80% or more in order to receive your certificate of attendance.
This course meets the criteria for 3 contact hours (0.3 CEUs) Intermediate Level.
If your state is not listed below and you have three or more therapists interested in attending, please contact us at info@educationresourcesinc.com or call 800-487-6530 to speak with a team member. We will review whether approval can be obtained for your state.
To receive a certificate of completion all registered attendees are required to attend and participate fully in all applicable course activities (i.e., labs, discussions, group work, polls, post-tests with passing grade of 80% or greater etc.) and complete the evaluation form.
AOTA – American Occupational Therapy Association
AOTA - Education Resources Inc. is an AOTA Approved Provider of professional development. Course approval ID# 15024 . This Distance Learning-Independent course is offered at 3 contact hours 0.3 CEUs. (Intermediate level, OT Service Delivery & Foundational Knowledge). AOTA does not endorse specific course content, products, or clinical procedures.
NBCOT - This course can be used toward your NBCOT renewal requirements for 3 units.
FL OT - Approved provider of the FL Board of Occupational Therapy-CE Broker – 3.5 hrs. This course meets the approval of the TX Board of OT Examiners.
ASHA – American Speech-Language-Hearing Association
ASHA - ASHA CE Provider (Intermediate level) 0.3 ASHA CEUs. ASHA CE Provider approval and use of the Brand Block does not imply endorsement of course content, specific products, or clinical procedures. SLPs that require ASHA must submit your ASHA participant form to ERI. ASHA participant form to ERI.
TX SLP - ASHA credits are accepted by the Texas Department of License and Renewal.
PT – Physical Therapy by State
IL PT - Approved sponsor by the State of Illinois Department of Financial and Professional Regulation for Physical Therapy for 3.5 contact hours.
ILEI - Approved by the Illinois Early Intervention Training Program for 3 INT for hours of EI credential credit in the area of Intervention.
MD PT - Approved by the Maryland Board of Physical Therapy Examiners.
NJ PT - Application has been made to the New Jersey Board of Physical Therapy Examiners.
NY PT - Approved provider by the New York State Board of Physical Therapy for 3.5 contact hours.
Education Resources, Inc. is an approved provider for Physical Therapy CEUs in the following states: CA, NM, OK, TX and the assignment do not imply endorsement of specific course content, products, or clinical procedures for these.
The following state boards of physical therapy accept other states’ approval: AK, AR, AZ, DC, DE, GA, HI, ID, IN, KS, KY, MA, MI, MO, MS, NC, OR, PA, RI, SC, UT, VA, VT, WI, WY. The following state boards of physical therapy either do not require course pre-approval or do not require CEUs for re-licensure: AL, CO, CT, IA, ME, MT, NE, ND, NH, SD, WA.
NDTA - 3 hours of this course qualify towards the discipline-specific hours for the 20-hour requirement for NDTA re-certification. They do NOT qualify towards the 8-hour NDTA Instructor requirement for re-certification.
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