Program

The conference as a whole was estimated to be 29.5 contact hours (2.9 CEUs) ivstep-logo
TOPIC | EVENT INVITED SPEAKERS
Thursday, Jul 14, 6:00 PM – 9:00 PM — Evening Opening Reception
Celebration & History Susan R. Harris, PT, PhD, FCAHS
Carolee J. Winstein, PT, PhD, FAPTA
Friday, July 15, 8:00 AM – 12:00 PM — AM Plenary Session (Moderator: Deborah S. Larsen, PT, PhD, FAPTA)
Movement System Diagnosis and Prediction Ann F. VanSant, PT, PhD, FAPTA
Prediction of Outcomes using Movement System Diagnoses Susan J. Harkema PhD
Elizabeth Ardolino, PT, PhD
Andrea L. Behrman, PT, PhD, FAPTA
Friday, July 15, 2:00 PM – 5:00 PM — PM Breakout Sessions
Video Based Case presentations & discussion exploring
o Adult: TBI, CVA, SCI, MS, PD, CNS Neoplasms
o Pediatric: CP, TBI, DS, MD, DCD
Facilitated by Residency Program Directors & Residents
Saturday, July 16, 8:00 AM – 1:00 PM — AM Plenary (Moderator: Lara Boyd, PT, PhD)
Genetics and Epigenetics; Prediction and Plasticity Steven C. Cramer, MD
Jill C. Stewart, PT, PhD
Regenerative Rehabilitation; Plasticity Chet T. Moritz, PhD
Fabrisia Ambrosio, PT, PhD
Telehealth Practice for Prevention, Plasticity, Participation Alan Chong W Lee, PT, PhD, CWS, GCS
Jane Burridge, PhD
Saturday, July 16 — PM – No Programming (Zoo Event from 4:00 PM – 9:00 PM)
Sunday, July 17, 8:00 AM – 12:00 PM — AM Plenary (Moderator: Teresa Kimberley, PT, PhD)
Primary Health Promotion Practices for Prevention Edgar van Mil, MD, PhD
Ellen McGough, PT, PhD
Secondary Health Promotion Practices for Prevention Lori Quinn, PT, EdD
Don W. Morgan, PhD
Sunday, July 17, 2:00 PM – 5:00 PM — PM Breakout session
Video-Based Case Presentations/Discussion Facilitated by Residency Program Directors & Residents
Sunday, July 17, 5:00 PM – 7:00 PM — Evening Poster Session with Reception
Monday, July 18, 8:00 AM – 12:30 PM— AM Plenary Session (Moderator: Eileen Fowler, PT, PhD)
Dosage and Timing for Plasticity and Participation Catherine Lang, PT, PhD
Michele Basso, PT, EdD
Mary Gannotti, PT, PhD
Technology Use for Plasticity and Participation Judy Deutsch, PT, PhD
Sarah (Sally) Westcott McCoy, PT, PhD, FAPTA
Arun Jayaraman, PT, PhD
Monday, July 18,  2:00 PM – 5:00 PM — PM Breakout session
Video-Based Case Presentations/Discussion Facilitated by Residency Program Directors & Residents
Tuesday, July 19, 8:00 AM – 12:00 PM — AM Plenary Session: (Moderator: Iona Novak, OT, PhD)
Interprofessional Practice for Participation Lisa Chiarello, PT, PhD, PCS, FAPTA
Research Design Options for Individual and Complex Interventions and Participation Outcomes Michele Lobo, PT, PhD
Sarah H. Kagan, PhD, RN, FAAN
John Corrigan, PhD, ABPP
Deborah Backus, PT, PhD
Tuesday, July 19, 2:00 PM – 5:00 PM
Plenary Session: (Moderator: Iona Novak, OT, PhD)
Knowledge Translation: Your Role as an Attendee Jennifer Moore, PT, DHS, NCS
Keiko Shikako-Thomas, OT, PhD
Conference Summation Susan Harris, PT, PhD, FAPTA, Carolee Winstein, PT, PhD, FAPTA, Deborah Larsen, PT, PhD, FAPTA, Lara Boyd, PT, PhD, Teresa Kimberley, PT, PhD, Eileen Fowler, PT, PhD, and Iona Novak, OT, PhD
Closing Ceremony Celebration (5:00 PM – 8:00 PM)

Special Events:

  • Saturday Afternoon and Evening: The Columbus Zoo is consistently rated among the top few zoos in the nation. We will have a special event including a pass to the zoo as a whole for the afternoon, dinner, and a special venue to see some animals up close.
  • Tours of the clinical and research facilities of the OSU PT program, including The NeuroRecovery Network at Dodd Hall and the Motion Analysis and Performance Lab, will be open Friday night.

Thursday, July 14

6:00 PM – 9:00 PM

Evening Opening Plenary and Reception: From NUSTEP to IV STEP – Fifty Years of Progress in Neurorehabilitation

Speakers: Susan Harris, PT, PhD, FCAHS; Carolee J. Winstein, PT, PhD, FAPTA

This opening plenary session will trace the history and purposes of the three previous STEP conferences, present the overall conference objectives for IV STEP, and define and describe the interdependence of the four Ps: prevention, prediction, plasticity and participation. Thoughts and reflections on current trends in research and practice with regard to the four Ps will be followed by discussion of future directions. Together, we will imagine how the future of neurorehabilitation research and practice will look for children and adults with movement disorders.

Participants will be able to:

  • Provide the background and purposes for the three initial STEP conferences.
  • Define the four Ps: prevention, prediction, plasticity and participation and describe their interdependence.
  • Based on recent research, discuss current trends in neurorehabilitation as delivered by physical therapists and others.
  • Brainstorm (along with the presenters) and imagine the future of neurorehabilitation for children and adults with movement disorders.

Friday, July 15

8:00 AM – 9:30 AM 

Movement System Diagnosis: Groundwork for Prediction

Speaker: Ann F. VanSant, PT, PhD, FAPTA

The centrality of movement system diagnosis (MSDx) to our ability to predict outcomes will serve as the primary focus of this presentation. Our role as primary practitioners addressing disorders of the movement system will be emphasized. Characteristics of MSDxs will be presented with examples that provide a vision for practice and research.

Participants will be able to:

  • Describe the role of MSDx in predicting intervention outcomes.
  • Identify the characteristics of MSDxs.
  • Provide examples of effective MSDxs to guide treatment and research.
  • Identify the roles of clinicians, researchers and scholars in developing MSDxs for the profession.

10:00 AM – 12:00 PM 

Activity-dependent Plasticity for Neuromuscular Recovery: Use of Classifications to Drive Therapies and Outcomes

Speakers: Andrea L. Behrman, PT, PhD, FAPTA; Susan J. Harkema, PhD; Elizabeth Ardolino, PT, PhD

Our knowledge of the capacity for activity-dependent plasticity within the central nervous system, and in particular after neurological injury-disease, is mounting and serves as the platform for developing novel therapies with the aim of recovery and improved function. In this session, we will review key scientific evidence and discuss its relevance in the current and future design of a family of therapies. Accompanying such novel therapies is the need to assess a patient’s neuromuscular capacity to perform functional tasks, though without compensation from behavioral strategies, equipment, or physical assistance. The Neuromuscular Recovery Scale (adult and pediatric) will be introduced as a measure for diagnostic purposes, classification of recovery, and rehabilitation outcomes. Lastly, the evidence for activity-dependent plasticity will be extended to application in the pediatric population with chronic spinal cord injury. The sensorimotor experience of typical childhood development, current rehabilitation after pediatric SCI, and activity-based therapies will be explored as a basis for different outcomes including participation, and expectations. Together, these three presentations represent a new frontier in the scientific basis for rehabilitation, delivery, measurement, and expectations for health and quality of life across the lifespan for individuals with neurologic disorders.

Participants will be able to:

  • Describe scientific evidence for activity-dependent plasticity as a basis for therapies promoting recovery in individuals with neurologic injury/disorders.
  • Introduce the rationale for the Neuromuscular Recovery Scale, content, scoring, and use for clinical and research purposes.
  • Identify outcomes for adults based on assessment and classification by neuromuscular capacity (and undergoing activity-based therapies).
  • Compare and contrast the sensorimotor experiences of typical childhood development, current rehabilitation practices, and activity-based therapies contributing to outcomes in the pediatric population with neurologic injury.

12:00 PM – 2:00 PM 

Lunch (on your own)

2:00 PM – 5:00 PM (Break: 3:15 PM – 3:45 PM)

Video-based Case Presentations & Discussion Exploring Adult (TBI, CVA, SCI, MS, PD, CNS Neoplasms) and Pediatric (CP, TBI, DS, MD, DCD)

(Facilitated by Residency Program Directors & Residents)

IV STEP plenary sessions have been designed to examine emerging topical areas that will impact the future practice of physical therapy. Video-based patient cases will serve as the anchor for break-out small group discussions that will occur following 3 of the IV STEP plenary sessions. Residency Program Directors have been invited to develop 12 (6 adult and 6 pediatric) diagnosis specific video-based clinical case scenarios (max 30 minutes) that will be unfolded by the residency program during the break-out small group sessions. Following the unfolding of the case scenario the small groups will explore prepared questions (max 45 minutes) that will link the topics discussed in the plenary session and the concept of 4P’s to the specific cases. The discussion portion of the break-out session will be facilitated by the resident along with content experts who have been assigned to the session (minimum one expert per case and IV Step committee member). Cases will be repeated twice during the break-out sessions so that participants can engage in two different cases per session. It is the overarching intent of the break-out session for clinicians, educators, and researchers to work together to apply content from the day’s plenary session to the video case presented in order to foster an implicit and explicit understanding of the concepts. The goal is to assist participants in examining the relevance and potential application of the topical areas reviewed (Movement System Diagnosis & Prediction, Genetics-Plasticity-Regenerative Rehab, and Health Promotion Practices- Dosage and Timing- Technology)  in relation to the video-based case presented; to assist participant’s in applying the principles of prevention, prediction, plasticity, and participation (4P’s) to their daily practice and teaching via video-based case presented; and to provide an opportunity for interaction amongst participants from diverse backgrounds to foster and IPP (PT, PTA, Basic Scientist, Researcher, Academician) approach to PCC.

Participants will be able to:

  • Explore and apply physical therapists role in preventing disabling conditions.
  • Evaluate and apply ways to diagnose and classify the individuals’ movement disorders, as well as strategies to link classification with specific interventions and accurately predict outcomes.

 

Residency Director Residency Program Case Description
Anne Kloos, PT, PhD, NCS

 

OSU, Physical Therapy Division

Columbus, OH

Adult

CNS neoplasms

Helen Carey, PT, PhD The Nisonger Center, OSU

Columbus, OH

Peds

CP

Jennifer Fernandez, PT, DPT, NCS, PCS Brooks Rehabilitation

Jacksonville, FL

Peds

TBI

Arlene McCarthy, PT, DPT, MS, NCS Kaiser Permanente

Redwood City, CA

Adult

TBI

Sally Le Cras, PT, DPT, PCS Cincinnati Children’s Hospital Medical Center

Cincinnati, OH

Peds

Down Syndrome

James Moore, PT, PhD, PCS University of Miami & Nicklaus Children’s Hospital

Coral Gables, FL

Peds

Muscular Dystrophy

Cindy Miles Miles and Associates Peds

Developmental Coordination Disorder

Karen McCain, PT, DPT, NCS UT Southwestern Medical Center

Dallas, TX

Adult

CVA

Tina Stoeckmann, PT, DSc, MA Marquette University & Zblocki VA Medical Center

Milwaukee, WI

Adult

CVA

Lauren Snowdon, PT, DPT Kessler Institute for Rehabilitation

West Orange, NJ

Adult

SCI

Heather Hayes, DPT, NCS, PhD University of Utah & University Healthcare Neurologic Residency

Salt Lake, UT

Adult

MS

Terry Ellis, PT, PhD, NCS Boston University

Boston, MA

Adult

PD

Kara Kobal, PT, DPT, PCS, ATC St Francis University

Loretto, PA

Peds

School Based Practice

 

Saturday, July 16

8:00 AM – 1:00 PM (Break: 11:00 AM – 11:30 AM)

Genetics and Epigenetics: Prediction and Plasticity

Genetic Variation and Brain Plasticity

Speakers: Steven C. Cramer, MD; Jill C. Stewart, PT, PhD

This talk will review patterns of genetic variation in humans and consider how these relate to brain structure, brain function, and plasticity of brain structure/function, in health and in disease, with respect to behavioral and imaging measures.

Participants will be able to:

  • Name two different forms of genetic variation.
  • Name a form of genetic variation associated with disease and one that is not.
  • Provide 3 specific examples from the talk of genetic variation that has been strongly associated with differences in human brain plasticity.

Individualizing Rehabilitation after Stroke: Role of Genetic Variation

This session will discuss the role of genetic variation on motor recovery after stroke. The impact of genetic variation on the response to exercise and task-oriented practice will be reviewed within the context of predictive models of motor recovery after stroke. Examples of how genetic data can be added to future research studies on neuroplasticity and motor recovery will be provided.

Participants will be able to:

  • Describe one way genetic variation can impact motor recovery after stroke.
  • Describe the interaction of genetic variation and response to exercise or task-oriented practice after stroke.
  • Explain how genetic variation may play a role in predictive models of individual response to rehabilitation interventions after stroke.

Regenerative Rehabilitation: Plasticity

Developing Neuroprosthetic Devices to Promote Plasticity and Rehabilitation after Brain and Spinal Cord Injury

Speaker: Chet T. Moritz, PhD

Neuroprosthetic devices that interact with the nervous system by recording and stimulation have tremendous potential to improve quality of life after brain and spinal cord injury. Neuroprostheses have progressed from animal studies to human trials, including ongoing work using brain activity to control Functional Electrical Stimulation (FES) of paralyzed hand muscles. Another promising method for enabling rehabilitation and plasticity is spinal stimulation. Both epidural and intraspinal stimulation can activate neural circuits distal to an injury, leading to either direct muscle contraction or fascilitating therapy and enabling volitional movements. Work is underway to merge these techniques and develop a brain controlled spinal stimulation system to restore volitional control of limb movements and perhaps promote directed plasticity and rehabilitation after brain and spinal cord injury.

Participants will be able to:

  • Describe the state of the art in neural technology and brain-computer interfaces.
  • Explain how neural devices may promote plasticity within the nervous system
  • Provide examples of recent progress in the field of neural engineering to improve rehabilitation after central nervous system injury.

Toward Optimized Skeletal Muscle Regeneration across the Lifespan: Measuring and Manipulating Stem Cell Function

Speaker: Fabrisia Ambrosio, PT, PhD

Muscle regeneration is predominantly dictated by the action of muscle stem, or “satellite”, cells (MuSCs), a reserve cell population that demonstrates considerable dysfunction with disease and increasing age. According to the stem cell niche concept, stem cell responses are significantly influenced by biophysical and biochemical cues that emanate from the surrounding microenvironment. An improved understanding of how disease and aging drive defects in tissue regeneration will help optimize the development of targeted and specific rehabilitation protocols to maximize physical functioning for individuals across the lifespan. In Dr. Ambrosio’s presentation, she will share her work investigating mechanisms underlying the decline in muscle regenerative capacity over time, and the potential for the application of targeted mechanical stimulation protocols to rejuvenate skeletal muscle healing. More broadly, her presentation aims to stimulate reflection and debate into the emerging role of regenerative medicine and regenerative biology in physical therapy practice.

Participants will be able to:

  • Describe the cellular basis for declines in skeletal muscle regeneration with myopathies and aging.
  • Describe how the application of mechanical stimulation may enhance stem cell functioning through modulation of the microenvironment.
  • Provide clinical examples of Regenerative Rehabilitation approaches to enhance skeletal muscle function.

Telehealth Practice for Prevention, Plasticity, Participation

Impact of Telehealth: Now and the Future for Physical Therapy

Speaker: Alan Chong W Lee, PT, PhD, CWS, GCS

Telehealth is a disruptive technology that will impact health care and society in the digital age. This session will provide current and future outlook of telehealth in the physical therapy in order to transform research, education, and practice now and in the future.

Participants will be able to:

  • Differentiate common nomenclature in telehealth, telemedicine, and telerehabilitation.
  • Identify research, education, and practice opportunities in telehealth.
  • Discuss current and future telehealth applications in physical therapist practice.

Telehealth in Stroke Recovery: Intensity and independence

Speaker: Jane Burridge, PhD

Intensive practice is key to recovery of function following stroke and our aim as physical therapists is to enable our patients to be independent. This session will present the case for the use of wearable sensors and the Internet to achieve both these goals

Participants will be able to:

  • Describe the theoretical basis for intensity to promote neuroplasticity can be applied in practice.
  • Understand the important considerations in designing an Internet-based intervention.
  • Know how information from wearable sensors could be used in everyday physical therapy practice to provide useful feedback to patients and objective measurements for therapists.

1:00 PM – 4:00 PM 

Lunch (on your own)

4:00 PM – 9:00 PM 

Zoo Event (separate registration/fee required)

 

Sunday, July 17

8:00 AM – 12:00 PM (Break: 10:00 AM – 10:30 AM)

Primary Health Promotion Practices for Prevention

Overweight and Obesity in Children: A New Approach Toward Intergrated Care

Speaker: Edgar van Mil, MD, PhD

Childhood obesity is still a frequent health problem in the Western world and beyond. Although the solution seems straightforward, health care professionals often do not feel confident in the success rates of their approach. Parents and patients themselves are put away as non-compliant, leading to demotivated health care professionals and potentially a lack of care. This pattern seems opposite to the desire of parents to raise a healthy individual. In the Netherlands a new approach was developed to tackle this mismatch of supply and demand by an innovative model of network care and prevention. The basis of this model is an approach that integrates somatic and psychosocial care. The purpose is not only to facilitate communication between the professionals in the network but also enhance self-management capacities of the parents and patients. This session will challenge the health care professionals to dwell on their own role in motivating parents and patients to improve their life style and learn from a new approach towards a frequent encountered problem.

Participants will be able to:

  • Realize that a new approach towards treatment is needed for sustainable effects.
  • Learn what skills this new model requires from the professional.
  • Understand how physical therapy can fit into this model.
  • Get acquainted with working with assessment tools and images for psycho education for parents and children.

Integrating Primary Health Promotion into Physical Therapy Practice to Improve Brain Health in Aging Populations

Speaker: Ellen McGough, PT, PhD

Physical therapists are well positioned to integrate primary health promotion into practice for the prevention of neurological conditions in older adults. Early detection may be achieved through the use of common clinical tests to identify functional markers of disease. Global and specific exercise interventions to address modifiable risk factors and impairments can play a pivotal role in the prevention and delay of functional decline. This session will address the state of the evidence for brain neuroplasticity in relation to physical activity and exercise in older adults. Specific examples will be presented in relation to neurodegenerative conditions, such as Alzheimer’s disease. Innovative strategies to promote brain health with the ultimate goal of enhancing activity and participation will be discussed.

Participants will be able to:

  • Describe modifiable factors associated with brain health in aging populations.
  • Identify early markers of decline in older adults at risk for neurodegenerative disease.
  • Discuss mechanisms that promote neuroplasticity and neuroprotection through exercise.
  • Consider innovative methods to improve activity and participation in aging populations.

From Disease to Health: Physical Therapy Health Promotion Practices for Prevention in Adult and Pediatric Neurologic Populations

Speakers: Lori Quinn, PT, EdD; Don W. Morgan, PhD

Recently, there has been a substantial increase in efforts to better understand how targeted physical activity and exercise interventions can be used to minimize secondary consequences arising from neurological damage. Physical therapists can play a unique role in developing forward-thinking approaches in using innovative health and wellness strategies, in both pediatric and adult populations, to promote positive changes in activity and exercise behaviors. This session will address contemporary research findings that address mediators of functional and neuroplastic adaptations to physical activity and exercise and seek to provoke thoughtful discussion about the role that physical therapists can play in encouraging consumers to embrace an active lifestyle.

Participants will be able to:

  • Summarize current research findings regarding the benefits of regular physical activity and exercise in youth and adults with neurologic disorders.
  • Assess the effectiveness and potential of various activity-based intervention and treatment strategies to enhance mobility and fitness.
  • Identify potential mediators and moderators of activity- and exercise-based interventions.
  • Evaluate the role of physical activity and exercise to increase participation and improve well-being in adults and children with neurological disorders.
  • Identify limitations and gaps in the literature, including the need for better stratification of patient groups and development of theoretically-driven models for targeted physical activity interventions.
  • Highlight potential strategies to encourage multi-site research efforts and foster translation of evidence-based findings for use by clinicians and consumers.

12:00 PM – 2:00 PM 

Lunch (on your own)

2:00 PM – 5:00 PM (Break: 3:15 PM – 3:45 PM)

Video-based Case Presentations/Discussion

(Facilitated by Residency Program Directors & Residents)

IV STEP plenary sessions have been designed to examine emerging topical areas that will impact the future practice of physical therapy. Video-based patient cases will serve as the anchor for break-out small group discussions that will occur following 3 of the IV STEP plenary sessions. Residency Program Directors have been invited to develop 12 (6 adult and 6 pediatric) diagnosis specific video-based clinical case scenarios (max 30 minutes) that will be unfolded by the residency program during the break-out small group sessions. Following the unfolding of the case scenario the small groups will explore prepared questions (max 45 minutes) that will link the topics discussed in the plenary session and the concept of 4P’s to the specific cases. The discussion portion of the break-out session will be facilitated by the resident along with content experts who have been assigned to the session (minimum one expert per case and IV Step committee member). Cases will be repeated twice during the break-out sessions so that participants can engage in two different cases per session. It is the overarching intent of the break-out session for clinicians, educators, and researchers to work together to apply content from the day’s plenary session to the video case presented in order to foster an implicit and explicit understanding of the concepts. The goal is to assist participants in examining the relevance and potential application of the topical areas reviewed (Movement System Diagnosis & Prediction, Genetics-Plasticity-Regenerative Rehab, and Health Promotion Practices- Dosage and Timing- Technology)  in relation to the video-based case presented; to assist participant’s in applying the principles of prevention, prediction, plasticity, and participation (4P’s) to their daily practice and teaching via video-based case presented; and to provide an opportunity for interaction amongst participants from diverse backgrounds to foster and IPP (PT, PTA, Basic Scientist, Researcher, Academician) approach to PCC.

Participants will be able to:

  • Explore and apply physical therapists role in preventing disabling conditions.
  • Identify critical periods of neuroplasticity and strategies, including dosage, timing, and technology, for maximizing experience-dependent plasticity.
  • Analyze and apply emerging measures, interventions, and research options to optimize participation within a patient-centered care model.

 
5:00 PM – 7:00 PM 

Evening  Scientific Poster Session and Reception

 

Monday, July 18

8:00 AM – 12:30 PM (Break: 10:00 AM – 10:30 AM)

Dosage and Timing for Plasticity and Participation

Dosing and Timing for Plasticity and Participation: Adult Stroke

Speaker: Catherine Lang, PT, PhD

This talk will address the critical issues of dosing and timing for physical rehabilitation post stroke. The first part will discuss parameters of dosing and review data on timing and dosing in current clinical practice. The middle part of the talk will discuss meta-analytic results regarding dosing and timing. The last part will present new data from our Phase II dose-response RCT evaluating doses of movement practice in order to improve functional motor capacity and motor performance in daily life.

Participants will be able to:

  • Explain the parameters of dosing that define motor intervention prescription.
  • Compare and contrast timing and dosing in clinical practice vs. in research studies with respect to patient characteristics, fidelity of interventions delivered, and service delivery options.
  • Integrate evidence about timing and dosing and apply this evidence to physical therapy practice.

When a Good Treatment Fails: Timing, Training Type, and Molecular Factors in SCI

Speaker: Michele Basso, PT, EdD

To date, therapeutic exercise holds the greatest potential for functional recovery after spinal cord injury (SCI). Unfortunately, current therapeutic training paradigms are not equally beneficial to all and little is known why. The first portion of the talk will demonstrate the effects of activity-based training for walking in human SCI with emphasis on factors associated with responders and non-responders. The second portion of the talk will use rodent SCI models. Here we will present evidence that maximal recovery depends on delivering the right type of training at the optimal time and that benefits will only be achieved within a permissive intraspinal cellular and molecular environment. The last portion of the talk will show the influence of intraspinal inflammation on learning, plasticity and motor recovery after SCI.

Participants will be able to:

  • Explain the importance of finding the optimal window for SCI rehabilitation.
  • Identify sources of inflammation and its role in mediating learning and plasticity.
  • Incorporate into clinical decision making the interrelationship of factors that impact rehabilitation outcome.

Dosage and Timing for Plasticity and Participation in Pediatric Neurologic Populations

Speaker: Mary Gannotti, PT, PhD

The purpose of this presentation is to summarize evidence about effective intervention programs with a specific focus on timing of services to maximize plasticity and participation of children with neurologic dysfunction. The differential impact of optimal type (focused on participation or body structures & function) at different critical periods during child development will be highlighted. The audience will be challenged to consider priorities for research and innovated clinical practice models designed to optimize plasticity and participation in pediatric neurologic populations.

Participants will be able to:

  • Explain the importance of timing of services to maximize plasticity and participation of children.
  • Compare and contrast the differential impact of type of intervention on plasticity and participation.
  • Integrate evidence about timing and type of therapy and apply this evidence to advancing research and practice.

Technology Use for Plasticity and Participation

The Promise of Virtual Environments (VES) and Serious Games to Promote Plasticity, Activity, and Participation across the Lifespan

Speakers: Judy Deutsch, PT, PhD, FAPTA; Sarah (Sally) Westcott McCoy, PT, PhD, FAPTA

This presentation will summarize the current literature supporting the use of virtual reality technologies and gaming to assist in the rehabilitation of individuals with neurological disorders across the lifespan. What we know about how the technology can be used to affect plasticity and participation will be highlighted. Presentation of the pros and cons of use of both custom and off-the-shelf systems and gaps in the current research should guide therapists on how to utilize this technology within the clinic, how to educate entry-level students and current practitioners, and what research is needed to facilitate growth in this arena.

Participants will be able to:

  • Understand how VEs and serious games has been shown to increase plasticity.
  • Consider how VE and serious games can be used to improve activity and participation.
  • Contemplate the gaps that future research can solve.

What to Expect and Not Expect from Lower Extremity Robotic Technology

Speaker: Arun Jayaraman, PT, PhD

Successful reintegration into society following a neurological injury such as spinal cord injury (SCI), stroke, or other neurological disorders is significantly influenced by the ability to be upright and mobile. Currently available lower extremity robotic systems have provided non-independent locomotor training therapy, with varying levels of intensity and repeatability, often improving lower extremity function in a limited population. In this session, we will take a unique look at how we can maximize the capabilities of these robotic systems for everyday clinical practice. However, these robots are usually based in rehabilitation hospitals and are large and complex. Recovery following neurological injury does not stop at the hospital level. A large percentage of individuals with neurological injuries who aim to walk still require a wheelchair for mobility in the community. Recently, robotic exoskeletons have harnessed a lot of attention on their ability to allow individuals with neurological impairments to be erect, and to walk independently. Several exoskeletons are now commercially available, but these systems have currently shown limited clinical efficacy. Furthermore, the models currently on the market are in the early stages of being prepared for everyday community and/or home mobility. Prescription of these devices require suitable assessment criteria and standardized training protocols, as well as safety strategies. In this part of the session, we will discuss about the complex relationship of the needs of the patient, the researcher, the manufacturer, the FDA, the insurance companies, the internet, the hospitals, with the Exoskeleton. What do we need to do as physical therapists to help prepare lower extremity robotics to meet the requirements of helping individuals with neurological injuries/ disorders walk at home and in the community?

Participants will be able to:

  • Discuss brief history on the perceived need for lower extremity robotics for rehabilitation.
  • Discuss strategies for identifying potential users and training protocols for hospital-based lower-extremity robotic systems.
  • Discuss history of using robotic exoskeletons for rehabilitation and personal mobility in individuals with neurological impairments.
  • Develop an understanding of current considerations for robotic exoskeletons, assessments techniques for potential users, dosage-timing planning, and training strategies specific to therapeutic/mobility goals.
  • Understand operational differences between devices and advantages/disadvantages for each device.
  • Discuss the current state of exoskeleton technology including clinical trial results and future impact of these device on the field of rehabilitation.
  • Discuss how emerging robotic technologies can be integrated into the continuum of care in an in-patient, out-patient, and home environment.

12:00 PM – 2:00 PM 

Lunch (on your own)

2:00 PM – 5:00 PM (Break: 3:15 PM – 3:45 PM)

Video-based Case Presentations/Discussion

(Facilitated by Residency Program Directors & Residents)

IV STEP plenary sessions have been designed to examine emerging topical areas that will impact the future practice of physical therapy. Video-based patient cases will serve as the anchor for break-out small group discussions that will occur following 3 of the IV STEP plenary sessions. Residency Program Directors have been invited to develop 12 (6 adult and 6 pediatric) diagnosis specific video-based clinical case scenarios (max 30 minutes) that will be unfolded by the residency program during the break-out small group sessions. Following the unfolding of the case scenario the small groups will explore prepared questions (max 45 minutes) that will link the topics discussed in the plenary session and the concept of 4P’s to the specific cases. The discussion portion of the break-out session will be facilitated by the resident along with content experts who have been assigned to the session (minimum one expert per case and IV Step committee member). Cases will be repeated twice during the break-out sessions so that participants can engage in two different cases per session. It is the overarching intent of the break-out session for clinicians, educators, and researchers to work together to apply content from the day’s plenary session to the video case presented in order to foster an implicit and explicit understanding of the concepts. The goal is to assist participants in examining the relevance and potential application of the topical areas reviewed (Movement System Diagnosis & Prediction, Genetics-Plasticity-Regenerative Rehab, and Health Promotion Practices- Dosage and Timing- Technology)  in relation to the video-based case presented; to assist participant’s in applying the principles of prevention, prediction, plasticity, and participation (4P’s) to their daily practice and teaching via video-based case presented; and to provide an opportunity for interaction amongst participants from diverse backgrounds to foster and IPP (PT, PTA, Basic Scientist, Researcher, Academician) approach to PCC.

Participants will be able to: 

  • Explore and apply physical therapists role in preventing disabling conditions.
  • Identify critical periods of neuroplasticity and strategies, including dosage, timing, and technology, for maximizing experience-dependent plasticity.
  • Analyze and apply emerging measures, interventions, and research options to optimize participation within a patient-centered care model.

 

 

Tuesday, July 19

8:00 AM – 11:30 AM (Break: 10:00 AM – 10:30 AM)

Excellence in Promoting Participation: Striving for the 10 Cs (Client-Centered Care, Consideration of Complexity, Collaboration, Coaching, Capacity Building, Contextualization, Creativity, Community, Curricular Changes, and Curiosity)

Speaker: Lisa Chiarello, PT, PhD, PCS, FAPTA

Supporting home and community participation of children and adults with physical disabilities is critical to optimizing their life roles and lived experiences. Dr. Chiarello will discuss a framework on optimal participation that recognizes the complexity of the construct including the multiple dimensions and determinants of participation. She will present a model of participation-based service delivery that acknowledges the need for embracing client-centered care and interprofessional practice to optimize participation outcomes for children and adults with disabilities. The roles and responsibilities of the physical therapist will be highlighted but the process of team collaboration including communication, coordination, and consultation will be emphasized. Dr. Chiarello will advocate for the transformation of rehabilitation services for children and adults with disabilities to focus on measuring participation and designing effective interventions. Supported by theory, research, practice knowledge, and client and family perspectives, she will discuss the principles of coaching to engage clients in their rehabilitation and build self-determination, self-efficacy, and capacity. Research also suggests the need to contextualize intervention through real life experiences in natural environments to foster adaptive behavior and support participation. Dr. Chiarello believes that creativity, innovation, and community partnerships enable opportunities for participation. Dr. Chiarello will propose directions for curricular changes and future research to optimize services and participation outcomes. This presentation aims to motivate practitioners, educators, and researchers to reflect on their current practices, challenge boundaries, and expand horizons to support participation of children and adults with disabilities.

Participants will be able to:

  • Reflect on their competency to support participation of children and adults with disabilities through practice, education, and research.
  • Advocate for a paradigm shift in practice, education, and research to support participation of children and adults with disabilities.

Research Design Options for Individual and Complex Interventions and Participation Outcomes

The New Face of Single Subject Research Design: P Values, Randomization, and Causality, Oh My!

Speaker: Michele Lobo, PT, PhD

This talk will highlight recent advances in the field of single subject research design, types of single subject research designs, and reasons why single subject research designs may be optimal for many types of physical therapy research.

Participants will be able to:

  • Describe and provide examples of single subject research designs.
  • Compare and contrast single subject research designs with more traditional experimental group study designs.
  • Identify ways that single subject research studies can be designed to assess causality, to calculate statistical significance of a treatment effect, to allow for randomization, and to increase external validity.
  • Identify examples of rehabilitation research where single subject research designs may be more feasible and useful than traditional group designs.

Qualitative Research Design Options for Complex Interventions and Participation Outcomes

Speaker: Sarah H. Kagan, PhD, RN, FAAN

The 4 P’s – Prevention, Prediction, Plasticity, and Participation – are explored from a Post-Positivist qualitative perspective. Aspects of design including those of paradigm, such as Post-Positivist clinical significance, and pragmatics, like sample size and rigor, are highlighted with reference to controversy and misinterpretation. Examples using each of the 4 P’s and practical strategies for advancing qualitative research design in these domains are discussed.

Participants will be able to:

  • Contrast and compare clinical significance in Positivist and Post-Positivist frames.
  • Analyze contemporary sampling strategies with an aim to enhance clinical significance in qualitative research design.
  • Interpret select techniques to improve rigor in qualitative research design.

Asking Rehabilitation Outcomes Questions with Observational Designs: The TBI Experience

Speaker: John Corrigan, PhD, ABPP

This decade has seen the creation or maturation of multiple large datasets examining outcomes following traumatic brain injury (TBI). Two of these datasets were specifically designed to evaluate rehabilitation populations: the TBI Model Systems National Database and the TBI Practice Based Evidence Study. These two datasets were designed to examine rehabilitation outcomes using observational analytic techniques, yet they differ significantly in their structure and composition and, as a result, strengths and weaknesses for examining treatment outcomes. This presentation will briefly describe the TBI Model Systems National Database and the TBI Practice Based Evidence Study and introduce studies exemplary of their relative strengths. Comparisons of the datasets will be used to explore emerging analytic techniques that are being applied to large, observational datasets.

Participants will be able to:

  • Describe two large datasets designed to investigate TBI rehabilitation outcomes.
  • Delineate strengths and weakness of their respective designs.
  • Identify at least one new analytic technique being applied to observational data.

11:30 AM – 1:30 PM 

Lunch (on your own)

1:30 PM – 3:00 PM 

Knowledge Translation: Your Role as an Attendee

Clinical Research Is Not Rocket Science: Empowering the Clinician for Evidence-based Practice

Speaker: Deborah Backus, PT, PhD, FACRM

The physical therapy (PT) profession embraces the importance of evidence-based practice (EBP). PT educational programs regularly include the language and principles of EBP throughout their curriculum. Most include some aspect of research training, based on the assumption that this will improve understanding of research and enhance the use of evidence in practice. Many PTs have gone on to obtain further research training in an effort to build the PT evidence base upon which clinicians can draw in every day practice. However, the chiasm between research and practice remains. A variety of barriers face PTs all along the continuum, from new grad to seasoned practitioner, that prevent them from regularly, systematically and adequately translating evidence into practice. PT researchers, in turn, are challenged to ask meaningful and applicable research questions that PTs can readily and easily apply to their practice. Instilling a research culture in the clinic can help facilitate knowledge translation and evidence-based practice, ultimately advancing clinical care, improving patient outcomes, and contributing to the PT evidence base. Training and supporting the PT clinician to embed research into their clinical practice is a critical component of knowledge translation. The PT “clinician scientist” should be trained to systematically measure and document outcomes, evaluate the effectiveness of their intervention and critically review the literature for the appropriate and ethical use of evidence in practice. Furthermore, the development of the PT clinician scientist will enable the definition of meaningful research questions and will advance PT research for a broader, more realistic and applicable evidence base. This presentation will discuss the rationale for adopting a research culture in a clinical setting to assist in overcoming the barriers PTs may face translating evidence into practice. A framework will be provided for developing and supporting the PT clinician scientist in the applied clinical setting in order to facilitate knowledge translation and to advance PT clinical care and research.

Participants will be able to:

  • Understand the need and describe potential mechanisms for developing a research culture in a clinical setting to advance PT practice and research.
  • Describe a potential model to engage and empower clinicians to embed research into their clinical practice.
  • Take it to Monday, and define three ways participants can immediately empower their clinical staff or incorporate research into their own clinical practice.

The Future Is Now: Innovation of Physical Therapy Through Knowledge Translation

Speaker: Jennifer Moore, PT, DHS, NCS

The implementation of research evidence into clinical practice takes a substantially long time, some estimate an average of 17 years or more to occur. Because of the urgent need to expedite this process and the complexities of changing clinical practice, the field of knowledge translation (KT) is quickly growing. The Canadian Institutes of Health Research (CIHR) defined KT as “a dynamic and iterative process that includes synthesis, dissemination, exchange and ethically-sound application of knowledge to improve the health [of the population], provide more effective health services and products and strengthen the health care system.“ Research studies have suggested that using systematic processes to implement knowledge may impact the success of KT initiatives. Other factors, such as a clear vision for clinical practice and leadership support may also accelerate these efforts. This presentation will describe a vision for the field of physical therapy that includes the systematic implementation of evidence based practice, collection and synthesis of data collected from practice-based evidence, and how this data can be used to guide clinical practice. Strategies to expedite the implementation of evidence into clinical practice through stakeholder engagement, leadership support, and use of KT interventions will also be discussed.

Participants will be able to:

  • Describe a vision for physical therapy practice that has a foundation of ongoing implementation of evidence and data collection from clinical practice.
  • Discuss how to engage organizational stakeholders in knowledge translation efforts.
  • Define KT frameworks that can be used to guide the implementation of evidence into practice.

Integrated Knowledge Translation: Engaging Stakeholders, Influencing Policies, Promoting Participation

Speaker: Keiko Shikako-Thomas, OT, PhD

This session will emphasize the current state of the art in stakeholder engagement as a vehicle of change of clinical practice and research in rehabilitation, with an especial emphasis in pediatric populations. The session will describe examples of stakeholder engagement in different integrated knowledge translation processes, and will suggest strategies to meaningfully engage groups such as: patients and families, community groups and policymakers. We will also review the current evidence about strategies to engage, measure engagement and measure the impact of stakeholder engagement in rehabilitation. Finally, we will discuss the role of rehabilitation professionals in influencing policy and the possibilities of impacting policies in health promotion strategies (prevention) and mostly in promoting participation for children with disabilities.

Participants will be able to:

  • Understand what is integrated knowledge translation and implications in rehabilitation practice and research.
  • Appreciate the evidence in the role of rehabilitation professionals in meaningfully involving stakeholders in research and practice.
  • Understand different strategies to engage stakeholders in research and practice.
  • Recognize the importance of “hard to reach” stakeholder groups such as policymakers and grassroots, and identify ways to engage these groups in knowledge translation initiatives.

3:00 PM – 3:30 PM 

Break

3:30 PM – 5:00 PM 

Conference Summation: Lessons Learnt and Future Directions about Prevention, Prediction, Plasticity, and Participation

Moderators: Susan Harris, PT, PhD, FAPTA; Carolee Winstein, PT, PhD, FAPTA

Speakers: Deborah Larsen, PT, PhD; Lara Boyd, PT, PhD; Teresa Kimberley, PT, PhD; and Iona Novak, OT, PhD

This session will provide a panel summation of the research, education and clinical practice lessons learnt from the conference about prevention of secondary impairments through timely intervention; prediction of optimal responses to intervention; plasticity research findings about timing, dosing, frequency, intensity and critical periods for intervention; and participation outcomes from intervention that produce meaningful change in the fulfilment of important life roles that matter to individuals

Participants will be able to:

  • Highlight and synthesize the critical points of the conference into practical “lessons learnt.”
  • Recommend future directions and knowledge translation strategies for clinicians, educators, researchers, clients and caregivers, based upon new theory and research evidence presented at the conference, relating to movement science for individuals of all ages with neurologic disorders.

5:00 PM – 8:00 PM

Closing Ceremony Celebration

Entertainment provided by the Monkey Rider Band.