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Course Description

This is a two day, 15 contact hour course, involving both lecture and lab instruction.  This course is open only to licensed physical therapists. This course will cover the theory, evidence, and application of manual therapy procedures for patients with musculoskeletal disorders involving the cervical-thoracic region including the thoracic spine, rib-cage, cervical spine, and cranio-cervical region.  This course provides evidence-informed instruction on differential diagnosis, examination and management of patients cervical-thoracic conditions. Manual therapy techniques, including thrust and non-thrust procedures, will be emphasized along with exercise prescription for patient with cervical-thoracic disorders. Clinical decision making involving the application of examination and intervention procedures will be presented. 

Course Outline

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Day One

Topic

8:00-8:30

Introduction and Overview

8:30-9:30

Cervicothoracic Differential Diagnosis

  • Screening for Red Flags
  • Neurological examination
  • Vascular examination
  • Instability screening

9:30-10:45

Cervical thoracic Exam

  • Postural screen
  • AROM with OP
    • C-spine
    • T-spine
  • C-spine ROM with inclinometer
  • Shoulder scan
  • Cervical and thoracic segmental motion testing
    • PA’s
    • Cervical PPVIM’s
    • Cervical sideglides

 

10:45-11:00

Break

11:00-12:00

Cervical Thoracic Manual Therapy

  • Mechanisms of MT
  • Manual therapy CDM
    • Assess-treat-reassess
  • Seated mid thoracic thrust
  • Seated CT junction thrust

12:00-1:00

Lunch

1:00-3:00

Manual Therapy for Cervical Thoracic Region continued

  • Cervical PA’s
  • Thoracic PA’s
  • Supine mid-thoracic thrust
  • Supine upper thoracic thrust
  • Prone middle-lower thoracic thrust
  • Cervical upglide/rotatory thrust

3:00 – 3:15

Break

3:15-4:30

Cervical thoracic motor control

  • Scientific rationale for motor control training
  • Finding neutral spine posture
  • Breathing pattern
  • Deep neck flexors
  • Cervical extensors
  • Sensory motor assessment and retraining
    • Joint position sense
    • Occulomotor assessment
    • Balance assessment
  • Progressing into functional activity

4:30-5:00

Review

Learner Outcomes

At the conclusion of the course students will be able to:

  1. Conduct an accurate differential diagnosis for patients presenting with cervical-thoracic region pain in order to identify serious disorders requiring referral. 

  2. Conduct an efficient and accurate clinical examination for patients with cervical-thoracic region pain.

  3. Utilize the current, best evidence to inform physical therapy management of patients with cervical-thoracic region musculoskeletal disorders.

  4. Perform skilled orthopaedic manual physical therapy interventions, including thrust and non-thrust techniques, targeting the cervical-thoracic region. 

  5. Apply sound clinical decision making within a biopsychosocial model to the management of patients with cervical-thoracic region musculoskeletal disorders.  

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