Combined Sections Meeting 2017
Programming Preview

In 2017, CSM will be held in San Antonio, Texas.  Here is a summary of a few of the exciting courses and presentations that are being offered this year.  Please make sure to join us at our business meeting on Saturday morning.  This is a great opportunity for networking.  We look forward to seeing you there!

Precon course: Wednesday, February 15, 8:00 AM - 5:30 PM: Managing Visual and Vestibular Dysfunction in the Home

Location: Grand Hyatt San Antonio Room: Seguin A

Speakers: Sharan Zirges, PT, DPT, MSHA; Dianne Wrisley, PT, PhD, NCS; and Michelle Gutierrez, PT, DSc

Description: Visual and vestibular deficits are associated with many neurological disorders and with an increased risk of falls. Home health physical therapists encounter these deficits frequently. Assessment and treatment of these systems may provide a challenge in the home. This course will provide an overview of visual and vestibular tests and screens for the home health clinician. The goal is to provide tools that can be utilized in the home to identify vestibular and visual deficits but also to recognize signs and symptoms requiring referral for more specific assessment. Differential diagnosis of causes of vestibular and visual deficits will be discussed. Interventions for visual and vestibular dysfunctions that can be performed in the home will be provided with an opportunity to practice in a lab setting.

Thursday, February 16, 11:00 am -1:00 pm: Evaluation and Treatment of Motion Induced Disorders

Location: Henry B. Gonzalez Convention Center Room: Hemisfair Ballroom 3

Speakers: Sara Oxborough, PT and Rachel Wellons, PT, DPT, NCS

Description: Motion is often times a trigger for vestibular disorders. In this session two disorders with vestibular involvement, but limited research, will be discussed. Mal de Debarquement is a rare but debilitating disorder that occurs after passive motion has ceased. Motion Sensitivity is another disorder that occurs while in motion, and causes dizziness, nausea, and imbalance while in passive locomotion or with motion of the visual surround while still and walking. Material will be presented in an unfolding case study format with clinical reasoning and decisions used to examine and provide intervention to individuals with these two disorders. The roles of medical management in these cases will also be discussed. A framework for managing patients with these disorders will be discussed. Recommendations for future research will be made for improved evidence in management of patients with these disorders.

Friday, February 17, 8:00 am -10:00 am:Clinical Management of Lateral (horizontal) Canal Benign Paroxysmal Positional Vertigo (BPPV)

Location: Henry B. Gonzalez Convention Center

Room: Hemisfair Ballroom 1

Speakers:  Anne Galgon, PT PhD, NCS; Janene Holmberg, DPT; Wendy Webb Schoenewald PT, OCS

Description: Benign Paroxysmal Positional Vertigo (BPPV) is a common diagnostic group seen in physical therapy practices. Posterior canal BPPV makes up the majority of cases seen in practice and effective diagnostic tests and interventions for this condition are well established. However, the frequency at which lateral canal (LC) BPPV is seen in clinics appears to be higher than previously recognized. High variability in the management of LC BPPV in both diagnostic and intervention methods has been reported in the literature and was seen in the physical therapy practices we examined. The variability may be explained by the pathophysiology of LC BPPV and poorer outcomes from any one type of maneuver as compared to posterior canal BPPV. The session will discuss the pathophysiology of lateral canal BPPV in relationship to the problems in diagnosis, intervention variability and outcomes. The session will present two alternative approaches to management of LC BPPV. Case studies will be presented to emphasize both differential diagnosis and intervention decisions in the subpopulations of BPPV. Participants will view video of ocular movements and nystagmus during examination and interventions in the case study presentations to advance clinical decision making skills.

Friday, February 17, 3:00 pm – 5:00 pm: Brain or Strain? Differentiating mTBI From Cervical Spine Injury

Location: Henry B. Gonzalez Convention Center

Room: Hemisfair Ballroom 1

Speakers: Rob Landel, DPT, OCS, CSCS, FAPTA and Laura Morris, PT

Description: The cause of dizziness following concussion/mild traumatic brain injury (mTBI) is multifaceted. Certainly central and peripheral vestibular dysfunction is common. Concussed patients likely also sustain neck injuries during the traumatic event, making cervical sensorimotor deficits possible contributors to the dizziness (aka cervicogenic dizziness, CGD). CGD is often overlooked, however, because a central origin is presumed. Appropriate management requires determining the cause of the dizziness, however this can be a diagnostic challenge. The purpose of this program is to present the common manifestations of symptoms arising from physiologic, vestibule-cochlear and cervical structures after a concussion event. In particular, the presenters will focus on how one might clinically differentiate dizziness due to each of these three sources. Suggestions for appropriate management for each condition will be presented.

Saturday, February 18, 6:45 am -7:45 am: Vestibular SIG Business Meeting

Come hear about what the SIG has been up to for the past year and what we plan to accomplish next year.  All who attend will receive tickets to be entered into a drawing for a number of fabulous prizes including vestibular text books, video frenzel goggles, optokinetic training DVD’s and more.  We hope to see you there!

Saturday, February 18, 3:00 pm – 5:00 pm: Expanding treatment strategies for persistent non-vertiginous dizziness

Location: Henry B. Gonzalez Convention Center

Room: Hemisfair Ballroom 1

Speakers:  Kenda Fuller PT; Janene M. Holmberg, PT, DPT, NCS; Brady Whetten, PT, DPT, GCS

Description: Persistent non-vertiginous dizziness can be a prominent disabling complaint secondary to migraine, concussion and following definable inner ear events despite evidence the initial crisis is physiologically well healed. The intent of this course will be to provide physical therapists specific tools to better treat and manage patients who exhibit primary impairments of visual motion sensitivity, somatosensory/vestibular processing deficits and autonomic nervous system maladaptation. We will present the latest evidence regarding the use of vision therapy techniques, sensory facilitation and integrative relaxation techniques. Through case applications, we will present a framework to successfully identify individuals that will benefit from this expanded toolbox based on their history and examination, and clear examples of progressing interventions and measuring progress. Proper dosage to ensure tolerance and sufficient training to optimize recovery will be reviewed. The diagnostic criteria and differential diagnosis have been well defined in the literature and this course provides the continuum of care that is critical to success in the clinic.

 

Other Presentations that may be of interest:

-Friday, February 17, 8:00 am – 10:00 am: Defining Dizziness: An Acute Care Approach to Vestibular Dysfunction in the Hospital

Section: Academy of Acute Care PT  Speakers: Kerry Lammers PT, DPT and Gabrielle Steinhorn PT, DPT, NCW

-Saturday, February 18, 8:00 am – 10:00 am: Knowledge Translation: Acute Care Neurology and Complex Vestibular Dysfunction

Section: Academy of Acute Care PT  Speaker: Daniel Stam PT, DPT, CBIS

 -Saturday, February 18, 8:00 am – 10:00 am: Forward Head Posture in Elderly: CoNECKtion to Vestibular Deficits

Section: Academy of Geriatric PT  Speakers: Leslie Allison PT, PhD; Sara Migliarese PT, PhD, NCS; and Emma White PT, DPT, OCS

 

If you have any ideas for future programming, please contact Lexi Miles at lexirmiles@gmail.com.  Thank you and hope to see you in San Antonio!

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