Course Catalog

Cervicogenic Dizziness: An Evidence-based Competency Course

This course is intended for physical therapists with experience managing patients with dizziness who wish to improve their skill in differential diagnosis, manual examination and treatment of patients with cervicogenic dizziness (e.g. whose dizziness has a cervicogenic component). Continually updated with the latest research and clinical findings, common conditions that will be discussed include traumatic onset neck pain (e.g. whiplash), concussion, and migraines. The emphasis of this course is on evidence-based practice, acquiring examination and treatment skills in lab sessions, and testing for competency in those skills. Participants should have a working knowledge of central and peripheral vestibular disorders and the ability to begin to differentiate their various presentations since this course will focus on the cervical aspects of dizzy complaints. Pre-assigned readings will familiarize the participant with the relevant literature, allowing the majority of time and emphasis to be on practicing motor skills. Engaging active learning techniques are utilized throughout, to maximize learning and skill acquisition while making the course enjoyable. The course begins on Friday evening with a discussion of the evidence regarding the presentation and differential diagnosis of cervicogenic dizziness. This discussion continues on Saturday and Sunday, with integrated lab sessions that allow practice of examination and intervention skills. Competency with the course’s knowledge and skills will be assessed by written (Saturday) and practical exams (Saturday and Sunday). Taking the examinations is optional, but participants who pass all exams (>75% score) will receive a certificate of competency. All participants will be able to immediately apply acquired skills in the clinical setting. Since its inception 19 years ago this course has averaged a 4.9/5.0 overall rating.

Level: Intermediate

Instructor: Rob Landel, PT, DPT, FAPTA

Manual Interventions for the Thoracic and Cervical Spine

This course is designed for the physical therapist who has some experience with treating thoracic and cervical spine dysfunction but would like to improve on his or her manual skills including soft tissue and joint mobilization, and thrust joint manipulation. Instruction of techniques for each region will be grounded in the supporting evidence where available, with discussion of the lack of evidence as appropriate. The indications, contraindications, precautions and adverse reactions for the various techniques will be presented via lecture and discussions. The majority of time will be spent in lab sessions, with ample time for practice of the techniques. The participant will gain confidence in his or her technique application, and will be able to assess whether or not application of the technique was successful and effective.

Level: Intermediate

Instructor: Rob Landel, PT, DPT, FAPTA

Basic Thoracic and Lumbar Thrust Joint Mobilization

This course is designed for physical therapists who wish to learn or advance their ability to apply thrust joint mobilization (TJM) techniques. Current accreditation standards require physical therapy programs to teach all grades of joint mobilization, including non-thrust and thrust, making these techniques a standard part of physical therapy manual therapy practice. The evidence supports the use of TJM in specific patient cases but not in others; thus a clinical reasoning process is required that includes indications, precautions and contraindications for these techniques, to allow for their safe clinical application. The participant will be able to incorporate TJM techniques into other aspects of physical therapy management, and to assess the outcome of the intervention. Ample time in lab sessions will allow for the demonstration and practice of selected techniques. The number of participants will be limited to allow for adequate student to teacher ratios. The goal is for the participant to develop a level of comfort in using TJM techniques.

Instructor: Rob Landel, PT, DPT, FAPTA

Concussion or Worse: Differentiating and Managing Patients with Dizziness in a Typical (Busy!) Outpatient Clinic

Disorders common to the orthopedic PT setting, such as a concussion or whiplash, can produce the trifecta of dizziness: “mild” brain injury, vestibular disorders (central and peripheral) and cervicogenic dizziness. The purpose of this course is to equip the physical therapist with the knowledge and skill, given a patient complaining of dizziness, to identify when a dangerous condition exists; to recognize common vestibular presentations; to differentiate these presentations from musculoskeletal conditions that may produce similar symptoms; to manage the basic issues; and to refer appropriately when needed. Topics will include the differential diagnosis and management of concussion, BPPV, and cervicogenic dizziness. We will emphasize determining which conditions are appropriate for PT interventions and which require referral. Physical therapists practicing in orthopedic, sports, acute and subacute settings will benefit from this course, as will PT’s with a background in vestibular rehabilitation but who are less comfortable managing the concurrent musculoskeletal issues.

Instructor: Rob Landel, PT, DPT, FAPTA

The Concussion CPG: Managing the Cervical and Vestibular-oculomotor Domains

The best practices for the management of patients who have experienced a concussive event has been a moving target recently due to rapid advances in our understanding of this complex condition. While several strong clinical practice guidelines (CPGs) exist to offer guidance in the acute management of sports-related and battlefield injuries, until 2020 no guidelines existed to help physical therapists manage and treat this diverse patient population. The purpose of this session is to introduce the audience to the CPG on Physical Therapy Evaluation and Treatment After Concussion / Mild Traumatic Brain Injury, and focus on two domains described therein: the cervical musculoskeletal impairments and vestibulo-oculomotor impairments. The participant will be able to differentiate between patients with cervical musculoskeletal impairments and vestibulo-oculomotor dysfunction, discuss treatment of those who are appropriate and refer those who are not. Participants will gain an understanding of the current recommendations in these domains, and an appreciation for where the literature is lacking and clinical experience must take precedence.

Level: Intermediate

Instructor: Rob Landel, PT, DPT, FAPTA

Managing complaints of dizziness in a busy PT clinic

This hands-on lab course is aimed at clinicians who are treating patients presenting with complaints of dizziness and/or balance problems. The participant will be able to differentiate between patients with central and peripheral vestibular dysfunction, treat those who are appropriate and refer those who are not. Difficult patient presentations such as migrainous vertigo, cervicogenic vertigo, and concussion will be discussed. Clinical tests of vestibular function, including BPPV and the various forms of positional testing, and the significance of abnormal findings, will be discussed, demonstrated, and practiced. The management of common vestibular disorders will be practiced, including canalith repositioning, liberatory maneuvers, vestibular habituation exercises. Guidelines for managing cervicogenic dizziness and concussion will be discussed and practiced. The recent literature including Clinical Practice Guidelines will be reviewed that justifies the use of these programs. The participant will leave the course with a thorough understanding of how to manage patients with complaints of dizziness.

Level: Basic

Instructor: Rob Landel, PT, DPT, FAPTA

Comprehensive Management of the Cervical Spine

This course is designed for the physical therapist who wishes to learn and refine the manual skills necessary for the examination, evaluation and management of patients with cervical musculoskeletal disorders. Participants are required to read assigned articles prior to class and take a test, which maximizes the effectiveness of lecture and discussion time, prepares the participant with the relevant evidence, and leaves more time for hands-on lab sessions. Discussion will focus on the validity and clinical usefulness of manual examination procedures, and the indications and outcomes for given manual interventions. Introduction of topics follows a case- based theme. Clinical problems covered include determining the appropriateness of PT for a patient with acute onset (traumatic and atraumatic) of neck pain, cervical radiculopathy, cervicogenic headache, cervicogenic dizziness, cervical hypo- mobility and hypermobility. The majority of the course is spent in lab instruction and practice time, to allow time for acquisition of motor skills. The participant will be able to utilize techniques learned in this course immediately. A CD-ROM with all of the techniques (photos, written descriptions, and videos) will be provided as part of the course fee.

Level: Intermediate

Instructor: Rob Landel, PT, DPT, FAPTA