Treating Cumulative Trauma Patients

Audience: Hand therapists, P.T., O.T.R./.L.

Course level: Beginner/Intermediate

Date: Saturday/Sunday, May 1-2, 2010
Check-In Time(s): 8:30 a.m.-9 a.m.
Class Time(s): 9 a.m.-5 p.m.
Location: Fairview Riverside campus, St. Kate's University
Contact Hours: 12.75

Emil F. Pascarelli, M.D. is an Emeritus Professor of Clinical Medicine at the College of Physicians and Surgeons of Columbia University He was the founder and Medical Director (1985-1995) of the Miller Healthcare Institute for Performing Artists at St. Luke's/Roosevelt Hospital. Dr. Pascarelli is a recognized expert on cumulative trauma disorders, having treated over 4,000 patients with this problem. He has written articles for professional journals and the general public, lectures often to industrial and music professionals and medical groups on the prevention and treatment of CTDs. His two books, Repetitive Strain Injury: A Computer User’s Guide (John Wiley & Sons, 1994) and Dr. Pascarelli’s Complete Guide to Repetitive Strain Injury (John Wiley & Sons, 2004) are the result of his years of clinical experience in a practice devoted to diagnosis, treatment and prevention of upper body CTDs.

Lisa Sattler D.P.T., M.S., is director and owner of two facilities in New York City: Midtown East Medical & Physical Therapy and Rehabilitation Services of Astoria, LLC. She is founder of the Treatment Center for Repetitive Strain Injuries (RSI). Lisa has 20 years experience working in the physical therapy profession with the last 12 years dedicated to neck, shoulder, arm pain syndromes. Most have been musicians and computer users. She earned her Master’s degree from Long Island University in 1994 and her clinical doctorate in 2007 from Stony Brook University. She has lecture nationally and internationally with Dr. Emil Pascarelli, author of numerous books and articles related to upper extremity (UE) pain syndromes. She has lectured in New York City with local physicians who also have experience with repetitive strain injuries, and independently on numerous occasions. Most recently she lectured this past October at the 50th annual American Translators Association convention. She has published an online article related to the topic of the incidence of reflex sympathetic dysfunction in repetitive strain injuries. Her treatment program has recently been published in Dr. Emil Pascarelli's new book, "The Complete Guide to RSI". She also published a chapter with reference to her work with RSI in a book titled, "40 things to do when you turn 40."

Course Description:
This seminar will focus on the advances in medical evaluation and treatment of upper body cumulative trauma disorders based on the published evidence and experience of a dedicated cumulative trauma disorders program. Anatomy of the "thoracic outlet" will be reviewed with emphasis on the peripheral nervous system. This interactive course offers participants the opportunity to participate in lively discussions and problem solving as well as hands on training that will bolster knowledge and skills. This course will provide an outline of the components of a comprehensive MD and PT/OT exam, including selected tests and definition and explanation of commonly involved pathology and lesions relative to pathogenesis, diagnosis, prognosis and intervention. This course will also include discussion of indications for mobilization versus Immobilization, ergonomics, posture, energy conservation and injury relapse prevention.

Course Objectives:

  • Achieve a greater understanding of upper body cumulative trauma disorders (CTDs)
  • Improve skills in developing a focused prevention and treatment approach for CTDs
  • Examine the etiology and pathophysiology applying evidence based concepts to diagnosis and treatment of CTDs
  • Identify practical approaches to diagnosis and treatment applying an understanding of managed care and insurance limitations
  • Develop a treatment plan which includes activity modification and re-integration allowing for improved discharge outcomes
  • Perform select manual therapy interventions and determine if selected interventions are efficacious
  • Design an exercise program to reinforce manual therapy interventions
  • Explore the implications of psychosocial factors as they are related to CTDs

Course Agenda:
Day One
8:30-9 a.m.                       Registration
9-9:45 a.m.                       Pre-course discussion, Introduction and definition, Pathophysiology, History
9:45-10:15 a.m.               Discussion of MD roles and MD exam
10:15-10:30 a.m.             Break
10:30 a.m. 12:30 p.m.    Demonstration of MD exam, Hands on audience participation including discussion of 
                                            MD prescriptions and differential diagnosis
12:30-2 p.m.                     Lunch
2-2:45 p.m.                       Anatomy of "thoracic outlet" with emphasis on brachial plexus
2:45-3:30 p.m.                 Review of evidence based information available internet
3:30-3:45pm                    Break
3:45-5 p.m.                       PT and OT evaluation review, "Basic 5" exercise demonstration, simultaneous 
                                            aspects of treatment

Day Two
9-9:15 a.m.                       Recap of day 1; summary of physicians role, Injuries to various groups including: office 
                                            workers, musicians and other workers with repetitive movements in their daily routines
9:15-10:30 a.m.                Evaluation review and conclusion, advanced exercises, D/C protocol, soft tissue 
10:30-10:45 a.m.             Break
10:45-11:45 a.m.             Musicians use computers too, ergonomics and instrument modification
11:45am-12:30 .p.m       Psychosocial aspects of RSI including alternative treatments
12:30-2 p.m.                     Lunch
2-3:30 p.m.                        LAB, soft tissue mobilization training
3:30- 4:30 p.m.                 Audience "real case" examples, discussion of several stubborn cases with suggestions 
                                            for alternative or additional treatment; physician and therapist
4:30-5 p.m.                        Dr. Pascarelli's exercise video, Conclusion, Q and A

This course is eligible for AOTA Approved Provider credit. The assignment of AOTA CEU's does not imply endorsement of specific course content, products or clinical procedures by AOTA.

*This course has been approved for Category 1 credit from the MN Board of PT for 12.75 contact hours. Course approval number 4087.

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