Rehabilitation Services Continuing Education Courses

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Date: Saturday, November 17, 2018
Audience: Lymphedema therapists, PT, OT
Course Level: Beginner
Check in time: 7:30-8 am
Course time: 8-4:30 pm
Location: St. Catherine’s University
601 25th Avenue S, Minneapolis, MN 55454
Held on 5th floor in room 560

Contact hours: 7.0
Course to be completed in full to receive your certificate.
Course Fee: $150

Course description: This course will provide the therapist with an increased level of understanding of how edema is formed as well as assisting in assessment and differential diagnoses of common conditions that present with edema.  It will cover etiology and treatment options for various medical edemas, orthopedic and post surgical edemas as well as precautions for patients with lymphedema or 'at risk' for lymphedema.  This course will address evidence based treatment options beyond the basics for both inpatient and outpatient settings as well as a discussion on documentation.

Lisa Karrow, MPT, CLT-LANA is a certified Lymphedema therapist who has worked with in Fairview for 20 years.  She obtained her masters of Physical Therapy from Mayo’s School of Health Related Sciences in Rochester, MN in 1993 and in 1997 earned her lymphedema certification.  She became nationally certified through the Lymphology Association of North America (LANA) in 2001.  Lisa has completed advanced level Edema/Lymphedema and Cancer Rehab Courses and has lectured on Edema management and lymphedema to both the University of MN, Fairview Rehab services and St. Catherine’s University Physical therapy programs.

Krista Thole, MS, OTR/L, CLT  is an occupational therapist and lymphedema therapist.  She received her MS of Occupational Therapy at the University of Minnesota.  Krista completed her lymphedema certification in 2011 from Norton School of Lymphatic Therapy using the Vodder Technique.  Krista has worked for Fairview since 2007 treating individuals in the in-patient and out-patient settings.  Currently, Krista works at the Fairview out-patient Specialty Rehab Clinic in Maple Grove. "

Objectives: TBD

Agenda: TBD

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Date: Saturday, January 12, 2019
Audience: PT
Course Level: Intermediate/Advanced
Check in time: 7:30-8 am
Course time: 8-5 pm
Location: St. Catherine’s University
601 25th avenue S, Minneapolis, MN 55454
Held on 5th floor Rm 560
Contact hours: 7.5
Course intended to be completed in full.  If you need to arrive late or leave early the CE department must be notified before course takes place for contact hours to be adjusted.

Course Fee: $175

Chris Pegram PT, OCS, FAAOMPT works as a physical therapist in Northfield, MN, at Northfield Hospital and Clinics Rehabilitation Services. In 1998 he completed his physical therapy training at Clarke University in Dubuque, IA, and has spent the vast majority of the past 20 years working in orthopaedics with a focus on manual therapy and exercise. In 2014 Mr. Pegram was board certified as an Orthopaedic Clinical Specialist (OCS). Shortly after receiving his OCS he began his fellowship training through Regis University in Denver, CO. In the summer of 2016 he was recognized as a Fellow in the American Academy of Orthopaedic Manual Physical Therapy (AAOMPT). Mr. Pegram lives in Northfield with his wife and two sons and is an active member of the American Physical Therapy Association (APTA) and the American Academy of Orthopaedic Manual Physical Therapy (AAOMPT).

Rick Mewes, PT, OCS is a graduate of St Catherine University in Minneapolis, MN where he remains adjunct faculty within the DPT Program. He is currently a Director at the Institute for Athletic Medicine and is a Board Certified Orthopedic Specialist. His clinical focus is in orthopedic lower extremity rehabilitation and low back pain care. Rick is currently involved in clinical best practice, continuing education, and technology innovation initiatives at IAM.

Course Description:

Lifetime prevalence for neck pain has been shown to be as high as 70%. Unfortunately, 44% of those will likely become chronic conditions. As such, neck pain and neck related upper extremity pain are common conditions physical therapists will treat throughout their careers. Manual therapy and exercise have been demonstrated in the literature as effective modes of treatment for those presenting with functional limitations related to the cervical spine. This one-day course will focus on specific clinical reasoning strategies to efficiently design and implement a treatment plan. Why do we use the techniques we use? When should we use them, and to what intensity? What exercise approach should be taken? To address these questions, this course will present an evidence based guideline to clinical decision making that will incorporate the JOSPT clinical practice guidelines, a process for understanding each individual’s unique pain experience, treatment strategies that are based on the patient’s unique characteristics and methods for retesting that ensure an efficient management plan. Significant lab time will be used to practice manual assessment techniques of the cervicothoracic spine, as well as mobilization and manipulation for treating neck pain and neck related upper extremity pain. Discussion and lab time will also be devoted to exercise prescription in order to maximize the effectiveness of our patient management.


  • Participants will be able to complete an evidence based subjective evaluation incorporating key concepts for clinical decision making
  • Participants will be able to efficiently complete an evidence based objective evaluation of cervical spine disorders by leveraging key concepts and appropriate hypothesis testing
  • Participants will understand cervical spine specific red flag considerations and risks associated with cervical spine manual therapy
  • Participants with perform safe and effective manipulation/mobilization of the thoracic and cervical spine
  • Participants will understand an evidence based approach to exercise prescription and cervical spine disorders


7:30-8 am         registration/continental breakfast


  • Introduction and course overview
  • Intro to clinical decision making
  • JOSPT Neck Pain CPG: classification of neck pain
  • The subjective evaluation: key concepts to aid clinical decision making
  • Determining a pre-test hypothesis


  • Clinical decision making and the cervical spine evaluation
  • Instruction and lab


  • Safety considerations and cervical spine manipulation
  • Cervical spine upslope manipulation

                 Instruction and lab

  • Cervical spine downslope manipulation

      Instruction and lab

10:15-10:30       Break


  • Clinical decision making and the manual therapy segmental assessment

Reliability and clinical utility

  • Manual therapy segmental testing

Instruction and lab


  • To mob and manip or not to mob and manip?

Evidence behind proposed neurophysiological mechanisms of manual therapy

Clinical decision making and manual therapy

  • Putting the pieces together

Clinical decision making within a test-treat-retest model

12:00-1:00     Lunch


  • Thoracic spine manipulation and neck pain

Instruction and lab


  • Mobilization of the cervical spine

Instruction and lab: supine and prone

  • Manipulation of the cervical spine

Instruction and lab: review upslope and downslope


  • Therapeutic Exercise: A patient response based method 
  • Therapeutic Exercise: An impairment based method
  • Proprioceptive and neuromuscular control exercise: Craniocervical flexion vs laser assisted exercise 
    • Instruction and lab

3:15-3:30    Break


  • Increasing strength and load tolerance: intensive neck and upper quarter strengthening

Evidence review

Instruction and lab


  • Round robin technique review
  • Questions and wrap-up

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Date: Friday/Saturday, January 18-19, 2019
Check in time: 7:30-8 am Friday
Course time: Friday: 8-6:15 pm Saturday: 8-3:45 pm
Location: Fairview Southdale Hospital
6401 France Avenue S, Edina, MN 55435
Held in International Room A and B
Course fee: $450

Contact hours: 15.0 
A certificate of attendance for 15 Contact Hours will be awarded to each participant. Approved CEUs provided by North American Seminars/Health Click. 

All courses are pre-approved by the state licensing boards for physical therapists, physical therapy assistants and occupational therapists, occupational therapy assistants and athletic trainers for license renewal in the state the course is offered. 

North American Seminars is and AOTA provider, provider #4487

North American Seminars, Inc. (BOC provider #P2047) is approved by the Board of Certification, Inc. to provide continuing education to Athletic Trainers. This program is eligible for the maximum stated hours of Category A hours/CEUs. Athletic Trainers should claim only those hours actually spent in the education program.

Course description
This two-day advanced course is designed for physical or occupational therapists, who have prior experience in vestibular rehabilitation and are seeking to refine their clinical evaluation and treatment skills beyond the basics. Therapists who are comfortable with their fundamental skills will find this course helpful at adding more treatment options to successfully treat the complex dizzy patient. Patient diagnoses discussed will include cervical dizziness, atypical BPPV, psychogenic, chronic subjective dizziness, migraine, acoustic neuroma, superior canal dehiscence, and Mal de Debarquement. Focus will be placed on case study applications with careful analysis of history, diagnostic clinical findings and classification of dysfunctions to al-low optimal customized treatment protocols. Clinical skills to be taught will include fistula screening, cervicogenic screening, BPPV treatments beyond the posterior canal (anterior/horizontal canals), acoustic neuroma management including exposure to facial rehabilitation techniques, migraine screening and treatments, and identification/management of psychologi¬cal factors. All testing and treatment protocols presented will be evidence-based and clinically relevant to more effectively manage the dizzy patient. Lectures will intersperse the refining of clinical testing protocols with specific treatment strategies for a wide range of diagnoses. Instruction will be provided via lecture, videotapes, lab breakouts, detailed demonstrations and case studies. Each participant will receive a comprehensive manual giving details of all recommended testing and treatment protocols. 

Janene M. Holmberg, PT, DPT, NCS received her BS degree in physical therapy from the University of Utah in 1987 and Doctor of Physical Therapy in 2009. Her doc¬toral project analyzed treatment outcomes/strategies in patients with refractory to care or resistive forms of BPPV. She has vast clinical experience having seen thousands of "dizzy" patients over the past 20 years. She became an ABPTS board certified Neurological Clinical Specialist in 1996, with Re-certification obtained in 2006. She is currently the Coordinator of Balance Rehabilitation at the Intermountain Hearing and Balance Center in Salt Lake City, Utah. Dr Holmberg serves as auxiliary faculty at Drs Herdman and Clendanial's annual Vestibular Competency course and the University of Utah physical therapy pro¬gram, and is the facial rehabilitation specialist for the Fa¬cial Disorders Center of the University of Utah School of Medicine. Her initial clinical work included an emphasis in stroke and brain injury rehabilitation with completion of her certification in NDT (Neuro Development Technique) in 1990. She completed clinical competency in Biofeedback training in 1991. Since 1991, she has passionately special¬ized in Vestibular Rehabilitation with a sub specialty (since 1996) in Facial Rehabilitation. Dr Holmberg is a member of the APTA Neurology Section's Vestibular Special Inter¬est Group, the Vestibular Disorders Association, and the Acoustic Neuroma Society. She has lectured nationally with many leaders in the field of vestibular and balance rehabilitation, including numerous national conferences/conventions. Since 1998, she has taught many courses in Vestibular Rehabilitation both introductory and advanced as well as courses in falls interventions in the elderly. Dr. Holmberg was the key note speaker in the Utah Chapter APTA annual conference and in 2000 and was awarded Physical Therapist of the Year by the Utah Chapter APTA in 2001. In 2009, she was selected from applicants around the country to form a national core group of vestibular therapists to discuss and develop advanced vestibular re-habilitation concepts for the APTA neurology section. She was guest lecturer at the APTA's 2011 Combined Sec¬tions Meeting for the Vestibular Special Interest Group. Dr. Holmberg is currently collecting clinical outcome data on the effectiveness of vestibular and facial rehabilitation. Her current clinical practice consists of a broad scope of vestibular and neurological patients for which she draws on her extensive experience to help clinicians learn how to manage the complexities of the dizzy and unsteady patient.

Course Objectives
Upon completion of this course participants will be able to:
  • Identify signs and symptoms that differentiate the diagnostic groups of BPPV, cervical dysfunction, psychogenic, Meniere’s disease and migraine. 
  • Perform appropriate examination procedures to distinguish between the diagnostic groups of BPPV, cervical, psychogenic, Meniere’s disease and migraine. 
  • Design customized exercise protocols for each of the diagnostic groups of BPPV, cervical, psychogenic, Meniere’s disease and migraine. 
  • Identify psychological problems that can affect the management of vestibular problems and learn how to modify treatment interventions, plans and goals. 
  • Recognize the role of Migraine as both primary (causing of distinct vertigious episodes) and secondary (traditional migraines leading to more persistent motion, intolerance) contributor to dizziness and its impact on rehabilitation. 
  • Develop an understanding of the important role of both the medical and rehabilitative aspects managing dizziness and when to refer to another provider. 
  • Identify a multitude of balance facilitation techniques both for motoric and sensory balance deficits with the dizzy patient. 
  • Develop skills related to the “fine art” of vestibular rehabilitation which is the accurate interpretation of eye motion as it relates to the patient’s clinical presentation. 
  • Develop improved management skills for patients with stable vestibular deficits such as status post acoustic neuroma surgery including an introduction to facial rehabilitation, expected outcomes, and treatment progressions. 
  • Identify the clinical presentation and learn clinical testing of patients with superior canal dehiscence (fistula) and current management. 
  • Recognize the clinical presentation of patients with Mal de Debarquement, current theories of pathophysiology and current recommended management strategies.
Day One 

7:30 8:00 am                Registration

8:00 10:15                    Introduction and Conceptual Framework

  • Overview of dizziness statistics
  • Review of key components of vestibular anatomy and physiology important to the understanding of clinical testing and treatment

10:15 10:30                  Break

10:30 12:00                  Understanding Diagnostics and Vestibular Pathology

  • Critical findings and implications of key diagnostic tests
  • ENG, Rotary Chair, computerized dynamic posturography, VEMP
  • Key clinical features of each of the common vestibular pathologies

12:00 1:00                    Lunch (on your own)

1:00 2:15                      Critical Clinical Examinations

  • Review critical clinical or bedside vestibular revaluations skills (gaze, spontaneous/ positional nystagmus, head thrust testing (beyond just horizontal), CTSIB sensory testing, Frenzel lens examination, vestibular- specific gait testing
  • Optimizing your skills, techniques and interpretation of each of the clinical tests
  • Reliability, validity and limitations of each specific test

2:15 3:45                      Identifying and Treating Cervicogenic Dizziness (Lecture/Lab)

  • Identifying key history/clinical findings
  • Criteria for diagnosing cervical dizziness
  • Neck torsion testing
  • Vascular and ligamentous stability screening
  • Cervicocephalic Kinesthesia re-education
  • Key components to rehabilitation techniques

3:45 4:00                      Break

4:00 6:00                      Update on BPPV testing and treatment (Lecture)

  • Most up to date treatment options for all types of BPPV
  • Discussion on BPPV “superstitions” • Determining when positional vertigo is not BPPV

BPPV (Treatment Lab)

  • Liberatory/canalith reposition for all canals • Teaching and prescribing self canalith repositioning maneuvers

6:00 6:15                      Question and Answers

Day Two

8:00 9:30                      BPPV Lecture/Lab (continued)

  • Analyzing eye movements
  • Infrared Frenzel lens analysis of eye movements
  • Integrating/applying clinical findings and complex clinical cases

9:30 9:45                      Break

9:45 11:30                    Identifying and Treating Fluctuating Vestibular Disorders

  • Pathophysiology, clinical presentations and treatment strategies of migraine and migraine associated dizziness including conservative treatment for visual motion sensitivity
  • Clinical presentation and treatment strategies of Menier’s disease
  • Differentiating Menier’s versus migraine and the important role of therapy sequential clinical testing
  • Clinical presentation of fistula, both endolymphatic and superior canal dehiscence

11:30 12:30                  Lunch (on your own)

12:30 1:30                    Managing Post-Surgical and Stable Vestibular Lesions (Lecture/Lab)

  • Surgical options and clinical course of recovery of Acoustic neuromas
  • Post-surgical consulting
  • Headache incidence and management
  • Application and progression of VOR adaptation exercise routine and vestibular balance/gait retraining protocols
  • Introduction to fascial rehab

1:30 2:15                      Identifying and Treatment of Central Pathologies

  • MS test findings
  • Brainstem
  • Central eye motion patterns
  • Balance retraining strategies including facilitating motor recovery strategy

2:15 2:30                      Break

2:30 2:45                      Considerations for the “Rocking” Patient

  • Understanding Mal de Debarquement (MdD)
  • Incidence and pathophysiology of MdD
  • MdD treatment options and case study application

2:45 3:30                      Identifying and Treating Psychological Disorders

  • Screening for anxiety and understanding panic attacks
  • Incidence and prevalence of psych overlay
  • Modifying treatment for anxiety
  • Applying relaxation strategies
  • Applying vestibular rehabilitation (habituation, adaptation, and balance retraining) to patient’s with psychogenic factors)

3:30 3:45                      Questions and Answers

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