A

WorldofHurt

CentralNervousSystemPainMechanisms:

PatientEducation&

ExercisePrescriptions

May5-6,2018

AWorldofHurt:CentralNervousSystemPainMechanismsPatientEducation&ExercisePrescriptionsCOURSEDESCRIPTION

Thistwo-daycoursedeepdivesinformationthatiscriticaltotheassessmentandtreatmentofpatientsdominatedbyCentralNervousSystem(CNS)PainMechanisms.Thiscoursewilloutlinechaptersix,seven,&eightofthebook“AWorldofHurt:AGuidetoClassifyingPain.”PainclinicianswilllearnhowtoassessandclassifyCNSpainmechanisms,whichincludecentralsensitization,affectiveandmotor/autonomicutilizingpsychometricmeasures,validatedoutcomemeasures,CNSsensoryandmotorevaluations.Thiscoursewillfocusontheidentificationandspecificinterventionsofpatienteducationtopics,patientreadinessquestionnaire,motivationalinterviewingtacticsandeducationalapproaches,andspecificexerciseprescriptionsfortheCNSmechanisms.Exerciseprescriptionsincludegradedexposuretofunctionalreturn,sensorimotorretraining,andscriptedwordsforeducationandactivecareforeachCNSpainmechanism.Videoandpaperpatientcaseswillbegiven,inadditiontolivepatientdemonstrationswhenavailablewillbeusedtoassisttheparticipantinunderstandinghowimportantthewordstheyuseandthemovestheyprescribeareincuringthecentralnervoussystempainmechanisms.WHOSHOULDATTEND

PhysicalandOccupationalTherapists,Chiropractors,Osteopaths,PhysicalTherapistAssistants,OccupationalTherapyAssistants,MedicalDoctors,Psychologists,AthleticTrainers,MassageTherapists,PersonalTrainersandanyotherpractitionerswhoareinvolvedintreatingmusculoskeletalpain.COURSEOBJECTIVES

Uponcompletionofthecourse,participantswillbeabletoapplytheprinciplesdirectlyintotheirclinicalpractice:

Attheconclusionofthiscourse,participantsshouldbeableto:

1)DifferentiatesubjectiveandobjectiveclinicalcharacteristicsintheCNSpainmechanismsincluding:centralsensitization,affectiveandmotor/autonomic.

2)ApplyCNSpainmechanismclassificationprinciplestoaneurologicalpatientpopulation.

3)ClassifyCNSdominantpainmechanismsandprescribeindividualizedpatienteducationandactivecareinterventiontomusculoskeletalandneurologicalpatients.

4)Administer,interpret,andusepatientratedpsychometricoutcomemeasuresintheeducationandactivecareprovidedtoeachpatient.

5)Effectivelycommunicatepaineducationwithinanindividualandgroupmodel.

6)Effectivelyevaluateandtreatmotor/autonomicsensorimotordysfunctions.

FACULTY

CourseInstructors:AnnieO’Connor,PT,OCS,Cert.MDT,isCorporateDirectoroftheMusculoskeletalPracticeandClinicalManageroftheRiverForestSpineandSportCenterattheRehabilitationInstituteofChicago.Anniehas

co-authoredtherecent2015book“AWorldofHurt:AGuidetoClassifyingPain”andtherecentSeptember2016JournalArticleinJMMT“ValidationofaPainMechanismClassificationSystem(PMCS)inPhysicalTherapyPractice.”Bothrecentpublicationsofferaresearchsupported“paradigmshift”inmanagingmusculoskeletalandcentrallydominatedpainpromotingeffectiveandefficientoutcomeswithsignificantcostsavings.SheisanOrthopedicClinicalSpecialist(OCS)oftheAmericanPhysicalTherapyAssociationandhasaCertificationinMechanicalDiagnosisandTherapyintheMcKenzieMethod.Shelecturesnationallyandinternationallyonmusculoskeletalpainclassificationandintervention,neurodynamicevaluation,andtreatment,mechanicaldiagnosisandtherapyofspineandextremities,kineticchainevaluation,andfunctionalmanualtherapyandexerciseprescriptionforpatientsofalldiagnosisandalllevelsofcare.Shewasinstrumentalinestablishingthealliedhealth’sclinicaldiagnosticapproachformusculoskeletalpainattheRehabilitationInstituteofChicago.SheisamemberofAmericanPhysicalTherapyAssociationintheorthopedicsectionandcaninespecialinterestgroup,theNorthAmericanSpineSociety(NASS),andMcKenzieInstitute.Sheservesonthe10X25tactilecoalitiontaskforcetoreducespinerelateddisabilityby10%inyear2025sponsoredbytheSpineFoundation,anationalgroupoftheNASS.Shecontinuestotreatorthopedic,neurologicalpatients,andcanineswithmusculoskeletalpaintohelpthemachievetheirbestlifepossible.MelissaWatson,MSPT,Cert.MDTreceivedherMaster’sinPhysicalTherapyandherBachelor’sinExercisePhysiologyfromOhioUniversity.MelissawascertifiedinMechanicalDiagnosisandTreatment–McKenzieMethod2017.MelissapracticesattheRehabilitationInstituteofChicagowith15yearsofclinicalexperience.MelissahasbeenhelpingtoleadRIC’sClinicalLadderProgramforover10yearswhereshementorsothercliniciansontheirprofessionalandclinicaldevelopment.Sheisacertifiedclinicalinstructorandconsistentlymentorsstudentsinclinicalpractice.SheispracticingclinicallyintheDayRehabilitationsettingwithaninterestinmusculoskeletalpainandapplyingbothMDTandpainclassificationprincipleswithintheneurologicalpopulationforspasticity.SheiscurrentlyleadingaDayRehabPainGroupCommitteewheresheismentoringotherDayRehabcliniciansonrunningpaingroupsthatarefocusingonpaineducationandactivecaretreatmentforpatientswithcentrallydominatedpainthroughout7sitesofcareandfacilitatingastandardforeducationthroughinpatientclinicians.ShehasbeentrainingthePainMechanismClassificationSystemoutlinedinthebook“AWorldofHurt:AGuidetoClassifyingPain”forthelast5yearsandusesbothsubgroupingmethodsexclusivelyinherneurologicalclinicalpracticetoguidepatienteducationandexerciseprescriptiontofacilitateoptimalfunctionalreturn.DisclosuresFinancial:ThepresentersAnnieO’ConnorandMelissaWatsonwillreceiveanhonorariumandexpensesforteachingthiscourse.Nonfinancial:AnnieO’ConnorandMelissaWatsonhavenorelevantfinancialrelationships.CourseBook:“AWorldofHurt:AGuidetoClassifyingPain”ParticipantDiscountUSD$50.00References:

• KolskiM,O’ConnorA.WorldofHurt:AGuidetoClassifyingPain,Chapters1-8.ThomaslandPublishersInc,2015

• KolskiM,OConnorA,VanDerlaanK,JungwhaA,KoslowskiA,DeutchA.(2014)Validationofapainmechanismclassificationsystem(PMCS)inphysicaltherapypractice.JournalofManualandManipulativeTherapy;08September,1-8.

• SmartKM,CurleyA,BlakeC,StainesA,DoodyC.(2010)Thereliabilityofclinicaljudgmentsandcriteriaassociatedwithmechanisms-basedclassificationsofpaininpatientswithlowbackpain

disorders:apreliminaryreliabilitystudy.JournalofManualandManipulativeTherapy,Volume18,No.2:102-110.

• SmartKM,BlakeC,StainesA,DoodyC.(2010)Clinicalindicatorsof‘nociceptive’,‘peripheralneuropathic’and‘central’mechanismsofmusculoskeletalpain.ADelphisurveyofexpertclinicians.ManualTherapy;15:80-87.

• Smart,K.,Blake,C.,Staines,A.,&Doody,C.(2011)TheDiscriminativevalidityof“nociceptive”,“peripheralneuropathic”,and“centralsensitization”asmechanisms-basedclassificationsofmusculoskeletalpain.ClinJPain;27(8),655-663.

• ButlerDS.TheSensitiveNervousSystem.Adelaide,Australia:Noigroup,2000.• BaronR.Peripheralneuropathicpain:Frommechanismstosymptoms.ClinJPain,2000:S12-S20.• MelzackR.Evolutionoftheneuromatrixtheoryofpain.PainPract.2005;5:85-94.• MoseleyG.Apainneuromatrixapproachtopatientswithchronicpain.ManuTher.2003;

8:130140.

• MoseleyG.Evidenceforadirectrelationshipbetweencognitiveandphysicalchangeduringaneducationinterventioninpeoplewithchroniclowbackpain.EurJPain.2004:8:39-45.

• WernekeMW,HartDL,GeorgeSZ,DeutscherD,StratfordPW.Changeinpsychosocialdistressassociatedwithpainandfunctionalstatusoutcomesinpatientswithlumbarimpairmentsreferredtophysicaltherapyservices.JOrthopSportsPhysTher,2011;41:969-980

AWorldofHurt:CentralNervousSystemPainMechanismsPatientEducation&ExercisePrescriptionsAGENDA

Saturday:May5,20188:00am

Registration/ContinentalBreakfast

8:30

Lecture:RiskAssessmentforMusculoskeletalPain:ACollaborationofClassificationSystems-IntroduceYellowFlagRiskForm[WoH:pg258]

9:00

Lecture:YouDon’tGetPainWithoutaBrain

9:45 Lecture:CentralNervousSystem(CNS)SubgroupsSubjectiveandObjectiveCharacteristics[WoH:pg222-223]10:30Break10:45 Lecture:CNSSpasticitySubjective,ObjectiveCharacteristics:Subgrouping

SpasticityforTherapeuticExerciseintervention11:15 PsychometricTesting/ScoringWorkshop:FABQ[WoH:pg198-199],PASS[WoH:

pg257],PHQ-9[WoH:pg257],ReadinessQuestionnaire[WoH:pg44-49]12:00Lunch1:00 WordsWorkshop:PatientPainEducationusingtheYellowFlagRiskForm:

IndividualtoGroupModel[WoH:pgix],DocumentationGuidelinesandGoalRecommendations,BatteryLifeMeaningAssessmentTool

3:00 Break3:15 Video/PaperCaseStudiesorLivePatientDemonstration:CentralSensitivity4:15 Video/PaperCaseStudiesorLivePatientDemonstration:AffectivePainMechanism5:30Adjourn

SundayMay6,20187:30am ContinentalBreakfast8:00 Lecture:AffectivePainMechanism 9:00 Lecture: Motivational Interviewing, Cognitive Behavioral Therapy (CBT), Acceptance

and Commitment Therapy (ACT):What are the differences?What patientsrespondtowhattherapy?

10:00Break10:15 Workshop:SettheSceneandActthePart:Observeandactivelyparticipatein

livedemonstrationsofroleplayingclinicianandpatientscenarios;howtouseyourwordstomotivate,directtreatment,andguidethepatienttotaketheleadintheircare

12:00Lunch1:00 Video/PaperCasestudiesorLivePatientDemonstration:CNSMotor/Autonomic2:00 Lecture:CNSMechanismsPatientEducationandActiveCareIntervention(MSK

&NeuroSpasticity)[WoH:pg236]2:30 Lecture:CNSSensoryandMotorEvaluationObjectiveTests[WoHpg328-335]3:00 Workshop:CNSSensoryandMotorPatientVideoDemonstration:Actively

practicesensoryandmotortestsincludingCNSleft/rightdiscriminationinboththespineandextremities

4:15 Questions/Answers4:30Adjourn