Spring Meeting

This course is the 2nd in our implicit bias training series. In 2021, APTAMD developed the course, Starting the Conversation: Implicit Bias – Cognitive Gaps in Patient Care. This course will further explore historically recognized racial and ethnic disparities in patient care. It will also review resources for students and clinicians to intentionally provide culturally competent client interactions and clinical care for various communities.

This course was developed to meet the new implicit bias training requirement for Maryland health professionals. The goal was to develop a training session for clinicians. The content was developed for professionals of any health occupation with an emphasis on physical therapy professionals. 

Course Objectives
Section 1:
1.Explain how the design of the US health system drives utilization of health services
2.Describe the state of Fair Copay legislation for physical therapy services in the US

Section 2:
1.The participant will identify strategies for self-awareness of biases towards the LGBTQIA+ community to minimize barriers to healthcare delivery
2.The participant will express gender-neutral communication to affirm LGBTQIA+ clients/patient

Section 3:
1. Participants will recognize how cultural and personal beliefs impact the quality of care delivered and take action to improve customer ratings and retention.
2. Participants will be able to explain how mastering the 4Ps of customer service – promptness, professionalism, personalization and politeness – will ensure a value-driven service culture.

Section 4:
1. Assess the current status of implicit bias exposure in DPT programs based on data from informal national survey
2. Summarize 3 essential benefits of implicit bias training in preparation for clinical care.

Speakers

Dr. Roy J. Film is an assistant professor and the Director for Residency and Fellowship Education at the University of Maryland School of Medicine (UMSOM) in the Department of Physical Therapy & Rehabilitation Science where he teaches in the areas of orthopaedics, persistent pain, and evidence-based practice. He is the Program Director for the UMSOM Fellowship in Orthopaedic Manual Physical Therapy as well as the Academic Director for the University of Maryland Orthopaedic Physical Therapy Residency. He is Board Certified in Orthopaedic Physical Therapy and a Fellow of the American Academy of Orthopaedic Manual Physical Therapists (AAOMPT). Roy serves as the Vice President and President-elect of APTA Maryland as well as the Secretary of AAOMPT. He is a member of the UN’s World Health Organization Peer Review Group for Musculoskeletal Conditions and a former taskforce leader for nonpharmacological pain management for US Army MEDCOM’s National Opioid Crisis Community Summit. He is currently a part-time PhD student in Epidemiology at the University of Maryland Baltimore where he studies health services research and nonpharmacological pain management treatment to mitigate opioid use.

Clarisse Labor is a Physical Therapist with 20+ years of experience. She has worked in various PT settings, from Acute Care, SNF, Home Health, and Outpatient Orthopedics. Her primary practice has been in Outpatient Orthopedics. She has had several management positions supervising outpatient clinics. She has also been a clinical instructor and has fostered and supervised many students throughout her career. She has a strong passion for DEI and has served as the Mentorship Chair for the APTAMD Mentorship Workgroup in the DEI Committee for the last 2 years, as well as a Chapter Ambassador for the APTA PT Moves Me program, which has programming in recruiting students to increase diversity within the PT profession. She was a recent 2021 Richard T. Peret. Jr. Distinguished Service Award for her mentorship efforts and leadership with the APTAMD. She graduated from Cleveland State University with her PT degree, obtained an Upper Quarter Graduate Certificate from Drexel University, and is currently enrolled in a Transitional DPT program at St. Scholastica University.

 Dr. Monique J. Caruth, PT, DPT is the CEO and founder of Caruth Staffing Agency P.C in Bowie, Maryland providing home health physical therapy, occupational therapy, speech therapy, social work and mental health counseling to residents of Prince George’s and Anne Arundel Counties. Monique serves as the secretary of the Home Health Academy of the American Physical Therapy Association, secretary of APTA Maryland Board, Southern District Delegate for APTA Maryland, DEI committee member/board liaison for APTA Maryland, member of the Maryland Physical Therapy PAC, APTA Media Spokesperson and cohost of The Alex and Mo Podcast.

Dr. Michael Ukoha, PT, DPT is a Physical Therapist at FOX Rehabilitation in Maryland and Washington DC. He currently serves as the Chair of the APTA Maryland DEI Committee and created the Live and Grow Mentorship organization to help diversify the field of physical therapy through the development of a support system for pre-PT students applying to DPT programs. He currently serves as a PT Moves Me Ambassador for APTA Maryland to further educate pre-pt students on the profession, career pathways within it, and expectations of practice in various clinical settings. Michael was presented with the APTA Maryland Student Leadership Award in 2016 for his contributions to the chapter as a student delegate for House of Delegates (HoD) and co-founder of the student special interest group (SSIG). Michael was awarded the Geriatrics and Gerontology Education and Research (GGEAR) award by the GGEAR program of University of Maryland Baltimore in 2017 for his graduating class. He was awarded Twenty Tigers in Their Twenties award by the Towson University Alumni Association in 2018 recognizing his consistent achievements and contributions that have positively impacted the Towson community and university. He is the 2021 Recipient of the Steven M. Levine Award from the APTA Maryland recognizing his current leadership at the state and national level, advocacy for the profession, and a role model for professionalism. He is the 2022 Recipient of the University of Maryland: Baltimore Department of Physical Therapy and Rehabilitation Science (PTRS) Alum of the year recognizing great work and achievements within the physical therapy community.

The purpose of this course will be understanding and implementing strength training principles, exercise physiology, and exercise prescription with goal of returning a field sport athlete to play following a lower extremity injury; ACL-R and Hamstring Strain will be used as examples.

Mechanism of Injury (MOI) for ACL tear and Hamstring strain will be reviewed. There will be an overview of muscle anatomy and physiology, contraction-types, and training volume for
desired outcomes.

After establishing a strong foundation and understanding of anatomy, physiology, and exercise science, there will be a literature review highlighting Clinical Practice Guidelines and Research articles that review rehabilitation/training variables can help progress athletes through rehabilitation for a safe and effective return to sport.

Following the oral presentation, a combined video presentation and skill session will demonstrate selected interventions, modifications, progressions, and testing to ensure desired outcomes along the rehabilitation spectrum progressing to discharge and return to play (RTP). An ongoing theme will be starting with the end-goals in mind with exercise selection. A summarization of take-home messages for attendees to be able to incorporate what they learned in clinic on Monday.

Learning Objectives: By the conclusion of the course, the Physical Therapist will have:
1) A foundational understanding of the basics of muscle structure and function down to cellular level
2) Be able to differentiate types of contractions (Eccentric, Isometric, Concentric, Plyometric with Stretch Shortening Cycle (SSC)) with different considerations during the phases of rehabilitation
3) Understand how training volume can be manipulated to bias different training goals (muscle endurance, hypertrophy, strength, power, plyometric) along the rehabilitation continuum
4) A familiarity with research articles that provide treatment protocols and rehabilitations considerations that have shown to be beneficial for athletes recovering from ACL-R and Hamstring Strains
5) Demonstrate understanding of selected exercise set-up, performance, and cuing for clinicians attending session to be able to effectively implement in clinic

Speaker
Jimmy Hoyt, PT, DPT, OCS, SCS, CSCS, XPS graduated from the University of Maryland Eastern Shore with his Doctorate of Physical Therapy in 2014. Particular areas of interest and specialization include Orthopaedic and Sports Physical Therapy. He became a Board-Certified Specialist in Orthopaedic Physical Therapy in 2018 and in Sports in 2022.

Further area of interest include Strength and Conditioning becoming a Certified Strength and Conditioning Specialist (CSCS) through the National Strength and Conditioning Association (NSCA) and an EXOS Performance Specialist (XPS). Of particular interest is working with soccer players both as a Physical Therapist and Performance Trainer.

Jan Dommerholt and Noelle Schlegel will provide an in-depth overview of the current scientific dry needling literature going back to 2019. While dry needling is used primarily in orthopedic and sports medicine physical therapy, new applications include neurological dry needling (mostly for spasticity), fascial and scar tissue dry needling, and even dry needling for performance enhancement. During the past three years, many systematic reviews, scoping reviews, and meta-analyses have been published in support of dry needling for a wide variety of clinical diagnoses, including migraines and tension-type headaches, neck pain, spasticity, intramuscular electrical stimulation (IMES), lateral epicondylalgia, fibromyalgia, non-traumatic shoulder pain, and musculoskeletal pain, among others.

In spite of the evidence and cost-effectiveness of dry needling even though most insurance companies, including Medicare, still do not pay for dry needling. The workshop will explore possible mechanisms of dry needling and IMES, and include a discussion of issues in dry needling research, such as the difficulty in conducting blinded studies, non-pragmatic studies, and other methodological problems.

At the conclusion of this workshop, students will be able to
1. Describe three recent studies exploring the possible mechanisms of dry needling
2. Describe five recent systematic reviews and meta-analyses in support of dry needling for several
clinical conditions
3. Describe two recent studies on dry needling for neurological conditions, including spasticity
4. Describe three studies of the cost-effectiveness of dry needling
5. Describe possible mechanisms and applications of dry needling for scar tissue management and fascial adhesions

Course Outline / Timed Agenda
8:30 – 8:45 Introduction
8:45 – 10:15 Scientific evidence of dry needling
10:15 – 10:45 Dry needling for neurological conditions
10:45 – 11:15 Dry needling for scar tissue and fascia
11:15 – 11:30 Summary and Conclusions

Speakers
Dr. Jan Dommerholt is co-founder and president/CEO of Myopain Seminars and Bethesda Physiocare. His early career mentors included Drs. Janet Travell, David Simons, Robert Gerwin, Richard S. Materson, Karel Lewit, and Peter Baldry, among others. Together with Robert Gerwin, Jan started teaching dry needling courses in 1996, first in Spain and from 1997 onwards also in the USA. Jan is a Dutch-trained physical therapist who holds a Master of Professional Studies degree with a concentration in both Biomechanical Trauma and Healthcare Administration from Lynn University, and a Doctorate in Physical Therapy from the University of St. Augustine for Health Sciences. Dr. Dommerholt has taught hundreds of courses and lectured at over 80 conferences throughout the United States, Canada, Mexico, South America, Europe, Australia, and the Middle East while maintaining an active clinical practice. He is a member of the editorial board of the Journal of Manual & Manipulative Therapy, Cuestiones de Fisioterapia, and the Journal of Invasive Therapies in Physical Therapy.

Jan is an Honorary Member of the Iranian Physiotherapy Association and of the Polish Association of Invasive Physiotherapy. In 2016, he received the Janet G. Travell Excellence in Education Award from the National Association of Myofascial Trigger Point Therapists. The American Physical Therapy Association recognized his achievements by awarding him the 2014 Henry O. and Florence P. Kendall Practice Award. Dr. Dommerholt was a Diplomate of the Academy of Integrative Pain Management (until the organization was dissolved). He is a member of several professional organizations, including the American Academy of Orofacial Pain, the American Academy of Orthopaedic Manual Physical Therapists, the American Academy of Pain Medicine, the American Association for the Advancement of Science, the American Physical Therapy Association, the American Physical Therapy Association of Maryland, the Performing Arts Medicine Association, and the Society of Automotive Engineers.

Dr. Dommerholt has edited several books on myofascial pain, dry needling, and manual physical therapy, authored about 80 book chapters, and more than 140 articles on dry needling, myofascial pain, fibromyalgia, complex regional pain syndrome, and performing arts physical therapy. From 2004 through 2021, he prepared a quarterly literature review column on myofascial pain initially with Dr. David Simons for the Journal of Musculoskeletal Pain followed by the Journal of Bodywork and Movement Therapies with a variety of co-authors.

Dr. Noelle Schlegel earned her Bachelor’s and Master’s degree in Physical Therapy from the University of Maryland School of Medicine, and her Doctorate in Physical Therapy from the College of St. Scholastica. She has a particular interest in kinesthetic and movement therapy and has undergone yoga teacher training through the Yoga and Ayurveda Center to earn her status as a Registered Yoga Teacher as well as a Certified Ayurveda Specialist. Additionally, she holds a certification in Tai Chi for Rehab through Dr. Paul Lam’s Tai Chi for Health Institute. Currently, she specializes in the treatment of patients with headaches, movement disorders, fibromyalgia, sports injuries, orthopedic issues, TMJ, and chronic pain. Noelle is recognized as a specialized practitioner of dry needling by the Maryland Board of Physical Therapy Examiners. She is a dry needling instructor with Myopain Seminars and lectures throughout the United States.