Integrating IV STEP Pearls into Entry-Level Education
Purpose
STEP conferences over the past fifty years have brought clinicians, educators, and researchers together to explore new theories and examine emerging evidence related to movement science, and to translate this theory and evidence into physical therapy practice for individuals of all ages with neurologic disorders. IV STEP, the most recent STEP conference, focused on exploring four “Ps”: Prevention, Prediction, Plasticity, and Participation as they relate to the roles and responsibilities of today’s physical therapists.
Given, the overarching goal of STEP conferences to foster, guide, and affect neurologic physical therapy practice this session is intended to provide PT educators with an overview of the Pearls from IV STEP and explore strategies for integrating the content, themes, and video-based cases into PT entry-level education. Members of the IV STEP conference committee will synthesize the IV STEP content and explore teaching and learning strategies, which employ IVSTEP video-based cases into pediatric and adult neurological physical therapy curriculum.
Methods and/or Description of Project
This session will utilize didactic and discussion format to:
Summarize and synthesize content delivered in the IV STEP plenary sessions
Explore the utility of IVSTEP video based cases in promoting clinical reasoning surrounding the 4 P’s
Engage participants in a process to integrate this knowledge to PT curriculum for the continued advancement of evidenced-based practice to improve the lives of those we serve.
Results/Outcomes
Following this presentation, participants will be able to:
Summarize the IV STEP key take-home messages.
Design teaching and learning activities that utilize the video based cases for the development of clinical reasoning
Discuss strategies to translate IV STEP content into entry-level PT curriculum
Conclusions/Relevance to the conference theme: Through the Looking Glass: Transforming Physical Therapy Education
IV STEP content, exploring Prevention, Prediction, Plasticity, and Participation as they relate to the roles and responsibilities of today’s physical therapists is key in transforming Physcial Therapy Education. Providing educators with innovative ways inwhich to infuse IVSTEP content will promote this transformation and support the devleopment of a culture of inquiry in Physcial Therapy Education.
References
Selected Current References:
Prediction of Outcomes using Movement System Diagnoses
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2. Behrman AL, Watson E, Fried G, et al. Restorative rehabilitation entails a paradigm shift in pediatric incomplete spinal cord injury in adolescence: an illustrative case series. J Pediatr Rehabil Med 2012;5(4):245-59.
3. Behrman AL, Nair PM, Bowden MG, et al. Locomotor training restores walking in a nonambulatory child with chronic, severe, incomplete cervical spinal cord injury. Phys Ther 2008;88(5):580-90.
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Dosage and Timing for Plasticity and Participation
1. Kimberley TJ, Samargia S, Moore LG, Shakya JK, Lang CE. Comparison of amounts and types of practice during rehabilitation for traumatic brain injury and stroke. J Rehabil Res Dev 2010;47(9):851-62
2. Lang CE, Wagner JM, Edwards DF, Sahrmann SA, Dromerick AW. Recovery of grasp versus reach in people with hemiparesis poststroke. Neurorehabil Neural Repair 2006;20(4):444-54
3. Hansen CN, Linklater W, Santiago R, et al. Characterization of recovered walking patterns and motor control after contusive spinal cord injury in rats. Brain Behav 2012;2(5):541-52
4. Michele Basso D, Hansen CN. Biological basis of exercise-based treatments: spinal cord injury. Pm r 2011;3(6 Suppl 1):S73-7
5. Gannotti ME, Gorton GE, 3rd, Nahorniak MT, Masso PD. Gait and participation outcomes in adults with cerebral palsy: a series of case studies using mixed methods. Disabil Health J 2013;6(3):244-52
6. Herbert WJ, Powell K, Buford JA. Evidence for a role of the reticulospinal system in recovery of skilled reaching after cortical stroke: initial results from a model of ischemic cortical injury. Exp Brain Res. 2015 Nov;233(11):3231-51. doi: 10.1007/s00221-015-4390-x. Epub 2015 Aug 1.
Interprofessional Practice for Participation
1. An M, Palisano RJ, Dunst CJ, Chiarello LA, Yi CH, Gracely EJ. Strategies to promote family-professional collaboration: two case reports. Disabil Rehabil 2015:1-15.
2. Chang HJ, Chiarello LA, Palisano RJ, Orlin MN, Bundy A, Gracely EJ. The determinants of self-determined behaviors of young children with cerebral palsy. Res Dev Disabil 2014;35(1):99-109
3. Kang LJ, Palisano RJ, King GA, Chiarello LA. A multidimensional model of optimal participation of children with physical disabilities. Disabil Rehabil 2014;36(20):1735-41.
4. King G, Chiarello L. Family-centered care for children with cerebral palsy: conceptual and practical considerations to advance care and practice. J Child Neurol 2014;29(8):1046-54.
5. McMurtry A, Rohse S, Kilgour KN. Socio-material perspectives on interprofessional team and collaborative learning. Med Educ 2016;50(2):169-80
Secondary Health Promotion Practice
1. Busse M, Quinn L, Debono K, et al. A randomized feasibility study of a 12-week community-based exercise program for people with Huntington's disease. J Neurol Phys Ther 2013;37(4):149-58
2. Busse M, Quinn L, Khalil H, McEwan K. Optimising mobility outcome measures in Huntington's disease. J Huntingtons Dis 2014;3(2):175-88
3. Busse M, Quinn L, Dawes H, et al. Supporting physical activity engagement in people with Huntington's disease (ENGAGE-HD): study protocol for a randomized controlled feasibility trial. Trials 2014;15:487
4. Holbrook EA, Kang M, Morgan DW. Acquiring a stable estimate of physical activity in adults with visual impairment. Adapt Phys Activ Q 2013;30(1):59-69
5. Ishikawa S, Kim Y, Kang M, Morgan DW. Effects of weight-bearing exercise on bone health in girls: a meta-analysis. Sports Med 2013;43(9):875-92
6. Stevens SL, Fuller DK, Morgan DW. Leg strength, preferred walking speed, and daily step activity in adults with incomplete spinal cord injuries. Top Spinal Cord Inj Rehabil 2013;19(1):47-53.
Research Design Options for Individual and Complex Interventions and Participation Outcomes
1. Lobo MA, Kokkoni E, Cunha AB, Galloway JC. Infants born preterm demonstrate impaired object exploration behaviors throughout infancy and toddlerhood. Phys Ther 2015;95(1):51-64
2. Lobo MA, Koshy J, Hall ML, et al. Playskin Lift: Development and Initial Testing of an Exoskeletal Garment to Assist Upper Extremity Mobility and Function. Phys Ther 2015
3. Bourbonniere M, Kagan SH. Nursing intervention and older adults who have cancer: specific science and evidence based practice. Nurs Clin North Am 2004;39(3):529-43
4. Kagan SH. Seeing the methodological "trees" in the "forest" of gerontological nursing research. Res Gerontol Nurs 2009;2(2):93
5. Corrigan JD, Horn SD, Barrett RS, et al. Effects of Patient Preinjury and Injury Characteristics on Acute Rehabilitation Outcomes for Traumatic Brain Injury. Arch Phys Med Rehabil 2015;96
6. Horn SD, Corrigan JD, Beaulieu CL, et al. Traumatic Brain Injury Patient, Injury, Therapy, and Ancillary Treatments Associated With Outcomes at Discharge and 9 Months Postdischarge. Arch Phys Med Rehabil 2015;96
Technology use for Plasticity and Participation
1. Deutsch JE, Merians AS, Adamovich S, Poizner H, Burdea GC. Development and application of virtual reality technology to improve hand use and gait of individuals post-stroke. Restor Neurol Neurosci 2004;22(3-5):371-86
2. Mountz JM, Liu HG, Deutsch G. Neuroimaging in cerebrovascular disorders: measurement of cerebral physiology after stroke and assessment of stroke recovery. Semin Nucl Med 2003;33(1):56-76
3. Dicianno BE, Fairman AD, McCue M, et al. Feasibility of Using Mobile Health to Promote Self-Management in Spina Bifida. Am J Phys Med Rehabil 2015
4. Dobkin BH, Dorsch A. New evidence for therapies in stroke rehabilitation. Curr Atheroscler Rep 2013;15(6):331
5. Daly JJ, Ruff RL. Construction of efficacious gait and upper limb functional interventions based on brain plasticity evidence and model-based measures for stroke patients. ScientificWorldJournal 2007;7:2031-45
Genetics and Epigenetics: Prediction and Plasticity
1. Pearson-Fuhrhop KM, Burke E, Cramer SC. The influence of genetic factors on brain plasticity and recovery after neural injury. Curr Opin Neurol 2012; 25(6):682-8.
2. Pearson-Fuhrhop KM, Cramer SC. Genetic influences on neural plasticity. Pm r 2010; 2 (12 Suppl 2):S227-40.
3. Pearson-Fuhrhop KM, Kleim JA, Cramer SC. Brain plasticity and genetic factors. Top Stroke Rehabil 2009;16(4):282-99.
4. Cramer SC. A window into the molecular basis of human brain plasticity. J Physiol 2008; 586(Pt 23):5601.
5. Burke E, Dobkin BH, Noser EA, Enney LA, Cramer SC. Predictors and biomarkers of treatment gains in a clinical stroke trial targeting the lower extremity. Stroke 2014;45(8):2379-84.
Telehealth, Practice for Prevention, Plasticity, Participation
1. Lee AC, Harada N. Telehealth as a means of health care delivery for physical therapist practice. Phys Ther 2012;92(3):463-8.
2. Lee AC, Billings M. Telehealth Implementation in a Skilled Nursing Facility: A Case Report for Physical Therapist Practice in Washington. Phys Ther 2015.
3. Solana J, Caceres C, Garcia-Molina A, et al. Improving brain injury cognitive rehabilitation by personalized telerehabilitation services: Guttmann neuropersonal trainer. IEEE J Biomed Health Inform 2015; 19(1):124-31.
4. Sanders C, Rogers A, Bowen R, et al. Exploring barriers to participation and adoption of telehealth and telecare within the Whole System Demonstrator trial: a qualitative study. BMC health services research 2012; 12.
5. Levy CE, Silverman E, Huanguang J, Geiss M, Omura D. Effects of physical therapy delivery via home video telerehabilitation on functional and health-related quality of life outcomes. Journ Rehab Research Devel 2015:361-69.
Primary Health Promotion Practices for Prevention
1. Visscher TL, Nicolaou M, Pasman WJ, et al. What is the value of obesity research? - Comment on Blundell JE, Hebebrand J, Oppert JM. What is the value of obesity research? Obes Facts 2010;3:279-282.
2. Jimenez DE, Begley A, Bartels SJ, et al. Improving health-related quality of life in older African American and non-Latino White patients. Am J Geriatr Psychiatry 2015; 23(6):548-58.
3. Hartman SJ, Risica PM, Gans KM, Marcus BH, Eaton CB. Tailored weight loss intervention in obese adults within primary care practice: rationale, design, and methods of Choose to Lose. Contemp Clin Trials 2014; 38(2):409-19.
4. Pace WD, Lanigan AM, Staton EW, et al. Effectiveness of 2 methods of promoting physical activity, healthy eating, and emotional well-being with the americans in motion--healthy interventions approach. Ann Fam Med 2013; 11(4):371-80.
5. Heron N, Tully MA, McKinley MC, Cupples ME. Steps to a better Belfast: physical activity assessment and promotion in primary care. Br J Sports Med 2014;48(21):1558-63.
Regenerative Rehabilitation: Plasticity
1. Dalise S, Ambrosio F, Modo M. Brain plasticity and recovery in preclinical models of stroke. Arch Ital Biol 2014;152(4):190-215 doi: 10.12871/00039829201442[published Online First: Epub Date]|.
2. McHenry CL, Wu J, Shields RK. Potential regenerative rehabilitation technology: implications of mechanical stimuli to tissue health. BMC Res Notes 2014;7:334 doi: 10.1186/1756-0500-7-334[published Online First: Epub Date]|.
3. Houle JD, Cote MP. Axon regeneration and exercise-dependent plasticity after spinal cord injury. Ann N Y Acad Sci 2013;1279:154-63 doi: 10.1111/nyas.12052[published Online First: Epub Date]|.
4. Klaissle P, Lesemann A, Huehnchen P, Hermann A, Storch A, Steiner B. Physical activity and environmental enrichment regulate the generation of neural precursors in the adult mouse substantia nigra in a dopamine-dependent manner. BMC Neurosci 2012;13:132 doi: 10.1186/1471-2202-13-132[published Online First: Epub Date]|.
5. Kerr AL, Cheng SY, Jones TA. Experience-dependent neural plasticity in the adult damaged brain. J Commun Disord 2011;44(5):538-48 doi: 10.1016/j.jcomdis.2011.04.011[published Online First: Epub Date]|.
Course Objectives
Course Objectives:
Following this presentation, participants will be able to:
Summarize the IV STEP key take-home messages.
Design teaching and learning activities that utilize the video based cases for the development of clinical reasoning
Discuss strategies to translate IV STEP content into entry-level PT curriculum
Instructional Methods
didactic presentation, video case observations, reflective questioning and large and small group discussion
Tentative Outline/Schedule
Outline of Time and Content:
45 Minutes: Summarize and synthesize content delivered in the IV STEP plenary sessions
30 Minutes: Explore the utility of IVSTEP video based cases in promoting clinical reasoning surrounding the 4 P’s
25 Minutes: Engage participants in a process to integrate this knowledge to PT curriculum for the continued advancement of evidenced-based practice to improve the lives of those we serve.
20 Minutes: Questions and discussion