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If You Can't Breathe, You Can't Function

Date: May1-3, 2020
Audience: PT, PTA, OT, COTA, SLP
Course Level: Intermediate
Check in time: 8:00-8:30 AM
Course time: Friday 8:30-5:30, Saturday 8:30-5:30, Sunday 8:30-3:00
Location: St. Catherine's University
601 25th avenue S, Minneapolis, MN 55454
Held on 5th Floor #560

Contact Hours: 20.5

Course Fee: $550.00

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.

Cancellation Policy:  Cancellation Fee will apply

Group Discounts:

If three people from the same organization register for a course, each person will receive a 10% discount. Four or more registered will receive a 15% discount. Please email or call ahead of time with the names of the people who will be registering as a group, [email protected] or 612-672-5607.

For Group discounts:  USE CODE rehab10 for 10% discount and rehab15 for 15% discount for group. 

Instructor: Nechama Karman, PT, MS, PCS
Certified Faculty of Mary Massery                 

Nechama Karman, from New York City, received her MSPT from Columbia University in 1994, her Advanced MS in orthopedic PT from Touro College in 1998, and she has completed all coursework toward a PhD in Health Sciences at Seton Hall University.  She has held academic appointments at Hunter College and NYIT.  Nechama is chief clinical educator at Mobility Research, providing pediatric and adult trainings, introductory and advanced seminars, webinars, and clinical support for LiteGait in the USA and internationally. She is a primary instructor in LiteGait's "train the trainer" program. Nechama owns a private practice (“A Step Beyond Physical Therapy”) in NYC, where she treats patients with complex neurological conditions and/or complex pelvic conditions.

Nechama had served as a teaching assistant for each of Mary Massery’s courses for over a decade before starting a 2-year faculty apprenticeship in 2014.  She became Mary’s first certified faculty member in June of 2016!  One of Nechama's proudest “Mary Massery” moments occurred when she treated a man suffering from prostatectomy-related incontinence using Mary’s approach.  She taught him to transfer without incontinence for the first time in 9 months - all in under 15 minutes!  She is passionate about helping other therapists learn these important concepts

Course Summary:
This course, developed by Mary Massery, will challenge the practitioner to make a paradigm shift: connecting breathing mechanics and postural control with management of trunk pressures. Using Dr. Massery’s model of postural control (Soda Pop Can Model), the speaker will link breathing mechanics with motor and physiologic behaviors (a multi-system perspective).  The speaker will present novel research demonstrating the role of vocal folds as postural stabilizers, extending the concept of “core stability” from the vocal folds on the top of the trunk to the pelvic floor on the bottom.  Numerous interventions will be presented that use positioning and ventilatory strategies to optimize motor performance.  Neuromotor breathing retraining techniques and manual assistive cough techniques will be the focus of treatment labs.  Multiple patient cases will be presented throughout the course.  The emphasis of the course will be on developing practical, quick clinical solutions for pediatric and adult patients in all practice settings. 
Objectives:
At the conclusion of Day 1, participants should be able to: 
1. Describe how trunk pressures link breathing and postural control using the Soda Pop Can Model.
2. Describe the multiple, simultaneous roles of the diaphragm as related to breathing, postural control, gastroesophageal reflux,constipation, and venous return.
3. Demonstrate the role of the vocal folds in normal postural stability responses (balance) and make the case for using
    speaking valves for patients with tracheostomies.
4. Contrast normal infant chest wall development to those with impaired breathing mechanics.
5. Position patients for optimal physiological and biomechanical support of breathing with simple
     equipment (towels, pillows, etc.).
6. Use a ventilatory strategy algorithm presented in class to optimally match breathing with
     movements from bed mobility to athletic endeavors.

At the conclusion of Days 2- 3, participants should be able to:

1. Present a multi-system (physical and physiologic) evaluation of motor impairments.
2. Identify the variations of “normal” breathing patterns and discuss the
    efficiencies/inefficiencies for individual patient conditions.
3.Evaluate need for, and demonstrate, appropriate neuromotor retraining techniques for patients with ineffective
   breathing/postural control strategies (health or participation deficits).
4. Participate in a live patient demonstration (if a patient is available) and suggest possible evaluation and treatment ideas based on the course material.
5. Design a targeted airway clearance program using the principles of mobilization,
    expectoration and oral management.
6. Demonstrate airway clearance techniques, with an emphasis on manual assistive cough techniques, and apply
    an airway clearance algorithm to specific patient conditions.
7. Identify thoracic cage/spine restrictions as they pertain to breathing mechanics and postural control
    (a very brief introduction musculoskeletal issues). 
8. Evaluate need for, and demonstrate, neuromotor retraining techniques to improve
    breath support for voicing and postural control (eccentrics). 
9. Suggest means for incorporating the course material into therapy activities in your
    clinical setting immediately.
Agenda:
Day 1  Friday (7.5 contact hours)
8:00-8:30 AM          Registration/Continental Breakfast
8:30-10:30 AM        Overview of course topics
                               Breathing and posture: Part 1-Pressure control (Soda pop model)
10:30-10:45 AM      BREAK
10:45-12 PM           Breathing: Part 2 - The Diaphragm
12:00-1:00PM         LUNCH
1:00-2:15 PM           Breathing: Part 3 - The vocal cords
2:15-2:30 PM           BREAK
2:30-3:30 PM           Mini-Lab: Positioning strategies: What can you do in 90 Seconds or less that has a profound
                                and lasting effect? 
3:30-4:15 PM           Lecture:  Normal and abnormal chest wall development and function
4:15-5:30 PM           MIni-Lab: Ventilatory or movement strategies: Integrating neuromuscular, musculoskeletal, respiratory and sensory systems
Day 2 Saturday (7.5 contact hours)
8:00-8:30 AM         Registration/Continental Breakfast    
8:30-9:30 AM         Review, synthesis and Q&A 
9:00-10:15 AM       Demo and Lecture: Chest assessment:  Focus on musculoskeletal alignment and breathing patterns
10:15-10:30 AM     BREAK
10:30-12:00 PM      Lab: Assessing breathing patterns and postural implications
12:00-1:00 PM        LUNCH
1:00-1:45 PM         Airway clearance: From Sherlock to solution
1:45-2:45 PM         Lab: Facilitating efficient breathing patterns and endurance training: Neuromotor techniques for diaphragm, chest and other breathing patterns
2:45-3 PM              BREAK
3:00-4:30 PM         Lab: Facilitating breathing patterns (continued)
4:30-5:30 PM         Patient demonstration 
Day 3  Sunday (5.5 Contact hours)
8:00-8:30 AM      Registration/Continental Breakfast
8:30-9:00 AM      Review, synthesis and Q&A 
9:00-10:30 AM    Differential diagnosis (patient demo): “Find the Problem”
10:30-10:45 AM   BREAK
10:45-12:00 PM   Lab:Airway clearance lab: Focus on manual assistive cough techniques       
12:00-12:45 PM   LUNCH
12:45-1:15 PM    Lecture/Demo:Brief introduction to rib cage and trunk musculoskeletal restrictions associated with breathing difficulties
1:15-2:30 PM      Lab: Enhancing breath support for phonation and postural control
2:30-3:00 PM       Group problem solving: Putting it all together  

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