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Advancing Clinical Practice Series

Comprehensive Rehabilitation Techniques for Persons with Limb Loss

TIRR Speakers:

Danielle H. Melton, MD
Kristine Higgins, PT
Kristin Reeves, MSPT
Erin Henry, OTR, MOT
Karen Moreno, OT
Carla Stevens, OT

Guest Speakers:

Jon Holmes, PT, CP
Fanny Schultea, MD, MSEd, CPO, LP

Open to: PT/ PTA and OT/OTA

Open to: PT, PTA, OT, OTA

Course Date: Saturday, February 16, 2019

Time: Registration at 7:30 a.m., Course from 8 - 5:30 p.m.

Location:

TIRR Memorial Hermann
1333 Moursund, Houston, TX 77030
2nd floor Research Conference Center
http://tirr.memorialhermann.org/locations/tirr-memorial-hermann-rehab-hospital/

Class size: Limited to 40 attendees

Required Pre-requisites:

  1. Physical Medicine and Rehabilitation Board Review 3rd edition Sara Cuccurullo, MD; From Chapter 6, Prosthetics and Orthotics by Uustal, MD, Edgardo Baerga, MD, and Kacklyn Joki, MD pages 471-518.
    • Lower Limb: Gait, p 471-474; Prosthetics, p. 490-518
    • Upper Limb: Upper limb amputation levels and prosthetics p. 478-490
  2. Review and Know K Levels: Download PDF.

Target Audience

PT, PTA, OT, OTA Clinicians looking to advance their clinical expertise in working with those with Limb Loss and their Rehabilitation.

Description

This day-long seminar will educate participants on medical concerns, therapy treatment approaches, team planning, prosthetic information, and collaboration across the rehabilitation team for those with an amputation. This will include medical and rehabilitation considerations for pre-amputation, acute post-surgical, pre-prosthetic, and prosthetics.

Learning Objectives: Upon completion of this course participants will be able to:

  • Discuss how medical complications affect long term prosthetic use and patient outcomes
  • List considerations when seeking education and peer resources for those with an limb loss
  • Categorize prosthetic candidates and equate them with K-levels for functional outcomes and prosthetic component
  • Understand lower extremity prosthetic components and illustrate how to maximize gait
  • Understand upper extremity prosthetic components and illustrate how to maximize function
  • Explain how a team approach is effectively implemented across a spectrum of care
  • Apply appropriate outcome measures for patients with limb loss

Assessment of Learning Objectives: Course evaluation, participate in lab/demonstrations.

Speakers

P. Jacob Joseph

P. Jacob Joseph, MD
P. Jacob Joseph, M.D., is the Medical Director of the International Program at TIRR Memorial Hermann, the Clinical Chief for Specialty Rehabilitation Programs at TIRR Memorial Hermann and he is the Vice Chair of Clinical Operations for Physical Medicine and Rehabilitation at McGovern Medical School at UTHealth in Houston.

Dr. Joseph joined the medical staff at TIRR Memorial Hermann after completing his residency at The University of Washington in Physical Medicine and Rehabilitation in June 2010. He received his medical degree in 2006 at McGovern Medical School and completed internship and residency at the University of Washington in Seattle.

Dr. Joseph is an assistant professor of physical medicine and rehabilitation at McGovern Medical School. As an attending physician at TIRR Memorial Hermann, Dr. Joseph’s primary focus is on caring for patients recovering from traumatic brain injury and neurological trauma. His clinical and research interests include spasticity management and electrodiagnostic medicine. He is a member of the American Academy of Physical Medicine and Rehabilitation and the Association of Academic Physiatrists.

Speaker Disclosures & Conflicts of Interest:

  • Financial: TIRR Memorial Hermann Employment - Paid Medical Directorship
  • Non-financial: None reported

Kristine Higgins

Kristine Higgins, PT, MS, NCS
Kristine Higgins, PT, MS, NCS, received her Master’s degree in Physical Therapy from the University of Connecticut, CT in 2008. She has treated a wide variety of clients with diverse neurological conditions at TIRR Memorial Hermann Adult and Pediatric Outpatient Rehabilitation for 8 years. She has a specific passion for working with patients with amputations, Parkinson’s disease, and spinal cord injury. Ms. Higgins obtained certification in Neurologic Physical Therapy by the American Board of Physical Therapy Specialties (A.B.P.T.S.) in 2010. She currently serves the role as primary outpatient mentor for the TIRR’s Neurologic Physical Therapy Residency program, a post-professional residency program for physical therapists in neurology. For the past 5 years she has served as the facility lead for treatment of clients with amputation and provide on-site education for new employees and students with the focus of pre-prosthetic intervention, prosthetic gait training, and high level prosthetic skills training. Ms. Higgins also assists as guest lecture and lab instructor for amputee pre-gait training and amputee gait training curriculum at The University of Texas Medical Branch (UTMB) Galveston.

Speaker Disclosures & Conflicts of Interest:

  • Financial: Employment relationship with TIRR Memorial Hermann
  • Non-financial: None reported

Kristin Reeves

Kristin Reeves, MSPT
Kristin Reeves, MSPT, is a physical therapist who received her Bachelor of Science in Health from Texas A&M University and her Master of Science from Texas Women's University in Houston. She specializes in lower limb loss rehabilitation and has been a licensed therapist for 20 years. Kristin was previously an inpatient therapist at TIRR Memorial Hermann Hospital specializing in spinal cord rehabilitation. She then transitioned to the Coordinator of Amputee Services for the past 16 years. In that capacity she coordinates, treats and oversees the clinic that has approximately 1500 visits peryear. She also treats patients with amputations in an outpatient setting two days per week. Her background includes clinical as well as teaching experience with a history of teaching at University of Texas Medical Branch, Galveston, Texas Woman’s University- Houston, Pima Institute, and most recently at the American Physical Therapy Association (A.P.T.A.) convention in Salt Lake City, Utah.

Speaker Disclosures & Conflicts of Interest:

  • Financial: Employment relationship with TIRR Memorial Hermann
  • Non-financial: None reported

Erin Henry

Erin Henry, OTR, MOT
Erin Henry, OTR, MOT, earned her Master of Occupational Therapy from Texas Women's University (TWU) in 1997. She worked at Quentin Mease for 2 years before joining the Spinal Cord Injury (SCI) Team at TIRR Memorial Hermann in 1999. Her primary specialty is treating high cervical ventilator dependent patients, seating and mobility, and Upper Extremity Amputee programs. She has developed many groups here at TIRR Memorial Hermann including SCI Functional Group for high tetras to address upper extremity, hand and/or mouthstick skills. She is one of the group leaders for the Community Reintegration Program (CRP) for patients returning to the community for the first time post injury. For several years, Erin taught the bowel, bladder, skin, and sexuality patient education classes at TIRR Memorial Hermann. She routinely mentors new staff and participates in the student fieldwork education here at TIRR. Her passion is treating the SCI population and thinking outside the box with difficult patient issues.

Speaker Disclosures & Conflicts of Interest:

  • Financial: Employment relationship with TIRR Memorial Hermann
  • Non-financial: None reported

Karen Moreno

Karen Moreno, MS, OTR, CLT
Karen Moreno, MS, OTR, CLT, received her Master’s degree in Occupational Therapy from the University of Texas Medical Branch in 2015. She specializes in upper limb loss rehabilitation at TIRR Memorial Hermann and is a Certified Lymphedema Therapist. She was previously working on the spinal cord injury team with TIRR Memorial Hermann in addition to upper limb loss rehabilitation. Karen works with a variety of patients ranging from unilateral partial hand limb loss to the multiple limb loss patient, focusing on pre-prosthetic and prosthetic training for a comprehensive and holistic approach to regaining functional independence. Karen is a U.S. armed forces veteran having served in the United States Marine Corps for 6 years.

Speaker Disclosures & Conflicts of Interest:

  • Financial: Employment relationship with TIRR Memorial Hermann
  • Non-financial: None

Carla Stevens

Carla Stevens, OTR/L, MOT
Carla Stevens, OTR/L, MOT, graduated in 1997 from Florida State University with a Bachelor of Science in Nutrition. She graduated in 2000 from the University of St. Augustine with a Master’s Degree in Occupational Therapy. After graduation, she moved to Baton Rouge, Louisiana, where she began her career in pediatrics. In 2001 Carla completed the 3 week Neurodevelopmental Therapy (NDT) training in the treatment of adults with hemiplegia and found her passion in working with adults with varying neurologic conditions. She transitioned to an inpatient rehabilitation setting, and later to a day neuro program where she assisted in the development of an upper extremity limb loss outpatient program and pre-driving assessments. Carla has worked in a variety of clinical settings with her main focus being on neurological impairments, limb loss and specialty rehabilitation. She is currently a senior therapist on the Spinal Cord Injury and Specialty Rehabilitation team at TIRR Memorial Hermann, providing education and mentorship to both students and new staff. In her free time, Carla and her husband enjoy keeping up with all the activities their 3 kids are involved in: soccer, swim, dance, youth group, and many more!

Speaker Disclosures & Conflicts of Interest:

  • Financial: Employment relationship with TIRR Memorial Hermann
  • Non-financial: None

Jon B. Holmes

Jon B. Holmes, PT, CP
Jon B. Holmes PT, CP, graduated from Physical Therapy school in 1979. From there, Jon Holmes went to work as a physical therapist at Hermann Hospital specializing in Orthopedics. As the Senior PT, he chose to help amputees with their rehabilitation. Jon graduated from Northwestern's Prosthetic program in June of 1984. He continued to work at Hermann Hospital part-time while a full-time employee of Muilenburg Prosthetics for 5 more years. He was a loyal employee at Muilenburg Prosthetics for 22 years and the last 8 years served as the Clinical Director. In 2006, Jon established Holmes Prosthetic Center. His unique training and experience led him to be a specialist in Lower Limb prosthetic devices, Multiple Limb amputees, and challenging cases. He has worked as a consultant to the TIRR Memorial Hermann Amputee clinic for the last 20 years and The Shriner's Hospital for over 20 years.

Speaker Disclosures & Conflicts of Interest:

  • Financial: Owner of Holmes Prosthetic Center, Consultant TIRR Amputee clinic for the last 20 years and The Shriner's Hospital for over 20 years.
  • Non-financial: Jon is currently on Faculty at Baylor College of Medicine in the PM+R Department, Texas Woman's University School of Physical Therapy, University of Texas Medical Branch School of Physical Therapy and is a member of the Advisory committee for Baylor's Orthotic and Prosthetic.

Fanny Schultea

Fanny Schultea, MS, MSEd, CPO, LP
Fanny Schultea, MS, MSEd, CPO, LP, is a certified Prosthetist/Orthotist, licensed prosthetist and Assistant Professor in the Baylor College of Medicine’s School of Health Professions’ Orthotics and Prosthetics Program. She is course director for the Upper Limb Prosthetic Management, Lower Limb II Prosthetic Management, and Clinical Compliance courses. Mrs. Schultea conducts and advises on graduate research in the areas of upper limb prosthetics and outcome assessments. Fanny is Treasurer for the Upper Limb Prosthetic Scientific Society with the American Academy of Orthotists and Prosthetists. She is highly committed to enhancing the evidence base and quality of care delivery for individuals with upper limb loss or deficiency.

Speaker Disclosures & Conflicts of Interest:

  • Financial: Employment relationship with Baylor College of Medicine
  • Non-financial: None reported



Speaker Disclosures & Conflicts of Interest:
Policy & Procedures exist whereby all speakers must disclose any relationships which may cause a conflict of interest. Any relevant financial and non-financial relationships will be disclosed via speaker agreement, written notification after agreement, and prior to presentation.

Program Schedule

Schedule subject to change.

TimeTopics & Activities
7:30 - 8 a.m.Registration & Refreshments
8 - 9:30 a.m.

Medical Management & Team Approach

9:30 - 10:30 a.m.Physical Therapy focused topic: Lower Extremity Pre prosthetic lectureOccupational Therapy focused topic: Upper Extremity Pre prosthetic treatment lecture
10:30 - 12 p.m.Physical Therapy focused topic: Lower extremity prosthetic components & higher level thinking; case studyOccupational Therapy focused topic: Upper Extremity pre prosthetic treatment techniques and lab stations
12 - 12:45 p.m.Lunch provided
12:45 - 1:45 p.m.Physical Therapy focused topic: Lower Extremity Outcome Measures & Pre gait lecture + HandoutOccupational Therapy focused topic: Upper Extremity Prosthetic training lecture
1:45 - 3:15 p.m.Physical Therapy focused topic: Initial prosthetic training and gait deviations lectureOccupational Therapy focused topic: Upper Extremity Prosthetic training lab
3:15 - 4:15 p.m.Physical Therapy focused topic: Higher level Prosthetic training labOccupational Therapy focused topic: Upper Extremity Assessment tools
4:15 - 5:30 p.m.Multiple-Limb Loss case studies; Resources

Instructional Methods Used: PowerPoint, lecture, video, labs

 

Education

OT Approved CE

OT: Memorial Hermann Health System is an AOTA Approved Provider of continuing education. The assignment of AOTA CEUs does not imply endorsement of specific course content, products, or clinical procedures from AOTA.

Instructional Level: Intermediate
AOTA CEU: 0.85
Contact Hours: 8.5
AOTA Classification Code: Occupational Therapy Process-Intervention.

No partial credits will be given.


TPTA 2017


PT: Memorial Hermann Health System is TPTA Approved Provider of continuing education.

Instructional Level: Intermediate
TPTA CCUs: 8.75

No partial credits will be given.

Participants must attend the entire course in order to receive CEU’s/CCU’s and course certificate. No partial credits will be given.

Registration

Registration closes Monday, February 11, 2019 at 4 p.m. or at capacity of 40 attendees.

Course MHHS AttendeeNon-MHHS Employee
Any Course Day 1$75$175
Any 2 day course $150$325
Register for any 3 or more courses at the same timeReceive a $75 discountReceive a $75 discount
Register for all 8 courses at the same time (*other discounts no longer apply)Receive a $150 discount for registering for all 8 classes. Total price when registering for all 8 classes, with discount applied, is $825.Receive a $250 discount when registering for all 8 classes. Total Price when registering for all 8 classes, with discount applied, is $1900.

Discounts applied when you register for 3 course or more, or when you register for all 8 courses.
Discounts automatically applied as courses are selected on registration.

MHHS employees must register with their MHHS email to receive the employee benefit.

Any questions, please contact: ContinuingEducationRegistration@memorialhermann.org.

Parking: Please refer to www.texasmedicalcenter.org for additional information on parking. The closest parking available is in Garage 6 and is next to TIRR Memorial Hermann Hospital.

TIRR Memorial Hermann Hospital
1333 Moursund, Houston, TX 77030
2nd floor Research Conference Center


Cancellation policy: All cancellations must be in writing 14 calendar days prior to the course start date to ContinuingEducationRegistration@memorialhermann.org. Refunds will not be granted past this date. Cancellation of the event by TIRR Memorial Hermann will result in a full refund of monies received. TIRR Memorial Hermann is not responsible for the refund of travel or hotel expenses under any circumstances. TIRR Memorial Hermann reserves the right to cancel or change any programs for due cause. In the event of a course cancellation, participants will be notified via email & contact phone number on the registration form below. Please fill out all information in registration form.

Conflicts of Interest: Policy & Procedures exist whereby all speakers must disclose any relationships which may cause a conflict of interest. Any relevant financial and non-financial relationships will be disclosed via speaker agreement, written notification after agreement, and/or prior to presentation.

Complaints: Complaints of faculty and participants are handled with dignity and respect by the course coordinator and/or Director of Rehabilitation with resolution of the complaint communicated to all involved parties. All participants in Memorial Hermann Continuing Education Courses are entitled to an accessible, accommodating, and supportive teaching and learning environment.

Assistance: All participants in Memorial Hermann Continuing Education Courses are entitled to an accessible, accommodating, and supportive teaching and learning environment. Please email or note on registration any specific needs we can work to assist you with.