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Advancing Clinical Practice Series

Pathological Gait Analysis and Orthotic Intervention for Adults with Neurologic Dysfunction


TIRR Faculty:
Lauren Szot, PT, DPT, NCS
Tamara Juden, PT, DPT, NCS
Todd Klekar PT, DPT, NCS

Guest Speaker:
Tom DiBello, CO, FAAOP

Open to: PT, PTA

Course Date: Saturday & Sunday, July 28-29, 2018

Registration at 7:30 a.m.
Course from 8 a.m. - 5 p.m. (Saturday), 8 a.m. - 12 p.m. (Sunday)


TIRR Memorial Hermann
1333 Moursund
Research Building, 2nd floor
Houston, TX 77030

Parking: Garage 6, $12 per visit. Please refer to the Texas Medical Center's website for information on parking. The closest parking is available in Garage 6 and is next to TIRR Memorial Hermann.

Class size: Limited to 40 attendees.

Recommended Prerequisites:

Prior to attendance of this course, the participant should be able to:

  1. Identify the parameters of normal gait, including necessary range of motion, muscle activity and functional implications
  2. Basic knowledge of types of orthotics
  3. Participants should be familiar with NORMAL gait as a preparation for this course. Normal gait will not be taught, participants are expected to use the Normal Gait handout as a guide for normal gait knowledge.

Course Handouts:

Normal Gait
Gait Module Handout Stance
Gait Module Handout Swing
Rancho Roadmap AFO
Video Cases

Target Audience

PT, PTA clinicians looking to advance their clinical expertise pathological gait and orthotics when working with those with a neurologic injury or illness.


This intermediate level course will apply the participants’ knowledge of normal gait to the analysis of pathological gait in persons with neurological injuries. Also included will be practical information in regards to biomechanics, component selection, prescription rationale, orthotic design and problem solving. Interventions targeting pathological gait will be reviewed, including orthotic intervention. This information will be conveyed through lecture, video case presentations, clinical observation and resident case presentations.

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

  1. Identify common gait deviations in adults with neurologic conditions and hypothesize potential causes of gait deviations
  2. Select appropriate outcome measures for measuring gait outcomes
  3. Appraise available literature on evidence-based interventions to address gait dysfunction
  4. Discuss biomechanical principles related to orthotic design, fit, and componentry
  5. Demonstrate understanding of biomechanics, design, and componentry by formulating an appropriate orthotic prescription and justification for orthotic device
  6. Develop evidence guided interventions and gait training strategies designed to target specific gait deviations, underlying impairments, and functional limitations through a series of case studies

Assessment of Learning Objectives: Course evaluation

Requirements for course completion: Full attendance, full participation, course feedback form

Speaker Information

TIRR Faculty Information

Catherine Lauren Szot

Lauren Szot, PT, DPT, NCS

Lauren Szot, PT, DPT, NCS graduated with a Master of Physical Therapy in 2007 and transitional Doctorate of Physical Therapy in 2009 from Louisiana State University Health Sciences Center in Shreveport, LA. She is a graduate of the TIRR Memorial Hermann Neurologic Physical Therapy Residency Program in 2011 and received her Board Certification in Neurologic Physical Therapy in 2011. In her 8 years of practice, Lauren has worked in a variety of clinical settings with focus on neurologic rehabilitation. She is currently a Clinical Assistant Professor and Assistant Director of Clinical Education at Texas Woman’s University in Houston. She also participates in clinical practice in neurologic inpatient rehabilitation at TIRR Memorial Hermann, where she has served as residency mentor and faculty for the TIRR Memorial Hermann Residency Program. Lauren also enjoys professional service through her involvement as prior Chair of the Nominating Committee and current 2nd Vice Co-Chair of Southeastern District of the TPTA.

Speaker Disclosures & Conflicts of Interest:

  • Financial: Employment relationship with TIRR Memorial Hermann and Texas Women's University (TWU).
  • Non-financial: She is assistant DCE and Assistant Clinical Professor for TWU.


Tamara Juden, PT, DPT, NCS

Tamara Juden, PT, DPT, NCS has been working as a physical therapist within the TIRR Memorial Hermann system since 2012 and is currently working in the outpatient rehabilitation setting. Prior to this she completed the TIRR Memorial Hermann Neurologic Physical Therapy Residency Program, treating patients throughout the neurologic continuum of care ranging from the Neurotrauma ICU to the TIRR Challenge program, a community re-integration program for brain injury survivors. Tamara completed her undergraduate education at Texas State University in San Marcos, Texas with a bachelor’s degree in Exercise Sports Science and went on to complete her doctorate in physical therapy at Texas Woman’s University in Houston, Texas. She works with adult and pediatric clients of varying neurologic diagnoses and serves as a clinical instructor at the TIRR Memorial Hermann Memorial City campus. Tamara is certified in LSVT Big and her special interests include working with clients with Parkinson’s Disease, amputation, and spinal cord injury.

Speaker Disclosures & Conflicts of Interest:

  • Financial: Employment relationship with TIRR Memorial Hermann
  • Non-financial: TIRR Memorial Hermann Adult and Pediatric Outpatient Services: Center Coordinator for Clinical Education (CCCE) Kirby Glen

Todd Kleker

Todd Klekar PT, DPT, NCS

Todd Klekar PT, DPT, NCS is a physical therapist who currently works at Memorial Hermann Rehabilitation Hospital – Katy in the outpatient therapy department where he primarily works with patients post-stroke. His professional interests include orthotic interventions and the impact of high intensity in treatment sessions on patients’ functional outcomes. Todd is a board-certified clinical specialist in neurology and completed the TIRR Memorial Hermann Neurologic Residency Program in 2013. He obtained his Doctorate in Physical Therapy from Texas Women’s University in 2011 and his Bachelor of Science degree in Kinesiology/Exercise Science from the University of Houston in 2006. He has been an active member of the American Physical Therapy Association since 2008 and member of the neurologic section since 2012.

Speaker Disclosures & Conflicts of Interest:

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

Guest Speaker


Tom DiBello, CO, FAAOP

Tom DiBello, CO, FAAOP is the Director, Clinical and Scientific Affairs, Hanger Clinic. He holds a Bachelors of Pharmacy Degree from Duquesne University and certificates in Orthotics and Prosthetics from Northwestern University. He has lectured extensively on Lower Extremity Orthotics throughout the United States and Mexico as well as Italy, Australia, Southeast Asia and Africa and has authored chapters in two textbooks and two chapters for the new Atlas of Orthotics.

He has served the American Academy of Orthotists and Prosthetists as a past president and board member. Tom is a Fellow of the Academy and received the American Academy of Orthotists and Prosthetists distinguished practitioner award in 2007 and as awarded the American Orthotic and Prosthetic Associations Lifetime Achievement Award in 2015.

Speaker Disclosures & Conflicts of Interest:

  • Financial: Director, Clinical and Scientific Affairs, Hanger Clinic; Hangar Clinic receives referrals from TIRR Memorial Hermann
  • Non-financial: Tom is Clinical Assistant Professor at the Baylor College of Medicine, Honorary Adjunct Faculty at Texas Women’s University and Chairman of the Advisory Committee of the Baylor College of Medicine Master’s Program on Orthotics and Prosthetics.

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.

Saturday, July 28, 2018

TimeTopic & Activity
7:30 - 8 a.m. Registration & Refreshments
8 - 10 a.m.

Intro to gait analysis & pathological Gait

10 - 10:15 a.m. Break
10:15 - 11:30 a.m.

Pathological gait

11:30 a.m. - 12:30 p.m. Examination & Evaluation
12:30 - 1:30 p.m.

Lunch provided

1:30 - 3 p.m.Evidence based interventions
3 - 3:15 p.m.


3:15 - 5 p.m.Orthotics & prescription writing


Sunday, July 29, 2018

TimeTopic & Activity
7:30 - 8 a.m.Registration & Refreshments
8 - 8:30 a.m.

Pathological gait and orthotics review

8:30 - 10 a.m.Clinical decision making
10 - 10:15 a.m.


10:15 - 11:30 a.m.Clinical application & case studies
11:30 a.m. - 12 p.m.

Course summary & Evaluations, Q & A

Instructional Methods Used: PowerPoint, lecture, video, labs

Class Size: Registration is open to 40 participants.


PT: Memorial Hermann Health System is TPTA Approved Provider of continuing education. This course meets continuing competence requirements for physical therapist and physical therapist assistant licensure renewal in Texas for 11.25 CCUs.

Instructional Level: Intermediate. Participants must attend the entire course in order to receive CEUs/CCUs and course certificate. No partial credits will be given.

TPTA 2017



Cancellation Fee
Refunds, minus 25% administrative fee, will be granted if cancellation notice is received in writing according to the stated cancellation policy below.

Cancellations Policy
If you register and do not attend, or do not fulfill the requirements of the class, your course and all other associated fees will not be refunded. All cancellations must be in writing 14 days prior to the course start date to Refunds will not be granted past this date.

Cancellation by the Sponsor/Instructor will result in a full refund of the tuition. Sponsor/Instructor is not responsible for additional expenses incurred by registrants.

TIRR Memorial Hermann reserves the right to cancel or change any programs for due cause. Cancellation of the event by TIRR Memorial Hermann will result in a full registration refund of monies received. TIRR Memorial Hermann is not responsible for the refund of other expenses, such as travel or hotel expenses, under any circumstances. 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.

Contact at (713) 797-7432 or email

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.

Class Size: Registration is open to 40 participants.

*Registration closes July 23, 2018

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


Registration for this course has closed.