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Any recommendations for manual certification?
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Any recommendations for manual certification? - August 25, 2008 8:36:08 PM
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mmr-pt-atc
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Was wondering if anyone had any comments or suggestions of manual certifications. I am looking to expand my knowledge of manual therapy, specifically spine rehabilitation. Thanks in advance!
Mike Reinold
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Visit my rehab blog at MikeReinold.com
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RE: Any recommendations for manual certification? - August 25, 2008 9:23:15 PM
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TexasOrtho
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Hi Mike. You'll probably get lots of good recommendations, but I will put in for the IAOM courses. They have a certification, fellowship program, and doctoral program through Texas Tech University. I've taken six of their courses (two spine and four extremity) and they are top notch. I believe they advertise here on RE. There are some great programs out there but these are outstanding.
Here is the URL: www.iaom-us.com
_____________________________
Rod Henderson, PT
Board Certified Orthopedic Specialist (or Super-Freak)
Certified Strength and Conditioning Specialist
www.texasorthopedics.blogspot.com
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RE: Any recommendations for manual certification? - August 26, 2008 1:24:07 AM
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rv36116
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From: Texas
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McKenzie Part A-E and the Clinical Skills Update with either Mark Miller or Scott Herbowy.
http://www.McKenzieMDT.org
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RE: Any recommendations for manual certification? - August 26, 2008 8:59:01 AM
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ptim
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I'd also recommend the McKenzie program, an excellent foundation for evaluation and treatment.
There is also the diploma program after certification
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RE: Any recommendations for manual certification? - August 26, 2008 11:22:41 AM
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torques
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From: Marion, IN
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Hi,
Check APTA credentialed residency/fellowship programs. A few offers certification programs like Ola Grimsby, St Augustine, Institute of Physical Arts, Manual Therapy institute. You can click on links from APTA site. Any of these groups are great. I took Back education from institute of Physical Arts. Great course. IPA is PNF/function based. The others are more mechanistic.
Julius
_____________________________
Julius Quezon PT DPT MTC CPed
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RE: Any recommendations for manual certification? - August 26, 2008 6:41:10 PM
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SJBird55
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Mike, since I have heard you present and I know you are hanging with a crowd of "leaders," I think before you determine manual certification specifically with the spine, you probably ought to be also thinking about the evidence behind the program. Does the evidence indicate substantial value for manual certification? Any staff within a program will definitely brag up the program... but what about unbiased proof? Does the actual clinical performance of the therapist significantly improve? Does evidence support the biomechanical evaluative approach? Unless your goal is to acquire more letters behind your name, in all honesty, treating the spine with evidence isn't necessarily difficult - the main difficulty is keeping familiar with the growing amount of evidence on guidelines and the evolving treatment classification system. If you review the research by Fritz, Brennan, Wainner, Childs, Cleland, Deyo, Flynn, Delitto, Teyhen (Deydre), Cook, Whitman, George... (those that the names that come quickly to me) and look at 2 articles by Resnik that focus on "expert clinicians," you'd actually have a good clinical base for clinical decision-making. The only aspect missing with those researchers would be patients with chronic back pain. I honestly think you need to mix in a little of the work done by Moseley to assist in developing a clinical approach to complement the current guidelines. JW Matheson just posted on EIM some new guidelines for the low back - those guidelines are even better than the original guidelines. Things are nicely evolving with conservative spine care. I'd even suggest looking into what has been going on over at Virginia Mason Medical Center and how low back pain is handled in their system.
Nice blog, by the way. It is nice to have an expert in shoulder pathologies available for opinions. Our field seems so top heavy in low back pain research so it is nice to see work being done on shoulder problems. I'd love to see a reasonable classification system for shoulder problems (I currently only have one article that classifies shoulder problems, but it is potentially a bit too burdensome to implement into the clinic to classify patients with shoulder problems. Think tying outcomes with whatever shoulder problem so apples to apples may be better compared.) Much of the work out there seems to be highly focused on athletes that require overhead performance and it really would be nice to have a broader focus for those Joe Schmos that require services for shoulder pain that may not be related to overhead activities.
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RE: Any recommendations for manual certification? - August 26, 2008 10:23:17 PM
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chita229
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What is the general consensus regarding the NAIOMT certifications in manual therapy?
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RE: Any recommendations for manual certification? - August 27, 2008 12:45:45 AM
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alodato
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Have done both the NAIOMT and McKenzie certification programs. Would recommend them both. I think they provide clinically relevant information and studying for the certifications made me a better clinician. I just took an Institute of Physical Art class this past weekend and came away impressed. I will probably continue with their courses. I have heard good things about Evidence in Motion and IAOM courses as well, but they do not venture up to my area....I am in the heart of NAIOMT country, so they dominate the manual therapy courses up here.
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RE: Any recommendations for manual certification? - August 27, 2008 1:47:45 AM
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mmr-pt-atc
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You bring up a lot of good points, I appreciate your comments. Evidence is a large part of my clinical care for patients. This is exactly what I am searching for but fear that these programs just do not exist. The spine is an area that seems so limited in research. I enjoyed McGill's book "Low Back Disorders" and his approach to applying evidence to spine treatment, but must say that we need to progress more in this area.
Thanks for visiting my blog, hope to continue expanding on it in the future.
_____________________________
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Mike Reinold
Visit my physical therapy blog
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RE: Any recommendations for manual certification? - August 27, 2008 7:28:29 AM
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SJBird55
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:) Mike, you've just been immersed in the shoulder for the majority of your time. There is a lot of awesome evidence out there for treating the low back. In all seriousness, about 5 years ago, I decided to take a look at my outcomes with the lumbar spine - I hated treating it. I believed it was a confusing, difficult problem to treat. I didn't feel that there was much literature out there to assist with treating patients with that kind of complaint. I started focusing on reading the literature out there for the spine - published articles, not books. I looked at my outcomes and saw that I was averaging about 14 visits at the time and discharging with 25% disability. Effect size did look good at about .8 or so... but I wasn't happy with my performance - things HAD to be better for these patients and I was discharging them satisfied with those numbers (which I had no idea until I looked at that particular group of patients). I reflected on my data and observed that I had a preference to use a lot of exercise and basically no manual intervention. I gambled with myself and bet that I could improve my performance and decided I wanted to see a change in my numbers to 10 visits with a 15% disability. BCBS has my numbers with their PPO plan members at 7 visits and $463 while the rest of the therapists in my state are at $1,060 and around 10 visits. Disability is about 13% (BCBS doesn't know that, that's from my own independent data). The only course I took was an EIM course in 2003 or 2004 on the cervical spine with Wainner, Childs and Bennett because at the time that was the only evidence-based continuing ed course I could find. What more could one want? The actual researchers teaching the course and sharing the evidence on the spine. Even though the course was for the c-spine, they did spend time with me on how to manipulate the lumbar spine and there was good, open discussion about their research on the clinical prediction rule. I can assure you, it wasn't taking course after course on manual techniques that improved my performance; it was simply knowing where I was with my performance and changing my clinical decisions to more reflect the literature that I read. Chronic back pain is the only area where I believe the literature is limited. The guidelines that came out that JW shared over on EIM - for any patient with low back pain - before I even evaluate them, I spend about a good 10-15 minutes discussing pain and prognosis (from research) and not necessarily the lack of value of diagnostic imaging, but that what is found during the imaging isn't really abnormal or scary and I tell them when they should worry. I changed my tactic on my communication probably 2 years ago and having a "discussion" prior to even beginning the evaluative portion seemed to have improved treatment effectiveness. I'm not sure exactly why, but I have my guesses. I honestly believe, if you spent the time both acquiring and reading the work done by the above researchers, you'd be surprised at how much good literature is out there for clinicians to guide treatments. All it takes is implementing the research and changing behaviors. I also think that after reading the research, then a better self-reflection can occur to know where time needs to be targeted for learning manual skills.
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RE: Any recommendations for manual certification? - August 27, 2008 8:34:38 AM
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ptim
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Mike
I'd recommend reading 'Rapidly Reversible Low Back Pain' by Ron Donelson. Its loaded with evidence supporting the MDT approach and also gives a nice overview of sub-grouping/classification and research model in LBP mamnagement.
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RE: Any recommendations for manual certification? - August 27, 2008 8:45:50 AM
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TexasOrtho
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Mike. After reading your blog, I think you already seem to have a pretty good inutition about the shoulder. Very good in fact! That being said I'm not sure you would need to pursue a manual therapy certification unless you are just dead set on it. I am going through the process as a means to get my terminal doctorate, but I don't have a burning desire to earn another set of initials behind the name. Sounds like you've got skills to pay the bills, just read and apply and you'll do great. I fancy myself as a bit of a UE/LE guy myself, but I find my spine cases do great with the same clinical reasoning. Good luck.
< Message edited by TexasOrtho -- August 27, 2008 8:50:35 AM >
_____________________________
Rod Henderson, PT
Board Certified Orthopedic Specialist (or Super-Freak)
Certified Strength and Conditioning Specialist
www.texasorthopedics.blogspot.com
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RE: Any recommendations for manual certification? - August 27, 2008 8:52:31 AM
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Tom Reeves DPT ATC
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Richard Jackson's series of three courses was helpful to me and evidence based.
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RE: Any recommendations for manual certification? - August 27, 2008 11:37:56 AM
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mmr-pt-atc
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quote:
Rapidly Reversible Low Back Pain
Thanks for the suggestion, sounds like a good book and just what I am looking for.
_____________________________
******
Mike Reinold
Visit my physical therapy blog
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RE: Any recommendations for manual certification? - August 27, 2008 2:00:29 PM
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ptim
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$21 at Amazon.com
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RE: Any recommendations for manual certification? - August 27, 2008 4:35:55 PM
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rv36116
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From: Texas
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I would highly suggest Donelson's book as well. He's coming from a MD/Ortho perspective and looking at the history of LBP research. Chapter 9 does an outstanding job looking at the old and new viewpoints of LBP assessment/treatment.
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RE: Any recommendations for manual certification? - August 27, 2008 7:59:00 PM
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blast7
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Isn't it somewhat ironic that everyone is recommending not continuing with manual therapy certification when some of the top researchers in the area of low back pain are Fellows of the AAOMPT.
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RE: Any recommendations for manual certification? - August 27, 2008 9:32:40 PM
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TexasOrtho
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Humble opinion follows: Certifications are just benchmarks of knowledge and understanding, and have the potential to be pretty meaningless. I think there have been some pretty good investigations that CME or CEU doesn't always equate to better clinical performance.
There must be more to making a better clinician than a specific course or certification. I think it's the level the therapist is willing to dispassionately scrutinize, filter, and utilize the information presented that makes the difference. I have a friend who's been a PT for over 30 years with NO certifications that I would stand in line and wait to treat me more than a few OCS or FAAOMPTs I've met. The OCS/FAAOMPT's of the world are going to be sharp without a doubt. You can't be a dumbass and meet the standards of those credentials. However, as most folks realize by now, there can be a wide gulf between doing and knowing.
I think There are some amazing literature reviews, clinical commentaries, and interdisciplinary publications written by non-FAAOMPT types.
_____________________________
Rod Henderson, PT
Board Certified Orthopedic Specialist (or Super-Freak)
Certified Strength and Conditioning Specialist
www.texasorthopedics.blogspot.com
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RE: Any recommendations for manual certification? - August 28, 2008 1:49:25 PM
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Kaden
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I will be pursuing fellowship and believe it or not, this decision has nothing to do with collecting more initials behind my name. My company provides me with support to do this so finanically it is feasible and I would probably not be shelling out that kind of money if there was not some help.
The main reason I am doing this is the ability to work with and learn from many good clinicians. The core of most of these programs is direct one on one or small group time with many different clinical instructors. To pick the brains of some elite clinicians and learn from a variety is a great opportunity to improve my clinical skills.
Why I do agree with some above, that staying current on literature and doing some reading one can become a fairly decent evidence based spine clinician. The problem is what to do when the evidence does not neatly apply. If I have a patient meet the CPR for lumbar manip but has osteoporosis or when I set them up to do the Chicago technique and they are painful and can't tolerate the position. Then what do you do.
This is where I think clinical residency, fellowship, etc come in by providing the clinical experience aspect of evidenced based medicine. EBP is a combination of research to lead us down the best possible path and clinical experience to guide us when the evidence is not so clear or the patient does not nicely fit into some sub group.
These programs are nice opportunities to continue to gleam some of that clinical experience piece of the puzzle from others that have been practicing for longer. That is how I view it, rather than just to collect some more initials.
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RE: Any recommendations for manual certification? - September 2, 2008 12:00:02 PM
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mmr-pt-atc
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Anyone have any experience with the Institute of Orthopedic Manual Therapy (IOMT) using the Kaltenborn-Evjenth concepts?
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Mike Reinold
Visit my physical therapy blog
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