Ambulation, Activity, and AFOs: Addressing the Ankle to Improve Gait and Function
April 17-18, 2021
Would you like to increase your skill with orthotic recommendations? Are you interested in increasing your treatment repertoire for the foot and ankle for patients with pediatric and adult neurological health conditions? This course presents a movement systems approach to management of the foot and ankle. Using a kinesiopathological lens, participants examine the effect of repeated movements, sustained alignments, cumulative micro-trauma, and altered relative flexibility on the function of the ankle. This course presents a comprehensive approach to care based on differential diagnosis, while examining the evidence for interventions which maximizes the resiliency of the ankle complex through skeletal maturation and into adulthood. Participants learn hands-on skills for an integrated approach, including: mobilizations to promote adaptive relative flexibility, improving intrinsic stability through strengthening of the ‘foot core”, and interventions to positively impact neuroplasticity. Participants also actively use the ICF model to guide recommendations for targeted use of the external support of orthoses and therapeutic casts to guide adaptive tissue-specific stresses.
Upon completion of this course, attendees will be able to:
- Recognize the interplay of Musculoskeletal and Neuromuscular Movement System Diagnoses and neuroplastic changes on foot and ankle dysfunction.
- Describe the impact of altered foot and ankle function during development on the structural outcome of the movement system.
- Perform a detailed foot and ankle examination, including gait kinematics, neuromotor function, and musculoskeletal structures.
- Develop a comprehensive plan of care for the foot and ankle to address task-relate goals in the context of supporting best structural outcome of the movement system.
- Perform treatment techniques to address relative stiffness and flexibility in foot and ankle mobility and function.
- Design a progressive strengthening program to improve intrinsic stability of the foot and ankle.
- Make detailed recommendations for casting and orthotic interventions.
- Describe elements of the ICF model that may impact individual goals in regard to lower extremity orthosis recommendations.
Texas Children’s Hospital
14 contact hours or CCU’s through TOTA. Texas Children’s Hospital is a preferred provider for the Texas Physical Therapy Association, APS #2303051TX.
Registration - Register online
Amanda Hall, PT, MPT, PCS, ATP, received her Master of Physical Therapy from the University of Washington in 2001. She was certified as a Pediatric Clinical Specialist through the APPTS in 2011, and as an Assistive Technology Professional in 2017. She has developed a framework for pediatric and neuro ankle intervention, including therapeutic casting, and orthotic design based on developmental kinesiopathology, differential diagnosis, manual therapy, and alignment for therapeutic gait, with individualized intervention and patient-centered designs. At the HSC Pediatric Center in Washington, DC, she provides therapeutic casting as well as orthotic and assistive technology evaluations. National conference presentations include: “Therapeutic Casting: A Modern Clinical Pathway to Improve Outcomes” at APTA’s Combined Sections Meeting 2019, “Orthotic Device Design Using Movement System Diagnoses as a Guide” at the American Academy of Pediatric PT’s 2019 Annual Conference, and “Are we Underserving the Pediatric Ankle? Supporting Development Through a Multi-System Approach” at APTA’s Combined Sections Meeting 2020.
09:00-10:00 Foot and Ankle Function
- Functional anatomy of the foot and ankle
- Kinesiopathological impact of Pediatric/Neurologic health conditions on ankle function
- Requisites for Therapeutic Gait
10:00-11:00 LAB + Lecture: Foot and Ankle Examination
11:15-11:45 LAB (including video) + Lecture: Gait Analysis
11:45-12:30 LAB + Lecture: Movement System Analysis for the foot and ankle
- Developmental Kinesiopathological Framework
- Foot and Ankle Movement System Analysis System
- Special tests
12:30-01:30 Lunch (on your own)
01:30-02:00 Do We Need to Intervene? Review of the Evidence
02:00-02:30 Interventions and Evidence: Maximizing the resiliency and resources of the foot and ankle complex
02:30-03:45 LAB: Joint Mobilizations to improve ankle mobility and relative flexibility
04:00-04:45 LAB: Soft tissue mobilizations to improve ankle mobility and relative flexibility
04:45-05:30 Applied Lab: comprehensive exam and application of treatment techniques
05:30-06:00 Case Studies
08:30-09:00 Sign-in/Continental Breakfast
09:00-09:30 Improving Motor Control and Strength of the foot and ankle
09:30-11:15 LAB: Improving intrinsic stability through progressive strengthening
- Retraining patterns of recruitment and tonic contraction: emphasis on stability in the “foot core”
11:30-12:00 The Role of Neuroplasticity in Foot and Ankle Function
12:00-01:00 Lunch (on your own)
01:00-02:00 Interventions to address neuroplastic changes
02:00-03:00 Targeted use of external supports to guide adaptive tissue-specific stresses
- Taping Interventions
- Casting as an adjunct to joint mobilization/soft tissue interventions
03:00-03:45 Use of orthoses to support neuromotor and musculoskeletal rehabilitation and development
- Goals of orthotic intervention
- Key Questions for Orthotic Design
- Special considerations based on Health Condition
- Designing support: Coronal, Sagittal, and Transverse Planes
04:00-04:30 LAB: Applied Orthotic Design
- Low profile, Supra-malleolar, Ankle-foot orthoses, KAFOs and beyond
04:30-05:00 Case Studies