Mary Massery's LINKED: Breathing and Postural Control

Participants can attend Day one (Part One: Theory), Days 2-3 (Part Two: Hands-on labs), OR Days 1-3 (Part One and Two: Theory AND Hands-on labs).  Participants must have attended Day one virtually (or previously in-person) in order to attend days 2-3.

General registrant cost:
$200 for Day 1  (8 CEU)
$400 for Days 2-3 (13 CEU)
$600 for Days 1-3 (21 CEU)

COURSE DESCRIPTION: 

This course, developed by Mary Massery, proposes a new definition of “core stability;” redefining it as the dynamic control of trunk pressures to optimize postural stability (balance).  Dr. Massery’s “soda pop can model” links breathing mechanics to postural control using multi-system interactions.  The speaker presents 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.  In Part-1, foundational information and quick interventions will be the focus (positioning and ventilatory strategies).  In Part-2, the focus shifts to hands-on techniques: assessing “normal” breathing patterns and learning neuromotor breathing retraining techniques and manual assistive cough techniques.  Multiple clinical cases will be used to cement the concepts.  The course is applicable for any pediatric or adult patient (or therapist) who breathes!

COURSE OBJECTIVES
At the conclusion of Part-1 (Day-1), participants should be able to:
Describe how trunk pressures link breathing and postural control using the Soda Pop Can Model.
Describe the multiple, simultaneous roles of the diaphragm as related to breathing, postural control, gastroesophageal reflux, constipation, and venous return.
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.
Position patients for optimal physiological and biomechanical support of breathing with simple equipment (towels, pillows, etc.).
Use a ventilatory strategy algorithm presented in class to optimally match breathing with movements from bed mobility to athletic endeavors.
Apply concepts to a wide variety of patient populations from infancy to geriatrics.


At the conclusion of Part-2 (Days 2- 3), participants should be able to:
Use a multi-system approach to evaluating motor impairments.
Identify the variations of “normal” breathing patterns and discuss the efficiencies/inefficiencies for individual patient conditions.
Evaluate need for, and demonstrate, appropriate neuromotor retraining techniques for patients with ineffective breathing/postural control strategies (health or participation deficits).
Participate in a live patient demonstration (if a patient is available) and suggest possible evaluation and treatment ideas based on the course material.
Design a targeted airway clearance program using the principles of mobilization, expectoration and oral management.
Demonstrate airway clearance techniques, with an emphasis on manual assistive cough techniques, and apply an airway clearance algorithm to specific patient conditions.
Identify thoracic cage/spine restrictions as they pertain to breathing mechanics and postural control (a very brief introduction of chest wall restrictions).
Evaluate the need for, and demonstrate, neuromotor retraining techniques to improve breath support for voicing and postural control (eccentrics).
Suggest immediate ways to incorporate the concepts into therapy activities in your clinical setting.

SPEAKER BIOGRAPHY
Nechama Karman, PT, MS, PCS received her MSPT from Columbia University in 1994, her Advanced MS in orthopedic PT from Touro College in 1998, and has completed her Health Sciences PhD coursework at Seton Hall University.  Nechama is an APTA board-certified pediatric clinical specialist and the chief clinical educator at Mobility Research for LiteGait nationally and internationally. In addition, Nechama owns a private practice in NYC focusing on complex neurological conditions and complex pelvic conditions.

Nechama has completed two invited Massery faculty apprenticeships.  In 2016, she became Mary’s first certified faculty member for the “Breathing” course!  And in 2019, she was the first certified faculty for Mary’s “I Survived” musculoskeletal course.  Two huge accomplishments!  In addition, she co-authored a new one-day course with Mary: “BRAKING BAD: ECCENTRIC CONTROL FROM TALKING TO WALKING.”  

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.

AGENDA:

Part-1:  Friday, September 8h (8.0 Contact Hours)
7:30 – 8:00 Registration
8:00 – 8:20 Discussion: Introduction to course topics
8:20 – 9:45 Lecture: Breathing and posture: Part 1 - Pressure control (Soda pop can model)
9:45 - 10:00 Break
10:00 – 11:30 Lab: Positioning strategies: What can you do in 90 Seconds or less that has a profound and lasting effect? 
11:30 - 12:15: Breathing and posture: The Diaphragm's many roles

12:15 – 1:15 Lunch

1:15 –1:35: Lab: Sneak peek: Ventilatory/movement strategies

1:35 - 3:15 Lecture Breathingand posture: The internal organs.  The vocal folds.
3:15 – 3:30 Break
3:30 – 5:10 Lab: Ventilatory/movement strategies:  Integrating neuromuscular, musculoskeletal, respiratory and sensory systems
5:10 – 5:30 Lecture: Summary, "Pearls", sleep homework 



Part-2:  Saturday, September 9th (8.0 Contact Hours)
7:30 – 8:00 Coffee and ...
8:00 – 8:30 Discussion: Review, synthesis, and Q&A
8:30 – 9:45 Lecture/Demo: Chest assessment:  Focus on musculoskeletal alignment and breathing patterns
9:45 – 10:00 Break
10:00 – 11:30 Lab:  Assessing breathing patterns and postural implications
11:30 – 12:30 Lunch
12:30 – 1:15 Lecture:  Airway clearance: From Sherlock to solution
1:15 – 2:15 Lab:  Facilitating efficient breathing patterns and endurance training: Neuromotor techniques for diaphragm, chest and other breathing patterns
2:15 – 2:30 Break
2:30 – 4:00 Lab:  Facilitating breathing patterns (continued)
4:00 – 4:30 Lecture/Demo: Brief introduction to rib cage and trunk musculoskeletal restrictions associated with breathing difficulties – Quick Screening!
4:30 - 5:30 Demo Patient demonstration (if possible)





Part-2:  Sunday, September 10th (5.0 Contact Hours)
7:30 – 8:00 Coffee and ...
8:00 – 8:30 Discussion: Review, synthesis, and Q&A
8:30 – 10:00 Lecture/Discussion: Differential diagnosis (patient demo): “Find the Problem”
10:00 – 10:15 Break
10:15 - 11:30 Lab:  Airway clearance lab: Focus on manual assistive cough techniques
11:30 – 12:15 Lunch
12:15 – 1:30 Lab:  Eccentric trunk control: using voice for postural control and vice versa
1:30 - 2:00 Discussion/Homework: Homework: Putting it all together 
Course wrap up

1. 1. Describe how trunk pressures link breathing and postural control using the Soda Pop Can Model. (Part 1)
2. 2. Describe the multiple, simultaneous roles of the diaphragm as related to breathing, postural control, gastroesophageal reflux, constipation, and venous return. (Part 1)
3. 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. (Part 1)
4. 4. Position patients for optimal physiological and biomechanical support of breathing with simple equipment (towels, pillows, etc.). (Part 1)
5. 5. Use a ventilatory strategy algorithm presented in class to optimally match breathing with movements from bed mobility to athletic endeavors. (Part 1)
6. 6. Use a multi-system approach to evaluating motor impairments. (Part 2)
7. 7. Identify the variations of “normal” breathing patterns and discuss the efficiencies/inefficiencies for individual patient conditions. (Part 2)
8. 8. Evaluate need for, and demonstrate, appropriate neuromotor retraining techniques for patients with ineffective breathing/postural control strategies (health or participation deficits). (Part 2)
9. 9. Participate in a live patient demonstration (if a patient is available) and suggest possible evaluation and treatment ideas based on the course material. (Part 2)
10. 10. Design a targeted airway clearance program using the principles of mobilization, expectoration and oral management. (Part 2)
11. 11. Demonstrate airway clearance techniques, with an emphasis on manual assistive cough techniques, and apply an airway clearance algorithm to specific patient conditions. (Part 2)
12. 12. Identify thoracic cage/spine restrictions as they pertain to breathing mechanics and postural control (a very brief introduction of chest wall restrictions). (Part 2)
13. 13. Evaluate the need for, and demonstrate, neuromotor retraining techniques to improve breath support for voicing and postural control (eccentrics). (Part 2)
14. 14. Suggest immediate ways to incorporate the concepts into therapy activities in your clinical setting. (Part 2)

If your ticket type is sold out, please email [email protected] 

General Registrant cost:

$200 Part 1 only $400 Part 2 only $600 Parts 1 and 2

Cancellation and Refund Policy: OhioHealth reserves the right to cancel or delay a course due to any unforeseen circumstances. In the event a course is cancelled, OhioHealth will refund all registration fees. OhioHealth is not responsible for any travel, hotel or other costs incurred.
B. Participant Cancellation: If a participant cancels, a refund of the conference fee minus an administrative charge of 25% of the registration fee will be made if written notice of cancellation is received no later than one week prior to the event. Exceptions may be approved on a case-by-case basis.
C. Inclement Weather: If a participant is unable to attend due to inclement weather (Level 3 Snow Emergency), refund of the registration fee minus 25% administrative charge will be issued.
D. Exceptions: Exceptions are considered at the discretion of the primary activity planner on a case-by-case basis.

Part 1: Approved for 8 hours by the Ohio Physical Therapy Association (OPTA), the Ohio OTPTAT Board - OT Section, and the Ohio Board of Speech and Hearing Professionals (SHP).

Part 2: Approved for 13 hours by the Ohio Physical Therapy Association (OPTA) the Ohio OTPTAT Board - OT Section, and the Ohio Board of Speech and Hearing Professionals (SHP).

Parts 1 and 2: Approved for 21 hours by the Ohio Physical Therapy Association (OPTA) and Ohio Board of Speech and Hearing Professionals (SHP), with reapproval pending for 21 CEU by the Ohio OTPTAT Board - OT Section.