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Certificate Course in Stroke Physiotherapy

HANDS ON WORKSHOP On RAJAN’S ECLECTIC APPROACH FOR STOKE / HEMIPLEGIA

Courses Offered

DEDICATED TO THE PIONEERS WHO INVENTED & DESCRIBED THESE PRECIOUS & EXCELLENT NEUROLOGICAL APPROACHES

WHAT IS ECLECTIC APPROACH . Stroke is an challenging condition where physiotherapy plays an exemplary role in bringing back the potentials of an impaired individual. So many approaches like MRP, Bobath / NDT, Brunnstrom, Roods, PNF, Johnstonne, Patricia Davies etc are used in retraining the motor & sensory components but unfortunately no single approach gives complete recovery. Because each approach concentrates on different components of recovery, for eg: MRP – Motor Relearning / Neuroplasticity, Brunnstrom – Synergy / Spasticity, Bobath / NDT – Milestone Development / Normalization of Tone & Movement, PNF – Proprioceptive Facilitation etc. If one approach is used to treat hemiplegic client he never ever attains the fullest independence / Motor & Sensory Optimization. Many research studies have been done to compare the effectiveness of one over the other but every research has concluded that no single approach is complete enough to treat the impairments. So we are in dreadful need of an integrated approach which addresses all the components of Hemiplegic recovery. I designed this Eclectic Approach during 2006 & experimented in more than 600 hemiplegic clients & still on. I found excellent recovery in clients including chronic cases which is of 10 years & above with my Eclectic Approach. It is my small effort to train my fellow physios with this extraordinary invention. I am sure that this workshop will change the dimension of stroke physiotherapy practice among the participants. Eclectic Approach for Stroke / Hemiplegia is fully hands on training with purely techniques along with Neurophysiological explanation / evidence from all the above mentioned approaches. Each Technique application will be rationalized / justified accordingly. It is completely evidence based approach to hemiplegics, not the traditional physiotherapy.

RAJANS RIGHT PRINCIPLE FOR ECLECTIC APPROACH

RIGHT TECHNIQUE FROM A RIGHT APPROACH TO A RIGHT PATIENT ON A RIGHT COMPONENT IN A RIGHT TIME PROVIDES A RIGHT SOURCE FOR THE COMPLETE RECOVERY.

COURSE CONTENTS

The details of the course are as follows. (PPT SLIDES INCLUDES RELEVANT PICTURES & VIDEOS OF THE CONTENTS)

DAY 1 - CONTENTS: LECTURE AND HANDS ON TECHNIQUES

1. NEUROANATOMY & NEUROPHYSIOLOGY OF BRAIN: 9.00 – 9.30 am

Lobes – Functions & Dysfunctions, Circle of Willis and its significance.

2. INTRODUCTION TO STROKE: 9.30 – 10.00 am

Stroke, TIA, RIND - Definition, Statistics, Types. Clinical features of MCA, PCA and ACA.Impairments- Motor, Sensory, Visual, Cognitive & Perceptual.

3. MOTOR CONTROL: 10.00 – 10.20 am

Definition, Theories, Neurophysiological basis, Prerequisites of Motor Control, Clinical Implications, Assumptions on Motor Control, Therapeutic Applications.

4. VOLUNTARY CONTROL : 10.20 – 10.40 am

Definition, Components of Voluntary Control, Theories, Neurophysiological basis, Assessment of Voluntary Control/Movement, Therapeutic Applications.

5. MOTOR LEARNING: 10.40 – 11.00 am

Definition, Stages of Motor Learning, Theories, Neurophysiological basis, Clinical Implications, Factors affecting Motor Learning, Concepts Determine Motor Learning, Assumptions on Motor Learning, Therapeutic Applications.

6. NEUROPLASTICITY: 11.00 – 11.30 am

Definition, Theories, Neurophysiological basis, Principles, Therapeutic Applications, Adaptation of motor performance, Post interventional Neuroplastic changes, Functional Outcomes, Recent evidence on recovery.

Tea Break - 11.30 – 11.45 am

7. CONCEPTUAL FRAMEWORK: 11.45 am – 12.15 pm

Eclectic Approach – Definition, Core Concepts, Principles, Merits & Demerits, Therapeutic interventions, Steps to follow, Effectiveness of Approach, Physiological basis, Theories strengthening the approach, Clinical Importance.

8. MOVEMENT AND ITS FACILITATION 12.15 am – 1.30 pm

Normal movement – Definition, Prerequisites, Physiological basis, Direct & Indirect impairments etc

TECHNIQUES OF FACILITATION & INHIBITION

    Postural reflexes
  • Tonic Neck Reflexes (TNR) - Asymmetric Tonic Neck Reflexes (ATNR), Symmetric Tonic Neck Reflexes (STNR), Tonic Labyrinthine Reflexes (TLR), Tonic Lumbar Reflex (TLR). Influences on movement.
    • Associated Reactions
  • Definition, Theories, Physiology, Homolateral Synkinesis, Raimste’s Phenomena, Soques Phenomena. Influences on Movement, Clinical Importance.
    • Exteroceptive & Proprioceptive Stimulus
  • Stroking, Tapping, Vibration, Stretching Maneuvers, Cryotherapy, Weight bearing, Proprioceptive Inputs, Vestibular, MFR, NMES, Neurodynamics etc

STEPS TO APPROACH – TONAL DISORDERS

  • Spasticity
  • Flaccidity
  • Techniques of Inhibition/Facilitation

HAND’ S ON TRAINING

9. ACUTE PHASE/ICU MANAGEMENT OF STROKE – 2.00pm – 3.00pm

Bed side assessment, Therapeutic aims in acute phase/ICU , Positioning of patient, Chest physiotherapy, Positioning, Facilitation of orientation, Strategies to prevent unstable vitals, perceptual & musculoskeletal deficits, Points to remember

10. SUPINE TO SITTING RETRAINING- 3.00pm – 3.30pm

Analysis, Essential components, Common Problems, Compensatory Strategies.

TEA BREAK – 3.30 – 3.45PM

11. SUPINE TO SITTING RETRAINING Cont”d - 3.45pm – 4.15pm

Elicitation of Muscle Activity & Training of Motor Control, Clinical & Functional Implications

12. TRUNK CONTROL RETRAINING – 4.15 – 5.00PM

Analysis, Essential components, Common Problems, Compensatory Strategies, Facilitation of Head/Neck movements, Evoking balance responses, Facilitation/Elicitation of Muscle Activity

DAY 2 - CONTENTS: LECTURE AND HANDS ON TECHNIQUES

13. TRUNK CONTROL RETRAINING 9.00 – 11.30 AM

Training of Motor Control, Maintenance of Soft Tissue Length, Clinical & Functional Implications, Advanced training of trunk musculature

TEA BREAK – 11.30 – 11.45 AM

14. UPPER LIMB RETRAINING 11.45AM – 1.30PM

Analysis of movement, Essential components, Common Problems, Compensatory Strategies, Tone management / Elicitation of Muscle Activity with Postural Reflexes, Associated Reactions, Proprioceptive/Exteroceptive Stimulus.

LUNCH BREAK- 1.30-2.00PM

15. UPPER LIMB RETRAINING 2.00 – 3.30PM

Training of Motor Control in Upper Limb, Maintenance of Soft Tissue Length, Clinical & Functional Implications.

TEA BREAK – 3.30 – 3.45PM

16. WRIST AND HAND RETRAINING 3.45 – 5.00PM

Analysis, Essential components, Common Problems, Compensatory Strategies, Elicitation of Muscle Activity, Tone management / Initiation and facilitation of movements with associated reactions, hand reactions, reflexes, Wrist fixation techniques, Finger flexor release techniques, Activation of extensors,

DAY 3 - CONTENTS: LECTURE AND HANDS ON TECHNIQUES

17. WRIST AND HAND RETRAINING Cont`d – 9.00 – 10.30 AM

  • Training of Motor Control in Wrist & Hand, Maintenance of Soft Tissue Length, Clinical & Functional Implications
  • Training of Various grasps & Manipulations.

18. SIT TO STAND RETRAINING – 10.30 – 11.30 AM

  • Analysis, Essential components, Common Problems, Compensatory Strategies, Elicitation of Muscle Activity
  • Training of Motor Control in Upper Limb, Maintenance of Soft Tissue Length, Clinical & Functional Implications Transference of Training.

TEA BREAK – 11.30 – 11.45 AM

19. LOWER LIMB RETRAINING – 11.45AM – 1.30 PM

Analysis, Essential components, Common Problems, Compensatory Strategies, Tone Management / Hip, knee, ankle movements – initiation, activation, dissociation, association, isolated movements – through reflexes, associated reactions, proprioceptive-exteroceptive stimulus, etc.

LUNCH BREAK – 1.30 – 2.00PM

20. LOWER LIMB RETRAINING – 2.00 – 3.30 PM

Training of Motor Control in Lower Limb, Maintenance of Soft Tissue Length, Clinical & Functional Implications Transference of Training.

TEA BREAK – 3.30 – 3.45PM

21. STANDING BALANCE RETRAINING – 3.45 – 5.00PM

Analysis, Essential components, Common Problems, Compensatory Strategies

DAY 4 - CONTENTS: LECTURE AND HANDS ON TECHNIQUES

1. STANDING BALANCE RETRAINING Cont`d – 9.00 – 10.00 AM

Elicitation of Muscle Activity & Training of Motor Control, Maintenance of Soft Tissue Length, Clinical & Functional Implications, Transfer of Training

22. GAIT RETRAINING – 10.00 – 11.30 AM

Normal Gait Biomechanics, Analysis, Essential components, Common Problems, Compensatory Strategies

TEA BREAK – 11.30 – 11.45 AM

23. GAIT RETRAINING Cont’d – 11.45AM – 1.30 PM

Elicitation of Muscle Activity & Training of Motor Control, Maintenance of Soft Tissue Length, Clinical & Functional Implications, Transfer of Training.

LUNCH BREAK – 1.30 – 2.00PM

2. COMPLICATIONS OF STROKE & ITS MANAGEMENT

  • Dysphagia – Clinical aspects, Physiology of swallowing, Assessment, Complications & Physiotherapy Management (2.00 – 3.00 PM)
  • Shoulder Subluxation – Biomechanics & Pathomechanics of Shoulder complex, Clinical aspects, Assessment, Complications, Physiotherapy Management. (3.00 – 3.30 PM)

TEA BREAK – 3.30 – 3.45PM

  • Complex Regional Pain Syndrome – Clinical aspects, Assessment, Complications, Physiotherapy Management (3.45 – 4.00 PM)
  • Perceptual Dysfunction – Perception & its disorders, Clinical aspects, Limitations in Motor Control, Relearning and Neuroplastiticy. Assessment, Complications, Physiotherapy Management. (4.00 – 4.30 PM)

24. ADJUNCTS IN STROKE PHYSIOTHERAPY – 4.30 – 5PM

a. Mirror Therapy b. Neural Mobilization C. Myofascial Trigger Point Therapy

PROGRAMME SCHEDULE

Practical training program consists of 40 hours

1st Day Schedule

S. No Duration Contents
1 9.00 – 9.30 Relevant facts in Neuro anatomy & physiology
2 9.30 – 10.00 Overview of Stroke – Clinical
3 10.00 – 11.00 Motor Control / Voluntary Control & Motor Learning & its relevance
4 11.00 – 11.30 Neuroplasticity & Therapeutic Applications
5 11.30 - 11.45 Tea Break
6 11.45 – 12.15 Conceptual Framework - Introduction to Approach , core concepts,
7 12.15 – 1.30 Steps to approach – spastic / flaccid patient
8 1.30 – 2.00 Lunch Break
9 2.00 – 3.00 Acute phase PT management. Bed mobility retraining
10 3.00 – 3.30 Supine to Sitting Retraining
11 3.30 – 3.45.00 Tea Break
12 3.45 – 4.15 Supine to Sitting Retraining Cont’d
13 4.15 – 5.00 Trunk Control Retraining

2nd Day Schedule

S.No Duration Contents
1 9.00 - 11.30 Trunk Control Retraining Cont’d
2 11.30- 11.45 Tea break
3 11.45 – 1.30 Upper Limb Retraining
4 1.30 – 2.30 Lunch break
5 2.00 – 3.30 Upper Limb Retraining Cont’d
6 3.30 – 3.45 Tea break
7 3.45 – 5.00 Wrist & Hand Retraining

3rd Day Schedule

S. No Duration Contents
1 9.00 - 10.30 Wrist & Hand Retraining Cont’d
2 10.30- 11.30 Sit to Stand Retraining
3 11.30 – 11.45 Tea break
4 11.45 – 1.00 Lower Limb Retraining
5 1.00 – 2.00 Lunch break
6 2.00 – 3.30 Lower Limb Retraining Cont’d
7 3.30 – 3.45 Tea break
8 3.45 – 5.00 Standing Balance Retraining

4th Day Schedule

S. No Duration Contents
1 9.00 - 10.00 Standing Balance Retraining Cont’d
2 10.00 – 11.30 Gait Retraining
3 11.30 – 11.45 Tea break
4 11.45 – 1.00 Gait Retraining Cont’d
5 1.00 – 2.00 Lunch break
6 2.00 – 3.00 Dysphagia & its PT management
7 3.00 – 3.30 Shoulder Subluxation
8 3.30 – 3.45 Tea break
9 3.45– 4.00 Complex regional Pain syndrome
10 4.00- 4.30 Perceptual Disorders
11 4.30- 5.00 Adjuncts in Stroke Rehabilitation
12 5.00 onwards Certificate Distribution / valedictory

Special features

  • Video demonstration of approach on patients (more than 500 video clippings & pictures)
  • Emphasis on hands-on training ( 28 hours )
  • Clinical reasoning & Neurophysiological evidence
  • Step by Step approach
  • Includes management of complications like Dysphagia, Shoulder Subluxation etc
  • Valid Course Certificate in Stroke Physical therapy with 19.5 credit hours
  • Nullifies the demerits of Brunnstrom, MRP, Roods, PNF, NDT, Johnstone, Bobath approaches etc.

What you get:

Certificate, Study Material,Transcript, File, Working Lunch etc

Who can join?

BPT Interns, Postgraduates & Physiotherapists

RESOURCE PERSON :

Dr.D.THIAGARAJAN

MPT (Neurosciences) MIAP

  • SENIOR CONSULTANT PHYSIOTHERAPIST
  • FIRST CONTACT INDEPENDENT PHYSIOTHERAPY PRACTITIONER
  • RESOURCE PERSON / COURSE INSTRUCTOR IN MUSCULOSKELETAL AND NEUROLOGICAL PHYSIOTHERAPY
  • DIRECT ACCESS CLINICAL SPECIALIST / RESEARCHER IN MUSCULOSKELETAL AND NEUROLOGICAL PHYSIOTHERAPY
  • EXPERT IN STROKE REHABILITATION APPROACHES / MYOFASCIAL TRIGGER POINT THERAPY / NEUROMUSCULAR DRY NEEDLING / TAPING etc
  • GUEST SPEAKER IN VARIOUS REPUTED INSTITUTIONS LIKE AIIMS - NEW DELHI, SVIMS, BCIP, D.Y.PATIL - PUNE etc..
  • BOARD MEMBER / EXAMINER & RESEARCH EXPERT IN VARIOUS UNIVERSITIES OF INDIA.
  • FORMERLY PRINCIPAL / HEAD OF THE DEPARTMENT - PHYSIOTHERAPY - SANTHOSH MEDICAL COLLEGE & HOSPITAL - NCR, NEW DELHI.

YOUR KIND ATTENTION PLEASE

  • FOR DETAILS OF THE UPCOMING WORKSHOPS - PLEASE CHECK NEWS & UPDATES IN THIS WEBSITE
  • IF ANYBODY WANTS TO CONDUCT THIS COURSES IN YOUR VICINITY FEEL FREE TO CONTACT US FOR DATES & DETAILS
-------- GOOD LUCK – MEET YOU SOON --------

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