Concussion

QA Bulletin Q3 Concussion.pdf

"Concussion is recognized as a clinical syndrome of biomechanically induced alteration of brain function, typically affecting memory and orientation, which may involve loss of consciousness (LOC)."

Giz C, Et al. 2013 AAN. Summary of Evidence Based Guidelines Update: Evaluation and management of Concussion in Sports. Neurology 80; June 11, 2013

The Role of Physical Therapy in Concussion Rehabilitation

This article reviews the multi-modal approach to post-concussion treatment. Concussion symptoms are widely variable and recovery is influenced by many factors, therefore, an individualized treatment approach is needed for the best outcomes. The largest predictor for prolonged recovery is the severity of the initial symptoms in the first few hours or days after injury. The recommendation is a combination of graded exercise, vestibular and oculomotor training, and cervicogenic rehab to facilitate a faster return to function and a more complete recovery. Although initial rest is recommended, prolonged rest is linked to slower symptom resolution. 

Seminars in Pediatric Neurology (July 2019)

The Role of Physical Activity in Recovery From Concussion in Youth: A Neuroscience Perspective

This special interest article examined studies that use neuroimaging to characterize the complex and dynamic changes in the brain following concussion. The evidence supports participation in physical activity after an initial and brief period of rest (< 3 days) with gradual progression as indicated in the following table. 

Journal of Neurologic Physical Therapy (July 2018)

Welcome to the QA Bulletin!

Caring for patients with spinal conditions can be complex. Many times, patients come with chronic symptoms that have been with them for many years. In this bulletin you will find articles on therapy for the spine, helpful education tips and social media entities as well as some common certifications that can help increase the therapist’s knowledge and skills to better treat their patients.

“We’ve Got Your Back”

Orthopaedic Care of the Spine

A review of more than 60 RCT evaluating exercise therapy for adults with low back pain found that such treatment can decrease pain, improve function, and help people return to work. The American College of Physicians states that “non-pharmacologic interventions are considered first line options in patients with chronic low back pain.” http://www.apta.org/PTinMotion/2018/10/Feature/Opioid/

Lower Trapezius Muscle Strength

Individuals with unilateral neck pain exhibit significantly less lower trapezius strength in the side of neck pain as compared to the contralateral side. Progressive resistive exercises and core stabilization exercises may help restore balance of normal strength in the lower trapezius muscle may be in important part of successful rehabilitation of patients with cervical pain. https://doi.org/10.2519/jospt.2011.3503

Combined Effects of Thoracic Thrust Manipulation (TTM) and Cervical Non-Thrust Manipulation (CNTM)

Individuals with mechanical neck pain who received both TTM and CNTM plus exercise demonstrated better overall short-term outcomes compared to those receiving only non-thrust manipulation of the cervical spine plus exercise. https://doi.org/10.2519/jospt.2013.422

Read more from the Spring QA Bulletin here (PDF)

“Non-pharmacologic interventions are considered first line options in patients with chronic low back pain.” The American College of Physicians

 Updating the NDPTA membership on the current best evidence and standards of practice

In This Issue Resolve to Grow: Neurologic Physical Therapy Specialist Certification

How many PTs are Clinical Specialists?
What is the Neurologic Clinical Specialty?
How can I prepare to become a Clinical Specialist?
What do I need to know to pass the examination?
How much does it cost?
Time limits for the examination/reapplication

Resolve to Grow: Neurologic Physical Therapy Specialist Certification How many Physical Therapists are Clinical Specialists? (As of July 2018). Since last year, the total number of clinical specialists in North Dakota has increased by 8, while there are 98 more clinical specialists in Minnesota. The ABPTS website (www. abpts.org) has a national database of board-certified clinical specialists in physical therapy.

What is the Neurologic Clinical Specialty?

The Neurologic Specialist Certification is the 3rd most common certification with about one in nine of all clinical specialists being certified in neurologic physical therapy. In the United States, there are 2,648 Neurologic Clinical Specialists as of July 28, 2018, with 6 in North Dakota and 63 in Minnesota.

The first step is to become a Neurologic Clinical Specialist is submitting the application. The application and application review fee are both due on July 31 for Neurologic applicants. The examination fee is due November 30. If you are interested in taking the examination in 2019, check the ABPTS website for specific deadlines.

Neurologic applicants must meet one of the following requirements for Direct Patient Care.

Option A: Submit evidence of 2,000 hours of direct patient care as a licensed U.S. physical therapist (temporary license excluded) in Neurologic in the past 10 years. At least 500 of these hours must be completed in the last 3 years. The direct patient care hours only include time practicing in Neurologic physical therapy in the United States or its possessions or territories, and must include activities involving examination, evaluation, diagnosis, prognosis and intervention.

Option B: Submit evidence of successful completion of an APTA-accredited post professional clinical residency in Neurologic in the last 10 years. Applicants currently enrolled in an ABPTRFE-accredited clinical residency, or enrolled in a residency program that has been granted candidacy status, may apply for the specialist certification examination prior to completion of the clinical residency. These applicants will be conditionally approved to sit for the examination as long as they meet all other eligibility requirements pending submission of evidence of successful completion of the clinical residency to the APTA’a Specialist Certification Program no later than one month before the examination window opens.

How can I prepare to become a Neurologic Clinical Specialist?

The ABPTS has a candidate guide for individuals interested in the Neurologic Specialist Certification. http://www.abpts.org/uploadedFiles/ABPTSorg/Specialist_Certification/Neurology/ SpecCert_Neurologic_Application.pdf The ABPTS and the APTA sections all have information for preparing for the examination. ABPTS: http://www.abpts.org/Resources/ExamPreparationMaterials/ Academy of Neurologic Physical Therapy, Inc. www.neuropt.org

What do I need to know to pass the examination?

The ABPTS provides an outline of the content of the examination. www.abpts.org/Resources/ ExamOutlines/Neurology I. Knowledge Areas (20%) II. Professional Roles, Responsibilities and Values (15%) III. Patient/Client Management Model (65%) a. Patient/Client Examination (30%) b. Intervention (30%) c. Outcomes (5%)

How much does it cost to take the examination?

There is a nonrefundable application review fee, which is submitted at the time of application. The examination fee is submitted after the applicant is approved to sit for the examination. For applicants who do not pass the examination the first time, they can retake the test the following year. The fees have increased slightly since the last newsletter. Application Review Fee Exam Fee APTA Member $525 $810 Non-APTA Member $810 $1535

Time Limits for Active Application/Reapplication Eligibility

Your file will remain active for two consecutive exam administrations. If you choose to delay sitting for the exam, if you are not approved to sit for the exam, or if you do not pass the exam, the following requirements exist. You must submit an online reapplication submission, and pay a reapplication review fee and the current examination fee. The reapplication review fee is $170 regardless of your APTA membership status. Reapplicants must meet all current requirements. After two consecutive examination administrations, you must start with a completely new application and initial application review fee.

Taking the examination

The examination is completed online. The complete examination session is seven hours long. There is an online tutorial that can be up to 10 minutes. The examination itself consists of 4 periods. Each period is 90 minutes, and there is an optional break that can be taken after any test period. After the test, there is a post-examination survey if time is available.