Page 1

. .

.

.. .

.

. . . ........ . . . ......... . . . . . . . . . . .. . . . . . . .. . . . . . . . . . . .. . . . .. . . . .. . . ..

.

. .. . .

. . . . . . . . .

.

.

SPRING 2014, VOLUME 69, NO. 1

. ..

.... .. . . . . . . . . . . .. . . . .. . .... . . . . . . .. .. .

. ..

. . .... ... ... . . . . .. . . . .......... . . . . .. . . . . . .. .. . . . . .. . . . . .. . . . .

. .. .

.

. . . . . . . . . . ........ . . . ..... .

. . . . . . . . .

.

.

. . . . . .

........ . . . . . . . . . . . . .. . . . . . . . . . . .. . . . . . . . . .. . . . . . . . . . . .. . .

. . . . . . . . . . .

Are You Ready to Lean In to Our Profession? By Peggy Gleeson, PT, PhD Outgoing President of Education Section

I REMEMBER WHEN I BEGAN ATTENDING NATIONAL CONFERENCES, SEEING THE LEADERS OF THE PROFESSION FACILITATING MEETINGS, STANDING BEFORE HUNDREDS OF PTS AND PTAS , GUIDING THE STAKEHOLDERS OF OUR PROFESSION. THEY LOOKED SO CAPABLE, SO CONFIDENT AND SO DISTANT FROM WHERE I SAT IN THE AUDIENCE, LISTENING AND MARVELING AT WHAT THEY WERE ABLE TO DO. I DON’T REMEMBER EVER MAKING A CONSCIOUS DECISION THAT I COULD ACTUALLY DO THAT. Dr. Peggy Gleeson, being recognized for her service as outgoing President of the Education Section by Dr. Lisa Saladin, APTA Board Member during APTA CSM in Las Vegas, February 2014

Inside This Issue PRESIDENT’S MESSAGE

2

EXECUTIVE DIRECTOR’S NOTEBOOK

3

SHOES FOR KIDS 3 MEMBERSHIP MATTERS

4

CCAP CORNER

5

MOTIONS

11

DISTRICT NEWS

13

RESEARCH CORNER

14

Well…this May will mark the end of my second (and final) term as President of the Education Section of the APTA. In total, I will have spent 12 years in various leadership roles within the Section (Academic Co-Chair of the Clinical Education Special Interest Group, Vice President and President). How did this incredible journey begin? Well… a funny thing happens when you keep showing up, sharing your ideas, and engaging in discussions. You begin to see possibilities—not big ones, but small, incremental ones. You meet folks who ask you to serve on a committee and you say yes. Then you meet more folks and someone suggests your name to join a task force and you say yes. Strangers on pedestals become colleagues that you can actually sit and have a conversation with. You keep in touch in between conferences; you ask for guidance, information, mentorship—and someone gives it. Before long you realize that some of those “big name people” actually remember YOUR name—and they may ask YOU for information. The one way path becomes a two way street, and before

long that two way street is more like the Houston freeway system, networking you to more and more interesting possibilities and other roads to professional development. N E W S L E T T E R O F T H E We ask our patients to Move Forward. How about you? Are you ready to Move Forward as well? It might just be the right time to “lean in” to our profession, to help move it forward! Take the first small step. Go to the Volunteer website and complete the Volunteer Interest Profile. Let others know that you want to participate. Volunteer for a committee or task force; run for office; voice your thoughts and opinions; be present. Stay tuned, stay informed and stay engaged. The rewards are truly amazing.

History Project Do you have pictures and memories on how things were when the Texas Chapter and its Districts were forming? How about the early days of writing our Physical Therapy Bill? The Texas Chapter is anxious to save its history. The Historical Committee is gathering vignettes of personal remembrances of the trips to Austin, the Bill, early Chapter meetings, funny times, sad times. Please share them with the Chapter. We will compile them and make them available to the members and to our leaders for mining ideas that could inspire us now. Send your remembrances to: Joan Firra at joanfirra31@gmail.com


. . . . . . . . . . . . .

.

.

. . . . . . . .

.

.

. . . .......... . . . . .. . . ..... . . . . . . . . . . .... . . . . . . . .. .. . . . . . ... . ... . . ... .

.

. .

. ..

.. .

. . . . . . . . . . . .

. . . .......... . . . . . ... . . ............ . . . . . . . . . . . . . . . . . . . .. . . . . . . .

. ..

.

......... . . . . .. . . . .. .... . . . . . .. . . . .. . . . . . . . . .. .. . . . . .. . . .

..

.

. . ......... . . . . ........ . . . . . . . . . . .. . . . . . . .. . . . . . . . ... . . . .. .. . . .

.

.

.

. . . . . . . . . .

Volume 69, Number 1 A publication of the Texas Physical Therapy Association www.tpta.org PUBLISHE R Texas Physical Therapy Association E DITO R Paul Hardin

Board Of Directors PRESIDENT

Cynthia Fisher, El Paso (cfi408@aol.com)

PRESIDENT-ELECT

Michael Connors, Fort Worth (michael.connors@att.net)

VICE PRESIDENT

Brant Capps, Amarillo (bcappspt@sbcglobal.net)

SPEAKER OF THE ASSEMBLY

Denise Gobert, Austin (d.gobert@alumni.utexas.net)

SECRETARY

Venita Lovelace-Chandler, Garland

(venita.lovelace-chandler@unthsc.edu) TREASURER

Lisa Kearns, Grapevine (lakearns@verizon.net)

TREASURER-ELECT

Lynne Hughes, San Antonio (lchpt@yahoo.com)

CAPITAL AREA DISTRICT CHAIR

Allan Besselink, Austin (cad.apta@gmail.com)

CENTRAL DISTRICT CHAIR

Barry Jackson, Cibolo (baj1963@yahoo.com)

COASTAL BEND DISTRICT CHAIR

Jan Spigner, Corpus Christi (jspigner@delmar.edu)

EAST TEXAS DISTRICT CHAIR

Carla Gleaton, Lone Star (cgleaton@kilgore.edu)

GREATER EL PASO DISTRICT CHAIR

Bryan Boyea, El Paso (bryanpt1@hotmail.com)

HEART OF TEXAS DISTRICT CHAIRS

Kristi Trammell, Clifton (trammell.kristi@gmail.com)

MIDWEST DISTRICT CHAIR

Kimberly Mayes, Tuscola (kimmer45@hotmail.com)

NORTH TEXAS DISTRICT CHAIR

Jeanie Parsley, Dallas (jdparsley@verizon.net)

PANHANDLE DISTRICT CHAIR

Lois Stickley, Amarillo (lois.stickley@ttuhsc.edu)

PERMIAN BASIN DISTRICT CHAIR

vacant

TPTA does not endorse the products nor services of any of its advertisers or exhibitors.

SOUTHEASTERN DISTRICT CHAIR

Collete Pientok, Houston (cpientok@gmail.com)

SOUTH PLAINS DISTRICT CHAIR

Patti Kissko, Lubbock (patricia.kissko@va.gov)

SYNERGY ADVERTISING RATES A 10% discount is available with prepaid advertising commitment of two to three issues; 15% discount for prepaid commitment of four issues.

EXECUTIVE COMMITTEE REP

Lois Stickley, Amarillo (lois.stickley@ttuhsc.edu)

CHIEF DELEGATE

Michael Geelhoed, San Antonio (geelhoed@uthscsa.edu)

PTA CAUCUS REPRESENTATIVE

Nicole Volek, Richmond (nicole@volek.us)

EDITO R IAL STA FF Tiffany Downey For more information, email Tiffany Downey or call (512) 477-1818. Synergy is digitally published quarterly by the Texas Physical Therapy Association, Inc., a chapter of the American Physical Therapy Association, 900 Congress Avenue, Suite 410, Austin, TX 78701, (512) 477-1818. Subscriptions at $30 per year are included in the Texas Chapter membership dues. Yearly subscriptions for APTA members are $50 and for non-APTA members are $115.

DISPLAY ADS All display ads must be camera-ready. Prepayment and a signed contract are required. (All dimensions are width x height) • $175 for 1/12 Page Ad (2 1/4” x 2 5/16”) • $259 for 1/6 Page Ad (2 1/4” x 4 5/8”) • $391 for 1/3 Page Ad (2 1/4” x 9 1/2” or 4 3/4” x 4 5/8”) • $563 for 1/2 Page Ad (7 1/4” x 4 5/8”) • $777 for 2/3 Page Ad (4 3/4” x 9 1/2”) • $995 for Full Page Ad (7 1/4” x 9 1/2”) To receive a contract or for details on advertising opportunities and deadlines, contact Tiffany Downey at the TPTA chapter office; e-mail tiffany@tpta.org or phone (512) 477-1818. Synergy is a quarterly digital publication.

Staff Liaisons For information in the areas listed below, contact the appropriate person via e-mail or by calling the TPTA chapter office at (512) 477-1818. Paul Hardin Executive Director (paul@tpta.org)

Government Affairs; Political Action Committee; Ethics and Practice Committees; Administration

Jenifer Leans Director, Meetings and Education (jeni@tpta.org)

Professional Development; Special Projects; Conferences & Expositions; APTA House of Delegates; Bylaws Committee

Nancy Rennaker Bookkeeper (nancy@tpta.org)

Finance/Accounting

Tiffany Downey Manager, Membership and Communications (tiffany@tpta.org)

Membership; PTA, Private Practice and Student Special Interest Groups; Advertising

Stacey Mather Continuing Competence Approval Program; Nominating Director, Payer Relations Committee; Payer Relations and Payment Committee and Payment Policy CCAP Administrator (stacey@tpta.org) Amber Townsley CCAP Administrator (amber@tpta.org)

Continuing Competence Approval Program


PRESIDENT’S MESSAGE

President’s Message By Cynthia Fisher, PT, DPT, MS, PCS TPTA President

IT IS ALWAYS INVIGORATING TO ATTEND APTA CSM MEETING. THERE WERE OVER 11,000 REGISTRANTS THIS YEAR. IT IS AMAZING TO ATTEND THE EDUCATIONAL PROGRAMMING, AND RESEARCH PLATFORMS FOR EACH SPECIALTY SECTION AND TO SEE WHAT EVERYONE ACROSS THE COUNTRY IS DOING. THERE IS SO MUCH INFORMATION THAT IT IS OVERWHELMING. It is also a great opportunity for networking and catching up with friends who you haven’t seen since last CSM. There is so much work being accomplished for Physical Therapy in each section. New innovative approaches to treatment were presented. National legislative issues were discussed. Updates on payment policy and reimbursements were given. The new CEO for APTA was introduced. What hit home to me is that Physical Therapy is a vibrant changing profession and that there are no limits as to what we can accomplish for our profession. We are limited only by our imagination and creativity. So it made me think. Whose responsibility is it to ensure that physical therapy continues to be a vibrant evolving profession. Is it the TPTA? The faculty at PT and PTA programs? Your supervisor? Your colleagues? NO, it is each and every one of our responsibility. Each of us represents physical therapy. What we do, how we present ourselves both at work and in the community, how we practice affects how physical therapy is viewed.

It is each of our responsibility to keep ourselves up on current practices so that we can give the best evidence based care to our patients. We are currently 10 months away from our next legislative session. We will be introducing legislation again on patient access to physical therapy. Even though we have worked hard to represent physical therapy concerns to our legislators, we have not been successful in establishing our grassroots effort and have not established a key contact for each and every legislator in the House and Senate. This needs to be done so that our concerns and issues are familiar to every legislator. Your TPTA officers, Government Affairs Committee and BOD cannot do this alone. Our Government Affairs Committee is spearheading an effort to connect each Texas legislator with a PT, PTA and /or a student who would be willing to meet with their legislator to talk about our issues. Step up to the plate and help. Don’t wait for someone else to do it. Healthcare is in a very challenging and difficult time. We can’t depend on it getting better so we all need to pay attention to what’s affecting our profession in order to better protect and support it. We are all busy with our jobs and our lives but without our continued efforts our practices may be affected. Can we prove that what we do does make a difference and that our interventions can assist with cost containment? Our Payment Policy Committee is intervening on our behalf with Texas Medicaid as they are writing new rules that may affect reimbursement. So many volunteers working on our behalf to protect Physical Therapy practice. Many more volunteers are needed to carry on the work.

What will be your role? Is physical therapy just a job or is it your profession? How will you help ensure that our profession continues? I can say that after 40 years of practice that it was not ever just a job but has always been my profession. What will it be for you?v

.

..

. ..

.

..

..

..

......... .... ... . . . . . . . . .. . . . . .. ... . . . . . . . . . . . . . . . .. . . . . . . .

.......... . .. . . . . . . . . . . .. . . . . . . . . . . . .. . . . . . . . .. .. .. ... . . . . . . . .

.......... ... .. . . . .. ..... .. . . .. . . . . . . . . . . .. ... . . .. . . . . .. . . . . .

.

........... ... .. . .. ... .... .. . . . .. . . . . . . . . . . . . . ... . . .. .. .. . . . . . .

spring 2014

32


EXECUTIVE DIRECTOR’S NOTEBOOK

What’s the Difference Between You and a Nurse Practitioner? By Paul Hardin, CAE Executive Director

I ASK THIS QUESTION IN THE LEGISLATIVE REALM, NOT PRACTICE ABILITY AND SKILLSET. YOUR GOVERNMENT AFFAIRS COMMITTEE HAS TAKEN A HARD LOOK AT EXACTLY WHAT HAS MADE OTHER GROUPS SUCCESSFUL IN THE LEGISLATIVE ARENAS. While we looked at numerous groups, we focused on one: Advanced Nurse Practitioners. Why? Because they were able to successfully pass legislation last session that was strongly opposed by the physician lobby group. Throughout the review of other groups, several questions were asked. Did they have a buzillion dollar PAC? No, but they did have healthy PACS, typically at least double our size. Did they have 50,000 members? No, and many were about our size. Did they have dirty pictures of legislators? No, not that anyone would admit to. So what is it? What is the silver bullet? The one common

thread that those successful groups had is a strong Key Contact Program. Basically, their members get that they must have a relationship with their legislators for the common good of their organization. Don’t get me wrong, we have some VERY passionate members with great relationships with their legislators; however, the majority of our membership does not see the importance of that relationship.

I’m talking close enough to have that Senator or Representative’s cell phone number. Yes, that close. That is what it is going to take. That is what has made other groups successful in the legislature. TPTA GAC member Jennifer Kish has agreed to chair the Key Contact Program subgroup under the GAC. She and her group will be working hard to provide you with the appropriate

materials/collateral/training/videos to better arm and educate you about the KCP. We are going to provide any and all tools, but it really comes down to you taking the first step and meeting with your legislators. Many are in their district offices currently, so the timing is right. We cannot wait until session starts. Not even sure who your state legislators are? Just visit “who represents me,” enter your address, and there you go. Make that call to them today and start that relationship. Your profession thanks you. As always, if I or any of the staff may be of assistance in any way, please contact me at 512-477-1818, or paul@tpta.org.v

Shoes for Kids North Carolina, home of Tar Heels and Blue Devils, is a state with more than just collegiate basketball rivalries. North Carolina, sadly, also has more than 603,000 under-served children. In 2012, there were over 49,000 children who live in poverty in Charlotte, NC. APTA and Shoes4Kids has been working diligently to keep the issue of under-served kids and their health a top priority during annual conference. Your participation last year helped put shoes on over 1200 under-served, under-privileged kids in Salt Lake City, UT. Today, I ask that we share our strength by making sure kids in Charlotte have a clean pair of socks and a well fit and comfortable pair of athletic shoes. Together, we can expand our reach and touch more kids. For more information, contact Brad Thuringer, PTA, at 800.657.4344 Ext 325 or brad.thuringer@lakeareatech.edu.

. . . . .. . . . . .. .. .. . . . . . .. . .. . . . .. . . ........ . . .. . . . . . . . .... . . .... . ... . . .... . . . . . . .. ..... . .. . . . . . .... .... ... . . . . . . . . .. .

.

.. .

. .. . .

.

.

..

......... .... ... . . . . . . . . .. . . . . .. ... . . . . . . . .. ....... .. . ..... .. ...... . . . . ......... . . . . . . . . . . . . .. .. ... . . . . . . . . . . . . . . . .. . . . .

.. ..

.......... ... .. . . . .. ..... .. . . . . . . ..... .. .... . . . . . . . . . . ....... .. . . ... . ...... . . . . .. . . . . . . . .. ... . . . . . . . . . . .. ... . . .. . . . . .. . . . . .

.. ..

.

.

. . . . .. .. . . . .. .. .. .. . . . . ... ... . . ... . . .............. . ..... . . . . . . .... . .. .. . . . . .. .. .. .. .. .... . . . . . ... . . . . . . .. . ..... . . . . . . .. .

43

spring 2014


M E M B E R S H I P M AT T E R S LLeOis ! HEnam My

REACH 100 and Facility Challenge Update PHYSICAL THERAPY SCHOOLS* Hardin-Simmons University Texas State University - San Marcos Texas Woman’s University - Dallas Texas Woman’s University - Houston University of the Incarnate Word University of North Texas University of St. Augustine - Austin University of Texas - El Paso

PHYSICAL THERAPIST ASSISTANT SCHOOLS* Blinn College Del Mar College El Paso Community College Kilgore College South Texas Community College Western Technical College

University of Texas Southwestern Medical Center - Dallas The programs listed acheived 100% student and faculty membership prior to the publication of this newsletter. If your school is not listed and has reached 100% student and faculty membership for the current year please contact Tiffany Downey at tiffany@tpta.org.

FACILITIES**

Austin HealthWorks Austin, TX Baylor College of Medicine - Neuromuscular Disease Center Houston, TX Baylor Institute for Rehab - McKinney McKinney, TX Blinn College Physical Therapist Assistant Program Bryan, TX Concentra Medical Center (Fossil Creek) Fort Worth, TX East Texas Physical Therapy Sulphur Springs, TX El Paso Community College Physical Therapy Assistant Program El Paso, TX El Paso Physical Therapy El Paso, TX El Paso Physical Therapy Services - Horizon Valley El Paso, TX El Paso Physical Therapy Services - West El Paso, TX Hardin-Simmons University, Department of PT Abilene, TX Hunter Professional Therapy Arlington, TX Kilgore College Kilgore, TX Meehan Sports Therapy & Pediatrics Southlake, TX Pate Rehabilitation - Dallas Dallas, TX Pima Medical Institute Houston, TX

Riata Therapy Specialists, PLLC Bedford, TX Scott & White Rock Prairie Sports Medicine & Rehab Scott and White Clinic - Boonville Bryan, TX Spine & Rehab Specialists - Edgemere El Paso, TX Texas Physical Therapy Specialists Austin, TX Texas State University Department of Physical Therapy San Marcos, TX Texas Tech University Health Sciences Center Department of Rehabilitation Services Lubbock, TX TheraSpecialists Jasper, TX TX Physical Therapy Specialist - Bulverde/Spring Branch Spring Branch, TX University of Texas at El Paso Physical Therapy Program El Paso, TX University of Texas Health Science Center at San Antonio San Antonio, TX UT Southwestern Medical Center Dallas, TX US Army-Baylor University Postprofessional Doctoral Fellowship in Orthopaedic Manual Physical Therapy Fort Sam Houston, TX US Army-Baylor University Doctoral Program Fort Sam Houston, TX UTMB/SHP/PT Department Galveston, TX

**The facilities listed acheived 100% membership prior to the publication of this newsletter. If your facility is not listed and has reached 100% membership for the current year please register here. .

..

. ..

.

..

..

..

......... .... ... . . . . . . . . .. . . . . .. ... . . . . . . . . . . . . . . . .. . . . . . . .

.......... . .. . . . . . . . . . . .. . . . . . . . . . . . .. . . . . . . . .. .. .. ... . . . . . . . .

.......... ... .. . . . .. ..... .. . . .. . . . . . . . . . . .. ... . . .. . . . . .. . . . . .

.

........... ... .. . .. ... .... .. . . . .. . . . . . . . . . . . . . ... . . .. .. .. . . . . . .

spring 2014

54


CCAP CORNER

Changes to TBPTE Rule 341.3 Expand Qualifying Continuing Competence (CC) Activities Summary of Changes to the Activities listed in §341.3, Qualifying Continuing Competence Activities Engagement Activities Awarded CCUs The major focus of the revision to the CC rules is to acknowledge that engagement in profession-related activities help practitioners stay competent in their field. Beginning with license renewals that are completed AFTER February 28, 2014, licensees will be given CC credit for a number of membership and service activities, such as membership in APTA/TPTA, serving on specific regulatory or professional boards, volunteering as an item writer for the national exam, and service as a Clinical Instructor. For a complete list of professional membership or service activities that will be recognized, and the documentation required as proof for each activity, please see the rule.

More Activities Pre-approved Additionally, more activity categories have pre-approved status, so that licensees will not have to submit them to TPTA for individual approval. Along with Residencies, Fellowships, Examinations, and Practice Review Tools, the following types of activities will be assigned a standard approval number by TPTA that can be used by all licensees:

1. College or university courses that are part of a post-professional physical therapy degree program, or are part of a CAPTEaccredited program bridging from PTA to PT.

2. Service as a clinical instructor (CI) for full-time, entry-level PT or PTA students enrolled in accredited education. 3. First-time development or coordination of course(s) in a CAPTE-accredited PT or PTA program, or a post-professional physical therapy degree program, or a CAPTE-accredited program bridging from PTA to PT.

4. Presentation or instruction as a guest lecturer in a CAPTE-accredited PT or PTA program, or a post-professional physical therapy degree program, or a CAPTE-accredited program bridging from PTA to PT.

5. Supervision or mentorship of a resident or fellow in an APTA credentialed residency or fellowship program. 6. APTA Certification for Advanced Proficiency for the PTA. Terminology Changes The names of several activity categories have been changed to reflect the inclusion of new types of activities. For example, “Self-directed Study” is now “Scholarship” and includes manuscript submissions, grant reviews, and other new scholarly activities. What was previously called “Home Study” is now “Self-Study” and is defined more clearly.

Other Changes Some pre-existing activities have new credit calculations. For example, CCUs for Teaching and Presentation, as well as related activities, are now based on student contact hours. Other changes to pre-existing activities include documentation required; licensees are advised to carefully check the amended rules to make sure they are collecting the correct information to use for renewal of their license.

.

..

. ..

.

..

..

..

......... .... ... . . . . . . . . .. . . . . .. ... . . . . . . . . . . . . . . . .. . . . . . . .

.......... . .. . . . . . . . . . . .. . . . . . . . . . . . .. . . . . . . . .. .. .. ... . . . . . . . .

.......... ... .. . . . .. ..... .. . . .. . . . . . . . . . . .. ... . . .. . . . . .. . . . . .

.

........... ... .. . .. ... .... .. . . . .. . . . . . . . . . . . . . ... . . .. .. .. . . . . . .

65

spring 2014


CCAP CORNER

Breakdown of Qualifying CC by Category and Activity CE Programs: Live programs (on-site/webinars)

Self-study programs (paper/web-based)

# CCUs Granted

1 contact hour = 1 CCU

# CCUs Granted

1 contact hour = 1 CCU

Requires CCAP Approval?

Yes - Form 1 (sponsor) or 2 (individual) Varies; Course # + TX OR Provider # + TX No maximum

Requires CCAP Approval?

Yes - Form 1 (sponsor) or 2 (individual) Varies; Course # + TX OR Provider # + TX No maximum

CCAP Approval # Max Towards Renewal? TBPTE Audit Info Required

Certificate with # CCUs, license #, CCAP approval #

CCAP Approval # Max Towards Renewal? TBPTE Audit Info Required

Certificate with # CCUs, license #, CCAP approval #

In-service-type programs

Large conferences with concurrent programming

# CCUs Granted

1 contact hour = 1 CCU

# CCUs Granted

1 contact hour = 1 CCU

Requires CCAP Approval?

Yes - Form 1 (sponsor) or 2 (individual) Varies; Course # + TX OR Provider # + TX No maximum

Requires CCAP Approval?

Yes - Form 1 (sponsor) or 2 (individual) Varies; Course # + TX OR Provider # + TX No maximum

CCAP Approval # Max Towards Renewal? TBPTE Audit Info Required

Certificate with # CCUs, license #, CCAP approval #

CCAP Approval # Max Towards Renewal? TBPTE Audit Info Required

Certificate with # CCUs, license #, CCAP approval #

College/University Programs: Grade C or higher; pass/fail courses do not qualify. Requests for ethics credit for post-professional PT/PTA bridge courses need to be submitted for credit.

Varies; Individual approval # + TX No maximum CCAP approval letter

.......... . .. . . . . . . . . . . .. . . . . . . . . . . . .. . . . . . . . .. .. .. ... . . . . . . . .

..

.

..

..

.......... ... .. . . . .. ..... .. . . .. . . . . . . . . . . .. ... . . .. . . . . .. . . . . .

.

spring 2014

. ..

Official sealed transcript; CCAP course-type approval # from TPTA website

Requires CCAP Approval? CCAP Approval # Max Towards Renewal? TBPTE Audit Info Required

1 semester credit hour = 10 CCUs Yes - Form 3

......... .... ... . . . . . . . . .. . . . . .. ... . . . . . . . . . . . . . . . .. . . . . . . .

90001TX No maximum

# CCUs Granted

.

Requires CCAP Approval? CCAP Approval # Max Towards Renewal? TBPTE Audit Info Required

1 semester credit hour = 10 CCUs NO

..

# CCUs Granted

Non-post-professional PT/PTA bridge courses OR ethics post-professional PT/ PTA bridge courses

........... ... .. . .. ... .... .. . . . .. . . . . . . . . . . . . . ... . . .. .. .. . . . . . .

Post-professional PT/PTA bridge courses (non-ethics)

76


CCAP CORNER

Breakdown of Qualifying CC by Category and Activity (cont.) Scholarship: Publications # CCUs Granted

Requires CCAP Approval? CCAP Approval # Max Towards Renewal? TBPTE Audit Info Required

Newpaper article = 3 CCUs Regional/national magazine article = 10 CCUs Peer-reviewed journal case study OR Peer-reviewed book chapter = 20 CCUs Peer-reviewed journal research article OR Book = 30 CCUs Yes - Form 4 Varies; Individual approval # + TX No maximum CCAP approval letter

Manuscript review

Grant review

# CCUs Granted

1 manuscript reviewed = 3 CCUs

# CCUs Granted

1 grant reviewed = 3 CCUs

Requires CCAP Approval?

Yes - Please contact the TPTA office for more information and submission process. Varies PTs - 9 CCUs PTAs - 6 CCUs CCAP approval letter

Requires CCAP Approval?

Yes - Please contact the TPTA office for more information and submission process. Varies PTs/PTAs - 6 CCUs

CCAP Approval # Max Towards Renewal? TBPTE Audit Info Required

Grant submission - Must be the sole or coprimary investigator to qualify. # CCUs Granted 1 grant submission = 10 CCUs Requires CCAP Approval? CCAP Approval # Max Towards Renewal? TBPTE Audit Info Required

.

..

. ..

.

..

..

..

......... .... ... . . . . . . . . .. . . . . .. ... . . . . . . . . . . . . . . . .. . . . . . . .

.......... . .. . . . . . . . . . . .. . . . . . . . . . . . .. . . . . . . . .. .. .. ... . . . . . . . .

.......... ... .. . . . .. ..... .. . . .. . . . . . . . . . . .. ... . . .. . . . . .. . . . . .

.

........... ... .. . .. ... .... .. . . . .. . . . . . . . . . . . . . ... . . .. .. .. . . . . . .

87

spring 2014

Yes - Please contact the TPTA office for more information and submission process. Varies; Individual approval # + TX PTs/PTAs - 10 CCUs CCAP approval letter

CCAP Approval # Max Towards Renewal? TBPTE Audit Info Required

CCAP approval letter


CCAP CORNER

Breakdown of Qualifying CC by Category and Activity (cont.) Teaching/Presentation: PT/PTA program course development

PT/PTA program presentation - Must be an

# CCUs Granted

1 student contact hour = 4 CCUs

Requires CCAP Approval? CCAP Approval #

NO

adjunct faculty member or guest lecturer to qualify. # CCUs Granted 1 student contact hour = 2 CCUs

Max Towards Renewal? TBPTE Audit Info Required

PTs - 10 CCUs PTAs - 8 CCUs Course syllabus indicating the licensee as course presenter or instructor; CCAP course-type approval # from TPTA website

90002TX

Non-PT/PTA accredited college program presentation - Applies to programs for other health professionals. # CCUs Granted 1 student contact hour = 2 CCUs Requires CCAP Approval? CCAP Approval #

Yes - Form 7 CCAP

Max Towards Renewal? TBPTE Audit Info Required

PTs - 10 CCUs PTAs - 8 CCUs CCAP approval letter

Varies; Individual approval # + TX

Requires CCAP Approval? CCAP Approval # Max Towards Renewal? TBPTE Audit Info Required

NO 90003TX PTs - 10 CCUs PTAs - 8 CCUs Course syllabus indicating the licensee as course presenter or instructor; check with TBPTE for additional required information

Other course development, presentation, or co-presentation - Applies to courses offered at a state, national or international workshop, seminar, or professional conference, or at a board-approved continuing education course. # CCUs Granted 1 contact hour = 4 CCUs Requires CCAP Approval? CCAP Approval # Max Towards Renewal? TBPTE Audit Info Required

Yes - Form 7 Varies; Individual approval # + TX PTs - 10 CCUs PTAs - 8 CCUs CCAP approval letter

Clinical instructor

PTs - 10 CCUs PTAs - 8 CCUs CCAP course-type approval # from TPTA website; check with TBPTE for additional required information

.

.

. ..

..

..

..

......... .... ... . . . . . . . . .. . . . . .. ... . . . . . . . . . . . . . . . .. . . . . . . .

.......... . .. . . . . . . . . . . .. . . . . . . . . . . . .. . . . . . . . .. .. .. ... . . . . . . . .

.......... ... .. . . . .. ..... .. . . .. . . . . . . . . . . .. ... . . .. . . . . .. . . . . .

spring 2014

.

Max Towards Renewal? TBPTE Audit Info Required

90004TX

..

Requires CCAP Approval? CCAP Approval #

6-11 week supervision of full-time PT/PTA student= 5 CCUs 12+ week supervision of full-time PT/PTA student = 10 CCUs NO

........... ... .. . .. ... .... .. . . . .. . . . . . . . . . . . . . ... . . .. .. .. . . . . . .

# CCUs Granted

98


CCAP CORNER

Breakdown of Qualifying CC by Category and Activity (cont.) Advanced Training/Certification/Recognition Specialty examination - Examination must be from the list of TBPTE-pre-approved specializations (available here). # CCUs Granted Successful completion = 30 CCUs Requires CCAP Approval? CCAP Approval #

NO

Max Towards Renewal? TBPTE Audit Info Required

No maximum

90005TX

CCAP course-type approval # from TPTA website; Documentation of successful completion from certifying organization

Residency or fellowship - Residency/fellowship must be APTA-credentialed to qualify. # CCUs Granted Successful completion = 30 CCUs Requires CCAP Approval? CCAP Approval #

NO

Max Towards Renewal? TBPTE Audit Info Required

No maximum

90007TX

CCAP course-type approval # from TPTA website; Documentation of successful completion from certifying organization

FSBPT Practice Review Tool # CCUs Granted

Completion = 15 CCU

Requires CCAP Approval? CCAP Approval #

NO

Max Towards Renewal? TBPTE Audit Info Required

No maximum

.

..

. ..

.

..

..

..

......... .... ... . . . . . . . . .. . . . . .. ... . . . . . . . . . . . . . . . .. . . . . . . .

.......... . .. . . . . . . . . . . .. . . . . . . . . . . . .. . . . . . . . .. .. .. ... . . . . . . . .

.......... ... .. . . . .. ..... .. . . .. . . . . . . . . . . .. ... . . .. . . . . .. . . . . .

.

........... ... .. . .. ... .... .. . . . .. . . . . . . . . . . . . . ... . . .. .. .. . . . . . .

10 9

90009TX

CCAP course-type approval # from TPTA website; Documentation of completion from FSBPT

spring 2014

APTA Certification for Advanced Proficiency for the PTA exam # CCUs Granted

Successful completion = 20 CCUs

Requires CCAP Approval? CCAP Approval # Max Towards Renewal? TBPTE Audit Info Required

NO 90006TX No maximum CCAP course-type approval # from TPTA website; Documentation of successful completion from APTA

Supervision of a resident/fellow - Residency/fellowship must be APTA-credentialed to qualify. # CCUs Granted Successful completion = 20 CCUs Requires CCAP Approval? CCAP Approval # Max Towards Renewal? TBPTE Audit Info Required

NO 90008TX PTs/PTAs - 20 CCUs CCAP course-type approval # from TPTA website; Documentation of supervision from certifying organization


CCAP CORNER

Breakdown of Qualifying CC by Category and Activity (cont.) Membership/Service - CATEGORY LIMIT: This category has a limit to the number of CCUs a licensee may apply to their license renewal. PTs are limited to 15 CCUs from this category; PTAs are limited to 10 CCUs. Please note that the activities may also include limits. APTA membership # CCUs Granted

1-year membership = 1 CCU

Requires CCAP Approval? CCAP Approval #

NO

Max Towards Renewal? TBPTE Audit Info Required

PTs/PTAs - 2 CCUs (SEE CATEGORY MAX) CCAP course-type approval # from TPTA website; Documentation of membership from APTA

91010TX

Board/committee/task force service for APTA & components or FSBPT or TBPTE # CCUs Granted

1-year service = 3 CCUs

Requires CCAP Approval? CCAP Approval # Max Towards Renewal?

NO

TBPTE Audit Info Required

CCAP reviewer

91011TX PTs - 9 CCUs PTAs - 6 CCUs (SEE CATEGORY MAX) CCAP course-type approval # from TPTA website; Documentation of service from organization

# CCUs Granted

1-year service = 3 CCUs

NPTE item-writer

Requires CCAP Approval? CCAP Approval #

NO

# CCUs Granted

1-year service = 5 CCUs NO

Max Towards Renewal? TBPTE Audit Info Required

PTs/PTAs - 6 CCUs (SEE CATEGORY MAX) CCAP course-type approval # from TPTA website; Documentation of service from organization

Requires CCAP Approval? CCAP Approval # Max Towards Renewal? TBPTE Audit Info Required

91012TX

91013TX PTs/PTAs - 10 CCUs (SEE CATEGORY MAX) CCAP course-type approval # from TPTA website; Documentation of service from organization

For more information regarding the CCAP program or to download CCAP application forms, visit the TPTA website. Please refer to TBPTE Rule 341.3 for more information regarding recent rule changes.

.

..

. ..

.

..

..

..

......... .... ... . . . . . . . . .. . . . . .. ... . . . . . . . . . . . . . . . .. . . . . . . .

.......... . .. . . . . . . . . . . .. . . . . . . . . . . . .. . . . . . . . .. .. .. ... . . . . . . . .

.......... ... .. . . . .. ..... .. . . .. . . . . . . . . . . .. ... . . .. . . . . .. . . . . .

.

........... ... .. . .. ... .... .. . . . .. . . . . . . . . . . . . . ... . . .. .. .. . . . . . .

spring 2014

10 11


MOTIONS

Motions Passed By the Board of Directors BOD 01-25-14:1 The TPTA Executive Committee moves that the following be adopted: Standards of Conduct in Social Media/ Electronic Networking 1) STANDARDS OF CONDUCT IN THE USE OF SOCIAL MEDIA/ELECTRONIC NETWORKING POSITION STATEMENT: The TPTA acknowledges the rights of members to use Internet-based and other electronic forms of communication such as social networking sites and personal websites and blogs as a medium of selfexpression. Examples of social networking sites include but are not limited to: Facebook, Twitter, MySpace,Instagram, LinkedIn, blogs, and include postings in textual, photographic, and videography formats. This policy serves to provide TPTA members with guidance for participation in social networking tools and media in which a member’s TPTA affiliation and/or professional occupation is known, identified or presumed. Members are encouraged to think carefully about what they post and whether it reflects a professional demeanor, and members should assume that electronic communication may be circulated to others. Social Media Policy: Social media creates opportunities to communicate in a public forum. Physical therapists (PT), physical therapist assistants (PTA), and physical therapy students (students) must be knowledgeable and respectful of the principles of patient/client privacy and confidentiality in safeguarding identifiable patient/client information as it relates to social media. PTs, PTAs, and students who use social media should represent their own views and be professional and accurate in their communications. Errors and omissions in communication, harassing statements, and unprofessional language presented via social media may have a long-lasting and possibly negative impact on the individual or the physical therapy profession. PTs, PTAs, and students shall consider when and how to separate their personal and professional .

..

. ..

.

..

..

..

......... .... ... . . . . . . . . .. . . . . .. ... . . . . . . . . . . . . . . . .. . . . . . . .

.......... . .. . . . . . . . . . . .. . . . . . . . . . . . .. . . . . . . . .. .. .. ... . . . . . . . .

.......... ... .. . . . .. ..... .. . . .. . . . . . . . . . . .. ... . . .. . . . . .. . . . . .

.

........... ... .. . .. ... .... .. . . . .. . . . . . . . . . . . . . ... . . .. .. .. . . . . . .

11 12

spring 2014

lives on social media. PTs, PTAs, and students should be knowledgeable about employers’, educational institutions’, or clinical training sites’ published policies on social media. PTs, PTAs, and students engaging in social media activities shall demonstrate appropriate conduct in accordance with the Code of Ethics for the Physical Therapist and Standards of Ethical Conduct for the Physical Therapist Assistant. Therefore, Physical therapists (PTs), physical therapist assistants (PTAs) and physical therapy students (students) shall consider whether to interact with patients on social media or create separate personal and professional social media profiles. PTs, PTAs, and students shall not misrepresent when they are speaking for themselves or the Texas Physical Therapy Association (TPTA), other organizations, educational institutions, clinical sites, or employers; and if an individual identifies content posted to social media by a colleague that appears unprofessional, s/he has a responsibility to bring that to the attention of the individual that has posted the content so that s/he can remove it or take other appropriate action. Members may not use the name, logo, or otherwise protected material of the TPTA in social networking and electronic formats without the permission of the TPTA. Disciplinary Action: These social networking guidelines are subject to all existing association policies which govern the rights and privileges of membership. A. Complaints While each member is expected to uphold this policy, complaints to the effect that a member has violated this policy or the Code of Ethics for the Physical Therapist and Standards of Ethical Conduct for the Physical Therapist Assistant shall be processed in accordance with the APTA’s Procedural Document on Disciplinary Action. If the TPTA finds that a member’s conduct in regards to social networking / electronic media violates this policy, the member may be subject to disciplinary measures. If necessary, the TPTA will advise appropriate authorities of any illegal actions.

B. Suspension Any member of the TPTA who is suspended by the APTA shall have their membership privileges suspended from the APTA and the TPTA. Likewise, any member who is expelled from membership in the APTA shall also be expelled from TPTA membership. Appropriate conduct in the use of social media as the professional team. Currently, there are no TPTA guidelines available for direction on use of social media or electronic networking. TPTA members are required to maintain patient privacy by following APTA’s Code of Ethics for the Physical Therapist and Standards of Ethical Conduct for the Physical Therapist Assistant, the state practice act and rules, and HIPAA rules at all time, including social media. BOD 01-25-14:2 The TPTA Executive Committee moves that the following be adopted: COMMITTEE CHAIR TERMS OF OFFICE The TPTA recognizes the following Standing Committees: A) Bylaws B) Ethics C) Finance D) Nominating and the following Other Committees: E) Governmental Affairs F) Membership G) Payment Policy H) Practice I) Professional Development J) Public Relations In order to clarify and standardize the process for appointing committee chair(s) and establish the term of service and number of consecutive terms one can serve as a committee chair, the executive committee moves the following terms of service be adopted: A) Bylaws Appointment: Appointed by BOD Term of service: 3 years Consecutive Terms: 2


MOTIONS

Motions Passed By the Board of Directors

H) Practice Appointment: Appointed by BOD Term of service: 3 years Consecutive Terms: 2 I) Professional Development Appointment: Appointed by BOD Term of service: 3 years Consecutive Terms: 2 J) Public Relations Appointment: Appointed by BOD Term of service: 3 years Consecutive Terms: 2 BOD 01-25-14:3 The TPTA Executive Committee moves that the following be adopted: COMMITTEE MEMBERSHIP TERMS OF OFFICE The TPTA recognizes the following Standing Committees:

B) Ethics Appointment: Appointed by BOD Number of Members: Minimum of 3 Term of service: 3 years Consecutive Terms: Unlimited

BOD 01-25-14:4 I move that the 2014 Budget be amended as below. to include budgets for the CAD, CD and HOTD which were not included in the 2014 Budget approved in October.

C) Finance Appointment: Appointed by BOD Number of Members: Minimum of 4 Term of service: 3 years Consecutive Terms: Unlimited

BOD 01-25-14:5 Executive Committee moves that Robert Sandoval be appointed as Ethics Committee Chair for a 3 year term.

D) Nominating Appointment: Elected by Membership Number of Members: 5 including chair Term of service: 3 years Consecutive Terms: None E) Governmental Affairs Appointment: Appointed by BOD Number of Members: Unlimited Term of service: 3years Consecutive Terms: Unlimited F) Membership Appointment: Appointed by BOD Number of Members: Unlimited Term of service: 3 years Consecutive Terms: Unlimited

BOD 01-25-14:6 The Executive Committee moves that $40,000 of excess revenue of budget be moved to long term investment account. BOD 01-25-14:7 The Executive Committee moves that the TPTA BOD approve $1,265 from the excess 2013 revenue to be allocated for President Elect travel to CSM in order to attend component executive meetings. BOD 01-25-14:9 The Executive Committee moves that $5,000 of net excess revenue over budget be allotted to history task force for preservation of video and photo historical property .......... . .. . . . . . . . . . . .. . . . . . . . . . . . .. . . . . . . . .. .. .. ... . . . . . . . .

.

..

..

.......... ... .. . . . .. ..... .. . . .. . . . . . . . . . . .. ... . . .. . . . . .. . . . . .

.

spring 2014

..

G) Payment Policy Appointment: Appointed by BOD Term of service: 3 years Consecutive Terms: 2

A) Bylaws Appointment: Appointed by BOD Number of Members: Minimum of 3 Term of service: 3 years Consecutive Terms: Unlimited

J) Public Relations Appointment: Appointed by BOD Number of Members: Unlimited Term of service: 3 years Consecutive Terms: Unlimited mittees and does not want to impose arbitrary limitations

. ..

F) Membership Appointment: Appointed by BOD Term of service: 3 years Consecutive Terms: 2

I) Professional Development Appointment: Appointed by BOD Number of Members: Unlimited Term of service: 3 years Consecutive Terms: Unlimited

......... .... ... . . . . . . . . .. . . . . .. ... . . . . . . . . . . . . . . . .. . . . . . . .

E) Governmental Affairs Appointment: Appointed by BOD Term of service: 3years Consecutive Terms: 2

In order to clarify and standardize the process for appointing committee members and establish the term of service and number of consecutive terms one can serve as a committee member, the executive committee moves the following terms of service be adopted:

H) Practice Appointment: Appointed by BOD Number of Members: Unlimited Term of service: 3 years Consecutive Terms: Unlimited

.

D) Nominating Appointment: Elected from within the committee by committee members Term of service: 1 year Consecutive Terms: 3

G) Payment Policy Appointment: Appointed by BOD Number of Members: Unlimited Term of service: 3 years Consecutive Terms: Unlimited

..

C) Finance Appointment: Elected by Membership (Chapter Treasurer) Term of service: 3 years Consecutive Terms: 2

A) Bylaws B) Ethics C) Finance D) Nominating and the following Other Committees: E) Governmental Affairs F) Membership G) Payment Policy H) Practice I) Professional Development J) Public Relations

........... ... .. . .. ... .... .. . . . .. . . . . . . . . . . . . . ... . . .. .. .. . . . . . .

B) Ethics Appointment: Appointed by BOD Term of service: 3 years Consecutive Terms: 2

12 13


DISTRICT NEWS

District News CAPITAL AREA DISTRICT: The Capital Area district is forging ahead with it’s new multi-site “CAD Round-Up” meeting format. There are now 5 sites involved: University of St. Augustine, ACC Eastview, Texas State University, Texas Physical Therapy Specialists, and Scott And White Round Rock. Each location has a social followed by a broadcast of district news and “special topic” discussion from the primary location to satellite locations.

We have some exciting plans for educational and CCU programs for 2014 with dates and topics to be announced soon. For the most up-to-date information, please visit us on Facebook or the TPTA website, or contact CAD chair Allan Besselink, PT, Dip. MDT at cad.apta@gmail. com. CENTRAL DISTRICT: The Central District (CD) held its meeting Jan 30, 2014 at Concorde College where committee reports by Executive Committee were shared with all members. The meeting was followed by a presentation/CCU by Ron Scott, “Ethics for Physical Therapists and Physical Therapist Assistants”. The next District meeting is scheduled for April 24th to include an Oxford Debate: Affordable Care Act and its Effects on Physical Therapy – mark your calendars! The University of Incarnate Word will be hosting the debate. Regarding scholarship activities, the CD is currently accepting applications for Thomas C Turturro Scholarship. The CD will award 4 students $500 each.

The next meeting is scheduled for March 31 with social from 5:30 - 6:00, business from 6:00 - 6:30, and Hot Topic from 6:30 - 7:00. The primary broadcast location will be at Texas Physical Therapy Specialists. Kathleen Manella, GAC liaison, will be speaking about upcoming legislative issues. Watch your email for updates! Our now-legendary summer social is slated for Wed June 18. If you would like to volunteer in the preparation and planning, let us know!

COASTAL BEND DISTRICT Coastal Bend District 2014 schedule is as follows: • District meeting and continuing education course March 1, 2014, at Del Mar College PTA Program facility in Corpus Christi. Continuing education course “Run Smart Level One”, 9 am to 1 pm. District meeting to follow at 1 pm. • District meeting in May or June at Victoria College PTA Program facility in Victoria. • District meeting and continuing education course in September at South Texas College PTA Program facility in McAllen. • Ethics course offerings at multiple locations. • On-line elections for the Chair-Elect and Treasurer will be held in June. Please consider running for one of these district leadership positions. Contact Jan Spigner, PT, Coastal Bend at jspigner@delmar.edu

Location Courses Coming to Texas! A Clinical Competency accredited provider by TPTA ___________________________________________

342

Evaluation/Treatment of the Clumsy Child

Barbara Connolly, PT, Ed.D,FAPTA November 7-8, 2014 113

Donatelli’s Shoulder Rehab

344

124

September 5, 2014

Houston, TX

Tricks of the Trade for Rehab Patient Results

346

J.J. Mowder-Tinney PT, PhD, NCS September 20, 2014 237

Houston, TX

Stroke Recovery Toolbox

Stephen Page, Ph.D. September 13, 2014

.

..

. ..

.

..

..

..

......... .... ... . . . . . . . . .. . . . . .. ... . . . . . . . . . . . . . . . .. . . . . . . .

.......... . .. . . . . . . . . . . .. . . . . . . . . . . . .. . . . . . . . .. .. .. ... . . . . . . . .

.......... ... .. . . . .. ..... .. . . .. . . . . . . . . . . .. ... . . .. . . . . .. . . . . .

.

........... ... .. . .. ... .... .. . . . .. . . . . . . . . . . . . . ... . . .. .. .. . . . . . .

13 14

Peds Creative Treatment Ideas September 5, 2014

April 12, 2014 Austin, TX Strategies for Treating Neuro Patients Deficits

Dallas, TX

Marti Smith, OTR/L

Marsha Rutland, PT, ScD, OCS, COMT, CSCS 206

A Fresh Approach to Torticollis Treatment

Nancy Neiditz, PT

Matt Holland, PT, CSCS November 8, 2014

Dallas, TX

382

Pasadena, TX

Pediatric and Adult Therapeutic Taping

Patricia Martin, PT April 11-12, 2014

Dallas, TX

Also LIVE On-Line Webinars 3 hours of CEU’s $49

Austin, TX

 

spring 2014


RESEARCH CORNER

Evidence-Based Review By Anu Kalpathi, PT Touchstone Neurorecovery Center,Conroe, TX

Reisman DS, McLean H, Keller J, Danks KA, Bastian AJ. Repeated split-belt treadmill training improves poststroke step length asymmetry. Neurorehabil Neural Repair. 2013;27:460–8. Several novel locomotor retraining programs have emerged in the past decade. However many stroke survivors continue to demonstrate gait deficits impacting their community ambulation status. Spatiotemporal gait asymmetries commonly seen after stroke are related to slow walking speeds, and consequently, to reduced participation. This has resulted in a group of studies, based on the concept of locomotor adaptation, to promote walking recovery. Locomotor adaptation is an error-driven motor learning process used to alter spatiotemporal elements of walking1. While studying the impact of conscious step correction in motor adaptation, Reisman et al1 found that adaptation of spatial locomotor control is more flexible and accessible than temporal control. Motor adaptation can be achieved through a split-belt treadmill (ST) walking paradigm and has been seen to result in short-term improvements in gait asymmetry in individuals with chronic stroke. Since motor adaptation relies on error augmentation, an individual with stroke who takes a longer step with the non-paretic leg would walk with the paretic leg on the slow belt. Reisman et al2 note that through practice, and over time (<15 minutes), increased step length on the non-paretic side, and a shortened step on the paretic side is seen. They also observed the retention of improved step length asymmetry after ST training, irrespective of context (overground or treadmill). However, these improvements were short-lived and return to baseline was noted after several minutes of walking. The purpose of this study was to determine whether longer-term improvements in step length asymmetry could be achieved with repeated split-belt treadmill walking using an error augmentation strategy. Reisman et al4 also wanted to examine whether there was any difference between individuals in their response to training. Thirteen persons with chronic stroke (>6 months) participated in the study and were tested at baseline; after the training and in follow-up testing at one and three months. Participants trained 3 days/week for 4 weeks. Each participant walked on the split-belt treadmill in six five-minute bouts for a total of thirty minutes each day. The leg-belt speed configuration was designed to exaggerate baseline step length asymmetry. The speed of the fast belt was chosen to be as close as possible to participant’s fast overground walking speed, and the slow belt speed was half of that. The belt speeds were not increased during the training period. Every session of treadmill training was followed by five-ten minutes of overground walking (with verbal feedback and cueing) to reinforce improved step length asymmetry. Each participant was classified as a ‘responder’ or ‘nonresponder’ based on whether their reduction in step length asymmetry exceeded day-to-day variability. Step length asymmetry was the primary outcome measure for this study. Participants in the responder group (seven) showed significant improvement between baseline and all other testing points. The nonresponder group (five) did not show differences across time. Change in perceived exertion scores highly correlated with change in step length asymmetry across the entire group. Testing at 1-month and 3-month follow-ups approached significance suggesting that a positive trend. This study demonstrates that short-term motor adaptations can be capitalized on, using repetitive practice to induce longer-term changes. The authors attribute longer-term improvements to reinforcement-based learning mechanisms that get activated and are responsible for retention of the adapted pattern between sessions. A small sample size limits the external validity of this study. However, the trial demonstrated the split-belt training intervention is effective in reducing step length asymmetry in individuals with chronic stroke and could be considered as a potential intervention for longer-term change. REFERENCES: 1. Reisman DS, Wityk R, Silver K, Bastian AJ. Locomotor adaptation on a split-belt treadmill can improve walking symmetry poststroke. Brain. 2007;130:1861–1872. 2. Reisman DS, Wityk R, Silver K, Bastian AJ. Split-belt treadmill adaptation transfers to overground walking in persons poststroke. Neurorehabil Neural Repair. 2009;23:735–744.

.

..

. ..

.

..

..

..

......... .... ... . . . . . . . . .. . . . . .. ... . . . . . . . . . . . . . . . .. . . . . . . .

.......... . .. . . . . . . . . . . .. . . . . . . . . . . . .. . . . . . . . .. .. .. ... . . . . . . . .

.......... ... .. . . . .. ..... .. . . .. . . . . . . . . . . .. ... . . .. . . . . .. . . . . .

.

........... ... .. . .. ... .... .. . . . .. . . . . . . . . . . . . . ... . . .. .. .. . . . . . .

spring 2014

14 15

Tpta spring newsletter final