Erica A. Pitsch, PT, DPT, NCS works exclusively with persons with neurologic problems in both outpatient and wellness settings - which means she works with clients on a long-term basis and has to learn to keep things fresh and interesting. She is a board-certified Clinical Specialist in Neurology (NCS) and collaborates closely with the neurologists the university medical center where she works and teaches. In addition to patient care, she is also dedicated to teaching both as a course director, clinical instructor, and mentor. Dr. Pitsch's primary interest in both roles as clinician and professor is translating the current evidence into practice. As such, she strives to develop multi-modal rehabilitation strategies for physical function, cognition, and physical fitness/wellness at any level and most of all, making it fun! She earned her Transitional Doctor of Physical therapy from the University of Southern California and has been a member of the American Physical Therapy Association since 1993.

DISCLOSURES

FINANCIAL: Erica Pitsch is compensated by Summit as an instructor. She is an Associate Professor at the University of California, San Francisco for which she receives a salary.

NONFINANCIAL: Erica Pitsch has no non-financial relationships to disclose.

1. The Science of Stroke Recovery: Neuroplasticity and Motor Learning
   1. Guiding principles of neuroplasticity
   2. Motor learning review and update: Strategies for optimal motor learning
   3. External focus of attention
   4. Types of feedback and strategies for setting expectations
2. Motor Imagery as an Adjunct to Therapy: The Lowest Risk, Most Beneficial Thing You're Probably Not Doing
   1. The case for motor imagery
   2. How to do it
   3. Practice
   4. Hands-On Lab
3. Outcome Measure Decision Tree: Match the Outcome Measure to Your Patient and Needs
   1. Justification for levels of care
   2. Prognostic indicators
   3. Upper limb specific outcome measures
   4. Gait and balance-specific outcome measures for fall risk
   5. G-Code worthy measures to document progress
4. Rehabilitation of the Upper Limb
   1. Decision tree - What to do and when to do it
   2. Strengthening strategies
   3. Task-oriented training
   4. Mirror therapy
   5. Electrical stimulation
   6. Priorities for limb protection
   7. Case Study
5. Re-Training Gait and Balance: Best Practice Guidelines
   1. Body-weight-supported treadmill training, or not?
   2. Rhythmic cueing
   3. Electrical stimulation
   4. Balance training: Specificity matters
   5. Address the impairments - If they can move it, strengthen it!
   6. Lab/Case Study
6. Treatment and Management Solutions for the Hard Stuff:Spasticity, Neglect, Sensory Impairment
   1. Spasticity: What is it and what do we do about it
   2. To botox or not to botox
   3. Neglect: Assessment and intervention strategies
   4. Optokinetic training, prism glasses, what works?
   5. Sensory training: Add sensory experience to task- oriented training
   6. Lab/Case Study

Ron Sheppard OTD, OTR/L, C/NDT, FABDA is a clinician, university educator, speaker and consultant with over 30 years of clinical experience focusing on rehabilitation through the life span of the neurologically impaired populations. Dr. Sheppard is an experienced occupational therapist who has specialized in stroke rehabilitation with an emphasis on Neurological Developmental Treatment (NDT). He was instrumental in the establishment of three outpatient OT clinics and continues to treat private patients at various stages of their Stroke Recovery between his Summit workshops. Dr. Sheppard was previously an adjunct professor at Milligan College's MSOT Program where he developed and taught the Geriatrics class and performed live patient Neuro Labs. Dr. Sheppard also has experience in on-line education, supervising OTD candidates for their final capstones at the University of St. Augustine. He recently excepted a full time teaching position at Emory & Henry College's School of Health Sciences as a Clinical Assistant Professor. Dr. Sheppard will be responsible for teaching the Adults/Older Adults Class, Neuro and Advanced Neuro (all with labs) in the Doctoral OT Program. Dr. Sheppard received his education from Carson-Newman University (where he was a member of the football team) of Jefferson City TN, East Carolina University of Greeneville, North Carolina and from University of St. Augustine in St. Augustine, Florida.

DISCLOSURES

FINANCIAL: Ron Sheppard is compensated by Summit as an instructor.

NONFINANCIAL: Ron Sheppard is a member of the Mid Atlantic Clinical Ladder Committee for Gentiva Health Services.

1. Introduction to the Treatment of the Hemiplegic Upper Extremity
   1. When evaluation begins
2. Fabrication of Neurological FMC Activities "Bag of Tricks"
   1. Supplies
   2. Stroke simulation of the upper and lower extremities
3. Assessment of the Hemiplegic Upper/Lower Extremities
   1. Color
   2. Edema
   3. Skin integrity/breakdown
   4. Pain
   5. ROM/contractures
4. Hand Assessment Lab
   1. Capitate bone
   2. Disuse atrophy
   3. "Flat hand"
   4. Return the arch
5. Upper Extremity Edema Lab
   1. Management of the edematous hand
   2. Pillow technique and reasoning
   3. Edema pumping
   4. Wrist mobility
      1. Body on upper extremity
      2. Surface on upper extremity
      3. Body/surface on upper extremity
6. Movement Strategies of the Hemiplegic Upper Extremity
   1. Movement Lab
   2. Hand over hand taping
   3. Functional grasp and pinch
7. Tone Inhibition of the Hemiplegic Upper/Lower Extremities
   1. Inhibit the imbalance of the antagonist and agonistmuscles toward flexion of the upper extremity
   2. Tone Inhibition Lab
   3. Opening/hygiene of hand
   4. Ball technique of vibration
   5. Weight bearing techniques
8. Fine Motor Coordination of the Hemiplegic Hand
   1. Fine Motor Lab
   2. Transposing/transcending
   3. Grading of grasp/pinch
   4. Bilateral UE re- education
   5. Paper towel wading
   6. "Around the Bases"