Units of the PSP Certification Program™


Unit 1 – Fundamentals of Primary Spine Care


Unit 2 – The Lumbar Spine


Unit 3 – The Cervical Spine


Unit 4 – Clinical Management and Final Proficiency Exam


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Course Three: Applied PSP Clinical Management Principles:
The Cervical Spine

This is the third course offering in the Primary Spine Practitioner Program, which is 4-part course series that takes an in-depth look at the delivery of primary spine care to patients with Spinal Related Disorders. This third course will take an in-depth look at applying evidenced based practice principles to individuals presenting clinically for evaluation and treatment of neck and/or upper pain. Utilizing the Neck Pain Classification Guidelines, the CRISP® Principles, and the Treatment Based Classification (TBC) framework, this course will address the following clinical presentations:

  • Medical Screening Considerations and Neck Pain
  • Neurological Screening and Neck Pain
  • Neck Pain with Mobility Deficits
  • Neck Pain with Radiating Features
  • Neck Pain with Headache
  • Neck Pain with Motor Control, Strength, and Endurance Deficits.

Course Objectives

  1. Employ spine care principles and practices primary care for individuals with neck pain.
  2. Administer care to individuals with neck related disorders.
  3. Identify indications for advanced diagnostic testing and choose appropriate referrals for individuals with neck pain.
  4. Identify indications for intensive (e.g. multidisciplinary rehab) and invasive (e.g. injections, surgery) care and choose appropriate referrals for individuals with neck pain.
  5. Apply and interpret risk measures (e.g. Screening for Yellow Flags) and outcome assessments (e.g. NDI).
  6. Perform appropriate examination procedures for the purpose of medical screening in individuals with neck pain.
  7. Use evidence-based resources to identify perpetuating factors in individuals with neck pain.
  8. Apply triage criteria to differentiate care and patient management options, for individuals with neck pain.
  9. Apply evidence-based management strategies for individuals with neck pain, utilizing the most appropriate care delivery personnel.
  10. Effectively utilizes the principles associated with the Neck Pain Classification Guidelines the CRISP® principles, and the TBC framework to make clinical management decisions for individuals with neck pain.

Online Modules

Section One: Cervical Intervention Procedures

  • Epidural Steroid Injections (ESI)
  • Facet Procedures

Section Two: Cervical Surgical Procedures

  • Discectomy
  • Decompression
  • Fusion
  • Artificial Disc

Section Three: Cervical Conditions/Pain Generators

  • Radiculopathy
  • Spondylotic Myelopathy
  • Facet Joint Dysfunction
  • Myofascial Pain
  • Headache
    • Migraine
    • Non-Migraine
  • Thoracic Pain
  • Oculomotor Dysfunction
  • Orofacial Pain
  • Cervical Artery Dissection
  • Whiplash
  • Concussion
  • Thoracic Outlet Syndrome

Section Four: Overview of Physical Examination

  • Overview of Exam – Diagnostic question #1
    • Historical factors
    • Overview of the neurologic exam
    • Localizing the lesion in suspected cervical myelopathy
  • Overview of Exam – Diagnostic question #2
    • End range loading
    • Joint provocation
    • Neurodynamic exam
      • Median (C5-7)
      • Ulnar (C8-T1)
      • Radial (C7)
    • Myofascial exam
  • Overview of exam – Diagnostic question #3
    • Stability exam
    • Oculomotor exam
    • Nociceptive system sensitization exam including nonorganic signs
  • Outcome measures for patients with cervical disorders

Section Five: Therapeutic Exercise

  • Neural mobilization
  • Cervical stabilization
  • Oculomotor exercise
  • Scapular stabilization

Section Six: Diagnostic Imaging

Conventional radiography

  • Normal cervical anatomy
  • Pathologies
    • Trauma
    • Fracture/Dislocation
    • Osteomyelitis
    • Benign tumor
    • Malignancy

MRI

  • Normal cervical anatomy
  • Common pathologies
    • Disc herniation
    • Stenosis
  • Less common pathologies
    • Benign tumors
    • Malignancy
    • Infection
    • Spinal cord processes

CT

  • Normal cervical anatomy
  • Pathologies
    • Fracture/ dislocation
    • Osteomyelitis
    • Benign tumor
    • Malignancy
  • Common pathologies
    • Disc herniation
    • Stenosis
  • Less common pathologies
    • Benign tumors
    • Malignancy
    • Infection

Section Seven: Special Tests

Electrodiagnostic testing

  • EMG
  • NCV
  • SSEP

Section Eight: Data Collection

  • Outcome Measures for Neck

Unit Three Live Course: Agenda and Schedule

Friday - Day One (4:00-9:00pm)

4:00-4:30pm
  • Introduction
    • Overview of Neck Pain
    • Define PSP Program Goals, Objectives regarding Neck Pain
    • Overarching Principle: EBP Guidelines
      • Intro to CRISP Principles
      • Intro to Neck Pain Classification Guidelines
4:30-6:00pm
  • Medical Screening/First Contact Practitioner Responsibilities/Diagnostic Question #1
    • Workshop (4:30 PM to 5:40 PM)
      • Fracture Screening
      • Vascular Screening (Vertebral Artery, Internal Carotid Artery, Thoracic Outlet)
    • Medical Screening—Overview and Summary Slides (5:40 PM to 6:00 PM)
      • Cervical Trauma/Fracture/Concussion
      • Cervical Arterial Pathology (Vertebral Artery, Internal Carotid Artery)
      • CVA
      • Thoracic Outlet (Neurogenic, Arterial, Venous)
      • Visceral Referred Pain
6:00-6:30pm
  • Dinner Break (Pizza)
6:30-7:45pm
  • Medical Screening/First Contact Practitioner Responsibilities/Diagnostic Question #1
  • Neurological Screening—Summary Slides
    • UMN (Central Canal, Higher Centers)
    • LMN (Foraminal)
    • Cranial Nerve
    • Demonstration and Laboratory Practice
7:45-9:00pm
  • Group Assignments/Project and Group Discussions
    • Breakout into 6 groups of 7-8 participants. Underlying assumption is that all cases will be appropriate for the Symptom Modulation Approach. All cases will have a specific assignment/questions associated with the case. The participants will need to prepare the responses and be ready to discuss the responses to the questions posed when the group is called upon on during Saturday’s Session.

Saturday - Day Two (8:00am-5:15pm)

8:00-9:20am
  • Case One Discussion: Neck Pain with Mobility Deficits
9:20-9:30am
  • Break
9:30-10:40am
  • Workshop
    • Mid-Cervical Segmental Mobility Testing/Motion Palpation
    • Mid-Cervical Extension-Rotation Test vs. Spurling’s Test
    • Axial Compression vs. Axial Distraction
    • Upper Cervical Segmental Mobility Testing/Motion Palpation
    • Cervical Flexion-Rotation Test
10:40-10:50am
  • Break
10:50am-12:00pm
  • Case Two: Discussion: Neck Pain with Headache
12:00-1:00pm
  • Lunch Break
1:00-2:20pm
  • Case Three Discussion: Neck Pain with Radiating Features
2:20-2:30pm
  • Break
2:30-3:40pm
  • Workshop
    • End Range Loading Exam and Treatment Considerations
    • Selected Shoulder Tests
    • Neurodynamic Exam and Treatment Considerations
3:40-3:50pm
  • Break
3:50-5:20pm
  • Case Four Discussion: Neck Pain with Radiating Features
  • Final Questions and Adjourn
Sunday - Day Three (8:00am-12:30pm) 8:00-9:30am
  • Case Five Discussion: Neck Pain with Strength and Coordination Deficits
9:30-9:40am
  • Break
9:40-11:15am
  • Workshop
    • Clinical Tests for Hypermobility/Segmental Instability
    • Craniocervical Flexion Test, Cervical Muscle Performance
    • Occulomotor Exam and Treatment Considerations
11:15-11:30am
  • Break
11:30am-12:30pm
  • Unit Three Written Exam

*topics are subject to changed at the discretion of instructors


Updated | 04.27.2020

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Questions regarding the program:

Michael Timko, PT, MS
Fellow American Academy of Orthopedic Manual Physical Therapy
Certified Primary Spine Practitioner (PSP)
he/him

Department of Physical Therapy
University of Pittsburgh
Bridgeside Point 1
100 Technology Drive Suite 228
Pittsburgh, PA 15219
P: (412) 383-4509
  mtimko@pitt.edu

Questions regarding program registration:

Clarice Rutledge
Post-Professional Education Administrator
ADaPT Administrator
she/her

Department of Physical Therapy
University of Pittsburgh
Bridgeside Point 1
100 Technology Drive Suite 210
Pittsburgh, PA 15219
P: (412) 383-4509



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