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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Unit Four: PSP Clinical Management Principles:
Case Analysis, Review, and Certification

This is the final course offering in the Primary Spine Practitioner Program which is 4-part course series that takes an in-depth look at the delivery of Healthcare to patients with Spinal Related Disorders (SRDs). This final course will continue to focus on the clinical management of patients with SRDs building on the evidenced based principles that had been presented and developed in the previous three courses. Course participants will be asked to share their clinical experiences during case discussions. Examination and treatment strategies will be reviewed and discussed. The final portion of this live weekend will feature the PSP Certification Examination. Key content includes:

  • Evidenced-Based Practice Principles for Spinal Related Disorders
  • Communication Skills
  • Classification of Spinal Related Disorders
  • Triage and Diagnosing Spinal Related Disorders Utilizing a BioPyschoSocial Approach
  • Clinical Management of Spinal Related Disorders Utilizing Evidenced-Based and BioPsychoSocial Principles
  • Certification Examination Process included Written, OSCE, and Live Patient components

Course Objectives

  1. Employ spine care principles and practices primary care for individuals with SRDs.
  2. Effectively utilizes the principles associated with the Treatment Based Classification System and the CRISP® principles to make clinical management decisions for individuals with SRDs.
  3. Apply triage criteria to differentiate care and patient management options, for individuals with SRDs.
  4. Perform appropriate examination procedures for the purpose of medical screening in individuals with SRDs.
  5. Identify indications for advanced diagnostic testing and choose appropriate referrals for individuals with SRDs.
  6. Identify indications for intensive (e.g. multidisciplinary rehab) and invasive (e.g. injections, surgery) care and choose appropriate referrals for individuals with SRDs.
  7. Use evidence-based resources to identify perpetuating factors in individuals with SRDs.
  8. Apply evidence-based management strategies for individuals with SRDs, utilizing the most appropriate care delivery personnel.
  9. Demonstrate an acceptable standard of performance on the Written, OSCE, and Live Patient certification examination components.

Online Modules

Section One: Psycho-Social Factors and Chronic Pain

  • Review of Pain Neuroscience
  • Educating Patients Regarding Pain Neuroscience
  • Principles of Graded Exposure in Chronic Pain Patients
  • Review of Fibromyalgia and Chronic Widespread Pain (Parts 1 & 2)
  • Motivational Interviewing
    • Background & Spirit
    • Skills & Strategies
    • Processes
    • Screening, Brief Intervention, & Referral to Treatment (SBIRT)
  • Perceived injustice
  • The CBT/ACT Context in PSP Practice
  • Review of Key Psychological Factors (Parts 1 & 2)
  • Principles of Cognitive Behavioral Therapy (CBT)
  • Principles of Acceptance and Commitment Therapy (ACT)
  • General Communication Skills
  • Mindfulness
  • Psychoactive Medications (Parts 1 and 2)

Section Two: Clinical Management

  • Moving beyond diagnosis and treatment to clinical decision making and clinical management: the true PSP
  • Team Based Care

Section Three: Pharmacology

  • Part 1: Medications that are prescribed for spine pain
    • Anti-inflammatory medications: NSAIDs, steroids
    • Pain medications: acetaminophen, opioids
    • Muscle relaxants
    • Anti-convulsants
    • mood stabilizers
  • Part 2: Medications that can produce musculoskeletal side effects
  • Part 3: Identifying aberrant drug behavior

Section Four: Principles of Evidence-Based Practice

  • Overview of EBP – what is it?
  • Overview of research designs
  • Basic science research
  • Observational studies
  • Diagnostic studies
  • Qualitative research
  • Randomized, controlled trials, meta-analyses and systematic reviews
  • Asking clinical questions and seeking the answer

Section Five: Work-Related Topics

  • Stay at Work/ Return to Work process
  • Functional capacity evaluations
  • Work Conditioning/Work Hardening
  • Chronic Pain Management Programs/Functional Restoration

Section Six: Cervical Manipulation and Stroke – an Understanding for the PSP

  • Review
    • Pathophysiology of vertebral artery dissection
    • Epidemiology of vertebral artery dissection
    • Most common initial symptoms
  • The evolution of the association between CMT and vertebral artery dissection
    • Case reports and case series
    • Surveys
    • Biomechanical studies
    • Case-control studies
  • Where are we now?
    • How to communicate vertebral artery dissection as a “risk”
    • How to detect subtle signs and symptoms (if they are present)
    • What to do if a patient has a stroke in your office

Section Seven: Special Topics

  • Primary spine care in the context of public health Part 1
  • Primary spine care in the context of public health Part 2
  • Pre/Post Surgical Procedures
  • Scoliosis

Section Eight: Written Documentation and Communication

  • Documentation: Part 1
  • Documentation: Part 2

Unit Four Live Course: Agenda and Schedule

Friday - Day One (3:00-9:00pm)

3:00-5:30pm
  • Section One: The Recalcitrant Lumbar Radiculopathy
  • Section Two: The Individual with Chronic LBP
5:30-6:00pm
  • Dinner Break
6:00-8:45pm
  • Section Three: Acute vs Chronic Whiplash Associated Disorder
  • Section Four: The PSP Movement: What’s Beyond Education and Certification
8:45-9:00pm
  • Final Questions and Adjourn

Saturday - Day Two (8:00am-6:00pm)

8:00am-12:00pmM
  • Section Five: Participant Led Case Discussions and Experiences: Low Back Pain Cases
  • Section Six: Workshop and Technique Review: Selected Examination and Treatment Procedures
  • Section Seven: Participant Led Case Discussions and Experiences: Neck Pain Cases
12:00-2:00pm
  • Lunch Break
2:00-6:00pm
  • Section Eight: PSP Examination and Certification: OSCE and Live Patient Exams

Sunday - Day Three (7:00am-12:00pm)

7:00-7:45am
  • Section Nine: PSP Examination and Certification: Written Exam
8:00am-12:00pm
  • Section Ten: PSP Examination and Certification: OSCE and Live Patient Exams

*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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