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 Two: Applied PSP Clinical Management Principles:
The Lumbar Spine

This is the second 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. This second course will take an in-depth look at applying evidenced based practice principles to individuals presenting clinically for evaluation and treatment of low back pain. Utilizing both the Treatment Based Classification framework and the CRISP® Principles, this course will address the following clinical presentations:

  • Medical Screening Considerations and Low Back Pain
  • Neurological Screening and Low Back Pain
  • Acute, Subacute Low Back Pain with Mobility Deficits and/or Referred Pain
  • Acute, Subacute Low Back Pain with Radiating Features
  • Acute, Subacute, Chronic Low Back Pain with Motor Control, Strength, and Endurance Deficits

Course Objectives:

  1. Employ spine care principles and practices primary care for individuals with LBP.
  2. Administer care to individuals with LBP, without referral, in appropriate cases.
  3. Identify indications for advanced diagnostic testing and choose appropriate referrals for individuals with LBP.
  4. Identify indications for intensive (e.g. multidisciplinary rehab) and invasive (e.g. injections, surgery) care and choose appropriate referrals for individuals with LBP.
  5. Apply and interpret risk measures (e.g., STarT Back) and outcome assessments (e.g., Oswestry, NDI).
  6. Perform appropriate examination procedures for the purpose of medical screening in individuals with LBP.
  7. Use evidence-based resources to identify perpetuating factors in individuals with LBP.
  8. Apply triage criteria to differentiate care and patient management options, for individuals with LBP.
  9. Apply evidence-based management strategies for individuals with LBP, utilizing the most appropriate care delivery personnel.
  10. Effectively utilizes the principles associated with the Treatment Based Classification System and the CRISP® principles to make clinical management decisions for individuals with LBP.

Online Modules

Section One: Diagnostic Imaging/special tests

Imaging of The Lumbosacral Spine

  • Anatomy, part 1
  • Anatomy, part 2
  • Intervertebral Disc Disorders, part 1
  • Intervertebral disc Disorders, part 2
  • Articular Disorders: Spondyloarthropathy
  • Developmental (Congenital) Spine Disorders
  • Spondylolysis and Spondylolisthesis, part 1
  • Spondylolysis and Spondylolisthesis, part 2
  • Neoplasms
  • Spine trauma
  • Miscellaneous Disorders

Electrodiagnostic testing

  • Physiological principles and methods
    • Electromyography (EMG)
    • Nerve Conduction Velocity (NCV)
  • Interpretation of results
    • Electromyography (EMG)
    • Nerve Conduction Velocity (NCV)

Section Two: Interventional Procedures in Patients with Low Back Disorders

  • Epidural injections
  • Facet joint procedures
    • Joint injections
    • Medial branch blocks
    • Radio frequency ablation
  • SI joint injections
  • Intradiscal procedures

Section Three: Lumbar spine surgery

  • Discectomy
  • Decompression
  • Fusion
  • Artificial disc

Section Four: Manual Techniques

  • The Barrier Concept and Grades/Progression of Forces

Topic Five: Specific Low Back Conditions

  • Lumbar spinal stenosis
  • Disc herniation
  • Lumbar disc pain
  • Lumbar facet and sacroiliac joint pain
  • Lumbar myofascial pain
  • Spondylolisthesis – Isthmic
  • Spondylolisthesis – Degenerative

Section Six: Overview of Physical Examination

  • Overview of Exam – Diagnostic question #2
    • End range loading exam
    • Joint provocation
      • Facet
      • SI
    • Neurodynamic exam
      • Lumbosacral (L4-S1)
      • Lumbar (L2-L4)
    • Myofascial exam
  • Overview of exam – Diagnostic question #3
    • Stability exam
    • Nociceptive system sensitization exam including nonorganic signs
  • Outcome measures for low back patients

Section Seven: Therapeutic Exercise in Patients with Low Back Disorders

  • Neural mobilization
  • Spinal Stabilization
  • Education and Graded Exposure in the Management of Nociceptive system Sentitization
  • General Fitness

Section Eight: Hip Joint Conditions

  • Hip joint pain
  • Greater trochanteric pain syndrome
  • Piriformis syndrome

Section Nine: Outcome Measures

  • Outcome measures for low back

Unit Two Live Course: Agenda and Schedule

Friday – Day One (4:00-9:00pm)

  • Introduction
  • Define PSP
  • Define Program Parameters, Goals, Objectives
  • Overarching Principle: EBP Guidelines (Cite Sources)
    • Intro to CRISP Principles
    • Intro to TBC Framework
  • Medical Screening/First Contact Practitioner Responsibilities/Diagnostic Question #1
  • Workshop (4:30 PM to 5:40 PM)
    • Abdominal Screening
    • Fracture Screening
    • Ank Spond. Screening
    • Vascular Screening (AAA, DVT, PVD)
  • Medical Screening—Overview and Summary Slides (5:40 PM to 6:00 PM)
    • Cauda Equina
    • AAA
    • Fracture (Trauma, Cancer, Infection, Osteoporosis)
    • Systemic Conditions (Ank Spond, Diabetes, etc.)
    • Visceral Referred Pain
  • Dinner Break (Pizza)
  • Medical Screening/First Contact Practitioner Responsibilities/Diagnostic Question #1
  • Workshop: 2-4 Minute Neuro Screening Exam (6:30 PM to 7:30 PM)
    • Demonstrate and Laboratory Practice
  • Neurological Screening—Summary Slides (7:30 PM to 7:45 PM)
    • UMN (Central Canal, Higher Centers)
    • LMN (Foraminal)
    • Cranial Nerve
  • 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)

  • Case One: Review, Discussion, and Workshop
  • Break
  • Case Three: Review, Discussion, and Workshop
  • Break
  • Case Five: Review, Discussion, and Workshop
  • Break
  • Case Two: Review, Discussion, and Workshop
  • Break
  • Case Four: Review, Discussion, and Workshop
  • Break
  • Case Six: Review, Discussion, and Workshop
  • Final Questions and Adjourn

Sunday – Day Two 8:00am-12:30pm

  • Rehabilitation Practitioner Responsibilities/Diagnostic Question #3
  • Instability/Stabilization Principle
    • Overview of Concept Principle—Case Based Examples
    • Lack of Sufficient Stability vs. Pathoanatomical Instability
    • Motor Control vs. Stabilization vs. Movement Control
    • Movement Control Framework
  • Workshop
    • Clinical Tests for Segmental Instability
    • Evaluation of Trunk Performance
    • FMS Selected Examples
  • Break
  • Unit One 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)

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

Questions regarding program registration:

Clarice Rutledge
Post-Professional Education Administrator
ADaPT Administrator

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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