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Spinal Deformities FCM

Functional Cognitive Manual Therapy Approach

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Cairo - Egypt

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19-20-21 December, 2024

Tutor

Mirette M. Shehata

  • MSc Advanced Clinical Practice (Musculoskeletal pathway), Brunel University London.

  • Chevening Alumna 2023.

  • Primephysio UK and OMTA accredited Senior Tutor.

  • Musculoskeletal and Spinal Deformity specialist. UK, Germany, Italy.

  • Professional Certified Trainer (TOT), National Training Institute

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Mirette is a highly accomplished musculoskeletal physiotherapist with over 10 years of clinical experience specializing in managing complex musculoskeletal and spinal deformity conditions. She is a member of the Primephysio UK teaching and curriculum development team. Throughout her career, Mirette has honed her skills through invaluable mentorship under internationally renowned figures such as Brian Mulligan, Sarah Mottrum, Laura Finucane, Myles Butler, James Hinchcliffe, Mahmoud Saad, and Kenneth Olson as well as undertaken online continuing professional development course at Melbourne University, Australia. Her dedication to advancing clinical knowledge is evident through teaching multiple workshops on topics such as ankle-foot and frozen shoulder rehabilitation, as well as conducting spinal deformities rehabilitation courses in Egypt. Additionally, She was involved in teaching upper quadrant management course in Sheffield, UK, and OMTC program in Egypt. Mirette’s achievements underscore her commitment to excellence. She was awarded the prestigious Chevening Scholarship in 2022, becoming the First physiotherapist in Egypt to receive this honor. Her academic qualifications include a Master's degree in Advanced Clinical Practice Musculoskeletal Pathway from Brunel University London. She is actively engaged in research, conducted a Narrative Systematic Review "The effectiveness of adding shoulder complex stabilization exercises to lateral elbow pain management," which is slated for publication. As an accredited Primephysio tutor, Mirette has an international exposure which enriched her clinical insights and teaching methodologies. She has developed an innovative approach to managing various spinal deformities, integrating principles from cognitive neuromuscular training, active correction, functional training and manual therapy. Her professional credentials include ISST Schroth therapist (Germany), SEAS accredited therapist, ISICO Italy, Kinetic Control Movement Therapist (UK), Mulligan Practitioner (New Zealand), and Manual and Exercise Therapist (OMTA UK).

Learning Objectives:

  1. Describe the relevant kinematics and biomechanics of the spine and their impact on spinal deformities.

  2. Differentiate between structural and functional spinal deformities in adult and adolescent populations, and classify them based on established frameworks.

  3. Conduct a comprehensive assessment of various spinal deformities, including cervical kyphosis, spondylolisthesis (cervical and lumbar), thoracic hypo/hyperkyphosis, and scoliosis.

  4. Identify relevant red flags for surgical referral.

  5. Explain the impact of spinal deformities on the function of the upper and lower extremities.

  6. Develop and implement +30 evidence-based manual therapy and positioning strategies.

  7. Design +40 neuromuscular control training and active corrective exercises to address spinal deformities.

  8. Demonstrate the ability to appropriately prescribe spinal bracing, including considerations for brace characteristics, wear, weaning, and in-brace exercises.

  9. Educate patients on self-management techniques and lifestyle modifications to support long-term spinal health and sports participation.

 

Course Content:

This three-day face-to-face course with a mandatory online module introduces an integrated approach to managing spinal deformities and their associated upper and lower quadrant dysfunctions. The evidence informing clinical practice is highlighted throughout the course. The essential theoretical background is covered, but the emphasis is on practical sessions, clinical reasoning and paper case studies based on actual patients.

 

Online modules:

Module 1

  1.  Relevant kinematics and biomechanics of normal and deformed spine.

  2. Muscle synergies and spinal deformities impact on motor coordination.

Module 2

  1. Important radiological parameters influencing sagittal and coronal balance.

  2. Appraising the role of radiological scanning in physical examination

Module 3

  1.  Adult spinal deformities (cervical, thoracic, and lumbar region) classification and etiology.

  2. Adolescent idiopathic scoliosis classifications and risk of progression.

Module 4

  1. Brace characteristics and selection criteria

  2. ExercisesPrescription, wear, weaning, and in-brace

  3. Comprehensive subjective examination of various deformities.

B- Face-to-Face Teaching

 

Day 1

  • Functional vs structural deformities.

  • Identify Red flags

  • Upper cervical instability

  • Management principles of spinal deformities

  • Cervical spine deformity case study

  • Cervical spondylolisthesis case study

  • Scheuermann’s disease vs degenerative hyperkyphosis

  • Thoracic hyperkyphosis case study

  • Practical hands-on\off strategies for cervical and thoracic regions

Day 2

  • Flat back and lumbar spondylolisthesis Case study

  • Adult scoliosis (degenerative and sciatica scoliosis)

  • Risk of progression and decision making (mini case scenarios)

  • Adult scoliosis Case study

  • Adolescent idiopathic scoliosis, back pain and pregnancy safety.

  • Risk of progression and decision making (mini case scenarios)

  • Gait deviations in scoliosis and Hip associated disfunctions.

  • Practical functional and gait evaluation and postural

  • correction strategies for lumbar deformities.

Day 3

  • Revise clinical classification systems

  • Shoulder associated dysfunction

  • Functional screening for the upper quadrant

  • AI Scoliosis Case studies

  • Sports participation and life activities modification.

  • Practical corrective strategies and its integration in ADL and sports for scoliosis.

C- Practical Labs.

Day 1

  • Examine cervical kyphosis flexibility.

  • Cervical spine stability test battery.

  • Cognitive movement dissociation training for the cervical.

  • Deep neck muscles activation and active correction.

  • Proprioception training.

  • Manual therapy strategies for cervical spine.

  • Examine thoracic spine flexibility.

  • Hyperkyphosis active correction and breathing exercises.

  • Ribs and thoracic mobilization.

Day 2

  • Lumbar spine stability test battery.

  • Deep lumbar stabilizers training

  • Scoliometer application in scoliosis assessment.

  • Cognitive movement dissociation training for the lumbar.

  • Positioning and active 3-dimensional corrective exercises for lumbar scoliosis.

  • Functional screening tests for scoliosis.

  • Gait assessment and training in scoliosis.

Day 3

  • Balance and functional screening for upper quadrant.

  • Corrective breathing and diaphragm training

  • Facilitation of scoliosis active correction of the lateral curve.

  •  Positioning and active 3-dimensional corrective exercises for thoracic, thoracolumbar and double and three scoliosis.

  • Integrate 3-dimensional corrective exercises in daily activities and sport training

Prerequisites:

  • Foundational knowledge of human surface anatomy.

  • Undergraduate students must pass orthopaedic (musculoskeletal) round before attending the course.

Course Requirements:

  • Since this course is highly practical, it is recommended to wear light comfortable clothes, preferably cotton based to ease the practical labs.

  • Successful completion of online module and quizzes before the starting of the teaching days to get the highest benefit from the course.

  • Active participation in practical sessions and case discussions

  • Demonstrated ability to apply clinical reasoning and decision-making via practical quizzes based on case studies.

Benefits and Applications:

​This course provides a comprehensive and evidence-informed approach to the integrated management of spinal deformities. Participants will gain the knowledge and skills to:

  • Accurately assess and classify various spinal deformities

  • Developing advanced clinical reasoning and decision-making skills for holistic patient care in a niche area of musculoskeletal practice

  • Develop personalized treatment plans using +80 techniques of manual therapy, functional screening and neuromuscular training strategies, and bracing

  • Recognize and address associated upper and lower quadrant dysfunctions

  • Empower patients through self-management and lifestyle modifications

  • Collaborate effectively within an interdisciplinary healthcare team.

Learning Outcomes:

Knowledge:​

  1. The participants will learn how to interpret a comprehensive clinical and radiological assessment into an efficient patient-centered tailored rehabilitation program based on the clinical findings and latest evidence.

  2. The participants will be able to do proper clinical follow-ups for their cases’ progression and facilitate adequate documentation.

  3. the participants will be inspired to engage in different research activities and construct innovative rehabilitation programs.

Skills:

Throughout the course, students will develop the following skills:

  1. Apply critical thinking and clinical reasoning skills to develop patient-centered treatment plans that address the specific needs and goals of individuals with complex multiple spinal deformities.

  2. Design and implement effective therapeutic exercise programs to improve neuromuscular control, spinal stability, and functional outcomes for patients.

  3. Effectively communicate with patients and other healthcare providers, including making appropriate referrals and collaborating on interdisciplinary care.

  4. Demonstrate proficiency in prescribing braces and patient education for spinal deformities in adult and adolescent populations.

  5. Continuously evaluate the effectiveness of interventions and modify the treatment approach based on patient progress and evolving evidence-based practices.

Attitudes:

Through this course, students will:

  1. Develop a patient-centered approach to the management of spinal deformities, prioritizing the individual's goals, preferences, and quality of life.

  2.  Foster a commitment to evidence-based practice, incorporating the latest research and guidelines into their clinical decision- making.

  3. Cultivate an appreciation for the importance of interdisciplinary collaboration in the comprehensive care of patients with spinal deformities.

  4. Embrace the role of healthcare professionals in empowering patients to actively participate in the management of their spinal condition through education and self-management strategies.

  5. Demonstrate a dedication to ongoing professional development and lifelong learning to stay current with the evolving field of spinal deformity assessment and management.

Who can attend:

The course is designed for

  • Physical and/or occupational therapists, graduates, or interns who are eager to add to their knowledge to help clients with different conditions related to spinal deformities.

  • Undergraduate students must pass orthopaedic (musculoskeletal) round before attending the course.

How to Prepare for this course:

  • Brush up on surface anatomy .

Course fee:

  • Individual registration: 1700 LE.

  • Group registation: 1400 LE.

For inquiries & booking:

Contact our office in Egypt

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