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The Thorax & Pelvis – 2 day lecture/demonstration course

Note: This course can be offered as either a 4 day lecture/practical course (suitable for small groups interested in acquiring the skills (practicing) necessary to apply this model in clinical practice) or as a 2 day lecture/demonstration course (suitable for large group conferences)

2 Day Course Description

Do you see patients with recurrent problems and, in the face of limited evidence, question if you are being the most effective you can be in your approach to treatment? Do you know how to determine if the thorax, lumbar spine and/or pelvis (essentially the trunk) is playing a role in the clinical presentation and if so what to do or where to begin treatment?

Increasingly, scientific evidence suggests that function of the pelvis is essential for the performance of almost every task. However, how do we know if the loss of pelvic function is the cause of the patient’s primary complaint (the criminal) or merely the victim of an impairment elsewhere. How do we know if the loss of function of the thorax is the cause of the loss of pelvic function? How do we know if the relationship between the thorax & the pelvis is responsible for the failure of the lumbar spine to transfer loads optimally?

The restoration of function and performance depends on being able to identify and treat the underlying source of the problem and it is common to find the pelvis as the criminal in some cases and the victim in others. The same is true for the thorax. Do you have a way of knowing when to treat the pelvis, when to treat the thorax, when to treat the lumbar spine and when to look elsewhere?

This course will introduce the functional interplay between the thorax and the lumbopelvic-hip region and how the Integrated Systems Model can facilitate the understanding and interpretation of each patient’s unique clinical picture.

What is The Integrated Systems Model for?

The Integrated Systems Model is a framework to help clinicians organize knowledge (evidence and experientially based) and develop clinical reasoning skills to facilitate best decisions for treatment. A key feature of this approach is Meaningful Task Analysis and Finding the Primary Driver. Briefly, this involves choosing tasks to assess that are relevant to the patient’s story (meaningful to the patient’s complaints and functional difficulties), assessing the whole body (strategy analysis of the task) to find the criminal (the driver), and then developing sound hypotheses as to how the criminal relates to its multiple victims.

Objectives & Learning Outcomes

At the conclusion of this 2 day course, you will understand:

  1. How the Integrated Systems Model is used to assess function of the trunk, and thus the relationship between the thorax and pelvis.
  2. How to find the primary driver. When there are multiple regions that are impaired, how do you determine which one should be the focus of your intervention? Is this a hip problem that is causing the pelvic joints to lose control and become painful (or alternately a thorax or foot problem), or is the impairment intrinsic to the pelvis itself (i.e. stiff SIJ or altered motor control of pelvic floor/transversus abdominis – a pelvic driven pelvis)?
  3. When to choose specific system tests (articular, neural, myofascial, visceral, physiological etc) to further identify the cause and effect of various impairments within and between regions of the body so you are able to ‘do the right thing at the right time’.
  4. How to design a multimodal treatment program (including education, manual therapy, neuromuscular release, and movement training) to restore function and performance for any patient (from postpartum moms to elite level athletes) since the principles of the ISM approach are applicable to all groups of patients.

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