The Official Publication of the American Academy of Orthopaedic Manual Physical Therapists. Message from the. AAOMPT President

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1 September/October 2004 The Official Publication of the American Academy of Orthopaedic Manual Physical Therapists Message from the AAOMPT President Kenneth A. Olson, PT, DHSc, OCS, FAAOMPT Vol. 10, No. 3 A Vision of Fellowship I n February 2003, twenty-five AAOMPT past, present, and immediate future leaders met in Tampa, Florida for a strategic planning meeting. New vision and mission statements were drafted as well as 5 primary goals for the organization. The members approved the mission statement at the October, 2003 business meeting, but there were some reservations with the wording of the vision statement, and it was referred back to the executive for further revision. The following is the newly revised vision statement approved by the executive that will be further debated and put to a vote for the membership at the business meeting this October in Louisville: AAOMPT Vision (proposed) Orthopaedic Manual Physical Therapy will be an accepted, evidence-based musculoskeletal clinical practice in the United States, whereby Fellows of the American Academy of Orthopaedic Manual Physical Therapists are recognized by the public as specialists in Orthopaedic Manual Physical Therapy. Fellowship education will be the primary means for achieving advanced skills in orthopaedic manual physical therapy, based on a foundation of orthopaedic manual physical therapy education provided in the professional physical therapy curriculum. All the members of the Academy are important to supporting the goals and objectives of our organization. To comply with the constitution of the International Federation of Orthopaedic Manipulative Therapists (IFOMT) and to seek membership in IFOMT, the AAOMPT was set up to have two primary membership classifications: Member and Fellow. Fellow status in the AAOMPT is a membership classification and is commonly used as a professional credential. The only Academy document that defines Fellow is the AAOMPT bylaws, which state under the section on membership classifications that to achieve the Fellow membership status, a physical therapist must complete a credentialed fellowship program in the orthopaedic manual physical therapy (OMPT), or up until December 31, 2006, the physical therapist must successfully pass a portfolio review process and oral/ practical examination. (continued on page 3) INSIDE THIS ISSUE... All the members of the Academy are important to supporting the goals and objectives of our organization. Reports from the Executive Board... 4 Credentialed Fellowship Programs... 5 Committee Reports... 6 Practice Affairs Corner...11 New Fellows...11 Oscilations...12 Clinical Pearl th Annual AAOMPT Conference...16 Conference Registration Form...18 AAOMPT Membership Benefits...22 AAOMPT Membership Application...24

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3 3 Message from the President continued from page 1 This proposed vision statement states that the primary means in the future of achieving advanced skills in OMPT will be fellowship training. Much work is needed to make this a reality. The standards committee is working with the APTA residency/fellowship credentialing committee to address some of the perceived barriers to proliferation in manual therapy fellowship programs. For further information, please refer to the standards committee report in this edition of Articulations and attend the session the standards committee is planning for the Academy meeting in October. The Fellow membership classification affords the member privileges to vote on issues related to practice standards, international affairs, and bylaws changes. Additionally, only Fellows are allowed to serve on the executive committee as President, Vice- President, Secretary, or Treasurer. Over time, FAAOMPT has evolved to denote a standard of excellence in OMPT practice and has been used as a professional credential. A Fellow in the AAOMPT is becoming an international recognition of competence and expertise in the practice of orthopaedic manual physical therapy by a physical therapist licensed in the USA. The Fellow is a physical therapist who has demonstrated advanced clinical, analytical, and hands-on skills in the treatment of musculoskeletal disorders. The proposed AAOMPT mission statement of the Academy includes that Fellows in the AAOMPT will be recognized by the public as specialists in OMPT. I would like to see this public recognition extend internationally so that countries with OMPT specializations would accept a FAAOMPT as an OMPT specialist in their country. However, there is nothing in the AAOMPT bylaws or policy statements that define the FAAOMPT as a professional credential, that clarifies who is allowed to use this as a professional credential, or that specifies if FAAOMPT can no longer be used as a professional credential if the person is no longer a member in good standing with the Academy. Passing the proposed vision statement is the first step in formalizing Fellowship in the AAOMPT as a professional credential and will put the Academy on a course to clarify these issues. If this vision statement is approved by the membership, further clarity will need to be provided by either creating an official policy or a bylaw revision that establishes FAAOMPT as a professional credential that signifies specialization in OMPT in the United States. Many organizations have separated the professional credential from membership requirements in an attempt to prevent restraint of trade lawsuits, and the Academy leadership will need to contemplate many issues as they chart the course of the Academy to attempt to fully attain a clearer Vision of Fellowship over the next years. Please make plans to attend the AAOMPT annual conference in Louisville this October. The line up of speakers is one of the best ever, and there are numerous important issues to discuss at the business meeting. The best way to get involved in the Academy and to make a contribution to our specialty area of OMPT is to attend our annual conference. Help us get the word out to make this the biggest and best conference ever. Kenneth A. Olson PT, DHSc, OCS, FAAOMPT AAOMPT President AAOMPT OFFICERS President Kenneth A. Olson, PT, DHSc, OCS, FAAOMPT Phone (815) Fax (815) Ken.Olson@aaompt.org Vice President Stephen C.F. McDavitt, PT, MS, FAAOMPT Phone (207) Fax (207) Stephen.McDavitt@aaompt.org Secretary Jake Magel, PT, DSc, OCS, FAAOMPT Phone (505) Fax (505) Jake.Magel@aaompt.org Treasurer John C. Gray, DPT, OCS, FAAOMPT Phone (858) Fax (858) John.Gray@aaompt.org Member-at-Large Krista J. Clark, PT, FAAOMPT Phone (435) Fax (435) Krista.Clark@aaompt.org COMMITTEE CHAIRPERSONS Standards (Co-Chairs): Catherine Patla, PT, DHSc, OSC, FAAOMPT Phone (904) Fax (904) cpatla@usa.edu Bob Rowe, DMT, MHS, MOMT, PT, FAAOMPT Phone (504) Fax (504) Bob.Rowe@aaompt.org Education (Co-chairs): Marcie Swift, MS, PT, FAAOMPT Phone (913) Fax (913) Marcie.Swift@aaompt.org Dave McCune, MPhty St, PT, OCS, ATC, FAAOMPT Phone (607) Fax (607) Dave.McCune@aaompt.org Examination: Michael Puniello, DPT, MS, OCS, FAAOMPT Phone (781) Fax (781) Michael.Puniello@aaompt.org Research: Todd Watson, DPT, OCS, FAAOMPT Phone (828) Fax (828) Todd.Watson@aaompt.org Membership (Co-chairs): Anne H. Campbell, PT, MS, OCS, FAAOMPT Phone (281) Fax (936) Anne.Campbell@aaompt.org Michael D. Rogers, PT, OCS, OMPT, FMAAOMPT Clinic (228) Fax (228) Michael.Rogers@aaompt.org Newsletter (Co-editors): David Miers, PT, OCS, FAAOMPT Phone (269) Dave.Miers@aaompt.org MAJ Matt Garber, PT, DSc, OCS, FAAOMPT Phone (210) Matt.Garber@aaompt.org Nominations/Awards: Tamara Little, DPT, FAAOMPT Phone (209) Fax (209) Tamara.Little@aaompt.org Practice Affairs: Bill Boissonnault, PT, DHSc, FAAOMPT Bill.Boissonnault@aaompt.org International Affairs: Chris Showalter, MPT, OCS, FAAOMPT Phone (631) Fax (631) Chris.Showalter@aaompt.org Web Site Coordinator: John C. Gray, DPT, OSC, FAAOMPT Phone (858) Fax (858) John.Gray@aaompt.org Journal: John Medeiros Phone (503) John.Medeiros@aaompt.org Fax (503) Public Relations: Ronald J. Schenk, Ph.D, PT, OCS, FAAOMPT Phone (716) Fax (716) Ron.Schenk@aaompt.org

4 4 Treasurer s Report Submitted by John C. Gray Assistance from Craig Crosby & Jamie Bellamy Budget for 2004 Income $213,420 Expense $207,310 Difference $6,110 Income & Expenses for 2004 (January June) Income $89,122 Expense $93,514 Difference -$4,392 (PAF) Practice Affairs Fund (January June, 2004) Income $1,008 Expense $0 Difference $1,008 Assets as of June 30, 2004 Operating Account $93,061 Practice Affairs Fund (PAF) $14,462 Reserve Fund $106,906 Total Assets $214, Club Members Glenn Decker John C. Gray Anne Porter Hoke Peter Morris Christopher Pogson Roadrunner Rehabilitation Larry Yak The 140 Club is the designation used to describe and honor those individuals who have donated at least one hundred and forty dollars ($140.00) to the PAF in a calendar year. The 140 refers to the CPT code for manual therapy, The 140 Club members are investing in the future of our profession by ensuring that money and resources are available to fight for the protection of our right to practice orthopaedic manual physical therapy. Our 140 Club members receive numerous benefits: A warm fuzzy feeling in the center of their chest. Recognition in Articulations. Recognition on our web site. Recognition at our annual conference. ***Send your membership ($140 AAOMPT PAF ) to our headquarters in Tallahassee*** Member-at-Large Report Member-at-Large Report Krista J. Clark, PT, FAAOMPT Proposed Bylaws Changes There are a number of issues facing the AAOMPT with regards to the bylaws. We have recently had a compliance review of AAOMPT IFOMT bylaws and an analysis of our bylaws done by Parliamentarian John D. Stackpole. He gave suggestions for conformity with the IFOMT bylaws and consistency within our own bylaws. In addition, there are several issues that the Executive Committee and Committee Chairs and members have discussed that need to be addressed. Some of the changes we need to make are merely housekeeping and some are rather considerable. We have put the bylaws on the website for your reference. Please refer to in the Members Only section and link to Resources for the current version of the bylaws. These topics and other proposed changes will be discussed at the business meeting at the annual conference on Saturday Oct. 23. Balloting will be done by mail vote following the conference. Following are the highlights of the issues to be addressed: We are looking at changing the interim wording of residency/fellowship to fellowship. The concern not to create language that may exclude fellows who completed programs when residency was the recognized term has dissipated. The standards committee will refine a policy to address eligible graduates who completed programs when residency was the accepted term and who may still apply for fellowship status. The Executive Committee and members have discussed the need for credentialing relationships with other IFOMT member organizations for consideration of foreign residency trained members for fellowship. At the meeting in Cape Town South Africa, Ken Olson initiated addressing this issue by communicating with members of the IFOMT executive and delegates from other member organizations. We have discussed empowering the AAOMPT standards committee to develop these relationships. In analysis of compliance with IFOMT bylaws for voting rights, Mr. (continued on page 5)

5 5 Kaltenborn Teach I Must Executive Board Reports continued Award The Executive Committee and the Awards Committee are pleased to announce the annual institution of the Freddy Kaltenborn Teach I Must Award. Dr. Kaltenborn has been a consummate teacher and leader in OMPT for decades. His worldwide teaching and books on arthrokinematics and specific manipulative techniques have profoundly influenced today s clinicians, teachers and researchers. He was instrumental in bringing together leaders of the OMPT residency programs in the U.S. to found the AAOMPT. This paved the way for full membership in the International Federation of Orthopaedic Manipulative Therapists. This award will be given to an outstanding instructor in an APTA credentialed clinical fellowship in orthopaedic manual physical therapy. The candidates must be nominated by one of their students or former students with a second by another student. Students must currently be enrolled in, or have completed an APTA credentialed OMPT Fellowship program. Nomination procedure is via to Tamara Little, Nominations and Awards Committee Chair, at tlittle@pacific.edu. Both students must send a statement giving the instructor s name, the program they teach in, highlights of the reason for the nomination and how the instructor has influenced their process of learning and applying orthopaedic manual physical therapy principles and techniques to patient care. Due date for nominations has been extended. Contact Tamara Little for more information. The award recipient will receive a complimentary conference registration and be recognized at the awards luncheon during the conference on Friday, October 22, Stackpole recommends changes to Article IV, Section 3: By inserting a clarifying sentence reading; Founding Members and Fellows may vote on matters concerning the IFOMT only if they have met the requirements specified in the IFOMT Bylaws. There are changes needed to clarify the duration of service and voting rights for the immediate past president as well as the appointing power of the president. There is some contradictory wording in the different sections of the bylaws. In Article IX, Section 2.B: change of language is needed to address membership dues payment and expiration. This goes hand-in-hand with the concern of Fellow being a membership category and credential. The Executive is considering making the position of IFOMT representative an elected position, as well as a few other items that are under review and may be presented at the business meeting. I would like to thank John Stackpole for his keen parliamentarian s eye in his analysis of AAOMPT and IFOMT bylaws. His review, the input and involvement of our members and committees have been very helpful. I am looking forward to the conference in October not only for the exceptional educational opportunity it affords but also for the opportunity for all to get involved at the business meeting and committee meetings. As we shape our future as an organization, involvement is makes all the difference. See y all in Louisville. Credentialed Clinical Fellowships in OMPT 1. Institute of Orthopaedic Manual Therapy (IOMT) c/o Orthopaedics Plus 101 Cambridge, Burlington, MA Phone (781) Fax (781) Contact person: Martin Langaas, PT, OMT iomt@yahoo.com 2. Kaiser Permanente Los Angeles Orthopeadic Manual Therapy Fellowship Physical Medicine and Rehabilitation 6041 Cadillac Ave., Los Angeles, CA Phone (323) Fax (310) Contact person: Joe Godges DPT, MA, OCS Joseph.J.Godges@kp.org http//xnet.kp.org/socal_rehabspecialists/ 3. Kaiser Hayward PT Fellowship in Advanced Orthopedic Manual Therapy Hesperian Blvd., Hayward, CA Phone (510) Fax (510) Contact person: Carol Jo Tichenor, MA, PT caroljo.tichenor@kp.org 4. The Manual Therapy Institute 2204 Old Mill Rd., Cedar Park, TX Phone (512) Contact person: Pieter Kroon, PT, OCS, FAAOMPT or Tim Kruchowsky PT, OCS, FAAOMPT mti@austin.rr.com 5. NAIOMT, Inc Coburg Rd., PMB 129, Eugene, OR Phone (800) Fax (541) Contact person: Mary Sokol Chavin 6. U.S. Army-Baylor University Postprofessional Doctoral Program in Orthopaedic and Manual Physical Therapy Brooke Army Medical Center 3851 Roger Brooke Dr. Fort Sam Houston, TX Phone (210) Fax (210) Contact person: Dan Rendeiro, PT, DSc, OCS, FAAOMPT Daniel.Rendeiro@cen.amedd.army.mil 7. Ola Grimsby Institute 4420 Hotel Circle Court, Suite 210 San Diego, CA Phone (800) Fax (619) Contact person: Ola Grimsby, PT, MOMT info@olagrimsby.com 8. University of St. Augustine for Health Sciences 1 University Boulevard St. Augustine, FL (904) ext. 254 Contact person: Catherine Patla, PT, DHSc, OCS, FAAOMPT cpatla@usa.edu *For information regarding APTA approved Fellowships/Residencies in Manual Therapy go to the APTA website at

6 6 International Affairs Committee Submitted by Alycia Markowski (Committee Member) The 8th International Federation of Orthopedic Manipulative Therapists, Conference was filled with exciting developments in evidence based treatment approaches from around the globe. Papers from 21 different nations were presented to delegates representing 40 countries. The United States was in the top 5 of the most represented nations. The conference was hosted in Cape Town, South Africa; a beautiful city with even better hospitality. The conference entitled Balancing the Outcomes of Manual Therapy achieved just that. The major themes focused on the identification and classification of dysfunction that will benefit from manual therapies, assessing our effectiveness as therapists to treat these disorders, and most importantly identifying the biomedical, psychosocial and biopsychosocial approach to health and disability. Through current research we have identified the need to focus on sub-grouping and classification in order to better assess our management strategies. Julie Fritz and Julie Whitman both presented aspects of their current research and were outstanding representatives of the Academy, and hence the USA. Michele Sterling, Gwen Jull and Paul Hodges from the University of Queensland, Australia continue to make excellent advancements on identifying patients with whiplash associated disorders who will respond well to therapy. They also continue to make exciting advancements in identifying our skills as therapists in addressing motor control dysfunction with the use of EMG and real-time ultrasound. The need still remains for clinically viable, noninvasive assessment tools. The final and most recurrent theme focused on exploring the important role of the brain in health and disability. The research of Paul Watson and Lorimer Moseley supplies clinicians with the evidence to support our role as educators to address pain processing, fear avoidance, and motor control. There is a need for more in depth psychosocial assessment and a means of identifying those individuals who will require an early interdisciplinary approach. IFOMT has made some amazing strides under the direction of Agnetta Lando, the former president and is expected to continue to do so under the new direction of Michael Ritchie from Canada. The website is an invaluable resource: which continuously updates clinical research in relation to current clinical guidelines as well as expert resource contacts. I urge everyone to mark their calendar as June 9 13th 2008 promises to be an exciting conference in Rotterdam, Netherlands. Practice Affairs Committee Submitted by Bill Boissonnault, PT, DHSc, FAAOMPT General Legislative Update: As of July, four states had Chiropractic-driven legislative activity in 2004-South Carolina, New Jersey, New York and Oklahoma. The South Carolina and Oklahoma bills were killed in committee. While, the New Jersey and New York bills are still in committee. The 2005 forecast (continued on page 8)

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8 8 Committee Reports continued from page 6 includes activity in Georgia, and possibly Texas as they consider Sunset Review of their practice act. If you live in any of these states please contact the Chapter office and offer assistance, including making sure they have contacted APTA State Governmental Affairs. This will insure the Chapters receive the appropriate resources developed by the Academy, APTA and the Orthopaedic Section. Internet Access for Legislative Updates: The Academy has arranged with APTA for Academy members to link to the APTA State Governmental Affairs website from the Academy s website. This link will provide Academy members with quick access to legislative Chapter updates, plus APTA is developing a page specific for manual therapy issues. Manipulation Legislative Resources for APTA Chapters: The APTA Manipulation Action Packet will be sent to APTA Manipulation Task Force members this Fall for review and update. The Orthopaedic Section Practice Committee will discuss the status of the Manual Therapy Legislative Compendium during a Summer conference call headed by Robert Rowe. Manipulation Education Manual (MEM): Under the leadership of Trish King the MEM has been completed and the distribution has begun. The MEM will be a valuable resource for academic and clinical education faculty. Copies of the MEM were sent to all PT Program Directors, APTA Chapter Presidents, APTA BOD and Education and Orthopaedic Sections leadership. The MEM is also provided to participants attending the Manipulation Continuing Education Courses being sponsored by the Academy. The initial Academy manipulation course, sponsored by Regis University, Denver, CO, was very wellattended. In addition, there will be a 2- day pre-conference faculty workshop at the Fall, 2004 AAOMPT Conference and there will be 3 courses offered next year, plus CSM 2005 programming. Manipulation Language in APTA PT Education Documents: One of the original APTA Manipulation Task Force s goals was to have specific manipulation language in the APTA Normative Model for PT Professional Education and the CAPTE Evaluative Criteria for Accreditation of PT Professional Programs. We have partially succeeded. The 2004 Normative Model contains language under Manual Therapy Interventions-page 146; Mobilization/manipulation including thrust and non-thrust of the spine and peripheral joints. Our proposed similar language for the CAPTE criteria has made it into the 2 nd draft! Bill Boissonnault presented testimony in support of our efforts at the CAPTE Open Forum held during the Annual Conference in Chicago in support of this language. The CAPTE target date for finalizing the language remains October, The language will then go into effect January, Standards Committee Submitted by Catherine E Patla, PT, DHSc, MMSc, OCS, MTC, FAAOMPT Bob Rowe, PT, DMT, MHS, MOMT, FAAOMPT The Standards Committee remains active with several tasks that include the development of a process and mechanism for Fellow re-recognition, working to assist groups who are in the process of developing a manual therapy fellowship, developing a Break Out session for the AAOMPT 2004 Conference, and we are revising the annual renewal form for institutional members and for those seeking recognition as a Fellow within the AAOMPT. The Standards Committee is close to finalizing the process and mechanism to perform the re-recognition of Fellows when their 10 year certification expires. As mentioned in a previous report, we are somewhat behind since several Fellows 10 year certification expires in The Standards Committee will present their recommendation to the AAOMPT Executive Board at the Annual Conference and expect immediate implementation upon approval. The AAOMPT Executive has agreed to extend the certification for Fellows whose expiration date is in 2004, 2005, and 2006 until Therefore all Fellows whose certification expires between 2004 and 2007 will complete the re-recognition process by 12/31/07. The Standards Committee established a task force that is revising the current renewal process including documentation for AAOMPT institutional members. This tool will be in place by Fall 2004 so it will be utilized for the renewal process at the end of The task force is also investigating the current application process for individual members to apply for recognition as Fellows within the AAOMPT. This is expected to be completed by the 2004 AAOMPT Annual Conference as well. The Standards Committee continues to serve as a resource to those interested in developing a Manual Therapy Fellowship. Currently we have assisted several groups who are in various stages of the process. If you are considering development a manual therapy fellowship in the near future or you are already somewhere in the process, please feel free to contact us. As you know the Standards Committee is developing and sponsoring a break out session at the 2004 AAOMPT Annual Conference that will be focused on Development of a Manual Therapy Fellowship. This will provide participants with an overview of the entire process including the logistics of having a Manual Therapy Fellowship. Education Committee Submitted by Marcie Swift & Dave McCune Planning and organizing for the Annual Conference is complete. We have a full and interesting slate of clinicians and researchers sharing their expertise on the topic of Functional Manaul Physical Therapy. We will be exploring the essential combination of exercise and manual physical therapy techniques in the management of musculoskeletal disorders and dysfunction. Keynote speakers include: Brian Mulligan and Karim Khan, MD. Breakout session opportunities include a wide array of talented individual speakers and topics. (continued on page 9)

9 9 The Manipulation Task Force in conjunction with the APTA Department of State Governmental Affairs identified a working group, the Manipulation Education Committee, in early 2003, to develop strategies to heighten awareness among academic and clinical faculty of legislative and regulatory threats to physical therapist use of manipulation in practice and in academic instruction. The Manipulation Education Manual (MEM) was developed to support the ongoing efforts in physical therapist education programs to provide appropriate, evidence-based instruction in thrust manipulation. The MEM has been an outstanding collaborative effort between the APTA and the AAOMPT. The APTA manipulation task force has given the AAOMPT the opportunity to offer 4-5 courses in for faculty and clinical instructors on Manipulation in 1st professional Physical Therapist programs based on the MEM document. The first course will be offered as a pre-conference course at the Annual Conference in Louisville, KY. Nominating Committee Submitted by Tamara Little, DPT, FAAOMPT The Nominating Committee would like to thank all members who have thus far informed the committee of their willingness to serve in various capacities and remind all members that nominations are still being taken for Member-at Large, Treasurer, and Nominating Committee Member. Any member or fellow in good standing may be elected to the executive committee as a Member at Large. This position offers an excellent opportunity for any member to be involved. Nominees for Treasurer or Nominating committee member must be fellows. Election will be by mail ballot in November or December of Terms of service will be for 3 years beginning in January of The Nominating committee would like to encourage all members to consider serving in any of these capacities. Nominees should submit a personal statement not to exceed 150 words, biographical information not to exceed 150 words, a passport size electronic photo, and a signed statement agreeing to serve if elected. Submit this information or questions regarding nominations to Dr. Tamara L. Little, Chair of the Nominating Committee, at tlittle@pacific.edu. Receipt of information will be acknowledged by return . Institutional filters are less than perfect, and occasionally inadvertently prevent receipt of legitimate mail. If you do not receive acknowledgement by return , please follow up with a phone call to Dr. Little at Nominations are also being taken for the Freddy Kaltenborn Teach I Must award. Information regarding the nomination process for these two awards is included elsewhere in this edition of Articulations. In other business, the nominations committee will be discussing ways to streamline the nominations process for awards at the next meeting. Members should feel free to forward any suggestions regarding the process to the chair. (continued on page 10)

10 10 Committee Reports continued from page 9 Membership Report Submitted by Anne Campbell, PT, MS, OCS, FAAOMPT THOSE WHO PARTICIPATE USUALLY GET THEIR WAY Really? Let s explore this together... Hello Friends and colleagues, from your friendly Membership Chair. I hope your summer has been great. As I sit enjoying a beautiful summer day, rare for August in Texas, I think about sitting and enjoying a beautiful professional day. Relaxed, confident about the future of my profession in general and my practice in general. I have not experienced that feeling for a long time. Have you? I am very glad that you are out there, however, sharing my concerns for the future, my legislative, practice and reimbursement worries. Having Wilder life on Safari. Countries: Australia, Canada, Great Britian, Iceland, Norway, Slovenia, Spain and USA. been a Physical Therapist for over 30 years, I realize that in the last ten years, there have been few if any moments of a RELAXED confidence in the future. Dire comments? Actually, knowing you are there, all of you, makes this not so dire. Read on, please. I know that there are so many of you working at the details of state and national legislation, at lobbying and just at continuing in excellence in practice. So, I write this reminding you that your membership, your participation, makes a difference. In the recognition that healthcare in general, and Physical Therapy is particular, is in the middle of difficult times, INVOLVEMENT is truly the key. There is one truth regarding organizational membership that I recognize after all of these past few years. Let me share it with you. Wow - what a concept. But it is SO Wildlife on Safari. Julie Whitman and Anne Campbell share a manipulation technique with Shangana tribal chief. true. Take the APTA. Delegates are those who show up to local meetings, interact and become state delegates. They show up at state meetings, speak up and participate in the Business meeting. They get known, and become APTA delegates. A few hundred of the 100 thousand + Physical Therapists out there. That would be less than one-half of one percent. So, take AAOMPT. About 1200 members. Of how many Orthopaedic Manual Physical Therapists out there? And how many of you are at our Business Meeting? Less than 200. How many at our Conference? A few hundred - for the best orthopaedic programming available in the USA. We have one of our best advocates, Steve McDavitt, on the APTA Board of Directors, our most recent such accomplishment. A few very interested persons in AAOMPT are having huge impact on the APTA in its development of Manipulation Guidelines for entry level and for general practice. WHO you say - they are doing WHAT? Well, come on to the Conference, in Louisville Kentucky, October, Transform one of them into One of US. It was remarkable, in Capetown, South Africa, to see so many Manual Therapists from so many countries. We have many common problems, which is comforting. There are so many Manual Therapists doing such remarkable work, which is humbling. Our own Julie Whitman won a research award, which is so encouraging. And the Manual Therapists there were setting the world standards for Manual Therapy in the future. It seems that Manual Therapists are truly setting the standards for clinically relevant evidence-based practice in Orthopaedic Physical Therapy. I really look forward to seeing you in October, Louisville Kentucky. Meanwhile, do yourself a favor. Invite a friend to join. Share the message. We will all win if you do. Thanks for being a member, thanks for reading this, and thanks in advance for your efforts.

11 11 Practice Affairs Corner I would like to thank Academy members (and Practice Committee members) Gwen and Ken Simons for their overview of the APTA House of Delegates. The purpose of the column is to update membership of recent House activities and hopefully encourage Academy members to consider running for election as a Chapter delegate to the House. Keep us informed as issues come up. The Academy contributes to a tremendous collaborative structure (APTA Manual Therapy Task Force) designed to respond to legislative challenges, but we rely on information from the grassroots membership to guide our activities. Membership profile for 2004 Bill Boissonnault, PT, DHSc, FAAOMPT Founding Members: 8 Student Members: 49 Fellows: 347 Institutional Members: 7 Members: 932 Foreign Trained Members: TOTAL: 1347 NEW FELLOWS Josephine Flees John W. Ware David Saraceni Jeff Nasman Howard Levine Leilani Connors Dr. John Medeiros Named Pacific University s 2004 Distinguished University Professor Medeiros is one of three professors who were awarded a Hewlett grant to create an interdisciplinary course on understanding disabilities that has been incorporated into a disabilities study minor for undergraduate students at Pacific. In being named Distinguished University Professor, he was cited for his vision, persistence and professional self-understanding in moving the University forward as a place in which the liberal arts permeate the professional programs and where the College of Arts and Sciences are deeply informed by a sense of civic mission. For example, he and a faculty colleague in the philosophy department developed and implemented a comprehensive bioethics curriculum in the School of Physical Therapy in 2002.

12 12 O s c i l a t i o n s In the January / February edition of Articulations (Vol.10, No.1 p11), Stephen McDavitt PT, MS FAAOMPT, in his AAOMPT Vice President s Report, addressed the APTA position CLINICAL CONTINUING EDUCATION FOR INDIVIDUALS OTHER THAN PHYSICAL THERAPISTS AND PHYSICAL THERAPIST ASSISTANTS HOD (Program 60) [Initial HOD ] and it s implications for its use as a tool in PT peer edification in teaching continuing education. As an example in his report he described a situation involving conflicts within a continuing education course being taught by a physical therapist to students other than physical therapists. The course used as an example was an NATA course on mobilization of the lumbar spine with a prerequisite of extremity mobilization being taught by a PT who is a member of APTA and therefore falls within that member supporting APTA positions. In reading a copy of Stephen McDavitt s report, the NATA sent a letter to AAOMPT wishing to address concerns they had with the points mentioned about the NATA course described in that report. The AAOMPT Executive felt strongly that the sincere concerns of the NATA be respected and voiced in an open forum within Articulations with an opportunity of a reply to their concerns. Below, are the concerns addressed by the NATA to AAOMPT with a reply by Stephen McDavitt PT MS FAAOMPT, Vice President, AAOMPT.

13 13 O s c i l a t i o n s Dear Editor, Thank you for the opportunity to respond to the concerns expressed by the NATA as they pertain to my AAOMPT Vice President s Report in Articulations (Jan/Feb; Vol. 10 No.1; 2004; p.11). It is very unfortunate that the NATA read my report as a misrepresentation of the capabilities of the athletic trainer. Such a view is totally opposite to the meaning and intent of my report. My report specifically addressed the APTA position CLINICAL CON- TINUING EDUCATION FOR INDIVIDUALS OTHER THAN PHYSICAL THERAPISTS AND PHYSICAL THERAPIST ASSISTANTS HOD (Program 60) [Initial HOD ] and it s implications for physical therapists who provide continuing education courses in physical therapy. The position states; It is the position of the American Physical Therapy Association that: Physical therapists and physical therapist assistants conducting clinical continuing education courses are obligated to identify target audiences and indicate in the printed, lecture, and advertising materials, that course content is not intended for use by participants outside the scope of their license or regulation. Furthermore, they should make it clear when teaching elements of physical therapist patient/client management that subsequent use of those elements is physical therapy only when performed by a physical therapist or by a physical therapist assistant under the direction and supervision of a physical therapist, in accordance with Association policies, positions, guidelines, standards, and ethical principles and standards. In the interest of public safety, physical therapists and physical therapist assistants should not conduct clinical continuing education courses that teach elements of physical therapist patient/client management to individuals who are not licensed or otherwise regulated, except as they are involved in a specific plan of care, and in accordance with Association policies, positions, guidelines, standards, and ethical principles and standards The course mentioned in the AAOMPT report was used as a specific example of how the APTA position might apply to a continuing education course being taught by a physical therapist to students other than physical therapists. The course was an NATA sponsored course on mobilization of the lumbar spine. The instructor was a physical therapist who is a member of APTA and who, therefore, might be expected to support the APTA position noted above. The actions mentioned in the report had nothing to do with policing the NATA in regard to its guidelines, policies or positions. The references (continued on page 15)

14 14 CLINICAL PEARL Figure 1 Figure 2 Aquatic Dynamic Lumbar Stabilization Todd Watson, DPT, OCS, FAAOMPT Will Summers, MPT Spinal instability has often been described as excessive or abnormal quality of motion in a vertebral motion segment. 1,2 Dynamic lumbar stabilization has historically been advocated as an effective intervention to ameliorate pain and loss of function. 3 A basic tenet of lumbar stabilization exercise programs involve teaching patients with low back pain how to maintain functional activities via dynamically stabilizing the impaired motion segment. Various exercise programs have been developed 4,5 which advocate progression for the core stabilizing muscles from simple activation (phase 1) to holding while performing extremity motion exercises (phase 2), and finally holding during dynamic activities (phase 3). We are introducing aquatic dynamic lumbar stabilization exercise, which for our purposes would be classified as a phase 2 exercise. The advantage to aquatic dynamic lumbar stabilization, in addition to the challenge of stabilizing on an unstable platform, is the heat, and buoyancy (unloading) of the water. The general feeling is that there is a reduction in fear-avoidance behavior due to the comfort of the water. Below is an example of one such exercise. The patient uses two floatation devices, one for the upper extremity, and one for the lower extremity. The patient begins with the lumbar spine relaxed (figure 1), and is then asked to move into neutral spine position (figure 2). The clinician can see that the patient has moved from a full lordosis to a neutral position as the lumbar spine is elevated out of the water. Figure 3 represents a close-up of figure 1, and figure 4 is figure 2 close-up. The patient is asked to initially hold for second periods. Frequency, duration and progressions are per patient response & clinician judgment. Figure 3 Figure 4 1. Dupuis, PR, Yong-Tiing, K, Cassidy, JD, et al. Radiologic diagnosis of degenerative lumbar spine instability. Spine 10: ; Panjabi, M. The stabilizing system of the spine, part II. Neutral zone and stability hypothesis. J Spinal Disorders 5: ; O Sullivan, PB, Twomey, LT, Allison, GT. Evaluation of specific stabilizing exercise in the treatment of chronic low back pain with radiologic diagnosis of spondylolysis or spondylolisthesis. Spine 22: ; Liehmohn, W. Exercise prescription and the back. 2001, New York, McGraw-Hill. 5. Norris, CM. Back stability. 2000, Manchester, UK, Human Kinetics.

15 15 Improving End Range Flexion of the Shoulder By Vikas Johri, PT, MTC Patient s Position: Lies supine on the table with hips and knees flexed (to prevent hyperextension of the lumbar spine). A towel is placed under the scapula for stabilization. Therapist s Position: Stands by the patient s shoulder facing the feet end. Cranial hand (figure 1) holds the distal end of humerus and caudal hand (figure 2) holds the proximal end of the humerus with first web space. Figure 1 CLINICAL PEARL Technique: Therapist s flexes the patient s shoulder to the restriction and then provides a long axis distraction to humerus with the left hand (to minimize the joint compression during the final thrust). Therapist then cricumducts the humerus to find the barrier. Final thrust is provided by the right hand in the dorsal direction parallel to the plane of glenoid fossa. Figure 2 Oscillations Oscillations continued from page 13 in the article have no implications other than to physical therapists teaching in conflict with an APTA position. Based on that particular APTA position, my report questioned the appropriateness of a brief weekend course on the lumbar spine requiring only entry competencies of extremity mobilization with no prerequisites for knowledge or skills in manual therapy to the spine. Further, in support frankly for the NATA, I openly published my finding and admission when I questioned the instructor on the competency level for such education being within ATC practice guidelines or scope of practice and was directed and referenced to the NATA Athletic Training Educational Competencies Manual, 3rd Edition,1999. In my report I pointed out that the manual referenced states; the student will demonstrate the ability to assess joint end point and to select and perform appropriate joint mobilization techniques for the appendicular and axial skeleton, including the following: a) long-axis distraction and b) appropriate glides. In my opinion if anything, this inclusion in the report exemplifies my open recognition and acknowledgement of my apparent invalid assumption of limited documented / referenced competency for ATCs in spinal (axial / appendicular) manual therapy and elevated the awareness of the NATA publication that professed ATC competencies in this area. Even though such a description appears in that document however, I further mentioned in my report that I questioned whether that document alone could suffice to ensure that the participants in the continuing education had actually completed curricula that would have prepared them for this particular course content. In closing, nothing in my actions or report even remotely claimed that athletic trainers are a public health threat. I never made reference to APTA positions or policies other than that noted above. There is nothing in the report that misrepresents athletic trainers, because it addresses only physical therapists. I hope these comments serve to dispel any misperceptions concerning my report. Sincerely, Stephen McDavitt PT, MS, FAAOMPT Vice President AAOMPT

16 16 10th Annual AAOMPT Conference Functional Manual Physical Therapy: The Essential Combination of Manual Therapy and Exercise Distinguished Guest Speakers Brian Mulligan, FNZSP (HON), Dip MT Karim Khan, MD, PhD Pre-Conference Courses October 20-21, 2004 October 22-24, 2004 The Seelbach Hilton Louisville, Kentucky

17 17 Wednesday, October 20, :00-5:00 pm Mulligan Manual Therapy: An Advanced Course Presenter: Brian Mulligan FNZSP (HON), Dip MT 8:00-5:00 pm Manipulation in First Professional Physical Therapy Programs Presenters: Timothy W. Flynn, PT, PhD, OCS, FAAOMPT Elaine Lonnemann, PT, MSc, FAAOMPT Kenneth A. Olson, PT, DHSc, OCS, FAAOMPT Thursday, October 21, :00-5:00 pm Mulligan Manual Therapy: An Advanced Course (Day 2 of 2) Presenter: Brian Mulligan FNZSP (HON), Dip MT 8:00-5:00 pm Manipulation in First Professional Physical Therapy Programs (Day 2 of 2 day course) Presenters: Timothy W. Flynn, PT, PhD, OCS, FAAOMPT Elaine Lonnemann, PT, MSc, FAAOMPT Kenneth A. Olson, PT, DHSc, OCS, FAAOMPT 8:00-5:00 pm The Use of Real-Time Ultrasound in the Management of Lumbopelvic Dysfunction Presenter: David A. McCune, PT, Mphty, St, OCS, ATC, FAAOMPT 7:00 pm Opening Reception SCHEDULE OF EVENTS Friday, October 22, :00 am Registration Open 8:30-10:00 am Mulligan Approach to Functional Manual Therapy 10:00-10:30 am Exhibitor Break 10:30-12:00 pm Mulligan Approach to Functional Manual Therapy (cont d) 12:00-1:30 pm Lunch for all conference attendees 1:30-3:00 pm Tendinopathy: Clinically-Relevant Science and Evidence Based Treatment 3:00-3:30 pm Exhibitor Break 3:30-4:30 pm Tendinopathy: Clinically-Relevant Science and Evidence Based Treatment Saturday, October 23, :15-8:15 am Committee Meetings 8:30-10:00 am Breakout Session 1 10:00-10:30 am Exhibitor Break 10:30-12:00 pm Breakout Session 2 12:00-1:00 pm Lunch 1:00-2:30 pm Breakout Session 3 2:30-3:00 pm Exhibitor Break 3:00-4:30 pm Breakout Session 4 4:45-7:45 pm AAOMPT Business Meeting 7:00-11:00 pm Reception Sunday, October 24, :30-1:00 pm Research Presentations (See below for schedule) Research Presentation Schedule Sunday October 24th. 8:30-1:00 TIME PLATFORM PRESENTATIONS TIONS PRESENTER 7:45 am WELCOME to Research Day Todd Watson 8:00 am The interrater reliability of the cervical rotation lateral flexion test and correlation to first rib mobility testing. Phil Sizer 8:15am Lumbosacral nerve root mobility within the lateral recess and strain during distally initiated straight leg raise neural tension testing: a fresh cadaveric study. Phil Sizer 8:30 am Straight leg raise and slump testing for low back pain provocation: Evaluation of specificity and sensitivity in a population of 40 to 80 year olds. Phil Sizer 8:45 am SI Joint Injections with Manipulation: a Study in Therapeutic Efficacy. Jim Beazel 9:00 am Risks associated with the failure to offer manipulation for patients with low back pain. John Childs 9:15 am Immediate effects of thoracic spine manipulation in patients with neck pain: A randomized controlled trial. Josh Cleland 9:30 am Psychosocial variables associated with back pain in the elderly: A retrospective analysis. Chad Cook 9:45-10:15 am Unopposed Poster Viewing with Authors ALL PRESENTERS 10:15 am Immediate effects of a cervicothoracic gapping manipulation on shoulder flexion and grip strength. Dale Jensen 10:30 am Introduction of the standardized traction measure to quantify forces delivered during mechanical traction. Guy Majkowski 10:45 am Spinal Topography Analysis with a Shadow Moiré - Phase Shifting Technique. Kenneth Olson 11:00 am Thrust joint manipulation clinical education opportunities for entry-level physical therapy students. Bill Boissonault 11:30 am-1:00 pm INVITED LECTURE Keynote Research Presenter Julie Fritz

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20 20 What is a fellow and what can I do to become one? Afellow is an individual who has demonstrated that they are functioning, within an orthopaedic manual therapy practice setting at an advanced level. Fellows are generally members of the AAOMPT who may serve on the Executive Board as an officer and fellows are also authorized to vote regarding changes in the Constitution and Bylaws of the AAOMPT. There are many benefits to becoming a member such as the items just stated above as well as the voluntary listing of your name on the AAOMPT website as a fellow where potential patients/referral sources/third party payers may seek you out. You also receive The Journal of Manual and Manipulative Therapy, the very informative quarterly newsletter Articulations, and discounted rates to AAOMPT sponsored CEU courses and conferences. There are two mechanisms by which an individual can become recognized as a fellow within the AAOMPT. The first is to demonstrate that you are a graduate of a fellowship program in manual therapy credentialed by the American Physical Therapy Association (APTA). A fellowship program in Manual Therapy is a program of study in manual therapy involving both mentored clinical hours and didactic study. Fellowships in manual therapy are directed towards a clinician who currently demonstrates advanced skills in orthopaedics. Fellowship programs in manual therapy are credentialed by the APTA. Three documents are imperative to study regarding the process and content for fellowship programs. The documents are: Standards for Orthopaedic Manual Therapy Residency Education (1999), Description of Advanced Clinical Practice (DACP) (1998) both acquired Catherine Patla PT,DHSc,OCS,FAAOMPT Bob Rowe PT, DMT,MHS,MOMT, FAAOMPT (Co chairs of AAOMPT Standards Committee) through the AAOMPT and Guidelines for Curriculum Development for Post Professional Residences in Orthopaedic Physical Therapy and Orthopedic Manual Physical Therapy (2001) published by the Orthopaedic section of the APTA and the AAOMPT and acquired through both organizations. Upon completion of the formal training through an APTA credentialed Manual Therapy program you are eligible to apply to become a fellow of the AAOMPT. A list of these programs can be found at apta.org and aaompt.org. The second mechanism for those who have not completed a formal training program, but believe that they have received the equivalent level of clinical expertise through years of informal clinical training, may go through a process known as the Challenge Exam. Up until Dec 31st 2006, a physical therapist who believes that they have achieved an advanced level of competency in manual therapy, through years of informal training, may choose to go through the challenge process. The challenge process includes completion of an application, development of a portfolio, and finally an oral/practical examination. Those who have successfully completed this process are eligible to apply to become a fellow of the AAOMPT. For specific inquiresof the benefits of being a fellow, visit the AAOMPT web site and click on Find a Fellow where you can find the contact information for fellows to make further inquiries. Terminology The following definitions were adopted by APTA and can be found on the APTA web site: Clinical fellowship A clinical fellowship is a post professional, funded, and planned learning experience in a focused subspecialty area of clinical practice, education, or research. The fellowship is intended for postdoctoral, post-residency prepared, or board-certified therapists. Information on the APTA website further describes the difference between a residency and a fellowship as: A clinical residency is designed to substantially advance a resident s expertise in examination, evaluation, diagnosis, prognosis, intervention, and management of patients in a defined area of clinical practice (specialty). This focus may also include community service, patient education, research, and supervision of other health care providers (professional and paraprofessional). Often, the residency experience prepares an individual to become a board-certified clinical specialist. A fellowship is designed for the graduate of a residency or boardcertified therapist to focus on a subspecialty area of clinical practice, education, or research. Additionally, applicants of a clinical fellowship program must have the following qualifications: 1) specialist certification or completion of a residency in a specialty area, 2) substantial clinical experience in a specialty area, and 3) demonstrable clinical skills within a particular specialty area. More Information at AAOMPT October 2004 meeting: At the AAOMPT meeting in Louisville, Kentucky on 23rd October 2004, Saturday, a scheduled break out session will occur titled: Benefits and Mechanism to Create a Manual Therapy Fellowship within your Practice/Institution This session will be informative for those seeking advice and posing questions regarding their own interests in mentoring, both as a participant and/or in developing a program.

21 21 McDavitt elected to APTA, Schenk to take his place If you have not already heard, Stephen McDavitt was elected to the APTA Board of Directors (APTA BoD) during the APTA House of delegates meeting in Chicago on June 29, 2004! The election is well deserved. Steve will be an asset to the Board of Directors and, no doubt, will serve with the same unwavering commitment with which he has served the AAOMPT. While serving on the APTA BoD, he will marshal his unique energy and expertise to positively influence all areas of our profession, not just orthopaedics and manual physical therapy. His election, however, is bittersweet. Steve will resign from the office of the Vice-President of the AAOMPT effective at the business meeting during the next AAOMPT annual conference in October. Steve has served as VP of the Academy for nearly two years during which time he has been liaison to the standards committee and the practice affairs committee. Steve served as practice committee chair for nearly six years prior to being elected as VP. Steve s experience in dealing with orthopaedic and manual therapy practice issues has been a great asset to the current executive and his expertise, wisdom, and energy will be missed. The executive has unanimously voted to have Ron Schenk complete the remainder of Steve McDavitt s term as VP effective with Steve s formal resignation in October. Biography Ron Schenk PT, PhD, OCS, FAAOMPT, Cert. MDT is an Associate Professor of Physical Therapy at Daemen College in Amherst, NY. Dr. Schenk earned his BS and MS degrees from Ithaca College, and a PhD from the University at Buffalo. An Orthopaedic Clinical Specialist, Dr. Schenk is credentialed in the Mechanical Diagnosis and Therapy through the McKenzie Institute, USA, and is a Fellow of the American Academy of Orthopaedic Manual Physical Therapists (AAOMPT). He has also completed the course sequence in Diagnosis and Treatment of Muscle Imbalances through Dr. Shirley Sharmann. While active in clinical practice, Dr. Schenk has published numerous clinical research articles in peer-reviewed journals and has presented this research at national and international physical therapy conferences. Dr. Schenk is also active in the Western District of the American Physical Therapy Association and has served as Secretary and Public Relations Chair of AAOMPT. Candidate Statement I am honored to be nominated to serve as acting Vice- President of the American Academy of Orthopaedic Manual Physical Therapists. I have served this organization as Secretary ( ) and more recently as Public Relations Chair. During this time, I have seen AAOMPT grow in stature to become recognized as the leading organization for the promotion and advancement of manual physical therapy practice and research. As Secretary, I maintained the correspondence for the Academy, actively participated in our two strategic plans, and served as liaison between the research committee and the Executive. This work has given me an understanding of the dynamics of the Academy, as well as our joint efforts with the APTA. WANTED: Literature and Book Reviewers Clinical Pearl Submissions for Articulations Improve your AAOMPT by contributing to the newsletter! Book Reviewers receive FREE books for contributions. Literature Reviewers and Clinical Pearl Submissions receive personal satisfaction for contributing to the OMPT profession. Interested? Contact Matt Garber at: Matt.Garber@aaompt.org The American Academy of Orthopedic Manual Physical Therapists 1705 S. Gadsden Street, Tallahassee, FL Craig Crosby, Executive Director, ccrosby@fpta.org Articulations is published three times a year. Advertisers please contact David Miers (269) Dave.Miers@aaompt.org for a rate card. AAOMPT 2004 All Rights Reserved.