After almost a year to the day of the country shutting down, this course marked a refreshing beginning to some normalcy with teaching PRI Myokinematic Restoration again. We had at least 50 participants virtually with attendees in and outside of the U.S. ranging all the way from Canada, Slovenia, and the UK. We had 9 in person attendees that made the trek to Lincoln and served as the “models” for our myokinematic lab portion.

We began the first morning with didactic material learning all about the patterns of the L AIC. This  included non pathology and pathology discussions in relation to the compensatory demands of the femur in the acetabulum. Respiration demands, underlying neurology and asymmetry helped to shape and understand the reasoning behind the L AIC pattern.

The weekend concluded with an ample amount of lab and hands on time, learning to assess position of the hip, compensatory findings, and frontal plane performance testing with the Hruska ADDuction test and Hruska ABDuction test. The attendees then went through myokinematic techniques to restore and retrain pathomechanics of the pelvis.

We had several thought provoking questions and the enthusiasm was great from the group and could be felt even virtually!

Jennifer Smart, DPT, PRC is one of three speakers for this year's 12th Annual Interdisciplinary Integration Symposium. This symposium topic came together as a result of the extraordinary work she has been doing with those managing Parkinson’s Disease in her community, and the engaging discussions she has had with Ron over the past couple years. Jen is a clinician at heart, but also one who is current with the research and medical advancements that have been made for those experiencing extrapyramidal symptoms.

Her growing interest in Parkinson’s Disease began around 2015 when her best friend was diagnosed. This was the year she completed the PRC credentialing program, and shortly after neurologist, Dr. Jay Alberts, published research showing how, when a person with PD rides on the back of a tandem that is being pedaled at a cadence of 80-90 RPM, a variety of their PD symptoms decrease. After dissecting the research, Jen bought a tandem bike, and her and her friend rode for over an hour 3 times a week at the specified cadence. Others with PD heard what they were doing, and she ended up getting several tandem bikes and set them up on stationary trainers at a local gym, where she coordinated having members of the local cycling community ride on the front to set the cadence while people with PD rode on the back. “Park’n Ride” was officially started as a non-profit in January 2015.

Based on the success of this cycling program, Jen has become a regional expert on Parkinson’s Disease, where individuals have moved to her small coastal town of Oriental, North Carolina after their diagnosis. She became certified in LSVT BIG, Parkinson’s Wellness and Recovery (PWR!) and Rock Steady Boxing, which are all evidence-based, Parkinson’s-specific programs. Jen has attended the Parkinson’s World Congress and has even volunteered for a week with Becky Farley, PT, PhD who developed LSVT BIG and PWR. In 2017, Jen received a grant from the National Parkinson’s Foundation to organize and run a two-day event, called the Parkinson’s Exercise Program (PEP) Retreat, which was designed to help both patients and medical providers better understand how to use exercise as an evidence-based treatment for PD.

In her own words, “What I have taken away from all of this training, from working extensively with this population, and from the currently exploding literature regarding the benefits of specific exercise programs for PD, is that, perhaps unknowingly, the components that make each of these treatment techniques so effective, are the components that are based on the science of PRI. People with PD, just like all of us, need to be able to rhythmically alternate, but their disease, or somewhere along their journey towards developing this disease, this ability to rhythmically alternate was compromised so they needed to develop involuntary tics, muscle spasms, tremors, restless legs, dystonia and/or postural changes to help them to get to the other side, to help them to alternate. This is now the message that I am trying to get across in both the prevention and treatment of Parkinson’s, and so many other, syndromes or diseases.”

Learn more about Jen’s upcoming presentations at our 12th Annual Interdisciplinary Integration below.

Practical Implication of Intervention and Management of Patients Who Have Been Diagnosed with Basal Ganglia Disease
-Jennifer Smart, DPT, PRC
The first half of this presentation will review a variety of diseases involving basal ganglia dysfunction, examining both their common and uniquely different motor and non-motor manifestations, while exploring not only the current and experimental pharmacological, surgical and physical treatment techniques that are being employed to treat them, but also the underlying reasoning behind each of these interventions.  The second half of the presentation will focus more on a variety of evidence-based physical treatment programs, compiling the common effective visual, auditory, postural and respiratory components from each physical activity program. Emphasis will be placed on assessing how each technique addresses the temporal, lateralization and pressure regulatory deficits seen in people who have been diagnosed with Basal Ganglia Diseases (in order to unlock, through oscillatory function, the axial skeletal system from the appendicular skeletal system in an attempt to better balance the autonomic nervous system with the central nervous system).

A Clinical Perspective on Geocentricism, Lateralized Linkages, Sleep, Timing and Weight Shifting
-Jennifer Smart, DPT, PRC
The research states that the Basal Ganglia is involved in the perception of time, but what does that clinically mean? It means that a person with a Basal Ganglia disease, such as Parkinson’s, does not know how to navigate through space since such movement is inextricably linked to time, not only for understanding when to move but also at what speed (since speed is distance per unit of time) but also for knowing where they are (“five minutes from home”) and how to integrate all their moving parts. For example, knowing when to supinate and for how long to experience appropriate weight shifting in order to avoid over lateralization relies on timing.  This presentation is going to discuss clinical ways to address the various issues involved with timing deficits, through visual, auditory, positional, and respiratory cuing, in people with Basal Ganglia deficits.

Clinical Case Study Presentations
-Jennifer Smart, DPT, PRC
This presentation will be a discussion of the treatment and management of several patients who have been diagnosed with Basal Ganglia Disease, either Parkinson’s Disease or Progressive Supranuclear Palsy (PSP). A few of the cases were ones in which Jennifer Smart had the opportunity to collaborate with Ron Hruska. Management discussion will include group exercise application, in addition to individual rehabilitation considerations.

There are four kinds of documentation that most of us use to change our behavior:  
1)  Learning oriented tutorials.
 2) Goal oriented how-to guides.
3) Understanding-orientated discussions.
4) And, information-oriented reference material.

Each of these four types of documentations usually have instances within the document that refers to related information elsewhere in the same document. This is important as it forms a network structure of relations that exist between different parts of data, dictionary-internal as well as dictionary-external. If the cross-reference mechanism is well designed, visibly or technically, the reader, and in this case, the course attendee, will be able to follow each and apply ‘cross-reference’ event, to the referenced content whether the content is presented visibly or technically.  

The last example, of the four listed above, enhances usability and application of content in each of the PRI Non-Manual Techniques. Documentation or description that identifies direct reference and referent sites of consistent interest; is required so documentation that indirectly implicates cross references from these and other discrete or unconsidered sites can provide content-strategies to meet the desired needs and expectations, from both the provider and the participant.

As the author of these techniques, and as the author of cross-referencing design associated with each technique, effort to ensure that location and content of the target of the cross-reference in each technique needs to be consistent, regardless of the aptness of the provider or the participant.  

These opportunities to provide my reasoning behind each of the techniques, that were selected by this course’s participants, are not exceeded in any other course offered in PRI. Therefore, the guidance I offer to answer questions on the ‘why’s, ‘when’s, ‘who’s and ‘what’s regarding each technique’s reference’s, referent’s, and cross-reference’s content, is an absolute unique opportunity for both the author and the attendee seeking behavior modification through documentation that is resourcefully dissected at a level that is unsurpassed in this Institute.  Each technique (documentation) dissection experience is truly one of the most rewarding things I have done in my life.  And I am grateful.

 
I want to thank Dan Houglum, Torin Berge, Dave Drummer, Jen, Hannah and RJ for their assistance in making this course so enjoyable to teach and apply to “real” life limitations and likenesses.

Happy New Year!

As we approached this New Year, I reflected on the the year that was 2020. As I transitioned into this new role of Executive Director at the beginning of this year, I could have never imagined the challenges we would be facing in just a few short months. I think most people would agree that 2020 was a year that none of us could have ever predicted, but even with the challenges presented from COVID 19, we were determined to make the best of it. And that’s just what we did! The events of 2020 really encouraged us to explore new ways to expand our ‘reach’. Although we already had our primary courses available online, we transitioned quickly to live stream virtual courses for our secondary, tertiary and affiliate courses, and this allowed us to reach interdisciplinary professionals from all over the world. Several live stream courses were sold out with 100 attendees, and many had at least a dozen countries represented. We are grateful that we were able to continue to reach you through PRIVY and podcasts, in addition to some new projects geared towards expanding our reach to the general public, including the ‘Restoring Alternation’ Patient Daily Living Guide. We also took advantage of the circumstances and reached thousands with our ‘PRI Breathing in COVID Times’ 9-week webinar series, which was (and still is) available online for both the general public and healthcare & fitness professionals. The word ‘reach’ has always been a staple of our Institute, and for those of you who are familiar with the PRI non-manual techniques, you have undoubtedly experienced the power of a reach. While our ability to reach you over this past year has been primarily through digital formats, we are excited to get back to reaching (with) you at our live in-person courses. We will be forever grateful for all of you who allowed us to continue to reach you during this crazy, uncertain past year that was 2020. It’s a year that we will never forget, but due to the circumstances that were presented, we now have many new means in which we plan to continue to reach you in 2021 and beyond.

Although we didn't print a brochure this year, you can see that 'reach' would have been the theme carried out within the pages of our Programs and Courses brochure. Please visit our website over the coming year for the most up to date schedule of our programs and courses. In addition to returning to hosting courses across the country this Spring, we are excited to be offerering over 20 live stream courses this year, and we will also have limited in-person attendance available for each of the live stream courses held in Lincoln, Nebraska.

We hope we have the opportunity to reach you, in one way or another, in this New Year!