Assessment-Treatment-Prevention Cumulative Disorders of the Upper Limb

 (Regional Application of the Duffy-Rath System©)

Brief Description of the Course:

The Duffy-Rath System© (DRS) is a unique approach to the assessment, treatment and prevention of musculoskeletal disorders (MSD) and disability. Developed in 1984 by Wayne and Jean Rath, the system is currently utilized at outpatient clinics and industrial sites across the United States and internationally.  This workshop provides the clinician with a system to improve their effectiveness and efficiency in assessing and treating 6 common MSD affecting the upper extremity; all treatment strategies are oriented towards recovery of activity tolerance and long-term self-efficacy (i.e. secondary and tertiary prevention). The 6 MSDs are:

     1. Shoulder Impingement Syndrome

     2. Elbow Epicondylar Disorders

     3. Carpal Tunnel Syndrome

     4. Trigger Finger

     5. DeQuervain’s Syndrome

     6. OA 1st CMC

This workshop has an online and a live component. The online component must be completed before attending the live workshop; this involves having to successfully complete an ‘open-book’ test. The live workshop is a 1-day format with a focus to treatment strategies, procedures and problem-solving techniques specific to the most common back pain diagnoses and relevant classification systems. 

Pre-requisite to Registering for this Workshop: Evidence of successful completion of the online course entitled; “Introduction to the Duffy-Rath System©: Linking treatment and prevention for musculoskeletal self-efficacy” is required to register for this workshop.  

Workshop Goal:  Promote a systematic, prevention-oriented and non-operative approach to the treatment of 6 common repetitive strain disorders affecting the upper limb.  

Workshop Instructional Objectives – upon completion of this activity, participants will be able to:

1. Perform the DRS examination for each musculoskeletal region of the upper limb. 

2. Identify the distinguishing clinical characteristics required to diagnose the 6 MSDs from stage 1 to stage 3 presentations. 

Identify the indication for each of the 6 treatment strategies.

Perform manual and therapeutic techniques to achieve biomechanical control, restore ROM, normalize muscle contraction and/or restore function for the 6 MSDs.   

Identify the most common and relevant cautions and contraindications to physical therapy treatment of CTD/RSI of the upper limb. 

Workshop Schedule:

Topic

Description
Online Registration and Orientation Participants register online and are orientated to the structure and process for completing the online component.
Introduction  Application of DRS axioms to assessment, treatment and prevention of cumulative disorders of the upper limb.
Epidemiology: upper limb MSDs Incidence, prevalence, risk factors (onset, occupational reporting and disability distinguished), natural history, socioeconomic impacts and the growing issue of iatrogenic disability.
Anatomy & Biomechanics Review of relevant upper limb anatomy, biomechanical and physiological responses to movement and loading under normal and pathological conditions.
Diagnostic Imaging & Testing Review of the diagnostic accuracy of x-rays, CT scans and MRI relevant to upper limb disorders; focused to shoulder impingement and CTS mostly.
History & Basic examination of the shoulder Identifies and reviews the basic history and examination utilized in the Duffy-Rath System©.
History & Basic examination elbow/proximal forearm Identifies and reviews the basic history and examination utilized in the Duffy-Rath System©.
History & Basic examination wrist/distal forearm Identifies and reviews the basic history and examination utilized in the Duffy-Rath System©.
History & Basic examination of the hand Identifies and reviews the basic history and examination utilized in the Duffy-Rath System©.
Test Open-book test; 20 multiple choice questions – 80% passage required, multiple opportunities (i.e. as many as needed) provided.
Study Time 4 – 8 hours is expected to complete the online section of the course

 

Live Portion of Course
Time Regristration Brief Description
8:30 Registration & Continental Breakfast Participants sign-in and receive course materials.
9:00 Introduction & Online Review A brief lecture to review basic principles in the Duffy-Rath System© (DRS), identify the strengths and weaknesses of evidence-based practice, review guidelines and systematic reviews relevant to the 6  MSD.
9:15 Clear the C/T Spine (DEMO/LAB) The role of the C/T spine in upper limb function and the clinical process to identify or rule-out the C/T spine as the source of upper limb symptoms and signs is reviewed and practiced.  Common findings are identified and the growing problem with cervico-brachial syndrome is discussed.
9:45 Shoulder Impingement Syndrome  Demonstrate and practice basic DRS examination and discuss common findings and stages of the various disorders.
10:30 Break
10:45 Shoulder Impingement Continued  Continue practicing the most common treatment procedures used for the 3 stages of shoulder of the disorders.
12:30 Lunch  30 minutes
1:00 Elbow Epicondylar Disorders Demonstrate and practice basic DRS examination; Identify and practice performing the most common treatment procedures used for the 3 stages of elbow/proximal forearm disorders.
2:00 Carpal Tunnel Syndrome Demonstrate and practice basic DRS examination; Identify and practice performing the most common treatment procedures used for the 3 stages of wrist and distal forearm disorders.
3:00 DeQuervain’s syndrome Demonstrate and practice basic DRS examination; Identify and practice performing the most common treatment procedures used for the 3 stages of this syndrome.
3:30 BREAK  15 minutes
3:45 Trigger Finger Demonstrate and practice basic DRS examination; Identify and practice performing the most common treatment procedures used for the 3 stages of this syndrome.
4:15 OA 1st CMC Demonstrate and practice basic DRS examination; Identify and practice performing the most common treatment procedures used for the 3 stages of this syndrome.
4:45 Review & Summary  Summarize the online and live components; provide direction for further information and training.Certificates awarded after critique is submitted.
5:00 Conclusion  The day is summarized, instructions to prepare for day 2 are provided.
8 hours – 1 hour 7.0 Contact Hours (Total 11 hours)