Despite the growing amount of scientific evidence supporting exercise as an effective rehabilitation intervention for clients, translating that research into practice has proven challenging for clinicians. The result is that clients aren’t having their impairments appropriately assesses for the best object outcomes. Rather, clients often guide the progress based solely on their subjective biases. In more extreme cases, we see individuals who need intervention to assist with their impairment who are turning solely to exercise and attempting to rehabilitate without the guidance and skill or a licensed therapists.
It is time for a reset.
We must translate evidence-based rehabilitation into daily clinical practice to ensure that all clients receive adequate, intense, and progressive exercise rehabilitation.
This 2 day course presents a step-by-step approach for precision therapeutic exercise dosing and delivery within a comprehensive framework for implementing clinical best practice rehabilitation in daily practice within a value-based delivery system. As hands-on professions, practical lab components using real clinical scenarios are mixed with interactive discussion-based lectures for skills that can be applied right away in the clinic. To help therapists build clinical reasoning skills in exercise prescription, therapeutic exercise dosing and delivery are taught with an emphasis on the “why” and “how” rather than on specific
exercises. Hands-on skills for the clinical application of hand-held dynamometry in comprehensive assessment, documentation of objective strength measures, and precision exercise dosing are practiced and mastered.
We urge clinicians to move beyond symptom moderation alone, and this course focuses on delivering clinically meaningful improvements to clients in all 4 outcome domains: symptom moderation; impairment correction; subjective functional performance; and objective functional performance. Further, we teach a systematic structure to the order of interventions provided to a client within one session as well as the progression from session to session.
Our framework, the MET MET-odology, is a contemporary development of medical exercise therapy concepts introduced by Oddvar Holten. It does not replace your current treatment practices (the tools in your toolbox), rather it provides structure to them (your very organized toolbox).
- Define 2 guiding principles of the MET MET-odology.
- Identify the 3 contributing factors to clinical best practice.
- List 3 factors for optimal patient improvement.
- Describe 3 tactics for creating patient buy-in.
- Develop 1 treatment plan to achieve meaningful improvements in 4 outcome domains
- Apply the 4 training principles to therapeutic exercise prescription.
- Distinguish clinical muscular fatigue from muscle endurance and exhaustion.
- Operate a hand-held dynamometer (HHD) in 1 biomechanical examination.
- Execute Clinical Fatigue Tests (CFT) in 2 clinical scenarios.
- Recognize 3 dosing zones to achieve an appropriate physiological response.
- Interpret the results of a HHD test for the initial resistance for a CFT.
- Interpret the results of the CFT to appropriately dose 2 therapeutic exercises.
- Design 1 precision therapeutic exercise prescription.
Topics: exercise prescription; training principles; biopsychosocial model; hand-held dynamometry; clinical fatigue test; dosing and dosage; concentric, eccentric and isometrics; intra and inter session progression; optimal improvement; 4 outcome domains
All modules are a combination of lecture and lab
07:45 AM Registration
08:00 AM Introduction; Background; Pre-course reading discussion; Clinical Scenarios
09:00 AM The MET MET-odology
10:00 AM Break
10:15 AM Optimal Patient Improvement
12:45 PM Lunch
01:30 PM From Hand-held dynamometry (HHD) to Clinical Fatigue Test (CFT)
– HHD in daily clinical practice
– Movement bias tests
03:30 PM Break
03:45 PM From HHD to CFT
– Muscle-bias tests
– Exercise-bias tests
05:30 PM Adjourn
07:45 AM Check-in
08:00 AM Therapeutic Exercise dosing / dosage
– Clinical neuro-muscular fatigue
– Clinical Fatigue Test
10:00 AM Break
10:15 AM Therapeutic Exercise dosing / dosage
– Dose and physiological response
– Dosing guidelines – concentric
12:15 PM Working Lunch – Clinical Scenarios
01:00 PM Therapeutic Exercise dosing / dosage
– Dosing guidelines – isometric and eccentric
02:00 PM Revisit Clinical Scenarios (practical interaction)
03:00 PM Post- course interaction / Q&A
04:00 PM Adjourn
Course reading materials provided by MET following registration.
- Aerts F, Carrier K, Alwood B. Inter-rater Reliability of Sustained Aberrant Movement Patterns as a Clinical Assessment of Muscular Fatigue. The Open Orthopaedics Journal, 2016, 10, 125-134.
- Booth J, Moseley GL, Schiltenwolf M, et al. Exercise for chronic musculoskeletal pain: A biopsychosocial approach. Musculoskeletal Care. 2017 Dec;15(4):413-421.
- Brody LT. Effective therapeutic exercise prescription: the right exercise at the right dose. J Hand Ther. 2012 Apr-Jun;25(2):220-31.
- Khan KM, Scott A. Mechanotherapy: how physical therapists’ prescription of exercise promotes tissue repair. Br J Sports Med. 2009 Apr;43(4):247-52.
- Lorås H, Østerås B, Torstensen TA,3, Østerås H. Medical Exercise Therapy for Treating Musculoskeletal Pain: A Narrative Review of Results from Randomized Controlled Trials with a Theoretical Perspective. Physiother Res Int. 2015 May 25.