Date of Course:
07 Oct 2018 - 10 Oct 2018
NEUROMUSCULAR CONDITIONING FOR REHABILITATION COURSE; INCORPORATING SCIENTIFIC PRINCIPLES TO ENHANCE OUTCOMES; Manama, Bahrain – With Dr Claire Minshull
Please contact Dr Asaad to book – +973 3343 3495
CPD point; 10 points by NHRA and Supported by Tamkeen fully 100% for Bahraini private sector only
07-10 October 2018
Course times : 8.30 AM – 4.30PM
@Claire_Minshull you were excellent, amazing, awesome and even more than that! you had such an attention and dedication to us, such a passion for teaching and a huge experience! and you gave us so many personalized tips and the most useful advice!
The focus here is on developing a basic understanding of the indices of neuromuscular performance that determine dynamic joint stability (Strength, muscle response times, rate of force development). We look at the terminology and definitions of each and how such influences the efficacy of rehabilitation and conditioning interventions – for example what ‘is’ strength and thus how can we optimally train it. In doing so we learn the limitations of prescribing 3 sets of 10 repetitions. We look at the measurement of these indices of performance, the underlying physiological events and establish a hierarchy of importance of each in its influence on dynamic joint stability, evaluated alongside the ‘time frame for injury’. The principles of specificity, progression and overload are introduced and critically evaluated within rehabilitation and conditioning settings and within the rehabilitation literature. Group work encourages incorporation of these basic principles in the design of progressive strength-focussed rehabilitation interventions for specific clinical case studies. Ultimately students will understand and be able to prescribe the correct dose of true muscle strengthening interventions with progressions and regressions to accommodate patients with different physical capabilities and goals
We recap the previous day’s learning on dynamic joint stability and strength rehabilitation and each group will peer-review each other’s strengthening intervention. The focus afterwards is on progressing our understanding of the rate of force development and the speed of muscle response; the underlying physiologic determinants, and their importance in avoiding injury or recovering from injury or surgery. Using the principles of specificity, progression and overload, group work will include the design of interventions that will ensure sustained adaptation of rate of force development and muscle response times. We separate out the performance characteristics and adaptation capability of contractile and non-contractile tissue, understand their influence on determining the speed of muscle response and ultimately inform the optimal design of rehabilitation/ conditioning interventions. It will become clear that one resistance-based intervention will not promote adaptation across a number of indices of performance important in joint function.
We critically evaluate the pertinent literature, both rehabilitation- and non-rehabilitation focussed. Ultimately students will understand and be able to prescribe the correct type and dose of intervention with progressions and regressions to accommodate patients with different physical capabilities and goals to promote adaptations in rate of force development and speed of muscle response.
Exercise-Induced Muscle Damage. Skeletal muscle is susceptible to ultrastructural damage following unaccustomed high-intensity eccentric exercise. This may be evident in individuals who commence training or match play following a prolonged period of inactivity, or in patients during rehabilitation following injury-related deconditioning and, or, surgery. The patterns of impairment, recovery and adaptation following exercise-induced muscle damage are different to following acute muscle fatigue and are subjectively recognised by symptoms of delayed-onset muscle soreness (DOMS) that peak 24-48 hours following exercise. We explore the physiological characteristics of exercise that induce muscle damage, the specific impairments to muscle function, recovery profiles and how to assess muscle damage. We will also explore how, through the repeated-bout effect, even subtle muscle damage can be used to enhance rehabilitation and provide an inoculation effect against future episodes of high-intensity exercise. Volunteer students will undertake a short, high-intensity exercise protocol on Day 2 of the course to illustrate the effects of muscle damage on function, subjective responses and recovery profiles. Students will assess these responses throughout the ensuing days. This will provide a practical exemplification of the pertinent to consider issues during the subsequent design of rehabilitation interventions. Prehabilitation: Prehabilitation has become a popular concept within sports medicine and rehabilitation settings, and research in to prehabilitation interventions is expanding as a means to improving post-operative outcomes, especially where significant post-operative declines are experienced. Within athletic populations, prehabilitation research can represent the evaluation of prophylactic interventions to prevent problems or injuries before they happen. Optimal neuromuscular performance is essential to the maintenance of dynamic joint function. Prehabilitation interventions offer the opportunity to intervene before an anticipated decline in function or performance and, or, to ameliorate the risk of injury. However, whether or not the strategy is effective is dependent on several factors, including the specificity of the intervention and the setting in which is it applied. Here we explore conceptually what prehabilitation is within a model for joint health and dynamic stability, evaluate the efficacy of prehabilitation strategies and identify the key components of an effective prehabilitation intervention within different clinical scenarios.
We recap the previous days’ learning and bring each element together within a clinical context. Students will be able to design and deliver specific and progressive rehabilitation and conditioning intervention to optimise the recovery/performance of each specific index of neuromuscular performance within both clinical and non-clinical settings. Knowledge and practical skill are advanced over the next two days of the course. Here we delve into the scientific literature and explore how contemporaneous advancements in neuromuscular performance research could enhance clinical practice. The Cross-Education Effect: Unilateral orthopaedic injuries carry a risk of significant asymmetry of neuromuscular function, where the function of the injured limb becomes much less than the non-injured limb. Disuse and immobilisation result in losses to muscle strength, cross-sectional area and functional capabilities and changes to muscle composition and neural drive. The cross-education phenomenon describes the strength gain in the opposite, untrained limb following unilateral resistance training of the ‘trained’ limb and is well-documented in healthy and athletic populations. In orthopaedic populations, the magnitude of this effect could offer the opportunity to accelerate the rehabilitation process and restore function more quickly. We evaluate the contemporary scientific literature (including clinical trials led by Dr Minshull), evaluate the potential clinical gains and how to design and deliver these interventions.
Concurrent vs. Non-Concurrent Rehabilitation. Concurrent training involves an individual training for strength and cardiovascular endurance outcomes in close proximity i.e. within the same workout/session. This type of training is typically used in contemporary MSK rehabilitative clinical practice, whereby time and resources are scarce. In a concurrent training format the body must adapt to both training cardiovascular and muscle resistance stimuli simultaneously. However, the physiological adaptations associated with each type of training are diverse and research shows gains in muscle strength can be attenuated during concurrent training interventions. We evaluate the contemporary scientific literature (including publications by Dr Minshull), evaluate the potential clinical gains and how to design and deliver non-concurrent interventions for no net cost in time or resources.
Get Back To Sport: Dr Claire Minshull
The afternoon for day 4 will be spent preparing for and delivering to the group case-study presentations
*** this course involves practical work in a gym setting;
• Expansion of knowledge on detailed aspects of neuromuscular function;
• Key principles that drive adaptation and thus recovery (contractile and non-contractile tissue);
• Develop immediately deployable skills and techniques to enhance clinical rehabilitation practice and the subtle, but important changes that can translate into big gains for patients;
• Design of resistance-based rehabilitation interventions to promote progressive and long-term gains separately for indices of muscle activation, force production and strength;
• Detailed appreciation of contemporary issues in scientific research and how to apply the concepts of cross-education and non-concurrent training to rehabilitation to enhance outcomes;
• Practical programme design and evaluation and assessment.
This course is perfect for you if you work with athletes / clients and incorporate athletic rehabilitation into your clinical work.
Scope of practice; Physiotherapists, sports trainers and rehabilitators, personal trainers, osteopaths, chiropractors, sports therapists; upper and lower limb specialists.
NMR Course – Timetable
8:30-8:50 Welcome; Introductions & Outline
8:50-9:40 Dynamic Joint Stability; Indices of Neuromuscular Performance; Time Frame for Injury
10:00-11:00 Components and determinants of neuromuscular activation. Practical: Moderating Maximal Effort
11:00-12:00 Understanding Strength; Defining muscle performance: strength; endurance; power Practical: Designing Strengthening Interventions
1:00-2:00 Designing Strengthening Interventions; How to really rehabilitate strength Practical: Designing Progressive Resistance Training
2:00-3:00 Understanding Rate of Force Development & Muscle Response Times
3:20-4:30 Ensuring the desired stimulus-response: Programme design and delivery. Clinical Case Studies
8:30-9:00 Recap: Principles of Resistance Training
9:00-10:00 Strength: Programme Delivery & Evaluation
10:20-11:20 Practical: Assessing the Consequences of Eccentric Exercise
11:20-12:00 Practical: Rate of Force Development; Speed of Muscle Response
1:00-1:45 Establishing a hierarchy of importance for rehabilitation; Patient, function and goals
1:45-2:15 Practical: Strength & RFD Programme Design & Delivery
2:30-4:30 Clinical Case Study: Full Programme Design, Delivery & Evaluation
8:30-9:00 Course Recap
9:00-10:00 Exercise-Induced Muscle Damage
10:20-11:20 Practical: Assessing the Consequences of Eccentric Exercise
11:20-12:00 Exercise-Induced Muscle Damage II; The Repeated-Bout Effect
1:00-1:45 Prehabilitation; Concepts, Application, Utility
2:30-3:30 Practical: Designing Prehabilitation Interventions
3:30-4:30 Course summary
8:30-9:00 Course Recap
9:00-10:00 The Cross-Education Effect
10:20-11:20 Practical: Assessing the Consequences of Exercise-Induced Muscle Damage
11:20-12:00 Concurrent vs. Non-Concurrent Rehabilitation
1:00-1:45 Case-study presentation preparation
2:30-3:30 Case-study presentations
3:30-4:30 Course Summary
Claire Minshull – brief CV
Claire has worked in the field of sports medicine for 20 years as a Senior Lecturer, Researcher, Consultant and as a Practitioner. She has designed, led and managed major clinical and non-clinical research trials, supervised several PhD students, and has published over 30 research papers in leading peer- reviewed sports medicine journals. She is regularly invited to speak at national and international academic and professional symposia, writes for sports magazines and, serves as expert reviewer for several scientific sports medicine and physiology peer- reviewed journals.
Claire’s research and teaching interests include the influences of exercise, training and rehabilitation on dynamic joint stability, neuromuscular, musculoskeletal and psychobiological performance. Her work also focuses on assessing neuromuscular function optimally and developing specialised rehabilitation protocols for enhancing functional and performance. Claire’s area of expertise means that she uniquely spans the gap between the physiology of conditioning and physiotherapeutic rehabilitation.
You will be awarded a Certificate of attendance at the end of the course.
A Club Physio Courses registration includes:
• Most supplies needed for the course as suggested by the instructor; you may be requested to bring along some equipment needed for the course and in your clinic thereafter.
• An electronic course manual (you can choose to print it out or save and bring it along on your laptop / tablet; please bring extra writing paper should you wish to make extra notes;
• Tea / coffee / snacks on each day;
• A signed certificate of attendance.
How To Book This Course:
• Step 1: Create an account; register your details here or click on the ‘Members Area’ button on the top menu: we need your details in order to reserve your seat and email you the preliminary materials for the course – PS; please note that registering your details does not book you onto the course – you need to follow step 2 below.
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View the course times:
- day 1&2: 8.30 AM – 4.30 PM