Treatment of the Thoracic Orthopedic Patient

Course Description

Management of the patient with orthopedic dysfunction of thoracic origin is critical for the practice of physical therapy. It is required that therapists build upon their differential diagnostic and examination skills in order to form a more nuanced understanding of how to apply their findings to the management of more complex cases. That management should be a balanced incorporation of accepted general orthopedic treatment interventions, but also derive from applied knowledge of the nuances of the thoracic spine. Limited resources exist to assist therapists in integrating accepted concepts like regional interdependence, soft tissue and joint mobilization, as well as basic strengthening principles into the management of the thoracic patient. This course seeks to improve the clinician’s decision making in treatment of this challenging population through building a systematic approach to their care. That decision making includes, but is not limited to, the need to refer or proceed to sensible evidence-based interventions.

Course Objectives

At the end of this course, the participant will be able to:

• Identify the current incidence and prevalence of thoracic pain, as well as recognize patient populations who have the highest incidence
• Recall the components of the thoracic motion segment and costal cage
• Categorize the different regions of the thoracic spine for the purposes of better organizing treatment planning
• Recognize how the thoracic spine can contribute to dysfunction in adjacent regions, namely the cervical spine, lumbar spine and shoulder girdle
• Identify methods for quickly supporting or refuting hypotheses of thoracic involvement region by region
• Construct the foundations of an organized approach to managing patients who demonstrate the signs and symptoms associated with thoracic outlet syndrome (TOS).
• Summarize the strength and muscle length assessment integral to identify before treating thoracic pain
• Describe straightforward strengthening exercises for the thoracic region
• Utilize the identification of movement patterning to treat the thoracic spine patient
• Create a well-balanced therapeutic exercise program for the patient with thoracic spine involvement (the pyramid principle) in order for the patient to be able to progress toward goals of independence and greater participation in ADLs.
• Integrate subjective examination findings in case presentations with biomechanical considerations for the thoracic spine and differentiate the objective examination data in order to form a treatment hypothesis.
• Distinguish which movements, special tests and confirmatory techniques can help support their theory
• Develop a treatment algorithm through the case presentation to prioritize treatment interventions in order to maximize chances for success.

• Prerequisites

  None

• Educational Level

  Intermediate

• Other

  Satisfactory completion of this course will require the participant to complete a 10 question post-test with a minimum passing score of 70%.