Electrical Stimulation: Enhancing Pediatric Outcomes

Photo courtesy of Michelle Cameron, MD, PT, MCR and Sara Shapiro, MPH, PT

Learn to appropriately select parameters for using TENS and FES to enhance treatment protocols specifically for the pediatric population. 

Specialty applications, which reference the differences between Neurologic and Orthopedic diagnoses will be reviewed.  Specific protocols for shoulder subluxation, rhomboid stabilization, brachial plexus injuries, and facial paralysis will be reviewed and practiced in lab. Review of TENS and FES, including parameter selection for chronic pain, muscle strengthening, and neuromuscular rehabilitation will be discussed. Recent research will be reviewed for electrical modalities, with contraindications specifically referring to Pediatrics. Prior exposure and/or knowledge of modalities & anatomy is helpful to maximize learning experience.

The educational information is presented in combination with intensive hands-on lab format. The presentation style is relaxed, with the instructor willing to answer questions throughout the class.  Labs are set up to allow equipment for each set of therapist partners, insuring that participants are comfortable with both the theoretical constructs, the physical set up of the equipment, and the actual outcome expected when working with pediatric patients.

Program subject to change. Participants are cautioned to apply new information and skills within the scope of state licensure law.

During the hands-on lab sessions, the course instructor will evaluate each E-Stim application to determine proficiency of 3/5 correct using 5 variables as listed in the objectives. A post-test at the end of the course is used to evaluate new knowledge. At the end of the course each participant will be given a course evaluation and a self reflective questionnaire

COURSE OBJECTIVES

After completing this course, the participant will:

  • Identify 3 indications for utilizing Electric Stimulation with the pediatric population (3 months to 21 years of age) with orthopedic or neurologic conditions.
  • Identify 3 major interventions utilizing Electric Stimulation with the pediatric population (3 months to 21 years of age) with orthopedic or neurologic conditions.
  • Identify 3 contraindications for the use of Electrical Stimulation with the pediatric population (3 months to 21 years of age) with orthopedic or neurologic conditions.
  • Identify 3 precautions when applying Electrical Stimulation with the pediatric population (3 months to 21 years of age) with orthopedic or neurologic conditions.
  • Choose at least 1 modality for the treatment of pain, for the pediatric population (3 months to 21 years of age) with orthopedic or neurologic conditions (PTA’s will achieve this objective through the established plan of care by the PT).
  • Choose at least 1 modality to be used for muscle strengthening, with the pediatric population (3 months to 21 years of age) with orthopedic or neurologic conditions (PTA’s will achieve this objective through the established plan of care by the PT).
  • Demonstrate the correct use of 2 modalities by utilizing the following: electrode size, electrode placement, pulse rate, pulse duration for the pediatric population (3 months to 21 years of age) with orthopedic or neurologic conditions.  
  • Identify at least 2 normal physiological responses to treatment when using Electrical Stimulation with the pediatric population (3 months to 21 years of age) with orthopedic or neurologic conditions.
  • Identify at least 2 abnormal physiological responses to treatment when using Electrical Stimulation with the pediatric population (3 months to 21 years of age) with orthopedic or neurologic conditions.
  • Identify the 2 most often forms of FES used for the treatment of the pediatric population (3 months to 21 years of age) diagnosed with Brachial Plexus Injuries.

CE Credits

15 Contact Hours
Day 1: 8:00 – 5:00
Day 2: 8:00 – 5:00

This course is accepted by many professional credentialing organizations and state professional regulatory boards. Rules and regulations change frequently without notification, and apply differently to live and online courses. Please check with your state board to confirm accuracy of this list and acceptance of contact hours. Certificate of Attendance will be issued to all participants upon completion of the course and may be used for CEU verification of credits. CE credits vary by state. Please check with your state board/certifying agency to confirm conversion of contact hours to CE. See links below.

 

Physical Therapy Board of California: The Physical Therapy Board of California recognizes Rehab Education, LLC as an approval agency to approve providers offering continuing competency courses for CA licensed PTs and PTAs. This course is approved for 15 contact hours.

California OT Board: In accordance with Title 16, California Code of Regulations section 4154, the California Board of Occupational Therapy (Board) has approved this course and instructor for 8 contact hours of post-professional education in the advanced practice area of physical agent modalities (Course # 22-P4); and for 8 contact hours of post-professional education in the advanced practice area of hand therapy (Course # 22-H18).

Illinois State Board of Physical Therapy: Approved CE Sponsor by Illinois State Board of Physical Therapy, Division of Professional Regulations, Approval #216.000227. (Course must be taken prior to 09-30-2020)

New Jersey State Board of Physical Therapy Examiners: This course has been approved by the New Jersey State Board of Physical Therapy Examiners for 14 continuing education credits, Approval #1710-36. (Course must be taken between 02-1-2018 and 01-31-2020)

NY State Physical Therapy Board: Rehab Education, LLC is recognized as an approved provider of PT and PTA continuing education by the NY State Education Department Board of Physical Therapy. (Course must be taken prior to 05-10-2019)

Texas Board of Physical Therapy Examiners: This course has been approved by the Texas Board of Physical Therapy Examiners as meeting continuing education requirements for PTs and PTAs for 15 CEU. Approval #64137TX. (Course must be taken between 03-24-2018 and 03-24-2020)

American Occupational Therapy Association (AOTA) Approved Provider #6177: See states that currently recognize AOTA Approved Providers for OT

Federation of State Boards of Physical Therapy (FSBPT): Federation of State Boards of Physical Therapy (FSBPT) / ProCert has awarded certification in the amount of 14 Continuing Competence Units (CCUs) to this activity. Approved CCUs are a unit of relative value of an activity based on its evaluation against a rigorous and comprehensive set of standards representing the quality of an activity. The CCU determination is a valuation applying many factors including, but not limited to, duration of the activity. No conclusion should be drawn that CCUs correlate to course hours. (Course must be taken between 12-31-2017 and 12-30-2019) Click Here to view the state physical therapy boards that currently accept the Federation of State Boards of Physical Therapy (FSBPT) certification.

  • AOTA Approval States

    These states currently recognize AOTA Approved Providers for OT continuing education either in regulatory language or by formal written communication to AOTA:

    Alaska
    Arkansas
    Delaware
    District of Columbia
    Illinois
    Indiana
    Kentucky
    Louisiana
    Maryland
    Minnesota
    Mississippi
    Missouri
    Montana
    Nevada
    New Hampshire
    New York
    North Carolina
    North Dakota
    Ohio
    Oregon
    Oklahoma
    Pennsylvania
    Rhode Island
    South Carolina
    Tennessee
    Texas
    Vermont
    Virginia

    *Disclaimer: Rehab Education LLC provides this list for your convenience. At the time of listing, the following state boards accept courses by virtue of approval by other organizations. It is the responsibility of the participant registering for a course to check with their state board to confirm rules and regulations regarding acceptance of contact hours for live and online courses.

    The following PT Boards accept courses approved by other state PT boards or APTA state associations*:

    Georgia
    Kentucky
    Montana
    North Carolina
    Oregon
    Virginia

    The following PT Boards accept courses approved by other APTA state associations*:

    Arizona
    Florida
    Indiana
    Mississippi
    Missouri
    Rhode Island
    Utah
    Vermont
    Wisconsin

    The following PT Boards accept courses provided by AOTA approved providers*:

    Arizona
    District of Columbia
    Rhode Island

    HELPFUL LINKS:
    *NBCOT…National Board for Certification of Occupational Therapy (view PDU requirements)

    +HTCC… Hand Therapy Certification Commission  (view recertification requirements)
    Hand Therapy Certification Commission (HTCC): This course is accepted by HTCC towards re-certification.

    State PT Boards
    State OT Boards

Day 1: 

7:30-8:00 Registration
8:00-10:00 Electric Stimulation: A Basic Review
10:00-10:15 Break
10:15-12:00 TENS & FES- Using sensory stim to facilitate proprioception & position
12:00-1:00 Lunch (on your own)
1:00-3:00 TNS LAB: Pain Control/Sensory Stim.
3:00-3:15 Break
3:15-4:00 FES: similarities/differences to TENS
4:00-5:00 FES: questions/contraindications
5:00 Adjourn

Day 2:

7:45-8:00 Registration
8:00-10:00
  • FES LAB/protocols/case studies differences between ortho/neuro Dx.
  • CHANGING parameters when working on gait vs tone
  • rhomboid stabilization
  • shoulder subluxation
  • hand function – can you use FES for small muscles?
  • hand/foot switches- are they absolutely necessary?
  • facial paralysis
10:00-10:15 Break
10:15-11:00 Obstetrical Brachial Plexus Paralysis
11:00-11:30 Case studies/ problem solving OBPP
11:30-12:15 Clinic Equipment-What works best in your clinic/is it available?
12:15-1:15 Lunch (on your own)
1:15-2:15
  • Problem Solving the Equipment
  • Patient Problems with Clinic Equipment
  • What’s in your clinic? How does it work?
2:15-3:00 Gait Lab
3:00-3:15 Break
3:15-4:15 Gait Lab- Dorsiflexors vs hip abductors or both?
4:15-5:00
  • Recommendations/Literature Review
  • Questions/Concerns/Wrap-up
  • Post-course assessment, Adjourn

Instructors:

Sara Shapiro, MPH, PT

was a faculty member at UCSF/SFSU Graduate Program in PT in San Francisco, from 1983 until 2009. In 2012 she joined the faculty of the Graduate Program in PT at the University of Puget Sound in Tacoma, WA. as an Assistant Clinical Professor. She recently retired from full time teaching to pursue her passion for further research in the area of physical agents, and teaching therapists in active practice to incorporate the agents into their practice for enhanced patient outcomes.

Sara is a graduate of SUNY at Buffalo, and holds an MPH from the University of North Carolina, Chapel Hill, where she also completed a post-graduate fellowship in pediatrics. She has been in practice for more than 45 years, with certification in NDT, Brazelton, and the Baby course.

Sara has worked in teaching modalities in Long Term Care, to assist therapists in better utilizing modalities to facilitate improved outcomes, and in Pediatrics to enhance physical function. She continues to be a frequent speaker at conferences, mentor new therapists, and teach and maintain a small caseload of patients, integrating her knowledge of electrical stimulation and ultrasound for wound care, pain management, women’s & pediatric diagnoses, and rehabilitation of facial paralysis. Sara is the author of the Electrical Currents chapters in Physical Agents in Rehabilitation, 5rd Edition (to be published this year), M Cameron, ed. She recently co-authored an article titled Healing wounds under Mechanical Stress: A Case Example.

Classes taught by Sara Shapiro: