AAP EDUCATION

Hand Hygiene Australia: Free Online Learning & Resources

Free Online Learning Hand Hygiene Australia is providing free online learning packages on hand hygiene for a range of professional groups. The packages cover all aspects of hand hygiene including the importance of practicing excellent hand hygiene and best practice. An online test and the ability to print a certificate of completion is included. On completion of the HHA Online Learning Package, the participant will be able to: Explain what hand hygiene is and why it is importantDescribe when they should perform hand hygieneList the 5 Moments for Hand HygieneList the common products which are available for hand hygieneDescribe how to perform hand hygieneExplain the consequences of failing to perform adequate hand hygieneExplain the importance of cleaning shared equipment The HHA...

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Dr. J Lewis Frozen Shoulder Evening | Mulligans UQ - New Grad Savings

Hi A couple of unique opportunities are presenting themselves in the next couple of months for both students and practitioners, that I thought were worth emphasising so you didn't miss out. For students and recent graduates there are some significant savings for these offerings on a first come basis. Pizza & PD: Thawing the Frozen Shoulder - 18 September 6.30 - 8.30pm If you missed out on enrolling in the shoulder courses (both full with waiting lists) this is the ideal opportunity for students & practitioners to hear Dr. Jeremy Lewis, who is visiting from England, discuss his area of clinical expertise; the shoulder, with special reference to epidemiology, assessment, diagnosis, and EBP management of the Frozen Shoulder condition. These evenings...

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SATNAV & Dry Needling

Hi We have just completed 3 dry needling courses in Perth and 2 Living Anatomy Workshops at the University of Australia. I had just driven down with family after a couple of weeks outback holiday and was really looking forward to mixing it up with some great physios, chiros and osteopaths for the week. Not disappointed, this week of courses brought out a range of great new ideas. Introductory Course The first amazing thing about this course was participants age. Apart from 2, all participants had been out for 6 months or less. Dry needling as a skill in both private practice and hospital environments is becoming a 'must have' skill as evidenced from participants comments. Quite the change around from...

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Clinical Kit 13/6/2014 | Thawing a Fozen Shoulder - Management Options

Hi Frozen shoulder/Idiopathic Adhesive Capsulitis (IAC) is one of the clinical areas that has long held a fascination for me, largely because of the paradox between pain and range of motion. Whenever it is mentioned I prick up my ears, hoping for a silver bullet to use to assist my clients. While no single Lone Ranger moments have occurred, I have picked up some interesting clinical pearls that I discuss below. This recent case report is a good starting point for discussion. Abstract Available Trigger Point Dry Needling as an Adjunct Treatment for a Patient With Adhesive Capsulitis of the Shoulder My Classical Presentation Female > male, presenting with increasing degrees of shoulder pain and stiffness over several months. Can’t recall...

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May Perth Course | DOMS experiment | On the Farm

Hi - Introductory Dry Needling Boy did we have some fun! Just an awesome group of practitioners came together for the May/June Introductory Dry Needling Course. Some courses just flow and this was one. Here are a couple of pics of the happy tribe hard at work.  Feed back from this course was very positive; How interesting was this course? Interesting 18% Very Interesting: 82%As a physiotherapist how relevant was this course to your work? Interesting 18% Very Interesting: 82%The education level of the information presented was: Interesting 12% Very Interesting: 88%Would you recommend this course to other therapists? Yes 100% Physio and Pharming Reason for getting to this post a bit later than usual, is that my 'spare time' has...

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Clinical Kit 29/5/2014 | Don't Miss the Psoas Connection | Case Studies | Video of Jump Response

Hi Titled “Electroacupuncture treatment of acute low back pain: unlikely to be a placebo response” and written by Dr. Kwan Leung Chia, from the School of Medicine at Flinders University in SA, you could be forgiven for passing over the abstract if you weren’t interested in or currently using electroacupuncture, however this case report leads to broader discussion. You can read the full case report here My Comment As others treating this age group and gender will agree, this type of history and presentation is not uncommon when the pain is in the buttock or lateral thigh. Often the onset is an unremarkable single legged, sudden overload situation; like a miss step, trip or hop. Pain is initially mild and builds...

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Clinical Kit 15/5/2014 | Tumor Alert | Slacklining, Stroke & Outcome Measures

Hi For this fortnights Clinical News I am providing links to several clinical resources for you to have a look at. The first three links relate to a series of blogs on different tumors presentations that I have encountered in the past few years. Less than 5% of primary care physicians routinely examine for red flags during their initial screen (Bishop PB, Wing PC. Knowledge transfer in family physicians managing patients with acute low back pain: a prospective randomized control trial. Spine J. 2006;6:282–288) and in 160 cases, 96% physical therapists examined 64% of 11 red flag questions, but routinely didn’t ask about weight loss (Leeraret, PJ et al. Documentation of Red Flags by Physical Therapists for Patients with Low Back...

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Clinical Kit 29/10/2014 Useful Vestibular Resources

Hi In preparation for the upcoming range of vestibular workshops and courses, I have been looking around and collating information that I have found useful and perhaps you will also. I am sure this list amounts to only a feather on the chook's back in regards to what is out there, so I would really appreciate you adding additional resource links at the end of this blog post. Much appreciated. Upcoming courses that are available include; Vestibular Introductory WorkshopVestibular Basic 5 day CourseVestibular Advanced 3 day Course and while some of these might seem awhile away, people are already enrolling such is the popularity. Currently the first Introductory Workshop in December, is 50% full. Vestibular Resources Videos Anatomy Eye Movement and...

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Cranial Nerve Testing

I had a client present with Horner’s syndrome that made me think it appropriate to check all their cranial nerves. That made me realise I didn’t have a good recall of each cranial nerve function and appropriate test. So back to the books and I thought that I would share with you what I have learnt. Firstly yes, there are still 12 paired cranial nerves and here are some ways to clinically test. I was looking for quick tests that could be performed in the clinic, and I may well have missed a couple of easier ones. Please let the group know of your best/easiest test for each CN via the blog. Thanks. I Olfactory Sense of smell, but don’t use...

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Clinical Kit 29/4/2014 Faulty Needles & Clinical Relevance

Hi Faulty Needles & Clinical Relevance You maybe aware of the current discussion about needle quality and based upon some of the high resolution needle tip pictures , wondered how far we have advanced forward from stone needles, in this area of technology. The discussion has picked up after publication of research in the current edition of Acupuncture in Medicine, titled “Examination of surface conditions and other physical properties of commonly used stainless steel acupuncture needles” by Xie YM, Xu S, Zhang CS, et al. (Acupunct Med Published Online First: doi:10.1136/acupmed- 2013-010472). You can see the abstract here and because it is open access you can see full paper here. In this paper, needles from 2 of the ‘most commercially available’...

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Treasure Hunts and Your Credit Rating

Hi Do you enjoy a treasure hunt? I recently found this 'treasure map' and had quite a bit of fun looking up family and friends names, to see how much money was sitting in a bank waiting for them to claim. Finding Unpaid Monies – Little Pots of Gold Did you know there maybe stashes of cash, that for one reason or another, you don’t know about and are waiting for you to claim? There are different government organisations that hold this information. At a federal level it is organised by ASIC (Australian Securities and Investment Commission) and it seems at a state level it is organised by the relevant Treasury department (State or Territory). At a federal level, go to...

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Perth Introductory Course – April 2014

Hi Perth Introductory Course – April 2014 This April's Introductory Dry Needling Course was a bit different for several reasons. These changes were based upon feedback from many previous course participants suggestions. It was the first of our Dry Needling courses in which we have provided the manual as an e-manual. We started this with the Mulligan’s Concept Lower Quadrant Course last month and will be continuing with all our Dry Needling Courses into the future. Here are the busy vegemites creating their own Pablo Picassos of the Pelvis. There are several benefits to this for participants;  Many participants now have ipads or tablets and prefer the electronic version for portability, durability and ease of accessBy providing two weeks in advance,...

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Clinical Kit 26-2-2014 - Achilles Tendinopathy

Hi Past readers of my blog 'Creating Clinical Success' will know about my past incursions into the realm of achilles tendinopathy. If you missed out here are the blog links; clinical-kit-30-9-2013-achilles-tendinopathyclinical-kit-5-11-2012-achilles-tendonopathy Researchers MARC STEVENS and CHEE-WEE TAN have just published a paper in Journal of Orthopaedic & Sports Physical Therapy titled "Effectiveness of the Alfredson Protocol Compared With a Lower Repetition-Volume Protocol for Midportion Achilles Tendinopathy: A Randomized Controlled Trial". The research comparison taken in this paper looked at the standard protocol of 180 eccentric heel drops cf. a Do-As-Tolerated protocol for 6 weeks. The short time frame is a bit of a weakness, as 12 weeks is standard. They used the The Victorian Institute of Sport Assessment-Achilles (VISA-A) as the...

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Summer Dry Needling Courses Perth - 2014

Hi We have just completed the Summer Season of dry needling courses in Perth. As usual the weather was exceptional and those traveling to Perth for the courses, were appreciative of the warm weather and clear skies. New Skills As with every summer or winter season of courses unique 'things' happened. During this block of courses Brittany let us all into a clinical secret - that she had discovered there was an elusive 'love muscle'. Participants also learnt about the new theory of Rib Relativity - if there are 12 thoracic vertebra, there usually won't be 16 ribs even if they are practicing to be physiocassos. Thanks Eloise. New Suggestion One of the suggestions made during these courses, was to develop...

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Clinical Kit - 26/01/2014 - My First Quadratus Femoris

Hi Possibly my first presentation of Quadratus Femoris apart from the other ones that I have missed …… Clinical Presentation 51 year old male commercial painter with 2/7 Hx of pain. Not sure about cause of onset but had been painting a residential home (ladders, squatting, awkward positions) , plus moving around furniture day prior. Went to bed okay, slight sore in AM that increased as day progressed. Pain developed slowly and was described as a strong ache in R lumbar, lateral buttock with radiation to lateral thigh and hadn’t gone in the past 2/7. No PNN sensations. Over 24 Hr supine was fine, sidelying either side increased pain, walking was fine, but sit to stand or sitting increased painHad tried...

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Clinical Kit 14/1/2014 How do you Learn?

Hi Webinar cf. Course With the increasing profusion of information online plus greater demands on personal time, consideration is made about whether to attend a course or in some way gain the information via an online format. I certainly seek out a lot of information for my research online, not much shopping for IR cameras, access to research articles or experts in Esperance. When it comes to clinical education there are many reasons why I prefer to attend a course in person. The main one is that I am seeking to learn and therefore integrate or change a current clinical behavior. It maybe that I have recognized a skill set I need to develop – say occupational health or neurological treatment...

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Clinical Kit - 15/4/2014- Miracle Muscles and Neuropraxia

Hi Miracle Muscles and Neuropraxia When a client presents with noticeable weakness or other ‘hard’ neurological findings; abnormal sensation (temperature, light touch, pinprick), not just altered sensation or absent reflex, often I find clinicians jump to implicate a central nerve root involvement (dermatonal) without considering peripheral nerve compression or a somatic source. I think this just reflects the strong emphasis of our undergraduate training. This case report looks at the cubital tunnel and flexor carpi ulnaris as a source of peripheral nerve compression. No mention in this report is made of the anatomical variation anconeus epitrochularis, that would cause the same situation and as no MRI was conducted we are none the wiser as to which muscle was actually involved. You...

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Mulligans Lower Quadrant | The Shoudler | Nick Clark 2015

Hi Yes, yes and yes. In answer to several emails. Happy to say that we do have additional places available for Examination and Treatment of the Lower Quadrant Utilising the Mulligan Concept. There are 2 places for recent graduates (still with the generous $150 discount) and 2 additional places for experienced clinicians. For those of you forward planning practitioners, there no places   available for Jeremy Lewis's The Shoulder: Theory and Practice in September in Perth but positions are available at present for his Sydney course. Seems along way away, but it will be longer if you wait till he returns... if you treat shoulders consider it well worth while attending. For you even longer term planners, I am letting you know...

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Clinical Kit 18-03-2014 Needling & Safety During Pregnancy

Hi I recently received this email from Tenielle Henson (with thanks), which coincided with a systematic review of the related literature, that I thought would be relevant, and of interest to a wider audience. “ I enjoy getting your news & research updates and having a read through. But I wonder if you have any info on the use of dry needling in pregnant women. As far as I was aware, all was okay as long as the patient had blood pressure managed & wasn't anywhere near the foetus & in general was asymptomatic for any vascular or neural related illness. However, I have a friend who is in the very early stages of pregnancy & who has an Achilles issue...

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Clinical Kit 5/1/2014 Treating cLBP

Hi Happy New Year and Welcome to 2014 Interesting Lower Quadrant Research Article Li J, Zhang J-H, Yi T, Tang W-J, Wang S-W, and Dong J-C. Acupuncture treatment of chronic low back pain reverses an abnormal brain default mode network in correlation with clinical pain relief. Acupuncture in Medicine 2013. URL: http://aim.bmj.com/content/early/2013/12/02/acupmed-2013-010423.abstract Abstract Summary Background Acupuncture is gaining in popularity as a treatment for chronic low back pain (cLBP); however, its therapeutic mechanisms remain controversial, partly because of a similar improvement in sham acupuncture control groups (but both sham and verum improve significantly more than 'usual care'). Resting-state functional MRI (rsfMRI) has demonstrated aberrant default mode network (DMN) connectivity in patients with chronic pain, and also shown that acupuncture increases DMN...

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Clinical Kit 28/12/2013 THR Caught between the Bedsheets

Hi Interesting Lower Quadrant Case 1 In the past 2 weeks saddling the Christmas period I have had a couple of interesting lower limb cases that highlight the usefulness of dry needling. I will outline the first now as between clients and send the other next week. He was a 70-year-old gentleman 2 months post L THR. Progress was good and he was very happy, nil pain and completing most of his pre-operation ADLs. Two weeks prior he was getting out of bed, right foot on ground and his left foot got caught in the sheets. He felt a severe left anterolateral hip pain and feared dislocation. On gentle passive movements he was largely fine but any active hip flexion, rolling...

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Recent Perth Courses | New Course Calender for 2014

Recent Perth Courses I am just returning from a very enjoyable stay in Perth after conducting an AAP Education Introductory/Refresher Course and two Anatomy Wet Lab Workshops at UWA. The Anatomy Labs are proving to be very popular and attendees are amazed at how fast the 2 hours fly by when reviewing such an interesting and integral part of our core skills. Next Anatomy Lab is in February (scroll to bottom of link page). Remember that those enrolling in the Advanced Dry Needling Courses automatically are enrolled into the Wet Lab held that week. See you there! An ongoing feature at AAP Education is to improve the quality of content and also course service provisions and for this reason we evaluate...

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Symantec/Nortons Software - Beware

My first rant I have been using PC Tools Internet software for many years on all computers and been really happy. It turns out that recently it was 'purchased/morphed' by Symantec (the dark lord :<). Somewhere in the transition Symantec has decided to roll Nortons and PC Tools into one and cancelled my subscription with PC Tools so now it doesn't work. I contact PC Tools by live chat and they say I need to deactivate my license with Nortons before they can activate the PC Tools one again (even though I have never paid Nortons money nor subscribed to any of their programs). I phoned Nortons and after being transferred and then waiting 25 mins I hung up and start...

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Clinical Kit 2/11/2013 Acupuncture ANS & Sea Turtles

Hi ANS and Acupuncture Regardless of the types of clients you treat, the ANS will be there. Involved in the recovery from training and injury (sports & MSK), excessive daytime sleepiness (occupation health), anxiety (chronic conditions) and insomnia (20-30% population), you can see how important an understanding is. This webinar was recently presented to the October 2013 Australian Physiotherapy Association in Melbourne. As a one off special to Bronze Members this recording will only be available to you on this link for 2 weeks, then it will be added as a permanent resource for AAP Education Gold Members. Reviving Sea Turtles Jessica Seebauer sent in this photo from her friend's Australian Seabird Rescue Centre in Ballina, QLD explaining how they use...

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Clinical Kit 30-9-2013 Achilles Tendinopathy

Hi This is the second part of the Tendinopathy series. If you didn't receive the first part on the Lateral Epicondyle, you can find it in Member > Resources > eZine Archives after login. You can also view an earlier Clinical Kit on Achilles Tendinopathy and clinical interventions. Achilles Tendinopathy Toolkit This toolkit was developed by the British Columbia Tendinopathy Task Force comprised of; Dr. Alex Scott, Dr. Joseph Anthony, Diana Hughes, Michael Yates JR Justesen and Alison Ezzat. The Achilles Tendinopathy toolkit includes; A summary of the strength of evidence, key messages and recommendations for practice for an array of interventions used by physiotherapists (manual therapy, exercise, ultrasound, low level laser therapy, shock wave therapy, taping, orthotics, night splints and...

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Clinical Kit 16-9-2013 Lateral Elbow Tendinopathy

Hi September is Tendinopathy Month with Clinical Kits first looking at the up to date information and research on Lateral Elbow Tendinopathy. You can find a previous Clinical Kit about wet & dry needling of the lateral epicondyle and then later in the month we will look at Achilles Tendinopathy. Lateral Elbow Tendinopathy On our beef farm, tenderness along with flavor is the key challenge, in the clinic managing tendinous clients is usually a key challenge. A group of hard working researchers and clinicians called the BC Physiotherapy Tendinopathy Task Force, have assembled (both evidence-informed and expert-informed)and released their findings, translating research into clinical practice. I was fortunate to have worked with one of the authors for a year; Carol Kennedy,...

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New Infection Control in Dry Needling & Acupuncture Report Version 2.0

Infection Control Report Version 2.0 Following the recent release of the 2013 Immunisation Handbook Guidelines and the new AHPRA Chinese Medicine Board guidelines I have updated my "Infection Control in Dry Needling and Acupuncture Report" to include this latest information. Expanded to 20 pages, it contains new sections on managing needle stick injuries, necessity or not of swabbing and correct swab disposal. New members will receive the full report when first joining - see here Existing Bronze Members can download it from Member > Resources > Resources Gateway > Documents > AAP Education documents >2103 Infection Control in Dry Needling & Acupuncture Report_LR. Remember to log in first! If you have any questions regarding the content, please let me know. All...

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Jack & his Paper Strip

   In researching information for my presentation Masqueraders (see All Has Not Been Quiet On The Western Shore!) at this years APA Conference in Melbourne, I noticed the exceptionally poor prognosis when diagnosed with pancreatic cancer.   Sure more people die from lung cancer, but if you are diagnosed with pancreatic cancer, your 5 year survival rate is basically less than 5% and this figure has hardly changed in the past 30 years. The poor survival rate relates back to the method of diagnosis that is poorly specific, expensive and only detects cancer late in the disease process - too late really for effective therapy.   That may all be about to change as the result of some ingenuity and heavy...

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Clinical Kit 30-8-2013 The Meaning of Exercise

Hi Exercise means different things to different people. Exercise & Health Benefits Every day it seems that we are hearing about another benefit from regular exercise; both physical and mental. Just as frequently, we hear how our populations are getting fatter, eating poorer quality foods, dying more from preventable disease and suffering every greater stress levels. Not sure about Australia, but between 50 million and 70 million Americans suffer from sleep disorders or sleep deprivation, according to the Institute of Medicine, and in 2008, market research from Thomson Reuters found that sleeping pill prescriptions had tripled among people younger than 45. Given exercise has been shown to enhance sleep, mood, a healthy weight, self esteem and physical longevity, it is important...

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Your App Guide: Top 5 iphone Apps

I have just completed a list of my favorite 5 (tough gig)  iPhone apps that I use on a regular basis in clinical situations and sent out to all our Clinical Kit members. This list of my "Fab 5" came about from others asking what I use in such-in-such a situation, so I thought I would share with you also. Once the idea was out there, it started to grow wings and become a bit of a game with a few friends.    Hence this becoming an FAVORITES APP BLOG for THERAPISTS. So after you have had a look at my Fab 5 list, please add comments to the blog if you have an app that you also are keen about....

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Mark Oliver's TMJ Course

On the weekend of the 17 & 18 August Mark Oliver presented his popular TMJ Course.   One course attendee said"I thought the TMJ course was really good! There was a big range of physios there, including those who specialise in TMJ. Mark is a great presenter and very engaging, he even bought us all coffees on Sunday morning which was a bonus :] I definitely want to learn more about TMJ and considering the volume covered over the course I think I'll need a month or so to digest and review the course work. ". Big thanks to Phoebe for her photographs   Doug Cary FACP APAM Specialist Musculoskeletal Physiotherapist email doug@aapeducation.com.au ph/fx 08 90715055 You are free to use...

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All Has Not Been Quiet On The Western Shore!

Hi All Has Not Been Quiet On The Western Shore! Apologies, no Clinical Kit as spare time in the past few weeks have been tied up with preparation for presentations at the APA conference. Kinda newbie at this stuff, and it seems to take a fair chunk of time pulling together all required information. If you are also going to be there in October, would love to catch up. Masqueraders The hidden aspects of tumors presenting as musculoskeletal presentations has been one of my most popular blogs series (30,000 total + hits) series. I was fortunate enough to be studying Manips in Perth, 1992 at Curtin, when Mr Gregory Grieve visited. He presented a talk of the same name and raised...

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Dry Needling Courses - July Perth 2013

Introductory/Refresher Course The Introductory Course in this teaching block has had a real international flavour. In addition to physiotherapists from Australia, we had physios from England, Canada, Singapore and some that had practiced in Germany. As well as sharing different treatment options, it was very enlightening to hear how the different physios practice in each jurisdiction, particularly in the areas of independence (primary contact practitioners status) and accountability. In general, it seemed with greater responsibility comes greater advancement of the profession and subsequent satisfaction of the practitioners. We were indeed lucky to have had such foresighted Australian physiotherapists that paved the way for our profession. Here are a couple of pics as they busily go about practing their palpation and needling...

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