Áföll og sjúkraþjálfun; áfallafræði, áfallamiðuð nálgun, áfallameðferð

Námskeið verður haldið föstudaginn 17.apríl kl. 9 – 16 og laugardaginn 18.apríl kl. 9.30-15.

Kennari: Margrét Gunnarsdóttir sérfræðingur í geðsjúkraþjálfun/áfallameðferð og sálmeðferðarfræðingur MSc

Staður: Fræðslusalur BHM, Borgartúni 27, 105 Reykjavík

Á þessu námskeiði verður farið í mikilvæga þætti sem tengjast því að vinna með fólki með áfallasögu og virka áfallastreitu. Sjúkraþjálfarar sinna oft einstaklingum með áfallastreitu og annað form af langvinnri streitu, þótt það sé sjaldnast skilgreint sem ástæða komu. Áfallastreita og langvinn streita almennt veldur álagi og ójafnvægi í taugakerfinu. Hjá sumum er opinskátt rætt um reynslu sem áfall en hjá öðrum birtast einkenni í líkamanum sem verkir, bólgur, truflun í ónæmis – og hormónakerfi, svefnvandi, meltingarvandi, óútskýrð einkenni osfr. Á þessu námskeiði fá sjúkraþjálfarar fræðslu og kenndar leiðir til að mæta þessum hópi af meiri næmni. Farið er ítarlega í starfsemi ósjálfráða taugakerfisins út frá Polyvagal kenningu og mikilvægi þess að meðferðaraðili hugi að eigin taugakerfi og velferð í starfi.

Námskeið fer fram með fyrirlestrum, stuttum æfingum og umræðum.

Ítarlegri lýsing:

Markmið og efni námskeiðs:

1. Skilgreiningar og einkenni áfallastreituröskunar og flókinnar áfallastreituröskunar

2. Mismunandi stig áfallameðferðar

3. Birtingarmyndir áfallastreitu í daglegu lífi og áhrif í meðferðarstarfi

4. Polyvagal kenningin, flökkutaugin og mikilvægi ósjálfráða taugakerfisins þegar unnið er með áföll, streitu og einstaklinga í viðkvæmri stöðu

5. Áfallamiðuð (trauma-informed) nálgun í sjúkraþjálfun / velferðarþjónustu

6. Vægi upplifunar öryggis og góðra meðferðartengsla

7. Taugakerfi meðferðaraðilans

8. Fræðsla um mikilvægi meðvitundar um vald/valdamisræmi í meðferðarstarfi.

9. Hlutverk sjúkraþjálfara í áfallameðferð

10. Leiðir til að mæta þörfum einstaklinga með áfallastreitu, í einstaklingsmeðferð og hópmeðferð

11. Áfallameðferð, m.a. EMDR meðferð, áfallamiðuð hópmeðferð og líkamsmiðuð áfallameðferð.

12. Að hlúa að sjálfum sér sem meðferðaraðila í krefjandi starfi

Í lok námskeiðs hafa þátttakendur öðlast skilning og þekkingu á eðli áfallastreitu og hvernig hún getur haft áhrif á gang meðferðar. Þátttakendur vita hvað áfallamiðuð nálgun felur í sér og kunna leiðir til að aðlaga meðferð og umhverfi í því samhengi.

Þátttakendur hafa dýpri þekkingu á mikilvægi þess að meta og skilja ástand taugakerfis, bæði hjá skjólstæðingum og sjálfum sér og kunna leiðir til að byggja upp betra jafnvægi í taugakerfi. Þátttakendur kunna leiðir til að skima fyrir áfallastreitu og eru með verkfæri til að vinna með hana innan starfsviðs sjúkraþjálfara í því umhverfi sem þeir starfa og styðja við áfallameðferð sem skjólstæðingur er mögulega í hjá fagaðila á geðheilbrigðissviði.

Dagskráin og ítarlegri upplýsingar um viðburðinn koma inn bráðlega.

Námskeiðið er haldið í tengslum við Dag sjúkraþjálfunar 2026. 

Time to rethink an old disease? Exploring the contemporary understanding and management of knee osteoarthritis

Kennari: Professor Tasha Stanton, BScPT, MScRS, PhD. 

Staðsetning: Viska - Borgartún 27, 3. hæð

Tímasetning:  maí kl.9-16

Course description: Osteoarthritic pain is often assumed to be driven solely by structural damage to the joint and surrounding tissues. However, pain levels hold a tenuous relationship with the degree of structural damage and people with severe osteoarthritic changes on imaging experience improvements in pain with exercise, in the absence of overt joint changes. Together, this suggests that we need to re-think such an assumption.

Using a combination of lecture and hands-on format, this course will explore the contemporary understanding of osteoarthritis. It will explore evidence spanning pain science, systematic inflammation, and psychosocial contributors, supporting a need to reconceptualise both how we think about osteoarthritis and pain ourselves and how we discuss osteoarthritis and pain with our patients. It will explore the multiple contributing factors to osteoarthritis progression/pain, as well as the ongoing presence of bioplasticity (changeability) even in severe OA, discussing the implications of this knowledge for our treatment, including evidence for (appropriate) loading in the context of the patient with osteoarthritis. Finally, this course will explore novel interventions targeting altered sensorimotor processing in osteoarthritis that may hold therapeutic value.

Learning objectives (at the end of this course, attendees should be able to):

• Compare and contrast older ideas of OA as a peripheral entity (i.e., involving the joint) with modern ideas of OA as a system wide process (i.e., involving the whole body)
• Explain the concept of bioplasticity and how it relates to osteoarthritis and the management of osteoarthritis
• Implement pain management strategies for osteoarthritis based on a modern understanding of the complexity of pain

Kennari: Peter Malliars

Dagsetning: 22. - 23. maí 2026

Tímasetning: Auglýst síðar

Staðsetning: Auglýst síðar

Peter Malliaras is a physiotherapist and researcher from Melbourne, Australia focusing on the problem of tendinopathy. He is the first ranked tendinopathy expert globally according to the website ExpertScape. Appointed Professor of Physiotherapy Research in 2022 at Monash University (Australia), his research focuses on understanding pain and neuromuscular impairments, and clinical trials testing the efficacy of exercise, education and other interventions in tendinopathy. Peter maintains a strong clinical focus, consulting to elite athletes and people with persistent tendinopathy presentations in Australia and internationally.

Practical frameworks and practical strategies is a comprehensive online course launched in 2024 that provides a structured, evidence-informed approach to the management of lower limb tendinopathy. Rather than isolated techniques or protocols, the course presents an integrated system of clinical frameworks that can be applied directly in everyday practice.

The course covers a series of core frameworks, including:

• Diagnostic decision-making
• Assessment and screening
• Strength assessment
• Load management
• Rehabilitation planning
• Stretch–shorten cycle training
• Outcome measurement
• Designed for clinicians across all levels of experience, this course is suitable for new graduates through to highly experienced practitioners working in private practice, hospital settings, or elite sport. Prof Peter Malliaras delivers practical, adaptable frameworks that go beyond standard CPD content, providing clear structure, clinical reasoning tools, and actionable strategies you can use immediately with patients.
• Learning outcomes
• Describe the structure, function and adaptation of healthy tendon
• Describe the stretch shorten the cycle and its functional role in energy storage tendons
• Define tendon ‘stiffness' and how this relates to tendon function
• Compare the key parameters for tendon versus muscle adaptation
• Describe key tissue, psychological, biomechanical, metabolic, hormonal and neuromuscular impairments in tendinopathy
• Describe and demonstrate effective diagnosis and assessment for lower limb tendinopathy.
• Construct an individualised management plan that includes consideration of key screening and assessment findings
• Describe and justify a rehabilitation framework for common lower limb tendinopathies which includes consideration of muscle strength and power development and tendon adaptation
• Develop a strategy for effective deliver of individualised education for people with tendinopathy
• Plan and implement an individualised stretch-shorten cycle rehabilitation progressions for people with lower limb tendinopathy returning to walking, running and various sports
• Compare and contrast evidence for common adjunct therapies, as well as medicine, injectable and surgical treatments

Kennari: Vincent Leddy, PT, DPT, PCS

Dagsetning: 11.-13. september 2026

Tímasetning: 8-17:30

Staðsetning: Viska, Borgartúni 27, 3. hæð

COURSE DESCRIPTION

This course, developed by Mary Massery, proposes a new definition of “core stability;” redefining it as the dynamic control of trunk pressures to optimize postural stability (balance). Dr. Massery’s “soda pop can model” links breathing mechanics to postural control using multi-system interactions. The speaker presents novel research demonstrating the role of vocal folds as postural stabilizers, extending the concept of “core stability” from the vocal folds on the top of the trunk to the pelvic floor on the bottom. In Part-1, foundational information and quick interventions will be the focus (positioning and ventilatory strategies). In Part-2, the focus shifts to hands-on techniques: assessing “normal” breathing patterns, and learning neuromotor breathing retraining techniques and manual assistive cough techniques. Multiple clinical cases will be used to cement the concepts. The course is applicable for any pediatric or adult patient (or therapist) who breathes!

PART-1:  Friday, September 11th   (8.0 Contact Hours)

7:30 – 8:00 Registration

8:00 – 8:20 Discussion - Introduction to course topics

8:20 – 9:45 Lecture: Breathing and posture: Pressure control (Soda pop model)

9:45 – 10:00 BREAK

10:00 – 11:30 Lab - Positioning strategies: What can you do in 90 Seconds or less that has a profound and lasting effect? 

11:30 – 12:15 Breathing and posture: The diaphragm’s many roles

12:15 – 1:15 LUNCH

1:15 - 1:35 Lab - Sneak peek:  Ventilatory/movement strategies

1:35 – 3:15 Lecture - Breathing and posture: The internal organs.  The vocal folds.

3:15 – 3:30 BREAK

3:30 – 5:10 Lab - Ventilatory/movement strategies:  Integrating neuromuscular, musculoskeletal, respiratory and sensory systems

5:10 – 5:30 Lecture - Summary, “Pearls,” sleep homework

PART-2:  Saturday, September 12th   (8.0 Contact Hours)

7:30 – 8:00 Coffee

8:00 – 8:30 Discussion - Review, synthesis, and Q&A

8:30 – 9:45 Lecture/Demo - Chest assessment:  Focus on musculoskeletal alignment and breathing patterns

9:45 – 10:00 BREAK

10:00 – 11:30 Lab - Assessing breathing patterns and postural implications

11:30 – 12:30 LUNCH

12:30 – 1:15 Lecture - Airway clearance: From Sherlock to solution

1:15 – 2:15 Lab - Facilitating efficient breathing patterns and endurance training: Neuromotor techniques for diaphragm, chest and other breathing patterns

2:15 – 2:30 BREAK

2:30 – 4:00 Lab - Facilitating breathing patterns (continued)

4:00 – 4:30 Lecture/Demo - Brief introduction to rib cage and trunk musculoskeletal restrictions associated with breathing difficulties – Quick Screening!

4:30 - 5:30 Demo - Patient demonstration (if possible)

PART-2:  Sunday, September 13th   (5.0 Contact Hours)

7:30 – 8:00 Coffee

8:00 – 8:30 Discussion - Review, synthesis, and Q&A

8:30 – 10:00 Lecture/Discussion - Differential diagnosis:  “Find the Problem”

10:00 – 10:15 BREAK

10:15 - 11:30 Lab - Airway clearance lab: Focus on manual assistive cough techniques

11:30 – 12:15 LUNCH

12:15 – 1:30 Lab - Eccentric trunk control: using voice for postural control and vice versa

1:30 - 2:00 Discussion/Homework - 

Homework: Putting it all together 

Course wrap up

COURSE OBJECTIVES

At the conclusion of Part-1 (Day-1), participants should be able to:

1. Relate trunk pressures to breathing and postural control using the Soda Pop Can Model.
2. Identify the multiple, simultaneous roles of the diaphragm as related to breathing, postural control, gastroesophageal reflux, constipation, and venous return.
3. Correlate the role of the vocal folds in normal postural stability responses (balance) and make the case for using speaking valves for patients with tracheostomies.
4. Choose the best client positions using simple equipment (towels, pillows, abdominal binders, etc) for optimal physiological and biomechanical support of breathing.
5. Utilize a ventilatory strategy algorithm presented in class to optimally match breathing with movements from bed mobility to athletic endeavors.
6. Apply concepts to a wide variety of patient populations from infancy to geriatrics

At the conclusion of Part-2 (Days 2- 3), participants should be able to:

1. Utilize a multi-system approach to evaluating motor impairments.
2. Identify the variations of “normal” breathing patterns and discuss the efficiencies/inefficiencies for individual patient conditions.
3. Evaluate need for, and demonstrate, appropriate neuromotor retraining techniques for patients with ineffective breathing/postural control strategies (health or participation deficits).
4. Participate in a live patient demonstration (if a patient is available) and suggest possible evaluation and treatment ideas based on the course material.
5. Design a targeted airway clearance program using the principles of mobilization, expectoration and oral management.
6. Demonstrate airway clearance techniques, with an emphasis on manual assistive cough techniques, and apply an airway clearance algorithm to specific patient conditions.
7. Identify thoracic cage/spine restrictions as they pertain to breathing mechanics and postural control (a very brief introduction of chest wall restrictions).
8. Evaluate the need for, and demonstrate, neuromotor retraining techniques to improve breath support for voicing and postural control (eccentrics).
9. Suggest immediate ways to incorporate the concepts into therapy activities in your clinical setting.

SPEAKER BIOGRAPHY

Vincent Leddy, PT, DPT, PCS

Dr. Leddy completed his BS in PT in the Netherlands in 1988, his DPT at Rocky Mountain University in 2017, and his certification as a MasseryPT faculty in 2019. Vincent is an APTA pediatric clinical specialist from San Francisco with expertise in diverse conditions such as complex neuro, adult orthopedic, elite level ballerinas, and breathing disorders.

Dr. Leddy is a life-long learner who loves teaching other therapists; sharing his curiosity and holistic approach to motor problems. His client and family centered goals work towards meaningful participation using hands on therapy and family education. His goal is to move his clients from just “surviving” to “thriving” in a complex world.

His proudest Mary Massery moment was working with a nonverbal toddler allowing her to stand up and walk for the first time after focusing on her voice and core pressures.