Join the Paradigm Shift and Change Stroke Rehabilitation Outcomes for Your (Future) Patients and Grow Your Practice

Stroke.Rehab Certification Program 2024-2025

Table of Contents

• Introduction to Stroke.Rehab (Cross-Cord) Certification Program
  1.1. Overview of Course Philosophy
  1.2. Target Audience
  1.3. Course Duration and Structure
  1.4. Certification and Assessment Criteria

• Course Objectives
  2.1. Learning Outcomes
  2.2. Skills and Knowledge to be Acquired
  2.3. Practical Application Focus

• Course Outline and Schedule
  3.1. Module 1: Advanced Spasticity and Hemiplegia Management
  3.1.1 Morning Session: Neurophysiology of Spasticity
  3.1.2 Practical: Cross-Cord and Priming Strategies
  3.2. Module 2: Foot and Ankle Recovery
  3.2.1 Morning Session: Neurophysiology of Foot Drop
  3.2.2 Practical: Functional Ankle Stabilization and Priming
  3.3. Module 3: Balance Optimization and Enhanced Rehabilitation Strategies
  3.3.1 Morning Session: Balance Neuroanatomy
  3.3.2 Practical: Graded Balance Program
  3.4. Module 4: Shoulder and Arm Function Recovery
  3.4.1 Morning Session: Motor Control in the Upper Limb
  3.4.2 Practical: Bilateral Movement Training
  3.5. Module 5: Normalizing Walking After Stroke
  3.5.1 Morning Session: Gait Neuroanatomy
  3.5.2 Practical: Quadrupedal and Bilateral Strategies for Walking
  3.6. Module 6: Reducing Knee Hyperextension
  3.6.1 Morning Session: Knee Neurophysiology and Functional Re-training
  3.6.2 Practical: Walking Normalization and Exam Instructions

• Detailed Course Content
  4.1. Neurophysiological Foundations of Motor Recovery
  4.2. Cross-X-Cord™ and Bilateral Training Strategies
  4.3. Practical Applications of Priming Techniques
  4.4. Sensory-motor Feedback and Circuit Training

• Assessment and Certification
  5.1. Written Examination Guidelines
  5.2. Practical Examination Criteria
  5.3. Certification Requirements and Issuance

• Graduation and Post-Course Support
  6.1. Post-Course Integration of Skills
  6.2. Access to Continued Learning Resources

Introduction to Stroke.Rehab Certification Program

The Online (virtual classroom) Stroke. Rehab Certification Program offers an advanced, immersive experience for rehabilitation professionals specializing in stroke recovery. The program focuses on the theoretical background for the practical application, providing participants with extended knowledge for hands-on training in cross-cord and bilateral movement strategies to optimize motor control, limb recovery, and functional movement in stroke survivors. In addition practitioners will get access to specific training protocols in a seperate portal after succesful (completing mandatory home work and assignments) completion of the first 4 modules. By emphasizing spasticity management, gait normalization, and limb rehabilitation, this course ensures that participants acquire both the theoretical knowledge and practical skills necessary to support post-stroke rehabilitation.

Course Objectives

By the end of the program, participants will have acquired the following skills and knowledge:

• Advanced Spasticity Management: Understanding the neurophysiology of spasticity and hemiplegia and applying cross-cord and bilateral strategies to reduce spasticity.

• Foot and Ankle Recovery Expertise: Proficiency in restoring foot and ankle function through reflex utilization, stabilization exercises, and step-by-step rehabilitation techniques.

• Balance and Motor Control Optimization: Mastery of graded balance programs and the sensory-motor feedback required to enhance post-stroke recovery.

• Upper Limb Recovery Techniques: Skills in shoulder and arm rehabilitation, focusing on proprioception, muscle isolation, and bilateral movement training.

• Gait Normalization: Ability to support walking rehabilitation through quadrupedal transfers and cross-cord strategies, addressing the weak muscular chains affecting gait post-stroke.

• Reducing Knee Hyperextension: Targeted approaches for addressing knee hyperextension through neuroanatomical understanding and practical rehabilitation techniques.

Course Outline and Schedule

Module I.Advanced Spasticity and Hemiplegia Management

Welcome and Introduction

Neurophysiology of Spasticity and Hemiplegia

• Neurophysiological mechanisms behind spasticity

• Cross-cord strategies for spasticity management

Cross-Callosal and Bilateral Movement Training

• Bilateral movement strategies

• Enhancing sensory feedback for functional recovery

Module II. Foot and Ankle Recovery

Neuroanatomy of Foot and Ankle Post-Stroke

• Addressing foot drop and ankle inversion

• Initiating movement and recovery in the foot and toes

Ankle Stabilization and Recovery

• Reflex utilization for foot stabilization

• Rebuilding ankle control for brace-free walking

Module III. Balance Optimization and Rehab-Enhancing Strategies

 Vestibular Mechanisms and Balance Recovery

• External and internal vestibular systems

• Sensory-motor feedback in motor control

Graded Balance and Stabilization Training

• Priming strategies for enhanced balance recovery

• Graded challenges to reinforce motor learning

Module IV. Shoulder and Arm Function Recovery

Motor Control in the Shoulder and Arm

• Neurophysiology of upper limb function

• Re-establishing proprioception and load-bearing capacity

Functional Upper Limb Training

• Priming and bilateral movement training

• Addressing compensatory strategies in shoulder recovery

Normalizing Walking After Stroke

Gait Rehabilitation

• Neurophysiology of walking

• Bilateral movement strategies to support walking

Gait Optimization and Quadrupedal Transfer

• Priming techniques to normalize walking

• Graded challenges for optimal motor learning

Module 6: Reducing Knee Hyperextension and finals preparation

Addressing Knee Hyperextension

• Re-distribution of forces around the knee

• Strengthening the muscular chain for knee stability

Exam Preparation Written and practical exams (hand in video recordings of home assignments)

• information on Certification and instructions for integrating knowledge

Detailed Course Content

The course's content is designed to blend neurophysiological theory with hands-on practice. Participants will explore foundational elements such as spasticity management, cross-cord strategies, and priming techniques in a real-world setting, ensuring they can effectively apply these skills in their rehabilitation practice. Specific attention will be given to:

• Neurophysiological Foundations: Understanding motor recovery from a neurological perspective.

• Cross-Cord and Bilateral Training: Utilizing advanced techniques to support motor function recovery.

• Priming Techniques: Preparing the body for movement recovery through neurological stimulation.

• Sensory-Motor Feedback Circuits: Engaging the sensory-motor circuits for enhanced motor control.

Assessment and Certification

To earn certification, participants must pass both a written examination and a practical skills assessment (for those currently not working as Stroke rehab trainers). The assessments will focus on the participant's ability to apply the new rehabilitation strategies effectively in a clinical setting (you will be asked to film application of certainn routines and demonstrate this on video).

Graduation and Post-Course Support

Upon completing the course, graduates will receive a Stroke. Rehab Certification, allowing them to apply advanced stroke rehabilitation techniques professionally. Continued support will be provided, including access to learning resources and a network of stroke recovery specialists to ensure ongoing professional development.

Some of the References Referred to in the Masterclass

1. Advanced Long-Term Spasticity Management
   Utilizing Crossed Spinal Cord Reflexes and Reticulospinal Up and Down Regulation (Brainstem)
   Benefits:

• Reduction in Muscle Spasticity: Improves muscle tone and flexibility.
• Enhanced Voluntary Movement: Better control over motor functions.
• Decreased Discomfort: Alleviates pain associated with spastic muscles.

• Gracies, J. M. (2020). Pathophysiology of spastic paresis. I: Paresis and soft tissue changes. Muscle & Nerve, 63(4), 423-432.
• Thibaut, A., Chatelle, C., Ziegler, E., Bruno, M. A., Laureys, S., & Gosseries, O. (2019). Spasticity after stroke: Physiology, assessment and treatment. Brain Injury, 33(9), 1098-1110.

2. Bilateral and Quadrupedal Training
   Stimulating Interlimb, Interhemispheric (Intercallosal), and Quadrupedal Coupling
   Benefits:

• Improved Neural Plasticity: Encourages new neural connections.
• Enhanced Coordination: Synchronizes limb movements.
• Accelerated Recovery: Promotes restoration of motor skills.

• Yao, J., Zheng, Y., & Wang, N. (2021). Bilateral training in stroke rehabilitation: A systematic review and meta-analysis. Journal of Clinical Neuroscience, 86, 45-53.
• Kim, S., Park, D. S., & Lee, G. (2019). Effects of quadrupedal walking exercise on brain wave, balance, and gait function in stroke patients: A randomized controlled trial. Journal of Physical Therapy Science, 31(5), 413-417.

3. Retraining of Spatial and Limb Awareness
   Specialized Techniques to Restore Proprioception and Spatial Awareness
   Benefits:

• Better Balance: Reduces risk of falls.
• Increased Independence: Enhances daily activity performance.
• Heightened Proprioception: Improves limb position awareness.

4. References:
    
• Kang, N., Lee, S., & Park, D. S. (2020). Effect of virtual reality-based rehabilitation on upper extremity function and proprioception in persons with stroke: A randomized controlled trial. Journal of Physical Therapy Science, 32(3), 222-227.
• Schaefer, S. Y., & Lang, C. E. (2020). Using repetitive sensory stimulation to improve sensorimotor function in chronic hemiparetic stroke: A pilot study. Journal of Neurophysiology, 123(2), 738-747.

4. Training from the Spastic Position to Regain Lost Function
   Starting Rehabilitation Exercises from Positions of Maximum Spasticity
   Benefits:

• Targeted Muscle Control: Enhances control over spastic muscles.
• Functional Improvement: Aids recovery of daily living skills.
• Adaptive Techniques: Facilitates effective movement despite spasticity.

5. References
    
• Picelli, A., Tamburin, S., Gajofatto, F., Zanette, G., & Smania, N. (2019). Pathophysiology of spasticity: Implications for neurorehabilitation. BioMed Research International, 2019, Article ID 3549064.
• Li, S. (2017). Spasticity, motor recovery, and neural plasticity after stroke. Frontiers in Neurology, 8, 120.

5. Muscle Isolating Techniques for Precision in Arm and Shoulder Movement
   Focusing on Isolating Specific Muscles to Improve Precision and Control
   Benefits:

• Enhanced Fine Motor Skills: Improves ability to perform detailed tasks.
• Better Muscle Activation: Strengthens muscles for targeted movements.
• Increased Range of Motion: Greater flexibility and movement.

6.  
• Arya, K. N., & Pandian, S. (2018). Interlimb neural coupling: Implications for poststroke hemiparesis. Annals of Physical and Rehabilitation Medicine, 61(5), 338-345.
• Wu, C. Y., Yang, C. L., Chuang, L. L., & Lin, K. C. (2020). Effect of mirror therapy on motor and sensory recovery in chronic stroke: A randomized controlled trial. Archives of Physical Medicine and Rehabilitation, 101(7), 1101-1110.

6. Interhemispheric Training to Increase Disinhibition and Control from the Affected Hemisphere
   Reducing Interhemispheric Inhibition to Enhance Neural Activity
   Benefits:

• Improved Motor Function: Restores movement in affected limbs.
• Neural Reorganization: Promotes brain plasticity and recovery.
• Functional Independence: Increases ability to perform activities unaided.

7. References:
    
• Di Pino, G., Capone, F., Pellegrino, G., et al. (2018). Immediate and long-term plasticity of the human ipsilesional motor cortex after stroke with regard to fine hand motor skills. Frontiers in Human Neuroscience, 12, 206.
• Takeuchi, N., & Izumi, S. (2020). Rehabilitation with poststroke motor recovery: A review with a focus on neural plasticity. Stroke Research and Treatment, 2020, Article ID 2492781.

• Arya, K. N., & Pandian, S. (2018). Interlimb neural coupling: Implications for poststroke hemiparesis. Annals of Physical and Rehabilitation Medicine, 61(5), 338-345.
• Di Pino, G., Capone, F., Pellegrino, G., et al. (2018). Immediate and long-term plasticity of the human ipsilesional motor cortex after stroke with regard to fine hand motor skills. Frontiers in Human Neuroscience, 12, 206.
• Gracies, J. M. (2020). Pathophysiology of spastic paresis. I: Paresis and soft tissue changes. Muscle & Nerve, 63(4), 423-432.
• Kang, N., Lee, S., & Park, D. S. (2020). Effect of virtual reality-based rehabilitation on upper extremity function and proprioception in persons with stroke: A randomized controlled trial. Journal of Physical Therapy Science, 32(3), 222-227.
• Kim, S., Park, D. S., & Lee, G. (2019). Effects of quadrupedal walking exercise on brain wave, balance, and gait function in stroke patients: A randomized controlled trial. Journal of Physical Therapy Science, 31(5), 413-417.
• Li, S. (2017). Spasticity, motor recovery, and neural plasticity after stroke. Frontiers in Neurology, 8, 120.
• Picelli, A., Tamburin, S., Gajofatto, F., Zanette, G., & Smania, N. (2019). Pathophysiology of spasticity: Implications for neurorehabilitation. BioMed Research International, 2019, Article ID 3549064.
• Schaefer, S. Y., & Lang, C. E. (2020). Using repetitive sensory stimulation to improve sensorimotor function in chronic hemiparetic stroke: A pilot study. Journal of Neurophysiology, 123(2), 738-747.
• Takeuchi, N., & Izumi, S. (2020). Rehabilitation with poststroke motor recovery: A review with a focus on neural plasticity. Stroke Research and Treatment, 2020, Article ID 2492781.
• Thibaut, A., Chatelle, C., Ziegler, E., Bruno, M. A., Laureys, S., & Gosseries, O. (2019). Spasticity after stroke: Physiology, assessment and treatment. Brain Injury, 33(9), 1098-1110.
• Wu, C. Y., Yang, C. L., Chuang, L. L., & Lin, K. C. (2020). Effect of mirror therapy on motor and sensory recovery in chronic stroke: A randomized controlled trial. Archives of Physical Medicine and Rehabilitation, 101(7), 1101-1110.
• Yao, J., Zheng, Y., & Wang, N. (2021). Bilateral training in stroke rehabilitation: A systematic review and meta-analysis. Journal of Clinical Neuroscience, 86, 45-53.