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PAEDIATRIC INTEGRATIVE MANUAL THERAPY This is the training course for you! Contents This is the training course for you 4 Letter from the director 5 What will you learn in this course? 6 Pre-requisites. The Programme . Course structure The teachers 2 7 8 20 3 Do you want to be able to treat children and babies with a gentle, effective and integrated Manual Therapy in Neurodevelopment? Finally, here is everything you need to assess and treat articular and tissue dysfunctions with manual therapy in children and infants, with an in-depth understanding of neuro-development and the keys to stimulate it. Develop your manual capacity with accurately and simply Learn about the keys to work with children and babies Discover a new focus on Therapy Manual This is the training course for you... Do you want to be able to assess and treat children in a new and effective way HAVE YOU TRAINED in manual therapy but you were not taught how to apply it to children and infants. HAVE YOU STUDIED OSTEOPATHY but still have a lot of questions about how to integrate neuro-development. DO YOU HAVE EXPERIENCE IN PAEDIATRICS but you do not have the effective tools to treat dysfunctions at an articular, tissue and cranial level. Do you want to be capable of preventing and treating development, attention deficit and learning difficulties from a physiotherapy point of view. 4 5 Most physiotherapists would like to know the practical keys to be able to help their patients from a technically efficient and specific manual application, but also with a global and inclusive approach and thinking. The problem is that those who trained in Manual Therapy do not have much experience with children and infants whose anatomy and physiology is clearly different from adults. Some experienced snippets of Manual Therapy but with a focus on more osteopathic techniques and did not learn to assess neurodevelopment and their interrelation with mechanical dysfunctions. This relationship is fundamental and is a distinguishing factor of a good manual therapist. And those who specialised in Paediatrics had no opportunity for training in Paediatric Manual Therapy, so they lack the tools to be effective with a torticollis, a hip dysfunction or drainage of an otitis. Even fundamental aspects such as vestibular and tactile stimulation in neurodevelopment probably did not have much relevance in their training. Unlike other programmes, this course focuses on specific manual aspects such as the child's motor and sensory construction, offering key tools in assessment and treatment. Also unlike other programmes in paediatrics, this course addresses in particular the dysfunctions of children without brain damage but with pain or dysfunction, even with a an immature neurodevelopment that affects their balance, coordination, attention or learning abilities. When you finish training at PIMT you will have the attitude, resources and tools needed to enter or progress in the field of paediatrics. Iñaki Pastor Pons What will you learn in this training course? Manual Therapy • Paediatric manual assessment of tissues (aponeurotic, muscular or membranous). • Manual articular paediatric assessment (peripheral joints, spine and skull). • The management of structural and functional techniques in the framework of paediatric practice. • Understanding the specific anatomy of the child and their developmental changes into adulthood. • The treatment of mechanical dysfunctions in the musculoskeletal system (torticollis, hip problems, postural alterations, backaches, costal problems, etc.). • The treatment of gastrointestinal dysfunctions of a neuromechanic origin (reflux, baby colic, constipation, dyskinesia of the small intestine, etc.). • Treatment of respiratory dysfunctions (bronchitis, asthma, etc.) integrating respiratory physiotherapy and manual therapy. 6 Development Physiotherapy • The neurofunctional assessment of the newborn, the infant and child. • The approach to the immaturity of neurodevelopment and its consequences (coordination, balance and development problems of the baby and the child). • The use of official screening scales and tests to assess neurodevelopment. • The determination of the age of development against the biological age in the baby and the newborn. • Stimulation programmes for babies with hypotonia and developmental disorders. 7 Skull and face • The assessment of cranial development in the baby and its relation to the cervical spine. • Assessment and treatment of intraand extracranial headaches • The birthing process as the origin of cranio-cervical alterations that influence the neurodevelopment. • How to clean and open the High Respiratory Tract. • How to treat otitis through cranial and drainage techniques. • Treatment of non-synostosis cranial deformations: plagiocephaly. Attention deficit and learning problems • The approach to attention deficit and learning problems of the child (dyspraxia, dyslexia, literacy alterations etc.) from an integrative model in manual therapy. • Understand the influence of vestibularproprioceptive and vestibular-cerebellar dysfunctions in learning disabilities. • Assessment of the vestibular, proprioceptive and oculomotricity.system. • Assessment of the presence of nonintegrated primitive or postural reflexes. • Coordination with other professionals in the treatment of learning disabilities: psychopedagogues, optometrists, speech therapists, occupational therapists, psychologists, neuropediatricians, etc. PRE-REQUISITES The training is open to physiotherapists. You must submit: • Copy of the diploma of studies. • Certificate of association or certificate of liability insurance (practical work is with infants and children so this is a necessary requirement). • Brief letter of motivation in just a few lines indicating the "why" you want to do this training. • Brief C.V. one side of an A-4 page, indicating professional experience, major postgraduate training and current job position. Experience in the paediatric field will be particularly valued. The programme COMPLETE STRUCTURE OF THE TRAINING Training in PIMT is structured in 3 levels and different seminars of advanced level. The levels are: LEVEL 1 Paediatric integrative manual therapy and introduction to neurodevelopment 2 seminars LEVEL 2 Assessment and treatment of neurodevelopment disorders from an integrative model in paediatric manual therapy 2 seminars LEVEL 3 Assessment and treatment of the skull and face from an integrative model in paediatric manual therapy 2 seminars 8 9 LEVEL 1 PAEDIATRIC INTEGRATIVE MANUAL THERAPY AND INTRODUCTION TO NEURODEVELOPMENT SEMINAR 1 PAEDIATRIC INTEGRATIVE MANUAL THERAPY. LUMBOPELVIC DYSFUNCTIONS AND LOWER LIMBS Duration 30 hours over 4 days of training. Aims • Understand the concept of Integrative Manual Therapy. • Differentiate between structural and functional manual techniques, and their integration into the paediatric application. • Understand the multifactorial concept of pathology, and the relationship between mechanical and neurodevelopment dysfunctions. • Acquire basic skills for articular and tissue assessment of the pelvis and lower limbs in paediatrics. • Acquire basic practical technical resources to treat mechanical dysfunctions of the pelvis and lower limbs in paediatrics. Contents General aspects • Introduction to Integrative Manual Therapy. • Integration of structural and functional aspects with three-dimensional parameters in Integrative Manual Therapy. • Manual Paediatric Therapy and Neurodevelopment in children without brain damage. Towards a global conception of Paediatric Physiotherapy. • Relationship between biological systems in health and disease. Specific aspects • Mechanical dysfunctions in the hip in the infant and the child. Impact on the integration of movement and postural patterns. • Mechanical dysfunctions in the lumbopelvic hip joint in the infant and the child. • Implications of mechanical dysfunction in the integration of movement patterns, postures and integration of primitive reflexes. Consequences for development. • Dorsolumbar mechanical dysfunctions and digestive problems. • Towards a comprehensive integrative exploration in paediatric manual therapy. Exploration and Treatment in PIMT • Exploration and Treatment of an actual paediatric patient. • Joint and tissue exploration in PIMT. • Introduction to joint and myofascial functional techniques. • Correction techniques in PIMT for mechanical and aponeurotic dysfunctions in the pelvis (I). • Correction techniques in PIMT for mechanical and aponeurotic dysfunctions in lower limbs (I). • Correction techniques in PIMT for mechanical and aponeurotic dysfunctions in the dorso-lumbar spine (I). 10 SEMINAR 2 BIOMECHANICS OF BIRTH, CERVICAL SPINE AND UPPER LIMB DYSFUNCTIONS Duration 30 hours over 4 days of training. Aims • Learn about the birthing process from the biomechanical point of view of the baby's skull and neck. • Learn about the responsibility of mechanical craneocervical dysfunctions in neurodevelopmental disorders. • Acquire the basic skills for the joint and tissue assessment of the superior cervical and cervical dorsal spine. Acquire basic practical technical resources to treat the mechanical dysfunctions of the cervical spine of the baby and the child. Contents General aspects • Biomechanics of childbirth. Types of presentations. The mechanical stress of the baby's cervical spine and the skull at birth. • The "trauma of childbirth" as possible onset of neurodevelopmental disorders. • Risk factors during childbirth: instrumental delivery, Kristeller's manoeuvre, labour time, etc. • Anatomical differences between the baby and the adult at a cervical and cranial level. • Importance of cervical proprioception in vestibular sensorial integration and oculomotricity. Specific aspects • Cervical mechanical dysfunctions.. Severe re-percussion in neurodevelopment. • Introduction to perinatal mechanical factors in attention deficit and learning problems. • Baby colics 11 • Congenital muscular torticollis • Cervical dysfunctions as a key factor in plagiocephaly. • Cervicothoracic dysfunctions and respiratory pathology. Integrative approach of respiratory physiotherapy in manual therapy. • Introduction to an integrative cervical cranial model in Paediatric Integrative Manual Therapy Exploration and Treatment in PIMT • Exploration and Treatment of an actual paediatric patient. • Assessment of the cervical spine of the child and the newborn. • Correction techniques in PIMT for mechanical and aponeurotic dysfunctions in the superior cervical spine (I). • Correction techniques in PIMT for mechanical and aponeurotic dysfunctions in the cervical dorsal spine (I). • Correction techniques in PIMT for mechanical and aponeurotic dysfunctions in the lower limb (I). • Techniques of assessment and treatment of the thorax and ribs in PIMT. LEVEL 2 ASSESSMENT AND TREATMENT OF NEURODEVELOPMENT ALTERATIONS FROM AN INTEGRATIVE MODEL IN PAEDIATRIC MANUAL THERAPY SEMINAR 3 SENSORY AND MOTOR NEUROPROGRAMMING IN THE BABY AND THE NEWBORN. A NEW ASSESMENT AND CONCEPTUAL FRAMEWORK Duration 30 hours over 4 days of training. Aims • Understand sensory and motor development and neuroprogramming in the infant. • Understand the stages of motor development and assessment of postural control in the infant and the newborn. • Acquire skills for neurodevelopmental assessment in the infant and the newborn. • Acquire basic skills for treatment and stimulation of neurodevelopment. Contents General aspects • Philogenesis and ontogenesis in postural and movement organisation. • Movement as the basis of a physiological motor development. • A great variety of innate and acquired motor programmes. • Assessment of the motor and spontaneous behaviour in the first 15 months. • Sensory integration as a modulator of a natural development. • Prenatal factors in developmental problems 12 13 Specific aspects • The assessment of postural reactions as an indicator of healthy development. • The assessment of primary and postural reflexes in the infant as an indicator of healthy development. • Mechanical dysfunctions that can block ideal neurosensory motor development. • Phases of sensory processing and its programming. • The development of the different senses: somatic and special • The role of the vestibular system and tactile information in the neurodevelopment of the infant. • Keys to programming: stimulation, repetition and relevance. • The ideal stimulation frame and ideal environment for the baby. Parent education and advice to health workers. Exploration and Treatment in PIMT • Exploration and Treatment of an actual paediatric patient. • Exploring the infant's neurodevelopment: -- Attitude, posture and spontaneous movement - Postural reactions. -- Primitive reflexes. - Tonic assessment. • Advanced correction techniques for the cervical cranial complex. • Correction techniques in PIMT for mechanical dysfunctions in the superior cervical spine (I). • Vestibular and tactile stimulation techniques. • Development of correct postural patterns and movement in the baby. SEMINAR 4 SENSORY AND MOTOR N THE CHILD. PHYSIOTHERAPY IN COORDINATION, ATTENTION AND LEARNING DISORDERS Duration 38 hours over 5 days of training. (From 2017). Aims • Understand the role of vestibular, tactile and proprioceptive information in neurodevelopment and its alterations. • Acquire basic practical technical resources to assess and treat neurodevelopmental disorders from an integrative model in manual therapy. • Understand the relationship between motor development and sensory development problems and learning disabilities. • Acquire the basic competences for neurodevelopment assessment in children. Contents General aspects • Classification of learning disabilities. • Main theories on motor control: hierarchy, programming and dynamic systems, and their impact on a treatment model. • Physiology and function of the vestibular system. • Presence of primitive reflexes as a sign of CNS immaturity? Relevance of evidence. • Evaluation in PIMT of neurodevelopmental disorders. • Towards an integrated model of manual therapy in neurodevelopment. • Towards a neurosensory-motor reprogramming. 14 Specific aspects • Proprioceptive information as a contrast with visual and vestibular information in the CNS. • Mechanical dysfunctions as a source of proprioceptive error. • Mechanical dysfunctions linked to the persistence of primitive reflexes. Specific correlation. • Reflections based on ocular motor control: vestibulo-ocular reflex, cervico-ocular reflex and optokinetic reflex. Assessment instruments. • Interdisciplinary treatment and communication: Optometrist, speech therapist, occupational therapist, psychomotrician, psychologist, psychopedagogue, neuropediatrician ... • Advice in the educational framework. • Visual therapy and acoustic therapy.. When are they essential? • The role of paediatric integrated manual therapy in paediatric physiotherapy. 15 Exploration and Treatment in PIMT • Exploration and Treatment of an actual paediatric patient. • Treatment of the cervical-cranial complex in disorders of postural control. • Exploring the infant's neurodevelopment: -- Posture and balance. -Coordination. -- Cerebellar function. -- Vestibular function. -- Primary and postural reflexes. - Proprioceptive quality. -- Oculomotricity. • Neurosensory-motor stimulation programmes in the child with coordination, attention and learning problems. • Use of scales and official screening tests of neurodevelopment. • Treating balance and coordination problems in the child. • Vestibular stimulation: practical codes of application. • Tactile and proprioceptive stimulation: practical keys of the application. LEVEL 3 ASSESSMENT AND TREATMENT OF THE SKULL AND FACE FROM AN INTEGRATIVE MODEL IN PAEDIATRIC MANUAL THERAPY SEMINAR 5 ASSESSMENT TREATMENT OF THE SKULL IN PAEDIATRICS Duration 30 hours over 4 days of training. Aims • Discover the basic anatomical-physiological aspects of the skull in paediatrics. • Acquire the basic competences for the assessment of cranial structures in manual therapy. • Acquire basic practical technical resources for the treatment of cranial structures in paediatrics. Contents General aspects • Anatomy of the skull and its development in infancy. • Comparison of anatomy between the infant's and adult's skull. • Cranial adaptations inside and outside of uterus • Assessment and treatment of the paediatric skull. Specific aspects • Principles of cranial embryology. • Bones of the skull. • The components of the cranial base. • • • • • The components of the cranial vault. Skull and cervical spine ossification centres. Chondral and desmal ossification. Intraosseous and overlap lesions. Fontanelles or fonticulus and their development. • Physiology and structure of cranial sutures. • Synostosis and non-synostosis plagiocephaly. • Orthotic treatment of plagiocephaly. • Synotosic plagiocephaly or craniosynostosis and their types. • Craniometric measurements. Craniometrics. Cranial indices and asymmetry of the vault. Assessment with laser scanner and 3D photography. 16 17 • Dural relationship between sacrum and skull. • Relationship between cranial and cranial nerves. • Assessment and visualisation of paediatric cranial imaging methods. Exploration and Treatment in PIMT • Exploration and Treatment of an actual paediatric patient. • Assessment of the vault and cranial base. • Palpation and listening to changes in cranial pressure. • Paediatric techniques of treatment on the cranial base and the cranial vault. • Paediatric techniques of treatment on on vault sutures. • Paediatric techniques of treatment on the dura and intracranial membranes. • Paediatric techniques for treatment of cervical-neoplasms.. • Paediatric techniques on cerebral ventricles. SEMINAR 6 ASSESSMENT AND TREATMENT OF THE FACE IN PAEDIATRICS Duration 30 hours over 4 days of training. Aims • Discover the basic anatomical-physiological aspects of the viscerocranium in paediatrics. • Acquire the basic competences for the assessment of alterations of viscerocranium in paediatrics. • Acquire basic practical technical resources for the treatment of face structures in paediatrics. Contents General aspects • Anatomy and development of the viscerocranium and the face. • Comparison of anatomy between the infant, child and adult's face. • Asymmetries and orofacial adaptations. • Cranial adaptations in labour (I). • The trauma of childbirth for the face. • Assessment and treatment of the face paediatrics. in Specific aspects • The bones of the face. • Development of the skull and development of the face. • Symmetry and facial asymmetries. • The components of the perineal sinuses. • The temporomandibular joint. • The orbicular cavity and the tear duct. • The ear and the auditory tube. • Facial and obstetric trauma. • Types of childbirth and their implications in the cranial molar. • Accessory instrumentation in childbirth. • Orthodontic treatment in paediatrics, Interdisciplinary coordination. • Mouth breathing and its consequences. • Otitis in infants. Assessment and treatment. • Rhinitis and sinusitis in children. Assessment and treatment. • Headache and migraines in paediatrics. • Cleft lip and palate. Interdisciplinary coordination. • Assessment and treatment of alterations of the oculomotor system. • Assessment and visualisation of facial imaging methods in paediatrics. Exploration and Treatment in PIMT • Exploration and Treatment of an actual paediatric patient. • Exploration of the viscerocranium in paediatrics. • Paediatric techniques for palate treatment. • Paediatric techniques of treatment of the bones of the face. • Pumping and drainage techniques of the perinasal sinuses. • Pumping and drainage techniques of the autistic tube. • Treatment techniques of spheno-palatine ganglion. • Treatment techniques of the lacrimal canal. • Pumping and draining techniques of the orbits. 18 19 Unique course with practice in children and infants The teachers Our teachers and tutors are renowned physiotherapists. Find out more about them online. As well experienced physiotherapists, we know what works and what does not work with children and infants, and they will communicate this with clarity and generously. You can expand the information about the teaching team on our website: www.terapiamanualpediatrica.es 20 Iñaki Pastor Pons Nuno Matos Physiotherapist. Director of the Paediatric Integrative Manual Therapy Training and the Institute of Integrative Therapies. Author of the book Manual Therapy in the Oculomotor System (Elsevier, 2012). Iñaki has a Masters in Paediatric Physiotherapy and is responsible for Global Postural Reeducation training in Canada. He gives training courses and seminars in the cervicocranial area in different countries of the world. Director of the Aragonese Institute of Health and Child Development (IASDI). Physiotherapist and osteopath, trainer in the area of Manual Therapy with more than 15 years of experience. He is director of the Cabinet of Manual Therapies and Integrated Medicine in Cascais, Portugal. He is currently doing a master's degree in the musculoskeletal area. Nuno is creator of the myo-neuromeningeal technique. Author and coordinator of the Cranio-facial Assessment and Treatment Course both in Portugal and Spain. 21 Miren Echániz Martínez Anxo Cachinero Torre Physiotherapist. Specialist and trainer in Paediatric Integrative Manual Therapy (PIMT). Master in Orthopedic Manual Therapy. Trained in the INPP concept, in rhythmic movement therapy, in the Upledger concept and in Paediatric Osteopathy. Iñaki Pastor of the Aragonese Institute of Health and Child Development. Physiotherapist. Specialist and trainer in Paediatric Integrative Manual Therapy (PIMT). Master in Physiotherapy Manual of the Locomotor Apparatus. Master in Neuroscience. Teaching assistant at the Aragonese Institute of Health and Child Development. Manu López Paez Physiotherapist. Specialist and trainer in Paediatric Integrative Manual Therapy (PIMT). Higher Diploma in RPG. Director of the Fysio Salud y Deporte Group. C/ San Miguel, 16, Entlo. Dcha. 50001 Zaragoza www.terapiamanualpediatrica.es Tel. +34 665 677 723 [email protected]