Course Description

Beverly (Billi) Cusick begins this program with an explanation of the controversy over the issue of W-sitting and the related state of evidence to support both sides of the issue. Bringing the sciences of full-term neonatal posture and bone geometry to the discussion, she relates the typical hip neonatal and knee joint alignments to typical strategies used to acquire the ring-sitting position. Billi will then discuss the pathomechanics and pathokinesiology inherent in habitual and prolonged W-Sitting with legs and feet in lateral rotation, i.e. W-Sit-LR. She will discuss the physiologic adaptation of soft tissues, bones, and joints to routine use, and the condition known as “miserable malalignment syndrome.” The presentation targets children with potential orthopedic issues and ligament laxity although the principles pertain to children with cerebral palsy.
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Course Objectives

By the end of this course, the participant is expected to:

  • Explain the biomechanical benefit that typical full-term newborn alignment of the leg and foot brings to the independent acquisition of the ring-sitting position.

  • Name three of the hip muscles used by typical infants to drive and decelerate the transitions between ring-sitting and quadruped positions.

  • Compare the triplane alignment of the femoral head and neck axis (HNA) in ring sitting and in W-sitting positions.

  • Discuss the influence of W-sitting-LR on the incidence of lateral weight shifts of the torso in play.

  • Describe the rotary forces applied to the femur during transitions between W-Sitting-LR and kneel-standing positions.

  • Discuss the status of evidence regarding the contributions of habitual W-Sit-LR to musculoskeletal problems after childhood.

  • Describe the condition of the long bones and knee joints in “miserable malalignment syndrome.”

  • Explain the science that associates habitual, prolonged W-sitting-LR with miserable malalignment syndrome.

  • Distinguish between common advice and kinesiologically healthy alternatives to W-Sitting.

Who Should Take this Course

Practicing clinicians and students of pediatric physical therapy, orthotics, rehabilitation medicine, and orthopedics.

Level: Intermediate. Clinicians are expected to know neuromusculoskeletal anatomy, kinesiology, and the physiology of adaptation-to-use-history.

Pricing

Course Completion Requirements

  • Section Videos and Quizzes

    Watch each section video in its entirety. Complete all quizzes with a score of 80% or better. You get unlimited attempts to pass the quizzes.

  • Course Evaluation

    Let us know what you thought and how we can improve this course. Complete the course evaluation at the end of the course to receive your course completion certificate.

  • Course Access Period

    Once you have registered, you will have 60 days to review the course material. Each section must be completed before moving on to the next, but you can review any completed section at any time.

Course Outline

    1. We're glad you're here...

    2. Introduction: The Dispute

    1. Typical Features of Newborn Lower Extremity Alignment

    2. Musculoskeletal Components of Ring-Sitting Acquisition and Position Transitions

    1. Biomechanical Factors

    1. Physiologic Adaptation - Muscle & Fascia

    1. Modeling Mechanisms

    2. Miserable Malalignment Syndrome

    1. W-Sitting: Discourage or Ignore?

    2. Examining Common Interventions

    3. Strategies for Indoor Play

About this course

  • $59.00
  • 17 lessons
  • 1.5 hours of video content

CEUs

Physical Therapists and Physical Therapist Assistants: Florida: Progressive Gaitways is a rule approved provider of the PT Board of Florida #50-45480.  (1.5 hours) 

California: Progressive Gaitways has been approved as a provider of continuing education for Physical Therapists and Physical Therapist Assistants in California (CA) by Redefine Health Education, a recognized approval agency of the Physical Therapy Board of CA. (1.5 hours)

Courses approved by other state boards in the following jurisdictions are likely accepted for licensure credit based on the state regulation. 

AL | AK | AR | CO | CT | DE | GA | HI | ID | IN | IA | KS | KY | ME | MA | MI | MO | MT | NE | NH | NC | ND | OR | PA | RI | SC | SD | TN | UT | VT | VA | VI | WA | WI | WY

Please reach out to your state licensing board to confirm the currency and accuracy of this information. If you have a specific question about CEU approval for this course in your state, please direct your inquiry to [email protected]

The following states are not pre-approved:    LA, IL, MN, NV, NY, NJ, OH, OK, TX, WV

Participants licensed in states not pre-approved may file for individual approval using the instructions on this document.

For Orthotists: The W-Sitting course has been approved for 1.75 scientific contact hours by ABC.

Instructor

President / Senior Instructor Beverly (Billi) Cusick

Beverly (Billi) Cusick PT, MS, NDT, COF/BOC is an internationally known pediatric physical therapist whose specialty is the orthopedic development and orthotic management of children with cerebral palsy and other neuromotor deficits.

She has been teaching these and related topics since 1978 - including presentations by invitation for the APTA, AACPDM, AOPA, and AAOP and more than 460 full programs and workshops worldwide.

Ms. Cusick received her BS in PT from Bouve College at Northeastern University in Boston, MA in 1972, and her MS in Clinical and College Teaching for Allied Health Professionals from the University of Kentucky in Lexington in 1988. She is an Associate Professor for the Rocky Mountain University of Health Professions – Pediatrics Program – Provo, Utah (2006-present) and is NDT basic- and baby-trained.

Inclusion/Non-Discrimination Statement 

Progressive GaitWays LLC and the Cusick Center for Learning do not and shall not discriminate on the basis of race, color, religion (creed), gender, gender expression, or military status, in any of its activities or operations. These activities include, but are not limited to, provision of training services, products, or consultations to rehabilitation clinicians such as physical therapists, occupational therapists, orthotists, and physical therapy assistants. We are committed to providing an inclusive and welcoming environment for all attendees, colleagues, clients, and vendors.

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