APTA Montana Primary Care Conference

This session provides an evidence-informed, clinician-focused overview of how physicians approach the preparticipation physical evaluation (PPE) in pediatric and adolescent athletes. Emphasis is placed on risk stratification, medical clearance decision-making, and identification of conditions that predispose to injury or sudden cardiac events.
Learning Objectives: 
1. Review the common components of Pediatric Sports Preparticipation Paperwork.
2. Describe the components of the Preparticipation Physical Evaluation.
3. Learn standard cardiac auscultation and how findings affect preparticipation management.
4. Identify key red flags in pediatric athletes (e.g., syncope, cardiac history, concussion, overuse injuries, disordered eating) that warrant further medical evaluation or restriction from sport.
5. Interpret how clearance decisions are made, including full clearance, conditional participation, or disqualification.

Provides physical therapists with a practical, tiered framework for evaluating and managing the dizzy patient in direct access practice. Through key subjective questions and indicators, special tests, red flag identification, reference resources and a case study attendees will build confidence in bedside screening for emergent conditions, differential diagnosis, and knowing when and how to refer dizzy patients

Learning Objectives:

• Identify subjective red flags and orange flags in patients presenting with dizziness or vertigo.
• Recognize clinical indicators of emergent and urgent conditions -- including brainstem and cerebellar pathology, cervical instability, and hemodynamic compromise -- and determine appropriate referral pathways.
• Apply foundational peripheral vestibular assessment skills including the Dix-Hallpike and supine roll test, and identify patients appropriate for in-clinic management versus specialist referral.
• Utilize a practical referral decision framework tailored to the rural Montana primary care setting, including telemedicine neurology access, ER criteria, and in-clinic vestibular intervention options.

This course will cover two very important clinical disorders of the vascular tree of the lower extremity; Venous Thromboembolism (VTE) which includes Deep Venous Thrombosis and Pulmonary Embolism (DVT/PE) and peripheral arterial disease (PAD). DVT is one of the more common and potentially serious vascular disorders seen in patients who are hospitalized and receiving physical therapy. This course will address the pathophysiological changes that lead to DVT and describe factors that place certain people at high risk for developing DVT and the potential for PE. Differential diagnosis and utilization of reliable and valid clinical scales will be covered. This portion of the course will culminate in a discussion of how physical therapists can make clinical decisions about when to contact another healthcare provider or begin ambulation or implement other interventions in patients who experience an acute episode of DVT or PE.

Peripheral arterial disease (PAD) affects primarily the lower extremity and is the accumulation of fibrous fatty (atherosclerotic) lesions that occlude the lumen of the vessel. With progression of this disorder symptoms of peripheral ischemia may include intermittent claudication, ischemic rest pain, ulceration and possibly amputation. Differential diagnosis utilizing valid and reliable techniques will be covered. This portion of the course will culminate in a demonstration of an ankle/brachial (ABI) test of how physical therapists can make clinical decisions about when to contact another healthcare provider or implement interventions.Upon completion of this course, the participant will:  

• Explain the pathophysiology of VTE (DVT & PE) and PAD.  
• List the risk factors for DVT and PAD.  
• Identify the signs/symptoms of DVT, PE, and PAD.  
• Explain the usefulness (validity) of clinical tests for determining risk of a DVT/PE and PAD.
• Explain when it is appropriate to treat these vessel disorders and the efficacy of the treatment.