A Practical Guide to Treating Thoracic Outlet Syndrome

Instructor

Ann Porretto-Loehrke

PT DPT CHT COMT CMTPT

Ann graduated from Marquette University in 1994 with a BS in Physical Therapy. She became a Certified Hand Therapist in 2002 and completed the IAOM-US certification for the upper quadrant in 2003. In 2007, Ann completed her DPT degree with a specialty in hand and upper quarter rehabilitation from Drexel University in Philadelphia. She also became certified in dry needling in 2015. Ann is the Clinical Development Coordinator at the Hand to Shoulder Center of Wisconsin, located in Appleton, Wisconsin. She is one of the creators and lead instructors of the Hand and Upper Extremity Track. Ann has co-authored a chapter in Rehabilitation of the Hand & Upper Extremity on nerve compression syndromes of the elbow and forearm, as well as published two peer-reviewed articles entitled “Clinical Manual Assessment of the Wrist” and “Taping Techniques for the Wrist” in the 2016 Journal of Hand Therapy’s special edition of the wrist. Ann serves as the planning committee chair for the Wisconsin Hand Experience conference and has presented at American Society of Hand Therapists (ASHT) annual conferences, Canadian Society of Hand Therapist Annual Conference, Philadelphia meeting, and Teton Hand Conferences. Disclaimer: Ann Porretto-Loehrke also teaches online content through MedBrigde and gets paid for these courses. MedBridge has a collaboration with IAOM-US. The courses taught by Ann both at IAOM-US and Medbrige are mentioned at the beginning of each course.

Description

3.88 Hours / .388 CEUs Gain the knowledge and skills to provide treatment for patients with disputed neurogenic thoracic outlet syndrome (TOS)! This course will emphasize treatment for the 3 biggest impairments related to TOS: 1st rib elevation, poor scapular positioning, and posterior shoulder tightness. Via a virtual format, therapists will perform specific clinical testing, assessment and treatment of the 1st rib and posterior shoulder, as well techniques to improve resting scapular position and dynamic control. Target group: PT, PTA, AT, OT Education Level: Intermediate

Objectives

• 1. Analyze the relationship between the three main passageways involved in nonspecific thoracic outlet syndrome — the scalene triangle, costoclavicular space, and subcoracoid space — and the client’s symptom presentation.
• 2. Differentiate compressor and releaser clinical presentations of TOS based on symptom patterns and aggravating activities.
• 3. Differentiate the indications, client positioning, procedure, and positive findings of the Roos test (Elevated Arm Stress Test), the Cyriax release test, and the Cervical Rotation Lateral Flexion test.
• 4. Order the examination and treatment steps used to identify and address first rib mobility limitations associated with nonspecific TOS.
• 5. Identify the scapular faults that contribute to TOS and the strategies used to improve resting scapular position and dynamic control.
• 6. Classify posterior glenohumeral capsule limitations related to TOS according to their corresponding assessment and treatment progression.
• 7. Relate nonspecific TOS examination findings to the client’s ability to participate in desired occupations in context, including overhead dressing, grooming, bathing, lifting and carrying at work or in caregiving, and sleeping