19IDSIM033 - PORi Approach to Lower Extremity Lymphedema

Description

Registration for this program is now closed.

This Oncology-based Lower Extremity (LE) Lymphedema course (including the pelvis) is designed to highlight and broaden the clinician's knowledge and clinical skill set needed for expertise in the functional management of lower extremity lymphedema in patients with cancer. Using the PORi management system, participants will be provided with integrated pathways in the assessment and treatment of patients diagnosed with cancer and recovering from treatment sequelae.

The PORi assessment and treatment pathways include manual therapy application of the body systems approach – neuro-musculo-skeletal-lymphovenous-integumentary – designed for functional and management of sub-clinical and clinical LE lymphedema, combined with the development of prescribed functional exercises for the lymphatic system. The PORi assessment and treatment pathways are built according to evidence-based guidelines, clinical tests and screening systems presented in the course. Both the functional treatment of the lymphatic system and the functional exercise prescription will integrate with functional movement patterns of the patient and translate into ADLs (home, occupational, recreational, community-based) relevant to the patient. To deepen clinical understanding of the relationship between cancer and lymphedema, the course will offer the opportunity for participants to acquire a more in-depth knowledge about cancer pathogenesis and the standards of care for cancers that are commonly associated with the onset of LE lymphedema.

The course will go into detail about the key recovery trajectories for oncology patients recovering from surgical intervention, chemotherapy intervention, and radiation therapy intervention, and participants will be provided with knowledge on how to identify complications with healing during these recovery trajectories that commonly impact the functioning of the lymphatic system. Participants will learn to apply pathways of care to effectively implement Prehabilitation and early intervention of Rehabilitation at each phase of cancer-related treatment, as well as use the PORi management system to provide a continuum of care to successful long-term survivorship.

This course presents both didactic and lab-based course work. The lab-based course work is "patient-based" where patient volunteers attend the lab portions of the course in order to create a direct hands-on learning opportunity for participants.

Target Audience

Physical therapists, physical therapist assistants, occupational therapists & certified occupational therapy assistants

Objectives

• Implement an oncology-related LE Lymphedema rehabilitation program into clinical practice using key PORi navigation pathways, PORi protocols, and evidence-based clinical practice presented in the course manual that is within the scope of professional practice
• Describe the disease process and the progression of oncology-related LE lymphedema
• Utilize key PT/OT clinical identifiers to assess the "at risk" patient for onset of clinical LE Lymphedema
• Differentiate between the key recovery trajectories for patients recovering from surgical intervention, chemotherapy intervention, and radiation therapy intervention, and how these impact the lymphatic system
• Implement appropriate evaluative and treatment goals for patients presenting with sub-clinical or clinical LE lymphedema during these recovery trajectories
• Apply pathways of care to effectively implement Prehabilitation and early intervention of Rehabilitation at each phase of cancer-related treatment - surgery, chemotherapy, and radiation therapy - as well as use the PORi management system to provide a continuum of care across these phases of treatment and into long-term survivorship
• Effectively utilize appropriate, evidence-based Functional Outcome Measurement Tools, Objective Measurements, and Quality of Life Measurement Tools for the evaluation and treatment of sub-clinical and clinical LE lymphedema and associated cancer diagnoses
• Identify and list three anatomical/physiological body structures/systems, according to the International Classification System of Function and Disability and Health (ICF), to be included in the evaluation and treatment of patients with pelvic and lower GI cancers who are at risk for LE lymphedema
• Classify three activity-based and participation-based functional impairments, according to the ICF, that are commonplace in patients with pelvic and lower GI cancers who are at risk for LE lymphedema
• Through practical application, explain how manual therapy and exercise techniques can be implemented to strengthen the functional capacity of the lymphatic system during Stage 0-1 sub-clinical lymphedema and how these can mitigate the lifetime risk of clinical LE lymphedema
• Clinically implement the PORi manual therapy application of the body systems approach – neuro-musculo-skeletal-lymphovenous-integumentary – designed for functional management of LE lymphedema and combine this with the development of PORi prescribed functional exercises for the lymphatic system and integrate these with functional movement patterns of the patient during ADLs (home, occupational, recreational, community-based)
• Respond to the additional treatment needs for patients presenting with wound care needs in the same anatomical area of lymphedema
• Demonstrate understanding the clinical identifiers for progressive disease process in cancers associated with LE Lymphedema
• Analyze the clinical impact of progressive cancer disease on the lymphatic system
• Provide patients with education and access to appropriate compression therapy for oncology-related LE lymphedema
• Incorporate two to three "medically necessary" criteria, into the documentation guidelines for patients with oncological/chronic conditions, such as LE Lymphedema, as stated by the Medicare Amendment of December 2013
• Document at least three appropriate ICD-10 codes, three CPT codes, and implement appropriate G-codes from the CMS Fee Schedule and the Medicare Practice Guidelines for Physical Therapists and Occupational Therapists, to reflect the skilled rehabilitation services provided to patients with LE lymphedema and who are participating in oncology rehabilitation

Faculty

• Stephanie Bowman, PT
• Alaina Newell, PT
• Julia Osborne, PT, CLT-LANA