A. & E. If You Can't Breathe,
You Can't Function:
Integrating the Cardiopulmonary and Postural Control Strategies in the Pediatric Population
Presented by Mary Massery, PT, DPT, DSc
A. Thursday, February 26, 2015 (Part 1)
E. Friday-Saturday, February 27-28, 2015 (Part 2)
7 contact hours (Part 1); 13.5 contact hours (Part 2)
Intermediate Level
This session is offered for up to 20.5 ASHA CEUs (Intermediate Level; Professional Area)
Space Still Available!
Audience: PTs, OTs, Respiratory Therapists, SLPs,
and interested others
How these techniques are being used in one former participant's practice
A. Thursday, February 26, 2015 (Part 1)
E. Friday-Saturday, February 27-28, 2015 (Part 2)
7 contact hours (Part 1); 13.5 contact hours (Part 2)
Intermediate Level
This session is offered for up to 20.5 ASHA CEUs (Intermediate Level; Professional Area)
Space Still Available!
Audience: PTs, OTs, Respiratory Therapists, SLPs,
and interested others
How these techniques are being used in one former participant's practice
This course will challenge the practitioner to make a paradigm shift; acknowledging the importance of the cardiopulmonary system as an integral component of postural control. The speaker will present a model of postural control (Soda Pop Can Model) that demonstrates how breathing mechanics are linked to motor and physiologic behaviors. This is the cornerstone for the speaker’s multi-system clinical approach to the evaluation and treatment of trunk and/or respiratory impairments. She will demonstrate how to integrate the cardiovascular, pulmonary, musculoskeletal, neuromuscular, integumentary and internal organ systems into every evaluation and intervention, as well as how to recognize physiologic causes or consequences that may accompany these motor dysfunctions. The speaker will show the participants how to effectively pair ventilatory strategies with specific movements in order to establish the pulmonary system as an asset rather than a liability for their patients, regardless of whether their original diagnoses were physiologic or physical. The emphasis of the presentation will be on developing and applying practical quick clinical solutions that are applicable for both pediatric and adult patients in all practice settings.
Objectives: Participants will be able to
Day 1
Days 2 and 3
Attendance at Day 1 is required to attend Days 2-3; Day 1 may be taken as a 1 day option.
Agenda*
Day 1 - 7 contact hours
8:00 - 8:30 Registration
8:30 - 10:30 Breathing and Posture: A Multi-system Event!
10:30 - 10:45 Break
10:45 – 12:00 Breathing and Posture (continued)
12:00 - 1:00 Lunch
1:00 - 2:00 Breathing and Posture (continued)
2:00 – 2:45 Normal and Abnormal Chest Wall Development and Function
2:45 - 3:00 Break
3:00 – 5:00 What can you do in 90 Seconds or Less that has a Profound and Lasting Effect? Positioning Strategies
Day 2 - 7 contact hours
8:00 - 8:30 Registration
8:30 - 9:30 Ventilatory or Movement Strategies
9:30 - 10:30 Finding the Problem: Pulmonary Assessment from a Multi-System Perspective
10:30 - 10:45 Break
10:45 - 12:00 Lab 1: Chest Assessment: Focus on Breathing Patterns and Musculoskeletal Alignment
12:00 - 1:00 Lunch
1:00 - 1:30 Lab 1 Continued
1:30 – 2:45 Lab 2: Enhancing Phonation Skills through Improved Breath Support
2:45 – 3:00 Break
3:00 - 3:45 Airway Clearance: From Sherlock to Solution
3:45 – 5:00 Lab 3: Airway Clearance
Day 3 - 6.5 contact hours
8:30 - 10:30 Lab 4: Thoracic Complex: Mobility Exercises and Techniques
10:30 - 10:45 Break
10:45 – 12:00 Lab 4: continued
12:00 - 1:00 Lunch
1:00 - 2:45 Lab 5: Facilitating Efficient Breathing Patterns and Building Endurance
2:45 – 3:00 Break
3:00 - 4:00 Lab 5: continued
4:00 - 4:30 Lab 6: Group Problem Solving: Putting It All Together
*Topic times may vary; contact hours do not.
How to prepare for your upcoming respiration course experience.
1) Required attire for labs: tank tops, sports bras, etc. One-piece bathing suits are not appropriate. Participants not wearing lab clothes are invited to come and observe.
2) Anatomy books: Participants are encouraged to bring their favorite anatomy book to help visualize the presentation on Day 1.
3) Suggested pre-readings for the course: www.MasseryPT.com “publications”:
o Massery, M., Breathing and Upright Posture: Simultaneous Needs, in 26th International Seating Symposium, Vancouver, BC. March 11-13, 2010;25-28.
o Massery M. The Linda Crane Memorial Lecture: The patient puzzle - piecing it together. Cardiopulmonary Phys Ther J.
2009;20(2):19-27.
o Massery M. The patient with multi-system impairments affecting breathing mechanics and motor control. In: Frownfelter D, Dean E, eds. Cardiovascular and Pulmonary Physical Therapy Evidence and Practice, ed. 4. St. Louis, MO.: Mosby & Elsevier Health Sciences; 2006:Chapter 39:695-717.
o Massery M. Musculoskeletal and neuromuscular interventions: a physical approach to cystic fibrosis. Journal of the Royal Society of Medicine. May 2005;98(Supplement 45):55-66.
4) Long hair: Attendees with long hair should bring a hair clip or pony tail band for the labs.
5) Linens: Day 1 participants need one bath towel. Day 2 & 3 participants need one each: beach and bath towel, and one pillow.
6) DVDs for purchase: A DVD on the “RESPIRATORY MANAGEMENT OF THE PATIENT WITH QUADRIPLEGIA” will be available for purchase at the course for the discounted rate of $30 ($39 if purchased later through Mary Massery’s website). This is an educational DVD written by Mary Massery, PT and Frederick Schneider, MEd, PT, released in 1999, reformatted and re-released in 2005, and produced at the Rehabilitation Institute of Chicago. The contents of the DVD will be used to augment concepts presented during the course. A limited number of DVDs will be available at the course. Purchases can be made by cash, check or credit card. For the specifics of the DVD content, see Mary’s website at www.MasseryPT.com.
7) There are extensive handouts provided, but if you tend to take copious notes, you may want to bring plenty of note paper.
Reminder: The course is being held as part of the RAIR Symposium at the Bloomington Airport Marriott. Location information and map can be found on the website: www.rairsymposium.com. Weather projections for the days of the course predict cold temperatures, but no precipitation. Allow time for traffic delays if you are driving, or avoid the hassels and stay at the Marriott and take advantage of the evening learning opportunities or explore the Mall of America.
If you have questions or need to contact a Symposium organizer, call: Eileen at 612-867-9840; Alexis at 651-271-1443 or Steve at 651-398-6359.
The number for the Marriott Hotel is: 952-851-4749.
Objectives: Participants will be able to
Day 1
- State how the mechanics of breathing and postural control are inter-active and inter-dependent components of normal movement strategies.
- Describe the multiple, simultaneous roles of the diaphragm as related to breathing, postural control, gastroesophageal reflux, constipation and venous return.
- Contrast normal musculoskeletal development of the chest in infants and the concurrent motor skill acquisition to that observed in patients with impaired trunk function resulting from multiple different diagnostic categories.
- Position patients for optimal cardiopulmonary function (physiological and biomechanical) with simple equipment such as towel rolls and pillows in recumbent and upright positions for use in and out of hospital settings.
- Optimize patient function by integrating appropriate ventilatory strategies with all movements from low level activities to athletic endeavors.
- Apply theoretical concepts to multiple clinical cases.
Days 2 and 3
- Integrate the cardiopulmonary system into a multi-system physical and physiologic evaluation approach to motor dysfunction.
- Identify numerous different breathing patterns and evaluate their efficiency for use while moving, talking and eating.
- Evaluate breath support and postural control needs for verbal communication and perform therapeutic techniques to improve respiratory and/or trunk muscle support.
- Design an airway clearance program targeted to a patient’s particular need using the principles of mobilization, expectoration and management.
- Demonstrate multiple airway clearance techniques and state when each would be applicable for a particular patient.
- Participate in a live patient demonstration (if a patient is able to participate on that day) and suggest possible evaluation and treatment ideas based on the course material.
- Demonstrate the use of thoracic cage/spine exercises and techniques to enhance rib cage and thoracic spine mobility and/or pulmonary function and state how this could lead to improved physical participation and health.
- Demonstrate pulmonary therapeutic exercise techniques geared toward modifying inefficient breathing patterns and state when each would be applicable for a particular patient.
- Demonstrate the integration of a multi-system approach to patient’s motor deficits by designing an individual evaluation and intervention program for specific clinical problems and share the findings with the class.
Attendance at Day 1 is required to attend Days 2-3; Day 1 may be taken as a 1 day option.
Agenda*
Day 1 - 7 contact hours
8:00 - 8:30 Registration
8:30 - 10:30 Breathing and Posture: A Multi-system Event!
10:30 - 10:45 Break
10:45 – 12:00 Breathing and Posture (continued)
12:00 - 1:00 Lunch
1:00 - 2:00 Breathing and Posture (continued)
2:00 – 2:45 Normal and Abnormal Chest Wall Development and Function
2:45 - 3:00 Break
3:00 – 5:00 What can you do in 90 Seconds or Less that has a Profound and Lasting Effect? Positioning Strategies
Day 2 - 7 contact hours
8:00 - 8:30 Registration
8:30 - 9:30 Ventilatory or Movement Strategies
9:30 - 10:30 Finding the Problem: Pulmonary Assessment from a Multi-System Perspective
10:30 - 10:45 Break
10:45 - 12:00 Lab 1: Chest Assessment: Focus on Breathing Patterns and Musculoskeletal Alignment
12:00 - 1:00 Lunch
1:00 - 1:30 Lab 1 Continued
1:30 – 2:45 Lab 2: Enhancing Phonation Skills through Improved Breath Support
2:45 – 3:00 Break
3:00 - 3:45 Airway Clearance: From Sherlock to Solution
3:45 – 5:00 Lab 3: Airway Clearance
Day 3 - 6.5 contact hours
8:30 - 10:30 Lab 4: Thoracic Complex: Mobility Exercises and Techniques
10:30 - 10:45 Break
10:45 – 12:00 Lab 4: continued
12:00 - 1:00 Lunch
1:00 - 2:45 Lab 5: Facilitating Efficient Breathing Patterns and Building Endurance
2:45 – 3:00 Break
3:00 - 4:00 Lab 5: continued
4:00 - 4:30 Lab 6: Group Problem Solving: Putting It All Together
*Topic times may vary; contact hours do not.
How to prepare for your upcoming respiration course experience.
1) Required attire for labs: tank tops, sports bras, etc. One-piece bathing suits are not appropriate. Participants not wearing lab clothes are invited to come and observe.
2) Anatomy books: Participants are encouraged to bring their favorite anatomy book to help visualize the presentation on Day 1.
3) Suggested pre-readings for the course: www.MasseryPT.com “publications”:
o Massery, M., Breathing and Upright Posture: Simultaneous Needs, in 26th International Seating Symposium, Vancouver, BC. March 11-13, 2010;25-28.
o Massery M. The Linda Crane Memorial Lecture: The patient puzzle - piecing it together. Cardiopulmonary Phys Ther J.
2009;20(2):19-27.
o Massery M. The patient with multi-system impairments affecting breathing mechanics and motor control. In: Frownfelter D, Dean E, eds. Cardiovascular and Pulmonary Physical Therapy Evidence and Practice, ed. 4. St. Louis, MO.: Mosby & Elsevier Health Sciences; 2006:Chapter 39:695-717.
o Massery M. Musculoskeletal and neuromuscular interventions: a physical approach to cystic fibrosis. Journal of the Royal Society of Medicine. May 2005;98(Supplement 45):55-66.
4) Long hair: Attendees with long hair should bring a hair clip or pony tail band for the labs.
5) Linens: Day 1 participants need one bath towel. Day 2 & 3 participants need one each: beach and bath towel, and one pillow.
6) DVDs for purchase: A DVD on the “RESPIRATORY MANAGEMENT OF THE PATIENT WITH QUADRIPLEGIA” will be available for purchase at the course for the discounted rate of $30 ($39 if purchased later through Mary Massery’s website). This is an educational DVD written by Mary Massery, PT and Frederick Schneider, MEd, PT, released in 1999, reformatted and re-released in 2005, and produced at the Rehabilitation Institute of Chicago. The contents of the DVD will be used to augment concepts presented during the course. A limited number of DVDs will be available at the course. Purchases can be made by cash, check or credit card. For the specifics of the DVD content, see Mary’s website at www.MasseryPT.com.
7) There are extensive handouts provided, but if you tend to take copious notes, you may want to bring plenty of note paper.
Reminder: The course is being held as part of the RAIR Symposium at the Bloomington Airport Marriott. Location information and map can be found on the website: www.rairsymposium.com. Weather projections for the days of the course predict cold temperatures, but no precipitation. Allow time for traffic delays if you are driving, or avoid the hassels and stay at the Marriott and take advantage of the evening learning opportunities or explore the Mall of America.
If you have questions or need to contact a Symposium organizer, call: Eileen at 612-867-9840; Alexis at 651-271-1443 or Steve at 651-398-6359.
The number for the Marriott Hotel is: 952-851-4749.

Dr. Massery received her BS in Physical Therapy from Northwestern University in 1977, her DPT from the University of the Pacific in 2004 and her DSc from Rocky Mountain University in 2011. Her publications and interests focus on linking motor behaviors to breathing and/or postural mechanics in both pediatric and adult patient populations.
Dr. Massery has been invited to give over 750 professional presentations in 48 US states, 9 Canadian provinces, and 13 countries worldwide. Mary has delivered keynote/major addresses on topics such as cystic fibrosis and posture, neuropulmonary deficits, pectus excavatum (chest deformities), and connections between posture & breathing for the Royal Society of Medicine in London, England; the Australian & New Zealand Spinal Cord Injury Conference in Brisbane, Australia; the Irish Society of Chartered Physiotherapists Meeting in Galway, Ireland; the International Seating Symposium in Vancouver, Canada; and the Conference on Posture and Mobility in Coventry, England; as well as numerous presentations at the American Physical Therapy Association’s (APTA) Combined Sections Meetings across the USA.
Mary has received national awards from the APTA, including its highest clinical award, The Florence Kendall Practice Award, and the honorary Linda Crane Memorial Lecture.
She continues to maintain a private practice in Chicago as well, specializing in ventilation and postural dysfunction. Visit her at her website.
Disclosures:
Financial Relationships: Ms Massery receives a speaking fee from Richter Active Integration Resources for If You Can't Breathe, You Can't Function Parts 1 & 2.
Ms Massery receives royalties from the sales of DVDs related to the course, but which are not required materials.
Non-Financial Relationships: Ms Jelm has no non-financial relationships to disclose.
Dr. Massery has been invited to give over 750 professional presentations in 48 US states, 9 Canadian provinces, and 13 countries worldwide. Mary has delivered keynote/major addresses on topics such as cystic fibrosis and posture, neuropulmonary deficits, pectus excavatum (chest deformities), and connections between posture & breathing for the Royal Society of Medicine in London, England; the Australian & New Zealand Spinal Cord Injury Conference in Brisbane, Australia; the Irish Society of Chartered Physiotherapists Meeting in Galway, Ireland; the International Seating Symposium in Vancouver, Canada; and the Conference on Posture and Mobility in Coventry, England; as well as numerous presentations at the American Physical Therapy Association’s (APTA) Combined Sections Meetings across the USA.
Mary has received national awards from the APTA, including its highest clinical award, The Florence Kendall Practice Award, and the honorary Linda Crane Memorial Lecture.
She continues to maintain a private practice in Chicago as well, specializing in ventilation and postural dysfunction. Visit her at her website.
Disclosures:
Financial Relationships: Ms Massery receives a speaking fee from Richter Active Integration Resources for If You Can't Breathe, You Can't Function Parts 1 & 2.
Ms Massery receives royalties from the sales of DVDs related to the course, but which are not required materials.
Non-Financial Relationships: Ms Jelm has no non-financial relationships to disclose.