CMEs (Continuing Medical Education) for PTs (physical therapists), OTs (occupational therapists) from Davenport, Stevens, VanNess, 2019

Medfeb

Senior Member (Voting Rights)
Todd Davenport, Mark VanNess & Staci Stevens have announced two CMEs for PTs, OTs and nurses provided through MedBridge.

The first one is
ME/CFS Part 1: Introduction and Identification
https://www.medbridgeeducation.com/...on-todd-davenport-staci-stevens-mark-van-ness

ME/CFS Part 2: Etiology and Analeptic Management
https://www.medbridgeeducation.com/...nt-todd-davenport-staci-stevens-mark-van-ness

I have not watched these yet but expect these courses will be very helpful to get PTs and OTs get ME and PEM
 
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More info on Chapters and Learning Objectives

Part 1: Introduction and Identification

1. What's in a Name and Why Does it Matter?
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is identified on the basis of case definition criteria. Over time, several sets of case definition criteria have been developed. The purpose of this section is to describe the epidemiological background of case definition criteria, present the common contemporary case definition criteria for ME/CFS for use in the clinic, and discuss the relative utility of contemporary case definition criteria to identify ME/CFS

2. Objective Evidence of Post-Exertional Malaise and Exercise Impairment in ME/CFS
The provocation of symptoms and signs in ME/CFS in response to exertion suggests the presence of measurable physiological deficits in the post-exertional state. A 2-day maximal cardiopulmonary exercise test (CPET) paradigm was devised, which has revealed a whole host of cardiac, pulmonary, metabolic, and symptomatic differences between people with ME/CFS and sedentary people after an initial bout of exertion. The purposes of this chapter are to acquaint the learner with the 2-day maximal CPET paradigm and to describe the scientific research it has generated regarding the physiological basis of post-exertional malaise.
Part 2 - Etiology and Analeptic Management
1. Etiological Clues From Cardiopulonary Exercise Testing
Measurements obtained during maximal cardiopulmonary exercise tests (CPET) are commonly used across clinical populations to make determinations regarding cardiac, pulmonary, and metabolic deficits that may underlie disablement, as well as to stratify the severity of functional impairment. Similarly, maximal CPET has been used in people with ME/CFS. The purpose of this chapter is to introduce the learner to inferences that can be made regarding the pathoetiology of disablement in ME/CFS, based on maximal CPET data.

2. Analeptic Strategies for ME/CFS
Clinical management strategies for ME/CFS should be informed by current physiological evidence. Specifically, CPET findings of aerobic system dysfunction suggest that clinical management should emphasize energy conservation self-management strategies and restorative anaerobic activities, as tolerated by the patient. The purpose of this chapter is to describe a staged approach to analeptic management for people with ME/CFS.​
 
they seem to have courses for a few more health professionals as well, including home care aides and nurses.

allied-health-certs-for-workwell-cme.png
 
I would like to know more about the activity part before recommending this to anyone.

Anaerobic activity didn't do better than pacing or the relaxation (control) group in the study referenced in these posts (each group recorded some symptoms better and some worse, iirc, but pacing was better than others overall--if there was even a statistically significant difference between groups):
https://forums.phoenixrising.me/thr...erapist-management-of-cfs-me.2638/#post-62338
https://forums.phoenixrising.me/thr...-recent-afme-survey-report.30354/#post-464586

(The site that was hosting the paper is now down.)
 
I would like to know more about the activity part before recommending this to anyone.

Anaerobic activity didn't do better than pacing or the relaxation (control) group in the study referenced in these posts (each group recorded some symptoms better and some worse, iirc, but pacing was better than others overall--if there was even a statistically significant difference between groups):
https://forums.phoenixrising.me/thr...erapist-management-of-cfs-me.2638/#post-62338
https://forums.phoenixrising.me/thr...-recent-afme-survey-report.30354/#post-464586

(The site that was hosting the paper is now down.)
Thanks. I'm following this. It's potentially useful info.
 
Very interested to hear if any Occupational Therapists, Physiotherapists or Exercise Psychologists have done this training and provided feedback? @PhysiosforME? And if any ME/CFS experts have reviewed the content.

I understand that Workwell Foundation recommend this (were involved in it's development in fact) and have a good reputation, but would appreciate knowing if this particular material is worth recommending.
Kind of have an urgent need actually. :)

https://workwellfoundation.org/resources/ suggests it is normally US$375 to do, but if you use the promo code WORKWELL the cost is discounted to US$200. A bit of a blocker from us doing it for review purposes.
 
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The course seems to consist of the following:

Part 1: Introduction and Identification
Chapter 1: What's in a name and why does it matter

There's 2 x 20 minute lectures
Chapter 2: Objective evidence of Post-Exertional Malaise and Exercise Impairment in ME/CFS
again 2 lectures

Part 2: Etiology and Analeptic Management
Chapter 1: Etiological clues from CPET
Chapter 2: Analeptic strategies for ME/CFS


I found the Medbridge site confusing, not helped, I am sure by my trying to do what I could for free. I did the sections in bold without having to pay anything.

I'm really sorry to say that I found the sections I did to not be worth the high cost.

Part 1: Chapter 1: Lecture 1
It's 20 minutes long. There's quite a bit of listing what will be achieved, which gets overwhelming. And then there's 10 minutes of discussion about false positives and false negatives and sensitivity and specificity - none of that related to ME/CFS. I seriously thought I was in the wrong lecture. So after that 10 minutes, we learn that we have to rely on case definitions for ME/CFS, and so there's a discussion of the various criteria and how they were developed. This is ok, but it's a lot of detail for physical therapists who just want to know what they can do to help people with ME/CFS. At the 19 minute mark, we are told that it's not a rare disorder and some prevalences for the US are given.

Part 1: Chapter 1: Lecture 2
Also 20 minutes long. So, I think up to the 17 minute mark was mostly patients being interviewed about their diagnosis process. This is not a criticism of the patients - but getting a diagnosis of ME/CFS is tedious and complicated and confusing, and recounting of the process in unscripted interviews can reflect that. I don't think it will be super compelling for people with just a limited level of interest in ME/CFS. I think much more editing to just include key bits from patients would work better. And again, I don't think this needs to be the focus for physios/physical therapists who probably won't be doing the diagnosing.

After the interviews there is some information about the the severity of the disease. I found it confusing and I probably know quite a bit more about ME/CFS than the target audience. The slides didn't match with a lot of what was being said. It was as if the narration and the slides weren't coordinated properly. I spent so much time being confused about what was going on that I didn't really take away much information.

Here's one example slide, this is the full slide - and there were only 4 slides. It was shown while SF36 scores in ME/CFS, healthy controls, rheumatoid arthritis and cancer and depression and heart disease were talked about.
Screen Shot 2019-09-28 at 4.32.36 PM.png

I think the sections I didn't do are the ones that would be the most interesting, after all they would be on the material that Workwell are experts in. But I'm afraid that I lost confidence in the product and didn't feel that I could justify what is quite a lot of money to buy it. I think the course could do with a rethink, to get into the meat of things quickly and focus on what physical therapists need to know.

I'm sorry if I have got things wrong. I'd really like to hear what others think of the course.
 
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Well, I guess the hope was that that good material was neatly packaged up into a course that covered most of what physios need to know about ME/CFS and that could be accredited to count for continuing professional development hours.
 
Thanks @Hutan, I guess at this stage we recommend the other non-cme material is done on an individual basis and with the professionals applying for credits personally.
 
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