Preliminary Conference Programme
Friday, 28 August 2020
12.30 pm
1.00pm –2.30pm

Conference Welcome
Chairman Opening Remarks

Ron Schenk

Plenary Session I: The Burden of MSK Disability

Greg Lynch, Moderator

Introduction
MSK Disability:
Why We Need to Pay Attention and What We Can Do About It
How Can We Provide High-Value Care for Our Patients? The Roleof a Phenotype-Based Diagnosis in Musculoskeletal
Rehabilitation
The Burden of MSK Disability: Can We Do Better with MDT?

Greg Lynch

Session Review
2.30pm – 3.00pm
Afternoon Tea
3.00pm –Parallel Sessions I (Attendees choose one)
4.30pmPain: Frameworks for Identification
Therapeutic Alliance: Factors to Consider
Patient Demonstrations: Lumbar & Lower Limb Extremity
4.30pm – 4.45pm
Rotation Break
4.45pm –Plenary Session II: Beyond the Spine
6.15pmIntroduction
Poking into Pain: The Case for Painful Exercise and Activity
Tendinopathies: Does the Exercise and Dose Matter?
Beyond Cauda Equina Screening: Better Bladder/Bowel Screeningfor MDT Clinicians
Session Review
6.15pm – 8.00pm
Conference Welcome Reception

Jan Hartvigsen

Yannick Tousignant-LaflammeRichard Rosedale
Hans van Helvoirt
Greg Lynch

Yannick Tousignant-Laflamme, Nicolas
Naiditch and Faculty
Maike Müller and Faculty
Anja Franz and Sara Luetchford
Yvonne Body, Moderator
Yvonne Body
Greg LehmanPeter Malliaris
Carolyn Vandyken
Yvonne Body

Saturday, 29 August 2020
7.00am – 8:30am Breakfast for Registered Conference Attendees who are Registered Guests of the Westin Ottawa.
Westin Breakfast Vouchers Required
8.30am –Parallel Sessions II (Attendees choose one)
10.00amPain: Frameworks for Identification
Yannick Tousignant-Laflamme, Nicolas
Naiditch and Faculty
Therapeutic Alliance: Factors to ConsiderMaike Müller and Faculty
Patient Demonstrations: Cervical & Upper Limb Extremity
Colin Davies and Robert Medcalf
10.00am – 10.45am Morning Tea
10.45am –Plenary Session III: International Tastings: Current MDTMargaret Campbell, Moderator
12.45pm
ResearchIntroduction
Audrey Long
Historical Overview
Margaret Campbell

Saturday, 29 August 2020 Continued
Special Tests of the Shoulder? How Often Do They Change with
MDT Screening of the Spine?
Can MDT Reduce Surgical Rates Compared to Usual Care?
Preventing Lumbar Surgery
The role of the MDT Clinician in Predicting Relevant ModicChanges on MRI
Research Panel - Q & A
12.45pm – 2.15pm
2.15pm –3.45pmDavid Vandeput
Sinikka Kilpikoski
Hans van Helvoirt
Henk Tempelman
Audrey LongAwards Luncheon Buffet

Parallel Sessions III (Attendees choose one)Sports: Optimizing Intervention
Pelvic Health: The Pelvis and Beyond
MDT Beyond the Clinic

3.45pm – 4.00pm
Rotation Break
4.00pm –Plenary Session IV: Placebo / Nocebo
5.30pmIntroduction
Understanding Placebo and Nocebo: Basic Mechanisms and Their
Relevance for Treating Patients
Analgesic Words - Analgesic Relationships: Understanding
Placebo Effects to be a Better Clinician
Nocebo and Placebo in MDT: The Do’s and Don’ts - How Do We
Use Placebo and Avoid Creating Nocebo/Fear Avoidance Using
MDTSession Review
6.30pm – 10.30pm

Peter Malliaris, Greg Lehman andFaculty
Carolyn Vandyken, Di Wu and Faculty
Jason Ward, Michelle Miller andStephen Klassen
Georg Supp, Moderator
Georg Supp
Maike Müller
Vicente Hennemann

Simon Simonsen
Georg Supp

Delegate Dinner Cruise (Optional)

Sunday, 30 August 2020
7.00am – 8:30am
8.30am –10.00am

Breakfast for Registered Conference Attendees who are Registered Guests of the Westin Ottawa.
Westin Breakfast Vouchers Required

Parallel Sessions IV (Attendees choose one)Sports: Optimizing Intervention
Pelvic Health: The Pelvis and Beyond
Patient Follow-ups

10.00 – 10.45
Morning Tea
10.45am –Plenary Session V: Future Innovations
1.00pmIntroduction
If You Want to Change Practice, Involve Policy Makers
Potential Influence of Predictive Factors in the Initial Indication,
Follow-Up and Trajectory of the Chronic Painful Patient After
Spinal Surgery
Centralization 2.0: Welcome to the Era of Big Data
Using an Avatar for Tele-Mentoring
Panel Discussion / Q&A
Chairman Closing Remarks

Peter Malliaris, Greg Lehman andFaculty
Carolyn Vandyken, Di Wu and Faculty
Anja Franz and Sara Leutchford;
Colin Davies and Robert Medcalf
Eva Novakova, Moderator
Eva Novakova
Jan Hartvigsen
Nicolas Naiditch

Jean-Philippe Deneuville
Jon Weinberg
Eva Novakova
Ron Schenk

The total contact hours for the Conference are 15.25. Preliminary Program is subject to change.

Description of Parallel Sessions (Workshops):
Friday 3.00pm – 4.30pm and Saturday 8.30am – 10.00am▪ PAIN: FRAMEWORKS FOR IDENTIFICATION
Description
Many clinicians do not have a routine /standard way to assess for psycho social factors – What are some things thatclinicians can consider that will aid in this issue from both the assessment standpoint & then what can we do withthat information for treatment. The two workshops will focus on a framework and sociological approach and aid
the clinician in measurement and assessment strategies.
Yannick Tousignant-Laflamme: General view of chronic pain through a framework· Introduce the pain and disability Drivers management model· Present a role to provide a framework for the diagnosis… leading to a more appropriate Dx that accounts forthe complexity of LBP (for example). Thus, the model will dig further into it during the workshop· Discuss potential role in the solution to the way MSK pain and disability are currently managed
Nico Naiditch: Social Perspective of pain
· Reintroduce what the sociological approach is and the confusion that exists with the psychological approach.
Use the model of Shaw and al. 2013 and illustrate each category with qualitative or quantitative examples(Social Disadvantages, social factor at work, Social factor at home and social factors at the clinic).
· Review the main questionnaires and factors to which you should pay attention.
· Provide some examples of existing aids in France to socially manage physical pain
Objectives: Upon completion of this session, participants will gain strategies to:
1. Review the role of a diagnostic framework to assess and address the complexity and heterogeneity ofcommon MSK disorders and the management of musculoskeletal pain
2. Discuss how this diagnostic framework may play a critical role to address the complexity and heterogeneity ofcommon diagnostic labels.
3. Identify the primary social factors of chronicization
4. Review how social factors can aid clinical identification and the impact on the pain management
effectiveness.
▪ THERAPEUTIC ALLIANCE: FACTORS TO CONSIDER
Description
The practice of contemporary clinical patient care is both a science and an art. It involves not only a proposed targetedintervention being delivered but also that the relational interaction between the clinician and the patient is enhanced.
The optimisation of the clinician patient interactions has been termed therapeutic alliance. MDT, utilising theevidence of the patient to inform decision making, seeking a patient specific plan of care and the promotion of selfmanagement, embodies the principles of therapeutic alliance. Having an improved understanding of the theoreticalconceptualisation of therapeutic alliance, along with communication factors that are central to and correlate withenhancing alliance will give MDT clinicians improved strategies to facilitate and effect beneficial change in theirpatient interventions and interactions
Maike Müller: AllianceGroup Work – Communication: Margaret Campbell (New Zealand), Mark Cheel (Australia), and Ole Meyer(Denmark)Group Work – Alliance: Charlotte Krog (Denmark), Steen Olsen (Denmark), and Hans Van Helvoirt (Belgium)Objectives: Upon completion of this session, participants will gain strategies to:
1. Have a conceptualisation of therapeutic alliance and its importance in the management of musculoskeletal
disability.
2. Be able to discuss how communication can increase the capacity to develop therapeutic alliance.
3. Be able to discuss strategies to promote alliance for self-management and self-responsibility within healthcare provision.

Friday 3.00pm – 4.30pm and Saturday 8.30am – 10.00am continued▪ PATIENT DEMONSTRATIONS: LUMBAR & LOWER LIMB EXTREMITY (Friday)
Anja Franz (Canada) and Sara Luetchford (Italy)▪ PATIENT DEMONSTRATIONS: CERVICAL & UPPER LIMB EXTREMITY (Saturday)
Colin Davies (Canada) and Robert Medcalf (USA)▪ PATIENT FOLLOW-UPS (Sunday)
All faculty as above
Description
In these sessions, Canadian and International faculty will be assessing a range of musculoskeletal patients. Therewill be two clinicians assessing a patient in 45-minute demonstrations. Subject to availability, Friday will cover aLumbar Spine and a Lower Extremities patient, and Saturday will feature a Cervical and an Upper Extremities
patient. All four clinicians will review their patients on the Sunday morning.
Objectives: Upon completion of this session, participants will gain strategies to:
1. Utilize an effective MDT assessment for various regions of the body
2. Utilize an effective Physical Examination, including the correct use of terminology when performing Repeated
Movement Testing
3. Review communication styles within patient interactions to create an effective therapeutic alliance
4. Utilize a structured review process and confirm strategies for patient self-management

Saturday 2.15pm – 3.45pm and Sunday 8.30am – 10.00am▪ SPORTS: OPTIMIZING INTERVENTION
Description
Greg Lehmann: Expose or Protect
Pragmatic application of painful exercise for hamstring related pain.
Clinical decision making, exercise selection, pain science principles and exercise progression will be covered.
Peter Malliaras: Optimising Exercise Dose, Adherence and Fidelity
The aim of this workshop is to suggest practical strategies to enhance exercise dose delivery, adherence andfidelity, which overcome potential barriers to optimal exercise dosing. Rotator cuff and Achilles tendinopathy will
be used as exemplar conditions.
Objectives: Upon completion of this session, participants will gain strategies to:
1. Allow pragmatic application of painful exercise for hamstring related pain.
2. Assist with clinical decision making, exercise selection, pain science principles and exercise progression
3. Enhance exercise dose delivery, adherence and fidelity.
4. Overcome potential barriers to optimal exercise dosing.
▪ PELVIC HEALTH: THE PELVIS AND BEYOND
Description
Carolyn Vandyken
Lumbopelvic pain and pelvic floor dysfunction (PFD) are highly correlated. MDT clinicians need to screen bladder andbowel function beyond cauda equina syndrome to effectively address the ever-increasing level of disability associatedwith chronic low back pain. Learn to use a validated screening questionnaire to ask those tough questions about
bladder/bowel function, sexual function and comorbid urogynecological conditions. Central pain mechanisms also
play a significant role in lumbopelvic pain and PFD which needs to be screened appropriately and integrated into athoughtful and evidence-based treatment plan. You can't treat what you don't assess- assess lumbopelvic pain froma mechanical, pelvic health and a psychosocial perspective.

Pelvic Health: The Pelvis and Beyond Continued
Di Wu
In this workshop, the clinical case of a male with urinary and sexual dysfunction following a lower back injury will bepresented. Participants will be taken step by step through the assessment, classification and management of thepatient using MDT principles in a biopsychosocial framework. We will look at how to establish proper functional
baselines, recognize "red flags", and address the different drivers of pain and disability. We will also learn how toeducate the patient with urinary, bowel, and/or sexual dysfunction. Finally, we will discuss the role of the clinician inpelvic health and how to communicate with other healthcare professionals involved in the patient's care.
Objectives: Upon completion of this session, participants will gain strategies to:
1. Utilize evidence-based screening tools to assess relevant lower urinary tract symptoms, psychosocial
considerations of lumbopelvic pain, sexual health and bowel health
2. Develop basic skills to increase literacy in talking to your patients about bladder and bowel function as well as
sexual function
3. Understand the potentially significant role of MDT in pelvic health and when to refer to specialty
physiotherapy clinics or urology clinics

Saturday 2.15pm – 3.45pm▪ MDT BEYOND THE CLINIC
Description
MDT delivered via Tele Health - Stephen Klassen. The use of Tele Health to deliver care to patients has been usedfor decades in some areas of healthcare but less so in physical therapy until more recently. While many cliniciansdelivering conservative care for musculoskeletal conditions may have used it in informal ways, there is a growinginterest that MDT is well suited for this mode of delivery. Stephen Klassen will share successful platforms throughwhich to administer care, related legal considerations, the evidence that MDT is safe and effective, and key do’s anddon’ts for positive outcomes.
MDT delivered via Mobile Health - Michelle Miller. "Home Health” physical therapy is a familiar mode of care formany home-bound patients. Onsite evaluation, education and treatment in the workplace is another site at which
the individual with a musculoskeletal disorder would benefit from a mechanical exam. Is there a place for MDT athome or onsite? Michelle Miller will share her experience in delivering MDT at the patient’s home and in theirworkplace. Legal considerations, the evidence to support this mode of delivery and key do’s and don’ts.
MDT delivered to the Underserved - Jason Ward. Medical mission work is a common endeavor for many cliniciansin developed countries who want to share their skills to underserved people groups. More familiar are the tooth
extractions, limb amputations, cleft palate corrective surgeries, bloodborne disease treatment and other publichealth interventions as humanitarian efforts, but what about MDT for the greatest global cause of disability, backpain, and other musculoskeletal conditions? Jason Ward will share safety and legal considerations of thoseinterested in serving the less-fortunate, ways in which these efforts are effective and in what ways they may
actually do more harm, and the benefits to the served and to the volunteers.
Objectives: Upon completion of this session, participants will gain strategies to:
1. Discuss how clinicians are using MDT in a myriad of non-clinical environments
2. Review potential areas to use the MDT principles in the community, including the underserved, and incyberspace
3. Understand the logistics, legalities and ethics of telehealth and community consultations
4. Explore further opportunities to develop Robin McKenzie’s vision of MDT being the cornerstone ofmusculoskeletal care in a rapidly changing world
Sunday 8.30am – 10.00am▪ PATIENT FOLLOW-UPS