EM473: Rigo Concept Course Level 1

 Day 1:
9am Welcome!
9.15am Introductory Lecture – Adolescent Idiopathic Scoliosis – Overview
• What is Scoliosis?
• Cobb angle measurement
• Signs and Symptoms
• Structural or Functional Scoliosis
• AIS prevalence, aetiology, progression
• Treatment Aims & Recommendations
11am 11.15am Break
Rigo Concept
• History (origins to now)
• Comprehensive Care Model
• 3 Spheres of Knowledge (Scoliosis 3D nature, BSPTS Concept, BSPTS Technique)
• Corporal schema, postural and structural components of posture recap
Rigo Concept
• Main Objective (What do we want?)
o The Corrective Path First
• 4 General Principles of the BSPTS and Steps (What do we do?)
• Visceral Statics
• General Principles for Correction (How do we do it?)
• Specific Principles for Correction
1pm 1.45pm Lunch
Alterations in Sagittal Alignment – review of key points
• Global Frontal Plane Balance, Global Sagittal Plane Balance
• Sagittal configuration of the ‘Normal’ Spine
Pelvic parameters recap: PI, SS, PT and Roussouly classification in brief
Juvenile Kyphosis (Scheuermann)
• Clinical and radiological indicators recap
Sagittal Deformities (Sag D)
• General Principles for Correction in Sag D
• Specific Principles for Correction in Sag D
o First
o Second
• Predefined Strategies for Correction for Sag D
o First Pelvis Correction
o Second Pelvis Correction
o Proximal Expansion
4pm 4.15pm Break
Practical component
Teacher led ‘Expansion Experience’
Exercises for Sag D/Practice:
• Supine
• Prone on knees
• Prone on stool
• Semi-hanging sitting in band
Tactile cues
5.30 – 6pm End of day reflection
Suggested homework:
1. Practice drawing Sag D Schema of Blocks for a Thoracic Scheuermann’s and also
a TL Scheuermann
2. 3. List the General Principles of the BSPTS
Practice the Expansion Experience 5 minutes
 

Day 2:

9am Now in scoliosis!

• Dubousset Concept

• Mechanical torsion and Geometrical torsion, Growth induced torsion, RASO

• Rigo Concept Classification introduction

Rigo Concept (BSPTS) Recap

• Main Objective (What do we want?)

• General Principles of the BSPTS and Steps (What are we going to do?)

• General Principles of Correction (How are we going to do it Type A SCOLIOSIS)

• Specific Principles of Correction for Type A

o First

o Second

o Third

• Pre-defined Strategies of Correction for Type A

o Five Pelvis Corrections

o PE + TPSA

o PE + WSSA

11 11.15am 1pm Break

Practical component

Exercises for Type A/Practice:

• Supine

• Prone on knees

• Upright awareness kneeling, standing

• Semi-hanging

Tactile cues & Anatomical Landmarks for 3D reference

Lunch

1.45pm Practical component

Exercises for Type A/Practice:

• Side lying

• Prone on stool

• Upright awareness

Tactile cues & Anatomical Landmarks for 3D reference

4pm Break

4.15pm Teacher/Patient Demonstration: Clinical Type A

5.30 – 6pm End of day reflection - Recap Clinical Type A

Suggested homework:

1. Practice drawing Type A Schema of Blocks

2. Practice Supine set-up for Type A with Expansion Experience

3. Name the Specific Principles of Correction

4. Describe how we do the 1st Specific Principle of Correction.

Day 3:

9am Rigo Concept (BSPTS) Recap

• Main Objective (What do we want?)

• General Principles of the BSPTS and Steps (What are we going to do?)

• General Principles of Correction (How are we going to do it Type B)

• Specific Principles of Correction for Type B

o First

o Second

o Third

• Pre-defined Strategies of Correction for Type B

o Five Pelvis Corrections

o PE + TPSA

o PE + WSSA

11am 11.15 Break

Practical component

Exercises for Type B/Practice:

• Supine

• Prone on knees

• Semi-hanging

• Upright awareness

1pm Lunch

2pm Practical component

Exercises for Type B /Practice:

• Side lying

• Prone on stool

• Upright awareness

3pm Rigo Concept (BSPTS) Recap

• General Principles of Correction (How are we going to do it IN Type E?)

• Specific Principles of Correction for Type E

o First

o Second

o Third

• Pre-defined Strategies of Correction for Type E

o Five Pelvis Corrections

o ? PE + TPSA

o ? PE + WSSA

4pm 4.15pm Break

Teacher/Patient demonstration: Type B

5.30 – 6pm Suggested homework:

1. Practice drawing Type B Schema of Blocks

2. Practice setting up for Side Lying in Type B

3. How is Side Lying different for Type B and Type A?

4. Regarding expansion, what is the direction of corrective expansion for the WP,

WS and AF?

Day 4:

9am Rigo Concept (BSPTS) Recap

• Main Objective (What do we want?)

• General Principles of the BSPTS and Steps (What are we going to do?)

• General Principles of Correction (How are we going to do it IN Type C?)

• Specific Principles of Correction for Type C

o First

o Second

o Third

• Pre-defined Strategies of Correction for Type C

o Two Pelvis Corrections

o PE + TPSA

o PE + WSSA

Differential Diagnosis of 3C and 4C

Rigo Concept Classification in detail

Rigo Concept Classification Pathway summary

11:00 - 11:15 Break

Practical component

Review exercise set-up differences for all curve types

• Supine (set-up and discuss differences for: A, B, C and E)

• Side lying (set-up and discuss differences for: A, B, C and E)

• Prone on knees (set-up and discuss differences for: A, B, C and E)

• Prone on stool (set-up and discuss differences for: A, B, C and E)

• Semi-hanging (set-up and discuss differences for: A, B, C and E)

13:00 Lunch

13:45 Recap all key components of the Concept and different Clinical Types

Exam practice question examples

16:00 Break

16:15 Continue practice – remaining exercises and questions

Finish at 5pm? TBC

Exam tomorrow morning

Day 5:

9am Written Exam

11.30 am 11.45 am Break

Prepared Case examples at x6 different workstations, 15 minutes at each station,

participants practice independently (with Teacher support):

1. 2. 3. 4. 5. 6. Rigo Classification practice to arrive at Clinical Type and Rigo subtype: Look at

Case photos of Forward Flexion Test, Standing posture photos and EOS’s of

Case examples 1 – 3

Rigo Classification practice to arrive at Clinical Type and Rigo subtype: Look at

Case photos of Adams Test, Standing posture photos and EOS’s of Case

examples 4 – 6

Rigo Classification practice to arrive at Clinical Type and Rigo subtype: Look at

Case photos of Adams Test, Standing posture photos and EOS’s of Case

examples 7 - 9

Computer software practice (if available) to measure the Cobbs and Pelvic

Indices of Cases examples

Manual measuring practice of x-ray films on lightboxes of Case examples

Manual measuring practice of x-ray films of printouts of Case examples

1pm 2pm Break

Continue Classification and measurement practice as above

Risser and Sanders stages

Bracing discussion in brief

• Differences in A Type and B Type brace model examples

Dr Rigo recording (15 minutes)

• Evidence for Physiotherapy Scoliosis Specific Exercise

4pm 4.15pm Break

Beighton Score and hypermobility testing

Hip exercises

Stabilisation exercises, Pilates considerations

5.30 – 6pm End of day reflection

Day 6:

9am Review Written exam

10am Scoliosis Assessment

11am Break

11.15am Session Planning

• Duration of sessions, frequency of sessions

• Equipment required

• Home options

Some comments about communicating with surgeons

Some comments about Adult degenerative cases

Some comments about Surgical cases

Summarise key precautions and contraindications for Rigo PSSE exercises

1pm Lunch

2pm Integration into upright and function

Common ADL patterns and key points:

- Sit to stand, Lifting technique

- Walking, ‘The Schroth Walk’

- Kitchen work

- Heavy doors pushing/pulling

- Stairs

- Washing Line

- Gym exercises

Traditional ‘Co-ordination’ exercises

Remaining Practical components

What do you see? Picture series, training your eye

• Case photos of clients in different exercise positions

4pm Break

4.15pm Assessment 3 requirements

Level 2 course

SOSORT

Final things

• Specific questions

• PSSE additional practice

• Ready to go!

5pm Time for any student/s needing extra tuition, based on specific exam question difficulty,

5:30 - 6:00 test ECM