Course Description:

This course, developed by Mary Massery, proposes a new definition of “core stability;” redefining it as the dynamic control of trunk pressures to optimize postural stability (balance). Dr. Massery’s “soda pop can model” links breathing mechanics to postural control using multi-system interactions. The speaker presents novel research demonstrating the role of vocal folds as postural stabilizers, extending the concept of “core stability” from the vocal folds on the top of the trunk to the pelvic floor on the bottom. In Part-1, foundational information and quick interventions will be the focus (positioning and ventilatory strategies). In Part-2, the focus shifts to assessing “normal” breathing patterns, neuromotor breathing retraining techniques and manual assistive cough techniques during hands-on labs. Multiple clinical cases will be used to cement the concepts. The course is applicable for any pediatric or adult patient (or therapist) who breathes!

Course Objectives:
After completing this course you will be able to:
At the conclusion of Part-1 (Day-1), participants should be able to:
1.   Describe how trunk pressures link breathing and postural control using the Soda Pop Can Model.
2.   Describe the multiple, simultaneous roles of the diaphragm as related to breathing, postural control, gastroesophageal reflux, constipation, and venous return.
3.   Demonstrate the role of the vocal folds in normal postural stability responses (balance) and make the case for using speaking valves for patients with tracheostomies.
4.   Position patients for optimal physiological and biomechanical support of breathing with simple equipment (towels, pillows, etc.).
5.   Use a ventilatory strategy algorithm presented in class to optimally match breathing with movements from bed mobility to athletic endeavors.
6.   Apply concepts to a wide variety of patient populations from infancy to geriatrics.

At the conclusion of Part-2 (Days 2- 3), participants should be able to:
7.   Use a multi-system approach to evaluating motor impairments.
8.   Identify the variations of “normal” breathing patterns and discuss the efficiencies/inefficiencies for individual patient conditions.
9.   Evaluate need for, and demonstrate, appropriate neuromotor retraining techniques for patients with ineffective breathing/postural control strategies (health or participation deficits).
10.   Participate in a live patient demonstration (if a patient is available) and suggest possible evaluation and treatment ideas based on the course material.
11.   Design a targeted airway clearance program using the principles of mobilization, expectoration and oral management.
12.   Demonstrate airway clearance techniques, with an emphasis on manual assistive cough techniques, and apply an airway clearance algorithm to specific patient conditions.
13.   Identify thoracic cage/spine restrictions as they pertain to breathing mechanics and postural control (a very brief introduction of chest wall restrictions).
14.   Evaluate the need for, and demonstrate, neuromotor retraining techniques to improve breath support for voicing and postural control (eccentrics).
15.   Suggest immediate ways to incorporate the concepts into therapy activities in your clinical setting.
Part 1 (virtual):
Part 1a virtual 4.5 hours Part 1b virtual 3.5 hours
Date options for Part 1 (virtual) session:
9/19/25 & 9/20/25
or
12/5/25 & 12/6/25

Part 2 (in-person):
Part 2a in-person 8.0 hours, Part 2b in-person 5.0 hours
Date(s): 1/24/26 & 1/25/26