Clinical Application of Reduced Constraint Locomotor Therapy

Course overview

This continuing competency course prepares licensed physical therapists and physical therapist assistants to implement Reduced Constraint Locomotor Therapy (RCLT) in clinical practice, using Cadense variable friction footwear as a practice and competency exemplar. Cadense footwear serves as the clinical tool through which learners develop, apply, and demonstrate core physical therapy competencies in neurological rehabilitation, gait retraining, patient selection, clinical decision-making, and evidence-based practice. Content is grounded in current peer-reviewed research, including ongoing clinical trials at Shirley Ryan AbilityLab and Northwestern University, and is designed for immediate application across outpatient, home health, and skilled nursing facility practice settings. The course is organized into two clinically sequenced modules totaling 3.0 hours of learning participation, structured according to Knowles' principles of adult learning. All content is problem-oriented, opening with patient scenarios that establish clinical urgency before content is delivered, and each module concludes with an immediately actionable clinical takeaway. Module 1, Gait Science and the Cadense Mechanism (1.5 hours), establishes the neuroscientific and clinical foundation for RCLT. Learners examine neural plasticity, central pattern generator engagement through rhythmic gait, and auditory biofeedback as a clinical cueing tool. Patient selection, clinical decision-making, and first-session safety protocols are developed using beta test outcome data across stroke, Parkinson's disease, multiple sclerosis, peripheral neuropathy, cerebral palsy, and spinal cord injury populations. Evidence appraisal competency is developed through structured examination of the RCLT research lineage from foundational laboratory work through the current clinical trials. Module 2, Cadense in Therapeutic Practice (1.5 hours), develops direct clinical application competency through an expert-produced, eight-video clinical technique sequence covering the complete RCLT treatment arc, patient education, biofeedback introduction, balance and proprioceptive integration, step length symmetry training, rhythmicity and dual-task integration, gait speed progression, and discharge readiness. Learners design condition-specific session plans and home exercise programs using a structured goal bank and downloadable session plan templates for neurological rehabilitation, geriatric fall prevention, post-surgical rehabilitation, and home health populations. Assessment consists of 20 scenario-based questions at Bloom's Application and Analysis levels, requiring clinical reasoning applied to patient scenarios. Explanatory feedback referenced to course content and supporting evidence is provided for all responses. All downloadable clinical tools, including a patient selection decision tree, first-session safety guide, session plan templates, goal bank, and documentation reference, are available at topic start, prior to content completion, reflecting the andragogical principle of immediate applicability.