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Total Motion Release TMR Tots & Teens Level-1
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Susan M Blum PT

      Presented with a focus on Pediatric & Neurologic Patients



Total Motion Release is an innovative method to improve functional outcomes while empowering parents and caregivers. TMR uses a precise format to address issues in a systematic process, which is easily incorporated into the therapist’s knowledge base of traditional exercise and manual techniques. TMR is a user-friendly treatment easily incorporated into daily routines improving compliance with home programs for faster outcome achievement. TMR is a team intervention approach which gives parents and caregivers a greater understanding of the motor issues and better ability to manage care post discharge.  Level -1 will provide extensive lab treatment time to learn the foundational TMR concepts, a systematic process to identify restriction in mobility, the basic single plane TMR exercise. The student will be introduced to strengthening, postural control, weight shifting and pre-gait training using the TMR concept Level -1 is the introductory course in a 3 level program of Tots & Teens. It is the foundation for advanced discrete 3-D restrictions and motor control issues for the most complex patients.

Emphasis will be placed on developing & enhancing:

• Parent/ caregiver-therapist communication skills using a team approach to develop home programs and instruct in post treatment management.

• Observation skills to assess and record strengths based care plan

• Therapeutic handling to assess restrictions in range impacting alignment and achievement of optimal function

• Treatment strategies to implement and document therapeutic positions and motions to improve functional outcomes both in the session and post intervention.

• Strategies to reinforce postural control and body awareness in the new available range both in static and dynamic positions

• Understanding when to add alternate positions and how to progress

• Tear free treatment strategies for a variety of dysfunctions including CP, torticollis, Shaken Baby Syndrome, gait asymmetries, hypotonia, and Spina Bifida


Upon completion of TMR Tots & Teens Level 1 the student will understand the neuromuscular basis for TMR, know how to perform a full body assessment and treatment program and have learned the TMR documentation format for recording and tracking progress. The student will have experienced a new understanding of how the body heals and will be able to use this knowledge effectively to perform TMR on their patients Monday morning. During the seminar the student will be the patient and experience the exercises with their own body. This is the same information that they will then learn to apply to their patient’s functional issues. Attendees leave with a sense of empowerment and a renewed sense that they can teach parents and caregivers how to more effectively help those in their care in their daily routines.

• Perform a basic full body single plane TMR evaluation

• Perform TMR treatment focusing on the basic trunk dysfunctions

• Understand and be able to verbalize the 3D mechanical basis for TMR

• Design & assess home program using the TMR philosophy

• Upon completion of TMR Tots & Teens Level 1 the student will understand the Completion Certificate Requirements;

• Signed Evaluation Form



After 16 hours of face-to-face instruction, plus post-course support, participants will be able to:

▪ Assess areas of restricted mobility and weakness

▪ Make quick, clear assessments of right-sided and left-sided strength and mobility

▪Log quantitative results from session to session and from beginning to end of session

▪Identify the priority of what to treat in a session

▪Know how to progress in a treatment session 

▪Use TMR to improve flexibility, strength and function

▪Integrate TMR and present tools of therapy, such as NDT or strength training 

▪Develop home programs for family-friendly training


Total Motion Release® (TMR) Tots & Teens - Level 1 Agenda:

Day One morning and one afternoon break, each 15 minutes

7:30 am Sign-in

8:00 am Morning program: Learning the TMR System

Introduction to TMR handling

History of TMR Development of the Concept

Impact of asymmetrical alignment on skill acquisition

Introduction to the paradigm shift

Key concepts of TMR intervention

TMR globally

Immobilization and relationship to restrictions

Understanding fascia

Hypothesis & references supporting concept

Learning steps 1-2 (the ICF model, observation & measurement of function

Defining the easy side and test motions

Intro to Step 3 learning the basic motions on self

Step 2 Feel it - instructing the caregiver to identify restrictions

How we treat the motions

12:00 – 2:00 Lunch

2:00 PM Afternoon program: Applying the method

Learning to test and treat the 2 basic motions on self & partner

Testing the other one plane basic motions on self

Treating self and Identifying functional changes

Caregiver education

How limitations limit motor development

Practice in handling

Overview of key points

Q & A

6:00 Adjourn


Day Two

One 15-minute break in morning and in afternoon

7:30 am Sign-in 

8:00 AM: Morning program: Practicing the method & using

the 10 step form

Review main points

Overview of motions – retest self

Review testing on partners

Home Program

Organize & Activate

TMR & Transitions

Application in diagnoses

Torticollis & Infantile postural asymmetry

12:15 Lunch break

1:15 Afternoon program: Application & modified techniques

Torticollis & Infantile postural asymmetry (cont.)

Lower tort.

Details of Step 4 on the from

Filling out the 10 step protocol in child with torticollis

Interconnection in CP and other diagnoses

Filling out the form in demo

Therapeutic Play – combining motions

Special situations

Review on partners

Intro to Level 2 concepts

Q & A

5:30 Adjourn


CREDITS: 16 contact hours



Susan Blum obtained her Bachelor's degree in Physical Therapy in 1975.  She is the owner of Susan Blum Pediatric Physical Therapy, a private practice specializing in treatment of children in natural environments.  Susan provides physical therapy services in the York, Pennsylvania area both in Early intervention and private consultation.  In addition to using traditional pediatric strategies, Susan employs the step-by-step TMR approach, and is able to create more effective care plans.  Earlier in her 40 year career Susan had extensive experience treating adults with neurological, orthopedic, and women's health disorders using a variety treatment techniques which she is incorporated in her approach with children.  She has adapted TMR for the pediatric population and has witnessed a dramatic improvement in the functional outcome of her patients.  Her practice includes patients with a wide variety of pediatric issues including cerebral palsy, orthopedic issues, gait asymmetries, torticollis, developmental delays and other neuro-motor disorder.  All have benefited from TMR and exceeded former expectations.



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