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STEP Conferences began in the 1960s with Northwestern University’s Special Therapeutic Exercise Project (NUSTEP) held in Chicago in the summer of 1966. The federally funded project brought together basic scientists and physical therapist faculty to address science and theories that were promoting a paradigm shift in the physical therapy profession. At that time greater emphasis was being placed on the treatment of individuals with neurologic disorders, particularly those with spinal cord injury, stroke, or cerebral palsy. Therapists had begun to use principles of neurophysiology and developmental science as underpinnings for “Newer approaches” to therapeutic exercise in their treatment of children and adults with these conditions. Thus began a series of conferences, held primarily when paradigm shifts in physical therapy practice warrant reconsideration of scientific foundations for the treatment of movement dysfunction in individuals of all ages.

The purpose of this e-book is to provide the proceedings from the fourth STEP Conference (IV STEP), hosted by Ohio State University (OSU), in Columbus, Ohio, in July 2016, 50 years after the initial STEP conference. More than 700 participants gathered on the OSU campus to consider paradigm shifts in 4 areas influencing pediatric and neurologic physical therapy practice: Prediction, Plasticity, Prevention and Participation. The broad diversity of topics discussed share a common denominator as all relate to the human movement system.

The conference schedule offered mornings of plenary speakers and afternoon sessions provided opportunity for discussion of the information presented in the morning. Neurologic and Pediatric Physical Therapy Residency Programs developed video case materials to serve as a basis for conference participants’ smaller group discussions of the information presented by the plenary speakers. In these afternoon sessions, the Residency Program directors and residents took the lead in unfolding the clinical cases, and professional leaders served as Moderators and Facilitators of the discussions that followed.

Although this book does not capture the rich discussion that ensued in these afternoon sessions, a narrative of each case is included here and the vast majority of the case narratives include links to the PowerPoint and the video materials presented to IV STEP participants. It is the intent of the conference planning committee to promote ongoing discussion of the materials presented at IV STEP, and particularly to engage physical therapist students in the plenary session content and discussion of the cases provided in this book.