KINGSBOROUGH COMMUNITY COLLEGE
OF THE
CITY UNIVERSITY OF NEW YORK
Physical Therapist Assistant Program
Course Syllabus
PTA 8
SELECTED TOPICS IN PHYSICAL THERAPY
Course Description: This course presents selected topics related to the physical therapy
management of pathology with emphasis on comprehensive physical therapy. These topics include normal motor development, neuro-development techniques, proprioceptive neuromuscular facilitation, back pathologies and treatments, orthotic management, amputee and prosthetic management, orthopedic protocols, and administrative topics. This course is also designed to facilitate the application of all previous learning in the classroom, laboratory and clinical setting. It includes a two hour weekly seminar. Seminar hours are used to provide students with opportunities to implement comprehensive physical therapy treatments utilizing the knowledge and techniques gained from all physical therapist assistant courses.
NOTE: The seminars in this course are designed to further emphasize comprehensive treatment and integration of all course work. Though specific pathologies are examined, students continue to be encouraged to recognize and analyze disabilities, signs and symptoms rather than diagnoses, in implementing treatment procedures.
Pre-requisites: PTA1, PTA 2, PTA3, PTA 10, PTA 20, PTA 4, PTA 5, PTA 6
BIO 11, BIO 12
Co-requisites: PTA 7
Textbook Requirements: Kisner Carolyn, Therapeutic Exercise Foundations and
Techniques 4th edition, F.A. Davis Company, 1996.
Student Learning Objectives
As evidenced by successful performance and completion of written and practical examinations, assignments, oral presentations and participation in and analysis of clinical scenarios, the student will:
1.0 Implement basic neuromuscular and developmental treatment for adults and pediatric cases.
1.1. Identify and explain normal motor development.
1.2. Identify the determinants and development of balance and equilibrium.
1.3. Distinguish balance and righting reactions and their affects on normal and pathological motor development.
1.4. Identify pathological effects on normal motor development including synergistic patterns and tonal changes.
1.5. Identify and describe basic neuro-developmental techniques and basic proprioceptive neuromuscular facilitation techniques.
1.6. Demonstrate and instruct basic neuro-developmental techniques using proper hand placement and positioning.
1.7. Demonstrate and instruct basic proprioceptive neuromuscular facilitation techniques using primary and secondary patterns.
1.8. Perform neuro-developmental mat activities.
1.9. Perform basic neuro -developmental and proprioceptive neuromuscular facilitation techniques.
2.0 Implement treatment for neck and low back dysfunction.
2.1. Recall and distinguish major muscles of the neck and back.
2.2. Identify and describe approaches to the management of neck and low back pain.
2.3. Identify neck and low back exercises and self management strategies.
2.4. Explain neck and back pain in terms of dysfunction, derangement, and postural syndromes.
2.5. Explain the affects of back pain on normal gait and functional activities.
2.6. Explain the principles of mechanical traction in the management of neck and back pain.
2.7. Perform neck and back pain treatments using an eclectic approach and according to the plan of care.
2.8. Teach neck and low back exercise and self management programs.
2.9. Implement mechanical traction procedures.
3.0 Implement orthotic training programs.
3.1. Recall the major components and determinants of gait.
3.2. Describe and distinguish the uses, types, indications and contraindications of orthotic devices.
3.3. Discuss and illustrate the importance of the ankle foot orthosis in rehabilitation.
3.4. List the indicators of proper orthotic fit.
3.5. Demonstrate and instruct how to don and doff a basic ankle foot orthosis.
3.6. Teach precautions and importance of propre orthotic fit.
3.7. Use orthotic devices in ambulation training.
4.0 Implement prosthetic training programs.
4.1. Recall the major components and determinants of gait.
4.2. Describe types of lower extremity amputations.
4.3. Identify and describe pathologies leading to lower extremity amputation including diabetes mellitus and peripheral vascular disease.
4.4. Explain the basic types of prosthetic devices.
4.5. Identify the components of lower extremity prosthetic devices.
4.6. Summarize the mechanics of prosthetic components.
4.7. Instruct pre-prosthetic training including: skin care, residual limb wrapping/ compression, and therapeutic exercise.
4.8. Teach how to don and doff lower extremity prostheses.
4.9. Instruct transfer and ambulation activities with and without prosthesis using assistive devices.
5.0 Implement orthopedic treatments based upon standardized protocols.
5.1. Identify and describe basic orthopedic protocols and precautions related to the following surgeries: total shoulder/hip/knee replacements, hip hemiarthroplasty, crucuiate ligament reconstruction.
5.2. Use knowledge of pathology, anatomy and kinesiology, goniometry and manual muscle testing, other assessments and measurements, functional activities, modalities, and therapeutic exercise in implementing treatments.
5.3. Perform physical therapy treatments based upon the plan of care and the management protocol.
6.0 Given patient scenarios, implement comprehensive physical therapy treatment.
6.1. Perform therapeutic techniques demonstrating an understanding of
the role of the physical therapist assistant in rehabilitation.
6.2. Perform therapeutic techniques appropriately employing universal precautions and sound body mechanics.
6.3. Perform therapeutic techniques demonstrating an understanding of organizational structure, levels of authority, and fiscal considerations in the
health care delivery system.
6.4. Teach patients, families and other health workers, the uses, applications and responses of modalities and procedures with emphasis on safety and rationale.
6.5. Demonstrate the integrative nature of physical therapy by implementing comprehensive treatment programs, utilizing knowledge and skills attained in previous and concurrent courses.
6.6 Implement therapeutic interventions within the plan of treatment considering knowledge of assessments and measurements, functional activities, physical modalities and therapeutic procedures, pathology, kinesiology, and therapeutic exercise.
6.7. Implement therapeutic interventions within the plan of treatment demonstrating consideration of time management, therapeutic sequence and
procedure selection issues.
6.8. Demonstrate appropriate documentation of physical therapy treatments considering patient response, precautions, treatment parameters, long/short term goals, and effectiveness.
6.9. Perform physical therapy treatments and interact with patient and families considering influencing factors (psychosocial, cultural, economic, legal, ethic, etc.).
6.10.Assist in discharge planning and alternative levels of care decision making.
6.11.Identify clinical responses and situations that require the attention of the supervising physical therapist.
6.12.Communicate patient status and response to supervising physical therapist.
6.13.Analyze the effectiveness of modalities and procedures in specific clinical situations.
6.14.Assess patient status and response to treatment and appropriately alter or progress therapeutic interventions within the plan of treatment.
6.15. Delineate beneficial and untoward effects of thermal modalities.
6.16.Analyze the relationship of physical agents with other therapeutic procedures ( therapeutic exercise, range of motion, functional activities) as they relate to the achievement of rehabilitation goals.
6.17.Verify the effectiveness of his/her teaching behavior by analyzing performance.
7.0 Demonstrate appropriate professional behavior.
7.1. Attend and be on time for class, lab, and scheduled appointments.
7.2. Be prepared for lab activities; attend to tasks assigned.
7.3. Accept constructive criticism and respond and/or follows through appropriately.
7.4. Express self in a clear and easily understood manner.
7.5 Maintain appropriate personal hygiene.
7.6. Treat others with positive regard, dignity and respect.
7.7. Analyze and examine professional literature considering: specific scientific methods, interpretation of results, and clinical significance in order to
foster further personal investigation and clinical effectiveness.
7.8. Explain the importance of life long learning.
7.9. Describe how professional development can occur.
Student Assessment
As indicated in the student handbook, to receive a passing grade in this course the student must successfully complete all comprehensive examinations and assignments with a grade of “C” or better.. Additionally, the instructor assesses student competencies in skills critical to this course using the standardized skills checklists, located in the laboratory, requiring a passing score of at least 90%. Critical skills in this course include:
1. Performance of basic neurodevelopmental techniques.
2. Performance of basic proprioceptive neuromuscular facilitation techniques.
3. Performance of physical therapy treatments for the management of back pain.
4. Application of mechanical traction to the spine.
5. Performance of orthotic training activities.
6. Instruction of self-care and safety precautions as it relates to orthotic management.
7. Performance of prosthetic training activities, including: pre-prosthetic training, teaching amputee/prosthetic care and prosthetic gait training.
8. Performance of physical therapy treatment as prescribed in orthopedic protocols.
9. Instruction of self-care and safety precautions related to orthopedic conditions.
10. Reporting to supervising physical therapist.
Quizzes 20%
Case Presentation 10%
Mid-Term Examination 20%
Lab. Practical 20%
Final Examination 20%
100%
Students are instructed to find an article related to one of the topics discussed in class. Students summarize and critique the article and discuss how the article relates to the topic discussed in class. Students submit this paper during week six. This paper is worth 10% of the final grade.
Quizzes
The student complete 6-9 in class and take home quizzes. The student is required to read and analyze a clinical scenario. The student responds to questions specifically related to the material covered in this and concurrent courses. Student complete and submit take home quizzes within 24 hours of receipt. In addition, each student completes the computer based module on ethical practice and submits writing assignments to the professor. These quizzes are worth 20% of the final grade.
Case Presentation
Students in the class are divided into groups of 3-5. Each group is given a patient’s initial evaluation completed by a physical therapist. The group must present: the physical therapists initial findings, the latest research on the diagnosis, a treatment plan, demonstrate and justify exercises, design a home exercise program, and give an example of an oral presentation to a doctor or physical therapist about the patients status. This case presentation is worth 10% of the final grade.
Mid-term Examination
Students take a cumulative examination covering the first six weeks of the course. The examination includes mainly short essay and fill in type questions. The mid-term examination is worth 15% of the final grade.
Lab. Practical
Students take an oral laboratory practical examination based on laboratory activities during finals week. The lab practical is worth 20% of the final grade.
Final Examination
Students take a cumulative final examination. The examination is worth 20% of the final grade.
Course Outline
PROFESSOR HURLEY
Assignments: Handouts
This week introduces the student to normal motor development. Stages of development including the identification of primitive reflexes and motor mild stones are considered.
Students perform developmental mat activities and view normal motor development video tapes.
Students exhibit critical thinking and sound technical skill in the management of cerebral palsy case with multiple muscle contractures as presented by in the instructor and implement the prescribed plan of treatment. Students perform a patient treatment consisting of appropriate therapeutic exercise and gait training activities appropriate to scenario. While performing treatment, students consider additional factors influencing patient care and the contemporary practice of physical therapy including, psycho-social issues and other issues impacting the health care delivery system. Students practice reporting and documenting consequences of treatment to supervising physical therapist. Following this treatment application activity, students discuss patient management and therapeutic techniques.
SEMINAR TOPICS: Management of Cerebral Palsy and Developmental Disabilities
Assignments: Handouts
Neuro-motor development study continues. Righting and equilibrium are studied. The effects of balance on functional activities is reintroduced (formally discussed in PTA 3 in regard to transfer and ambulation activities.
Students will continue to practice proper hand positioning and placement in neuro-developmental techniques. Students also perform activities that illustrate righting and equilibrium reactions. Students practice using specialized balance enhancement equipment.
Students exhibit critical thinking and sound technical skill in the management of cerebral vascular accident case as presented by the instructor and implement the prescribed plan of treatment. Students perform a patient treatment consisting of appropriate therapeutic exercise, transfer and gait training and balance activities appropriate to the scenario. While performing treatment, students consider additional factors influencing patient care and the contemporary practice of physical therapy including, psycho-social issues and other issues impacting the health care delivery system. Students practice reporting and documenting consequences of treatment to supervising physical therapist. Following this treatment application activity, students discuss patient management and therapeutic techniques.
SEMINAR TOPIC: Management of Cerebral Vascular Accident
Assignments: Handouts
Pathological effects on normal development are considered. Treatment approaches are reviewed. Emphasis is placed on the impact of primitive reflex retention and muscle tone changes. Pathological conditions resulting in synergistic patterns and tonal changes are reintroduced.
Students are given patient scenarios and introduced to describe the clinical picture. Students practice taking each other through different positions including rolling, sitting, quadruped, ½ kneeling, kneeling, and standing. Hand positioning and placement will be emphasized. Mat activities will include exercise using the therapeutic ball.
Students exhibit critical thinking and sound technical skill in the management of cerebral palsy cases of varying degrees of severity as presented by the instructor and implement the prescribed plan of care. Students perform treatments consisting of appropriate therapeutic activities as well as bed mobility, transfer training, and gait training activities appropriate to the scenario. While performing treatment, students consider additional factors influencing patient care and the contemporary practice of physical therapy including, psycho-social issues and other issues impacting the health care delivery system. Students practice reporting and documenting consequences of treatment to supervising physical therapist. Following this treatment application activity, students discuss patient management and therapeutic techniques.
SEMINAR TOPIC: Management of Cerebral Palsy and Developmental Disabilities
Assignments: Handouts
This week the student is introduced to proprioceptive neuromuscular facilitation (PNF). Indications, benefits and techniques are presented.
Student practice primary and secondary patterns of PNF. Facilitation techniques are practiced.
Students exhibit critical thinking and sound technical skill in the management if a recovering Guillian Barre’ case as presented by the instructor and implement the prescribed plan of treatment. Students perform therapeutic activities including, exercise, PNF, balance activities, bed mobility, transfer training and gait training activities appropriate to the scenario. Students perform discharge planning activities including suggestions for home equipment and discharge alternatives. While performing treatment, students consider additional factors influencing patient care and the contemporary practice of physical therapy including, psycho-social issues and other issues impacting the health care delivery system. Students practice reporting and documenting consequences of treatment to supervising physical therapist. Following this treatment application activity, students discuss patient management and therapeutic techniques.
SEMINAR TOPIC: Management of Traumatic Brain Injury
Week #5---Amputee Management
Lecture
Assignments: Handouts
The student is introduced to amputee and prosthetic management. Common pathologies leading to amputation are discussed including, peripheral vascular diseases, diabetes mellitus and trauma. Factors influencing rehabilitation and prosthetic fit are presented. Types of amputations and prostheses are studied. Pre-prosthetic training is discussed.
Laboratory
Students perform pre-prosthetic activities including: skin integrity and sensation assessment, stump exercises and stump wrapping.
Treatment Application Activity
Students exhibit critical thinking and sound technical skill in the management of an above the knee amputation case as presented by the instructor and implement the prescribed plan of treatment. Students perform a patient treatment consisting of appropriate therapeutic exercise as well as bed mobility, transfer training, gait training activities and pre-prosthetic and safety activities appropriate to the scenario. Students perform discharge planning activities including suggestions for home equipment and discharge alternatives. While performing treatments students consider additional factors influencing patient care and the contemporary practice of physical therapy including, psycho-social issues and other issues impacting the health care delivery system. Students practice reporting and documenting consequences of treatment to supervising physical therapist. Following this treatment application activity, students discuss patient management and therapeutic techniques.
SEMINAR TOPIC: Management of Lower Extremity Amputation
Week #6---Amputee Management con’t
Lecture
Assignments: Handouts
Prosthetic training is studied. The student is introduced to prosthetic components. Factors influencing prosthetic selection are reviewed. Specific training techniques are studied with emphasis on muscular strength, balance, and gait implications.
Laboratory
Students practice prosthetic management activities including: donning and doffing prostheses, prosthetic transfers and ambulation training. Students continue to practice pre-prosthetic activities.
Treatment Application Activity
Students exhibit critical thinking and sound technical skill in the management of a below the knee amputation case as presented by the instructor and implement the prescribed plan of treatment. Students perform a patient treatment consisting of appropriate therapeutic exercise as well as bed mobility, transfer training, gait training activities and pre-prosthetic training, prosthetic donning/doffing and safety activities appropriate to the scenario. Students perform discharge planning activities including suggestions for home equipment and discharge alternatives. While performing treatments students consider additional factors influencing patient care and the contemporary practice of physical therapy including, psycho-social issues and other issues impacting the health care delivery system. Students practice reporting and documenting consequences of treatment to supervising physical therapist. Following this treatment application activity, students discuss patient management and therapeutic techniques.
SEMINAR TOPIC: Management of Lower Extremity Amputation
PROFESSOR SKINNER
Assignments: Kisner Chapter 14, 15
Computer Based Module on Ethics for PTA Students
Neck and back musculature and posture are reviewed (formally learned in PTA 2). Dysfunction, derangement and postural syndromes are studied.
Students palpate neck and back musculature. Given patient scenarios, students identify functional consequences Students begin to practice low back exercises.
Students exhibit critical thinking and sound technical skill in the management of a myofascial cervical pain case as presented by the instructor and implement the prescribed plan of treatment. Students perform a patient treatment consisting of appropriate therapeutic exercise, postural training and injury prevention appropriate to the scenario. While performing treatment, students consider additional factors influencing patient care and the contemporary practice of physical therapy including, psycho-social issues and other issues impacting the health care delivery system. Students practice reporting and documenting consequences of treatment to supervising physical therapist. Following this treatment application activity, students discuss patient management and therapeutic techniques.
SEMINAR TOPIC: Management of Multiple Sclerosis and Other Degenerative Disorders
Week #8-Neck and Low Back Dysfunction
Lecture
Assignments: Handouts
Neck and back pain discussion continues with emphasis placed on the differences and similarities of chronic and acute pain. Treatment precautions are also studied. Surgical interventions are discussed. Post-surgical rehabilitation is reviewed.
Laboratory
Given patient scenarios, students perform therapeutic management activities including exercises (such as McKenzie exercises), modalities (concurrent with PTA 7) and mechanical traction. Students must teach proper body mechanics (learned in PTA 1) and low back pain exercises.
Treatment Application Activity
Students exhibit critical thinking and sound technical skill in the management of a lumbar laminectomy case as presented by the instructor and implement the prescribed plan of treatment. Students perform a patient treatment consisting of appropriate therapeutic exercise as well as bed mobility, transfer training, , gait training activities and body mechanics and safety activities appropriate to the scenario. Students perform discharge planning activities including suggestions for home equipment and discharge alternatives. While performing treatments students consider additional factors influencing patient care and the contemporary practice of physical therapy including, psycho-social issues and other issues impacting the health care delivery system. Students practice reporting and documenting consequences of treatment to supervising physical therapist. Following this treatment application activity, students discuss patient management and therapeutic techniques.
SEMINAR TOPIC: Management of Multiple Sclerosis and Other Degenerative Disorders
Week #9---Introduction to Orthotics
Lecture
Assignments: Handouts
The student is introduced to orthotic management. Topics studied include: indications and types of orthoses. Students identify types of ankle foot orthoses.
Laboratory
Students practice donning and doffing orthoses. Precautions and the importance of proper fit are studied. Given patient scenarios, students teach the proper use of an ankle foot orthosis.
SEMINAR TOPIC: Management of Muscular Dystrophy and Myopathies
Week #10---Orthotics con't and Burns
Lecture
Assignment: Handouts
Orthotic management discussion continues. The pathologies (learned in PTA 2 and %) in which orthoses are used are reviewed. The student is introduced to other types of orthoses (such as KAFO's). Review of classifications of burns. The student is introduced to physical therapy management including compression garments and range of motion considerations.
Laboratory
Orthotic management activities continue.
Treatment Application Activity
Students exhibit critical thinking and sound technical skill in the management of traumatic brain injury case as presented by the instructor and implement the prescribed plan of treatment. Students perform a patient treatment consisting of appropriate therapeutic exercise as well as bed mobility, transfer training, gait training activities and orthotic management activities appropriate to the scenario. Students perform discharge planning activities including suggestions for home equipment and discharge alternatives. While performing treatments students consider additional factors influencing patient care and the contemporary practice of physical therapy including, psycho-social issues and other issues impacting the health care delivery system. Students practice reporting and documenting consequences of treatment to supervising physical therapist. Following this treatment application activity, students discuss patient management and therapeutic techniques.
.
SEMINAR TOPIC: Management of Muscular Dystrophy and Myopathies
Week #11---Orthopedic Protocols and Comprehensive Treatments
Lecture
Assignments: Handouts
Computer Based Module writing assignments due
The student is introduced to orthopedic protocols for common orthopedic surgeries. Specific exercises, precautions, weight bearing statuses (learned in PTA 3) and post-operative progression are explored. Comprehensive management is emphasized with special consideration to time management, and ethical practice.
Laboratory
Given patient scenarios, students perform treatments for post-operative total shoulder and hip replacements, hemiarthroplasty, total knee replacement and ACL reconstruction. Students teach post-operative precautions and home exercise programs.
Treatment Application Activity
Students exhibit critical thinking and sound technical skill in the management of an immediate post-operative total hip replacement case as presented by the instructor and implement the prescribed plan of treatment. Students perform a patient treatment consisting of appropriate therapeutic exercise as well as bed mobility, transfer training, goniometry, gait training activities and safety activities appropriate to the scenario. Students perform discharge planning activities including suggestions for home equipment and discharge alternatives. While performing treatments students consider additional factors influencing patient care and the contemporary practice of physical therapy including, psycho-social issues and other issues impacting the health care delivery system. Students practice reporting and documenting consequences of treatment to supervising physical therapist. Following this treatment application activity, students discuss patient management and therapeutic techniques.
SEMINAR TOPIC: Management of Total Joint Replacements
Week #12---Comprehensive Treatment cont.
Lecture
Assignments: Handouts
Discussion of comprehensive management continues.
Laboratory
Treatment Application Activity
Students exhibit critical thinking and sound technical skill in the management of a post surgical orthopedic case as presented by the instructor and implement the prescribed plan of treatment. Students perform a patient treatment consisting of appropriate therapeutic exercise as well as bed mobility, transfer training, goniometry, modalities, progressive gait training activities and home exercise program synthesis and instruction appropriate to the scenario. Students demonstrate appropriate documentation of their activities. Students perform discharge planning activities including suggestions for home equipment and discharge alternatives. While performing treatments students consider additional factors influencing patient care and the contemporary practice of physical therapy including, psycho-social issues and other issues impacting the health care delivery system. Students practice reporting and documenting consequences of treatment to supervising physical therapist. Following this treatment application activity, students discuss patient management and therapeutic techniques.
SEMINAR TOPIC: Management of Total Joint Replacements