PTAS 1180 - Physical Therapy Procedures 2-Laboratory

Credit Hours: 2.00

Objectives: The student will:

1. Describe the relationship between exercise, short term goals and functional outcomes.
2. Identify muscle contraction during specific exercise as eccentric, concentric or isometric.
3. Relate the role of gravity to exercise selection.
4. Relate specific exercises to short and long term goals.
5. Describe the role of the PTA in selecting exercise.

Outcome 2: Upon completion of this course, students will be able to the ability to implement an effective therapeutic exercise program as indicated in the plan of care developed by the physical therapist.

Objectives: The student will:

1. Describe and demonstrate effective teaching techniques considering learning style and barriers to learning.
2. Recognize the role of individual differences, preferences, and values in the implementation of therapeutic exercise programs in the implementation of exercise programs.
3. Recognize correct and incorrect performance of selected therapeutic exercises.
4. Recognize and report adverse response to therapeutic exercise programs and reports these to the physical therapist.
5. Use the medical record to identify pre‐treatment status
6. Recognize indications and contraindications to therapeutic exercise

Outcome 3: Upon completion of this course, students will be able to the ability to perform and instruct in a therapeutic exercise program as indicated in the established PT plan of care.

Objectives: The student will:

1. Perform and instruct in passive range of motion.
2. Perform and instruct in active assisted range of motion and active range of motion.
3. Perform and instruct in resistive exercise.
4. Perform and instruct in exercise programs to improve aerobic and muscular endurance.
5. Perform and instruct in protocols for post‐surgical patients including total hip and total knee arthroplasty.
6. Perform and instruct in the safe and effective use of equipment for exercise enhancement and resistance.
7. Perform and instruct in exercise for posture and trunk stability.
8. Perform and instruct in passive and active stretching techniques.
9. Perform and instruct in exercise for balance, coordination and relaxation.
10. Document an interim progress note related to exercise using the SOAP format.
11. Recognize and respond to safety concerns and possible emergencies related to exercise programs.

Outcome 4: Upon completion of this course, students will be able to demonstrate the ability to collect data as necessary to implement and progress an exercise program as indicated in the plan of care developed by the physical therapist.

Objectives: The student will:

1. Perform and record manual muscle tests.
2. Relate manual muscle test grades to functional outcomes.
3. Use data collected from manual muscle tests to select and progress exercise within the established plan of care.
4. Administer functional screening test related to balance and report data accurately

Outcome 5: Upon completion of this course, students will be able to the ability to progress an exercise program based on the patient’s response to the established plan of care.

Objectives: The student will:

1. Describe methods of advancing an exercise program.
2. Describe the relationship between manual muscle testing and exercise progression toward functional outcomes.
3. Identify indications of effective and ineffective exercise progression.
4. Describe physiological indicators related to safe and effective exercise progression.
5. Describe the role of the PTA in progressing an exercise program within the plan of care developed by the PT
6. Describe the role of the PTA in discontinuing an episode of care and the provision of a home exercise program

Outcome 6: Upon completion of this course, students will be able to the ability to apply mechanical traction as indicated by the plan of care established by the physical therapist.

Objectives: The student will:

1. Perform set up for lumbar traction recognizing positional variation indicated in the plan of care.
2. Perform set‐up for cervical traction.
3. Recognize and instruct patient regarding expected and adverse response to mechanical traction.
4. Recognize indications and contraindications to mechanical traction.
5. Report contraindications and/or adverse response to the physical therapist.
6. Demonstrate awareness of safety precautions for patient and PTA related to the use of mechanical traction.

1. Skills in Communicaĕon
   1. Objective – the student will be able to:
      1. demonstrate written, verbal, and nonverbal communication skills wich are productive
      2. contrast negative and positive behaviors
      3. descrive appropriate interactions with pateint and family
      4. demonstrate in writing appropriate technques for recording (SOAP)
      5. demostrate/discuss interactions of PT and PTA for treatment planning and implementation
   2. Specific topics covered:
      1. communication skills
         1. Verbal
         2. Nonverbal
         3. Client/patient interactions
         4. Patient teaching skills
      2. Written communications: SOAP notes
      3. PT and PTA roles in therapeutic exercise
2. Range of Motion Therapeutic Techniques
   1. Passive ROM
   2. Active assistive ROM
   3. Active ROM
   4. Specific topics covered:
      1. ROM protocals and regimes for spine and extremities
         1. passive ROM
         2. active assistive ROM
         3. active ROM
3. Stretching Techniques: Exercise to Increase joint ROM
   1. Objective-the student will be able to:
      1. demonstrate passive stretch
      2. demonstrate active stretch techniques
         1. Contract ‐ relax
         2. Reciprocal Inhibition
      3. demonstrates stretching techniques utilizing equipment
   2. Specific topics covered:
      1. parameters of active and passive stretch
      2. specific techniques to spine and extremities
         1. passive
         2. contract‐relax
         3. reciprocal inhibition
      3. pendulum exercises and use of equipment
      4. Case studies and problem solving
4. Resistive Exercise Techniques: Exercise for Strength
   1. Objective the student will be able to:
      1. demonstrate isometric exercises for the extremities and spine
      2. demonstrate manual resistive exercises of the extremities and spine
      3. demonstrate appropriate resistive exercise technique to include: proper stabilization, appropriate resistance, appropriate patient position and appropriate direction of resistance
      4. demonstrate appropriate utilization of exercise equipment including, but not limited to: t-band, cuff weights, dumbbells, weight bars, nustep, rebounder, fitter, airex, BAPS board.
   2. Specific topics covered:
      1. manual resistance
         1. Definition
         2. Principles of application
         3. Techniques ‐ extremities
      2. General principles of strength training
      3. Types of resistive exercises
         1. Isometric protocols
         2. Isotonic protocols
         3. Isokinetic protocols
      4. Choice of training protocols/methods
      5. Use of strength‐training protocols
         1. PRE programs
         2. Use of weights
         3. Use of other equipment for strength
      6. Case studies and problem solving
5. Relaxation Techniques
   1. Objective ‐‐ the student will be able to:
      1. demonstrate relaxation techniques
      2. demonstrate appropriate utilization of relaxation techniques as part of a therapeutic exercise program.
   2. Specific topics covered:
      1. Relaxation protocols/methods
      2. Use of environmental controls, role of PTA in promoting relaxation through voice, touch
6. Treatment of the Post surgical patient
   1. Objective‐‐ the student will be able to:
      1. demonstrate appropriate application of adaptive, assistive, and supportive devices.
      2. demonstrate appropriate application of treatment programs and therapeutic exercise programs
      3. demonstrate proper transfer techniques and bed mobility techniques
   2. Specific topics including hip, knee and shoulder replacement
      1. Precautions
      2. Exercise programs
      3. Assistive devices, supportive devices
      4. Exercise equipment
      5. Transfers, bed mobility, and gait training
7. Balance/Coordination
   1. Objective ‐‐ the student will be able to:
      1. implement an exercise program for the management of balance and coordination impairments as indicated in the PT POC.
      2. use data collected to advance a balance and coordination program as indicated by the PT POC
      3. utilize special safety precautions for patients with balance impairments
   2. Special topics covered:
      1. Frenkle’s exercise and other coordination exercises
      2. Developmental positions
      3. Equipment ‐ balls, balance beams, rocker boards, etc
      4. Case studies and problem solving
8. Posture/Spine Exercises
   1. Objective the student will be able to:
      1. analyze deviations of normal postural alignment
      2. demonstrate ability to instruct patient in proper postural and body mechanics
      3. demonstrate exercises to improve kinesthetic awareness regarding posture
      4. implement and progress a patient through an established scoliosis/postural exercise program under the supervision of a PT
      5. identify precautions and contraindications to postural/scoliosis exercises
      6. recognized and utilize exercise equipment with a postural program
      7. demonstrate the ability to instruct a patient in spinal stabilization activities.
   2. Special topics covered:
      1. Exercise techniques for trunk
         1. Active ROM
         2. Techniques to increase ROM
         3. Techniques to restore muscle imbalance
      2. Posture programs
      3. Case studies and problem solving
9. Mechanical Traction
   1. Objective‐‐ the student will be able to:
      1. demonstrate techniques for
         1. preparation for PTA
         2. treatment area
         3. equipment
         4. patient
      2. demonstrate techniques of application in use of cervical and pelvic mechanical traction
         1. position selection
      3. instruct patient and family
      4. identify and respond to changes in physiological state
      5. demonstrate appropriate techniques for
         1. care, use and maintenance of equipment
         2. correct safety measures for PTA and patient
         3. terminating the treatment
      6. record adequate and precise information
   2. Specific topics covered:
      1. General principles
      2. Indications and contraindications
      3. Equipment and supplies
      4. Techniques of application
      5. Patient application
      6. Unique problems and precautions
10. Manual Muscle Testing
    1. Objective‐‐ the student will be able to:
       1. choose the appropriate position for performing manual muscle test
       2. recognize patient response to manual muscle test
       3. record result of manual muscle test
       4. verbalize the role for the PTA in performing data collection
       5. verbalize the role of manual muscle testing in the clinical decision making progress
       6. describe manual muscle test grades
    2. Specific topics covered:
       1. Patient positioning
       2. Applying resistance
       3. Recording data
       4. Performing muscle test to:
          1. Head/neck
          2. Shoulder girdle
          3. Elbow/forearm
          4. Hand/wrist
          5. Trunk
          6. Hip
          7. Knee
          8. Ankle/foot
       5. Recording data and insuring accuracy of data