PTAS 1020 - Physical Therapy Procedures 1-Lecture

Credit Hours: 2.00

Objectives: The student will:

1. Describe models of disablement as an approach to patient management.
2. Describe steps of the patient management process.
3. Discuss treatment implementation as it relates to short term goals and functional outcomes.
4. Discuss the roles of the PT and PTA in patient management.
5. Discuss the history of medical documentation.
6. Describe various methods of documentation common to Physical Therapy.
7. Compare and contrast selected documentation methods.
8. Identify and describe components of an initial evaluation including plan of care.
9. Identify and describe components of a SOAP note.
10. Discuss the Health Care Insurance Portability Act and its implications for the PTA.
11. Describe the role of data collection in the progression of treatment within the plan of care.
12. Identify and describe data collection and intervention activities that are outside of the scope of practice for PTA.
13. Describe values based behaviors for PTA in the provision of care under the supervision of the physical therapist
14. Briefly describe the relationship between provision of care and third-party reimbursement

Outcome 2: Upon completion of this course, students will be able to describe the role of universal precautions, isolation techniques, and sterile technique in physical therapy settings.

Objectives: The student will:

1. Discuss the history of related procedures in health care.
2. List situations in which sterilization is required.
3. Describe methods of sterilization.
4. Describe sterile technique.
5. Compare and contrast medical asepsis and surgical asepsis.
6. Describe the role of hand washing in physical therapy.
7. Describe types of patient isolation relating each to common patient diagnoses.
8. Define universal precautions.
9. Describe procedures related to universal precautions in patient care settings including the use of protective equipment.
10. Describe procedures used by PTAs in isolation settings.
11. Discuss the role of health care workers in the transmission of antibiotic‐ resistant infections, HIV, hepatitis, and tuberculosis.

Outcome 3: Upon completion of this course, students will be able to describe the role of body mechanics in physical therapy settings to conserve energy, reduce fatigue, reduce incidence of injury, promote safety and wellness.

Objectives: The student will:

1. Describe basic anatomy related to body mechanics.
2. Describe principles of body mechanics related to given activities including lifting, pushing, pulling, and reaching.
3. Understand the relationship between body mechanics and safety for patients and clinicians.
4. Discuss methods of teaching related to body mechanics that may be effective for patients, families, and other members of the health care team.

Outcome 4: Upon completion of this course, students will be able to discuss vital signs as indicators of patient condition and the role of the PTA in measuring vital signs.

Objectives: The student will:

1. Define pulse, respiration, blood pressure, and pulse oximetry.
2. State normal ranges for pulse respiration, blood pressure, temperature and PO2.
3. Identify common measurement techniques for vital signs.
4. Describe peripheral pulses and their significance in patient health.
5. Recognize abnormal and normal variations in vital signs and common causations.
6. Discuss the importance of measuring vital signs and using data to assess a patient’s response to treatment.
7. Recognize when vital signs may be related to emergencies and describe appropriate PTA response.

Outcome 5: Upon completion of this course, students will be able to discuss techniques related to basic patient care including mobility and transfers.

Objectives: The student will:

1. Describe methods used to transfer and position patients including: assisted stand pivot, dependent stand pivot, two man lift, pneumatic lift, and sliding board.
2. Compare and contrast methods of transfer and relate attributes to selected patients.
3. Identify common hazards in transfers and safety precautions necessary to avoid hazards.
4. List and define descriptions of functional ability related to transfers and methods of documenting functional ability in transfers.
5. Describe necessary patient and environmental preparation necessary to perform safe and efficient transfers.

Outcome 6: Upon completion of this course, students will be able to discuss theories of pain.

Objectives: The student will:

1. Identify nervous system structures related to pain perception.
2. Describe pathways related to pain perception.
3. Describe theories related to pain perception and modulation and the role of PT in managing pain.
4. Compare and contrast acute, chronic, and referred pain.
5. Describe the pain/spasm cycle and the role of physical agents in its interruption.
6. Describe methods used to collect data related to pain.

Outcome 7: Upon completion of this course, students will be able to describe the use of physical agents in physical therapy.

Objectives: The student will:

1. List thermal and athermal agents.
2. Discuss the physiological effects of heat and cold.
3. Discuss the potential patient response to treatment with thermal agents.
4. Compare and contrast the physiological effects of heat and cold.
5. Describe physical mechanisms of heat exchange.
6. Discuss the role of the PTA in clinical decision making related to thermal agents.
7. Discuss the modification of treatment with physical agents in relationship to the physiological response of the patient.

Outcome 8: Upon completion of this course, students will be able to describe the use of superficial heating and of cryotherapy modalities in physical therapy.

Objectives: The student will:

1. List superficial heating modalities.
2. List cryotherapy agents.
3. Describe the attributes of hot packs, paraffin, fluidotherapy, and light and relate these to common conditions.
4. Describe the attributes of ice massage, cold packs, and cold baths and relate these to common conditions.
5. Discuss indications and contraindications for the use of superficial heat and cryotherapy.
6. Describe the use of superficial heat and cryotherapy in combination with other treatment approaches.
7. Describe the role of the PTA in applying superficial heat and cryotherapy interventions.
8. Discuss safety precautions in the use of superficial heating and cryotherapy modalities.

Outcome 9: Upon completion of this course, students will be able to describe the use of short wave diathermy in physical therapy.

Objectives: The student will:

1. List the effects of short wave diathermy (SWD).
2. Describe electrical field and magnetic field methods of application of SWD.
3. Identify tissues most likely to be impacted by SWD.
4. Describe safety reactions necessary for SWD and indications and contraindications for use.
5. Describe limitations of use in common practice.

Outcome 10: Upon completion of this course, students will be able to describe the use of therapeutic ultrasound in physical therapy.

Objectives: The student will:

1. Discuss the physical principles of ultrasound.
2. Discuss the theory and rationale for the application of ultrasound in the management of selected conditions.
3. Discuss thermal vs. non‐thermal ultrasound.
4. Describe the clinical applications of ultrasound and parameters of treatment related to clinical decision making.
5. Discuss safety precautions for the use of ultrasound including indications and contraindications.

Outcome 11: Upon completion of this course, students will be able to describe the role of physical therapy and the PTA in wound care.

Objectives: The student will:

1. Describe the stages of wounds.
2. Recognize the characteristics of viable skin tissue.
3. Discuss common causes and appearance of non‐healing wounds.
4. Relate principles of deconditioning, mobility, and patient care to wound prevention and management.
5. Identify common wound care products.
6. Describe methods of wound management including debridement, pulsatile lavage, and the selection of wound care products.
7. Describe the role of the PTA in application, removal, and disposal of dressings.
8. Describe the team approach to wound management and the role of PT and the PTA.

Outcome 12: Upon completion of this course, students will be able to describe the use of hydrotherapy in physical therapy.

Objectives: The student will:

1. Describe the physical principles of water.
2. Discuss the therapeutic benefits of hydrotherapy.
3. Discuss the methods of application and equipment used to provide hydrotherapy.
4. Discuss the role of hydrotherapy in wound management.
5. Discuss the indications and contraindications for hydrotherapy including potential for infection.
6. Discuss safety concerns unique to hydrotherapy.

Outcome 13: Upon completion of this course, students will be able to describe the use of therapeutic massage in physical therapy.

Objectives: The student will:

1. Define therapeutic vs. recreational massage.
2. Describe the physiological effects of massage.
3. Describe type of massage and massage strokes commonly used in PT.
4. Discuss the rationale for selection of massage strokes.
5. Discuss special considerations for the use of massage including draping, therapeutic environment, lubricants.
6. Identify indications and contraindications to the use of massage.

Outcome 14: Upon completion of this course, students will be able to describe edema management and the use of external compression in physical therapy.

Objectives: The student will:

1. Describe common causes of local edema and of lymph system failure.
2. Describe the components of complete decongestive physical therapy.
3. Describe the indications and contraindications for use of external compression.
4. Relate the uses of a compression pump to pathological conditions.
5. Discuss the safety considerations for the use of external compression.
6. Describe the equipment used for external compression.
7. Describe the monitoring of edema by girth and volumetric measurements.

Outcome 15: Upon completion of this course, students will be able to describe the principle of gait and gait training in physical therapy.

Objectives: The student will:

1. Name and describe the phases of normal gait.
2. List and define common weight bearing status indications.
3. Describe the role of assistive devices in a gait training program.
4. Describe common pre‐gait activities used in physical therapy.
5. Describe various assistive devices and compare and contrast their attributes.
6. Identify information necessary to select an appropriate assistive device.
7. Describe safety precautions necessary for gait training.
8. Describe the role of PTA in gait training.

• Communication: The graduate can communicate effectively for the intended purpose and audience.
• Critical Thinking: The graduate can make informed decisions after analyzing information or evidence related to the issue.
• Global Literacy: The graduate can analyze human behavior or experiences through cultural, social, political, or economic perspectives.
• Information Literacy: The graduate can responsibly use information gathered from a variety of formats in order to complete a task.
• Quantitative Reasoning: The graduate can apply quantitative methods or evidence to solve problems or make judgments.
• Scientific Literacy: The graduate can produce or interpret scientific information presented in a variety of formats.

1. Clinical Decision Making
   1. Patient management model and clinical decision making
   2. Collection of subjective and objective data
   3. Identification of impairments and functional limitations
   4. Long and short term goal setting
   5. Treatment implementation
   6. Reassessment and functional outcomes
   7. Discharge planning and the PTA
   8. Identify and describe data collection and interventions that are beyond the scope of practice for the PTA
2. Principles of Body Mechanics
   1. Basic spinal anatomy
   2. Gravity and body stability
   3. Basic principles of levers
   4. Friction
3. Vital Signs
   1. Introduction to vital signs
   2. Body temperature
   3. Pulse
   4. Pulse
   5. Respiration
   6. Documentation
   7. Emergency care: Responding to emergency situations
4. Documentation
   1. SOAP notes
   2. Electronic Medical Records
   3. Documentation for skill and necessity
   4. Documentation as it relates to reimbursement
   5. Role of documentation in quality improvement activities
5. Transfer and Moving Techniques
   1. Principle of transfers and moving techniques
   2. Functional assessment grading scale
   3. Body mechanics
   4. Types of transfers
6. Gait and Ambulation
   1. Assessment prior to gait training
   2. Selection of assistive device
   3. Progression of gait training program
      1. Preparation for standing ‐ preambulation mat program
      2. Parallel bars progression
      3. Assistive device progression
      4. Level surfaces to unlevel surfaces
      5. Stair climbing
7. Massage
   1. Principles of massage
   2. Types of techniques
      1. Effleurage
      2. Pétrissage
      3. Friction
      4. Tapotement
   3. Physiological response
   4. Indications and contraindications
8. Pain Management
   1. Classification of sensory system
   2. Transmission of sensory signals
      1. Non‐noxious
      2. Noxious
   3. Theories of pain modulation
      1. Gate theory
      2. Central pain modulation
   4. Types of pain and characteristics
      1. Acute
      2. Chronic
      3. Referred
   5. Assessment of pain
   6. Pain ‐ spasm cycle
   7. Role of thermal agents in the management of pain and inflammation
9. Cryotherapy
   1. Cold agents
   2. Indications and contraindications
   3. Physical principles
      1. Conduction
      2. Evaporation
   4. Physiological effects
      1. Hemodynamic
      2. Tissue temperature
      3. Cellular ‐ edema and inflammation
      4. Neuromotor ‐ peripheral nerves and muscle
10. Superficial Heat Agents
    1. General principles of heat
    2. Superficial versus deep heat agent
    3. Physiological principles
    4. Mild versus vigorous heating
    5. Indications and contraindications
    6. Clinical decision making
11. Hydrotherapy
    1. Physical properties
    2. Mode of heat transfer
    3. Precautions
    4. Physiological effects
    5. Mechanical effects
    6. Indications and contraindications
    7. Wound care and hydrotherapy
       1. Debridement
       2. Pulsatile lavage
       3. Selection of wound care products
12. Surgical Asepsis and Isolation Techniques
    1. Asepsis ‐ medical and surgical
    2. Isolation categories
       1. Strict isolation
       2. Contact isolation
       3. Respiratory isolation
       4. Reverse isolation ‐ protective measures
    3. Universal blood and body fluid precautions
       1. History of CDC recommendation
       2. Role in physical therapy
    4. Sterile technique
13. Therapeutic Ultrasound
    1. Superficial versus deep heat
    2. Physical principles
    3. Pulsed versus continuous ultrasound
    4. Intensity and dosage
    5. Generation of ultrasound
    6. Biophysical effects
       1. Thermal
       2. Non‐thermal
    7. Indications, contraindications, and precautions
    8. Phonophoresis
    9. Role of PTA
14. Diathermy
    1. Types of diathermy
       1. Shortwave/pulsed electromagnetic energy
    2. Induction and capacitance applications of SWD
    3. Biophysical effects
    4. Physiological effects
    5. Indications, precautions, and contraindications
15. Edema Management and External Compression
    1. General principles of the use of external compression
    2. Indications and contraindications
    3. Complete decongestive physical therapy
    4. Techniques of application
       1. Compression appliance
          1. Upper extremity
          2. Lower extremity
       2. Bandaging techniques
    5. Patient application
       1. Problems and precautions related to patient compliance