PTAS 2140 - Musculoskeletal Physical Therapy-Laboratory

Credit Hours: 1.50

Objectives: The student will:

1. Demonstrate effective patient management techniques including positioning, draping, and hand placement for selected treatment techniques.
2. Demonstrate awareness of patient safety in the application of physical therapy techniques for the musculoskeletal patient including tendonitis, bursitis, fractures, sprains, strains and compression syndromes.
3. Demonstrate passive stretching and related soft tissue techniques appropriate to the role of the PTA.
4. Describe the principles of joint mobilization and recognize the limitations of the PTA in the application of mobilization techniques.
5. Demonstrate proper exercise form for selected exercise techniques.
6. Demonstrate the ability to document the treatment of the patient with musculoskeletal impairments in a manner consistent with regulatory and ethical standards of the PTA.

Outcome 2: Upon completion of this course, given a patient profile and treatment plan, students will be able to apply appropriate intervention utilizing problem solving skills appropriate for the PTA.

Objectives: The student will:

1. Recognize when interventions should not be applied and report to the PT.
2. Recognize when appropriate interventions are beyond the scope of the PTA and report to the PT.
3. Identify contraindications and precautions for the treatment of common musculoskeletal conditions.
4. Select appropriate therapeutic exercise for the management of musculoskeletal impairments of the spine and extremities within the plan of care developed by the physical therapist utilizing sound rationale.

Outcome 3: Upon completion of this course, students will be able to provide instruction to patients and caregivers regarding exercise programs and home follow-up utilizing positive communication skills and teaching techniques.

Objectives: The student will:

1. Describe and demonstrate exercises using appropriate form and verbal and nonverbal cues.
2. Explain various exercise related activities using effective teaching methodology.
3. Develop and instruct an effective home exercise plan directed towards established outcomes.
4. Consider individual differences, values, and preferences related to patient learning and treatment compliance.

Outcome 4: Upon completion of this course, students will be able to demonstrate safe and appropriate use of equipment in the management of the musculoskeletal patient including selection, set-up, and monitoring of patient techniques.

Objectives: The student will:

1. Select equipment to support activities indicated in the plan of care developed by the physical therapist
2. Identify safety risk of selected equipment and appropriate emergency responses.
3. Describe the role of medicine balls, physioballs, steps and ramps, fitter, BAPS, and resistive equipment in the exercise management of patients with musculoskeletal impairments.

Outcome 5: Upon completion of this course, students will be able to demonstrate the ability to adjust treatment technique within the plan of care developed by the physical therapist in response to physiological and psychological changes in the patient and appropriate reporting expectations.

Objectives: The student will:

1. Apply selected data collection techniques for the purposes of carrying out the plan of care and report data as appropriate to the PT.
2. Explain the significance of the PT assessment and evaluation in determining the PT plan of care.
3. Describe common orthopedic assessment techniques and their significance to the PT plan of care.
4. Recognize and report adverse responses to treatment in the patient with musculoskeletal impairment.
5. Problem solve, recognize, and report the need for alternative methods of treatment.
6. Use data collected to adjust, modify, and progress an exercise program within the plan of care as necessary for progression toward outcomes identified by the PT.

Outcome 6: Upon completion of this course, students will be able to discuss the role of the PTA in the treatment of patients with musculoskeletal impairments.

Objectives: The student will:

1. Participate effectively in the discharge of planning of patient with musculoskeletal impairments.
2. Describe an effective PT/PTA relationship in the management of the patient with musculoskeletal impairments.

• 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. Demonstration of Orthopedic Evaluation as Performed by the Physical Therapist
   1. Objective the Student will be able to:
      1. verbalize the components of the orthopedic evaluation
      2. recognize the signs and symptoms that comprise the clinical picture of:
         1. contractile vsinert tissue problems
         2. hip, knee, ankle, and spine pathology
         3. bursitis vstendonitis
      3. identify the role of the PTA in the orthopedic evaluation
   2. Specific topics covered:
      1. Subjective evaluation
      2. General objective evaluation
         1. AROM
         2. PROM, joint end feel, and joint play
         3. Ligament testing
         4. Resistance tests
         5. Neurological tests - motor, sensory, reflexes and tension tests
      3. Specialized tests - spine, wrist, and knee
      4. Recording
      5. Role of PTA in recognizing and reporting patient response
2. Soft Tissue Treatment Techniques
   1. Objective the Student will be able to:
      1. given a treatment plan, demonstrate safe and effective treatment applications of transverse friction massage, soft tissue mobilization, trigger points, and auto mobilization to include:
         1. appropriate patient positioning and draping
         2. appropriate PTA position
         3. appropriate hand placement
         4. patient instruction
         5. explanation of treatment
         6. stabilization
         7. treatment duration
         8. termination of treatment
      2. communicate and instruct patients/family in therapeutic exercises utilizing:
         1. appropriate terminology
         2. appropriate communication skills
         3. principles of teaching
      3. utilization problem solving in the selection of appropriate therapeutic exercises for a given patient problem
      4. modify therapeutic technique based on patient’s physiological response
      5. describe the techniques of mobilization for orthopedic conditions that were demonstrated in class for:
         1. wrists
         2. shoulder
         3. knee
   2. Specific topics covered:
      1. Friction massage
         1. Treatment principles
         2. Common sites of treatment in peripheral joints
            1. Tendons
            2. Muscles
            3. Ligaments
         3. Other associated treatments
            1. Traditional exercise
            2. Modalities
         4. Patient problem solving
      2. Trigger points
         1. Types of trigger points
         2. Palpation of trigger points
         3. Treatment technique principles
         4. Treatment of specific areas
         5. Associate TX techniques and exercise
      3. Soft tissue mobilization
         1. Palpation and soft tissue mobility
         2. Techniques for soft tissue mobilization
         3. Associated treatment techniques of neuromuscular reeducation
         4. Patient problem solving
3. Treatment Techniques for Knee/Ankle/Foot
   1. Objective the Student will be able to:
      1. given a treatment plan, skillfully implement a therapeutic program for the management of soft tissue and joint lesions of the knee/ankle/foot to include:
         1. traditional exercises
         2. modalities/physical agents
         3. specialized techniques
      2. given a treatment plan, skillfully implement a therapeutic exercise program of the management of common surgical procedures for the knee/ankle/foot.
      3. demonstrate safe and appropriate use of exercise equipment as related to orthopedic conditions of knee/ankle/foot.
4. Fractures
   1. Objective the Student will be able to:
      1. utilize problem solving in the selection of therapeutic exercise/physical agents for post fracture, given patient treatment plan.
      2. demonstrate skillful implementation of treatment program for the management of fractures during immobilization and post immobilization.
      3. modify treatment technique/exercise based on physiological response to the patient.
   2. Specific topics covered:
      1. Treatment protocols for fractures of humerus, colles fracture, hip, and ankle
      2. Exercise programs
      3. Exercise equipment
5. Treatment Techniques for Pathology of the Spine
   1. Objective: the student will be able to:
      1. identify and describe the techniques of soft tissue mobilization, Williams exercise and Mckensie approach associated with cervical and lumbar spine.
      2. given a treatment plan, skillfully accurately, and effectively implement therapeutic exercise program to include:
         1. appropriate patient positioning and draping
         2. appropriate PTA position
         3. appropriate hand placement
         4. patient instruction
         5. explanation to patient
         6. stabilization
         7. treatment duration
         8. precautions
         9. termination of treatment
      3. modify treatment technique based on patient’s physiological response
      4. communicate and instruct patients in appropriate treatment techniques/procedures as directed by a supervising PT
      5. identify the role of the PTA in management of spine pathologies
      6. verbalize appropriate progression of treatment based on patient’s response, given a treatment plan.