Applied Health Physical Therapy 866

AHPT 866:  Neuromuscular Development/ Control II
               
Prerequisite: AHPT 844 or permission of the Department
               
Credit Hours: (4)

Neuromuscular Development/ Control II is the second in a sequence of neuromuscular patient management content areas. The course examines the theoretical and clinical basis for the treatment of neurological pathologies. The course builds on previous course content such as Neuromuscular Dev/ Control I.


Detailed Description of Course

Neuromuscular Development/ Control II is the second in a sequence of neuromuscular patient management content areas. The course will examine the theoretical and clinical basis for the treatment of neurological pathologies. The course builds on previous course content such as Neuromuscular Dev/ Control I, Patient Management I & II and the Clinical Medicine sequence. Historical and current treatment approaches and their relationship to CNS function, motor control, motor learning and development will be used as the framework for this course. Clinical implications and applications of treatment approaches will be discussed as they relate to specific diagnostic categories as described in the Guide to Physical Therapist Practice.  Students will receive instruction and practical experience in patient handling techniques and therapeutic procedures. This course prepares students to participate in their second and third clinical internships.
    

Detailed Description of Conduct of Course

Course content may be delivered by lecture, laboratory learning experiences, demonstration, small-group cooperative learning, case study analysis/ presentations and student debates.


Goals and Objectives of this Course

Will require students to:

1) Identify the components of the neuropathic approaches described by Signe Brunnstrom and Margaret Rood; 2) Identify Rood's developmental sequence and its treatment applications; 3) Analyze and demonstrate the PNF techniques including neurophysiologic rationales and clinical application for each: hold-relax, contract-relax, slow reversals, rhythmic stabilization, and rhythmic irritation; 4) Demonstrate PNF patterns following a progression through the developmental sequence ;5) Select the most appropriate PNF pattern and technique (s) that address the clinical problem (s) and demonstrate  the appropriate technique; 6) Examine the components of postural control and transitional motion as identified in children and adults as described by Berta Bobath; 7) Identify and distinguish neurodevelopment treatment principles as they apply to children and adults; 8) Formulate the relationship between movement analysis and handling techniques as described by the Bobath approach; 9) Analyze the current relationship between functional movement and the Bobath approach; 10) Utilizing current research, write a neurophysiological rationale for Brunnstrom, Rood, PNF and the Bobath treatment approaches; 11) Compare the neurophysiological rationale for Brunnstrom, Rood, PNF, and Bobath treatment approaches to current motor control and motor learning theories, as described in current literature; 12) Identify and distinguish clinical conditions appropriate for the application of Brunnstrom, Rood, PNF, and Bobath approaches; 13) Select the most appropriate sequence of motions and handling techniques that address the patient's functional movement limitations and demonstrate these approaches/ plans via a treatment program; 14) Identify and analyze the significant impairments that can interfere transitional motions such as bed mobility, transfers, gait, and stair climbing; 15) Identify and analyze the relationship of the movement components of the head, trunk, and extremities during supine and prone mobility, transfers, gait, and stair climbing; 16) Demonstrate handling techniques that promote improved functional supine and prone mobility: bed mobility, transfers, gait, and stair climbing; 17) Assess the alignment, motor control and impairments of patients with neurological injuries related to upper extremity, lower extremity and trunk mobility; 18) Select the most appropriate movement sequence and handling techniques that will improve bed mobility, transfers, ambulation, and stair climbing (demonstrate treatment progression); 19) Identify tone disorders in static postures and dynamic motion; 20) Demonstrate tone management techniques including handling, positioning, casting, and splinting and examine medical management with medications, nerve blocks, and surgical procedures; 21) Compare and contrast current and historical literature related to the etiology and treatment of tonal disorders; 22) Examine balance disorders in static postures and dynamic motion; 23) Demonstrate balance treatment strategies for anticipatory and reactive balance problems, biomechanical impairments, altered strategies, and sensory impairments; 24) Analyze vestibular dysfunction and its etiology, pathogenesis, prognosis, and treatment potential; 25) Demonstrate treatment strategies for patients with specific types of vestibular dysfunctions; 26) Compare and contrast current and historical literature related to the etiology and treatment of balance disorders; 27) Compare and contrast treatment strategies for patients with traumatic brain injury, CVA, Parkinson's disease, ALS, Polio, Multiple Sclerosis, Huntington's Chorea, and cerebella dysfunction through the use of current literature; 28) Given any of the diagnoses found in # 27, develop education programs for both the patient and family; 29) Identify and analyze adaptive equipment and seating for the patient with a neurological injury anddescribe the appropriate assessment and fitting of such equipment; 30) Identify and analyze the types of architectural and environmental considerations for a given patient to function at their highest functional level of independence at home/ work; 31) Identify and analyze the psychosocial issue that patients with neurological injuries and their families may encounter as they progress from the acute stage towards recovery; 32) Identify community resources for patients with neurological injuries; 33) Based on current evidence, propose lower and upper extremity orthotics,  their appropriate use, and appropriate progression following a spinal cord injury; 34) Compare and contrast functional abilities and treatment approaches for patients with spinal cord injury including all levels and the determination of complete or incomplete injury; 35) Develop a physical therapy problem list, functional outcomes and treatment plan for patients with spinal cord injuries; 36) Develop and demonstrate treatment plans to promote intact skin, improved respiration, upright sitting posture, and tolerance for sitting and adequate ROM, strength, and balance for all functional activities in a patient with a spinal cord injury; 37) Analyze the energy cost of and criteria for paraplegic ambulation; 38) Integrate physical therapy goals with the health beliefs, values, and cultural influences of the patient, family, and rehabilitation team; 39) Develop and demonstrate a comprehensive physical therapy care plan given a patient with a neurological diagnosis and co-morbidities; 40) Identify and use appropriate communication skills (e.g., culturally sensitive with consideration of the individual's health beliefs) when evaluating and treating patients with such neurological diagnoses asexpressive/ receptive aphasia, perceptual deficits, sense of loss, and depression; 41) Develop and demonstrate a comprehensive physical therapy program for a given patient with a neurological diagnosis and other co-morbidities that include modifying the plan as indicated by patient’s response and progress;  42) In mock scenarios, demonstrate the ability to recognize and respond in an appropriate and timely manner to "red flags" indicating acute spinal cord injury and/or chronic spinal cord injury emergencies.


Assessment Measures

May include but are not limited to:

Examinations, development of  intervention protocols, case study projects, student debates, and laboratory practical examinations


Other Course Information

None

Review and Approval

February 10, 2014