Applied Health Physical Therapy 840

AHPT 840: Management of Special Populations (Orthotics, Prosthetics, and Advanced Specialty Topics)
               
Prerequisite: Successful completion of AHPT 820 and AHPT 830 or permission of the Department
               
Credit Hours: (3)

Two hours lecture; one hour laboratory.

Management of Special Populations (Orthotics, Prosthetics, and Advanced Specialty Topics) introduces students to the management of special populations, with a major emphasis on the physical therapy management of persons with prosthetic and orthotic needs, and minor emphasis on the management of pelvic health. Integral to the management of patients with prostheses and/or orthoses is the reinforcement of concepts related to kinesiology/biomechanics, normal gait, pathologic gait deviations, and integumentary management. The course assists students with developing evaluation skills and plans of care for these special populations. This course prepares students to participate in their second clinical experience.


Detailed Description of Course

Week 1 - Course Introduction; Wound Evaluation & Management

Week 2 - Etiology of Amputations; Amputation Prognosis & Management

Week 3 - Transtibial Amputation Management

Week 4 - Transtibial Gait Deviations; Transfemoral Amputation Management

Week 5 - Transfemoral Gait Deviations; Exercise & Gait Progression

Week 6 - Lower Extremity Amputation Rehabilitation Progression

Week 7 - Pelvic Heath; Midterm

Week 8 - Spring Break!

Week 8 - Footwear: Construction, Deisgn & Modifications

Week 9 - Foot Orthoses, Foot Assessment, and Decision-Making for Custom Fabrication

Week 10 - Lower Extremity Musculoskeletal Orthosis Design and Application

Week 11 - Spinal Orthosis Design and Application

Week 12 - Upper Extremity Orthosis Design and Application

Week 13 - Lower Extremity Orthoses for Neurologic Dysfunction: AFOs

Week 14 - Lower Extremity Orthoses for Neurologic Dysfunction: KAFO, RGO, HKFO

Week 15 - Case Presentations

Week 16 - Final Exam

 

Detailed Description of Conduct of Course

Didactic, student presentations, online, individual and small group sessions. Class attendance is a privilege and an expectation, as long as you remain in good standing. All students will attend all scheduled classes and laboratories. Professional behavior, including class attendance, appropriate dress, no cell phones, no food in class and thorough preparation for each class session, is an expression of your commitment to this program, to yourself, and to becoming the best therapist you can be. If you anticipate being unable to attend class, for any given reason, you need to notify the course manager or the department office manager ahead of time. A full grade-reduction may result from unescused absences, consistent tardiness, consistent unprofessional behaviors, or unexcused electronic device usage.


Goals and Objectives of this Course

Will require students to:

1) Apply knowledge of basic biomechanical principles/concepts (i.e. forces) as they relate to anatomical function of orthoses and prostheses (CC-1);

2) Distinguish between dynamic and static biomechanical constraints in the application of orthotic devices (CC-5.39e);

3) Identify and analyze common gait deviations and formulate appropriate treatment and interventions, including the use of applicable orthotic, protective, and supportive devices (CC-5.30o);

4) Describe a foot orthosis based upon its biomechanical corrections, method of posting, and the rigidity of material used in its fabrication (CC-5.30o);

5) Interpret static and dynamic foot biomechanical evaluative data and determine and appropriate othotic device to accommodate the deformity (CC-5.30d);

6) Perform a gait analysis using the Rancho Los Amigos assessment form (CC-3; CC-5.30b; CC-5.30d; CC-5.30i; CC-5.30k; CC-5.30l; CC-5.30n; CC-5.30o; CC-5.30s;);

7) Using the Rancho Los Amigos gait assesment tool, systematically analyze and determine the cause of pathologic gait associated with orthotics or prosthetics (CC-1; CC-5.26; CC-5.30b; CC-5.30i; CC-5.30k; CC-5.30p; CC-5.30m; CC-5.30o; CC-5.30r; CC-5.30s; CC-5.31; CC-5.32);

8) Differentiate the types and scope of surgical interventions available to a patient requiring amputation (CC-5.27);

9) Select appropriate physical therapy interventions for pre-operative and post-operative management of persons with amputation (CC-5.39a: CC-5.39b; CC-5.39c; CC-5.39e; CC-5.39g; CC-5.39h; CC-5.39i);

10) Examine saftey of components, alignment, fit, and ability to care for the othotic or prosthetic device (CC-1; CC-5.19; CC-5.27; CC-5.30o; CC-5.30r);

11) Compare various orthotic and prosthetic components and explain the indications, principles, and types of adaptive devices available for patients with orthopedic and neurological dystunction (CC-5.30i; CC-5.30o; CC-5.30r);

12) Synthesize pertinent examination data to determine the need for orthotic/prosthetic devices, including appropriate referral as needed (CC-5.28; CC-5.29; CC-5.30o; CC-5.30r; CC-5.31; 7D-36);

13) Select and defend indications and rationale for the physical therapy management of patients with disorders requiring orthotics and with disorders related to amputation/prosthetics (CC-5.19; CC-5.20; CC-5.31; CC-5.36; CC-5.37);

14) Compare the influences of ambulatory aids on parameters such as step length, speed, and efficiency of gait pattern (CC-5.30d);

15) Describe appropriate methods of donning and doffing orthotic devices (CC-5.39e);

16) Describe safety of components, alignment, fit,and care for the orthotic or prosthetic device (CC-1; CC5.19; CC-5.27; CC-5.30o; CC-5.30r);

17) Determine patients needs for consultation/referral for orthotic or prosthetic prescription, fabrication, fitting, counseling, case management, or other specialized needs (CC-5.17; CC-5.27; CC-5.39e; 7D-36);

18) Describe preparation of the residual limb or adjacent segment for prosthetic fitting including shaping, edema control, range of motion, skin integrity desensitization and strengthening (CC-5.39g);

19) Consult with a prosthetics professional regarding prothetic prescription and fitting (CC-5.27);

20) Select appropriate physical therapy interventions for pre-operative and post-operative management of persons with amputation (CC-5.39a; CC-5.39b; CC-5.39c; CC-5.39e; CC-5.39g; CC-5.39h; CC-5.39i);

21) Analyze the influence of lower limb prosthetics on a patient's gait and functional mobility (CC-5.30r);

22) Design a prosthetic assessment including skin integrity, sensation, strength, and ROM (CC-5.30v);

23) Demonstrate the ability to teach a patient to don and doff his/her prosthetic device (CC-5.39b);

24) Identify the female genitourinary conditions that are amenable to physical therapy interventions and describe the underlying pathophysiology (CC-3; CC-5.27);


Assessment Measures

May include but not limited to:

Online participation in the form of discussion boards and written assignments (Both individual and small groups) will be the means of student evaluation.

Quizzes 20%, Midterm Exam 25%, Video Project 10%, Final Project 20%, Final Exam (Comprehensive) 25%


Other Course Information

Required Texts:

Printed or Electronic Materials:
    Lusardi, M.M., & Neilsen, C.C. Orthotics and Prosthetics in Rehabilitation. 2nd Ed. Philadelphia: W.B. Saunders Co., 2007.

    Required reading includes assignments (see schedule posted on Desire 2 Learn page).

Supplementary Reading

    Nawoczenski D., & Epler, M. Orthotics in Functional Rehabilitation of the Lower Limb. Philadelphia: W.B. Saunders Co., 1997.

    May, B.J. Lockard, M.A. Prosthetics & Orthotics in Clinical Practice: A Case study Approach. Philadelphia: F.A. Davis Co., 2011.

 

Review and Approval

April 30, 2018

February 10, 2014